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Profile of Extra-Pulmonary Tuberculosis in Internal Medicine

Open Journal of Internal Medicine 2024年第1期14卷 64-73页

作者： mouhamed Dieng Djiby Sow Demba Diédhiou Michel Assane Ndour Boundia Djiba mouhamed almahy niang Matar Ndiaye Oumar Boun Khattab Diouf Fatou Kiné Gadji Anna Sar Maïmouna Ndour Mbaye Clinique Médicale II H&ocircpital Aristide Abass Ndao Université Cheikh Anta Diop Dakar Sénégal

Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to December 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEG (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. Death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of

关键词： Extrapulmonary Tuberculosis Epidemiology Diagnosis Senegal

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Maintenance Strategies and Spare Parts Inventory Management for Use of Reconditioned Items

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Engineering（科研） 2022年第8期14卷 360-370页

作者： Mamadou Sagne mouhamed Fadel niang Doctoral School for Sustainable Development and Society Iba Der Thiam University Thies Senegal

The maintenance management of construction equipment occupies a prominent place in the overall strategy for managing the equipment fleet. It is also linked to the management of the stock of spare parts and particularly reconditioned spare parts. Because of the relatively low purchase cost of these, most companies are tempted by this option. The purpose of this article is precisely to study the impact of this category of parts in the stock and also in the optimization of maintenance costs, knowing that to do this;their use must obey certain constraints. It is therefore important to be able to characterize these reconditioned parts by estimating their optimal age, and studying their advantages and also their limits. The determination of the optimal age of reconditioned parts will be such that the total cost of replacement with used parts is at most equal to the total cost of replacement with new parts at the end of the operating period.

关键词： Strategies Maintenance Spare Parts Reconditioned

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Rectitis Radiation a Problem of Therapeutic Management in Senegal about Two Cases

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Open Journal of Gastroenterology 2022年第11期12卷 330-335页

作者： Alioune Badara Fall Nogoye niang Alsine Yauck mouhamed Sidibe Marieme Pole Fall Cheikh Anta Diop University of Dakar Hospital Aristide Le Dantec Dakar Senegal

Radiotherapy occupies an important place in the management of cancers of the pelvic-perineal organs, it is at the origin of the fact of the ionizing radiations of radiation proctitis which is most often revealed by hematochezia. Diagnosis is based on rectoscopy which highlights a telengiectatic proctitis aspect. The standard treatment is endoscopic and based on argon plasma electrocoagulation. We report two cases of radiation proctitis occurring a few months after radiotherapy. Case number 1: A 76-year-old hypertensive patient known to have a history of cancer of the cervix treated with radiochemotherapy, she was received in an array of hematochezia of medium abundance;total colonoscopy found an aspect of telengiectatic proctitis making retain radiation proctitis. She had benefited from medical treatment, however, after a two-month follow-up, there was a recurrence of rectal bleeding despite medical treatment, due to the unavailability of endoscopic treatment based on argon plasma, surgical treatment of a type of protectomy had been carried out on postoperative follow-up was marked by a regression of hemorrhage with the occurrence of a. Case number 2: An 87-year-old patient, hypertensive, with a history of prostate adenocarcinoma 3 years ago treated with brachytherapy and hormone therapy;he was hospitalized with hematochesia. Rectosigmoidoscopy found an aspect of telengiectatic proctitis. The diagnosis of radiation proctitis had been retained and the patient had received medical treatment. The short-term evolution was marked by an amendment of the hematochezia with a long-term recurrence requiring endoscopic destruction via the diathermic loop of the telengiectatic lesions with good evolution without relapse after the procedure. Conclusion: Radiation proctitis is a major side effect of pelvic radiotherapy. Management is very difficult in our regions due to the unavailability of endoscopic means, in particular argon plasma.

关键词： Radiation Proctitis Hematochesia Telangiectasias

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Lesions Superimposed by Traditional Medicine on Renal Biopsies in Senegal

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Open Journal of Pathology 2023年第4期13卷 224-228页

作者： Cherif mouhamed Moustapha Dial Toni Djibrilla Gani El Hadji Fary Ka Abdou niang Boucar Diouf Pathology Laboratory of the Idrissa Pouye General Hospital Dakar Senegal Reference General Hospital Niamey Niger Nephrology Department of Aristide le Dantec Hospital Dakar Senegal

Traditional African medicine products are responsible for kidney damage that baffles both nephrologists and pathologists. Renal biopsies reveal acute or chronic inflammatory changes that cannot be explained by the progressive stage of the basic lesion of the nephropathy. The aim of this study is to analyze the lesions superimposed on 73 kidney biopsies from patients who took traditional herbal medications to treat the symptoms of kidney disease.

