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Diabetic Macroangioapathy at the Internal Medicine Department of the Abass Ndao Hospital Center (About 359 Cases)

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Journal of Diabetes Mellitus 2024年第1期14卷 1-12页

作者： Sow Djiby Djiba Boundia Ndour Michel Assane Diedhiou Demba Dieng Mouhamed Diallo Ibrahima Mané fall Ndiouga Gueye Khoudia Gadji Fatou Kiné Sarr Anna Diop Said Nourou Ndour Mbaye Maimouna Department of Internal Medicine and Medical Specialties H&#244pital Abass Ndao Dakar Senegal

Introduction: Macroangiopathy plays an important role, with a high prevalence of morbidity and mortality in diabetic patients. The aim was to study the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of macroangiopathy in diabetic patients in the internal medicine department of the Abass Ndao hospital. Patients and methods: This was a descriptive and analytical cross-sectional study. Our investigations were recruited over a 7-year period (January 1, 2016 to December 31, 2022). Results: Three hundred and fifty-nine (359) patients (10.22%) were enrolled. The mean age was 62.83 years, with extremes ranging from 17 to 98 years. The [60 - 69] age group was more representative (37.32%). Women accounted for 180 cases (50.1%), with a sex ratio (m/f) of 0.99. The average duration of diabetes was 11.86 years. Average consultation time was 38.07 days, with extremes ranging from 1 to 368 days. Average hospital stay was 7.65 days. Inaugural diabetes was noted in 12 cases (3.34%). Type 2 diabetes accounted for 95.82% (n = 344) of patients. Hypertension was present in 150 patients (41.8%). Patients with 2 risk factors accounted for 173 cases (48.18%). Nineteen patients had already had a stroke (5.29% of cases). Fourteen (14) patients (4.2%) were amputees. Obliterative arteriopathy of the lower limbs (AOMI) was noted in 193 patients (54%). Stroke was noted in 101 patients (28%). Ischemic heart disease (IHD) was noted in 38 patients (11%). AOMI was more common in males (110 patients, 57%) than in females (43%). Seventy-three (73) patients (20.3%) died. Predictors of death were age over 60 and the existence of more than two cardiovascular risk factors. Conclusion: Diabetic macroangiopathy is a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

关键词： Macroangiopathy Diabetes Risk Factors Senegal

Cyclophosphamide, Thalidomide and Dexamethasone (CTD) as First-Line Therapy in Multiple Myeloma Patients: An Experience in a Clinical Haematology Centre in Dakar, Senegal

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Open Journal of Blood Diseases 2023年第1期13卷 43-50页

作者： El Hadji Daouda Niang Seynabou fall Khadim Sarr Marième Lolita Camara Aminata Dakono Awa Ndiaye Modou Moustapha Ciss Amy Thiam Serge Mwamba Fatou Samba Diago Ndiaye Department of Clinical Hematology Dalal Jamm Hospital Dakar Senegal

Introduction: Induction therapy followed by high-dose chemotherapy with autologous stem cell transplantation remains the gold standard for myeloma patients who can tolerate this treatment approach. In a developing country setting, in the absence of availability of bone marrow transplantation, the CTD protocol is an accessible treatment regimen whose efficacy and lower toxicity compared to the Melphalan Prednisone protocol has been reported. This protocol has been administered since 2018 in first line. It’s against this backdrop we perform this study to assess the efficacy of this CTD protocol in first line therapy. Methods: We conducted a descriptive and analytical study including clinical, paraclinical and evolutionary data of 50 patients with MM treated during the period range from 01 September 2018 and 01 July 2022 with the CTD protocol of cyclophosphamide (500 mg at D1, D8 and D15), dexamethasone (40 mg weekly) and thalidomide (100 mg/day) in 28-day cycles. Survival outcomes were estimated by the Kaplan-Meier method. Results: The mean age was 62.3 ± 9.1 years and the sex ratio was 0.7. An advanced prognostic score at diagnosis was found in 73.5% of patients according to the Salmon and Durie score and in 32% according to the ISS. Overall remission was noted in 64%, of which 34% were in very good partial remission and partial remission in 12% of cases. Progression was noted in 4 patients. Treatment-related side effects were mainly peripheral neuropathy and anaemia in 3 patients respectively. The median survival was 38.4 months. The progression-free survival was 60%. An advanced age (≥65 years) is correlated with negative impact on survival (p = 0.04). Conclusion: Cyclophosphamide, thalidomide and dexamethasone give good outcome with less toxicity. Thus, it remains a first-line treatment alternative for newly diagnosed and low-income patients.

