Background: Nowadays, emergence of Carbapenemase-Producing Enterobacterales (CPE) throughout the world has become a public health problem, especially in countries with limited resources. In recent years, CPE of type O...Background: Nowadays, emergence of Carbapenemase-Producing Enterobacterales (CPE) throughout the world has become a public health problem, especially in countries with limited resources. In recent years, CPE of type OXA-48 (Ambler class D) have been identified in Dakar. The aim of this study was to evaluate the phenotypic detection of OXA-48 CPE using a temocillin disc (30 μg). Methodology: A retrospective study was carried out at Medical Biology Laboratory of Pasteur Institute in Dakar on Ertapenem-Resistant Enterobacterales (ERE) strains isolated from 2015 to 2017. These strains were then tested with a 30 μg temocillin disc. Any strain resistant to temocillin (inhibition diameter Results: Forty-one ERE isolated during the study period were tested, of which 34 (82.9%) were OXA-48 based on phenotypic detection using temocillin disc and confirmed by PCR (100%). OXA-48 CPE strains detected were composed of Klebsiella pneumoniae (n = 14;41.2%), Enterobacter cloacae (n = 8;23.5%), Escherichia coli (n = 7, 20.5%), Citrobacter freundii (n = 3;8.8%), Cronobacter sakazakii (n = 1;3%) and Morganella morganii (n = 1;3%). Conclusion: Temocillin resistance has a good positive predictive value for detecting OXA-48 CPE by phenotypic method, confirmed by PCR. Temocillin is therefore a good marker for detection of OXA-48 CPE except Hafnia alvei.展开更多
Aflatoxin B1 is a mycotoxin that can contaminate a wide feedstuffs variety. Ingestion of contaminated feed by poultry can lead to impaired health and zootechnical performances but also a human diet safety problem rela...Aflatoxin B1 is a mycotoxin that can contaminate a wide feedstuffs variety. Ingestion of contaminated feed by poultry can lead to impaired health and zootechnical performances but also a human diet safety problem related to residues presence in animal origin products. Aflatoxin B1 contamination of poultry feed samples marketed in Dakar city and in peri-urban areas (Gorom, Sangalkam) was studied. A total of 15 samples were collected from Dakar city markets as well as from poultry farms in Gorom and Sangalkam areas. Aflatoxin B1 quantification was performed by high performance liquid chromatography and thin-layer chromatography. HPLC results showed that all samples were contaminated with levels ranging from 0.15 to 22 ppb, 0.099 to 2.05 ppb and 0.099 to 4.95 ppb respectively for Gorom, Sangalkam and Dakar. Only the finishing feed from Gorom had an aflatoxin B1 level above the maximum limit set by regulations. TLC is a suitable method for aflatoxins detection. However, it was associated with overestimation for aflatoxin B1 quantification. Results suggest that poultry feed represents a real source of human diet contamination. In addition, HPLC remains the most reliable quantification technique for quality control.展开更多
Introduction: Sleep disorders (SD) are common dialysis patients and can impact their quality of life. In previous studies, black ethnicity was associated with higher incidence of SD but a few data are available in Afr...Introduction: Sleep disorders (SD) are common dialysis patients and can impact their quality of life. In previous studies, black ethnicity was associated with higher incidence of SD but a few data are available in African patients. This study aimed to describe prevalence and risk factors of SD among Senegalese dialysis patients. Methods: We performed a cross-sectional study between February 15th and April 30th 2012 including 127 patients (75 males and 52 females) aged 46.8 ± 16.9 (16 - 85 years) and dialysed since >6 months in three dialysis centres. For each patient, we assessed insomnia according to international definition, obstructive sleep apnea syndrome (OSAS) with the Berlin questionnaire, restless leg syndrome (RLS) using abridged version of Cambridge-Hopkins RLS questionnaire, and excessive daytime sleepiness (EDS) with Epworth sleepiness scale. Logistic multivariate regression was used to identify factors associated with different SD. Results: Overall prevalence of SD was 88% comprising: insomnia (64.3%), OSAS (49.1%), RLS (24.1%) and EDS (20.5%). Forty-two patients presented at least two disorders. No difference was noticed in prevalence of SD between genders (p = 0.14). Level of blood pressure were not different across patients with and without SD. Insomnia correlated with anemia, inflammation and EDS. OSAS was associated with age ≥50 years, EDS and neck circumference ≥25 cm. RLS correlated with anemia and EDS. Other parameters such as gender, dialysis vintage, KT/V, obesity, diabetes status and hypoalbuminemia were not associated with the different SD. The majority of patients had not been diagnosed before the survey and none of them was under treatment. Conclusions: Our findings are compatible with high prevalence of sleep disorders reported in other populations. Insomnia and OSAS are the most frequent SD but some patients combined many disorders. Nephrologists should be more aware of these SD in order to detect them early and provide efficient treatment.展开更多
The use of food additives in industrial production has the advantage of improving sensory properties, technological quality and extending the shelf life of foods. Among the most widely used additives are antioxidants,...The use of food additives in industrial production has the advantage of improving sensory properties, technological quality and extending the shelf life of foods. Among the most widely used additives are antioxidants, which prevent oxidation, browning and rancidity reactions in foods. However, the strong presence of these additives on the market is not without risks for human health, and should be controlled to guarantee food safety. Analysis of the risks associated with consumption of foods containing these additives requires, among other things, information on the frequency of use of these additives in various consumer products. The aim of this study is therefore to identify the antioxidants present in industrial food products distributed in Dakar. The methodology adopted consists of a qualitative analysis based on the identification of additives from food labels. Investigations were carried out in 9 stores, 4 superettes and 2 supermarkets located in different districts of Dakar. The results revealed the presence of 12 antioxidant additives, dominated by citric acid (53%) and ascorbic acid (29%). These studies have also highlighted the simultaneous use of several antioxidants in the same food product. Moreover, for some artificial antioxidants identified antioxydant such as BHA and BHT, health risks are associated with their consumption. The results of this study open up prospects for the development of information databases on food additives.展开更多
