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Cardiac Resynchronization Therapy in Heart Failure in Sub-Saharan Africa Environment: Experience of the principal hospital of dakar (Senegal)

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World Journal of Cardiovascular Diseases 2023年第7期13卷 349-358页

作者： Khadidiatou Dia Waly Niang Mboup Djibril Marie Ba Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Rabab Yassine Demba Ware Balde Mouhamed Cherif Mboup Department of Cardiology Hospital Principal of Dakar Dakar Senegal Department of Cardiology Military Hospital of Ouakam Dakar Senegal

Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve cardiac function and the quality of life of patients. However, in Sub-Saharan Africa, very few studies have been done on cardiac resynchronization which is in its infancy. The aim of this study is to report the local data from our hospital. Method: It was a transversal, descriptive and analytical study conducted from November 2019 to September 2022 at the Cardiology Department of the principal hospital of dakar. Results: Twelve patients were implanted for Cardiac Resynchronization Therapy (CRT). The sex ratio was 8 males/4 females. The average age was 67 ± 11 years. Ten patients had non-ischemic heart disease and the two others had ischemic one. All of them had NYHA III or IV scores before CRT. The Quality of Life (QOL) was judged as poor by all of the patients. The average duration of QRS was 156 ± 9 ms. 27.9% ± 5% was the mean Left Ventricular ejection fraction (LVEF). Complications occur in 3/12 patients (25%). It was one CS vein dissection, one micro LV lead dislodgement and one phrenic nerve stimulation. Nine patients, who were considered as responders, had an improvement of QOL and NYHA, the LVEF increased and the end-diastolic dimension, and the duration of the QRS interval all decreased. Two patients do not respond and one (1) who had permanent atrial fibrillation, was a secondary responder after an atrioventricular junction ablation. Conclusion: Cardiac resynchronization is a therapy that improves the QOL of patients, the LVEF and reduces the duration of the QRS interval. However, this procedure is not without risk of complications. In sub-Saharan Africa, the major challenge is to improve the financial accessibility of this therapy for the population.

关键词： Cardiac Resynchronization Therapy CRT Heart Failure Biventricular Pacing Sub-Saharan Africa

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Cardiovascular and Cerebrovascular Prognosis at 5 Years of Patients Who Presented with an Ischemic Stroke at principal hospital of dakar

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World Journal of Cardiovascular Diseases 2022年第1期12卷 77-86页

作者： Waly Niang Mboup Mame Madjiguène Ka Serigne Cheikh Tidiane Ndao Demba Ware Balde Djibril Mari Ba Khadidiatou Dia Pape Diadji Fall Mouhamed Cherif Mboup Department of Cardiology principal hospital/dakar (HPD) Dakar Senegal Department of Cardiology Military hospital of Ouakam/dakar (HMO) Dakar Senegal

Aims: To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. Methods: We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 2019 for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. Results: Overall, one hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%, with a sex ratio of 1.28. Patients’mean age was 66.33 ±13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0.6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke

关键词： Cardiovascular Cerebrovascular Prognosis Ischemic Stroke dakar

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Pulmonary Embolism in Young Patients: About 24 Cases at the Cardiology Department of dakar principal hospital in Senegal

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World Journal of Cardiovascular Diseases 2019年第9期9卷 632-638页

作者： Joseph Salvador Mingou Amadou Tidjani Saadou Madjiguene Ka Zoumana Sangaré Serigne Cheikh Tidiane Ndao Khadidiatou Dia Mouhamed Cherif Mboup Pape Diadié Fall Department of Cardiology Hospital Principal Dakar Senegal Departement of Cardiology Hospital Aristide Le Dantec Dakar Senegal