关键词： Nephropathy Traditional Medicine Pharmacopoeia Senegal

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Diagnosis of Male Hypogonadism: Experience of a Subsaharan African Endocrinology Department: Transversal Study from January 1^st, 2020 to July 31^st, 2022

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Open Journal of Endocrine and Metabolic Diseases 2023年第11期13卷 217-226页

作者： Nafy Ndiaye Ngone Diaba Diack Yakham Mohamed Leye mouhamed Mbar niang Amadou Lamine Cisse Yousra Benani Abdoulaye Leye Internal Medicine/Endocrinology-Diabetology Department Teaching Hospital of Pikine Cheikh Anta Diop University Dakar Senegal

Introduction: Hypogonadism should be suspected in a man who has symptoms and signs of testosterone deficiency. Clinical manifestations depend on the severity and duration of testosterone deficiency, whether the testicular deficit is concerning only androgen synthesis, spermatogenesis, or both. The objective of our study was to evaluate the clinical and aetiological characteristics of male hypogonadism in Dakar’s suburb. Patients and methods: We conducted a transversal study from January 1st, 2020 to July 31st, 2022. We included all male patients aged at least 14 years old with hypogonadism confirmed by a low level of early-morning free testosterone based on two different dosages. For all patients included, sociodemographic and diagnostic parameters were collected by using a pre-established registration form. Results: In total, 20 patients were selected. The average age was 36.3 years old [14 - 62 years old]. Half of the patients were overweight. Five patients had an abdominal circumference greater than 94 cm (37 inches). The other comorbidities found in our patients were type 2 diabetes (n = 1), hypertension (n = 1) and primary hypercholesterolemia in 2 patients. The functional signs reported by the patients were: couple’s infertility in 17 patients, decreased libido in 14 patients, erectile dysfunction in 13 patients, premature ejaculation in 2 patients and anejaculation in 4 patients. The physical examination revealed a bilateral testicular atrophy in 17 patients and a unilateral testicular atrophy in 2 patients;no patient had varicocele or urethral meatus abnormalities. Ten patients presented a micropenis. A eunuchoid morphotype was present in 6 patients and a short stature was noted in 2 patients. It was peripheral hypogonadism (HH) in 18 patients and hypogonadotropic hypogonadism (Hh) in 2 patients. The hypogonadotropic hypogonadism was isolated in both cases. The testicular echography confirmed testicular atrophy and showed cryptorchidism

关键词： Diagnostic Hypogonadism Male Senegal

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Laryngeal Cancers at the Pathological Anatomical Laboratory (ACP) in Dakar about 215 Cases

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Open Journal of Pathology 2023年第2期13卷 79-86页

作者： Marie Joseph Dieme Ahouidi Adama Diedhiou Abdou Magib Gaye Dibor niang Falilatou Seidou Ibou Thiam Cherif mouhamed Moustapha Dial Anatomy and Pathological Cytology Laboratory Fann Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Aristide Le Dantec Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Gaston Berger University St Louis Sénégal Anatomy and Pathological Cytology Laboratory Idrissa Pouye Hospital Dakar Sénégal

Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients

关键词： Laryngeal Cancer Carcinoma Dakar

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Sex Differences in Clinical and Angiographic Characteristics in Acute Coronary Syndrome Patients in Dakar, Senegal

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World Journal of Cardiovascular Diseases 2022年第7期12卷 403-413页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Waly niang Mboup Aimé Gildas Portella Khadidiatou Dia Pape Diadie Fall mouhamed Chérif Mboup Department of Cardiology Hospital Principal Dakar Dakar Senegal

Background: Coronary artery disease (CAD) is in relentless progression, along with the adoption of western lifestyle in sub-Saharan Africa. In Senegal, the incidence of acute coronary syndrome (ACS) rose from 5% to 12% in Dakar during the last 20 years. That increase was observed in both women and men, and according to current data, the former paid the heaviest price in terms of mortality compared to men. In this study, we aim to retrospectively assess the clinical characteristics and angiographic profile of ACS in women compared to men in two tertiary care centers in Dakar. Methods: In this study, we retrospectively analyzed and compared data between men and women among 133 patients who underwent coronary angiogram for ACS in 2 tertiary centers from February 2019 to January 2020. Results: A total of 133 patients were included in our study of whom 97 (72.9%) were men. The mean age was 58 ± 13.6 years. Women were older than men (61.4 ± 14.3 years vs 56.6 ± 13.5 years (p = 0.07). Hypertension, sedentary lifestyle and obesity were significantly more frequent in women (69.4%, 52.7% and 19.4%) when compared to men (38.8%, 25.7% and 6.19%) respectively, (p = 0.001;0.002 and 0.03). Smoking was less frequent in women (2.8%) than in men (44.3%), (p Conclusion: In our study, women with ACS were older, had more cardiovascular risk factors but less angiographic extent of disease than men.