In order to better understand the cultural route, biochemical and nutritional composition of two ecotypes of fonio, a study was carried out in village of Tambananing located approximately 7 km from Sédhiou. The o...In order to better understand the cultural route, biochemical and nutritional composition of two ecotypes of fonio, a study was carried out in village of Tambananing located approximately 7 km from Sédhiou. The objective of studies was to determine nutritional composition of two ecotypes of fonio: the first called momo in short-cycle mandinka (75 - 90 days) and the other called medium-cycle dibong (90 - 110 days). For this, samples of two ecotypes were collected in an experimental field which was split into two equal parts, one sown with the momo ecotype and the other with the dibong ecotype. The nutritional composition (sugars, fats, proteins, minerals, ash, etc.) and the physicochemical properties (pH, humidity, water activity, color, etc.) of fonio’s were determined by appropriate physicochemical methods. The two ecotypes exhibited quite similar physicochemical properties. The levels of biochemical compounds were relatively close with protein contents of 7.05 ± 0.06 mg/100g for the momo ecotype and of 8.02 ± 0.04 mg/100g for the dibong ecotype, in carbohydrates (76.37 ± 1.2 mg/100g for momo and 78.7 ± 1.5 mg/100g for dibong) and in fat (2.92 ± 0.05 mg/100g for momo and 3.14 ± 0.004 mg/100g for dibong). Identical mineral element contents were found except for iron, an element for which the contents were 10.80 ± 0.008 mg/100g for the momo ecotype and 99.59 ± 0.005 mg/100g for the dibong ecotype. Thus, two ecotypes of fonio present a fairly interesting nutritional composition and their consumption deserves to be popularized and could contribute effectively to fight against the problems of malnutrition of certain vulnerable groups.展开更多
Protein is essential for the growth and maintenance of the body. They play a crucial role in different biological processes. This study focuses on comparing the protein contents of local rice grown in the Senegal Rive...Protein is essential for the growth and maintenance of the body. They play a crucial role in different biological processes. This study focuses on comparing the protein contents of local rice grown in the Senegal River valley and rice imported from Asia. The objective is to evaluate the importance of the protein nutritional value of local rice compared to imported rice. Protein contents were determined using the Kjeldahl method. The results of the protein assays show that local rice varieties such as Sahel 108 and Sahel 134 grown in the Thilène basins had protein percentages comparable to those of imported rice. The protein percentages were 15.19% ± 0.91% for the Sahel 108 variety and 16.62% ± 0.01% for the Sahel 134 variety compared to 15.8% ± 0.01% on average for imported rice. Thus from the point of view of protein content, local rice has a nutritional value identical to that of imported rice which it can validly replace. It is important in Senegal to encourage local production, which would make it possible to reduce imports on the one hand and to make quality rice available to the local Senegalese market on the other. Sahel varieties with high protein contents deserve large-scale development to meet the country’s protein needs.展开更多
Sweeteners and flavor enhancers are food additives widely used in industry, respectively, to add sweetness and flavor to foods. However, the presence of these substances is often criticized by consumers for their effe...Sweeteners and flavor enhancers are food additives widely used in industry, respectively, to add sweetness and flavor to foods. However, the presence of these substances is often criticized by consumers for their effects on health. What’s more, some scientific studies link these substances to certain pathologies. To guarantee food safety, competent authorities should have food standards based on risk analysis using consistent, reliable data. However, in developing countries, such data is often weak or non-existent. The aim of this study is therefore to carry out a pilot survey to establish the profile of sweeteners and flavour enhancers present in industrial food products marketed in Senegal. The methodology consisted of sampling various food products sold on the Senegalese market, based on analysis of labels containing information on ingredients, including additives. The investigation involved nine stores, one supermarket and 5 mini-markets in Dakar. The results showed the presence of 6 taste enhancers in food products, the most frequent being sodium L-monoglutamate (E621), inosinate (E631) and disodium guanylate (E627). Solid broths are the foodstuffs with the highest number of taste exhalters. As for sweeteners, 12 substances were identified, the most frequent being acesulfame potassium (E950), aspartame (E951), sucralose (E955) and saccharin (E954). Given the potential health risks associated with the consumption of these food additives, their control and monitoring on the market should be a priority for the competent authorities.展开更多
Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, whic...Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert<sup>?</sup> MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.展开更多
Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives:...Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.001]. Conclusion: In our series, infection with S展开更多
Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurrin...Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.展开更多
Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age...Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age. This study aims to determine the clinical and paraclinical characteristics of connective tissue diseases in the elderly population. Materials and Methods: We conducted a retrospective and descriptive study, from March 2010 to March 2021, in the Internal Medicine Department of Aristide Le Dantec Hospital, including all the medical records of patients followed up for connective tissue disease and whose symptomatology began at an age greater than or equal to 65 years. Epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from a pre-established survey form and then processed using SPSS software. Results: Overall, 22 cases were collected out of 275 seen on consultation. They involved 16 women and 6 men, aged between 65 and 85 years with a median of 70 years. The mean duration of the clinical picture was 15.7 months with extremes of 1 and 96 months. The clinical symptoms were joint pain in 21 patients associated with dry eye and mouth syndrome in seven cases and one patient underwent isolated dry eye and mouth syndrome. Joint involvement was deforming in 13 patients. Poor general condition was noted in 20 patients. Biology showed anemia in 14 patients, hyperleukocytosis (2 patients) and thrombocytosis (5 patients). The sedimentation rate (SR) was accelerated in 9 patients and the C-reactive protein (CRP) was positive in 12 patients. Immunology showed a positive Latex test (3 patients/6), Waaler-Rose reaction (8 patients/13), anti-cyclic citrullinated peptides (anti-CCP) antibodies (11 patients/11), anti-nuclear antibodies (2 patients/4). Anti-extractable nuclear antigens (anti-ENA) antibody testing in 4 patients showed positive anti-U1RNP (1 case), anti-SSA and anti-SSB (1 case). Plain X-Rays of the hands, wrists and feet showed destructive lesions in 16 patients. The 展开更多
Introduction: Unclassified inflammatory rheumatism is persistent inflammatory arthralgias with or without synovitis without sufficient classification criteria for an inflammatory rheumatism or a well-defined connectiv...Introduction: Unclassified inflammatory rheumatism is persistent inflammatory arthralgias with or without synovitis without sufficient classification criteria for an inflammatory rheumatism or a well-defined connective disease. Their outcome is variable and has been little studied in Africa. We report the epidemiological, paraclinical and evolutionary characteristics of seven cases of indeterminate polyarthritis. Material and Method: From January 2012 to May 2021, we selected all the files of patients followed up for unclassified inflammatory rheumatism and in whom a precise diagnosis was retained during the course of the disease. The diagnosis of unclassified inflammatory rheumatism was retained after biological, immunological and radiological explorations without specificities. Our study took place in the Internal Medicine Department of Aristide Le Dantec Hospital (HALD). Results: Seven cases out of 274 consulted were collected. They consisted of seven women with an average age of 39 years at the time of the first consultation (extremes: 19 and 67 years). All seven patients presented with inflammatory polyarthralgia or non-deforming, non-erosive peripheral polyarthritis, without extra-articular manifestations. A biological inflammatory syndrome was present in all seven patients. Autoantibodies (rheumatoid factor, ANA, anti-ENA and ACPA) were negative in all patients. The first-line treatments in all seven cases were hydroxychloroquine (200 - 400 mg/day) and prednisone (5 - 10 mg/day). Methotrexate was added in 3 cases. During follow-up, 2 cases progressed to Polyarthritis Rheumatoid (PR) after 3 and 4 years. Two cases progressed to Sjögren’s syndrome after 4 and 5 years. Two patients progressed to systemic scleroderma after 5 and 8 years. One patient progressed to lupus after 5 years. Conclusion: Regular follow-up is essential in IAN. It allows the early diagnosis of IJR or a well-differentiated connective tissue disease and ensures adequate management, especially early.展开更多
Introduction: Quality of life in Parkinson disease is not necessary linked to motor symptoms. It’s correlated of overactive bladders and prostatic symptoms. Prognosis factors of urinary quality of life are unknown. O...Introduction: Quality of life in Parkinson disease is not necessary linked to motor symptoms. It’s correlated of overactive bladders and prostatic symptoms. Prognosis factors of urinary quality of life are unknown. Objectives: Our study aims to find prognosis factors of quality of life associated specifically of urinary disorders in PD. Patients and methods: We conducted a transversal, analytic and descriptive study in Physical Medicine, and Neurology departments, Fann Teaching Hospital, Dakar and included patients followed for treatment of PD. Urinary disorders, quality of life and functional autonomy were assessed respectively by Urinary Symptoms Profile (USP), Qualiven Short Form, Schwab and England Scale. Results: 38 patients presented PD, with a mean age of 60.89 ± 13.6 years and sex-ratio of 2.45. Mean duration of PD was 3.1 ± 2.9 years. Urinary disorders were found in 47.36% and dominated by incontinence (88.88%) and overactive bladders (88.88%) which were minor in more than 55%. Quality of life was impaired in 88.88% of cases. Minor forms (43.75%) were predominant and constraint dimension (50%) was the most severely altered. Prognosis factors for quality of life of urinary disorders were PD stages (0.046) and functional autonomy (0.042). Discussion and conclusion: Urinary disorders in PD are common, impaired quality of life, especially the constraint dimension, depends on stage of evolution of PD and functional autonomy of patients.展开更多
Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black patients, although most of the published cases resided in a non-African country. ...Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black patients, although most of the published cases resided in a non-African country. We describe the features of the first six Senegalese cases diagnosed at the Neurology Department of the Fann Teaching Hospital in Dakar. Patients and Method: It was a preliminary retrospective and prospective study conducted at the Neurology department of Fann teaching hospital (Dakar-Senegal). The symptomatic CW diagnosis was based on angioCT-scan of the neck arteries. The National Institute of Health Stroke Scale (NIHSS) and the modified-Rankin Scale (mRS) were used to assess the severity of the IS and the functional disability after the event, respectively. Results: CW was causing a left sylvian infarction in 4 patients. The mean age of the patients at the IS diagnosis was 41 ± 6 years with a sex ratio of 1. The mean time to diagnosis of CW was 13 months. Smoking (1/6), hypertension (1/6), and obesity (1/6) were the main vascular risk factors. The mean LDL cholesterol level was 1.52 g/L ± 0.49. The mean initial NIHSS was 15 ± 6 (8-22). Half of the patients had a severe infarction (NIHSS ≥ 15). For secondary prevention, half of the patients were treated with aspirin and the other half with acenocoumarol. After 18 months ± 17 of follow-up, the mean mRS score was 2 ± 1 (1-3). Conclusion: CW is an unknown cause of IS in young black patients. An early and appropriate multidisciplinary management could help to reduce the risk of recurrences.展开更多
Introduction: Sjögren’s syndrome is an autoimmune epithelitis with various extraglandular signs, among which are neurological, with a variable frequency according to studies. We report three cases of periphe...Introduction: Sjögren’s syndrome is an autoimmune epithelitis with various extraglandular signs, among which are neurological, with a variable frequency according to studies. We report three cases of peripheral neuropathy revealing Gougerot-Sjögren’s syndrome, collected in the Neurology Department of the Fann University Hospital in Dakar (Senegal). Observations: The first patient, aged 48 years, presented with a length-dependent sensitivomotor polyneuropathy associated with retrobulbar optic neuritis, with dry eyes and dry mouth noticed by the patient for several years. The second patient, aged 28 years, was admitted to the hospital with chronic generalized paresthesia in the context of xerostomia and xerophthalmia. The results of the clinical examination and the electroeneuromyogram were in favour of pure sensory neuronopathy. The third patient was 32 years old female, with a history of thyroidectomy and acute inflammatory demyelinating polyneuropathy (AIDP), who was seen for acute ascending flaccid tetraplegia with facial diplegia, preceded by diffuse paresthesia. The diagnosis of recurrence of acute demyelinating polyradiculonueropathy was retained in view of the rapidly increasing character of the deficit, the hyperproteinorachy at the lumbar puncture, and the signs of demyelination at the ENMG. The diagnosis of Gougerot-Sjögren’s syndrome in our three patients was established on the basis of the 2016 ACR/EULAR criteria. Indeed, the anti-SSA antibodies (Ro) were positive in our 3 patients with a biopsy of the salivary glands which showed stage 3 in the first patient and stage 4 in the two others. Corticosteroid therapy and immunosuppressive treatment resulted in a favourable clinical evolution on the neurological and general levels. Conclusion: Gougerot-Sjögren’s syndrome is an autoimmune exocrinopathy that may present with peripheral neuropathy, which may precede the diagnosis of Sjögren’s syndrome, be concomitant or occur during the course of the disease.展开更多
Introduction: SARS-CoV-2 infection seems to have a brain tropism involving several pathophysiological mechanisms. The objective of our work was to study the epidemiological, clinical, paraclinical and evolutionary asp...Introduction: SARS-CoV-2 infection seems to have a brain tropism involving several pathophysiological mechanisms. The objective of our work was to study the epidemiological, clinical, paraclinical and evolutionary aspects of stroke patients following SARS-CoV-2 infection. Methodology: This was a retrospective descriptive and analytical study from 26 March 2020 to 30 September 2021, which took place at the Ziguinchor epidemic treatment center. All patients infected with SARS-CoV-2 confirmed by RT-PCR with clinical signs suggestive of stroke and confirmed by brain CT scan were included in our study. Patients with incomplete or unexploitable records were excluded. Results: Twenty-four patients were collected out of a total of 186 severe cases, a prevalence of 12.90%. All patients had an ischemic stroke. The mean age was 69 ± 6 years with extremes of 58 and 84 years. The sex ratio (M/F) was 1.2. Diabetes and hypertension were co-morbidities in 87.50% and 25% of cases respectively. Clinical signs were dominated by a hemi-corporal deficit (87.5%) and dyspnea (75%). All patients were on anticoagulation and corticosteroids. The evolution was favourable in 62.5% of patients against 37.5% of death. Conclusion: SARS-CoV-2 infection is responsible for numerous neurovascular complications and this risk increases with the presence of diabetes, arterial hypertension and emboligenic heart disease. Corticosteroid therapy and anticoagulation have allowed us to improve the prognosis of patients.展开更多
Creuzfelt-Jakob Disease is a rare and progressive neurodegenerative disease that results in fatal, transmissible, subacute, spongiform encephalopathy characterized by rapidly progressive dementia and movement disorder...Creuzfelt-Jakob Disease is a rare and progressive neurodegenerative disease that results in fatal, transmissible, subacute, spongiform encephalopathy characterized by rapidly progressive dementia and movement disorder. We present a 62-year-old male with no medical history who was admitted to our hospital because of gait and balance disturbance, language impairment and progressive motor deficit of the four limbs. A neurological examination found frontal lobe syndrome signs, myoclonic movements, pyramidal and extra-pyramidal signs. Brain Magnetic Resonance Imaging detected high intensity areas in the basal ganglia. EEG showed generalized triphasic sharp-wave complexes. A Cerebro Spinal Fluid examination found protein 14-3-3. Death occurred six months after onset. This is the first known case of Creuzfelt-Jakob Disease documented in Senegal.展开更多
