Introduction: Seizures are one of the most common neurological complications in the infant period. The aim of our study was to describe the epidemiological, clinical, therapeutic and prognostic features of seizures in...Introduction: Seizures are one of the most common neurological complications in the infant period. The aim of our study was to describe the epidemiological, clinical, therapeutic and prognostic features of seizures in infants at the Albert Royer Children’s Hospital (Senegal). Materials and Methods: This was a retrospective, descriptive study from 1 January 2012 to 30 September 2018 of infants aged 0 days to 2 months who presented with seizures. Results: The hospital rate was 8.5%. Almost all the mothers (99.1%) had undergone at least 3 antenatal visits. Urogenital infection, gestational arterial hypertension and funicular anomalies were the main pregnancy-related pathologies. Delivery was vaginal in the majority of cases (80.9%). Most infants (43.6%) had not cried at birth. The majority of infants (63%) were born at term. Trophicity was normal in 68% of cases. The average age of the infants was 6.7 days. The main causes of seizures were hypoxic-ischemic encephalopathy (48.7%), metabolic disturbances (48.1%) and central ոеrvοսѕ system infections (15.6%). Phenobarbital was the 1st-line anticonvulsant. The case fatality rate was 39.5%. The main sequela observed were delayed psychomotor development (20.6%). Conclusion: Optimal management of infant seizures requires early diagnosis and etiological treatment by improving the quality of perinatal care to ensure better management of risk factors, as well as increasing the availability of neuroimaging equipment.展开更多
This study aims to delineate the spatial distribution of nitrate and fluoride in groundwater and to estimate the non-carcinogenic risks using the human health risk assessment model recommended by the United States Env...This study aims to delineate the spatial distribution of nitrate and fluoride in groundwater and to estimate the non-carcinogenic risks using the human health risk assessment model recommended by the United States Environmental Protection Agency (USEPA). Forty-two samples were collected from wells and boreholes and analyzed for nitrate, fluoride and other water quality parameters. Results of the study indicate that fluoride and nitrate concentrations vary respectively from 0.13 to 9.41 mg·L−1 and from 0.13 to 432.24 mg·L−1 with respective median values of 2.65 and 13.85. About 69% of groundwater samples exceed the allowable limit (1.5 mg·L−1) of fluoride for drinking water. Spatial distribution of fluoride shows high concentrations in certain localities with values ranging from 6.74 mg·L−1 to 9.41 mg·L−1. The spatial distribution of nitrate indicates that the majority of water samples (87.18%) have nitrate concentrations lower than the World Health Organization (WHO) standard guideline value of 50 mg·L−1. Assessment of non-carcinogenic risks associated with intake of polluted groundwater in local populations indicates that 82.05% and 87.18% of groundwater samples have a THI > 1 in adults and children, respectively. However, the highest THI value (15.87) was recorded for children suggesting that children face greater non-carcinogenic risks than adults. The results of this study can be used as a support by the policymakers and practitioners to develop appropriate policies for effective and sustainable groundwater management and to monitor human health implications.展开更多
Introduction: Previous studies in sickle cell disease (SCD) patients have demonstrated low muscle mass (MM) and high fat mass (FM) percentages compared to individuals with normal hemoglobin. The relationship between t...Introduction: Previous studies in sickle cell disease (SCD) patients have demonstrated low muscle mass (MM) and high fat mass (FM) percentages compared to individuals with normal hemoglobin. The relationship between the evolutions of body composition (BC) parameters in the active SCD population is not well elucidated. The aim of the present study was to assess the body composition in active adult SCD patients in sub-Saharan Africa during the inter-critical period. Methodology: We conducted a descriptive and analytical cross-sectional study over an 8-month period. Eighteen SCD patients (sex ratio = 1) reported regular physical activity (RPA) corresponding to level 3 (RPA of moderate intensity) of the 4-level Saltin-Grimby physical activity scale were recruited. Anthropometric and BC parameters such as BMI, percentage FM and percentage MM were evaluated using an impedance meter. Results: The study population had a mean age of 26 ± 7 years and a mean BMI of 20.5 ± 1.9 kg/m2. We found a significantly higher percentage of FM in women compared to the men (25.6% ± 10.2% vs 11.1% ± 2.1%;p = 0.001). For the proportion of MM, all the women had a normal percentage. The men mostly had high levels of MM compared with reference norms. Men had significantly greater MM percentages than women (45.4% ± 1.8% vs. 26.5% ± 1.4%;p Conclusion: RPA appears to have positive effects on BC in active population with SCD, and a greater-than-expected effect was observed on MM in male patients. Promoting regular, adapted physical activity would be a promising way of improving BC parameters and quality of life in the SCD population. Further studies with larger cohorts will be needed to better substantiate these results.展开更多
