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Metabolic Emergencies in Newborns in a Subsaharian Neonatology Department: Evaluation of Glucose, Sodium and Potassium Disorders

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Open Journal of Pediatrics 2022年第1期12卷 263-273页

作者： Ndèye Fatou Sow Amadou Sow Mame Aita Seck yaay joor dieng Djeneba Fafa Cissé Papa Moctar Faye Ndèye Ramatoulaye Diagne Ousmane Ndiaye Department of Pediatrics National Children’s Center Albert Royer Dakar Sénégal

Introduction: Metabolic neonatal adaptation is a complex phenomenon and metabolic disorders can be frequent in immature newborns or in life-threatening situations. In Low and Middle income countries (LMIC) the difficult access to some diagnostic tests makes the management of the metabolic emergencies challenging. The main objectives of this study were to assess the frequency and circumstances of occurrence and to describe the clinical picture associated with glucose, sodium and potassium disorders in neonates. Patients and Methods: Our study was a retrospective and descriptive study conducted in the neonatology unit of National Children Hospital Albert Royer in Dakar (Senegal) from January 1 to December 31, 2014. Results: The prevalence of the studied metabolic disorders was 46.7%. The most common metabolic disorder noted was Hyperglycemia followed by Hyponatremia. Thermoregulation disturbances were found particularly in newborns with serum sodium disorders (hyponatremia 33.5% and hypernatremia 59.7%). Neurological signs were noted in case of blood sugar abnormalities (hypoglycemia 26.1% and hyperglycemia 29.8%). Half of the newborns with hyperglycemia (82 cases/50%) had blood sugar levels greater than or equal to 2 g/l. Hypernatremia was severe (Serum sodium> 180 mmol/l) in 12 neonates (16.7%). The main diagnoses retained were sepsis (159 cases/45.4%), prematurity (96 cases/27.4%), intrauterine growth retardation (66 cases/18.9%), malformations (63 cases/18%), perinatal asphyxia (44 cases/12.6%) and malnutrition (36 cases/10.3%). For most metabolic disorders, the correction was late and was done beyond 48 hours. On average, the correction time varied between 3 hours and 6 days. The most frequent complications were cerebral edema (12 cases), brain death (8 cases) and increased intracranial pressure (3 cases). The most lethal disorders were Hyperkalemia followed by Hyperglycemia. Conclusion: Metabolic disorders especially glucose, sodium and potassium disorders are c

关键词： Metabolic Disorders Newborn Hypoglycemia Hyperkalaemia Hyperglyce-mia Hypernatremia

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Evolutionary Profile of Graves’ Disease in Children at Albert Royer National Children Hospital in Dakar

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Open Journal of Pediatrics 2019年第2期9卷 119-125页

作者： Babacar Niang Lamine Thiam Fatou Ly Indou Dème Ly Djibril Boiro Amadou Sow Aliou Thiongane Aliou Abdoulaye Ndongo Aminata Mbaye Younoussa Keita Abou Ba Idrissa Demba Ba yaay joor dieng Dienaba Fafa Cissé Papa Matar Faye Amadou Lamine Fall Ousmane Ndiaye Albert Royer National Children Hospital Center Dakar Senegal La Paix Hospital Ziguinchor Senegal Pediatric Ward University Hospital Center of Pikine Dakar Senegal Pediatric Ward University Hospital Center of Abass Ndao Dakar Senegal Pediatric Ward University Hospital Center of Aristide Le Dantec Dakar Senegal

Graves’ disease is the most common cause of hyperthyroidism. Adequate management is an area of controversy, especially when it comes to children. The objective of our study was to assess the outcome of Graves’ disease treatment in Albert Royer Children Hospital of Dakar. This was a retrospective study conducted from 2001 to 2015, and which involved all children between 0 to 15 years of age who were being monitored in the Albert Royer National Children Hospital. The evolutionary modalities were: stability, remission, failure, relapse, lost to follow-up and death. The data were analyzed with SPSS software version 20.0. For the comparisons, the KHI 2 or Fisher test was used with a significance threshold (p < 0.05). During the study period, 88 children were enrolled. The average age was 8.6 years [ranging from 8 months to 15 years]. The consultation delay was 11.36 months. In our study, 61.4% of the patients were regular in the follow-up, the observance was good in 40.9% of the cases and 19 patients (21.6%) were lost to follow-up. Clinical courses of 69 children after treatment with Carbimazole for 37 months were promising in 21 cases (30.43%), with 17 cases of remission (24.63%) and 4 cases of stability (5.8%). Age older than 10, the initial ATD dose greater than 1 mg/kg/day and the initial free T4 lower than 50 pmol/l were significantly associated with remission with a p value of 0.01;0.024 and 0.004.

