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Acute Renal Failure in the Elderly in the nephrology department of aristide le dantec hospital in Senegal: About 45 Cases

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Open Journal of nephrology 2023年第4期13卷 451-463页

作者： Arlette Géraldine Nguea Ndjame Ameth Dieng Vincent Ebenezer Ngamby Mamadou Coume El Hadji Fary Ka Maria Fall Ahmed Tall lemrabott Mouhamadou Moustapha Cisse Abdou Niang department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Central hospital of Yaoundé Yaoundé Cameroon Health Sciences Training and Research Unit University of Thiès Thiès Senegal Regional hospital of Thiès Thiès Senegal Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop University Dakar Senegal National University hospital of Fann Dakar Senegal aristide le dantec hospital Dakar Senegal Dalal Jamm National University hospital of Guédiawaye Dakar Senegal

Introduction: The incidence of acute renal failure (ARF) increases with age. In Senegal, few studies have described the epidemiology of ARF in the elderly. The aim of our study is to establish the epidemiological profile of elderly patients with ARF, identify the causes of ARF in the elderly and assess treatment and prognosis. Methods: We conducted a descriptive and retrospective study over a five-year period from 2011 to 2015 involving patients aged 60 and over, treated for ARI during the study period. Data entry and analysis were done on Epi info 7.3. Results: We included a total of 45 patients. The prevalence of ARF was 3.34%. The mean age was 70.31 years (60 - 83) and the sex ratio was 3.5. Phytotherapy was found in 68.9%, hypertension was found in 68.9%, and diabetes was found in 31.1%. Prostate hypertrophy was found in 53.4% of patients. Pre-renal ARF was the most common (46.6%). Most of the cases, 66.67%, were at Stage 3 of KDIGO. The most common etiologies were respectively tumor (35.5%) and infection (20%). The most common complications were respectively hyperkalemia (33.3%) and hyponatremia (33.3%). Recovery was complete in 62.6% of cases, partial in 37.8% of patients and 13.3% of patients ended up on chronic hemodialysis. Mortality was 4.4%. Conclusion: Herbal medicine, hypertension and diabetes are frequently associated with ARF in the elderly. This justifies increased monitoring of the elderly subject with these conditions in order to subject him to early and appropriate care.

关键词： Acute Renal Failure Elderly Epidemiology

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Phenotypical Aspects of a Familial Syndromic Retinitis Pigmentosa

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Open Journal of Ophthalmology 2024年第2期14卷 168-173页

作者： Irma Eneida Dos Santos Joseph Matar Mass Ndiaye Mariama Diambone Badji Alioune Abdoulaye Ndongo Gerauld Akpo Jean Pierre Diagne Gabriel Karold Mendy Mouhamed Attye Aboubacry Sadikh Sow Elhadji Amadou Ba Paule Aida Ndoye Roth Ophthalmology department of aristide le dantec hospital Dakar Senegal Pediatric department of aristide le dantec hospital Dakar Senegal Radiological Imaging department of aristide le dantec hospital Dakar Senegal Ophthalmology department of Abass Ndao hospital Dakar Senegal

Aim: To report a familial case of syndromic retinitis pigmentosa identified at aristide le dantec hospital in Dakar and to describe their clinical characteristics ophthalmic. Observation: We report a sibling group of nine children, four died at a young age from unknown causes. Three children were affected by retinitis pigmentosa, two cases were syndromic. A history of nyctalopia was found in all three affected children. The mean age of onset of decreased visual acuity was 6.6 years. Patient 1 affected by syndromic retinitis pigmentosa had an extraocular sign of cystic dilation of the main bile duct. Patient 2 had myoclonic epilepsy, psychomotor retardation, and the molar tooth sign on cerebral MRI (highly suggestive of Joubert syndrome). The third child had isolated retinitis pigmentosa. Ophthalmological examinations (fundus examination, electroretinogram, and visual evoked potentials) and pediatric examinations in the remaining two children were normal. Discussion and Conclusion: Retinitis pigmentosa is a rare degenerative disease that can be associated with several other malformations, highlighting the importance of screening for associated conditions. It presents a grim functional prognosis and a life prognosis dependent on extraocular manifestations. Molecular biology (karyotyping, next-generation sequencing) could have identified the implicated genes and allowed for a formal diagnosis and genetic counseling.

