Introduction: Diabetes is a public health problem and is exposed to some complications, particularly infectious. The work on this entity remains segmentary in Africa. The objective was to describe the morbi infectious...Introduction: Diabetes is a public health problem and is exposed to some complications, particularly infectious. The work on this entity remains segmentary in Africa. The objective was to describe the morbi infectious mortality of the diabetics at the Medical Clinic II of Abass Ndao Health Center of Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 January 2016 to 31 December 2016. It covered patients with diabetes hospitalized during the study period. Epidemiological data and infectious diseases were evaluated. Results: During the study period, 346 diabetics have respected the inclusion criteria. These were 165 men (47.68%), a sex ratio of 0.91. The mean age was 56.17 years. The age group of [60 - 69 years] accounted for 31.5% and 95.6% of the patients came from the Dakar region. The average age of diabetes was 10.31. Diabetes had been evolving for less than 5 years in 25.15% of patients and inaugural in 11.46%. About 82.36% of our patients had type 2 diabetes. The acute complications of diabetes were ketoacidosis (51.89%), hyperosmolar hyperglycemia (0.58%), and hypoglycemia (1.45%). The mean infections were the skin and soft tissues (54.91%), urogenital infections (16.18%), respiratory infections (14.45%), malaria (3.46), infections of the skin and soft tissues were dominated by the diabetic foot (41.90%). The 125 non-diabetic patients developed 38 infectious pathologies, the main ones being respiratory infections (24.32%), infections of the skin and soft parts (24.32%). HIV infection was observed in 0.28% of diabetics and 8.10% of non-diabetic patients. 93 patients died (15.70%). Fifty-one of them died of infectious diseases (54.8%), 42 non-infectious diseases (45.16%), and subjects aged over 60 years, representing 72.54%. The means of consultation was 30 days. The highest rates of lethality were diabetes (37.41%), acute gastroenteritis (17.64%), and acute pyelonephritis (12.5%). The lethality rates of indeterminate infections and malaria were 10% and 8.33%, respectively. Conclusion: Infection is a significant complication in diabetics not neglectable to diabetes. These discovery patterns call for more early diagnosis and appropriate management to reduce the mortality of diabetics.展开更多
Introduction: The COVID-19 pandemic has led to changes in health systems. The objective was to assess the effect of Covid-19 on the frequency of prenatal consultations (PNCs) for pathological pregnancies at the Abass ...Introduction: The COVID-19 pandemic has led to changes in health systems. The objective was to assess the effect of Covid-19 on the frequency of prenatal consultations (PNCs) for pathological pregnancies at the Abass NDAO Hospital Centre. Materials and Methods: This was primarily a retrospective study conducted at the Abass NDAO Hospital maternity ward. The target was the medical records of women followed for a pathological pregnancy at maternity from July 2019 to November 2020. Second, the department’s qualified staffs were asked about their experiences with the Covid-19 pandemic. Data collection was carried out between October 2021 and February 2022. Results: A total of 690 prenatal charts for pathological pregnancy were collected: 375 (54%) before the pandemic compared to 315 during Covid-19 (46%). The average age of women was 28.15 years. The age group 25 and 35 was the most represented (36.81%). Reasons for consultation were dominated by threats of premature delivery (51%), followed by severe pre-eclampsia (14%) and premature membrane rupture (11%), respectively. The frequency of prenatal consultations (PNCs) was inversely related to pandemic dynamics and significant monthly variations were observed. Qualified health personnel were midwives (71.40%) and gynecologists (28.60%). During the pandemic, more than the majority of staff (67%) worked 3 days a week, and 24% of health workers 5 days. The majority of staff (60%) reported experiencing overwork during the pandemic. Non-compliance with consultation days was noted in 38% of health providers. Protective equipment was not provided to 14% of the staff. Staff difficulties during prenatal consultations were fear of occupational exposure (12%) and patient reluctance (88%). Conclusion: The Covid-19 pandemic is having a major impact on prenatal consultations for pathological pregnancies at Abass NDAO Hospital. Effective measures must be taken to avoid the consequences of maternal mortality and the functioning of the structure.展开更多
Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutio...Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutionary aspects. Materials and Methods: This was a cross-sectional, descriptive study, conducted over 5 years (from January 01, 2018 to December 31, 2022) at the National Abass Ndao Hospital Center and including all confirmed cases of primary hyperparathyroidism. Results: Twenty-nine patients were included with a female predominance (86.20%) and an average age of 48.10 ± 18.93 years. The discovery of hyperparathyroidism was fortuitous in 79.31% of cases. The main clinical manifestations were osteoarticular (62%) and urinary (34.5%). On average, serum calcium measured was 109.2 ± 7.92 mg/l, corrected serum calcium 111.3 ± 6.25 mg/l, urinary calcium 421.9 ± 96.45 mg/24h and parathormone at 145 ± 159.71 pg/ml. Among the patients, 25 had hypercalcemia (86.2%) and all had 24-hour hypercalciuria. The diagnosis was retained in view of the elevated parathyroid hormone (PTH) values in all patients. Cervical ultrasound objectified a parathyroid adenoma in 27.58% of cases and 12 patients or 46.2% had presented a scintigraphy in favor of a parathyroid adenoma. We found 01 cases of multiple endocrine neoplasia type 2. Bone densitometry performed in 10 patients found osteoporosis in 60% of cases (6 patients) and osteopenia in 40% of cases (4 patients). Surgical treatment was performed in 12 patients (41.4%). The histology of the surgical specimens was in favor of a parathyroid adenoma in all cases. Among the operated patients, the evolution was marked by a cure rate of 100%. Conclusion: The symptomatology of primary hyperparathyroidism remains mainly osteoarticular and urinary. Surgery has proven its effectiveness in our series. We insist on the systematic dosage of calcemia especially in women over 50 years and the promotion of morphological explorations.展开更多
Introduction: Vitamin D plays a key role in phosphocalcic metabolism, in normal functioning of the immune system and in the prevention of certain forms of cancer. Systematic vitamin D supplementation has been implemen...Introduction: Vitamin D plays a key role in phosphocalcic metabolism, in normal functioning of the immune system and in the prevention of certain forms of cancer. Systematic vitamin D supplementation has been implemented in most Western countries, which has drastically reduced the prevalence of rickets. In Senegal, a country with enough sunshine, no large-scale data exists on vitamin D deficiency in children. In addition, there are no guidelines from the Ministry of Health and Social Action (MoHSA) on vitamin D supplementation. Our objective was to determine the prevalence of vitamin D deficiency in children aged 6 to 59 months and to analyze the factors associated with it at the Institute of Social Pediatrics in Pikine-Guédiawaye, a suburb of Dakar. Patients and Methods: This was a prospective, descriptive and analytical cross-sectional study over a 3-month period (from January to March 2024) at the Institute of Social Pediatric (IPS) of Pikine-Guédiawaye. The study population consisted of all children aged 6 to 59 months free from any acute or chronic pathology, whose parents had agreed to answer the questionnaires after having consented and signed the consent and children who had had a sample taken for vitamin D dosage. Results: We included 102 children, 35 of whom had vitamin D deficiency, i.e. a prevalence of 34.31% with a slight male predominance (sex ratio 1.05). Infants aged 13 - 24 months were more affected (41.67%), but the difference was not statistically significant (p-value = 0.385). Patients with acute malnutrition had a significantly higher prevalence of vitamin D deficiency (54.17% of cases versus 28.38%) in those without acute malnutrition (p = 0.02). On the other hand, chronic malnutrition, underweight and diversification foods were not significantly associated with vitamin D deficiency (p of 0.60, 0.42 and 0.09 respectively). Conclusion: Vitamin deficiency affects one-third of apparently healthy children under 5 and this deficiency has no significant relationship with diversification foods. This suggests that the observed vitamin D deficiencies are less related to diet than to lack of sun exposure.展开更多
Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective stud...Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective study in a descriptive and analytic view or way. It happened within 6 months. Diabetic patients who performed the nycthemeral urinary albumin dose and mentioned in the file were included. The last study is considered as a positive one from 30 to 299mg/24h: Microalbuminuria. The creatinine has been noted and the clearing of the creatinine is calculated through the formula of Cockcroft and Gault. The statistical analysis of data has been done thanks to software such as excel 2013 and SPSS VER 18.0. Results: 221 patients have been noted with 70% women and 30% men. The age varied between 30 years and 85 years with an average of 56, 62 against 9.97 years. Sixty three (63) patients have microalbuminuria (29%);creatinine has been regularized to 25 patients with 14.8% of cases. Among the microalbuminuria patients having completed the creatinine, 32 patients (42.7%) and 16 (21.3%) are respectively in a state of chronical renal failure, light and moderated. Conclusion: The microalbuminuria is frequent to diabetics. But in our series a starting renal insufficiency could precede that microalbuminuria.展开更多