European Community policy concerning water is placing increasing demands on the acquisition of information about the quality of aquatic environments. The cost of this information has led to a reflection on the rationa...European Community policy concerning water is placing increasing demands on the acquisition of information about the quality of aquatic environments. The cost of this information has led to a reflection on the rationalization of monitoring networks and, therefore, on the economic value of information produced by these networks. The aim of this article is to contribute to this reflection. To do so, we used the Bayesian framework to define the value of additional information in relation to the following three parameters: initial assumptions (prior probabilities) on the states of nature, costs linked to a poor decision (error costs) and accuracy of additional information. We then analyzed the impact of these parameters on this value, particularly the combined role of prior probabilities and error costs that increased or decreased the value of information depending on the initial uncertainty level. We then illustrated the results using a case study of a stream in the Bas-Rhin department in France.展开更多
文摘Background: Nowadays, emergence of Carbapenemase-Producing Enterobacterales (CPE) throughout the world has become a public health problem, especially in countries with limited resources. In recent years, CPE of type OXA-48 (Ambler class D) have been identified in Dakar. The aim of this study was to evaluate the phenotypic detection of OXA-48 CPE using a temocillin disc (30 μg). Methodology: A retrospective study was carried out at Medical Biology Laboratory of Pasteur Institute in Dakar on Ertapenem-Resistant Enterobacterales (ERE) strains isolated from 2015 to 2017. These strains were then tested with a 30 μg temocillin disc. Any strain resistant to temocillin (inhibition diameter Results: Forty-one ERE isolated during the study period were tested, of which 34 (82.9%) were OXA-48 based on phenotypic detection using temocillin disc and confirmed by PCR (100%). OXA-48 CPE strains detected were composed of Klebsiella pneumoniae (n = 14;41.2%), Enterobacter cloacae (n = 8;23.5%), Escherichia coli (n = 7, 20.5%), Citrobacter freundii (n = 3;8.8%), Cronobacter sakazakii (n = 1;3%) and Morganella morganii (n = 1;3%). Conclusion: Temocillin resistance has a good positive predictive value for detecting OXA-48 CPE by phenotypic method, confirmed by PCR. Temocillin is therefore a good marker for detection of OXA-48 CPE except Hafnia alvei.
文摘Aflatoxin B1 is a mycotoxin that can contaminate a wide feedstuffs variety. Ingestion of contaminated feed by poultry can lead to impaired health and zootechnical performances but also a human diet safety problem related to residues presence in animal origin products. Aflatoxin B1 contamination of poultry feed samples marketed in Dakar city and in peri-urban areas (Gorom, Sangalkam) was studied. A total of 15 samples were collected from Dakar city markets as well as from poultry farms in Gorom and Sangalkam areas. Aflatoxin B1 quantification was performed by high performance liquid chromatography and thin-layer chromatography. HPLC results showed that all samples were contaminated with levels ranging from 0.15 to 22 ppb, 0.099 to 2.05 ppb and 0.099 to 4.95 ppb respectively for Gorom, Sangalkam and Dakar. Only the finishing feed from Gorom had an aflatoxin B1 level above the maximum limit set by regulations. TLC is a suitable method for aflatoxins detection. However, it was associated with overestimation for aflatoxin B1 quantification. Results suggest that poultry feed represents a real source of human diet contamination. In addition, HPLC remains the most reliable quantification technique for quality control.
文摘Introduction: Sleep disorders (SD) are common dialysis patients and can impact their quality of life. In previous studies, black ethnicity was associated with higher incidence of SD but a few data are available in African patients. This study aimed to describe prevalence and risk factors of SD among Senegalese dialysis patients. Methods: We performed a cross-sectional study between February 15th and April 30th 2012 including 127 patients (75 males and 52 females) aged 46.8 ± 16.9 (16 - 85 years) and dialysed since >6 months in three dialysis centres. For each patient, we assessed insomnia according to international definition, obstructive sleep apnea syndrome (OSAS) with the Berlin questionnaire, restless leg syndrome (RLS) using abridged version of Cambridge-Hopkins RLS questionnaire, and excessive daytime sleepiness (EDS) with Epworth sleepiness scale. Logistic multivariate regression was used to identify factors associated with different SD. Results: Overall prevalence of SD was 88% comprising: insomnia (64.3%), OSAS (49.1%), RLS (24.1%) and EDS (20.5%). Forty-two patients presented at least two disorders. No difference was noticed in prevalence of SD between genders (p = 0.14). Level of blood pressure were not different across patients with and without SD. Insomnia correlated with anemia, inflammation and EDS. OSAS was associated with age ≥50 years, EDS and neck circumference ≥25 cm. RLS correlated with anemia and EDS. Other parameters such as gender, dialysis vintage, KT/V, obesity, diabetes status and hypoalbuminemia were not associated with the different SD. The majority of patients had not been diagnosed before the survey and none of them was under treatment. Conclusions: Our findings are compatible with high prevalence of sleep disorders reported in other populations. Insomnia and OSAS are the most frequent SD but some patients combined many disorders. Nephrologists should be more aware of these SD in order to detect them early and provide efficient treatment.