关键词： Myeloma Chemotherapy Survival

Kimura’s Disease: A Case Report and Literature Review

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Open Journal of Internal Medicine 2015年第2期5卷 11-14页

作者： Atoumane Faye Nafissatou Diagne Sakho Awa Cheikh Ndao Mbengue Fatou Samba D. Ndiaye Seynabou fall Boundia Djiba Baidy Sy Kane Souhaibou Ndongo Abdoulaye Pouye Medical Clinic 1 University Teaching Hospital Aristide Le Dantec/Cheikh Anta Diop University of Dakar Dakar Sénégal

Kimura’s disease, common pathology in the East, responsible of chronic neck swelling is rarely reported in sub-Saharan Africa. We reported a case which was observed in the internal medicine department of Aristide Le Dantec hospital in Dakar. This was a young 15-year-old, with no particular disease history, who had recurrent non-inflammatory swelling next to the left zygomatic bone associated with itching. Biology revealed an inflammatory syndrom, eosinophilia and increased serum IgE. The histological examination of the mass biopsy concluded to Kimura disease. The corticosteroid has reduced the size of the mass within a few weeks of treatment. Kimura’s disease is unknown in our regions. His painless character and chronic evolution delay the time of diagnosis. This case proves the reality of this disease, which must find a place in the diagnosis approach of cervical swelling.

关键词： Cervical Lymph Nodes Kimura’s Disease Sub-Saharan Africa

Management of Multiple Endocrine Neoplasia Type 2A (MEN 2A): Diagnostic and Therapeutic Concerns with the First Documented Senegalese Family

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Open Journal of Endocrine and Metabolic Diseases 2018年第1期8卷 29-37页

作者： Abdoulaye Leye Ngone Diaba Diack Michel Assane Ndour Nafy Ndiaye Yakham Mohamed Leye Biram Codou fall Malick Ndiaye Abdoul Karim Daher Ahmed Tall Lemrabott Boucar Diouf Internal Medicine/Endocrinology department. Teaching Hospital of Pikine/Dakar ENT Department. Fann Teaching Hospital/Dakar Nephrology Department. Le Dantec Teaching Hospital

Introduction: Multiple endocrine neoplasia (MEN) type 2A is a multiglandular tumor condition inherited in an autosomal dominant manner. It is related to proto-oncogene RET mutation whose analysis is the best technique for family screening. It features in a variable way medullary thyroid cancer (MTC), primary hyperparathyroidism (HPT) and pheochromocytoma. The revealing manifestations of these tumors are often neglected for a long time and the screening should be systematic particularly in a known family context. Methods: After a family tree establishment of a MEN 2A index case, a family survey allowed to diagnose other cases in the family by means of biological, radiological and/or genetic examinations. Results: We report a family form of MEN 2A in a family of three households. In this family 13 people (index case included) were probed out of 34 members. The average age of our patients was 43.54. The sex ratio men/women was 0.85. The simultaneous diagnosis of a primary HPT and a MTC was carried out in our index case and constituted the circumstance of discovery of MEN 2A. The time limit of MEN 2A diagnosis on the other family members was on average 7.7 years. A MTC was recorded in 7 patients. It was asymptomatic in overall cases. A pheochromocytoma was present in only one patient. Primary HPT was found in four patients. Renal lithiasis with recurrent unilateral or bilateral nephritic colic attacks was the main manifestation. Besides the index case, 11 patients had a genetic testing. In 7 patients, a mutation on proto-oncogene RET located on the codon 634 was noted. A surgical care was carried out on 6 patients. We recorded three patients lost to follow-up. A patient died before surgery. In the index case, biological and radiological monitoring found a locoregional residual disease that indicated surgical revision and radiotherapy. Prophylactic thyroidectomy was not performed in any case driven by lack of compliance and/or low income. Conclusion: The discovery of a M