Malnutrition is a global health problem. It is very common in developing countries where it contributes to an increase in morbidity and mortality, especially among children under five years of age. The main objective ...Malnutrition is a global health problem. It is very common in developing countries where it contributes to an increase in morbidity and mortality, especially among children under five years of age. The main objective of this study was to describe the management of severe acute malnutrition (SAM) in children six months to five years of age hospitalized at Diamniadio Children</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s Hospital (DCH).</span><span style="font-family:""> </span><span style="font-family:Verdana;">This was an epidemiological, retrospective, descriptive and cross-sectional study of children aged six to 59 months hospitalized at DCH for SAM. The study took place over a 12-month period (from January 1, 2018 to December 31, 2018).</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">During the study period, 67 children were admitted for SAM, representing a hospital prevalence of 8.4%. The majority (88%) children were less than 24 months old. Reasons for consultations were dominated by diarrhea (57.5%) vomiting (38.8%). Complications related to SAM were mainly: anaemia (74.6%), infections (85%) and severe acute dehydration </span><span style="font-family:Verdana;">(40.3%). Factors associated with SAM were young age (infants under 24</span><span style="font-family:Verdana;"> months of age), poverty, the first four children of a sibling, poor behaviour of food diversification. The average length of hospitalization was 12 days. The nutritional recovery rate was 73.1% and lethality was 3%.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Conclusion:</span><span style="font-family:Verdana;"> The prevention of malnutrition must involve the fight against poverty, an optimal and well-diversified diet, monitoring the nutritional status of children up to five years of age</span><span style="font-family:Verdana;">.展开更多
Aim: To evaluate the attitude practice and knowledge of pharmacists in the management of diabetes in the department of Dakar. Methodology: Cross-sectional study, conducted from 01 March to 30 September 2017 including ...Aim: To evaluate the attitude practice and knowledge of pharmacists in the management of diabetes in the department of Dakar. Methodology: Cross-sectional study, conducted from 01 March to 30 September 2017 including all pharmacists in the Dakar region who agreed to participate in the survey. Data was collected through a pre-established questionnaire. Results: A total of 144 pharmacists were included in the study, representing a participation rate of 87.58%. The average age was 33.90 years, with a sex ratio of 1.69. Pharmacists were single in 50.88% of cases, and a minimum experience of 5 years was found in 64.03% of cases. Pharmacist assistants accounted for 57.9% of our study population. The assessment of knowledge based on 16 items shows an average score of 9.02. The level of knowledge was low to insufficient in 37.21% of cases, average in (50%) half of cases and good for (13.16%). Less than half (34.21%) of pharmacists had received training and the average date of last training was 33.76 ± 24.6 months. Training was provided by medical representatives and academics in 66.66% and 26.67% respectively. The most felt positive feelings were respectively the need for help, the compassion in respectively 98.42%, 42.11%. Feelings felt and simultaneously cited were: need for help and compassion in more than 40% of respondents. Only 29% of pharmacists did not have a lot of difficulty with patient questions and the only reason was the lack of awareness (84.68%) of patients about their disease. Screening for diabetes by capillary blood glucose was performed by 57% of pharmacists. Dietary advice (76.15%) and referral to the hospital (94.41%) were the most common practices in case of blood sugar disruption. The dialogue with patients was impossible in 22.81% of pharmacists and the main reasons given were lack of time (53.85%) and lack of knowledge (34.62%). The method of delivery of insulin was done on: medical prescription (98.25%), presentation of the box (69.30%), on request of the patient (54.39%). Only one pharmacist recognized advising insulin (0.88%). The delivery of oral antidiabetic agents was: on medical prescription (96.49%), presentation of the box (67.54%), at the request of the patient (52.63%). The good level of knowledge was more found in the subjects after 40 years (p = 0.69), the female sex (p = 0.84), the assistants and holders (p = 0.24), after 5 years of professional experience (p = 0.13). Conclusion: Despite the lack of knowledge of pharmacists, attitudes and practices are considered satisfactory in the management of diabetics. Continuing medical education sessions could strengthen knowledge and consolidate the attitudes and practices of community pharmacists.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