Background: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia. The latter plays an essential role in inflammation by stimulating the production of pro-inflammatory cytokines or by increasin...Background: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia. The latter plays an essential role in inflammation by stimulating the production of pro-inflammatory cytokines or by increasing their secretion by an oxidative mechanism. These cytokines control the hepatic synthesis of an inflammatory protein called C-Reactive Protein (CRP). High or average values of CRP would have a predictive value of cardiovascular diseases and type 2 diabetes. The relationship between low CRP values and the risk of developing type 2 diabetes and its cardiovascular complications is not sufficiently studied. The hsCRP could serve as a predictive biomarker of risk of onset, follow-up and prognosis for type 2 diabetes and its cardiovascular complications. To answer this problem, we conducted this study, the aim of which was to study the predictive role of hsCRP in the risk of occurrence of type 2 diabetes and its cardiovascular complications. Materials and Methods: This is a prospective and cross-sectional case-control study involving 200 participants including 100 control women and 100 women with type 2 diabetes (mean age was respectively 49.89 years ± 8.26 & 51.92 years ± 7.18;p = 0.066). The interviews were conducted on the basis of a questionnaire. Physical examination collected biometric data and cardiovascular constants. The biochemical parameters such as hsCRP were analyzed by an automated Abbott device. Results: We noted that hsCRP was significantly higher in type 2 diabetic subjects compared to control subjects (p (rho = 0.40, p systolic blood pressure (rho = 0.30, p = 0.003), diastolic blood pressure (rho = 0.28, p = 0.006), total body fat (rho = 0.48, p Conclusion: hsCRP has a prognostic value in the evaluation of cardiovascular risk. It seems to play an important role in the pathogenesis of type 2 diabetes mellitus and its cardiovascular complications. It could thus be considered as a biomarker for the screening, monitoring and prognosis of type 2 diabetes mellitus.展开更多
Introduction: Rabies is a serious disease, as it is always fatal, but it can be prevented by sero-vaccination. It is a neglected tropical disease endemic in Asia and Africa. The aim of this study was to assess knowled...Introduction: Rabies is a serious disease, as it is always fatal, but it can be prevented by sero-vaccination. It is a neglected tropical disease endemic in Asia and Africa. The aim of this study was to assess knowledge, attitudes and practices regarding rabies and to determine the factors associated with them among people aged 18 and over in the commune of Niakhène. Methods: This was a cross-sectional, descriptive and analytical survey of subjects aged 18 and over living in the commune of Niakhène. A sample of 300 individuals was drawn from a two-stage cluster survey stratified by age and sex. Bivariate analysis was performed using association tests. Results: The mean age of respondents was 35.3 ± 16.9 years. It was noted that 67% (201) of respondents had a good knowledge of rabies. The results showed that 7.3% (22) of respondents owned a dog. Of the 278 people who did not own a dog, 78.4% (218) said they would have vaccinated their dog if they had had one. It should be noted that 83.7% (251) of respondents said they would go to a health facility if an animal bit them. None of the dog owners had vaccinated their dogs against rabies. Of the 41 people exposed to rabies, 39% went to a health facility. The age and education of the respondents had statistically significant associations with knowledge of rabies. Respondents’ age and education were statistically significantly related to whether they had vaccinated a domestic dog. The age, education and economic well-being quintile of respondents’ households had statistically significant associations with the use of a health facility in the event of being bitten or scratched by an animal vector. The education of respondents who had been bitten by an animal vector was statistically significantly associated with the use of a health facility. Conclusion: It would be imperative for human and animal health authorities to collaborate in a “One Health” approach in order to increase knowledge and promote the adoption of good practices in rabies prevention.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: exotropia is a deviation outside the visual axes. In children, an association with ametropia is often observed, however, that with hyperopia is rare. The objective of this study was to highlight the part...Introduction: exotropia is a deviation outside the visual axes. In children, an association with ametropia is often observed, however, that with hyperopia is rare. The objective of this study was to highlight the particularities of the management of exotropia associated with hyperopia in children. Subjects and Methods: this was a retrospective study over 78 months including all children aged 0 to 15 years, treated for exotropia associated with hyperopia. Results: we found 20 cases of exotropia with hyperopia, or 57.15% of exotropia. The mean age was 4.3 years and the sex ratio was 0.82. Hyperopia was mild in 30 eyes (75%), moderate in 9 eyes (22.5%) and high in 2.5% of eyes. Over a one-year follow-up, 10 children (50%) had regular follow-up, including 6 with full hyperopic correction and 4 with partial hyperopic correction. After full hyperopic correction, one child had a resolution of his exotropia;2 had a decrease in the angle of deviation and 3 had no improvement of their exotropia. Among the 4 with partial hyperopic correction children, 2 had a resolution of their exotropia. Strabismus surgery was planned in 3 children after iso-acuity. Conclusion: the association of exotropia and hyperopia poses a management problem. The total correction or not of hyperopia is discussed according to several authors.展开更多
Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period f...Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period from 2012 to 2021. We collected and analyzed the data using Excel. Results: The frequency of eyelid wounds was 0.1%. The average age of our patients was 19.38 years with a range of 1 and 62 years. The sex ratio was 3.7. Eighty-one percent of patients lived in Dakar. Fifty-seven percent (57%) of patients consulted less than 24 hours after the trauma and 7% of patients on D1. The circumstances were brawls (11%), domestic accidents (9%), road accidents (6%), and work accidents (6%). We noted 1 case of dog bite. Thirteen patients presented with post-traumatic decreased visual acuity. Involvement of the isolated upper eyelid was noted in 40% of cases and both eyelids in 15% of cases. Involvement of the lacrimal ducts was noted in 17% of cases, and that of the free edge in 21% of cases. Eyelid wounds were associated with eyeball damage in 21% of cases. Various associated lesions were observed. Ninety-one percent of patients received surgical treatment. Three cases of superinfections, 1 case of conjunctival granuloma and 1 case of phthysis of the eyeball with postoperative retinal detachment were noted. Conclusion: Eyelid sores are relatively common in our context. They require rapid surgical treatment in order to preserve the functional and aesthetic prognosis. .展开更多
