<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is s...<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is still challenging. The objective of this study was to highlight the sociodemographic, clinical, and therapeutic aspects of retinoblastoma at the Donka Paediatric Haematology/Oncology unit in Donka university hospital, Guinea, and thereby highlight the conditions of this malignancy in this country. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study over 3 years (January 1, 2017 to December 31, 2019). The study population was all retinoblastoma patients who were treated in this unit. Socio-demographic, clinical, and therapeutic data were analyzed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 210 pediatric patients followed up for cancer in this unit during the period, retinoblastoma accounted for 46 (22%). The patient age at diagnosis was 35.17 months (range: 3 - 132 months). At admission, metastases were observed in 16 patients (35%): 14 with brain metastases and 2 with lymph node metastases. Preoperative chemotherapy was employed in 38 (83%), tumor resection was performed in 20 patients (43%), and postoperative chemotherapy was performed in 19 patients. As for the prognosis, remission in 9, death in 14, and treatment discontinuation in 15. Only one patient had health insurance (2%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In this region of Guinea, retinoblastoma is the most common ocular tumor in children. Its diagnosis is easy: strabismus and leukocoria are the early signs of retinoblastoma. The prognosis depends on how early the diagnosis is made. Physicians, care-givers, and family members should be aware of the nature of this malignancy and social education/message as such is necessary.</span></span>展开更多
Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty ...Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty degeneration would be at the origin of the occurrence of chronic low back pain which constitutes a public health problem in Senegal. Taking into account its anatomy is essential for the etiopathogenic analysis and the treatment of low back pain. The purpose of our work was to investigate the impact of multifidus muscle morphometry on the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to May 2022. It involved 100 patients seen in the neurology department of Fann Hospital for chronic low back pain and who had already had a scanner falling within the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software to model and analyze the morphometric data of the multifidus muscle after physiotherapy and control lumbar scans. Results: The sex ratio was 2.23. The average age of the patients was 45 ± 7 years. On the initial CT scan, according to the Hadar classification, we noted a predominance of grade 2 with 56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the majority of patients, 67%, had grade 1. A conflicting circumferential disc bulge with the roots predominating in L5/S1 was present in 94% of men (p-value = 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm<sup>3</sup> ± 39, after physiotherapy it was 203 mm<sup>3</sup> ± 42 with a progression rate of 5.2%. Clinically, severe type pain had regressed from 86% before physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion: Taking into account the morphometry of the multifidus is an essential element in the management of chronic low back pain.展开更多
Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective d...Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National Hospital. Methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.展开更多
Introduction: Growth is a reflection of a child’s health and nutritional status. Children with sickle cell disease often have slower statural and weight development. The aim of this study was to evaluate the nutritio...Introduction: Growth is a reflection of a child’s health and nutritional status. Children with sickle cell disease often have slower statural and weight development. The aim of this study was to evaluate the nutritional profile of children with sickle cell disease (SCD) registered in the CEMECO centre database. Methodology: This was a cross-sectional study with simple random sampling of children aged 1 to 16 years registered in the clinic database. Results: We collected information on 208 children, 121 of whom had sickle cell disease and 87 of whom were normal, with a sex ratio of 1.02. The mean age of the sickle cell patients was 8.7 ± 4.4 years, while that of the non-sickle cell patients was 9.5 ± 4 years. Haemoglobin electrophoresis revealed 103 homozygous (SS), 18 double heterozygous (SC, SBetaThal, SE) and 87 normal (AA) and/or sickle cell trait (AS) sickle cell cases. We observed a significant difference in the height/age ratio (P ¥). Conclusion: The results of our study revealed stunted growth in children with sickle cell disease.展开更多
Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that m...Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that mimics septic arthritis caused by the deposition of lipid droplets in the joint. We present the case of a patient hospitalized for mono-arthritis, which revealed systemic lupus. Observation: The patient is a 19-year-old woman, single, without children, and with no previous medical history, who was hospitalized for fever and inflammatory polyarthralgia. The clinical examination revealed an inflammatory swelling of the right knee with patellar ballottement, yellow citrine synovial fluid, an inflammatory tumor on the left arm, which was round, mobile, and fluctuating with purulent content, edema of the lower limbs, and facial puffiness, along with a systemic inflammatory response syndrome. Paraclinical examination showed hyperleukocytosis with neutrophil predominance, microcytic anemia, thrombocytopenia, antistreptolysin O (ASLO) 3, suggesting inflammatory arthritis. Bacteriological tests did not isolate any pathogens. An arthrotomy with synovial biopsy was performed, and the histopathological examination supported non-specific synovitis. A joint ultrasound showed signs of arthritis with a septic appearance. During the third hospitalization for persistent fever, she presented with facial puffiness, anemia syndrome, systemic inflammatory response syndrome, and a malar rash across the bridge of the nose. Antinuclear antibodies returned positive with a titer of 1280 and a speckled fluorescence pattern, and anti-native DNA antibodies were positive at 60.1 (normal Conclusion: Pseudo-septic arthritis is a feature of lupus that can mimic septic arthritis. Monoarticular involvement is rare but possible. The absence of pathogens and the inflammatory nature of the synovial fluid should prompt consideration of a lupus-related etiology.展开更多
Introduction: A congenital malformation is defined as a morphological abnormality of an organ or body region resulting from an abnormal developmental process during the formation of the embryo or fetus. Depending on t...Introduction: A congenital malformation is defined as a morphological abnormality of an organ or body region resulting from an abnormal developmental process during the formation of the embryo or fetus. Depending on their type, location and size, malformations can cause functional, psychological and aesthetic defects. The aim of this study is to document the frequency of congenital malformations, describe the characteristics of malformed newborns and their biological mothers, and identify the different types of malformations presented by newborns at the INSE. Methods: Descriptive cross-sectional study of clinically visible malformed newborns. It was carried out from January 1, 2021 to January 1, 2022 at the INSE neonatology unit. Epi info version 3.1 software was used for data entry and analysis. Results: Of a total of 2332 neonates hospitalized during the study period, 81 (3.5%) cases had at least one clinically visible congenital malformation. Nearly 84% had an age ≤ 7 days at the time of admission. The male sex was most concerned (60.5%). Newborns referred by a health facility accounted for 84%. Malformations of the digestive system accounted for 30.9% of cases, followed by those of the limbs (19.8%) and poly malformative syndrome (19.8%). Conclusion: This study shows that congenital malformations exist and are frequent in Guinea. Our results could therefore be the starting point for the future establishment of a national register of congenital malformations.展开更多
Introduction: Glomerular filtration is an important elimination pathway for many types of chemotherapy. Accurate estimation of glomerular filtration is essential in the management of children with cancer. Methodology:...Introduction: Glomerular filtration is an important elimination pathway for many types of chemotherapy. Accurate estimation of glomerular filtration is essential in the management of children with cancer. Methodology: This was a prospective cross-sectional study of the descriptive type extending over a period of 6 months from July 01 to December 31, 2021 on all children with cancer followed in the pediatric hemato-oncology unit of the HND with a renal, blood and urinary assessment associated with the GFR calculated by the SCHWARTZ formula during the study period. Results: During the study period, we registered 41 new cases of cancer in the pediatric oncology unit. The age group of 0 - 5 years was the most represented, i.e. 65.85% and the average age was 5.6 ± 4 years. The most cited clinical signs were fever ie 56.10% followed by abdominal pain 34.15% and anemia 26.83%. The most represented diagnosis was Burkitt’s Lymphoma, i.e. 26.83% followed by Retinoblastoma 24.39%. Mean serum creatinine was 70.65 ± 68.93 μmol/L. In our series, patients whose normal glomerular filtration rate were more represented, i.e. 70.73% and 29.27% had an abnormal GFR with an average of 87.28 ± 70 mL/min/1.73m<sup>2</sup>. Proteinuria and leukocyturia were observed in 31.71% and 19.51% respectively. Glycosuria and hematuria with common frequencies of 2.44% of patients. Conclusion: The prevention of renal toxicity of anticancer drugs always involves the precise evaluation of renal function using the Schwartz formula in children. .展开更多