<strong>Introduction:</strong> Diabetic patients adhering to their treatment are less likely to face complication from their disease. For this reason, we studied the compliance of diabetics with their trea...<strong>Introduction:</strong> Diabetic patients adhering to their treatment are less likely to face complication from their disease. For this reason, we studied the compliance of diabetics with their treatment. <strong>Materials and Method:</strong> This was a comprehensive cross-sectional study of adherence in diabetic patients. All patients meeting the inclusion criteria were enrolled in the study. This study took place at a private pharmacy called “pharmacy Elhadj Seydou Nourou Tall” located in the city of Pikine during the period from April 1 to September 30, 2019. <strong>Results:</strong> In total, the study population was composed of 125 diabetics;frequency of 8.47%. The average age was 62.5 years and there were more women (58.4%). Of the patients, 87% had a low socioeconomic level and 72% a low educational level. Only 65.6% of the patients knew their diabetes type. Even though 97.6% of the patients were confident in the treatment but due to financial reasons 20.8% did not adhere to the prescribed treatment and 16.8% to their diets. Moreover, 15.2% of the patients had changed the dosage of the prescribed medication, 44.4% had forgotten to take their medication regularly. 78.4% of them thought they were taking too much medication. No factors were found to be statistically associated with poor adherence, but the proportion of poor adherence patients was higher in patients over 60 years of age, with low socio-economic status and low education. <strong>Conclusion:</strong> Low socio-economic status is the main barrier to good adherence. Recommendations have been formulated to improve this adherence.展开更多
Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Meth...Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Methods: This was a descriptive cross-sectional study. Our investigations were recruited over a six-month period (October 17, 2021 to March 21, 2022). Results: Two hundred and twenty-six (226) patients were enrolled. The mean age was 45.9 years. The under-40 age group was the most represented with 37.2%. There were 129 men (57.1%), giving a male/female sex ratio of 1.33. The highest level was represented by 159 people (70.4%). Those who responded (heart disease) were in the majority (38.1%). Hypertension was the most common CVD for 101 people (44.7%). One hundred and ninety (190) people (84%) knew the risk factors for CVD. Good knowledge of risk factors concerned 103 people (54.2%). Obesity was the best-known risk factor in 156 cases (69%). The media was the most important source of information for 121 people (53.5%). Hypertensives were the most represented with 8.4%. One hundred and thirty (130) people (57.5%) had previously paid attention to these FDRCVs. Awareness campaigns were the most effective means of communication for 170 cases (75.2%). Sixteen (16) people (35.6%) were taking antihypertensive medication. Walking was the most popular physical activity for 102 people (45%). People with a balanced diet were in the majority, with 174 respondents (77.0%). Conclusion: NCDs are a major cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.展开更多
Introduction: The objective of that study was to evaluate diabetics knowledge, attitudes and practices on physical activity. Patients and Methods: That study has concerned 200 diabetics at Marc Sankale antidiabetic Ce...Introduction: The objective of that study was to evaluate diabetics knowledge, attitudes and practices on physical activity. Patients and Methods: That study has concerned 200 diabetics at Marc Sankale antidiabetic Center of Abass Ndao Hospital in Dakar. Women represent 76% with a sex ratio M: F0.13. The average age is 54 years with extremes of 4 to 84 years. The housewives are 29% and among them 15% haven’t any professional activity. 45.07% of the population is illiterate. In our study, 63.13% of patients have low socio economic level. In our series, the majority of patients is type 2 diabetes (89.5%). The diabetes evolution time is about 8 years inferior to 7% in 84 patients. In our study obesity is noted in 17.20% of cases. The HTA is present in 56% of cases. 54% of the studied population presents a dyslipidemia. Physical activity is practiced in 81% of patients. In our study the doctor’ advice motivates the half of our patients to practice physical activity (62.26%). The lack of time (43.2%) and volution (8.1%), the useless character of physical activity (2.7%) and the patients’ health state 45.9% are the obstacles to the practice of physical activity. The average frequency of physical activity practiced by patients is about 4 times a week with extremes ranging from 1 to 7 stages a week. The average time of activity practiced by patients is 39.72% with extremes ranging from 10 to 150 mn. 87% of patients practice physical activity at least 3 times a week. The main risks noted from intense physical activity in diabetics are hypertension 39.0%, ortestic hypertension 3.0%. In the contrary 58.8% of patients ignore the answer. Conclusion: Our study demonstrates the ignorance of diabetics on physical activity. Therefore it would be necessary to reinforce the training mainly therapeutic education in the patients taken into account.展开更多