关键词： Retinitis Pigmentosa Syndromic Heredity Ciliopathy

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Eyelid Wounds: Epidemiological, Clinical and Etiological Aspects

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Open Journal of Ophthalmology 2024年第1期14卷 55-62页

作者： Aly Mbara Ka Jean Pierre Diagne Aissatou Aw El Hadji Malick Sy Soda Mbaye Hawo Madina Diallo Audrey Samra Aboubacry Sadikh Sow Joseph Matar Mass Ndiaye Ousmane Ndiaga Senghor Lamine Ndiaye Mohamed Ndiaye Serigne Sohibou Gaye Papa Amadou Ndiaye Ophthalmology department of Abass Ndao hospital Dakar Senegal Ophthalmology department of aristide le dantec hospital Dakar Senegal

Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period from 2012 to 2021. We collected and analyzed the data using Excel. Results: The frequency of eyelid wounds was 0.1%. The average age of our patients was 19.38 years with a range of 1 and 62 years. The sex ratio was 3.7. Eighty-one percent of patients lived in Dakar. Fifty-seven percent (57%) of patients consulted less than 24 hours after the trauma and 7% of patients on D1. The circumstances were brawls (11%), domestic accidents (9%), road accidents (6%), and work accidents (6%). We noted 1 case of dog bite. Thirteen patients presented with post-traumatic decreased visual acuity. Involvement of the isolated upper eyelid was noted in 40% of cases and both eyelids in 15% of cases. Involvement of the lacrimal ducts was noted in 17% of cases, and that of the free edge in 21% of cases. Eyelid wounds were associated with eyeball damage in 21% of cases. Various associated lesions were observed. Ninety-one percent of patients received surgical treatment. Three cases of superinfections, 1 case of conjunctival granuloma and 1 case of phthysis of the eyeball with postoperative retinal detachment were noted. Conclusion: Eyelid sores are relatively common in our context. They require rapid surgical treatment in order to preserve the functional and aesthetic prognosis. .

关键词： Eyelid Wounds Epidemiology Clinic Etiologies

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High Urine Retention: Experience in a Series of Patients with Renal Failure Patients

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Open Journal of Urology 2024年第1期14卷 1-10页

作者： Cyrille Ze Ondo Abdoulaye Ndiath Amath Thiam Alioune Sarr Ndiaga Seck Ndour Ousmane Sow Babacar Sine Babacar Diao Alain Khassim Ndoye Urology department Aristide Le Dantec Hospital Dakar Senegal Urology department Ouakam Military Hospital Dakar Senegal

Purpose: High urinary retention (HUR) can negatively impact renal function. Our study aimed to present the epidemiological, diagnostic, and therapeutic aspects of HUR in a Senegalese academic hospital. Patients and Methods: We conducted a retrospective study of 70 patients with HUR associated with renal failure from January 2017 to December 2020. Parameters examined included: age, sex, coexisting conditions affecting renal function, clinical symptoms, diagnostic tests, causes of HUR, urinary diversion, and patient outcomes. Results: The average age was 66, with a majority of male patients (87%). Twenty-three patients had pre-existing medical conditions. Oligo-anuria was the most common reason for detecting HUR (70%). Half of the patients had an ECOG score ≥ 2. The mean creatinine level was 50.7 mg/l. Nineteen patients exhibited hydroelectrolytic disorders. Bacterial colonization was observed in 25 patients. Ultrasound and computed tomography were the most frequently performed imaging tests (100% and 62.8%, respectively). Sixty-seven patients had ureterohydronephrosis (UHN), with bilateral UHN in 88.6% of cases. Pelvic cancers (47.1%) were the primary cause of HUR, primarily bladder cancers (27.1%). Nephrostomy was the most common urinary drainage method (50%), particularly for obstructions due to pelvic cancer (88.6%). The majority of patients (52.8%) regained normal renal function after drainage. Nineteen deaths occurred among elderly patients with compromised general health. Conclusion: Urinary drainage significantly improved renal function for most patients. Pelvic cancer emerged as the leading cause of HUR. Nephrostomy was the predominant drainage method.