Introduction: Our study focused on the evaluation of renal function in children with sickle cell disease compared to children without sickle cell disease at the pediatric emergency unit of the Donka National Hospital ...Introduction: Our study focused on the evaluation of renal function in children with sickle cell disease compared to children without sickle cell disease at the pediatric emergency unit of the Donka National Hospital and SOS Drepano-Guinea center. Patients and Methods: This was a cross-sectional descriptive and analytical study lasting 3 months (October 1 to December 31, 2020). Were included, all sickle cell and non-sickle cell children aged 0 to 15 received on an outpatient basis and had undergone an exploration of renal function (serum creatinine and urine dipstick). Results: We performed the urine dipstick and serum creatinine in 75 children, 45 of whom were sickle cell and 30 were not sickle cell. 27 of our patients or 36% had a reduction in GFR, among them 9 or 20% were sickle cell and 18 or 60% were not sickle cell. The most affected age group was 5 to 9 years in sickle cell (66.7%) and non-sickle cell (38.9%). In sickle cell patients, 9 cases (100%) had mild renal failure (IRL). Non-sickle cell patients, had 14 cases or 77.8% of IRL and 4 cases (22.2%) of moderate IR. Sickle cell disease and antibiotics which had the respective p-value (0.01);(0.02), were statistically significant with the onset of renal failure. Conclusion: Several factors including sickle cell anemia and antibiotics are believed to be involved in lowering GFR. It would be essential to detect early the children received in consultation.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
Objectives: Senegal, with the support of WHO, had begun the establishment of a National Cancer Registry in 2009, although it had been at a standstill since 1969;the objective of this work was to test the reliability o...Objectives: Senegal, with the support of WHO, had begun the establishment of a National Cancer Registry in 2009, although it had been at a standstill since 1969;the objective of this work was to test the reliability of data collection tools and feasibility stages necessary for the validation of media before the establishment of a national cancer registry. Methodology: We conducted a non-exhaustive preliminary study over a period of three months from the first of January to 31 March 2010 at four major hospitals in Dakar at the time. Results: Two hundred and eighty-nine cases had been identified: 44% of men (n = 127) and 56% of women (n = 162) with a sex ratio of 0.8. The ages ranged from 20 to 90 years with an average of 50 years. The main diagnostic mode was essentially histological, with 76% of cases (n = 219). The most frequent locations were: ORL (ENT meaning Ear, Nose and Throat) with 25% of cases, liver 7% and bronchopulmonary 4.5% of cases. In men, liver cancer was the most common location and women for cervical cancer with 16%. Squamous cell carcinoma was the most common histological type with 68% of cases followed by adenocarcinoma with 22% of cases. Thirty-eight percent of patients were classified as stage III and IV. A quarter of our patients had received palliative treatment. In contrast, 15 (15%) had received chemotherapy and 4% had received radiotherapy. Data collection was satisfactory. Conclusion: Cancer is a reality in Senegal but it remains underdiagnosed. The materials made it possible to make the cancer registry effective throughout the country.展开更多
Background: Although hyperglycaemia is one of the known side effects of L-asparaginase, its contribution to the development of diabetic ketoacidosis (DKA) is less well known in the literature. Asparaginase is an essen...Background: Although hyperglycaemia is one of the known side effects of L-asparaginase, its contribution to the development of diabetic ketoacidosis (DKA) is less well known in the literature. Asparaginase is an essential component of treatment protocols for acute lymphoblastic leukaemia (ALL) in combination with other chemotherapeutic drugs. On further evaluation, she was found to have high anion gap metabolic acidosis, hyperglycaemia and ketonuria. In recent decades, the use of these chemotherapeutic agents has led to a decrease in mortality and disease-free survival in ALL. L-asparaginase is one of the chemotherapy protocols used in the treatment of acute lymphoblastic leukaemia (ALL) and can induce hyperglycaemia which is aggravated by the concomitant use of corticosteroids. We report the observation of a 14-year-old girl treated with chemotherapy (GFA LAL protocol) who developed transient diabetes following the use of L-asparaginase. She was treated at the Donka paediatric haemato-oncology unit by a multidisciplinary team including a paediatric oncologist, a psychologist and a diabetologist. The aim of this study was to highlight blood glucose monitoring before and after the use of asparaginase in acute lymphoblastic leukaemia. Conclusion: We conclude that the occurrence of ketoacidosis following the use of asparaginase is a rare event. We recommend close monitoring of blood glucose levels for hyperglycaemia in patients with ALL receiving L-asparaginase.展开更多
<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span st...<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Angina is a common </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> condition. It has certain peculiarities in children, particularly </span><span style="font-family:Verdana;">with regard to</span><span style="font-family:Verdana;"> the frequency of bacterial germs and the use of diagnostic tests. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the place of the rapid diagnostic test in the management of group A beta-hemolytic streptococcal angina in children in the </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> ward at Donka National Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a prospective descriptive study lasting 6 months from 1st February to 31st July 2019 concerning childr</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">en aged between 3 and 15 years old who were diagnosed with angina. Epidemiological, clinical, para-clinical </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> therapeutic variables were studied. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 1494 registered children, we collected 116 cases of angina (7.76%). Out of 52 patients who benefited from the rapid diagnostic test, we recorded 13 cases of angina due to group A beta-hemolytic </span><span style="font-family:Verdana;">strptococcus</span><span style="font-family:Verdana;">. The male sex was the most dominant with 31 cases (59.69%) and a G/F sex ratio of 1.47. The age group most affected was between 3 and 5 years old (50%). The average age of our patients was 4.8 years with extremes of 3 and 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
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
文摘<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is still challenging. The objective of this study was to highlight the sociodemographic, clinical, and therapeutic aspects of retinoblastoma at the Donka Paediatric Haematology/Oncology unit in Donka university hospital, Guinea, and thereby highlight the conditions of this malignancy in this country. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study over 3 years (January 1, 2017 to December 31, 2019). The study population was all retinoblastoma patients who were treated in this unit. Socio-demographic, clinical, and therapeutic data were analyzed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 210 pediatric patients followed up for cancer in this unit during the period, retinoblastoma accounted for 46 (22%). The patient age at diagnosis was 35.17 months (range: 3 - 132 months). At admission, metastases were observed in 16 patients (35%): 14 with brain metastases and 2 with lymph node metastases. Preoperative chemotherapy was employed in 38 (83%), tumor resection was performed in 20 patients (43%), and postoperative chemotherapy was performed in 19 patients. As for the prognosis, remission in 9, death in 14, and treatment discontinuation in 15. Only one patient had health insurance (2%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In this region of Guinea, retinoblastoma is the most common ocular tumor in children. Its diagnosis is easy: strabismus and leukocoria are the early signs of retinoblastoma. The prognosis depends on how early the diagnosis is made. Physicians, care-givers, and family members should be aware of the nature of this malignancy and social education/message as such is necessary.</span></span>
文摘Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty degeneration would be at the origin of the occurrence of chronic low back pain which constitutes a public health problem in Senegal. Taking into account its anatomy is essential for the etiopathogenic analysis and the treatment of low back pain. The purpose of our work was to investigate the impact of multifidus muscle morphometry on the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to May 2022. It involved 100 patients seen in the neurology department of Fann Hospital for chronic low back pain and who had already had a scanner falling within the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software to model and analyze the morphometric data of the multifidus muscle after physiotherapy and control lumbar scans. Results: The sex ratio was 2.23. The average age of the patients was 45 ± 7 years. On the initial CT scan, according to the Hadar classification, we noted a predominance of grade 2 with 56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the majority of patients, 67%, had grade 1. A conflicting circumferential disc bulge with the roots predominating in L5/S1 was present in 94% of men (p-value = 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm<sup>3</sup> ± 39, after physiotherapy it was 203 mm<sup>3</sup> ± 42 with a progression rate of 5.2%. Clinically, severe type pain had regressed from 86% before physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion: Taking into account the morphometry of the multifidus is an essential element in the management of chronic low back pain.
文摘Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National Hospital. Methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.
文摘Introduction: Growth is a reflection of a child’s health and nutritional status. Children with sickle cell disease often have slower statural and weight development. The aim of this study was to evaluate the nutritional profile of children with sickle cell disease (SCD) registered in the CEMECO centre database. Methodology: This was a cross-sectional study with simple random sampling of children aged 1 to 16 years registered in the clinic database. Results: We collected information on 208 children, 121 of whom had sickle cell disease and 87 of whom were normal, with a sex ratio of 1.02. The mean age of the sickle cell patients was 8.7 ± 4.4 years, while that of the non-sickle cell patients was 9.5 ± 4 years. Haemoglobin electrophoresis revealed 103 homozygous (SS), 18 double heterozygous (SC, SBetaThal, SE) and 87 normal (AA) and/or sickle cell trait (AS) sickle cell cases. We observed a significant difference in the height/age ratio (P ¥). Conclusion: The results of our study revealed stunted growth in children with sickle cell disease.