Introduction: Bilirubin encephalopathy is a debilitating complication of severe neonatal unconjugated bilirubin jaundice. The aim of this study was to determine the frequency of occurrence of this complication and to ...Introduction: Bilirubin encephalopathy is a debilitating complication of severe neonatal unconjugated bilirubin jaundice. The aim of this study was to determine the frequency of occurrence of this complication and to describe the diagnostic and prognostic aspects in Senegal. Materials and Methods: This was a multicenter, descriptive and analytical study conducted in 32 neonatal units of various levels, with retrospective (January to December 2020) and prospective (January to August 2021) collection. All neonates hospitalized for acute bilirubin encephalopathy were included. The diagnostic criteria were the presence of jaundice associated with neurological signs (muscle tone disorders, abnormal movements, convulsions, etc.), with no other obvious etiology found. The data were entered and analyzed using SPSS version 23 software. The significance threshold was retained for a p-value Results: We registered 151 patients. The mean age was 6 days and the sex ratio was 2.5 (clear male predominance). The majority of newborns were from Dakar (51%). Twenty-two (22%) were premature and 32% had low birth weight. Half of the newborns (50%) came from home and 87% were exclusively breastfed. The average time to consult was 3 days. Neurological signs were dominated by decreased primitive reflexes (74%), abnormal movements (59%) and lethargy (50%). Dehydration (30%) and anemia (26%) were often associated. The mean bilirubin level was 416 umol/l. Neonatal infections (19%) and Rhesus (16.7%) and ABO (8.7) incompatibility were the main causes. One third (33%) of patients had received intensive phototherapy and only 2% had received exchange blood transfusion. The case fatality was 48.9%. Conclusion: Bilirubin encephalopathy remains a major concern in Senegal. It is associated with high mortality and numerous neurological sequelae. Progress in terms of early detection and appropriate management is urgently needed on a national scale.展开更多
Introduction: Constipation is the infrequent emission of hard stools. It is common, most often of functional origin, with a prevalence ranging from 0.7% to 29.6%. The aim of our study was to investigate the prevalence...Introduction: Constipation is the infrequent emission of hard stools. It is common, most often of functional origin, with a prevalence ranging from 0.7% to 29.6%. The aim of our study was to investigate the prevalence of constipation in children undergoing paediatric gastroenterology. Methodology: This was a bi-centric retrospective study carried out at the Albert Royer Children’s Hospital and the Dalal Jamm Hospital Pediatrics Department. Children followed in the pediatric gastroenterology consultation during the period from January 1, 2013 to February 29, 2020 were included. Results: A total of 337 children (205 boys;60.83%) were included, representing a prevalence of 25%. The median age was 3 years 6 months. The 13 - 24 months age group was the most frequent (27.6%). Rare stools were the main reason for consultation (92.8%). Rare stools were noted in 92.88% of cases. Bristol types 1 and 2 accounted for 6.53% and 54.60% respectively. The main associated signs were abdominal pain (29.4%), followed by abdominal bloating (20.96%). Abdominal pain was functional in 73.58% of cases. Under treatment, 90.19% of children had a favorable outcome. Conclusion: Constipation is common in Senegalese children with a prevalence close to that reported in Western countries. In most case, it is functional with good prognostic.展开更多
Introduction: Systemic diseases are a variety of heterogeneous autoimmune and/or autoinflammatory diseases and syndromes usually affecting multiple systems and resulting from immune system dysregulation. We evaluated ...Introduction: Systemic diseases are a variety of heterogeneous autoimmune and/or autoinflammatory diseases and syndromes usually affecting multiple systems and resulting from immune system dysregulation. We evaluated risk factors for depression and anxiety in an autoimmune disease cohort compared with diabetic patients. Patients and Methods: We conducted an observational, cross-sectional, case-control survey comparing two groups: individuals with connective tissue disease (CTD) and diabetic controls who were followed within three Dakar University hospitals during the period from April to June 2023. Results: The sample comprised 106 participants, of whom 51 (48%) had CTD and 55 (52%) served as diabetic controls. In the CTD group, the majority had lupus (19) and rheumatoid arthritis (23). The CTD patients had a mean age of 41.0 years (SD 16.9), while the diabetic patients had a mean age of 55.9 years (SD 11.7), with a significant difference observed (p Conclusion: Compared to a chronic disease, devastating in Africa and evolving over the long term, autoimmune diseases are more strongly and more frequently associated with anxiety and depression. This is a factor to be taken into account in the holistic management of these patients.展开更多
