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Evaluation of Podological Risk at Type 2 Diabetics Tracked at the Mark Sankale Diabetes Center in dakar

Journal of Diabetes Mellitus 2020年第2期10卷 41-50页

作者： Michel Assane Ndour Demba Diedhiou Djiby Sow Ibrahima Mane Diallo Aissatou Diallo Ahmed Limane Barrage Ibrahima Kindy Diallo Muriel Diembou Lala Bouna Seck Pape Adama Dieng Maimouna Ndour Mbaye Anna Sarr Department of Internal Medicine Abass Ndao Hospital Center Dakar Senegal Department of Neurology Fann University Hospital Center Dakar Senegal Department of Cardiovascular Thoracic Surgery Fann University Hospital Center Dakar Senegal

Introduction: The diabetic foot is a real public health problem due to its economic and functional impact with a high risk of amputations. The objective was to determine the podiatric risk of type 2 diabetics according to the classification of the International Working Group on the Diabetic Foot (IWGDF) in order to put in place suitable prevention measures. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted over 12 months from May 01, 2018 to May 01, 2019 and concerning subjects with type 2 diabetes regularly followed up at the Marc Sankale Center at Abass Ndao hospital in dakar. Results: Two hundred (200) patients were collected with an average age of 58.9 ± 10 years, a sex ratio of 0.43. The majority of our patients had diabetes less than 5 years of age (52%) and were on non-insulin medication (63%). The average HbA1c level was 8.1%. Besides diabetes, high blood pressure and dyslipidemia were the most common cardiovascular risk factors in 65% and 25%, respectively. The main podiatric risk factors were: neuropathy (75.5%), arteriopathy (31.5%), deformities (19.5%), history of ulceration (24%) and amputation (2%). Factors associated with the risk of ulceration were: walking barefoot (42%), wearing tight shoes (26.5%), wearing unsuitable socks (46%), gait disturbance (39%), traumatic pedicure (3.5%). The podiatric risk assessment according to the IWGDF grading had identified a podiatric risk foot in 80% of the cases. Depending on the grade of injury, it was a grade 0 (20%), grade 1 (32%), grade 2 (34%) and grade 3 (14%) risky foot. A significant correlation was established between the onset of diabetic foot and age (p p p Conclusion: Podiatric assessment remains an essential point in the fight against complications of diabetes. This study demonstrates the high risk of developing diabetic foot, hence the importance of good grade planning to reduce the impact.

关键词： Diabetic Foot Podiatric Risk Prevention Marc Sankale Center

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Etiologic Aspects of Epileptic Seizures of Recent Onset in HIV-AIDS Infected Subjects at the Yaounde Central hospital (Cameroon)

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World Journal of AIDS 2013年第2期3卷 160-167页

作者： P. C. Mbonda C. Kuate A. K. Njamnshi Y. Fogang J. Fonsah W. Muna Neurology Department Central Hospital of Yaoundé University of Yaounde I Yaounde I Cameroon Neurology Department Fann Teaching Hospital Dakar Senegal

Introduction: Patients infected with HIV usually develop neurological complications. Seizures are amongst clinical manifestation of these neurological complications of HIV infection. We report on 150 HIV positive patients who presented with newly onset seizures. Objectives: Our objective was to evaluate the influence of HIV infection on epilepsy and particularly to look for the most common epilepsy induced complications in our context. Methodology: We recruited all patients infected with HIV and who consulted at the outpatient or admitted in the in the neurology unit of the Yaounde Central hospital, for seizures from August 1st 2008 to December 31st 2009. All the patients were aged above 18 years, black and of Cameroonian nationality. All those who had a family history of epilepsy, as well as those with a personal history of epilepsy were excluded from the study. Results: During the period of study, we recruited 150 patients aged 38.7 ± 9.9 years and with an M/F sex ratio of 0.76. Generalized seizures were observed in 66% of patients, of whom 58% were HIV 1 positive and an average CD4 count of 65.4 ± 11.7/μl. Cerebral toxoplasmosis was the most common etiology observed in 30% of cases. Discussion: This study being hospital based must have selected the most serious patient with severe immunodeficiency. This can explain why a precise etiology was found in the majority of cases. Modi et al. (1999) found a space occupying lesion in 53%, meningitis in 22% and 25% without identifiable etiology in black South Africans. Central nervous system tuberculosis was the most frequent cause encountered in 64% of patients with etiologies. Conclusion: Seizures are one of the principal manifestations of HIV infection or its complications. Their prevalence is 9.5% in our study. Cerebral toxoplasmosis is the most frequent etiology in our study, followed by cryptococcal meningitis and tuberculous meningitis.