关键词： Multiple Endocrine Neoplasia Pedigree RET Gene Senegal

Impact of COVID-19 on Biological Diagnosis of Malaria: Case of the Thierno Mouhamadoul Mansour Barro Hospital in Mbour, Senegal

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Advances in Infectious Diseases 2023年第1期13卷 31-40页

作者： Isaac Akhénaton Manga Coura Seye Ameth Dramé Cheikh Binetou fall Souleye Lélo Carole Pab Minlekib Marie Pierre Diouf Jean Louis Abdourahim Ndiaye Khadime Sylla Babacar Faye Service Parasitologie-Mycologie FMPO UCAD Dakar Senegal Ministry of Health and Social Action Dakar Senegal Hôpital Thierno Mouhamadoul Mansour Barro de Mbour Medical Region of Thiès Mbour Senegal Parasitology-Mycology Department UFR Santé Université Iba Der Thiam de Thiès Thiès Senegal

Background: In Africa, malaria-endemic regions have not been spared from COVID-19 outbreak which emerged in the first quarter of 2020. This pandemic has shown clinical and therapeutic similarities with malaria. This following study sought to determine the impact of COVID-19 on the malaria diagnosis. Method: A review of laboratory registers and an exploitation of the District Health Information Software 2 (DHIS2) to collect information on the diagnosis of malaria by microscopy and by rapid diagnostic test (RDT), but also that of COVID-19 was done from 2017 to 2021 at the Thierno Mouhamadoul Mansour Hospital in Mbour, Senegal. Results: In 2017, 199 Thick drops (TDs) and 1852 RDTs were performed for malaria diagnosis. In 2018, it was 2352 malaria tests with 2138 RDTs and 214 TDs, before reaching a peak of 3943 tests in 2019 including 3742 RDTs and 201 TDs. By 2020, 2263 tests were performed with 2097 malaria RDTs, 158 TDs and 8 COVID RDTs. The latter increased significantly in 2021, reaching 444 COVID RDTs, while TDs and malaria RDT kept decreasing to 147 and 1036 respectively. Positive TDs were higher in 2020 (11.4%) compared to 2017 (3.5%), 2018 (1.4%), 2019 (6.5%) and 2021 (6.8%). For malaria RDTs, a decrease in the number of positive tests was noted between 2017 (4.5%) and 2021 (1.3%). The COVID RDTs were all negative in 2020, 29.5% were positive and 4.1% were undetermined in 2021. Conclusion: COVID-19 has led to changes in efforts to diagnose malaria as well as an increase in malaria prevalence directed towards children under 5 years of age.

关键词： Impact COVID-19 Biological Diagnosis Malaria Senegal

Respiratory Flow Rates of Metal Welders Compared to a Population Not Exposed to Metal Welding Dust

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Open Journal of Respiratory Diseases 2024年第2期14卷 51-59页

作者： Robert Faomowe Foko Abdou Khadir Sow Awa Ba Mor Diaw Fatoumata Bah Mame Saloum Coly Absa Lam Cheikh Diop Aminata Toure Abdoulaye Ba Abdoulaye Samb Arame Mbengue Mathilde Cabral Mamadou fall Laboratory of Toxicology and Hydrology Faculty of Medicine Pharmacy and Odontostomatology Cheikh Anta Diop University of Dakar Dakar-Fann Senegal Laboratory of Physiology and Functional Exploration Faculty of Medicine Pharmacy and Odontostomatology Cheikh Anta Diop University of Dakar Dakar-Fann Senegal Laboratory of Physiology and Functional Exploration Alioune DIOP University of Bambey Bambey Senegal Laboratory of Physiology UFR of Health Sciences Functional Exploration Department Thies Regional Hospital Center Thies Senegal