Introduction: Infant and child morbidity and mortality linked to infections remain a major concern in both developed and developing countries. The general objective was to determine the characteristics of hospital mor...Introduction: Infant and child morbidity and mortality linked to infections remain a major concern in both developed and developing countries. The general objective was to determine the characteristics of hospital morbidity and mortality linked to infectious pathologies in the pediatric department of the King Baudouin hospital center in Dakar. Methods: This was a retrospective, descriptive and analytical study focusing on children hospitalized from January 1, 2018 to December 31, 2021 in the pediatric department of the King Baudouin hospital center in Dakar. Results: During the study period, 1474 children were hospitalized for an infectious pathology in the pediatric department. The sex ratio was 1.48. Children aged between one and twelve months represented 34.12%. Morbidity due to respiratory and digestive infections was 42.33% and 33.45%, respectively. Pediatric hospital mortality was 0.75% with a predominance noted in infants between 1 and 12 months (55.86%). Respiratory, digestive infections, sepsis and neurological infections were the main causes of death. Factors associated with mortality were age (1 to 12 months) with p Conclusion: Reducing infant and child mortality linked to infectious diseases remains a crucial challenge to address for improving children’s health. Early detection of related signs, prevention of infections, and adequate care and monitoring of infants and children can contribute to this reduction.展开更多
Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Pati...Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.展开更多
This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular ris...This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.展开更多
Purpose: To show epidemiological and imaging aspects of congenital optic disc abnormalities diagnosed late. Method: It was a retrospective study, including all patients with congenital optic disc abnormalities diagnos...Purpose: To show epidemiological and imaging aspects of congenital optic disc abnormalities diagnosed late. Method: It was a retrospective study, including all patients with congenital optic disc abnormalities diagnosed at a late age between January 2020 and October 2022 at the eye center of Abass Ndao Hospital. Complete ophthalmological examination was performed with eye imaging according to the cases. Results: 09 patients (10 eyes) were diagnosed with congenital optic disc abnormalities. The mean age was 29 years, with a sex ratio of 0.8. Three patients had consulted for unilateral decreased visual acuity since childhood, two for sudden vision loss and in four cases the diagnosis was fortuitous. Visual acuity was ranged from 1/200 to 20/20. Fundus examination showed myelinated retinal nerve fibers in four eyes, optic disc pit in three eyes including two complicated by maculopathy, two cases of morning glory syndrome and a case of pseudoduplication of the optic disc. Optical coherence tomography, ocular ultrasound B and OCT-Angiography were performed according to the cases. Conclusion: Congenital optic disc abnormalities are often diagnosed late. They are potentially amblyogenic and complications are not rare, worsening the visual prognosis. Their screening should be systematic by ophthalmological examination in newborns.展开更多
Introduction: Infantile spinal muscular atrophy (ISA) is an autosomal recessive disease caused by primary degeneration of cells in the anterior horn of the spinal cord, leading to muscle weakness and hypotonia. Its in...Introduction: Infantile spinal muscular atrophy (ISA) is an autosomal recessive disease caused by primary degeneration of cells in the anterior horn of the spinal cord, leading to muscle weakness and hypotonia. Its incidence is estimated at 1 in 6000 births worldwide. In Africa, particularly in Senegal, there are few studies interested on this pathology. We therefore deemed this study necessary, which set itself the objective of describing the diagnostic, therapeutic and progressive aspects of infantile spinal muscular atrophy at the Albert Royer National Children’s Hospital Center in Dakar (CHNEAR). Methodology: We conducted a retrospective descriptive study over a period of two (2) years from December 2020 to December 2022. Included were all hospitalized patients in whom the diagnosis of spinal muscular atrophy was made with or without genetic confirmation. The data were collected on a pre-established form then entered and analyzed with the following software: Excel 2013 and R version 4.1.3. Results: During our study period, 2100 children were hospitalized, the annual incidence was 0.76%. The average age of our patients was 9 ± 9 months with a range of 3 months to 32 months and the median was 6.5 months. The sex ratio was 7. The notion of family consanguinity was found in 62.5% of cases and the notion of ISA in the family in 25% of cases. Hypotonia and respiratory distress were found at the forefront in equal proportions (50% of cases). Electromyogram (EMG) was performed in 3 patients (37.5%). Symptomatic medical treatment was administered in 100% of patients, 04 patients had benefited from respiratory physiotherapy, i.e. 50% of cases, and genetic counseling was carried out in one patient (12.5%). The evolution was immediately favorable in 2 patients or 25% of cases, unfavorable in 75% of cases with a death rate of 50% and the average age of death was 5.5 months ± 1 with extremes ranging from 3 to 7 months. Conclusion: The number of Infantile spinal muscular atrophy cases remains low in hospitals in Dakar. 展开更多