关键词： Epilepsy HIV/AIDS Infection Cerebral Toxoplasmosis—Yaoundé (Cameroon)

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Peripheral Neuropathies Revealing Gougerot-Sjögren’s Syndrome: Description of 3 Cases

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Neuroscience & Medicine 2022年第3期13卷 120-125页

作者： Ndiaga Matar Gaye Alassane Mamadou Diop Khalifa Ababacar Mbaye Serigne Abdou Aziz Fall Mamadou Ka Momo Banda Ndiaye Maouly Fall Moustapha Ndiaye Amadou Gallo Diop Neuroscience Department Fann Hospital Dakar Senegal Neurology Department Pikine Hospital Dakar Senegal

Introduction: Sjögren’s syndrome is an autoimmune epithelitis with various extraglandular signs, among which are neurological, with a variable frequency according to studies. We report three cases of peripheral neuropathy revealing Gougerot-Sjögren’s syndrome, collected in the Neurology Department of the fann university hospital in dakar (Senegal). Observations: The first patient, aged 48 years, presented with a length-dependent sensitivomotor polyneuropathy associated with retrobulbar optic neuritis, with dry eyes and dry mouth noticed by the patient for several years. The second patient, aged 28 years, was admitted to the hospital with chronic generalized paresthesia in the context of xerostomia and xerophthalmia. The results of the clinical examination and the electroeneuromyogram were in favour of pure sensory neuronopathy. The third patient was 32 years old female, with a history of thyroidectomy and acute inflammatory demyelinating polyneuropathy (AIDP), who was seen for acute ascending flaccid tetraplegia with facial diplegia, preceded by diffuse paresthesia. The diagnosis of recurrence of acute demyelinating polyradiculonueropathy was retained in view of the rapidly increasing character of the deficit, the hyperproteinorachy at the lumbar puncture, and the signs of demyelination at the ENMG. The diagnosis of Gougerot-Sjögren’s syndrome in our three patients was established on the basis of the 2016 ACR/EULAR criteria. Indeed, the anti-SSA antibodies (Ro) were positive in our 3 patients with a biopsy of the salivary glands which showed stage 3 in the first patient and stage 4 in the two others. Corticosteroid therapy and immunosuppressive treatment resulted in a favourable clinical evolution on the neurological and general levels. Conclusion: Gougerot-Sjögren’s syndrome is an autoimmune exocrinopathy that may present with peripheral neuropathy, which may precede the diagnosis of Sjögren’s syndrome, be concomitant or occur during the co

关键词： Sjögren’s Syndrome Peripheral Neuropathy Salivary Gland Biopsy Senegal

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Stroke and Covid-19: The Experience of the Ziguinchor/Senegal Epidemic Treatment Center

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Neuroscience & Medicine 2022年第3期13卷 103-110页

作者： Khalifa Ababacar Mbaye Kalilou Diallo Rokhaya Diagne Moustapha Ndiaye Amadou Gallo Diop Noël Magloire Manga Ibrahima Pierre Ndiaye Neurology Department Fann Teaching Hospital Dakar Senegal Infectious Diseases Department Peace Hospital Ziguinchor Ziguinchor Senegal