Background: The welding trade includes many industrial activities in both the formal and informal sectors. Workers in this professional environment do not have access to individual and collective means of protection adapted to the activity, which exposes them to the dust emitted during their activity and therefore contributes to increasing the risk of developing respiratory disorders in this population. Objective: Our study aimed to evaluate the ventilatory function of metal welders in the city of Dakar. Method: This was a comparative study based on the analysis of the spirometric parameters of metal welders working in the city of Dakar (Senegal) with those of a control group of the same kind, selected from the general population. Measurements of forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and maximum mid expiratory flow (MMEF) were measured. Results: A total of 75 men between the ages of 19 and 61 were recruited and divided into two groups (43 controls and 32 welders). The welding population had more frequent distal and central obstructions and pulmonary restriction compared to the control group. The metals most commonly used by welders were aluminum for welders who had an obstruction, while for those who had a restriction, iron was the most used metal. Signs of metal fever were frequently found in welders, especially those with ventilatory disorders. Conclusion: The prevalence of respiratory disorders observed is close to that observed in industrial environments, where exposure levels are the highest. The lack of personal protective equipment could also be a significant risk factor in the development of these disorders.

关键词： Welder Occupational Exposure Spirometric Disorder Metal Fever Dakar

Domestic Accidents in Under-Fives: Epidemiology, Diagnosis, Management, and Outcomes

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Open Journal of Pediatrics 2022年第5期12卷 726-736页

作者： Florent Tshibwid A. Zeng Papa Alassane Mbaye Doudou Gueye Papa Mamadou Ndoye Ibrahima Bocar Wellé Ndeye Fatou Seck Mbaye fall Ndeye Aby Ndoye Aloïse Sagna Oumar Ndour Gabriel Ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital Centre Université Cheikh Anta Diop Dakar Senegal Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Université Cheikh Anta Diop Dakar Senegal

Introduction: Domestic accidents are a public health problem, and under-fives are particularly affected. We report these accidents’ epidemiology, diagnosis, management, and outcomes through this study. Patients and Methods: We conducted a prospective descriptive study for four months in the Albert Royer National Children’s Hospital Center pediatric surgery department in Dakar, Senegal. Of the 149 cases of domestic accidents, 109 were included in this study. Results: Infants (59.6%) were the most affected, with a slight male predominance (50.5%). Accidents occurred on Tuesday in 22.9% of cases and the afternoon in 38.5% of cases. Playing (59.6%) was the main activity, and falling (44%) was the most found mechanism. 78.9% of accidents occurred in the house, with the bedroom (27.5%) being the most represented place. In most cases (67.9%), the consultation was done within the first 24 hours. The upper limbs (48.6%) were the most affected, and fractures (31.2%) were the most frequent injuries. The outcomes were unremarkable in 94.5% of cases, as complications occurred in five patients with three who had an infection, one a persistent limping, and the last, a dental avulsion. No mortality was recorded. Conclusion: Domestic accidents among under-fives are frequent in our environment. Compared to those in older children, they occur similarly in both sexes, more often in the bedroom, and have a better prognosis.