关键词： Kidney Urinary Retention Renal Failure Urinary Diversions Senegal

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Obstructive Tumor of the Palate in the Old Person: A Case Report

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Open Journal of Stomatology 2024年第5期14卷 199-205页

作者： Silly Toure Mouhamadou Makhtar Ndiaye Abibou Ndiaye Mamadou Coume Mame Sanou Diouf Baye Karim Diallo Maxillofacial Surgery and Stomatology department Aristide Le Dantec University Hospital of Dakar Dakar Senegal Geriatrics department Aristide Le Dantec University Hospital of Dakar Dakar Senegal ENT and Head and Neck Surgery department FANN University Hospital of Dakar Dakar Senegal

Introduction: Pleomorphic adenoma or mixed salivary gland tumor is a heterogeneous benign tumor of the salivary glands. The most common site is the parotid gland. Its extra-parotid locations, particularly in the accessory salivary glands, are rarer. We report a case of a pleomorphic adenoma of the posterior palate which posed management problems. Observation: This is an 85-year-old patient who consulted for a tumor of the posterior palate that had been evolving for 3 years. The examination revealed a globular tumor of the posterior palate extending beyond the midline by approximately 7 cm in long axis, shooting towards the oropharynx and hindering breathing, speech and eating, indicating a life-saving tracheotomy. A CT scan of the facial area revealed a well-circumscribed tumor at the expense of the soft palate, with multiple sites of bone lysis. The biopsy performed was in favor of a pleomorphic adenoma. The patient underwent total surgical excision of a huge tumor on the palate. The aftermath of the operation was marked by a loosening of the sutures with an oronasal fistula requiring the creation of an obturator plate due to the patient’s refusal to have another operation. Conclusion: Large pleomorphic adenoma of the posterior palate is a rare entity that can cause respiratory problems and surgical difficulties. His prognosis is generally good.

关键词： Pleomorphic Adenoma Posterior Palate Respiratory Disorders Prognosis Obturator Plaque

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Thrombolysis in Pulmonary Embolia at the Cardiology department of aristide le dantec Cardiology department

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World Journal of Cardiovascular Diseases 2024年第9期14卷 521-538页

作者： Joseph Salvador Mingou Marguerite Téning Diouf Fatou Aw Simon Antoine Sarr Khadim Rassoul Diop Malick Bodian Mouhamadou Bamba Ndiaye Maboury Diao Abdoul Kane Cardiology department Aristide le Dantec Hospital Dakar Senegal Cardiology department Dalal Jam Hospital Dakar Senegal

Introduction: Venous thromboembolic disease is the 3rd most common cardiovascular pathology. Acute pulmonary embolism constitutes its most serious presentation and a major cause of mortality, morbidity and hospitalization in Africa and Senegal. The objectives of this work were to study the epidemiological profile of pulmonary embolisms and to evaluate the practice of thrombolysis in patients in a cardiological setting. Methodology: A retrospective, descriptive study was carried out in the Cardiology department of the aristide le dantec hospital (HALD) over the period from August 2011 to December 2019 in patients hospitalized in the cardiology department for pulmonary embolism confirmed by CT angiography and/or with thrombi on cardiac ultrasound and who had also benefited from thrombolysis. Results: Thirty-one patients with pulmonary embolism were thrombolyzed. There was a predominance of the female gender with an average age of 45.97 years. Risk factors were dominated by age (61.29%) followed by obesity (32.26%) and prolonged immobilization (22.5%). The functional signs were dominated by dyspnea (77.42%) followed by chest pain (51.62%) and cough (35.48%). The physical signs were dominated by right heart failure in 22.5% of cases, pulmonary condensation syndrome in 19.35%, and inflammatory large leg in 12.9% of cases. Echocardiography and chest CT angiography were the means of diagnosis. Nine of our patients presented with an intracardiac mass. Thrombotic treatment was administered in all patients. The average length of hospitalization was 12.32 days and in-hospital mortality was 32.26%. Conclusion: Pulmonary embolism does exist in our regions and is responsible for heavy mortality. Rapid and efficient support is essential. Prevention remains the corner-stone in the fight against this pathology.

