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Intraductal Prostatic Carcinoma: Epidemiological and Anatomopathological Aspects in Dakar

Open Journal of Pathology 2024年第2期14卷 54-63页

作者： Ibou Thiam Fabrice Senghor Omar Sow Kor Ndiaye mohamed moustapha chérif dial Anatomical Pathology Department Aristide Le Dantec University Hospital Dakar Senegal Anatomical Pathology Department Peace Hospital Ziguinchor Senegal General Surgery Department Peace Hospital Ziguinchor Senegal Anatomical Pathology Department Idrissa Pouye University Hospital Dakar Senegal

Introduction: Intraductal carcinoma is often associated with high-grade, high-stage adenocarcinoma. Its frequency is variable and it is considered a poor prognostic factor. In our context, when prostatic carcinoma is diagnosed, pathologists do not always report the presence of this anatomopathological entity. We therefore conducted a study to determine the epidemiological and anatomopathological profile of patients with this lesion in Dakar. Materials and Methods: This is a retrospective descriptive study covering a 1-year period from January to December 2022. It focused on cases of intraductal carcinoma diagnosed among prostatic carcinomas collected in the anatomopathology laboratories of Hôpital Général Idrissa Pouye (HOGIP) and Hôpital Militaire de Ouakam (HMO). It was based on archives of anatomopathological reports, blocks and slides. A total of 200 cases of prostatic carcinoma were collated and reviewed to identify those presenting with intraductal carcinoma according to the diagnostic criteria of Guo and Epstein. Results: 87 cases of intraductal carcinoma were found, representing 43.5% of prostatic carcinomas. The mean age was 71 years. Patients in their seventh decade were the most represented, i.e. 42.5%. The majority of samples examined were biopsies (72.4%). The mean PSA level was 965.91 ng/ml, with extremes ranging from 0.03 to 10,000 ng/ml. Histologically, 96.5% of cases (N = 84) were invasive prostatic carcinoma. Gleason score 8 (4 + 4) was the most common, accounting for 42.53% (N = 37). On average, the study found four (04) foci of intraductal carcinoma per specimen, with extremes ranging from 1 to 30. Dense cribriform architecture accounted for 78.16%, loose cribriform for 11.5%, solid for 8.04% and micropapillary for 2.3%. Six cases (6.9%) showed foci of comedonecrosis. The vast majority of radical prostatectomies (87.5%) were classified as pT3. Node invasion and perineural sheathing were observed in 12.5% and 52.32% of cases respectively. Conclusi

关键词： Intraductal Carcinoma Prostate Pathological Anatomy Senegal

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Contribution of Anti-p63 Antibodies in the Interpretation of Benign Label Prostatic Biopsies

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Open Journal of Pathology 2024年第2期14卷 31-44页

作者： Ibou Thiam Fabrice Senghor Frenette Codja Kor Ndiaye mohamed moustapha cherif dial Pathological Anatomy Department Aristide Le Dantec University Hospital Dakar Senegal Pathological Anatomy Department H&#244pital de la Paix Ziguinchor Senegal Pathological Anatomy Department Idrissa Pouye University Hospital Dakar Senegal

Introduction: Prostate cancer is the second most common cancer in men. The diagnosis is most often based on the prostate biopsies’ analysis and on histological criteria recognizable on standard coloring. In some cases, the use of immunohistochemistry is important. Objectives: This paper aims to specify the p63 phenotypic profile of lesions diagnosed benign, with minimal suspect foci, difficult to interpret, HGPIN (high grade intraepithelial neoplasia) and LGPIN (low-grade prostatic intraepithelial neoplasia) and evaluate the manual technique of p63 immunohistochemistry. Patients and Method: This was a retrospective, descriptive study of prostate biopsies recorded in the PAC service of the HALD from January 1st, 2018 to December 31st, 2018. It was completed by a manual immunohistochemical study of the blocks enrolled from November 19th to December 4th, 2020 in the PAC department of the HPD. The studied parameters were: registry number, age, clinical stage, prostate volume, PSA level, microscopic appearance and p63 immunohistochemical profile. Results: Our study included 60 prostate biopsies. The ages of our patients varied from 45 to 77 years, with an average of 64.2 years and a standard deviation of 6.2. The majority of patients were at clinical stage cT2b (33%) with a prostate volume varying between 33.15 and 169.4 cc. The minimum value of PSA in our series is 5 ng/ml, the maximum being 100 ng/ml with an average level of 24.1 ng/ml and a standard deviation of 21.2. Our series included 50 adenomyomatous hyperplasias, 7 adenomyomatous hyperplasias associated with chronic prostatitis, 2 HGPIN and 1 LGPIN. After re-reading we found 5 discordant cases, which corresponded to minimal suspect foci (kappa = 0.5098). The p63 marking was informative in 53 cases, i.e. 88%, and non-informative in 7 cases, i.e. 12%. Among the uninformative markings, 2 were due to lack of tissue adhesion to the slides. Among the informative markings, 11 were negative. p63 immunohistochemistry was