文摘The use of food additives in industrial production has the advantage of improving sensory properties, technological quality and extending the shelf life of foods. Among the most widely used additives are antioxidants, which prevent oxidation, browning and rancidity reactions in foods. However, the strong presence of these additives on the market is not without risks for human health, and should be controlled to guarantee food safety. Analysis of the risks associated with consumption of foods containing these additives requires, among other things, information on the frequency of use of these additives in various consumer products. The aim of this study is therefore to identify the antioxidants present in industrial food products distributed in Dakar. The methodology adopted consists of a qualitative analysis based on the identification of additives from food labels. Investigations were carried out in 9 stores, 4 superettes and 2 supermarkets located in different districts of Dakar. The results revealed the presence of 12 antioxidant additives, dominated by citric acid (53%) and ascorbic acid (29%). These studies have also highlighted the simultaneous use of several antioxidants in the same food product. Moreover, for some artificial antioxidants identified antioxydant such as BHA and BHT, health risks are associated with their consumption. The results of this study open up prospects for the development of information databases on food additives.
文摘In order to better understand the cultural route, biochemical and nutritional composition of two ecotypes of fonio, a study was carried out in village of Tambananing located approximately 7 km from Sédhiou. The objective of studies was to determine nutritional composition of two ecotypes of fonio: the first called momo in short-cycle mandinka (75 - 90 days) and the other called medium-cycle dibong (90 - 110 days). For this, samples of two ecotypes were collected in an experimental field which was split into two equal parts, one sown with the momo ecotype and the other with the dibong ecotype. The nutritional composition (sugars, fats, proteins, minerals, ash, etc.) and the physicochemical properties (pH, humidity, water activity, color, etc.) of fonio’s were determined by appropriate physicochemical methods. The two ecotypes exhibited quite similar physicochemical properties. The levels of biochemical compounds were relatively close with protein contents of 7.05 ± 0.06 mg/100g for the momo ecotype and of 8.02 ± 0.04 mg/100g for the dibong ecotype, in carbohydrates (76.37 ± 1.2 mg/100g for momo and 78.7 ± 1.5 mg/100g for dibong) and in fat (2.92 ± 0.05 mg/100g for momo and 3.14 ± 0.004 mg/100g for dibong). Identical mineral element contents were found except for iron, an element for which the contents were 10.80 ± 0.008 mg/100g for the momo ecotype and 99.59 ± 0.005 mg/100g for the dibong ecotype. Thus, two ecotypes of fonio present a fairly interesting nutritional composition and their consumption deserves to be popularized and could contribute effectively to fight against the problems of malnutrition of certain vulnerable groups.
文摘Protein is essential for the growth and maintenance of the body. They play a crucial role in different biological processes. This study focuses on comparing the protein contents of local rice grown in the Senegal River valley and rice imported from Asia. The objective is to evaluate the importance of the protein nutritional value of local rice compared to imported rice. Protein contents were determined using the Kjeldahl method. The results of the protein assays show that local rice varieties such as Sahel 108 and Sahel 134 grown in the Thilène basins had protein percentages comparable to those of imported rice. The protein percentages were 15.19% ± 0.91% for the Sahel 108 variety and 16.62% ± 0.01% for the Sahel 134 variety compared to 15.8% ± 0.01% on average for imported rice. Thus from the point of view of protein content, local rice has a nutritional value identical to that of imported rice which it can validly replace. It is important in Senegal to encourage local production, which would make it possible to reduce imports on the one hand and to make quality rice available to the local Senegalese market on the other. Sahel varieties with high protein contents deserve large-scale development to meet the country’s protein needs.
文摘Sweeteners and flavor enhancers are food additives widely used in industry, respectively, to add sweetness and flavor to foods. However, the presence of these substances is often criticized by consumers for their effects on health. What’s more, some scientific studies link these substances to certain pathologies. To guarantee food safety, competent authorities should have food standards based on risk analysis using consistent, reliable data. However, in developing countries, such data is often weak or non-existent. The aim of this study is therefore to carry out a pilot survey to establish the profile of sweeteners and flavour enhancers present in industrial food products marketed in Senegal. The methodology consisted of sampling various food products sold on the Senegalese market, based on analysis of labels containing information on ingredients, including additives. The investigation involved nine stores, one supermarket and 5 mini-markets in Dakar. The results showed the presence of 6 taste enhancers in food products, the most frequent being sodium L-monoglutamate (E621), inosinate (E631) and disodium guanylate (E627). Solid broths are the foodstuffs with the highest number of taste exhalters. As for sweeteners, 12 substances were identified, the most frequent being acesulfame potassium (E950), aspartame (E951), sucralose (E955) and saccharin (E954). Given the potential health risks associated with the consumption of these food additives, their control and monitoring on the market should be a priority for the competent authorities.
文摘Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert<sup>?</sup> MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.
文摘Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.001]. Conclusion: In our series, infection with S
文摘Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.
