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Profile of Autoimmune Polyendocrinopathies at the medical clinic II of the Abass Ndao hospital: About 40 Cases

Open Journal of Internal Medicine 2024年第1期14卷 74-82页

作者： Michel Assane Ndour Djiby Sow Mouhamed Dieng Ibrahima Mané Diallo Boundia Djiba Mélaine Honorine Olympio Julie Borges Preira Muriel Diembou Fatou Kiné Gadji Fama Ndiaye El Hadj Mamadou Moussa Thioye Charles Halim Demba Diédhiou Anna Sarr Maïmouna Ndour Mbaye Abass Ndao hospital Internal Medicine Department Cheikh Anta Diop University Dakar Senegal aristide le dantec hospital Internal Medicine Department Cheikh Anta Diop University Dakar Senegal

Introduction: Autoimmune polyendocrinopathies (AP) represent a group of rare concomitant pathologies, making them underdiagnosed. The objective was to study their profile at the medical clinic II of the Abass Ndao hospital. Patients and Methods: This was an observational, descriptive and analytical study, lasting 24 months, from January 1, 2020 to December 31, 2022. We assessed the epidemiological, clinical and paraclinical characteristics of the patients and classified the APs found. Results: We included 40 patients divided into type III (38 cases) and IV (2 cases). A female predominance was noted with a sex ratio of 0.21. The mean age was 38.6 years. A family history of component diseases of autoimmune polyendocrine syndrome (APS) was found in 62.5%. Goiter (80%) was the main clinical sign present. All 38 patients with ISAP-3 had autoimmune thyroiditis, including 29 cases of Graves’ disease (72.5%) and 9 cases of Hashimoto’s thyroiditis (22.5%). They were associated with either type 1 diabetes (57.9%), Biermer’s disease (21.1%), vitiligo + alopecia (18.4%), lupus (2.6%). The 2 patients with AP-4 had Biermer’s disease associated with either Addison’s disease or type 1 diabetes. Management depended on the pathologies present and their possible complications. The immunological phenomena were also controlled. Conclusion: This series is globally similar to the literature. The polymorphous character of the clinical pictures requires a better collaboration between specialists leading to a clinical and holistic synthesis.

关键词： APS Biermer Graves’ Disease Hashimoto’s Addison’s Vitiligo Senegal

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Immunoprophylaxis failure and vaccine response in infants born to mothers with chronic hepatitis B infection in Djibouti

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World Journal of Hepatology 2024年第7期16卷 1039-1050页

作者： Sahal Darar Dirir Ambroise D Ahouidi Aboubacry Drame Warsama Osman Abdi Guelleh Youssouf Kayad Mohamed Houmed Aboubakar Makhtar Camara Coumba Toure Kane Halimatou diop Ndiaye Laboratoire medical de la Caisse National de SécuritéSocial de Djibouti Caisse National de SécuritéSocial de DjiboutiDjibouti BP 696Senegal Parasitology Institut de Recherche en santéde Surveillanceépidémiologique et de FormationDakar 7325Senegal Ecole Doctoral UniversitéAlioune Diop de BambeyDakar 7325Senegal Department of Des Soins Caisse National de Securite SocialDjibouti 696Senegal Centre de Soin Caisse National de Securite SocialDjibouti 696Senegal Laboratoire medical Mer Rouge Djibouti 99399Senegal Centre hospitalier Universitaire aristide le dantec Laboratoire Bactériologie-Virologie-Hôpital Aristide le DantecDakar 7325Senegal Department of Virology Institut de Recherche en Santéde Surveillanceépidémiologique et de FormationDakar 7325Senegal Bacteriology and Virology Laboratory Le Dantec University Teaching HospitalDakar BP 7325Senegal

BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected *** mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by *** screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive *** To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti *** We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their *** study ran from January 2021 to May 2022,and infants were followed up to 7 mo of *** serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at *** infants were closely monitored to assess their seroprotective response and for failure of *** logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine *** statistical analyses were performed with version 4.0.1 of the R *** Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 *** MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/*** the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB100 mIU/mL)after HBV vaccination and hepatitis B immunoglobulin,while 40(84%)infants achieved a good level of seroprotection(anti-HB>100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA lev

关键词： Hepatitis B surface antigen Infants Hepatitis B immunoglobulin Hepatitis vaccine Djibouti