关键词： Prostate Cancer Diagnosis Anti-p6 Antibody

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Overview of Adrenals Tumors in Dakar Hospitals

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Open Journal of Internal Medicine 2024年第2期14卷 141-150页

作者： Nafy Ndiaye Yakham mohamed Leye Mouhamadou moustapha Ndong Ngoné Diaba Diack Amadou Fall Cisse Abdoulaye Leye Baidy Sy Kane Alpha Omar Touré cherif mohamed dial Pape Saloum Diop Internalmedeccine and Endocrinology Department Teaching Hospital of Pikine Dakar Senegal General Surgery Department Aristide Le Dantec Teaching Hospital of Dakar Dakar Senegal Anatomo-Pathology Department General Hospital of Grand Yoff Dakar Dakar Senegal General Surgery Department General Hospital of Grand Yoff Dakar Dakar Senegal

Introduction: Adrenal tumours (AT) are commonly encountered in clinical practice. For any patient presenting an adrenal mass, there are two crucial points to consider: is the adrenal mass malignant and is it hormonally active? The objective of our study was to evaluate the epidemiological, diagnostic, therapeutic, and evolutionary aspects of AT in a developing country. Methodology: We conducted a retrospective study spanning 17 years (from January 2005 to October 2022) in four Dakar hospital services. We included all patient medical records with explored AT. Results: AT was diagnosed in 35 patients who had a mean age of 36.62 years (range: 12-79), and a female predominance (26 women to 9 men). Among these patients, 17.2 % had incidental AT. Hypertension was the commonest presenting symptom in 27 patients (77%), which was associated with Mnards triad in 14 patients (40%). Abdominal pain was reported by 20 patients (57%), and 14 presented with an abdominal mass. Among the patients, 29 had functional AT: 22 with pheochromocytoma, 5 with primary hyperaldosteronism, and 2 with hypercortisolism. Imaging evaluations revealed that 33 patients had unilateral AT and one had bilateral AT. Tumour sizes varied, 5 patients had tumours 10 cm. Two patients presented with metastases. The therapeutic approach involved adrenalectomy in 32 patients. Perioperative complications were observed in five patients, including haemorrhage (two patients), hypotension (two cases), and hypertensive crisis (one case). One patient with bilateral pheochromocytoma developed acute adrenal insufficiency postoperatively, followed by abdominal herniation. Histopathological examination confirmed pheochromocytoma in 21 patients, Conns adenoma in 5, adrenocortical carcinoma in 3, cortisol adenoma in 2, and adrenal cyst in 1 patient. Non-functional AT included adrenocortical carcinoma (three patients), adrenal cyst (one patient), and pheochromocytoma (two patients). After a one-year follow-up, 29 patients wit

关键词： Tumour Adrenal Pheochromocytoma Conn Adrenocortical Carcinoma Dakar

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Humoral Response and Tolerance of Vaccination against SARS-CoV-2 in Adults Senegalese Patients Undergoing Hemodialysis: A Multicenter Prospective Study

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Open Journal of Nephrology 2024年第1期14卷 70-80页

作者： Lot Nehemie Motoula Latou moustapha Mbow Modou Ndongo Gnagna Faye Gora Lo Sidy mohamed Seck Department of Nephrology and dialysis Military Hospital of Ouakam Dakar Senegal Immunology Laboratory Military Hospital of Ouakam Dakar Senegal Department of Nephrology and dialysis Regional Hospital of Kedougou Kedougou Senegal Department of Nephrology Idrissa Pouye General Hospital Dakar Senegal Bacterioloy and Virology Laboratory CMIA Dakar Senegal IRL-3189 ESS/UGB/CNRS/UCAD/CNRST/USTB Faculty of Health Sciences University Gaston Berger Saint-Louis Senegal