Introduction: Multiple myeloma (MM) is characterized by the abnormal proliferation of a plasma cell clone invading the bone marrow, with secretion of a monoclonal immunoglobulin (Ig), detectable by serum protein elect...Introduction: Multiple myeloma (MM) is characterized by the abnormal proliferation of a plasma cell clone invading the bone marrow, with secretion of a monoclonal immunoglobulin (Ig), detectable by serum protein electrophoresis. The aim of our work was to study the electrophoretic profile of patients with MM. Methods: This is a retrospective descriptive and analytical study including 76 patients with MM, whose serum samples were received at the Biochemistry Department of the Dalal Jamm National Hospital during the period from January 1, 2021 to April 30, 2023. For each patient, we studied epidemiological data (age, sex, service) and biochemical variables (proteinemia, electrophoresis and serum protein immunofixation). Results: The mean age of our patients was 58 ± 10.24 years, with a sex ratio of 0.9, with a female predominance (52.6%). The majority of cohort (71.1%) were consulted as outpatients. Hyperproteinemia was observed in 27.6% of patients, with a mean average of 91.2 ± 25.2 g/L, while hypoalbuminemia was found in 43.4% of patients. A monoclonal peak was noted at the Serum protein electrophoresis (SPEP) in all patients in our series, 75% of whom were in the gamma zone and 22.4% in the beta zone. Immunofixation had objectified kappa-type IgG myeloma in the majority of patients (77.8%). Conclusion: Among the biological markers of MM, serum protein electrophoresis remains the most characteristic for detecting monoclonal immunoglobulin.展开更多
文摘Introduction: Diabetes is a public health problem and is exposed to some complications, particularly infectious. The work on this entity remains segmentary in Africa. The objective was to describe the morbi infectious mortality of the diabetics at the Medical Clinic II of Abass Ndao Health Center of Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 January 2016 to 31 December 2016. It covered patients with diabetes hospitalized during the study period. Epidemiological data and infectious diseases were evaluated. Results: During the study period, 346 diabetics have respected the inclusion criteria. These were 165 men (47.68%), a sex ratio of 0.91. The mean age was 56.17 years. The age group of [60 - 69 years] accounted for 31.5% and 95.6% of the patients came from the Dakar region. The average age of diabetes was 10.31. Diabetes had been evolving for less than 5 years in 25.15% of patients and inaugural in 11.46%. About 82.36% of our patients had type 2 diabetes. The acute complications of diabetes were ketoacidosis (51.89%), hyperosmolar hyperglycemia (0.58%), and hypoglycemia (1.45%). The mean infections were the skin and soft tissues (54.91%), urogenital infections (16.18%), respiratory infections (14.45%), malaria (3.46), infections of the skin and soft tissues were dominated by the diabetic foot (41.90%). The 125 non-diabetic patients developed 38 infectious pathologies, the main ones being respiratory infections (24.32%), infections of the skin and soft parts (24.32%). HIV infection was observed in 0.28% of diabetics and 8.10% of non-diabetic patients. 93 patients died (15.70%). Fifty-one of them died of infectious diseases (54.8%), 42 non-infectious diseases (45.16%), and subjects aged over 60 years, representing 72.54%. The means of consultation was 30 days. The highest rates of lethality were diabetes (37.41%), acute gastroenteritis (17.64%), and acute pyelonephritis (12.5%). The lethality rates of indeterminate infections and malaria were 10% and 8.33%, respectively. Conclusion: Infection is a significant complication in diabetics not neglectable to diabetes. These discovery patterns call for more early diagnosis and appropriate management to reduce the mortality of diabetics.
文摘Introduction: The COVID-19 pandemic has led to changes in health systems. The objective was to assess the effect of Covid-19 on the frequency of prenatal consultations (PNCs) for pathological pregnancies at the Abass NDAO Hospital Centre. Materials and Methods: This was primarily a retrospective study conducted at the Abass NDAO Hospital maternity ward. The target was the medical records of women followed for a pathological pregnancy at maternity from July 2019 to November 2020. Second, the department’s qualified staffs were asked about their experiences with the Covid-19 pandemic. Data collection was carried out between October 2021 and February 2022. Results: A total of 690 prenatal charts for pathological pregnancy were collected: 375 (54%) before the pandemic compared to 315 during Covid-19 (46%). The average age of women was 28.15 years. The age group 25 and 35 was the most represented (36.81%). Reasons for consultation were dominated by threats of premature delivery (51%), followed by severe pre-eclampsia (14%) and premature membrane rupture (11%), respectively. The frequency of prenatal consultations (PNCs) was inversely related to pandemic dynamics and significant monthly variations were observed. Qualified health personnel were midwives (71.40%) and gynecologists (28.60%). During the pandemic, more than the majority of staff (67%) worked 3 days a week, and 24% of health workers 5 days. The majority of staff (60%) reported experiencing overwork during the pandemic. Non-compliance with consultation days was noted in 38% of health providers. Protective equipment was not provided to 14% of the staff. Staff difficulties during prenatal consultations were fear of occupational exposure (12%) and patient reluctance (88%). Conclusion: The Covid-19 pandemic is having a major impact on prenatal consultations for pathological pregnancies at Abass NDAO Hospital. Effective measures must be taken to avoid the consequences of maternal mortality and the functioning of the structure.
