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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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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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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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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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Serious Burn by Sulfuric Acid: Case Report of Particular Therapeutic Strategy in a Non-Specialized ICU at Hôpital principal de Dakar (HPD) Sénégal

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Open Journal of Emergency Medicine 2016年第3期4卷 62-68页

作者： M. M. Fall E. H. M. Niang C. D. Niang B. Niang A. K. Toure B. Diatta Department of Emergency Care and Anesthesiology H?pital Principal de Dakar (HPD) Dakar Sénégal Department of Orthopaedic Surgery and Traumatology H?pital Principal de Dakar (HPD) Dakar Sénégal Medical Service Chemical Industries of Senegal (ICS) Dakar Sénégal

Managing severe burns remains problematic due to the lack of specialized units, but also because of the delay in implementing emergency care. The aim is to show that an adapted strategy, can lead to satisfying management of chemical burns. The authors report retrospectively the case of a patient admitted for chemical burns, and treated in a non-specialized intensive care unit;a 38 years old male, referred for burns by sulfuric acid at his workplace. On admission to H15, the clinic did not reveal any vital organs failure. Burns were localized on two legs and soles of the two feet (18% TBSA). Treatment combined daily dressings with silver sulfadiazine. On day 14, the wound healing associated occlusive gauze dressing, iodine cream application, and mechanical debridement. On day 47, a 5% dermal autograft performed on right foot favored with good attachment grafts. On day 58, the patient was released after complete skin recovery. Then, in a non-specialized burn unit and without early surgery access, our wound healing adapted strategy was successful. In Senegal, chemical burns represent about 2.5% of burn cases. They are often from accidents on occupation job, while generally in Africa chemical burns result from criminal attacks. Patients with severe lesions are admitted in non-specialized environments after an extended time of transfer, and don’t have efficient initial care. This may explain the high morbidity and mortality after burns in our country. The lack of surgical facilities such as skin substitutes, in non-specialized unit on low or median income countries (LMICs), explains this long period of wound healing. The treatment of severe burn in LMICs is hazardous.

关键词： Chemical Burns Sulfuric Acid Adapted Strategy Senegal

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Outcome of Pregnancies under Cupper Intrauterine Device: Experience of 10 Cases Collected at the principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

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Open Journal of Obstetrics and Gynecology 2022年第7期12卷 616-623页

作者： Bingo Kignomon M’bortche Kossi Edem Logbo-Akey Tina Ayoko Ketevi Baguilane Douaguibe Francis Baramna-Bagou Abdoul-Samadou Aboubakari Koffi Akpadza principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) Lomé Togo Department of Gynaecology-Obstetrics The University Hospital Kara Kara Togo Department of Gynaecology-Obstetrics The University Hospital Sylvanus Olympio Lomé Togo

Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with special reference to etiologies and pregnancy outcomes. Methodology: We analyzed all women who got pregnant under Cu-IUD at ATBEF Main Clinic from July 1, 2015 to June 30, 2020. Results: We retrieved 10 patients. The durations of Cu-IUD use were 3 months to 6 years. The etiologies were poor insertion;migration and spontaneous expulsion. The occurrence of pregnancy was poorly accepted by the women: 20% of women considered it was due to the providers’ incompetence. Of the 10 pregnancies, 5 women had given vaginal birth spontaneously;2 induced abortions, 2 spontaneous abortions and 1 ectopic pregnancy. The contraceptive method adopted after pregnancy was jadelle implants in 8 cases and spousal vasectomy in 2 cases. Conclusion: The prevention of IUD pregnancies may require adequate insertion time, insertion technique and follow-up.

关键词： Contraception Pregnancy Etiologies Outcome Lomé

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Spontaneous Pneumothorax Complicating Miliary Tuberculosis: About a Case at the “Centre Medical principal De La Gendarmerie Nationale Du Mali”

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Journal of Tuberculosis Research 2023年第2期11卷 67-73页

作者： Souleymane Coulibaly Marius Pembé Sanou Kassim Sidibe Ladji Mohamed Diaby Lassina Diallo Daouda Amara Traore Salif Kone Ami Diarra Salif Sow Abasse Sanogo Salif Satao Mamadou Cherif Kante Mahamadou Coulibaly Aminata Bagayoko Soumaila Keita Polyclinique des Armées Kati Mali Centre Médical principal de la Gendarmerie Nationale Bamako Mali Centre Médico-Chirurgical des Armées Bamako Mali Service de Pneumologie CHU Point G Bamako Mali

Introduction: Spontaneous pneumothorax is a rare but serious complication of tuberculosis. Miliary tuberculosis (MT) is a severe form of tuberculosis secondary to hematogenous spread of Mycobacterium tuberculosis. Objective: To report a case of MT complicated by pneumothorax. Methodology: This was a 25-year-old patient, farmer, followed up at the Pneumo-phtisiology department of the CHU du Point G for MT whose condition was improving after the introduction of anti-tuberculosis chemotherapy. He consulted again after experiencing chest pain. Clinical and imaging revealed a Spontaneous pneumothorax complicating MT. The treatment combined anti-tuberculosis chemotherapy, chest drainage and respiratory physiotherapy. Outcome was favorable with improvement of clinical and radiological signs. Conclusion: Pneumothorax complicating MT requires a reflective diagnostic approach and rapid management to improve its prognosis.