Introduction: Following the COVID-19 pandemic, vaccination has been proposed in several countries as the main preventive measure despite very limited data, particularly in dialysis patients. We conducted this study to assess the immunological response to vaccination in Senegalese hemodialysis patients. Patients and Methods: We conducted a prospective study, in two dialysis centers in Dakar from March 30th to August 30th, 2021 including patients on hemodialysis for >6 months, vaccinated against SARS-CoV-2 according to the vaccination schedule recommended by WHO. A vaccine response was considered positive when seroconversion was observed after one dose of vaccine. The clinical efficacy of immunization was defined as the absence of new COVID-19 infection in patients who received a complete vaccination. Results: Among the 81 patients included in the study, 7.4% had anti-Spike IgM antibodies before their first vaccination. Seroprevalence of IgM antibodies was 38.3% one month after the first vaccine dose (at M1) and 8.6% one month after the second dose (at M4). Anti-Spike IgG antibodies were present in 40.3% of patients before vaccination, in 90.1% at M1, and in 59.7% at M4. Among patients previously infected with SARS-CoV-2, 10.2% had IgM antibodies at M0, 31.6% at M1, and 10.5% at M4 post-vaccination. Similarly, seroprevalences of IgG antibodies in this subgroup were 31.5%, 61.3%, and 50.0% respectively at M0, M1, and M4 post-vaccination. A comparison of seroconversion rates between M0 and M4 showed significant differences only for IgG in COVID-19 naive patients. Mean duration in dialysis and the existence of previous COVID-19 infection were associated with patients’ vaccinal response after the two doses. Age, gender and the use of immunosuppressive treatment did not influence post-vaccinal antibody production. Conclusion: Vaccination against COVID-19 in Senegalese hemodialysis patients induced a low seroconversion rate but it was well tolerated. M

关键词： SARS-Cov2 Vaccination Humoral Response Tolerance Hemodialysis Senegal

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Neuroanatomical Basis of Postoperative Pain and Assessment of Its Management in a Series of Patients Undergoing Caesarean Sections

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Pain Studies and Treatment 2024年第2期12卷 21-32页

作者： moustapha Diedhiou Philippe Manyacka Ma Nyemb Ndiamé Sarr Aissatou Sarr Ousmane Thiam mohamed Lamine Fall Health Sciences Training and Research Unit Gaston Berger Saint Louis University Saint Louis Senegal Intensive Care Unit Saint Louis Regional Hospital Saint Louis Senegal

Introduction: In recent decades, the cost of postoperative pain has been the subject of many studies based on protocols developed by scientific societies for its assessment and optimization. At the Regional Hospital of Saint-Louis (Senegal), several protocols have been developed for pain management, but no study has focused on the assessment of postoperative pain management specifically. We therefore initiated this work, the objectives of which were to remind the neuroanatomical and neurophysiological bases of postoperative pain, and to analyze the assessment and management of this pain in patients who have undergone a caesarean section. Materials and methods: This was a prospective and descriptive study, which took place in the gynecology-obstetrics department, over a period from January 2019 to July 2020. All patients who gave birth by cesarean section were included. The data was collected from a survey sheet written for this purpose. For each of the patients, the information was taken every day throughout the duration of postoperative hospitalization. Results: It appears from our work that after a cesarean section, the pain felt evolves on the first postoperative days with a peak during the second day. As in the data reported in the literature, there does not seem to be a difference in terms of pain intensity and analgesia dosage between scheduled and emergency caesarean sections. However, young age and female gender—for other types of surgeries—are risk factors associated with high postoperative pain scores. This trend is probably related to the low pain experience of tested patients. Our initial hypothesis was that acute post-operative pain after caesarean sections could be linked to defects in the perception and processing of pain by caregivers. Indeed, we have shown that awareness-raising, information, and training actions have made it possible to significantly improve the management of pain after a cesarean section. Conclusion: After a cesarean section the p