Introduction: Pulmonary embolism is a relatively common life-threatening cardiovascular emergency. It remains a diagnostic problem because of its nonspecific clinical signs. Objective: The general objective was to study pulmonary embolism in young patients admitted to the cardiology department of dakar principal hospital in Senegal. Methodology: This was a retrospective, descriptive and analytical study in the cardiology department of the dakar principal hospital over a period of two (02) years from January 1, 2015 to December 31, 2016 in young patients admitted for pulmonary embolism. Results: We collected 24 patients with a hospital prevalence of 2.18%. The average age was 42.29 years ± 8.41 years with a male predominance (sex ratio of 1.6). The Wells probability score was low in 54.16% of patients and medium in 45.83%. Functional signs were dominated by chest pain (83.33% of cases) followed by dyspnea (79.16% of cases). The thromboembolic risk factors found were gynecological-obstetrical in 16.6% of cases followed by prolonged bed rest. One case of thrombophilia was present with a deficiency of protein C and antithrombin III. The electrocardiogram recorded sinus tachycardia in 29.16% of patients;the Mac Ginn White sign (S1Q3T3) was found in 25% of cases. Echocardiography showed pulmonary arterial hypertension in 12.48% of cases, dilation of the right ventricle and a paradoxical septal motion in 14.28% of cases. CT pulmonary angiography showed 63.63% of cases with bilateral pulmonary embolism;it was unilateral in 22.72% of cases. Long-term anticoagulation was based on acenocoumarol 4 mg (66.7%) and Rivaroxaban (33.3%). 62.5% of the patients were seen at the 3rd month, when a checking was made to evaluate the tolerance of the treatment, and the evolution of the patient. Conclusion: Pulmonary embolism is not a rare condition in young subjects but is often underdiagnosed. Gyneco-obstetrical factors are predominant in this age group. Direct oral anticoagulants are mor

关键词： Pulmonary Embolism Young Patients dakar (Senegal)

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Neonatal Thrombocytopenia at dakar principal hospital

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Advances in Infectious Diseases 2023年第4期13卷 586-595页

作者： Guèye Mamadou Wagué Fall Khadija Gadji Macoura Diawara Papa Silman Ndoye Maguette Nakoulima Aminata Diop Daffé Sokhna Moumi Mbacké Ngom Mor Fall Mbène Niang Tagouthie Seye Meissa Ndew Fall Bécaye Laboratory Federation Dakar Principal Hospital (DPH) Dakar Senegal Pediatrics Department Dakar Principal Hospital Dakar Senegal Biological Hematology and Oncological Hematology Department (BHOH) National Blood Transfusion Centre (CNTS)/FMPOS Cheikh Anta Diop University Dakar Senegal

Neonatal thrombocytopenia accounts for 20% of neonates hospitalized in the neonatal intensive care unit (NICU) at DPH. The etiologies are multiple, but bacterial infection is the third leading cause of neonatal mortality worldwide. We therefore set out to assess the frequency of neonatal thrombocytopenia associated or not with bacterial infection in the NICU. We conducted a retrospective and prospective study with the DPH NICU, over 10 months (August 2018 and April 2019). Thrombocytopenia encountered in the NICUs, were the subject of research into bacteriological, inflammatory, and epidemiological parameters using Inlog laboratory data processing software. During this period, 1280 babies were hospitalized, 94 of whom underwent thrombocytopenia, corresponding to 7.34%, with a sex ratio of 0.92. The number of babies presenting with thrombocytopenia during the first week of hospitalization was 72, accounting for 76.6%. The clinical context was usually low birth weight in 30.8% of cases and perinatal asphyxia (25%). Thrombocytopenia ranged from 2000 to 137,000 with an average of 69,520/mm3. Among these thrombocytopenias, 64 cases (68%) were below 100,000 mm3 and 44 cases had a CRP >5 mg/l. A total of 30 bacteria were isolated, including 23 Enterobacteria, 2 Streptococci, and 1 Acinetobacter. Among these enterobacteria, 14 were multidrug-resistant (MDR). Thrombocytopenia associated with a multidrug-resistant bacterial infection is a real challenging management.

关键词： Neonatal Thrombocytopenia Bacterial Infection Enterobacteria Newborns

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Button Cell Ingestion in Infants: A Report of Five Cases

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Journal of Biosciences and Medicines 2024年第8期12卷 199-209页

作者： Mbène Fall Aminata Diop Nakoulima Khadija Fall Alice Ingabiré Goumba Mame Aïta Seck Tagouthie Niang Madawase Mboup Mame Diarra Mbacké Ibrahima Diallo Meissa Ndew Seye Department of Pediatrics Dakar Principal Hospital Dakar Senegal Department of Surgery Dakar Principal Hospital Dakar Senegal Department of Medecine Dakar Principal Hospital Dakar Senegal