文摘Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutionary aspects. Materials and Methods: This was a cross-sectional, descriptive study, conducted over 5 years (from January 01, 2018 to December 31, 2022) at the National Abass Ndao Hospital Center and including all confirmed cases of primary hyperparathyroidism. Results: Twenty-nine patients were included with a female predominance (86.20%) and an average age of 48.10 ± 18.93 years. The discovery of hyperparathyroidism was fortuitous in 79.31% of cases. The main clinical manifestations were osteoarticular (62%) and urinary (34.5%). On average, serum calcium measured was 109.2 ± 7.92 mg/l, corrected serum calcium 111.3 ± 6.25 mg/l, urinary calcium 421.9 ± 96.45 mg/24h and parathormone at 145 ± 159.71 pg/ml. Among the patients, 25 had hypercalcemia (86.2%) and all had 24-hour hypercalciuria. The diagnosis was retained in view of the elevated parathyroid hormone (PTH) values in all patients. Cervical ultrasound objectified a parathyroid adenoma in 27.58% of cases and 12 patients or 46.2% had presented a scintigraphy in favor of a parathyroid adenoma. We found 01 cases of multiple endocrine neoplasia type 2. Bone densitometry performed in 10 patients found osteoporosis in 60% of cases (6 patients) and osteopenia in 40% of cases (4 patients). Surgical treatment was performed in 12 patients (41.4%). The histology of the surgical specimens was in favor of a parathyroid adenoma in all cases. Among the operated patients, the evolution was marked by a cure rate of 100%. Conclusion: The symptomatology of primary hyperparathyroidism remains mainly osteoarticular and urinary. Surgery has proven its effectiveness in our series. We insist on the systematic dosage of calcemia especially in women over 50 years and the promotion of morphological explorations.
文摘Introduction: Vitamin D plays a key role in phosphocalcic metabolism, in normal functioning of the immune system and in the prevention of certain forms of cancer. Systematic vitamin D supplementation has been implemented in most Western countries, which has drastically reduced the prevalence of rickets. In Senegal, a country with enough sunshine, no large-scale data exists on vitamin D deficiency in children. In addition, there are no guidelines from the Ministry of Health and Social Action (MoHSA) on vitamin D supplementation. Our objective was to determine the prevalence of vitamin D deficiency in children aged 6 to 59 months and to analyze the factors associated with it at the Institute of Social Pediatrics in Pikine-Guédiawaye, a suburb of Dakar. Patients and Methods: This was a prospective, descriptive and analytical cross-sectional study over a 3-month period (from January to March 2024) at the Institute of Social Pediatric (IPS) of Pikine-Guédiawaye. The study population consisted of all children aged 6 to 59 months free from any acute or chronic pathology, whose parents had agreed to answer the questionnaires after having consented and signed the consent and children who had had a sample taken for vitamin D dosage. Results: We included 102 children, 35 of whom had vitamin D deficiency, i.e. a prevalence of 34.31% with a slight male predominance (sex ratio 1.05). Infants aged 13 - 24 months were more affected (41.67%), but the difference was not statistically significant (p-value = 0.385). Patients with acute malnutrition had a significantly higher prevalence of vitamin D deficiency (54.17% of cases versus 28.38%) in those without acute malnutrition (p = 0.02). On the other hand, chronic malnutrition, underweight and diversification foods were not significantly associated with vitamin D deficiency (p of 0.60, 0.42 and 0.09 respectively). Conclusion: Vitamin deficiency affects one-third of apparently healthy children under 5 and this deficiency has no significant relationship with diversification foods. This suggests that the observed vitamin D deficiencies are less related to diet than to lack of sun exposure.
文摘Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective study in a descriptive and analytic view or way. It happened within 6 months. Diabetic patients who performed the nycthemeral urinary albumin dose and mentioned in the file were included. The last study is considered as a positive one from 30 to 299mg/24h: Microalbuminuria. The creatinine has been noted and the clearing of the creatinine is calculated through the formula of Cockcroft and Gault. The statistical analysis of data has been done thanks to software such as excel 2013 and SPSS VER 18.0. Results: 221 patients have been noted with 70% women and 30% men. The age varied between 30 years and 85 years with an average of 56, 62 against 9.97 years. Sixty three (63) patients have microalbuminuria (29%);creatinine has been regularized to 25 patients with 14.8% of cases. Among the microalbuminuria patients having completed the creatinine, 32 patients (42.7%) and 16 (21.3%) are respectively in a state of chronical renal failure, light and moderated. Conclusion: The microalbuminuria is frequent to diabetics. But in our series a starting renal insufficiency could precede that microalbuminuria.