Every person, in every country and on every continent, will be affected in one way or another by climate change. A climate cataclysm is looming on the horizon due to greenhouse gas emissions. This explains a strong de...Every person, in every country and on every continent, will be affected in one way or another by climate change. A climate cataclysm is looming on the horizon due to greenhouse gas emissions. This explains a strong demand for air conditioning in the years to come, hence the need for good thermal insulation at a lower cost. However, a policy of prevention, adaptation, and resilience is necessary for the protection of the environment in the future. This work aims to respond to the United Nations SDGs 7, 11 and 13. This paper presents the results of thermomechanical characterizations of the Typha additive (0%, 5%, 10%, 15%, 20%) in laterite matrices. First, we carried out a thermal characterization using the asymmetric hot plane method, which led to thermal conductivity and effusivity in different proportions. Next, mechanical tests were carried out to determine the traction and compression of each material with a matest press. Those which made it possible to obtain results according to the percentage for the thermal tests: a conductivity varying between 0.7178 W/m·K to 0.0597 W/m·K and an effusivity varying between 942.5392 J/m2·K·s1/2 at 287.0855 J/m2·K·s1/2 and for mechanical tests: traction varying between 0.035 MPa to 0.034 MPa and compression varying between 0.1115 MPa to 0.0805 MPa for the different samples. The exploitation of the results allowed us to study the conductivity, effusivity, traction, and compression as a function of their densities.展开更多
Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mit...Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.展开更多
Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study ...Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.展开更多
Aim: To report a familial case of syndromic retinitis pigmentosa identified at Aristide Le Dantec Hospital in Dakar and to describe their clinical characteristics ophthalmic. Observation: We report a sibling group of ...Aim: To report a familial case of syndromic retinitis pigmentosa identified at Aristide Le Dantec Hospital in Dakar and to describe their clinical characteristics ophthalmic. Observation: We report a sibling group of nine children, four died at a young age from unknown causes. Three children were affected by retinitis pigmentosa, two cases were syndromic. A history of nyctalopia was found in all three affected children. The mean age of onset of decreased visual acuity was 6.6 years. Patient 1 affected by syndromic retinitis pigmentosa had an extraocular sign of cystic dilation of the main bile duct. Patient 2 had myoclonic epilepsy, psychomotor retardation, and the molar tooth sign on cerebral MRI (highly suggestive of Joubert syndrome). The third child had isolated retinitis pigmentosa. Ophthalmological examinations (fundus examination, electroretinogram, and visual evoked potentials) and pediatric examinations in the remaining two children were normal. Discussion and Conclusion: Retinitis pigmentosa is a rare degenerative disease that can be associated with several other malformations, highlighting the importance of screening for associated conditions. It presents a grim functional prognosis and a life prognosis dependent on extraocular manifestations. Molecular biology (karyotyping, next-generation sequencing) could have identified the implicated genes and allowed for a formal diagnosis and genetic counseling.展开更多
<span style="font-family:Verdana;">Congenital cyanogenic heart disease (CCHD) is a malformation of the heart and large vessels characterized by an oxygen desaturation in the arterial blood, responsible...<span style="font-family:Verdana;">Congenital cyanogenic heart disease (CCHD) is a malformation of the heart and large vessels characterized by an oxygen desaturation in the arterial blood, responsible for cyanosis. The general objective was to study the profile of CCHD in Senegalese hospitals. This is a retrospective study carried out over a period of 8 years (January 1, 2010 - December 31, 2017) and including all children aged 0 to 16 years followed for a CCHD. The hospital prevalence was 0.87% for 420 cases collected. The sex ratio was 1.44 and the average age at diagnosis was 16 months. First degree parental consanguinity was noted in </span><span><span style="font-family:Verdana;">36 cases (30.78%). The main reasons for consultation were breathing difficult</span><span style="font-family:Verdana;">y</span></span><span> <span style="font-family:Verdana;">in 242 cases (57.62%) and fever in 136 patients (32.36%). Apart from cyanosis, the clinical signs were dominated by the heart murmur in 313 cases (74.7%), tachycardia in 283 cases (67.38%) and digital hippocratism in 162 cases (38.57%). Cardiomegaly was found in 239 patients (83.36%). The main types of CCHD were tetralogy of Fallot and transposition of the large vessels. In biology, 206 patients (49.05%) presented polyglobulia. A complete surgical cure was carried out in 22 patients (5.24%). Complications were anoxic crisis (52 cases) and hemorrhagic syndrome (17 cases). There were 97 deaths (28.28%) during hospitalization. The diagnosis of CCHD is late in our country and surgical management is poor explaining the high mortality</span><span style="font-family:Verdana;">.