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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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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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Pathological Fractures in Chronic Hemodialysis Patients in a teaching hospital in Senegal: Prevalence and Associated Risk Factors

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Open Journal of Nephrology 2023年第3期13卷 211-219页

作者： Ahmed Tall Lemrabott Baratou Coundoul Niakhaleen Keita Maria Faye Moustapha Faye Mansour Mbengue Bacary Ba Seynabou Diagne Abdou Niang El Hadji Fary Ka Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Department of Nephrology Dalal Jamm National Hospital Center Dakar Senegal Dialysis Center National Hospital Center of Pikine Pikine Senegal

Introduction: The lack of follow-up and adequate management of chronic kidney disease-mineral and bone disorder (CKD-MBD) in chronic hemodialysis patients is associated with pathological fractures. Few studies are available on the subject in sub-Saharan Africa. The objective of this work was to evaluate the prevalence of pathological fractures in our chronic hemodialysis patients, to analyze their clinical aspects and to determine the factors associated with their occurrence. Patients and Methods: We conducted a retrospective, descriptive and analytical study over 9 years (January 1, 2011, to December 31, 2020) based on the medical records of chronic hemodialysis patients at the CHU Aristide Le Dantec. The diagnosis of pathological fracture was retained in front of any fracture occurring spontaneously or following minimal trauma and confirmed by X-ray. Results: Nineteen cases of pathological fractures were collected with a hospital prevalence of 19.39%. The mean age was 53.32 ± 13.94 years with a sex ratio of 0.36. The average seniority in dialysis was 84.16 ± 29.88 months. Among these patients, one had had 3 episodes of fractures and another 6 episodes. The circumstances of occurrence of the fractures were the fall in 63% of the cases, spontaneously in 37% of the cases. The predominant site of fractures was the femoral neck (47.38% cases). Female gender (p 5 years (p = 0.049), gait disturbances prior to the fracture (p = 0.001), positive CRP (p = 0.028) and the presence of vascular calcifications (p = 0.002) were significantly associated with the occurrence of pathological fractures. Conclusion: This study has identified the factors associated with the occurrence of pathological invoices in hemodialysis patients in our context. These fractures are often associated with the lack of regular biological follow-up due to the low socioeconomic level of our patients.

关键词： Pathological Fractures CKD-MBD Hyperparathyroidism Osteomalacia Adynamic Bone Disease Chronic Hemodialysis

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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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Threatened Aortic Injury by Thoracic Pedicle Screw: A Case Report

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Open Journal of Orthopedics 2018年第2期8卷 51-56页

作者： Amadou Ndiassé Kassé Souleymane Diao Magatte Gaye Jean Claude Sané Jean Marie Vianey Hope Karim Hemmam Babacar Thiam Pape Adama Dieng Mouhamadou Habib Sy Orthopedics and Trauma Surgery Department of Grand-Yoff General hospital Dakar Sénégal Neurosurgery Department of Grand-Yoff General hospital Dakar Sénégal Thoracic and Vascular Surgery Department of fann university teaching hospital Dakar Sénégal

Iatrogenic vascular injury during posterior spinal surgery is a rare but potentially serious complication with treatment challenges. We report the case of threatened aortic injury by pedicle screw impingement during posterior fixation of thoracic spine T7 - T8 fracture dislocation. The removal of the conflicting screws was done posteriorly after a visual control of the absence of adventitious break-in by a thoracotomy.

关键词： Thoracic Spine Pedicle Screw Aorta Thoracotomy

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Place of Exercise Echocardiography in Stable Coronary Artery Disease in Sub-Saharan Africa:A Series in Senegal

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World Journal of Cardiovascular Diseases 2020年第1期10卷 19-29页

作者： F.Aw M.B.Ndiaye C.M.B.M.Diop S.A.Sarr J.S.Mingou M.T.Diouf M.M.Ka M.Ndiaye Hariniaina Ravaoavy M.Bodian A.A.Ngaide M.Dioum M.Leye A.Mbaye A.D.Kane A.Kane M.Diao S.A.Ba Cardiology Department Teaching Hospital Aristide Le DantecDakarSenegal Cardiology Department General Hospital of Grand YoffDakarSenegal Cardiology Department Teaching National Hospital of Fann Le DantecDakarSenegal Research and Training Unit of Thies ThiesSenegal Cardiology Department Regional Hospital of Saint LouisSaint LouisSenegal Cardiology Department Dalal Jamm HospitalDakarSenegal