文摘Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age. This study aims to determine the clinical and paraclinical characteristics of connective tissue diseases in the elderly population. Materials and Methods: We conducted a retrospective and descriptive study, from March 2010 to March 2021, in the Internal Medicine Department of Aristide Le Dantec Hospital, including all the medical records of patients followed up for connective tissue disease and whose symptomatology began at an age greater than or equal to 65 years. Epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from a pre-established survey form and then processed using SPSS software. Results: Overall, 22 cases were collected out of 275 seen on consultation. They involved 16 women and 6 men, aged between 65 and 85 years with a median of 70 years. The mean duration of the clinical picture was 15.7 months with extremes of 1 and 96 months. The clinical symptoms were joint pain in 21 patients associated with dry eye and mouth syndrome in seven cases and one patient underwent isolated dry eye and mouth syndrome. Joint involvement was deforming in 13 patients. Poor general condition was noted in 20 patients. Biology showed anemia in 14 patients, hyperleukocytosis (2 patients) and thrombocytosis (5 patients). The sedimentation rate (SR) was accelerated in 9 patients and the C-reactive protein (CRP) was positive in 12 patients. Immunology showed a positive Latex test (3 patients/6), Waaler-Rose reaction (8 patients/13), anti-cyclic citrullinated peptides (anti-CCP) antibodies (11 patients/11), anti-nuclear antibodies (2 patients/4). Anti-extractable nuclear antigens (anti-ENA) antibody testing in 4 patients showed positive anti-U1RNP (1 case), anti-SSA and anti-SSB (1 case). Plain X-Rays of the hands, wrists and feet showed destructive lesions in 16 patients. The
文摘Introduction: Unclassified inflammatory rheumatism is persistent inflammatory arthralgias with or without synovitis without sufficient classification criteria for an inflammatory rheumatism or a well-defined connective disease. Their outcome is variable and has been little studied in Africa. We report the epidemiological, paraclinical and evolutionary characteristics of seven cases of indeterminate polyarthritis. Material and Method: From January 2012 to May 2021, we selected all the files of patients followed up for unclassified inflammatory rheumatism and in whom a precise diagnosis was retained during the course of the disease. The diagnosis of unclassified inflammatory rheumatism was retained after biological, immunological and radiological explorations without specificities. Our study took place in the Internal Medicine Department of Aristide Le Dantec Hospital (HALD). Results: Seven cases out of 274 consulted were collected. They consisted of seven women with an average age of 39 years at the time of the first consultation (extremes: 19 and 67 years). All seven patients presented with inflammatory polyarthralgia or non-deforming, non-erosive peripheral polyarthritis, without extra-articular manifestations. A biological inflammatory syndrome was present in all seven patients. Autoantibodies (rheumatoid factor, ANA, anti-ENA and ACPA) were negative in all patients. The first-line treatments in all seven cases were hydroxychloroquine (200 - 400 mg/day) and prednisone (5 - 10 mg/day). Methotrexate was added in 3 cases. During follow-up, 2 cases progressed to Polyarthritis Rheumatoid (PR) after 3 and 4 years. Two cases progressed to Sjögren’s syndrome after 4 and 5 years. Two patients progressed to systemic scleroderma after 5 and 8 years. One patient progressed to lupus after 5 years. Conclusion: Regular follow-up is essential in IAN. It allows the early diagnosis of IJR or a well-differentiated connective tissue disease and ensures adequate management, especially early.
文摘Introduction: Quality of life in Parkinson disease is not necessary linked to motor symptoms. It’s correlated of overactive bladders and prostatic symptoms. Prognosis factors of urinary quality of life are unknown. Objectives: Our study aims to find prognosis factors of quality of life associated specifically of urinary disorders in PD. Patients and methods: We conducted a transversal, analytic and descriptive study in Physical Medicine, and Neurology departments, Fann Teaching Hospital, Dakar and included patients followed for treatment of PD. Urinary disorders, quality of life and functional autonomy were assessed respectively by Urinary Symptoms Profile (USP), Qualiven Short Form, Schwab and England Scale. Results: 38 patients presented PD, with a mean age of 60.89 ± 13.6 years and sex-ratio of 2.45. Mean duration of PD was 3.1 ± 2.9 years. Urinary disorders were found in 47.36% and dominated by incontinence (88.88%) and overactive bladders (88.88%) which were minor in more than 55%. Quality of life was impaired in 88.88% of cases. Minor forms (43.75%) were predominant and constraint dimension (50%) was the most severely altered. Prognosis factors for quality of life of urinary disorders were PD stages (0.046) and functional autonomy (0.042). Discussion and conclusion: Urinary disorders in PD are common, impaired quality of life, especially the constraint dimension, depends on stage of evolution of PD and functional autonomy of patients.
文摘Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black patients, although most of the published cases resided in a non-African country. We describe the features of the first six Senegalese cases diagnosed at the Neurology Department of the Fann Teaching Hospital in Dakar. Patients and Method: It was a preliminary retrospective and prospective study conducted at the Neurology department of Fann teaching hospital (Dakar-Senegal). The symptomatic CW diagnosis was based on angioCT-scan of the neck arteries. The National Institute of Health Stroke Scale (NIHSS) and the modified-Rankin Scale (mRS) were used to assess the severity of the IS and the functional disability after the event, respectively. Results: CW was causing a left sylvian infarction in 4 patients. The mean age of the patients at the IS diagnosis was 41 ± 6 years with a sex ratio of 1. The mean time to diagnosis of CW was 13 months. Smoking (1/6), hypertension (1/6), and obesity (1/6) were the main vascular risk factors. The mean LDL cholesterol level was 1.52 g/L ± 0.49. The mean initial NIHSS was 15 ± 6 (8-22). Half of the patients had a severe infarction (NIHSS ≥ 15). For secondary prevention, half of the patients were treated with aspirin and the other half with acenocoumarol. After 18 months ± 17 of follow-up, the mean mRS score was 2 ± 1 (1-3). Conclusion: CW is an unknown cause of IS in young black patients. An early and appropriate multidisciplinary management could help to reduce the risk of recurrences.