</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: Mechanical valve replacement in pediatric age is a dreaded but sometimes inevitable surgery. The purpose of this study was to determine the mortality of children with mechanical valve prostheses in the s...Introduction: Mechanical valve replacement in pediatric age is a dreaded but sometimes inevitable surgery. The purpose of this study was to determine the mortality of children with mechanical valve prostheses in the short, medium and long term. Patients and Methods: This was a retrospective and descriptive study conducted at the CUOMO cardio-pediatric center at Teaching National Hospital of Fann between January 1<sup>st</sup>, 2017 and December 31<sup>st</sup>, 2021. We included, children whose age is less than or equal to 16 years of age and who have benefited from a mechanical valve replacement and with a follow-up period of more than 6 months post-operative in the CUOMO cardio-pediatric center. Patients whose age at the time of surgery was over 16 years were excluded;patients who have benefited from bioprosthesis or valvular plastic surgery alone;as well as patients for whom a follow-up of more than 6 months was not found. Statistical analyses were carried out using the SPSS (Statistical Package for Social Science) software version 18 to calculate averages and percentages. Results: We included 85 patients. The average age was 12.84 ± 2.52 years. The male gender predominated with a sex ratio of 1.65. Dyspnea was found in 96.47% of children. Pure mitral regurgitation was the most common valve disease found in 67.06%. Rheumatic etiology was noted in 87.06% of cases. Mono valve replacement was performed in 84.71% of patients and double valve replacement in 15.3% of cases. Major mechanical complications were reported in 8 patients including 5 severe aortic mismatch cases. Hemorrhagic complications were observed in 4 patients requiring surgery. Hemodynamic complications were dominated by right ventricle dysfunction in 14 patients. Supraventricular rhythm disorders were present in 11 patients and one case of ventricular tachycardia. We found six cases of infectious endocarditis. Eight deaths were recorded with a mortality rate of 5.88%. Significant predictors of mortality were stage IV dyspnea of NYHA and preoperati展开更多
文摘Introduction: Seizures are one of the most common neurological complications in the infant period. The aim of our study was to describe the epidemiological, clinical, therapeutic and prognostic features of seizures in infants at the Albert Royer Children’s Hospital (Senegal). Materials and Methods: This was a retrospective, descriptive study from 1 January 2012 to 30 September 2018 of infants aged 0 days to 2 months who presented with seizures. Results: The hospital rate was 8.5%. Almost all the mothers (99.1%) had undergone at least 3 antenatal visits. Urogenital infection, gestational arterial hypertension and funicular anomalies were the main pregnancy-related pathologies. Delivery was vaginal in the majority of cases (80.9%). Most infants (43.6%) had not cried at birth. The majority of infants (63%) were born at term. Trophicity was normal in 68% of cases. The average age of the infants was 6.7 days. The main causes of seizures were hypoxic-ischemic encephalopathy (48.7%), metabolic disturbances (48.1%) and central ոеrvοսѕ system infections (15.6%). Phenobarbital was the 1st-line anticonvulsant. The case fatality rate was 39.5%. The main sequela observed were delayed psychomotor development (20.6%). Conclusion: Optimal management of infant seizures requires early diagnosis and etiological treatment by improving the quality of perinatal care to ensure better management of risk factors, as well as increasing the availability of neuroimaging equipment.
文摘This study aims to delineate the spatial distribution of nitrate and fluoride in groundwater and to estimate the non-carcinogenic risks using the human health risk assessment model recommended by the United States Environmental Protection Agency (USEPA). Forty-two samples were collected from wells and boreholes and analyzed for nitrate, fluoride and other water quality parameters. Results of the study indicate that fluoride and nitrate concentrations vary respectively from 0.13 to 9.41 mg·L−1 and from 0.13 to 432.24 mg·L−1 with respective median values of 2.65 and 13.85. About 69% of groundwater samples exceed the allowable limit (1.5 mg·L−1) of fluoride for drinking water. Spatial distribution of fluoride shows high concentrations in certain localities with values ranging from 6.74 mg·L−1 to 9.41 mg·L−1. The spatial distribution of nitrate indicates that the majority of water samples (87.18%) have nitrate concentrations lower than the World Health Organization (WHO) standard guideline value of 50 mg·L−1. Assessment of non-carcinogenic risks associated with intake of polluted groundwater in local populations indicates that 82.05% and 87.18% of groundwater samples have a THI > 1 in adults and children, respectively. However, the highest THI value (15.87) was recorded for children suggesting that children face greater non-carcinogenic risks than adults. The results of this study can be used as a support by the policymakers and practitioners to develop appropriate policies for effective and sustainable groundwater management and to monitor human health implications.
文摘Introduction: Previous studies in sickle cell disease (SCD) patients have demonstrated low muscle mass (MM) and high fat mass (FM) percentages compared to individuals with normal hemoglobin. The relationship between the evolutions of body composition (BC) parameters in the active SCD population is not well elucidated. The aim of the present study was to assess the body composition in active adult SCD patients in sub-Saharan Africa during the inter-critical period. Methodology: We conducted a descriptive and analytical cross-sectional study over an 8-month period. Eighteen SCD patients (sex ratio = 1) reported regular physical activity (RPA) corresponding to level 3 (RPA of moderate intensity) of the 4-level Saltin-Grimby physical activity scale were recruited. Anthropometric and BC parameters such as BMI, percentage FM and percentage MM were evaluated using an impedance meter. Results: The study population had a mean age of 26 ± 7 years and a mean BMI of 20.5 ± 1.9 kg/m2. We found a significantly higher percentage of FM in women compared to the men (25.6% ± 10.2% vs 11.1% ± 2.1%;p = 0.001). For the proportion of MM, all the women had a normal percentage. The men mostly had high levels of MM compared with reference norms. Men had significantly greater MM percentages than women (45.4% ± 1.8% vs. 26.5% ± 1.4%;p Conclusion: RPA appears to have positive effects on BC in active population with SCD, and a greater-than-expected effect was observed on MM in male patients. Promoting regular, adapted physical activity would be a promising way of improving BC parameters and quality of life in the SCD population. Further studies with larger cohorts will be needed to better substantiate these results.