关键词： Domestic Accidents Under-Fives Infants Preschool Children Senegal

Rosai-Dorfman Disease: Two Cases Report and Literature Review

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Open Journal of Internal Medicine 2015年第2期5卷 15-19页

作者： Atoumane Faye Nafissatou Diagne Sakho Fatou Samba D. Ndiaye Seynabou fall Awa Cheikh Ndao Mbengue Boundia Djiba Baidy Sy Kane Souhaibou Ndongo Abdoulaye Pouye Medical Clinic 1 University Teaching Hospital Aristide Le Dantec/Cheikh Anta Diop University of Dakar Dakar Sénégal

The lymph node is the revelation mode of several pathology. In tropical area, their etiology are dominated by tuberculosis and hemopathy. Some etiology such as histiocytosis are rarely mentioned. We report two cases of Rosai-Dorfman-Destombes disease. The first observation concerned a patient of 45 years without pathological antecedent, who had a inguinal and cervical tumoral lymph nodes. This evolved in a feverish poor general condition. Infection research was negative. Morphological explorations found deep lymph nodes. The excision biopsy examination concluded to Rosai-Dorfman-Destombes disease. The second observation concerned a patient of 40 years without pathological antecedent, who had a chronic non-inflammatory left supra-collarbone lymph node, associated with poor general condition and fever. X-ray showed mediastinal lymph nodes and ultra-sonography showed mesenteric lymph nodes, and latero-aortic lymph nodes. The examination of the excision biopsy was for Rosai Dorfman Destombes disease. The difficulty of diagnosis in our regions based on technical tray lack and our patients financial limits. Also this disease is rarely mentioned first. This is often the source of considerable diagnostic delay noted in our two patients and therefore the initiation of an untimely anti-tuberculosis treatment.

关键词： Histiocytosis Rosai-Dorfman-Destombes Disease Sub-Saharan Africa

Profiling Hepatitis B Viral Load: Treatment and Epidemiological Implications in a West African Hospital

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Advances in Infectious Diseases 2022年第4期12卷 703-714页

作者： Papa Silman Diawara Mor Ngom Maguette Ndoye Mamadou Wague Gueye Sokhna M. Daffe Nata Dieng Ibrahima Diallo Bécaye fall Macoura Gadji Moustapha Diop Pape Samba Ba Yankhoba Diop Federation of Laboratories Principal Hospital of Dakar Dakar Senegal Hematology Department Dakar Principal Hospital Dakar Senegal Hepato-Gastro-Enterology Department Dakar Principal Hospital Dakar Senegal Department of Biological Hematology & Oncology-Hematology (HBOH) National Blood Transfusion Center (CNTS)/FMPOS-UCAD Dakar Senegal Infectious Diseases Department Dakar Principal Hospital Dakar Senegal

Background: Chronic hepatitis B virus (HBV) infection is one of the largest public health problems with nearly 350 million chronic carriers and 500,000 deaths each year. These deaths are most often associated with disease progression to cirrhosis or hepatocellular carcinoma, which some studies have shown is associated with long-term viral replication in chronic carriers. Viral load quantification, a key element of disease management, is expensive and difficult to access. Viral load plays a crucial role in patient classification and treatment initiation. Four years after the implementation of viral load platform, the objective of this study was to assess viral load profile in HBs chronic carriers in a sub-Saharan Hospital and to determine the potential impact of this distribution on preventive and therapeutic strategies against hepatitis B infection. Materials and Method: The study was carried out between April 2016 and October 2020 in the laboratory of the PRINCIPAL Hospital in Dakar. All patients referred for HBV DNA viral load testing following a positive AgHBs test were included. Incomplete medical records were excluded from the study. Only the first quantification test performed on each patient is recorded. DNA extraction was performed with COBAS AmpliPrep (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Amplification was performed using COBAS TaqMan48 (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Data were collected from the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: A total of 3002 patients, 76.1% (2285/3002) men and 33.9% (717/3002) women, were included in the study. Young adults were most represented among the subjects (23.2%) and (20.1%) in the age groups 25 - 30 and 30 - 35. The majority (52.7%) of patients had viral loads between 20 and 2000 IU. Patients with undetectable viral loads and patients with viral loads below 20 IU comprised 14.6% and

关键词： Hepatitis B Viral Load Senegal Treatment