文摘Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that mimics septic arthritis caused by the deposition of lipid droplets in the joint. We present the case of a patient hospitalized for mono-arthritis, which revealed systemic lupus. Observation: The patient is a 19-year-old woman, single, without children, and with no previous medical history, who was hospitalized for fever and inflammatory polyarthralgia. The clinical examination revealed an inflammatory swelling of the right knee with patellar ballottement, yellow citrine synovial fluid, an inflammatory tumor on the left arm, which was round, mobile, and fluctuating with purulent content, edema of the lower limbs, and facial puffiness, along with a systemic inflammatory response syndrome. Paraclinical examination showed hyperleukocytosis with neutrophil predominance, microcytic anemia, thrombocytopenia, antistreptolysin O (ASLO) 3, suggesting inflammatory arthritis. Bacteriological tests did not isolate any pathogens. An arthrotomy with synovial biopsy was performed, and the histopathological examination supported non-specific synovitis. A joint ultrasound showed signs of arthritis with a septic appearance. During the third hospitalization for persistent fever, she presented with facial puffiness, anemia syndrome, systemic inflammatory response syndrome, and a malar rash across the bridge of the nose. Antinuclear antibodies returned positive with a titer of 1280 and a speckled fluorescence pattern, and anti-native DNA antibodies were positive at 60.1 (normal Conclusion: Pseudo-septic arthritis is a feature of lupus that can mimic septic arthritis. Monoarticular involvement is rare but possible. The absence of pathogens and the inflammatory nature of the synovial fluid should prompt consideration of a lupus-related etiology.
文摘Introduction: A congenital malformation is defined as a morphological abnormality of an organ or body region resulting from an abnormal developmental process during the formation of the embryo or fetus. Depending on their type, location and size, malformations can cause functional, psychological and aesthetic defects. The aim of this study is to document the frequency of congenital malformations, describe the characteristics of malformed newborns and their biological mothers, and identify the different types of malformations presented by newborns at the INSE. Methods: Descriptive cross-sectional study of clinically visible malformed newborns. It was carried out from January 1, 2021 to January 1, 2022 at the INSE neonatology unit. Epi info version 3.1 software was used for data entry and analysis. Results: Of a total of 2332 neonates hospitalized during the study period, 81 (3.5%) cases had at least one clinically visible congenital malformation. Nearly 84% had an age ≤ 7 days at the time of admission. The male sex was most concerned (60.5%). Newborns referred by a health facility accounted for 84%. Malformations of the digestive system accounted for 30.9% of cases, followed by those of the limbs (19.8%) and poly malformative syndrome (19.8%). Conclusion: This study shows that congenital malformations exist and are frequent in Guinea. Our results could therefore be the starting point for the future establishment of a national register of congenital malformations.
文摘Introduction: Glomerular filtration is an important elimination pathway for many types of chemotherapy. Accurate estimation of glomerular filtration is essential in the management of children with cancer. Methodology: This was a prospective cross-sectional study of the descriptive type extending over a period of 6 months from July 01 to December 31, 2021 on all children with cancer followed in the pediatric hemato-oncology unit of the HND with a renal, blood and urinary assessment associated with the GFR calculated by the SCHWARTZ formula during the study period. Results: During the study period, we registered 41 new cases of cancer in the pediatric oncology unit. The age group of 0 - 5 years was the most represented, i.e. 65.85% and the average age was 5.6 ± 4 years. The most cited clinical signs were fever ie 56.10% followed by abdominal pain 34.15% and anemia 26.83%. The most represented diagnosis was Burkitt’s Lymphoma, i.e. 26.83% followed by Retinoblastoma 24.39%. Mean serum creatinine was 70.65 ± 68.93 μmol/L. In our series, patients whose normal glomerular filtration rate were more represented, i.e. 70.73% and 29.27% had an abnormal GFR with an average of 87.28 ± 70 mL/min/1.73m<sup>2</sup>. Proteinuria and leukocyturia were observed in 31.71% and 19.51% respectively. Glycosuria and hematuria with common frequencies of 2.44% of patients. Conclusion: The prevention of renal toxicity of anticancer drugs always involves the precise evaluation of renal function using the Schwartz formula in children. .
文摘Introduction: Our study focused on the evaluation of renal function in children with sickle cell disease compared to children without sickle cell disease at the pediatric emergency unit of the Donka National Hospital and SOS Drepano-Guinea center. Patients and Methods: This was a cross-sectional descriptive and analytical study lasting 3 months (October 1 to December 31, 2020). Were included, all sickle cell and non-sickle cell children aged 0 to 15 received on an outpatient basis and had undergone an exploration of renal function (serum creatinine and urine dipstick). Results: We performed the urine dipstick and serum creatinine in 75 children, 45 of whom were sickle cell and 30 were not sickle cell. 27 of our patients or 36% had a reduction in GFR, among them 9 or 20% were sickle cell and 18 or 60% were not sickle cell. The most affected age group was 5 to 9 years in sickle cell (66.7%) and non-sickle cell (38.9%). In sickle cell patients, 9 cases (100%) had mild renal failure (IRL). Non-sickle cell patients, had 14 cases or 77.8% of IRL and 4 cases (22.2%) of moderate IR. Sickle cell disease and antibiotics which had the respective p-value (0.01);(0.02), were statistically significant with the onset of renal failure. Conclusion: Several factors including sickle cell anemia and antibiotics are believed to be involved in lowering GFR. It would be essential to detect early the children received in consultation.