文摘Background: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia. The latter plays an essential role in inflammation by stimulating the production of pro-inflammatory cytokines or by increasing their secretion by an oxidative mechanism. These cytokines control the hepatic synthesis of an inflammatory protein called C-Reactive Protein (CRP). High or average values of CRP would have a predictive value of cardiovascular diseases and type 2 diabetes. The relationship between low CRP values and the risk of developing type 2 diabetes and its cardiovascular complications is not sufficiently studied. The hsCRP could serve as a predictive biomarker of risk of onset, follow-up and prognosis for type 2 diabetes and its cardiovascular complications. To answer this problem, we conducted this study, the aim of which was to study the predictive role of hsCRP in the risk of occurrence of type 2 diabetes and its cardiovascular complications. Materials and Methods: This is a prospective and cross-sectional case-control study involving 200 participants including 100 control women and 100 women with type 2 diabetes (mean age was respectively 49.89 years ± 8.26 & 51.92 years ± 7.18;p = 0.066). The interviews were conducted on the basis of a questionnaire. Physical examination collected biometric data and cardiovascular constants. The biochemical parameters such as hsCRP were analyzed by an automated Abbott device. Results: We noted that hsCRP was significantly higher in type 2 diabetic subjects compared to control subjects (p (rho = 0.40, p systolic blood pressure (rho = 0.30, p = 0.003), diastolic blood pressure (rho = 0.28, p = 0.006), total body fat (rho = 0.48, p Conclusion: hsCRP has a prognostic value in the evaluation of cardiovascular risk. It seems to play an important role in the pathogenesis of type 2 diabetes mellitus and its cardiovascular complications. It could thus be considered as a biomarker for the screening, monitoring and prognosis of type 2 diabetes mellitus.
文摘Introduction: Rabies is a serious disease, as it is always fatal, but it can be prevented by sero-vaccination. It is a neglected tropical disease endemic in Asia and Africa. The aim of this study was to assess knowledge, attitudes and practices regarding rabies and to determine the factors associated with them among people aged 18 and over in the commune of Niakhène. Methods: This was a cross-sectional, descriptive and analytical survey of subjects aged 18 and over living in the commune of Niakhène. A sample of 300 individuals was drawn from a two-stage cluster survey stratified by age and sex. Bivariate analysis was performed using association tests. Results: The mean age of respondents was 35.3 ± 16.9 years. It was noted that 67% (201) of respondents had a good knowledge of rabies. The results showed that 7.3% (22) of respondents owned a dog. Of the 278 people who did not own a dog, 78.4% (218) said they would have vaccinated their dog if they had had one. It should be noted that 83.7% (251) of respondents said they would go to a health facility if an animal bit them. None of the dog owners had vaccinated their dogs against rabies. Of the 41 people exposed to rabies, 39% went to a health facility. The age and education of the respondents had statistically significant associations with knowledge of rabies. Respondents’ age and education were statistically significantly related to whether they had vaccinated a domestic dog. The age, education and economic well-being quintile of respondents’ households had statistically significant associations with the use of a health facility in the event of being bitten or scratched by an animal vector. The education of respondents who had been bitten by an animal vector was statistically significantly associated with the use of a health facility. Conclusion: It would be imperative for human and animal health authorities to collaborate in a “One Health” approach in order to increase knowledge and promote the adoption of good practices in rabies prevention.
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: exotropia is a deviation outside the visual axes. In children, an association with ametropia is often observed, however, that with hyperopia is rare. The objective of this study was to highlight the particularities of the management of exotropia associated with hyperopia in children. Subjects and Methods: this was a retrospective study over 78 months including all children aged 0 to 15 years, treated for exotropia associated with hyperopia. Results: we found 20 cases of exotropia with hyperopia, or 57.15% of exotropia. The mean age was 4.3 years and the sex ratio was 0.82. Hyperopia was mild in 30 eyes (75%), moderate in 9 eyes (22.5%) and high in 2.5% of eyes. Over a one-year follow-up, 10 children (50%) had regular follow-up, including 6 with full hyperopic correction and 4 with partial hyperopic correction. After full hyperopic correction, one child had a resolution of his exotropia;2 had a decrease in the angle of deviation and 3 had no improvement of their exotropia. Among the 4 with partial hyperopic correction children, 2 had a resolution of their exotropia. Strabismus surgery was planned in 3 children after iso-acuity. Conclusion: the association of exotropia and hyperopia poses a management problem. The total correction or not of hyperopia is discussed according to several authors.
文摘Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period from 2012 to 2021. We collected and analyzed the data using Excel. Results: The frequency of eyelid wounds was 0.1%. The average age of our patients was 19.38 years with a range of 1 and 62 years. The sex ratio was 3.7. Eighty-one percent of patients lived in Dakar. Fifty-seven percent (57%) of patients consulted less than 24 hours after the trauma and 7% of patients on D1. The circumstances were brawls (11%), domestic accidents (9%), road accidents (6%), and work accidents (6%). We noted 1 case of dog bite. Thirteen patients presented with post-traumatic decreased visual acuity. Involvement of the isolated upper eyelid was noted in 40% of cases and both eyelids in 15% of cases. Involvement of the lacrimal ducts was noted in 17% of cases, and that of the free edge in 21% of cases. Eyelid wounds were associated with eyeball damage in 21% of cases. Various associated lesions were observed. Ninety-one percent of patients received surgical treatment. Three cases of superinfections, 1 case of conjunctival granuloma and 1 case of phthysis of the eyeball with postoperative retinal detachment were noted. Conclusion: Eyelid sores are relatively common in our context. They require rapid surgical treatment in order to preserve the functional and aesthetic prognosis. .