Introduction: Exercise echocardiography is a non-invasive technique that occupies a special place for the detection of stable coronary disease. The main objective of this study was to report our experience and assess our practice in the diagnosis of stable coronaryartery disease. Methodology: We conducted a retrospective study, descriptive over a period of 34 months, from December 1, 2016 to September 30, 2019. All the patients received during the study period for stress echocardiography as part of a suspicion of stable coronary artery disease were included. A total of 100 examinations were completed during the study period. Results: Ninety (90) exams were studied. There were 56 men or a sex-ratio of 1.64. The mean age was of 57.3 ± 10 years. Hypertension (31 patients or 62%) was the most frequent risk factor. Typical chest pain was noticed in 45 patients (52.3%). The pre-test probability was intermediate in 77 patients (89.5%). Echocardiography at rest was normal in 86 patients (95.6%). A total of 62 tests were negative (69%) and 02 (2.2%) were non-contributory. Ten tests (10) of 26 electrical positive tests were associated with segmental kinetics disorders. In the 10 patients who had exercise kinetic disorders, 08 had coronary angiography. It was normal in 04 of them. The positive predictive value of exercise echography was 50% in our study. In a patient with a negative exercise echocardiography with a high clinical probability of coronary disease, the coronary angiography showed a two-vessel impairment with an intermediate lesion of Cx2 and an intermediate lesion of RCA2. It thus constitutes a false negative. Sensitivity was 80% in our study. We noticed an incident like non-sustained ventricular tachycardia. Conclusion: Exercise echocardiography is a safe and reliable examination for the diagnosis of stable coronary artery disease. A good selection of patients based on the clinical probability of coronary ischemia should improve our sensitivity. This is even more

关键词： Exercise Echocardiography Coronary Artery Disease

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Neurological Involvement in Systemic Lupus Erythematosus (SLE): Our Recent Experience

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第2期9卷 25-34页

作者： B. S. Kane M. Dieng B. C. Fall M. Sow A. C. Ndao B. Djiba M. Niasse N. Diagne A. Faye S. Ndongo A. Pouye Department of Internal Medicine Le Dantec Teaching Hospital Cheikh Anta DIOP university of dakar Dakar Senegal Department of Rheumatology Le Dantec Teaching Hospital Cheikh Anta DIOP university of dakar Dakar Senegal

Introduction: The central, psychiatric and peripheral neurological manifestations of lupus are among the most severe visceral disorders and are grouped under the general term of “neuro-psychiatric systemic lupus erythematosus” (NPSLE). We conducted a cross-sectional observational study within our Department of Internal Medicine aimed at describing the clinical and evolutionary aspects of central neurological disorders of SLE, excluding lupus myelopathy. Patients and Methods: This was a retrospective and observational cross-sectional study carried out from 1 January 2015 to 31 October 2017, in the Department of Internal Medicine of Aristide le Dantec university hospital in dakar (Senegal). All patients hospitalized during this period who met the 1997 ACR classification criteria of SLE and who presented with a central neuropsychiatric syndrome attributable to SLE (as defined by ACR 1999) were included. Patients with isolated headache, acute myelitis or secondary neurological involvement attributable to a toxic, metabolic, infectious or tumour-related cause were excluded from our study. Results: During the study period, 10 patients with neuropsychiatric lupus involvement were treated at our institution, including 9 women and 1 man;the median age was 29 years (20 - 55 years). Neurological involvement occurred during the course of lupus evolution in 9/10 cases. The median time to SLE evolution was 18 months (0 - 60 months). Neuropsychiatric syndromes as defined by the 1999 ACR were commonly associated and more than half of our patients had multiple neuropsychiatric syndromes. There were 5 cases of confusion syndrome and coma, 4 cases of seizure, 3 cases of psychosis, 2 cases of acute cerebrovascular disease and 1 case of aseptic meningitis. Among the extra-neurological manifestations of SLE, haematological and dermatological involvements were common. Renal involvement affected half of the patients. The other manifestations were: polyarthritis in 3 patients, serositis in

关键词： Systemic Lupus Erythematosus Lupus Vasculitis Central Nervous System Africa South of the Sahara

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The Epidemiological, Clinical, Paraclinical and Prognostic Aspects of Severe Malaria at the Regional hospital of Thies

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Advances in Infectious Diseases 2018年第3期8卷 162-171页

作者： Agbogbenkou Tévi Déla-dem Lawson Madoky Magatte Diop Viviane Marie Pierre Cisse Stéphanie Akanni Adama Berthe Papa Souleymane Toure Bernard Marcel Diop Mamadou Mourtalla Ka Department of Health Thies University Thies Senegal Internal Medicine Department Thies Regional Hospital Center Thies Senegal Infectious and Tropical Diseases Department Fann Teaching University Hospital Dakar Senegal

Introduction: Malaria, the first parasitical endemic disease in the world, is a serious disease with 407,000 deaths in Africa in 2016. It is the main cause of morbidity and mortality in Senegal [1] [2]. Methods: Our retrospective study carried out from 1st January 2010 to 31 December 2013, at the department of internal medicine in the regional hospital of Thies was aimed at studying the epidemiological, clinical, paraclinical and prognostic profile of severe malaria in the autochthonous adults with 15 years and more. Results: Over this 3-year period, 57 patients were hospitalized in 1275 patients due to severe malaria that is to say a hospital prevalence of 4.47%. The average age was 64.21. A clear male predominance has been observed, around 61% (34/57) against 39% (23/57) with a sex ratio of 1.6. The highest malarial infestation rate was found at the end of the rainy season and at the beginning of the dry season (September to November). The clinical picture which predominates is the neurological affection which represented 33.3% of the cases. The different aspects of this neurological affection were of coma type, convulsion and prostration in 87%;21.7% and 8.6% respectively. The cerebral malaria was associated or not with other symptoms of severity that are anemia in 41.6%;icterus was represented in 21% of the cases, cardio-vascular collapse in 15.8% and hypoglycemia in 5.5% of the cases. The complications were observed during the hospitalization in 73.6% of the cases with the type of bacterial pneumonia (47.6%) and urinary infections (26.2%). The curative treatment was based on quinine salts through intravenous track in 100% of the case with a shift to the Artemisinin combination therapy (ACT) associated with intense care measures. In our study the whole lethality is 17%. Conclusion: The results of our study shows that the severe forms of malaria are still affecting our tropical endemic area, in spite of the prevention efforts made to fight against this plague. Th