关键词： Spontaneous Pneumothorax Miliary Tuberculosis Antituberculous Chemotherapy Pleural Drainage Respiratory Physiotherapy

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Medical Interruption of Pregnancy in the Second Trimester at the principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF): About 25 Cases

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Open Journal of Obstetrics and Gynecology 2022年第1期12卷 81-92页

作者： Bingo Kignomon M’bortche Baguilane Douaguibe Kossi Edem Logbo-Akey Dédé Regina Ajavon Tina Ayoko Ketevi Akila Bassowa Francis Baramna-Bagou Koffivi Toovi-Madjé Abdoul-Samadou Aboubakari Koffi Akpadza principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) Lomé Togo Department of Gynecology-Obstetrics of the CHU Sylvanus Olympio Lomé Togo Department of Gynecology-Obstetrics of the CHU Kara Kara Togo Department of Gynecology-Obstetrics of the CHU Campus Lomé Togo

Introduction: Medical termination of pregnancy is a therapy that considerably reduces the number of obstetrical complications that can lead to maternal death and the number of births of children with diseases or malformations that are incompatible with life. Objective: To study the practice of medical termination of pregnancy at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF). Methodology: This was a retrospective and descriptive study conducted at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) covering the period from May 1st, 2012 to April 30th, 2021, i.e. a period of 9 years. All patients who underwent a medical termination of pregnancy during the study period and whose term of pregnancy was Fetal, maternal and obstetric causes were the main indications for medical termination of pregnancy in respectively 28%, 20% and 52%. Obstetrical u

关键词： Medical Termination of Pregnancy Indications Technique Togo

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Knowledge, Attitudes of Pregnant Women and Practices of Women Who Have Recently Given Birth on Contraception in the Immediate Postpartum Period at principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

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Open Journal of Obstetrics and Gynecology 2022年第1期12卷 67-80页

作者： Bingo Kignomon M’bortche Francis Baramna-Bagou Baguilane Douaguibe Kossi Edem Logbo-Akey Dédé Regina Ajavon Tina Ayoko Ketevi Akila Bassowa Abdoul-Samadou Aboubakari Koffi Akpadza principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) Lomé Togo Department of Gynecology-Obstetrics of the CHU Sylvanus Olympio Lomé Togo Department of Gynecology-Obstetrics of the CHU Kara Kara Togo Department of Gynecology-Obstetrics of the CHU Campus Lomé Togo

Background: The use of modern contraceptive methods contributes to the reduction of maternal and neonatal mortality. The initiation of a contraceptive method in the immediate postpartum period is one of the strategies to avoid missing out on contraceptive opportunities. This strategy will reduce the unmet need for contraception which is still high in the country. Objective: To describe the knowledge and attitudes of pregnant women and the practices of women who have given birth about immediate postpartum contraception. Methodology: This was a cross-sectional and descriptive study conducted at the main clinic of ATBEF from 20th March to 20th October 2020. Our study included pregnant women whose gestational age was greater than or equal to 37 weeks of amenorrhea who came for prenatal consultation or for any other consultation and then gave birth in the center. Data collection was based on a survey form. Data analysis and entry was done with the Epi info 2000 version 6.04 software. The parameters studied were: socio-demographic characteristics, knowledge and attitudes of pregnant women about contraception in the immediate postpartum period, and contraceptive practices of the women who gave birth. Results: During the study period, 201 women were selected for the survey. The average age of the respondents was 26.2 years. They were nulliparous in 41.3% of cases. Our respondents had knowledge of modern contraceptive methods in 82.10% of cases. A

关键词： Contraception Postpartum Pregnant Women Delivered Women Lomé

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NON-ABELIAN GAUGE THEORIES AND REIMANNIAN GEOMETRY ON principal BUNDLE WITH A SCALAR FUNCTION OR FUNCTIONAL

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Chinese Science Bulletin 1983年第1期28卷 34-39页

作者：安瑛陈时郭汉英 Institute of Theoretical Physics Academia Sinica Beijing Institute of Theoretical Physics Academia Sinica Beijingn the previous paper we have discussed the Kaluza type theories on the Minkowskian space-time M~4 and the physical contents of various U_1 gauge theories discribed by U_1 principal bundles on M~4 with an arbitrary scalar function or functional. In this note we consider the case of non-Abelian gauge theories. It is shown that

In the previous paper we have discussed the Kaluza type theories on the Minkowskian space-time M4 and the physical contents of various U1 gauge theories discribed by U1 principal bundles on M4 with an arbitrary scalar... 详细信息

关键词： gauge scalar bundles arbitrary invariant usual meaningful fibre unified dimensions

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