Introduction: SARS-CoV-2 infection seems to have a brain tropism involving several pathophysiological mechanisms. The objective of our work was to study the epidemiological, clinical, paraclinical and evolutionary aspects of stroke patients following SARS-CoV-2 infection. Methodology: This was a retrospective descriptive and analytical study from 26 March 2020 to 30 September 2021, which took place at the Ziguinchor epidemic treatment center. All patients infected with SARS-CoV-2 confirmed by RT-PCR with clinical signs suggestive of stroke and confirmed by brain CT scan were included in our study. Patients with incomplete or unexploitable records were excluded. Results: Twenty-four patients were collected out of a total of 186 severe cases, a prevalence of 12.90%. All patients had an ischemic stroke. The mean age was 69 ± 6 years with extremes of 58 and 84 years. The sex ratio (M/F) was 1.2. Diabetes and hypertension were co-morbidities in 87.50% and 25% of cases respectively. Clinical signs were dominated by a hemi-corporal deficit (87.5%) and dyspnea (75%). All patients were on anticoagulation and corticosteroids. The evolution was favourable in 62.5% of patients against 37.5% of death. Conclusion: SARS-CoV-2 infection is responsible for numerous neurovascular complications and this risk increases with the presence of diabetes, arterial hypertension and emboligenic heart disease. Corticosteroid therapy and anticoagulation have allowed us to improve the prognosis of patients.

关键词： Covid-19 Stroke Ziguinchor Senegal

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Risk Factors for COVID-19 Related Death during the First Three Waves of the Pandemic in an Epidemic Treatment Center at dakar, Senegal

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Advances in Infectious Diseases 2023年第2期13卷 117-131页

作者： Moustapha Diop Papa Samba Ba Viviane Marie Pierre Cisse Ndèye Aissatou Lakhe Betty Fall Moustapha Lo Ndong Essomba Bruce Wembulua Fatimata Wone Becaye Fall Khardiata Diallo-Mbaye Daye Ka Louise Fortes Ousmane Faye Ndongo Dia Khalifa Ababacar Wade Abdou Rajack Ndiaye Amadou Alpha Sall Moussa Seydi Mame Thierno Dieng Epidemic Treatment Center Dakar Principal Hospital Dakar Senegal Infectious and Tropical Diseases Department FANN Teaching Hospital Dakar Senegal Psychiatry Department Dakar Principal Hospital Dakar Senegal Internal Medicine Department Deido District Hospital Douala Cameroon Dalal Jamm hospital Dakar Senegal Federation of Laboratories Dakar Principal Hospital Dakar Senegal Pasteur Institute of dakar Dakar Senegal Anesthesia-Resuscitation Department Dakar Principal Hospital Dakar Senegal dakar Principal hospital Dakar Senegal

Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of dakar Principal hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: Our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.

关键词： COVID-19 Waves Death Risk Factors dakar

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Epidemiological Profile of Women with Mental Disorders in hospital in dakar

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Open Journal of Psychiatry 2023年第4期13卷 355-372页

作者： Racky Wade-Kane Sokhna Seck Khourédia Thiam Ndéye Dialé Ndiaye Ndongo Papa Lamine Faye Aida Sylla Mamadou Habib Thiam Department of Psychiatry and Medical Psychology National University Hospital Center of Fann Dakar Senegal

Introduction: Women are currently more likely than men to suffer from mental health problems. The prevalence of mental health problems among women is also increasing. However, few studies conducted in Africa provide epidemiological data on women. The aim of this study was to describe the epidemiological profile of women with mental health problems in dakar. Methodology: This was a cross-sectional, retrospective, descriptive study over a five-year period, from 1 January 2017 to 31 December 2021. It concerned all women hospitalised for psychiatric reasons at the Psychiatry Department of fann hospital, dakar, Senegal. The data collection form provided information on the sociodemographic profile, i.e., age, current address, marital status, ethnicity, religion, level of education, professional activity, and use of psychoactive substances. Results: The prevalence of mental disorders was 34.9% and concerned the following ICD-10 pathology groups [F00 - 09], [F10 - F19], [F20 - F29], [F30 - F39], [F40 - 48], [F50 - F59] and [F60 - F69]. The mean age of the patients was 37 years, with a standard deviation of 13 and extremes from 16 to 74 years. Most patients were unmarried (56%). Among the married patients, the monogamous regime was in the majority in our study: 56% compared with 44% for the polygamous regime. Women had to attend French school in 74% of cases. In our study, 32% of patients had reached university level. The majority were unemployed (67%). The notion of mourning was found in 214 patients (30.2%). The birth of one or more children marked the lives of 184 patients (26%). Divorce was noted in 103 patients (14.5%). Marital conflicts were experienced by 94 patients (13.3%). Twenty percent of the patients had used psychoactive substances. Conclusion: The epidemiological profile of a woman with a mental disorder in dakar is that of a single woman in her forties who had attended university and was a housewife. She does not use psychoactive substances and has experience