文摘Introduction: Infant and child morbidity and mortality linked to infections remain a major concern in both developed and developing countries. The general objective was to determine the characteristics of hospital morbidity and mortality linked to infectious pathologies in the pediatric department of the King Baudouin hospital center in Dakar. Methods: This was a retrospective, descriptive and analytical study focusing on children hospitalized from January 1, 2018 to December 31, 2021 in the pediatric department of the King Baudouin hospital center in Dakar. Results: During the study period, 1474 children were hospitalized for an infectious pathology in the pediatric department. The sex ratio was 1.48. Children aged between one and twelve months represented 34.12%. Morbidity due to respiratory and digestive infections was 42.33% and 33.45%, respectively. Pediatric hospital mortality was 0.75% with a predominance noted in infants between 1 and 12 months (55.86%). Respiratory, digestive infections, sepsis and neurological infections were the main causes of death. Factors associated with mortality were age (1 to 12 months) with p Conclusion: Reducing infant and child mortality linked to infectious diseases remains a crucial challenge to address for improving children’s health. Early detection of related signs, prevention of infections, and adequate care and monitoring of infants and children can contribute to this reduction.
文摘Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.
文摘This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.
文摘Purpose: To show epidemiological and imaging aspects of congenital optic disc abnormalities diagnosed late. Method: It was a retrospective study, including all patients with congenital optic disc abnormalities diagnosed at a late age between January 2020 and October 2022 at the eye center of Abass Ndao Hospital. Complete ophthalmological examination was performed with eye imaging according to the cases. Results: 09 patients (10 eyes) were diagnosed with congenital optic disc abnormalities. The mean age was 29 years, with a sex ratio of 0.8. Three patients had consulted for unilateral decreased visual acuity since childhood, two for sudden vision loss and in four cases the diagnosis was fortuitous. Visual acuity was ranged from 1/200 to 20/20. Fundus examination showed myelinated retinal nerve fibers in four eyes, optic disc pit in three eyes including two complicated by maculopathy, two cases of morning glory syndrome and a case of pseudoduplication of the optic disc. Optical coherence tomography, ocular ultrasound B and OCT-Angiography were performed according to the cases. Conclusion: Congenital optic disc abnormalities are often diagnosed late. They are potentially amblyogenic and complications are not rare, worsening the visual prognosis. Their screening should be systematic by ophthalmological examination in newborns.
文摘Introduction: Infantile spinal muscular atrophy (ISA) is an autosomal recessive disease caused by primary degeneration of cells in the anterior horn of the spinal cord, leading to muscle weakness and hypotonia. Its incidence is estimated at 1 in 6000 births worldwide. In Africa, particularly in Senegal, there are few studies interested on this pathology. We therefore deemed this study necessary, which set itself the objective of describing the diagnostic, therapeutic and progressive aspects of infantile spinal muscular atrophy at the Albert Royer National Children’s Hospital Center in Dakar (CHNEAR). Methodology: We conducted a retrospective descriptive study over a period of two (2) years from December 2020 to December 2022. Included were all hospitalized patients in whom the diagnosis of spinal muscular atrophy was made with or without genetic confirmation. The data were collected on a pre-established form then entered and analyzed with the following software: Excel 2013 and R version 4.1.3. Results: During our study period, 2100 children were hospitalized, the annual incidence was 0.76%. The average age of our patients was 9 ± 9 months with a range of 3 months to 32 months and the median was 6.5 months. The sex ratio was 7. The notion of family consanguinity was found in 62.5% of cases and the notion of ISA in the family in 25% of cases. Hypotonia and respiratory distress were found at the forefront in equal proportions (50% of cases). Electromyogram (EMG) was performed in 3 patients (37.5%). Symptomatic medical treatment was administered in 100% of patients, 04 patients had benefited from respiratory physiotherapy, i.e. 50% of cases, and genetic counseling was carried out in one patient (12.5%). The evolution was immediately favorable in 2 patients or 25% of cases, unfavorable in 75% of cases with a death rate of 50% and the average age of death was 5.5 months ± 1 with extremes ranging from 3 to 7 months. Conclusion: The number of Infantile spinal muscular atrophy cases remains low in hospitals in Dakar.