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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

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Scapula Fracture in a Child: Report of a Rare Injury

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Open Journal of Pediatrics 2023年第2期13卷 158-163页

作者： Florent Tshibwid A. Zeng Mbaye Fall Nankouman Konaté Faty Balla Lô Eben-Ezer Samé Souleymane Camara Aimé Lakh Faye Fall Oumar Ndour Gabriel Ngom Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Cheikh Anta Diop University Dakar Senegal Department of Pediatric Surgery Albert Royer National Children’s Hospital Center Cheikh Anta Diop University Dakar Sene-gal

Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-year-old patient admitted for blunt trauma of the left shoulder after falling from a speeding car. The diagnosis of a displaced fracture of the body of the scapula was made, and non-operative treatment was indicated and carried out for four weeks, followed by physiotherapy for another four weeks. Nine weeks after the trauma, the mobility of the affected shoulder was equivalent to that of the contralateral shoulder.

关键词： Fracture Scapula Child Non-Operative Management Case Report

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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

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Management and Outcome of Ureteropelvic Junction Obstruction in Senegalese Children

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Open Journal of Urology 2022年第11期12卷 549-555页

作者： Ibrahima Bocar Wellé Ndeye Aby Ndoye Papa Alassane Mbaye Doudou Gueye Ndeye Fatou Seck Faty Balla Lo Lissoune Cissé Anderson Safari Kibanja Florent Tshibwid A. Zeng Youssouph Diedhiou Aloï se 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: The ureteropelvic junction obstruction is a rare congenital malformation of the upper urinary tract. We report its management and outcome at Senegal’s main pediatric surgical department. Patients and Methods: We conducted a descriptive review of all patients managed in our pediatric surgical department at Albert Royer National Children’s hospital Centre from January 1st, 2013 to December 31st, 2017. Results: Thirty patients were included in our study. The mean age was three years. Males were more affected (sex ratio of 2.75). The prenatal diagnosis was made in 23% of cases using prenatal ultrasonography. An abdominal mass was the circumstance of discovery in 36% of cases, and lumbar contact and renal sloshing were found in 66% of cases. There was no renal function impairment in 93% of cases. Urinary tract infection occurred in 50% of cases. Ultrasonography (100%) and urinary computed tomography (56%) were used to diagnose. A temporary nephrostomy was performed in 23% of cases, and as definitive treatment, an open Anderson-Hynes procedure was performed in 96% as a nephrectomy was made in a patient. Early postoperative complications were encountered in 56% of cases: urinary tract infection (36%), surgical site infection and anastomotic stenosis (6% both), and urinoma and textiloma (both in 3%). A patient died from sepsis. After a mean follow-up of 12 months, no additional complication was reported. Conclusion: Ureteropelvic junction obstruction was frequently diagnosed late, and its management carried unneglectable morbidity in our environment. A laparoscopic approach would be a solution to improve its outcome.

关键词： Ureteropelvic Junction Obstruction Management Outcome Children Senegal

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Characterization of Bleeding and Laboratory Phenotype in Hemophilia A Carriers: A Cross-Sectional Study in Benin

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Open Journal of Blood Diseases 2023年第4期13卷 148-159页

作者： Tatiana Baglo Agbodandé Alban Zohoun Abdel Aziz Ouabi Edwige Araba Bienvenu Houssou Romaric Massi Charlotte Orou Guiwa Ludovic Anani Dorothée Kindé Gazard Awa Oumar Touré Fall Hematology Laboratory National Teaching Hospital Hubert KoutoukouMaga of Cotonou Cotonou Benin Faculty of Health Sciences University of Abomey-Calavi Cotonou Benin Hematology Laboratory of The aristide le dantec hospital Dakar Senegal Pharmacy and Odontostomatology Faculty of Medicine Cheikh Anta Diop University of Dakar Dakar Senegal