关键词： Epidemiological Profile dakar Mental Disorder Woman

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Nasosinus Metastases from Breast Cancer: A Review of Two Cases

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Advances in Breast Cancer Research 2021年第4期10卷 133-140页

作者： Papa Macoumba Gaye Mouhamadou Bachir Ba Fatimatou Néné Sarr Fallou Niang Maimouna Mané Franck Chouamou Aurélien Chemega Radiotherapy Department of Dalal Jamm hospital Cheikh Anta Diop University of Dakar Dakar Senegal Oto-Rhino-Laryngology Department of fann hospital Cheikh Anta Diop University of Dakar Dakar Senegal

Context: Breast cancer affects more than 2 million women a year worldwide. Improved treatments have made it possible to increase survival rates with more and more patients having time to develop secondary locations. Nasosinus metastases from this cancer are rare. Two recently treated breast cancer patients developed metastases to the sphenoidal and maxillary sinuses. These cases gave rise to an examination of the incidence of this disease, its diagnosis, the therapeutic means envisaged and the fate of these patients. Method: We report the diagnostic and therapeutic data of two patients suffering from breast cancer and presenting metastases at the nasosinus level, with a focus on the interest of radiotherapy in palliative care. Results: The two patients aged 56 and 60 presented in the course of their breast cancer secondary localizations in the sphenoidal and maxillary sinus confirmed by endoscopy and histology. All the cases presented massive lesions associated with other secondary bone locations in particular. After local radiotherapy and systemic chemotherapy treatment, one patient died 5 months after her diagnosis and the other was alive 16 months later. Conclusion: Nasal and sinus metastases from breast cancer are rare and have a poor prognosis as disseminated disease, they do not respond well to conventional systemic therapies even if palliative radiotherapy allows local control.

关键词： Cancer Breast Nasosinus Metastasis Senegal

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Clinical Profile of Women with Mental Disorders in dakar hospitals

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Open Journal of Psychiatry 2023年第S1期13卷 392-409页

Introduction: In Senegal, knowledge of the clinical profile of mental disorders in women has not been the subject of many studies, even though it is of vital importance to those involved in mental health. Thus, the aim of our study was to describe the clinical aspects of psychiatric disorders in women hospitalized at fann. Methodology: This was a cross-sectional, retrospective, and descriptive study over a five-year period. We identified 402 cases that met the selection criteria. The data collection form provided information on aspects of the clinical profile of mental disorders, such as medical, surgical, gynecological, obstetrical and psychiatric history, instigator of the request for care, diagnosis, duration and number of hospitalizations. ICD-10 was used for the various pathologies identified. Results: Asthma was noted in 7% of patients, as was hypertension. Gynecological surgery was found in 43 patients (11%). Eight patients were menopausal (2%). The mean number of gestations was 2.09, with a standard deviation of 2.257 and extremes between 0 and 10 gestations. Patients with a history of abortion numbered 58 (14%). The decision to hospitalize the patients was made by 96% (384 patients) of those around them. Hetero aggression was the most recurrent reason for hospitalization (19%). Pathology group F20-29 (schizophrenia, schizotypal disorder, and delusional disorders) was the majority group. Conclusion: The clinical profile of the mentally ill woman in dakar is a woman in her mid-forties who most often presents with a personal psychiatric history, and her hospitalization is prompted by hetero-aggression and/or logorrhea. She usually suffers from schizophrenia and related disorders. hospitalization usually lasts between 11 and 20 days.