文摘Every person, in every country and on every continent, will be affected in one way or another by climate change. A climate cataclysm is looming on the horizon due to greenhouse gas emissions. This explains a strong demand for air conditioning in the years to come, hence the need for good thermal insulation at a lower cost. However, a policy of prevention, adaptation, and resilience is necessary for the protection of the environment in the future. This work aims to respond to the United Nations SDGs 7, 11 and 13. This paper presents the results of thermomechanical characterizations of the Typha additive (0%, 5%, 10%, 15%, 20%) in laterite matrices. First, we carried out a thermal characterization using the asymmetric hot plane method, which led to thermal conductivity and effusivity in different proportions. Next, mechanical tests were carried out to determine the traction and compression of each material with a matest press. Those which made it possible to obtain results according to the percentage for the thermal tests: a conductivity varying between 0.7178 W/m·K to 0.0597 W/m·K and an effusivity varying between 942.5392 J/m2·K·s1/2 at 287.0855 J/m2·K·s1/2 and for mechanical tests: traction varying between 0.035 MPa to 0.034 MPa and compression varying between 0.1115 MPa to 0.0805 MPa for the different samples. The exploitation of the results allowed us to study the conductivity, effusivity, traction, and compression as a function of their densities.
文摘Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.
文摘Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.
文摘Aim: To report a familial case of syndromic retinitis pigmentosa identified at Aristide Le Dantec Hospital in Dakar and to describe their clinical characteristics ophthalmic. Observation: We report a sibling group of nine children, four died at a young age from unknown causes. Three children were affected by retinitis pigmentosa, two cases were syndromic. A history of nyctalopia was found in all three affected children. The mean age of onset of decreased visual acuity was 6.6 years. Patient 1 affected by syndromic retinitis pigmentosa had an extraocular sign of cystic dilation of the main bile duct. Patient 2 had myoclonic epilepsy, psychomotor retardation, and the molar tooth sign on cerebral MRI (highly suggestive of Joubert syndrome). The third child had isolated retinitis pigmentosa. Ophthalmological examinations (fundus examination, electroretinogram, and visual evoked potentials) and pediatric examinations in the remaining two children were normal. Discussion and Conclusion: Retinitis pigmentosa is a rare degenerative disease that can be associated with several other malformations, highlighting the importance of screening for associated conditions. It presents a grim functional prognosis and a life prognosis dependent on extraocular manifestations. Molecular biology (karyotyping, next-generation sequencing) could have identified the implicated genes and allowed for a formal diagnosis and genetic counseling.
文摘<span style="font-family:Verdana;">Congenital cyanogenic heart disease (CCHD) is a malformation of the heart and large vessels characterized by an oxygen desaturation in the arterial blood, responsible for cyanosis. The general objective was to study the profile of CCHD in Senegalese hospitals. This is a retrospective study carried out over a period of 8 years (January 1, 2010 - December 31, 2017) and including all children aged 0 to 16 years followed for a CCHD. The hospital prevalence was 0.87% for 420 cases collected. The sex ratio was 1.44 and the average age at diagnosis was 16 months. First degree parental consanguinity was noted in </span><span><span style="font-family:Verdana;">36 cases (30.78%). The main reasons for consultation were breathing difficult</span><span style="font-family:Verdana;">y</span></span><span> <span style="font-family:Verdana;">in 242 cases (57.62%) and fever in 136 patients (32.36%). Apart from cyanosis, the clinical signs were dominated by the heart murmur in 313 cases (74.7%), tachycardia in 283 cases (67.38%) and digital hippocratism in 162 cases (38.57%). Cardiomegaly was found in 239 patients (83.36%). The main types of CCHD were tetralogy of Fallot and transposition of the large vessels. In biology, 206 patients (49.05%) presented polyglobulia. A complete surgical cure was carried out in 22 patients (5.24%). Complications were anoxic crisis (52 cases) and hemorrhagic syndrome (17 cases). There were 97 deaths (28.28%) during hospitalization. The diagnosis of CCHD is late in our country and surgical management is poor explaining the high mortality</span><span style="font-family:Verdana;">.</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: Mechanical valve replacement in pediatric age is a dreaded but sometimes inevitable surgery. The purpose of this study was to determine the mortality of children with mechanical valve prostheses in the short, medium and long term. Patients and Methods: This was a retrospective and descriptive study conducted at the CUOMO cardio-pediatric center at Teaching National Hospital of Fann between January 1<sup>st</sup>, 2017 and December 31<sup>st</sup>, 2021. We included, children whose age is less than or equal to 16 years of age and who have benefited from a mechanical valve replacement and with a follow-up period of more than 6 months post-operative in the CUOMO cardio-pediatric center. Patients whose age at the time of surgery was over 16 years were excluded;patients who have benefited from bioprosthesis or valvular plastic surgery alone;as well as patients for whom a follow-up of more than 6 months was not found. Statistical analyses were carried out using the SPSS (Statistical Package for Social Science) software version 18 to calculate averages and percentages. Results: We included 85 patients. The average age was 12.84 ± 2.52 years. The male gender predominated with a sex ratio of 1.65. Dyspnea was found in 96.47% of children. Pure mitral regurgitation was the most common valve disease found in 67.06%. Rheumatic etiology was noted in 87.06% of cases. Mono valve replacement was performed in 84.71% of patients and double valve replacement in 15.3% of cases. Major mechanical complications were reported in 8 patients including 5 severe aortic mismatch cases. Hemorrhagic complications were observed in 4 patients requiring surgery. Hemodynamic complications were dominated by right ventricle dysfunction in 14 patients. Supraventricular rhythm disorders were present in 11 patients and one case of ventricular tachycardia. We found six cases of infectious endocarditis. Eight deaths were recorded with a mortality rate of 5.88%. Significant predictors of mortality were stage IV dyspnea of NYHA and preoperati