关键词： Postoperative Pain Neuroanatomical Bases Assessment Cesarean Section

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Manufacture of Industrial Refractory Crucibles Based on Clays from Burkina Faso

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Journal of Minerals and Materials characterization and Engineering 2024年第2期12卷 79-90页

作者： Kassoum Barry Youssouf Sawadogo moustapha Sawadogo Brahima Sorgho mohamed Seynou Boubié Guel Philippe Blanchart Lamine Zerbo Laboratory of Molecular chemistry and Materials (LC2M) University Joseph KI-ZERBO Ouagadougou Burkina Faso Institute of Research for Ceramic (IRCER) European Ceramic Centre (CEC) Limoges France

In Burkina Faso, one of the three largest gold producers in West Africa, foundry activity is often paralyzed when basic equipment such as crucibles and cups are not available or should be imported. However, previous studies have shown the availability of kaolinite-rich clay resources that could be used for the local manufacture of silico-aluminous ceramic crucibles. This work allowed to manufacture industrial ceramic crucibles with local clays and then they were tested in foundry industry. The materials were manufactured from three (03) raw materials including two clays (SAB and ROU) and sand. The chemical and mineral analysis has shown that the raw materials are suitable for the formulation of refractory materials. The results of characterization of the materials formulated showed that the properties of use are appreciable. The porosity of the materials is relatively low (23 - 28 vol%) with a diametral compressive strength between 0.61 and 1.34 MPa. Crucibles sintered at 1250˚C with a stay of 2 hours have a mechanical strength capable of supporting the weight of the ores contained. These crucibles have a refractoriness under load (T0.5) above 1141˚C and resist chemical attacks. Tests were carried out in the industry at 1100˚C, and the results were satisfactory.

关键词： Refractory Foundry Activity Compressive Strength chemical Resistance

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Treatment of Kidney Stones by Percutaneous Nephrolithotomy: Evaluation of the Results of the First Series of Our Experience in the Urology Department of the Idrissa Pouye General Hospital in Dakar

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Open Journal of Urology 2024年第2期14卷 104-114页

作者： Mouhamadou moustapha Mbodji mohamed Jalloh Medina Ndoye Abdourahmane diallo Issa Labou Lamine Niang Serigne Magueye Gueye Department of Urology and Andrology Hospital General Idrissa Pouye Dakar Senegal

The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study the epidemiological, clinical and paraclinical aspects of patients with renal lithiasis treated by PCNL and on the other hand the different technical aspects of PCNL. Materials and Methods: This was a retrospective descriptive study, conducted in the urology department of HOGIP, covering the period from January 2015 to January 2019. We studied the demographic and clinical aspects of patients presenting renal lithiasis;we also studied the technical aspects and treatment outcomes. Statistical significance was set for α = 0.05. Results: Our series covered 82 PCNLs performed during the study period. The average age was 45.95 years, the age group [40 - 49 years] was more affected. Our study involved 44 men and 38 women, a sex ratio of 1.15. At the clinic, atypical lumbar pain was more frequent in 45.83% of cases. On URO-CT, the calculations were located more at the pyelic level (31.2%) and lower caliceal (27.2%). The size of stones measured between 15 and 20 mm in 30.52%. The stone density was between 500 and 1000 HU in 47.54% of cases. Intraoperatively, the patients were placed in lateral decubitus in 41.46% of cases. Only one access to the kidney was necessary in 87.8% of cases. The lithoclast was used in 65.85% of cases. The overall success rate (stone free) in our series was 96%. The majority of cases, 41.44%, drainage were done by natural means (totally tubeless). The average duration was 92 minutes. The complications encountered in our experience concerned 10 cases, a rate of 12.19%. Conclusion: Urinary lithiasis is more and more frequent in our regions. The development of Endo-urology offers several therapeutic options. Thus, PCNL occupies an important place in the management of kidney stones.

关键词： HOGIP Kidney Stones PCNL Stone Free Uro CT Scan

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Superior Mesenteric Artery Syndrome, a Rare Complication of Severe Malnutrition: Two Cases from a Subsaharian Endocrinology Department

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Open Journal of Endocrine and Metabolic Diseases 2024年第4期14卷 87-93页

作者： Nafy Ndiaye Ngone Diaba Diack Yakham mohamed Leye Sokhna Awa Balla Sall Moussa Gueye Mouhamed Fawaz Mouhamadou moustapha Ndong Abdoulaye Leye Department of Internal Medecine and Endocrinology Teaching Hospital of Pikine Dakar Senegal

Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m2, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.