关键词： Pulmonary Embolism Thrombolysis Senegal

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When the Combination of a Chinese Flap and Dufourmentel Makes It Possible to Treat a Hopeless Case of Squamous Cell Carcinoma of the Upper Lip

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Open Journal of Stomatology 2024年第7期14卷 327-335页

作者： Silly Toure Abibou Ndiaye Mouhamadou Makhtar Ndiaye Mamadou Coume Mame Sanou Diouf Baye Karim Diallo department of Maxillofacial Surgery and Stomatology CHU Aristide Le DANTEC Dakar Senegal Geriatrics department CHU AT LE DANTEC Dakar Senegal Otorhinolaryngology and Head and Neck Surgery department FANN University Hospital Dakar Senegal

Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.

关键词： Surgical Flap Reconstruction Aesthetic Lip Cancer-Plastic Surgery

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Infection in Multiple Myeloma: Microbiological Profile and Prognosis in Senegalese Patients

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Open Journal of Blood Diseases 2024年第2期14卷 47-58页

作者： Seynabou Fall El Hadj Daouda Niang Khadim Sarr Lolita Mariéme Camara-Tall Modou Moustapha Ciss Amy Thiam Aminata Dakono Awa Ndiaye Fatou Samba Diago Ndiaye Clinical Hematology department of Dalal Jamm hospital Gudiawaye Dakar Sngal Hematology Clinic Unit of aristide le dantec hospital Dakar Sngal

Introduction: Infections are additional factors of morbidity and mortality in multiple myeloma (MM), and the current recommendation is antibiotic prophylaxis. In sub-Saharan Africa, few data on infectious complications of MM are available. We aim to describe the microbiological features of infections in MM, and their impact on survival in Senegalese patients. Methods: A retrospective (January 2005-January 2022), analytic, multicenter study on infections in patients followed for MM (IMWG criteria) in Senegalese clinical hematology services. The socio-epidemiological, diagnostic, microbiological, evolutionary and survival aspects were analyzed. Results: The study included 106 patients with multiple myeloma who had an infection at admission or during the treatment. Ten patients have the comorbidity (hypertension, lupus, type 2 diabetes). These patients had 136 infectious events identified at diagnosis (79.2%) or during chemotherapy (20.8%). The sites of infection are lung (42.6%), urinary (29.4%), dermatological (6.6%), digestive (5.2%), osteoarticular (4.4%), ear, nose and throat (3.7%), central nervous system (1.5%), or without site. We recorded 26.4% of patients with multi-site infections. The causal pathogens are bacteria (Gram-negative bacilli: 22.1%;Gram positive bacilli: 9.5%, Mycobacterium tuberculosis: 13.3%), parasitique (plasmodium falciparum 6.6%), viruses (SARS-COV2: 2.9%, VZV: 2.2%) and fungal (2.9%). Survival was reduced in patients who had an infection at the time of multiple myeloma diagnosis (p: 0.189) and those who had multiple infectious foci (p: 0.011). Conclusion: Infections in multiple myeloma are more frequent at diagnosis. The germs are varied and mostly bacteria, particularly gram-negative bacteria, and Kochs bacillus. Our study reveals that multiple infectious foci are a poor prognosis factor. It is necessary to evaluate the infectious risk early, and to adopt an antibiotic prophylaxis based on our tropical environment.

关键词： Multiple Myeloma Infections Tuberculosis Senegal

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Management of Square Carcinoma of the Lower Lip Using Camille-Bernard Flap under Local Anesthesia: When Constraints Dictate Our Attitude

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Open Journal of Stomatology 2024年第4期14卷 191-197页

作者： Silly Toure Mouhamadou Makhtar Ndiaye Abibou Ndiaye Mame Sanou Diouf Birame Loum Baye Karim Diallo department of Maxillofacial Surgery and Stomatology CHU Aristide Le Dantec of Dakar Dakar Senegal ENT department Fann University Hospital Dakar Senegal

Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.

关键词： Squamous Cell Carcinoma Lower Lip Camille Bernard Flap Local Anesthesia

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Profile of Autoimmune Polyendocrinopathies at the Medical Clinic II of the Abass Ndao hospital: About 40 Cases

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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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