关键词： dakar Clinical Profile Mental Disorders Woman

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Incidental Finding of a Fenestrated Vertebrobasilar Junction Aneurysm

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Forensic Medicine and Anatomy Research 2022年第2期10卷 44-49页

作者： Youssoupha Kassé Géraud Léra Akpo Ibrahima Niang Khadidiatou Diouf Ka Rokhaya Diagne Ndèye Bigué Mar Khaoulah Talhaoui Aminata Mbaye Papa Malick Dibor Diouf Mame Coumba Fall Sokhna BaDiop Radiology and Medical Imaging Department of fann hospital Dakar Senegal Neurology Department of fann hospital Dakar Senegal Anatomy Laboratory of Health Sciences Department of Iba Der Thiam University Thies Senegal

Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular fenestrations after the anterior communicating artery. Vertebrobasilar junction aneurysms are uncommon but often associated with basilar artery fenestration. We report the case of a fenestrated vertebrobasilar junction saccular aneurysm in a 57-year-old woman. The diagnosis was incidentally made on CT angiography which found the anatomical variant and the aneurysm. The radiological features illustrating this association are detailed here and a brief discussion of its pathogenesis and management was made. Vertebrobasilar junction aneurysms are rare and their presence should suggest an associated basilar fenestration.

关键词： Basilar Artery Fenestration Vertebrobasilar Aneurysm CT Brain Angiography

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Factors Associated with Death among Tuberculosis Patients in dakar

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Advances in Infectious Diseases 2021年第2期11卷 122-139页

作者： Moustapha Diop Papa Samba Ba Jean Augustin Diegane Tine Ndèye Maguette Fall Tracie Youbong Mouhamadou Ndiaye Ndèye Mouminatou Mbaye Mouhamed Bouye Nestor Diatta Alassane Sarr Sokhna Walo Ndiaye Ibrahima Cisse Louise Fortes Degenonvo Abdourahmane Niang Adama Faye Moussa Seydi Department of Infectious and Tropical Diseases Dakar Principal Hospital Dakar Senegal Health and Development Institute Cheikh Anta Diop University of Dakar Dakar Senegal Department of Infectious and Tropical Diseases FANN Teaching Hospital Dakar Senegal Department of Pulmonology Dakar Principal Hospital Dakar Senegal Faculty of Medicine and Odontology Cheikh Anta Diop University of Dakar Dakar Senegal Private Institute for Training and Research in Medicine Dakar Senegal

Introduction-Objective: Tuberculosis (TB) is the leading cause of death from a single infectious agent worldwide. The predictors of mortality due to TB are rarely evaluated in Senegal. The aim of our study was to identify factors associated with related TB death in two treatment centers in dakar, Senegal. Method: We conducted a prospective descriptive-analytical study dealing with TB patients followed in the Department of Infectious and Tropical Diseases at fann teaching hospital and dakar Principal hospital and in the Department of Pulmonology at dakar Principal hospital from March 1st, 2019 to February 29th, 2020. Univariate and multivariate logistic regressions were performed to identify the associated factors of death. Results: Two hundred eighty-two patients in the Department of Infectious and Tropical Diseases at fann teaching hospital (57%), in the Department of Infectious and Tropical Diseases at dakar Principal hospital (31%), and in the Department of Pulmonology at dakar Principal hospital (12%) were included in the study. The mean age was 39 ± 16 years and the male to female ratio was 2.2. Isolated pulmonary TB, isolated extrapulmonary TB, and both pulmonary and extrapulmonary TB were present in 33.3%, 30.5% and 36.2% of cases, respectively. Twenty-two patients died, corresponding to a mortality rate of 7.8%. Factors independently associated with death were age ≥ 60 years (26.2 [3.6 - 191.2]) compared to 16 - 40 years’ age group, HIV infection (7.2 [1.4 - 36.9]), neurological localization of TB (13.19 [3.2 - 54.3]), and hemoglobin level Conclusion: Tuberculosis remains a fatal disease despite therapeutic advances. Better knowledge of associated factors of death from TB may help to reduce its mortality.

关键词： Tuberculosis Death Associated Factors dakar

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