Button cell ingestion is a common household accident among infants, often leading to serious complications that require immediate diagnosis and urgent removal. We report five cases of button cell ingestion involving infants aged between 9 and 32 months, including four boys and one girl. The ingestion was accidentally discovered in two infants, while in the other three, it was suspected during play. In three cases, mothers attempted to induce vomiting by giving fluids, but the batteries remained in the digestive tract for 38 hours to 5 days. After confirming the diagnosis, the batteries were removed within 4 to 36 hours. The locations of the cells were the esophagus in two cases, the cardia in one, the stomach in one, and the bowel in one. One case involved a large cell in the esophagus, while the others involved smaller cells. Complications occurred in four cases, including esotracheal fistula, esophageal ulceration, and perforation of the jejunum and caecum. In one case, the digestive mucosa appeared normal upon endoscopy. One patient died.

关键词： Button Cell Domestic Accident Infant

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Surgical Management of Uterine Fibroids: About 175 Cases

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 481-489页

作者： Ngom Papa Malick Faye Marie Edouard Gaye Yaye Fatou Sylla Mafing Aya Niang Ndama Samb Abdoulaye Ndiogou Bentaleb Hajar Inzale Mohamed Amine Koné Madjiguène Department of Obstetrics Gynecology Hospital Principal Dakar Dakar Senegal Department of Anesthesia Hospital Principal Dakar Dakar Senegal

Background: Uterine fibroids are a common condition in Senegal and often symptomatic. Our study aims to determine the epidemiological profile, to clarify the diagnostic aspects and to evaluate the surgical management of patients with uterine fibroids. Patients and Method: We carried out a retrospective and descriptive study carried out over a period of 30 months, from August 1, 2017 to January 31, 2020, concerning all patients who underwent surgery for the treatment of uterine myomatosis in the department of Gynecology Obstetrics of the hospital principal of dakar. The data was collected from the patients’ medical records and analyzed using Excel version 2016 and R version 4 software. Results: We collected 175 surgical interventions for uterine fibroids, representing 44.7% of gynecological interventions. Most of the patients were between 30 and 39 years old, with an average age of 39 years. The nulliparous were the majority with 64.6%. The clinical symptomatology was represented by genital bleeding (32.6%), pelvic pain (18.85%) and infertility (12.6%). The diagnosis was confirmed by pelvic ultrasound in all patients with variable myoma topography. A myomectomy was performed in 82.3% of cases and a total hysterectomy in 17.7%. The postoperative course was simple in 94.2% of cases, and the results of treatment revealed a disappearance of symptoms in 94.3% of cases. Conclusion: Surgery occupies a prominent place in the management of uterine fibroids.

关键词： Uterine Fibroid Myomectomy Pelvic Ultrasound

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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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Conservative Approach Might Be the Strategy by Default in Stable Angina Patients: A Case Report

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World Journal of Cardiovascular Diseases 2020年第11期10卷 769-774页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Djibril Marie Ba Khadidiatou Dia Mouhamed Chérif Mboup Pape Diadie Fall Department of Cardiology Hospital Principal Dakar Dakar Senegal

Management of stable angina is still a matter of debate. Whether a conservative or invasive approach is better remains unclear. Even though recent large-scale randomized trials depict the conservative strategy as safe and efficient. In this report, we present a case of a 53-year-old male patient with cardiovascular risk factors of hypertension and hypercholesterolemia. He complained about typical chest pain at exertion. The coronary angiogram (CA) revealed severe stenosis of the proximal left anterior descending artery (LAD) ostium. After heart team discussion, coronary artery bypass graft (CABG) was advocated. However, due to a lack of means, the CABG was postponed. Meanwhile, he was managed with guideline-based medical therapy. In addition, he exercised regularly and adopted a healthy diet. Evolution was favorable with excellent symptoms control. A regular follow-up was organized with his cardiologist. A new CA before an eventual CABG six years later showed a significant plaque volume regression of the proximal LAD. We decided to continue conservative management. The stress echocardiogram to assess symptoms and exercise tolerance was normal. Our patient was sent to surgery on top of optimal medical therapy even though angioplasty was a good indication and was feasible. However, while he was struggling to afford the CABG procedure, he adopted a very healthy lifestyle along with medical therapy. Six years later, the result of that approach was without appeal, suggesting and reinforcing the conservative management

