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Assessment of Insulin Therapy in 281 children and Adolescents with Type 1 Diabetes in senegal

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Open Journal of Pediatrics 2022年第1期12卷 283-292页

作者： Djibril Boiro Amadou sow Aliou Abdoulaye Ndongo Idrissa Basse Lamine Thiam Ndiogou seck Cheha Fatoumia Babacar Niang Modou Guéye Maïmouna Ndour Mbaye Ousmane Ndiaye Abass Ndao hospital Dakar Senegal Aristide Le Dantec hospital Dakar Senegal Diamniadio children’s hospital Dakar Senegal Ziguinchor Peace hospital Dakar Senegal saint Louis Regional hospital Dakar Senegal albert royer children’s hospital Dakar Senegal

Introduction: In senegal, with the CDIC “Changing Diabetes In children” project, insulin has been made free. The objective of this study was to evaluate the accessibility and modalities of insulin therapy in the management of type 1 diabetes. Methodology: This was a retrospective study including patients followed for type 1 diabetes (T1DM) in hospital between April 2018 and December 2020. Results: 281 patients were included. The mean age was 14.22 years. The mean age at diagnosis was 11.28 years. Ketoacidosis was the main mode of discovery of diabetes at 51.6%. Premix and rapid insulins were most commonly used at 84.7% and 82.9% respectively, most often in combination. The most commonly used treatment regimen was three injections/day in 82.5% of cases. The average daily insulin dose was 0.62 IU/Kg/dr. Of the patients, 219 (78%) were self-monitoring of blood glucose. The average number of blood glucose checks was 1.78 per day. 76 patients (27%) went days without an insulin injection and up to 7 days in 51% of cases. The main reasons were forgetfulness, therapeutic errors and stock-outs. Hypoglycaemia was observed in 14.2%. The average glycated haemoglobin was 10%. Conclusion: Despite the efforts made, there are still challenges to improve access to insulin. The reinforcement of therapeutic education on insulin therapy is essential for a better quality of life of diabetic children and adolescents.

关键词： Diabetes children Insulin Therapy senegal

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

Ischemic stroke Complicating Neuromeningeal and Pulmonary Tuberculosis in children: About a Case in senegal

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Open Journal of Pediatrics 2023年第1期13卷 92-96页

作者： Papa souleye sow Khadim Bop Khalifa Ababacar Mbaye Guillaye Diagne Pape Malick Dibor Diouf Idrissa Demba Ba Papa Moctar Faye Amadou Lamine Fall Ousmane Ndiaye National hospital Center of children albert royer Dakar Sénégal National hospital Center of Fann Dakar Sénégal

Tuberculosis is a major public health problem, especially in developing countries. Neuro-meningeal involvement is rare but represents one of the most severe forms with high morbidity and mortality. We report the case of an ischemic stroke complicating neuromeningeal and pulmonary tuberculosis in a four-month-old infant at the National hospital Center of children albert royer (senegal). The case was a four-month-old, male infant with no history. His vaccination was up to date according to senegal’s expanded vaccination program. There was no notion of tuberculosis contagion. He was seen for a prolonged fever for more than a month and chronic cough. He had moderate malnutrition. Neurological examination revealed coma, meningeal syndrome, generalized tonic convulsions and hypertonia. The pupils were in bilateral miosis. Osteotendinous reflexes were abolished with a bilateral Babinski sign. He also had severe respiratory distress, bilateral pulmonary condensation syndrome. Brain computed tomography was in favor of an ischemic stroke. The test GeneXpert MTB/RIF was positive on cerebrospinal fluid and gastric tubing fluid. The curative treatment was based on a quadruple therapy based on rifampicin, isoniazid, pirazinamide and ethambutol. The evolution was unfavorable with the death of the patient.