关键词： Graves’ Disease Child Antithyroid Drug Remission Senegal

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Primary Immune Deficiencies (PID): Diagnosis Challenges

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Open Journal of Pediatrics 2021年第3期11卷 388-392页

作者： Indou Deme/ly Awa Kane Mame Sokhna Gueye Ibrahima Diop Mame Tene Ndiaye Abou Ba Idrissa Demba Ba Babacar Niang Aliou Thiongane yaay joor dieng Yaye Fatou Mbodj/Diop Ouafae Achnin Papa Moctar Faye Amadou Lamine Fall Ibrahima Diagne Tandakha Ndiaye Dièye Ousmane Ndiaye Albert Royer National Children’s Hospital Center Université Cheikh Anta Diop Dakar Senegal National Blood Transfusion Center Dakar Senegal Health Science Unit Gaston Berger University Saint -Louis Senegal

Background: Primary Immune Deficiencies (PID) are rare, under-determined diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. Aim: Our aim was to share the challenge of diagnosis and treatment in PID. Case Presentation: It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decreased level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants requires a substitution for life of immunoglobulin which is unavailable in our countries. Conclusion: PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.

关键词： Primary Immune Deficiencies Hypo-Gammaglobulinemia Infants

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Epidemiological, Diagnostic and Evolutionary Profile of Seizures in Young Infants at Albert Royer (Dakar/Senegal)

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Open Journal of Pediatrics 2024年第6期14卷 1079-1089页

作者： Cissé Djénéba Fafa dieng yaay joor Diagne Guillaye Sow Ndeye Fatou Kane Awa Mbaye Aminata Faye Papa Moctar Ly Fatou Gueye Modou Diagne-Gueye Ndeye Rama Sylla Assane Ndiaye Ousmane Pediatrics Department Pikine National Hospital Dakar Senegal Neonatal Department Albert Royer National Childrens Hospital Dakar Senegal Pediatrics Department Dalal Jamm National Hospital Dakar Senegal Neonatal Department Diamniadio Childrens Hospital Dakar Senegal Pediatrics Department Abass Ndao National Hospital Dakar Senegal

Introduction: Seizures are one of the most common neurological complications in the infant period. The aim of our study was to describe the epidemiological, clinical, therapeutic and prognostic features of seizures in infants at the Albert Royer Children’s Hospital (Senegal). Materials and Methods: This was a retrospective, descriptive study from 1 January 2012 to 30 September 2018 of infants aged 0 days to 2 months who presented with seizures. Results: The hospital rate was 8.5%. Almost all the mothers (99.1%) had undergone at least 3 antenatal visits. Urogenital infection, gestational arterial hypertension and funicular anomalies were the main pregnancy-related pathologies. Delivery was vaginal in the majority of cases (80.9%). Most infants (43.6%) had not cried at birth. The majority of infants (63%) were born at term. Trophicity was normal in 68% of cases. The average age of the infants was 6.7 days. The main causes of seizures were hypoxic-ischemic encephalopathy (48.7%), metabolic disturbances (48.1%) and central ոеrvοսѕ system infections (15.6%). Phenobarbital was the 1st-line anticonvulsant. The case fatality rate was 39.5%. The main sequela observed were delayed psychomotor development (20.6%). Conclusion: Optimal management of infant seizures requires early diagnosis and etiological treatment by improving the quality of perinatal care to ensure better management of risk factors, as well as increasing the availability of neuroimaging equipment.

关键词： Seizures Infant Albert Royer Hospital

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Pelvic Tuberculosis Simulating an Ovarian Tumor at a Stage of Peritoneal Carcinosis

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Open Journal of Obstetrics and Gynecology 2021年第10期11卷 1317-1322页

作者： Mohameth Mbodj Idrissa D. Ba yaay Dior K. B. dieng Fatim Tall Amadou Sow Serigne T. Ndiaye Guilaye Diagne Khadim Bop Pape S. Sow Sofiatou Dieye Sadio Konaté Ibrahima Diop Aziz Faye Amadou L. Fall Ousmane Ndiaye Albert Royer National Children Hospital Dakar Senegal Cheikh Anta DIOP University Dakar Senegal Abass Ndao Hospital Center Dakar Senegal

Tuberculosis is a global public health problem with 10 million people developing an active form each year. The exact incidence of the pelvic form of tuberculosis is not known due to under-reporting of asymptomatic cases, vague symptomatology and lack of reliable diagnosis. We report a case of ovarian tuberculosis mimicking cancer and peritoneal carcinosis. The case involved a 15-year-old girl, hospitalized for severe pelvic pain and secondary amenorrhea. The examination showed an altered general state, a fever, a sensitive distended abdomen. The biology showed an elevation of Ca125 to 357 IU/ml. The CT scan showed a latero-uterine mass taking contrast in a heterogeneous way with an irregular and nodular thickening of the peritoneum making evoke a peritoneal carcinosis. Exploratory laparotomy found a bilateral ovarian mass with ileo-ileal, ileo-parietal and ileo-ovarian adhesions. Biopsy of the mass and the peritoneum showed a caseo-follicular gigantocellular epitheloid granulomatosis.

关键词： Tuberculosis Granulomatosis Carcinosis Ca125

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