关键词： Stable Angina Chronic Coronary Syndrome Conservative Treatment Case Report

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Sex Differences in Clinical and Angiographic Characteristics in Acute Coronary Syndrome Patients in dakar, Senegal

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World Journal of Cardiovascular Diseases 2022年第7期12卷 403-413页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Waly Niang Mboup Aimé Gildas Portella Khadidiatou Dia Pape Diadie Fall Mouhamed Chérif Mboup Department of Cardiology Hospital Principal Dakar Dakar Senegal

Background: Coronary artery disease (CAD) is in relentless progression, along with the adoption of western lifestyle in sub-Saharan Africa. In Senegal, the incidence of acute coronary syndrome (ACS) rose from 5% to 12% in dakar during the last 20 years. That increase was observed in both women and men, and according to current data, the former paid the heaviest price in terms of mortality compared to men. In this study, we aim to retrospectively assess the clinical characteristics and angiographic profile of ACS in women compared to men in two tertiary care centers in dakar. Methods: In this study, we retrospectively analyzed and compared data between men and women among 133 patients who underwent coronary angiogram for ACS in 2 tertiary centers from February 2019 to January 2020. Results: A total of 133 patients were included in our study of whom 97 (72.9%) were men. The mean age was 58 ± 13.6 years. Women were older than men (61.4 ± 14.3 years vs 56.6 ± 13.5 years (p = 0.07). Hypertension, sedentary lifestyle and obesity were significantly more frequent in women (69.4%, 52.7% and 19.4%) when compared to men (38.8%, 25.7% and 6.19%) respectively, (p = 0.001;0.002 and 0.03). Smoking was less frequent in women (2.8%) than in men (44.3%), (p Conclusion: In our study, women with ACS were older, had more cardiovascular risk factors but less angiographic extent of disease than men.

关键词： Sex Differences Acute Coronary Syndrome Senegal

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Profiling Hepatitis B Viral Load: Treatment and Epidemiological Implications in a West African hospital

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Advances in Infectious Diseases 2022年第4期12卷 703-714页

作者： Papa Silman Diawara Mor Ngom Maguette Ndoye Mamadou Wague Gueye Sokhna M. Daffe Nata Dieng Ibrahima Diallo Bécaye Fall Macoura Gadji Moustapha Diop Pape Samba Ba Yankhoba Diop Federation of Laboratories Principal Hospital of Dakar Dakar Senegal Hematology Department Dakar Principal Hospital Dakar Senegal Hepato-Gastro-Enterology Department Dakar Principal Hospital Dakar Senegal Department of Biological Hematology & Oncology-Hematology (HBOH) National Blood Transfusion Center (CNTS)/FMPOS-UCAD Dakar Senegal Infectious Diseases Department Dakar Principal Hospital Dakar Senegal

Background: Chronic hepatitis B virus (HBV) infection is one of the largest public health problems with nearly 350 million chronic carriers and 500,000 deaths each year. These deaths are most often associated with disease progression to cirrhosis or hepatocellular carcinoma, which some studies have shown is associated with long-term viral replication in chronic carriers. Viral load quantification, a key element of disease management, is expensive and difficult to access. Viral load plays a crucial role in patient classification and treatment initiation. Four years after the implementation of viral load platform, the objective of this study was to assess viral load profile in HBs chronic carriers in a sub-Saharan hospital and to determine the potential impact of this distribution on preventive and therapeutic strategies against hepatitis B infection. Materials and Method: The study was carried out between April 2016 and October 2020 in the laboratory of the principal hospital in dakar. All patients referred for HBV DNA viral load testing following a positive AgHBs test were included. Incomplete medical records were excluded from the study. Only the first quantification test performed on each patient is recorded. DNA extraction was performed with COBAS AmpliPrep (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Amplification was performed using COBAS TaqMan48 (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Data were collected from the laboratory’s computer system and entered into Microsoft Excel (2007). Statistical analyzes were performed using Epi-Info 7 software. Results: A total of 3002 patients, 76.1% (2285/3002) men and 33.9% (717/3002) women, were included in the study. Young adults were most represented among the subjects (23.2%) and (20.1%) in the age groups 25 - 30 and 30 - 35. The majority (52.7%) of patients had viral loads between 20 and 2000 IU. Patients with undetectable viral loads and patients with viral loads below 20 IU comprised 14.6% and

关键词： Hepatitis B Viral Load Senegal Treatment

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