关键词： Sex Differences Acute Coronary Syndrome Senegal

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Cardiac Resynchronization Therapy in Heart Failure in Sub-Saharan Africa Environment: Experience of the Principal Hospital of Dakar (Senegal)

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World Journal of Cardiovascular Diseases 2023年第7期13卷 349-358页

作者： Khadidiatou Dia Waly niang Mboup Djibril Marie Ba Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Rabab Yassine Demba Ware Balde mouhamed Cherif Mboup Department of Cardiology Hospital Principal of Dakar Dakar Senegal Department of Cardiology Military Hospital of Ouakam Dakar Senegal

Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve cardiac function and the quality of life of patients. However, in Sub-Saharan Africa, very few studies have been done on cardiac resynchronization which is in its infancy. The aim of this study is to report the local data from our hospital. Method: It was a transversal, descriptive and analytical study conducted from November 2019 to September 2022 at the Cardiology Department of the Principal Hospital of Dakar. Results: Twelve patients were implanted for Cardiac Resynchronization Therapy (CRT). The sex ratio was 8 males/4 females. The average age was 67 ± 11 years. Ten patients had non-ischemic heart disease and the two others had ischemic one. All of them had NYHA III or IV scores before CRT. The Quality of Life (QOL) was judged as poor by all of the patients. The average duration of QRS was 156 ± 9 ms. 27.9% ± 5% was the mean Left Ventricular ejection fraction (LVEF). Complications occur in 3/12 patients (25%). It was one CS vein dissection, one micro LV lead dislodgement and one phrenic nerve stimulation. Nine patients, who were considered as responders, had an improvement of QOL and NYHA, the LVEF increased and the end-diastolic dimension, and the duration of the QRS interval all decreased. Two patients do not respond and one (1) who had permanent atrial fibrillation, was a secondary responder after an atrioventricular junction ablation. Conclusion: Cardiac resynchronization is a therapy that improves the QOL of patients, the LVEF and reduces the duration of the QRS interval. However, this procedure is not without risk of complications. In sub-Saharan Africa, the major challenge is to improve the financial accessibility of this therapy for the population.

关键词： Cardiac Resynchronization Therapy CRT Heart Failure Biventricular Pacing Sub-Saharan Africa

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MINOCA Resulting from Coronary Spasm Confirmed Angiographically without Ergonovine Stimulation: A Case Report

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World Journal of Cardiovascular Diseases 2022年第11期12卷 473-480页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguène Ka Waly niang Mboup Khadidiatou Dia Djibril Marie Ba Demba Waré Balde mouhamed Chérif Mboup Cardiology Department H&ocirc pital Principal Dakar Dakar Senegal Cardiology Department H&ocirc pital Militaire de Ouakam Dakar Senegal

Introduction: Myocardial infarction with nonobstructive coronary arteries disease (MINOCA) encompasses a heterogeneous group of disorders. Multimodality imaging is crucial to figure out the underlying mechanism. Coronary artery spasm is a common cause of MINOCA and might be difficult to identify. Case Presentation: A 43-year-old male with no cardiovascular risk factor presented with prolonged acute chest pain at 5 am that resolved spontaneously. On admission, he was asymptomatic and clinical findings were unremarkable. The electrocardiogram showed an anterolateral negative T wave. The troponin was positive. Coronary angiography (CA) revealed a moderate lesion of the proximal left anterior descending (LAD) coronary artery. He was treated with dual antiplatelet therapy, statin, and beta-blocker with a favourable hospital course. One week later, he presented chest pain recurrences with anterior ST-segment elevation. CA, without intra-radial nitrate, owing to a vasospasm suspicion, showed a sub-occlusion of the proximal LAD which resolved after intracoronary nitrates. Chest pain and ST-segment elevation then disappeared. He remained asymptomatic and was discharged on CCB (calcium channel blocker), long-acting nitrates dual antiplatelet and statin. Cardiac magnetic resonance (CMR) demonstrated an ejection fraction (EF) of 45% with anterior ischemia. Conclusion: Our case is about a common cause of MINOCA, namely coronary spasm, diagnosed by coronary angiogram without provocative test.

关键词： MINOCA Coronary Spasm Case Report

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Inadvertent Lead Malposition in the Left Ventricle during Permanent Ventricular Pacing about One Case

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World Journal of Cardiovascular Diseases 2023年第11期13卷 756-763页

作者： Khadidiatou Dia Waly niang Mboup Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Rabab Yassine Djibril Marie Ba Demba Ware Balde mouhamed Cherif Mboup Department of Cardiology Hospital Principal of Dakar Dakar Senegal Department of Cardiology Military Hospital of Ouakam Dakar Senegal

Inadvertent Lead Malposition in Left Ventricle is a rare and underdiagnosed incident, which may occur during implantation of cardiac electronic devices and may remain asymptomatic. We reported the case of a 71-year-old man who was implanted with a ventricular single-chamber pacemaker for a slow atrial fibrillation with syncope and whose routine transthoracic echocardiography 23 months after implantation displayed a malposition of the pacemaker lead into the Left Ventricle through a patent foramen oval. The patient was asymptomatic. The electrocardiogram showed right bundle branch block QRS-paced morphology with a positive QRS pattern in V1, a median paced QRS axis on the frontal plane at -120°, a Precordial transition on V5. At the lateral Chest X-ray the lead curved backwards to the spine. Given the age of this old patient who already received oral anticoagulant for Atrial Fibrillation and the Lead malposition discovered 23 months after pacemaker’s implantation, we decided to maintain the lead in LV and continue anticoagulation.

关键词： Lead Malposition Left Ventricle Lead Right Bundle Branch Block Ventricu-lar Pacing Transthoracic Echocardiography

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