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Objectives: Senegal, with the support of WHO, had begun the establishment of a National Cancer Registry in 2009, although it had been at a standstill since 1969;the objective of this work was to test the reliability of data collection tools and feasibility stages necessary for the validation of media before the establishment of a national cancer registry. Methodology: We conducted a non-exhaustive preliminary study over a period of three months from the first of January to 31 March 2010 at four major hospitals in Dakar at the time. Results: Two hundred and eighty-nine cases had been identified: 44% of men (n = 127) and 56% of women (n = 162) with a sex ratio of 0.8. The ages ranged from 20 to 90 years with an average of 50 years. The main diagnostic mode was essentially histological, with 76% of cases (n = 219). The most frequent locations were: ORL (ENT meaning Ear, Nose and Throat) with 25% of cases, liver 7% and bronchopulmonary 4.5% of cases. In men, liver cancer was the most common location and women for cervical cancer with 16%. Squamous cell carcinoma was the most common histological type with 68% of cases followed by adenocarcinoma with 22% of cases. Thirty-eight percent of patients were classified as stage III and IV. A quarter of our patients had received palliative treatment. In contrast, 15 (15%) had received chemotherapy and 4% had received radiotherapy. Data collection was satisfactory. Conclusion: Cancer is a reality in Senegal but it remains underdiagnosed. The materials made it possible to make the cancer registry effective throughout the country.
文摘Background: Although hyperglycaemia is one of the known side effects of L-asparaginase, its contribution to the development of diabetic ketoacidosis (DKA) is less well known in the literature. Asparaginase is an essential component of treatment protocols for acute lymphoblastic leukaemia (ALL) in combination with other chemotherapeutic drugs. On further evaluation, she was found to have high anion gap metabolic acidosis, hyperglycaemia and ketonuria. In recent decades, the use of these chemotherapeutic agents has led to a decrease in mortality and disease-free survival in ALL. L-asparaginase is one of the chemotherapy protocols used in the treatment of acute lymphoblastic leukaemia (ALL) and can induce hyperglycaemia which is aggravated by the concomitant use of corticosteroids. We report the observation of a 14-year-old girl treated with chemotherapy (GFA LAL protocol) who developed transient diabetes following the use of L-asparaginase. She was treated at the Donka paediatric haemato-oncology unit by a multidisciplinary team including a paediatric oncologist, a psychologist and a diabetologist. The aim of this study was to highlight blood glucose monitoring before and after the use of asparaginase in acute lymphoblastic leukaemia. Conclusion: We conclude that the occurrence of ketoacidosis following the use of asparaginase is a rare event. We recommend close monitoring of blood glucose levels for hyperglycaemia in patients with ALL receiving L-asparaginase.
文摘<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Angina is a common </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> condition. It has certain peculiarities in children, particularly </span><span style="font-family:Verdana;">with regard to</span><span style="font-family:Verdana;"> the frequency of bacterial germs and the use of diagnostic tests. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the place of the rapid diagnostic test in the management of group A beta-hemolytic streptococcal angina in children in the </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> ward at Donka National Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a prospective descriptive study lasting 6 months from 1st February to 31st July 2019 concerning childr</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">en aged between 3 and 15 years old who were diagnosed with angina. Epidemiological, clinical, para-clinical </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> therapeutic variables were studied. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 1494 registered children, we collected 116 cases of angina (7.76%). Out of 52 patients who benefited from the rapid diagnostic test, we recorded 13 cases of angina due to group A beta-hemolytic </span><span style="font-family:Verdana;">strptococcus</span><span style="font-family:Verdana;">. The male sex was the most dominant with 31 cases (59.69%) and a G/F sex ratio of 1.47. The age group most affected was between 3 and 5 years old (50%). The average age of our patients was 4.8 years with extremes of 3 and
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.