关键词： Tuberculosis Meningitis Child senegal

Kaposi’s Disease (Ks) in a senegalese Child Living with HIV

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Open Journal of Pediatrics 2020年第1期10卷 85-93页

作者： F. Ly B. Niang Y. Keita C. Dial A. sow A. sakho Kane B. s. Ndiaye A. sylla B. Camara A. Ly Ba O. Ndiaye Pediatric service of the Pikine National hospital Dakar Senegal Pediatric Department of the albert royer National children’s hospital Dakar Senegal Pediatric Department of the Aristide Dantec hospital Center Dakar Senegal Department of Anatomopathological of General hospital Idrissa Pouye Dakar Senegal Department of Dermatology of the Pikine National hospital Center Dakar Senegal Radiology Department of the albert royer National children’s hospital Dakar Senegal

Kaposi’s Disease or Kaposi’s sarcoma (sK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a senegalese HIV-positive child. It was an 11-year-old girl from a region in central senegal. she was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. she was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. she was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma.

关键词： Kaposi’s sarcoma Antiretroviral Therapy HIV Child

Factors associated with mortality in congenital malformations of the gastrointestinal tract in a tertiary center in senegal

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World Journal of Pediatric surgery 2023年第1期6卷 24-29页

作者： Tshibwid A Zeng Papa Alassane Mbaye Doudou Gueye Ndèye Fatou seck Ibrahima Bocar Wellé Rosalie Niang Youssouph Diedhiou Mbaye Fall Ndèye Aby Ndoye Aloïse sagna Oumar Ndour Gabriel Ngom Department of Pediatric surgery Albert Royer National Children’s Hospital CenterUniversitéCheikh Anta Diop Facultéde Medecine Pharmacie d'Odonto-StomatologieDakarSenegal Department of Pediatric surgery Aristide Le Dantec University Teaching HospitalUniversitéCheikh Anta Diop Facultéde Medecine Pharmacie d'Odonto-StomatologieDakarSenegal

Objective Patients with congenital malformations(CMs)of the gastrointestinal tract(GIT)have a very high ***,the literature on the factors associated with mortality in these patients is scarce in sub-saharan *** aim of this study is to identify independent risk factors for mortality in patients with CMs of the GIT at our pediatric surgical *** We conducted a retrospective analysis of cases with CMs of the GIT managed at a tertiary center from 2018 to *** were subdivided into two groups based on the outcomes,and variables with a significant difference were analyzed by logistic *** Our review included 226 patients,63 of whom died(27.88%).Patient age ranged from 0 to 15 *** into account statistical significance,mortality was more frequent in neonates than in older patients(57.30%vs 6.15%),in patients coming out of the dakar area than in those from the dakar area(43.75%vs 19.18%),in patients with abnormal prenatal ultrasound than in those with normal ultrasound(100%vs 26.67%),in premature children than in those born at term(78.57%vs 21.87%),in patients with an additional malformation than in those with an isolated malformation(69.23%vs 25.35%),and in those with intestinal,esophageal,duodenal and colonic atresia than in those with other diagnoses(100%,89%,56.25%and 50%,respectively).Referred patients died more than those who changed hospitals or came from home(55.29%vs 25%and 9.09%,respectively).On multivariable logistic regression,two independent factors of mortality were identified:presence of associated malformation[odds ratio(OR)=13.299;95%Confidence interval(CI)1.370 to 129.137]and diagnosis of esophageal atresia(OR=46.529;95%CI 5.828 to 371.425).Conclusion The presence of an associated malformation or diagnosis of esophageal atresia increases mortality in patients with CMs of the GIT in our environment.

关键词： mortality diagnosis congenital

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 span>way with an irregular and nodular thickening of the peritoneum making evoke a peritoneal carcinosis. Exploratory laparotomy found a bilateral ovarianspan> 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

Does Hearing Impairment Have an Impact on the children’s Education in Casamance, south of senegal?

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International Journal of Otolaryngology and Head & Neck surgery 2021年第4期10卷 313-319页

作者： Ndadi Tchiengang K. Junie Evelyne siga Diom Bay Karim Diallo ENT and CCF Department Peace Hospital Ziguinchor Senegal ENT and CCF Department Albert Royer Children’s Hospital Dakar Senegal