Background: In Africa, hemophilia is underdiagnosed and carriers have long been considered free from bleeding symptoms. However, recent research has begun to reveal hemostatic abnormalities and bleeding manifestations in carriers of hemophilia A, particularly due to excessive inactivation of normal X chromosomes. Objective: To describe the bleeding symptoms and hemostatic abnormalities in carriers of hemophilia A (HA) in Benin. Methods: This study was conducted as a prospective cross-sectional investigation between April 2021 to March 2022. The study population consisted of identified through pedigrees of persons with hemophilia A being treated in various hospitals in Benin. Data were collected through interviews conducted by trained physician and each carrier underwent a biological workup. Results: A total of 71 hemophilia A carriers were included and 38 of whom were obligatory carriers. Thirty-one carriers (43.7%) reported abnormal bleeding symptoms. Menorrhagia has (71%) being the most important manifestation, followed by bleeding during or after childbirth (45.2%). Among the 71 carriers, 45 were of reproductive age. Of whom 22 (48.8%) had a Higham score exceeding 100. Activated partial thromboplastin time was prolonged in 7 carriers (9.9%). The mean activity factor VIII:C (FVIII:C) levels were 68.8 ± 34.9 IU/dL. The average FVIII:C level in obligatory carriers was 56.9% and among potential carriers, the average FVIII:C level was higher at 80.4%. However twelve female carriers (16.9%) had FVIII:C levels le drivers. Obligatory carriers (p = 0.00003) and FVIII;C/FvWAg ratio = 0.003) were statistically associated with abnormal bleeding symptoms, while blood group O (p = 0.0002) and FVIII/FvWAg ratio = 0.0016) were associated with a higher risk of menorrhagia. Conclusion: In Benin, carriers of haemophilia A present bleeding symptoms and haemostatic abnormalities. Further studies on a larger number of carrie

关键词： Carrriers of Hemophilia A Bleeding Symptoms APTT Factor VIII FVIII:C/FvW:Ag ratio

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Pernicious Anemia Associated Autoimmune Diseases in a Sub Saharian African Internal Medicine Service

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Open Journal of Internal Medicine 2014年第3期4卷 59-63页

作者： Abdoulaye Pouye Seynabou Fall Dieng Daher Abdoukarim Oumar Fatou Samba Diago N’Diaye Nafissatou Diagne Sakho Atoumane Faye Souhaibou N’Dongo medical clinic 1 university teaching hospital aristide le dantec/cheikh anta diop university of dakar Dakar Senegal

Introduction: Pernicious anemia is an autoimmune disease. It is characterized by the presence of an autoimmune atrophic gastritis and various autoantibodies that lead to a vitamin B12 deficiency responsible for a macrocytic anemia. It is frequently associated with other specific or non-organ- specific autoimmune diseases. We report six patients with pernicious anemia associated with other autoimmune diseases. Patients and Results: There were six patients (4 females/2 males), mean age of 39.67 years. In all cases it was found macrocytic anemia. The average Hb was 6.08 g/dl and the average MGV: 110.67 fl. Bone marrow aspiration was performed in all patients. Megaloblastosis compatible with a lack of vitamin B12 or folic acid was constant. Determination of serum vitamin B12 was low in all cases while folic acid levels were within standards. Immuno- logically it was found in all patients, a positivity of anti-intrinsic factor antibody and/or anti- parietal cells antibody at rates up to 67 times over normal ranges. Pernicious anemia was associated with autoimmune thyroid dysfunction in 4 patients. It was two cases of Hashimoto thyroiditis at hypothyroidic phase (high TSHus, thyréoperoxydase anti-antibody positive (over 10 N) in both cases and Graves’ disease in the two other cases. Pernicious anemia was associated with a syndrome of primary antiphospholipid antibody in a case. Furthermore pernicious anemia was found in a patient autoimmune type 1 diabetes with strongly positive anti -GAD antibodies and rheumatoid arthritis by retaining it in the diagnosis of multiple autoimmune syndrome. Conclusion: These cases illustrate the existence of the association of pernicious anemia with other autoimmune diseases in our context. This should encourage practitioners to seek hided autoimmune diseases when they consider the diagnosis of pernicious anemia.