关键词： Superior Mesenteric Artery Syndrome Malnutrition Pikine

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Precocious Puberty in a 5-Year-Old Girl with a Giant Hypothalamic Hamartoma Discovered Perinatally: Case Report

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Open Journal of Endocrine and Metabolic Diseases 2024年第4期14卷 101-106页

作者： Ghita Bourkadi Sanae Habibi Sana Abourazzak moustapha Hida Department of Endocrinology Diabetology Metabolic Diseases and Nutrition Hassan II University Hospital Fez Morocco Department of Pediatrics Hassan II University Hospital Fez Morocco Faculty of Medicine and Pharmacy Sidi Mohamed Ben Abdellah University Fez Morocoo

Background: Hypothalamic hamartoma is a rare non-neoplastic lesion, typically identified in early childhood during investigations for precocious puberty and/or gelastic seizures. However, cases of diagnosis even earlier or during fetal development have been documented. Case Presentation: A newborn girl was diagnosed with hydrocephalus during pregnancy. An MRI revealed a large oval hypothalamic process, which suggested a hypothalamic hamartoma. At the age of 2, she experienced alternating crying and laughing seizures, followed by a decrease in visual acuity. Due to involvement of the optic pathways, surgery was not performed and she underwent antiepileptic medicines and gamma knife radiotherapy. At the age of 5 years and 3 months, she presented with breast development and laboratory tests confirmed central precocious puberty. Quarterly injections of GnRH agonists have since been administered with favorable results. Conclusion: Early-diagnosed hypothalamic hamartomas require close monitoring, by an experienced multidisciplinary, to promptly detect and treat potential complications, especially precocious puberty, and prevent any undesirable impact on final height.

关键词： Perinatally-Hypothalamic Hamartoma-Giant-Precocious Puberty

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Surgical Treatment of the Upper Urinary Tract Lithiasis at the Urology Department of the Hopital General Idrissa Pouye

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Open Journal of Urology 2024年第5期14卷 290-300页

作者： Mouhamadou moustapha Mbodji mohamed Jalloh Medina Ndoye Abdou Fall cheikh Gassama Babou Sakho Serigne Mbacké Ndiaye Moussa Sene Abdourahmane diallo Issa Labou Lamine Niang Department of Urology and Andrology Hopital General Idrissa Pouye Dakar Senegal

Upper urinary tract lithiasis is a condition characterized by the presence of stones which is a stony concretion of crystallized substances in the kidney and/or ureter. Objective: The objective of this work is to study the epidemiological, clinical and therapeutic aspects of upper urinary tract stones on the one hand, then to compare the different types of surgical treatments and their results. Materials and Methods: This is a retrospective and descriptive study focusing on the surgical management of upper urinary tract stones, between January 2017 and December 2020, at the Urology department of the Hopital General Idrissa Pouye. Results: During the study period, 7.59% of surgical interventions performed were related to the treatment of upper urinary tract stones. Average age was 45.20 ± 16.4 years, the age group [41 - 60] years was more affected with 42.68%. A history of urolithiasis was present in 25.52% of cases. Lower back pain was present in 97.48% of cases. On URO-CT scan, the stone was located more at the level of the ureter (49.57%). The size between 10 to 15 mm was more frequent (30.96%) and the density greater than 1000 HU was more frequent (33.47%). The most used therapeutic procedure was ureteroscopy (52.08%), followed by PCNL (40.83%) and open surgery (7.08%). The success rate (stone free) was 93.68% for the URS, 89.36% for the PCNL. The length of hospital stay for open surgery was 6.76 ± 4.25, for PCNL 2.62 ± 2 days and for URS 1.75 ± 1.62 days. Postoperative complications were present in 23.52% for open surgery, 11.22% for PCNL and 8% for URS. Conclusion: Urolithiasis is constantly growing in our regions. Effective endourological treatment is increasingly replacing open surgery. However, global access to these new techniques in our regions is slow to be effective.

关键词： Endo-Urology Open Surgery Renal Lithiasis Ureteral Lithiasis URO-CT Scan

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