Goal: To determine the impact of deafness on the schooling of children in Casamance and the factors that characterize these repercussions. Patients and Methods: This was a retrospective, cross-sectional and multicente... 详细信息

strong>Goal:strong> To determine the impact of deafness on the schooling of children in Casamance and the factors that characterize these repercussions. strong>Patients and Methods:strong> This was a retrospective, cross-sectional and multicenter study carried out in the ENT departments of the peace and regional hospitals of Ziguinchor over a period of 7 years from January 1, 2012 to December 31, 2019. It included hearing impaired children aged 1 to 18. strong>Results:strong> 178 hearing impaired children were collected during the study period. One hundred and forty-seven children were in school (82, 58%), the majority (85.03%) attending formal schools. Fifty-seven children had a speech disorder (32.02%). The average age of screening for deafness was 9 years. Deafness was mild in 53 patients. Thirteen patients had severe deafness. Two patients presented with cophosis. strong>Conclusion:strong> Our study shows that deafness does indeed have an impact on a child’s education in Casamance, but this impact is hardly taken into account.

关键词： Repercussion Hearing Impairment Child Casamance

Abdominal Cerebrospinal Fluid Pseudocyst—A Rare Complication of Ventriculoperitoneal shunt

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Open Journal of Modern Neurosurgery 2023年第3期13卷 105-110页

作者： Ndeye Fatou seck Ibrahima Bocar Wellé Cheikh Ahmadou Dit Ndongo Dieng Florent Tshibwid A. Zeng Fatou sy Doudou Gueye Papa Alassane Mbaye Ndeye Aby Ndoye Aloïse sagna Gabriel Ngom Department of Pediatric surgery Albert Royer National Children’s Hospital Center Université Cheikh Anta Diop Dakar Senegal

An abdominal cerebrospinal fluid pseudocyst is a rare complication of ventriculoperitoneal shunt. several theories have been suggested to explain its occurrence. The main symptoms are painful abdominal distension and vomiting, abdominal distension on examination, as abdominal ultrasound and computed tomography confirm its diagnosis. The treatment involves drainage associated with drain relocation and resection of the pseudocyst’s wall. We report two patients diagnosed with this condition who underwent surgical treatment. The first patient had an unremarkable 12-month follow-up, while the second died on the seventh postoperative day due to intravascular disseminated coagulation. In these patients, the cause has not been identified;however, an infection cannot be ruled out.

关键词： Abdominal Pseudocyst Cerebrospinal Fluid children Complication Ventriculoperitoneal shunt

Rheumatic Heart Disease in children: Epidemiological Aspects. Diagnostic and Evolutive at the dakar Chu

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Open Journal of Pediatrics 2023年第3期13卷 304-312页

作者： Guillaye Diagne Khadim Bop sadio Konate Papa souley sow Amadou Lamine Fall albert royer National hospital Center Dakar Senegal

Rheumatic heart disease is the ultimate consequence of acute articular rheumatism. It remains a public health problem in developing countries. It is a pathology found in all countries of the world, with a clear predominance in developing countries. In senegal, the hospital prevalence of rheumatic heart disease is 30.5%. Its seriousness lies in the risk of valvular sequel responsible for cardiac dysfunction that can lead to death. The objective of this study was to describe the epidemiological, diagnostic and evolutionary aspects of rheumatic heart disease at the albert royer National hospital Center of child (CHNEAR). We had carried out a retrospective, descriptive and analytical study lasting 3 years from January 1, 2017 to December 31, 2019. All children aged 4 to 17 hospitalized at CHNEAR for rheumatic heart disease were included. The hospital prevalence was 0.8%. The average age was 10.9 years with a sex ratio of 0.875 in favor of girls. 85.47% of cases came from parents who had a low economic level of life. The history of repeated angina and acute articular rhumatism (AAR) was found respectively in 22.69 and 15.13% of cases. The clinical symptomatology was dominated by heart failure with 58.3% of cases, arthralgia in 7.5% of cases. The biological inflammatory syndrome was found in 86.1%. 73% of the patients had a positive antistreptolysin O antibody (AsLO). Cardiomegaly was found in 89.7%. Heart doppler ultrasound found polyvalvular involvement in more than half of the cases. Mitral insufficiency was the predominant valve disease in 98.20% of cases. The evolution was favorable in the majority of cases but 9.32% of deaths were observed.

关键词： Rheumatic Heart Disease Child CHNEAR