文摘Introduction: Sjögren’s syndrome is an autoimmune epithelitis with various extraglandular signs, among which are neurological, with a variable frequency according to studies. We report three cases of peripheral neuropathy revealing Gougerot-Sjögren’s syndrome, collected in the Neurology Department of the Fann University Hospital in Dakar (Senegal). Observations: The first patient, aged 48 years, presented with a length-dependent sensitivomotor polyneuropathy associated with retrobulbar optic neuritis, with dry eyes and dry mouth noticed by the patient for several years. The second patient, aged 28 years, was admitted to the hospital with chronic generalized paresthesia in the context of xerostomia and xerophthalmia. The results of the clinical examination and the electroeneuromyogram were in favour of pure sensory neuronopathy. The third patient was 32 years old female, with a history of thyroidectomy and acute inflammatory demyelinating polyneuropathy (AIDP), who was seen for acute ascending flaccid tetraplegia with facial diplegia, preceded by diffuse paresthesia. The diagnosis of recurrence of acute demyelinating polyradiculonueropathy was retained in view of the rapidly increasing character of the deficit, the hyperproteinorachy at the lumbar puncture, and the signs of demyelination at the ENMG. The diagnosis of Gougerot-Sjögren’s syndrome in our three patients was established on the basis of the 2016 ACR/EULAR criteria. Indeed, the anti-SSA antibodies (Ro) were positive in our 3 patients with a biopsy of the salivary glands which showed stage 3 in the first patient and stage 4 in the two others. Corticosteroid therapy and immunosuppressive treatment resulted in a favourable clinical evolution on the neurological and general levels. Conclusion: Gougerot-Sjögren’s syndrome is an autoimmune exocrinopathy that may present with peripheral neuropathy, which may precede the diagnosis of Sjögren’s syndrome, be concomitant or occur during the course of the disease.
文摘Introduction: SARS-CoV-2 infection seems to have a brain tropism involving several pathophysiological mechanisms. The objective of our work was to study the epidemiological, clinical, paraclinical and evolutionary aspects of stroke patients following SARS-CoV-2 infection. Methodology: This was a retrospective descriptive and analytical study from 26 March 2020 to 30 September 2021, which took place at the Ziguinchor epidemic treatment center. All patients infected with SARS-CoV-2 confirmed by RT-PCR with clinical signs suggestive of stroke and confirmed by brain CT scan were included in our study. Patients with incomplete or unexploitable records were excluded. Results: Twenty-four patients were collected out of a total of 186 severe cases, a prevalence of 12.90%. All patients had an ischemic stroke. The mean age was 69 ± 6 years with extremes of 58 and 84 years. The sex ratio (M/F) was 1.2. Diabetes and hypertension were co-morbidities in 87.50% and 25% of cases respectively. Clinical signs were dominated by a hemi-corporal deficit (87.5%) and dyspnea (75%). All patients were on anticoagulation and corticosteroids. The evolution was favourable in 62.5% of patients against 37.5% of death. Conclusion: SARS-CoV-2 infection is responsible for numerous neurovascular complications and this risk increases with the presence of diabetes, arterial hypertension and emboligenic heart disease. Corticosteroid therapy and anticoagulation have allowed us to improve the prognosis of patients.
文摘Creuzfelt-Jakob Disease is a rare and progressive neurodegenerative disease that results in fatal, transmissible, subacute, spongiform encephalopathy characterized by rapidly progressive dementia and movement disorder. We present a 62-year-old male with no medical history who was admitted to our hospital because of gait and balance disturbance, language impairment and progressive motor deficit of the four limbs. A neurological examination found frontal lobe syndrome signs, myoclonic movements, pyramidal and extra-pyramidal signs. Brain Magnetic Resonance Imaging detected high intensity areas in the basal ganglia. EEG showed generalized triphasic sharp-wave complexes. A Cerebro Spinal Fluid examination found protein 14-3-3. Death occurred six months after onset. This is the first known case of Creuzfelt-Jakob Disease documented in Senegal.
文摘European Community policy concerning water is placing increasing demands on the acquisition of information about the quality of aquatic environments. The cost of this information has led to a reflection on the rationalization of monitoring networks and, therefore, on the economic value of information produced by these networks. The aim of this article is to contribute to this reflection. To do so, we used the Bayesian framework to define the value of additional information in relation to the following three parameters: initial assumptions (prior probabilities) on the states of nature, costs linked to a poor decision (error costs) and accuracy of additional information. We then analyzed the impact of these parameters on this value, particularly the combined role of prior probabilities and error costs that increased or decreased the value of information depending on the initial uncertainty level. We then illustrated the results using a case study of a stream in the Bas-Rhin department in France.