关键词： Malaria Severe Malaria Quinine ACT

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Assessment of Total Incapacity for Work or Incapacity in the Criminal Sense in Case of Penetrating Wounds of the Neck

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Forensic Medicine and Anatomy Research 2018年第1期6卷 1-9页

作者： El Hadji Oumar Ndoye Bobo Diallo Sidy Ahmed Dia Mouhamed Manibiliot Soumah Mame Coumba Fall Mor Ndiaye Department of Forensic and Labor Medicine University Cheikh Anta Diop (UCAD) Dakar Senegal ENT Department of the university hospital Center of fann Dakar Senegal

Penetrating wounds of the neck are often life-threatening. The victims are exposed to vascular and laryngotracheal lesions. The purpose of this work is to report the various aspects of the management of penetrating wounds in our context and to make the medico-legal assessment of incapacity in the criminal sense or total incapacity for work. This is a retrospective study (2002-2014) on thirty-nine (39) cases of penetrating neck wounds, received at the ENT departments of the Aristide Le Dantec and fann university hospital Centers. Patients were predominantly male, representing 94% of cases with an average age of 27 years. Seventy (70%) of the accidents occurred in the region of dakar. In 42% of cases, the circumstance of occurrence was a fight or an assault. The weapon used in most cases by the aggressor was a cutter or a knife. The average waiting time was 37 hours with extremes of 02 and 216 hours. Surgically, all patients had been examined under general anesthesia. In terms of lesions, 37 cases had profound cervical muscle injuries, i.e. 94%. There were 17 vascular lesions (43%). The medico-legal distribution of patients showed that among them, 10% had a total incapacity to work exceeding 21 days. The determination of total incapacity for work is an important medical procedure that requires capability and experience. The doctor must not fall into the trap of the confusion between the TIW on the criminal level and the TIW on the civil level. He must limit medically and should not make judgments.

关键词： Penetrating Neck Wounds Assessment of Total Incapacity for Work Criminal Incapacity Forensic Medicine

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Child’s Cardiopathies at the hospital De La Paix in Ziguinchor (Senegal)

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Open Journal of Epidemiology 2022年第1期12卷 50-56页

作者： Simon Joël Manga Sena Laurenda Houngbeme Mohamed Leye Lamine Thiam Sidy Lamine Sy Quinta Indafa Te Cardiology Department Hospital De La Paix Assane Seck University of Ziguinchor Ziguinchor Sénégal Paediatric Department Hospital De La Paix Assane Seck University of Ziguinchor Ziguinchor Sénégal Cardiology Department Regional Hospital of Mbour Thiès University Thies Sénégal Cardiologie Department Fann National University Center Dakar Sénégal

Introduction: Childhood heart disease consists of congenital and acquired heart disease. The aim of this study was to describe the epidemiological profile and the clinical and aetiological characteristics of childhood heart disease at the H?pital de la Paix in Ziguinchor. Method: This was a retrospective study from 1 January 2016 to 1 June 2020 in the cardiology and paediatrics departments of the H?pital de la Paix in Ziguinchor. We included in the study all patients aged 0 - 18 years, hospitalised with heart disease confirmed by cardiac ultrasound. Results: In total, we included 57 patients in the study. The hospital prevalence was 1.6%. The average age was 67.85 ± 65 months. The predominance was male with a sex ratio of 0.96. The majority of mothers (50%) were between 15 and 30 years old. In our study, 8.85% of patients had a history of previous angina. Trisomy 21 was present in 12.35% of our patients. Severe acute malnutrition was found in 21.05% of cases. Lower limb oedema (82.4%) and dyspnoea (59.6%) were the most frequent clinical signs. On cardiac ultrasound, 52.6% of patients had congenital heart disease and 47.4% of patients had acquired heart disease. Ventricular septal defect (33.33%) was the most common congenital heart disease. Among the acquired heart diseases, mitral insufficiency predominated with 70.8% of cases. Infective endocarditis was the main complication observed. Management was mainly drug-based with diuretics and ACE inhibitors. No patient had undergone surgery. The in-hospital evolution was favourable in 85.9% of cases and the mortality rate was 10.5%. Conclusion: Our study showed that congenital heart disease was more frequent than acquired heart disease and that management, particularly surgery, was lacking.

关键词： Heart Disease Child Ziguinchor De La Paix hospital

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