关键词： Pernicious Anemia Auto-Immune Diseases Auto Immune Thyroid Dysfunction Multiple Auto-Immune Syndrome

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clinical Management and Long-Term Follow-Up of Patients with Peripartum Cardiomyopathy: A Prospective Registry Study

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Open Journal of Epidemiology 2023年第3期13卷 167-177页

作者： Fatou Aw Simon Antoine Sarr Joseph Salvador Mingou Mohamed M. C. B. O. leye Malick Bodian Mouhammadou Bamba Ndiaye Abdoul Kane Maboury Diao Adama Faye Department of Cardiology University Hospital Center Aristide Le Dantec Dakar Senegal medical Department Cheikh Anta Diop University Dakar Senegal Training and Research in Health Sciences Unit University of Thies Thies Senegal Institute of Health and Development Department of Public Health and Research Support (CHU Fann) Dakar Senegal

Introduction: Peripartum cardiomyopathy (PPCM) is a rare pathology in Western countries but is common in Africa. Its progression is highly variable, left ventricular function improves in almost one-third to one-half of patients. In sub-Saharan Africa, there are few prospective cohort studies. We aimed to describe the long-term evolutionary aspects of this pathology in a sub-Saharan African country, so we developed a PPCM registry;here, we present the first results after 2 years of follow-up. Methodology: This work was performed at the cardiology clinic of the aristide le dantec teaching hospital of dakar from January 01, 2017, to January 01, 2021, for a total duration of 4 years. This was an observational, longitudinal prospective study including patients admitted for peripartum cardiomyopathy. Results: During our study, 5372 patients were admitted to the cardiology clinic. Considering the inclusion criteria, 79 patients were consecutively recruited. The mean age was 30.5 ± 6.7 years, ranging from 18 to 42 years. Half of the patients came from rural areas (56.3%), and 78.2% of patients had a low socioeconomic status. Multiparity and twin pregnancies were noted in 72.8% and 20% of the patients, respectively. A total of 91% of patients had advanced NYHA stage 4 heart failure, and 3 patients had cardiogenic shock. left ventricular dilatation was found in 52 patients, and severe left ventricular systolic dysfunction was found in 50 patients (90.9%). During hospitalization, 19 patients (34.5%) had complications. The evolution in the hospital was favourable in 45 patients (81.8%). The global mortality rate was 7.3% at 2 years. In multivariate analysis, fewer patients with a dilated left ventricle, a severe alteration of the LVEF and an advanced age progressed towards remission. Conclusion: The long-term evolution of PPCM is very variable. Despite a good rate of remission, progression to end-stage heart failure and death is not negligible in cases of advanced maternal age

关键词： Peripartum Cardiomyopathy Pregnancy Cardiovascular Disease Senegal

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Efficacy and Risk Factors Associated to Resistance to Single-Agent Chemotherapy in Low-Risk Gestational Trophoblastic Neoplasia

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Open Journal of Obstetrics and Gynecology 2016年第1期6卷 50-55页

作者： Mamour Gueye Mame Diarra Ndiaye-Gueye Serigne Modou Kane-Gueye Fatou Niass Dia Aissatou Thiam Sr. Elisabeth Diouf Jean Charles Moreau Gynecologic and Obstetric clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal

Objectives: This study aimed to assess efficacy of intramuscular methotrexate 8-day protocol in the treatment of low-risk gestational trophoblastic neoplasia and also identify prognostic factors associated with treatment failure, necessitating second line chemotherapy. Methods: This study was performed at Gynaecologic and Obstetric clinic of dakar teaching hospital, the reference Centre of Gestational Trophoblastic Disease in Senegal. At the beginning of 2011, patients were followed according to FIGO’s recommendations. From 2011 to 2014, we diagnosed 88 low-risk gestational trophoblastic neoplasia (GTN) patients (WHO score le agent chemotherapy. Results: Eighty-eight patients were diagnosed for GTN during the study period. Average age was 31 years. The antecedent pregnancy was molar in 98.1% of cases. Seventy-four patients underwent remission after single agent-chemotherapy. Resistance rate to single-agent chemotherapy was 15.9% (14 patients). Nine of them achieved remission after second line chemotherapy. WHO score was significantly associated with the risk of resistance to single-agent chemotherapy. Other variables included in the WHO as age, antecedent pregnancy, pre-treatment hCG, tumour size and FIGO stage were not significantly associated with resistance. We report five fatal cases. Conclusion: The 8-day protocol consisting of 1 mg/kg MTX in combination with 0.1 mg/kg folinic acid (FA) every other day is effective for women with LRGTN. The only significant prognostic factor for failure is pretreatment WHO score. We highly recommend the use of this protocol particularly in de

关键词： Gestational Trophoblastic Neoplasia Chemotherapy International Federation of Gynecology and Obstetrics Resistance

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