文摘Malnutrition is a global health problem. It is very common in developing countries where it contributes to an increase in morbidity and mortality, especially among children under five years of age. The main objective of this study was to describe the management of severe acute malnutrition (SAM) in children six months to five years of age hospitalized at Diamniadio Children</span><span style="font-family:Verdana;">’</span><span style="font-family:Verdana;">s Hospital (DCH).</span><span style="font-family:""> </span><span style="font-family:Verdana;">This was an epidemiological, retrospective, descriptive and cross-sectional study of children aged six to 59 months hospitalized at DCH for SAM. The study took place over a 12-month period (from January 1, 2018 to December 31, 2018).</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">During the study period, 67 children were admitted for SAM, representing a hospital prevalence of 8.4%. The majority (88%) children were less than 24 months old. Reasons for consultations were dominated by diarrhea (57.5%) vomiting (38.8%). Complications related to SAM were mainly: anaemia (74.6%), infections (85%) and severe acute dehydration </span><span style="font-family:Verdana;">(40.3%). Factors associated with SAM were young age (infants under 24</span><span style="font-family:Verdana;"> months of age), poverty, the first four children of a sibling, poor behaviour of food diversification. The average length of hospitalization was 12 days. The nutritional recovery rate was 73.1% and lethality was 3%.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Conclusion:</span><span style="font-family:Verdana;"> The prevention of malnutrition must involve the fight against poverty, an optimal and well-diversified diet, monitoring the nutritional status of children up to five years of age</span><span style="font-family:Verdana;">.
文摘Aim: To evaluate the attitude practice and knowledge of pharmacists in the management of diabetes in the department of Dakar. Methodology: Cross-sectional study, conducted from 01 March to 30 September 2017 including all pharmacists in the Dakar region who agreed to participate in the survey. Data was collected through a pre-established questionnaire. Results: A total of 144 pharmacists were included in the study, representing a participation rate of 87.58%. The average age was 33.90 years, with a sex ratio of 1.69. Pharmacists were single in 50.88% of cases, and a minimum experience of 5 years was found in 64.03% of cases. Pharmacist assistants accounted for 57.9% of our study population. The assessment of knowledge based on 16 items shows an average score of 9.02. The level of knowledge was low to insufficient in 37.21% of cases, average in (50%) half of cases and good for (13.16%). Less than half (34.21%) of pharmacists had received training and the average date of last training was 33.76 ± 24.6 months. Training was provided by medical representatives and academics in 66.66% and 26.67% respectively. The most felt positive feelings were respectively the need for help, the compassion in respectively 98.42%, 42.11%. Feelings felt and simultaneously cited were: need for help and compassion in more than 40% of respondents. Only 29% of pharmacists did not have a lot of difficulty with patient questions and the only reason was the lack of awareness (84.68%) of patients about their disease. Screening for diabetes by capillary blood glucose was performed by 57% of pharmacists. Dietary advice (76.15%) and referral to the hospital (94.41%) were the most common practices in case of blood sugar disruption. The dialogue with patients was impossible in 22.81% of pharmacists and the main reasons given were lack of time (53.85%) and lack of knowledge (34.62%). The method of delivery of insulin was done on: medical prescription (98.25%), presentation of the box (69.30%), on request of the patient (54.39%). Only one pharmacist recognized advising insulin (0.88%). The delivery of oral antidiabetic agents was: on medical prescription (96.49%), presentation of the box (67.54%), at the request of the patient (52.63%). The good level of knowledge was more found in the subjects after 40 years (p = 0.69), the female sex (p = 0.84), the assistants and holders (p = 0.24), after 5 years of professional experience (p = 0.13). Conclusion: Despite the lack of knowledge of pharmacists, attitudes and practices are considered satisfactory in the management of diabetics. Continuing medical education sessions could strengthen knowledge and consolidate the attitudes and practices of community pharmacists.
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<strong>Introduction:</strong> Diabetic patients adhering to their treatment are less likely to face complication from their disease. For this reason, we studied the compliance of diabetics with their treatment. <strong>Materials and Method:</strong> This was a comprehensive cross-sectional study of adherence in diabetic patients. All patients meeting the inclusion criteria were enrolled in the study. This study took place at a private pharmacy called “pharmacy Elhadj Seydou Nourou Tall” located in the city of Pikine during the period from April 1 to September 30, 2019. <strong>Results:</strong> In total, the study population was composed of 125 diabetics;frequency of 8.47%. The average age was 62.5 years and there were more women (58.4%). Of the patients, 87% had a low socioeconomic level and 72% a low educational level. Only 65.6% of the patients knew their diabetes type. Even though 97.6% of the patients were confident in the treatment but due to financial reasons 20.8% did not adhere to the prescribed treatment and 16.8% to their diets. Moreover, 15.2% of the patients had changed the dosage of the prescribed medication, 44.4% had forgotten to take their medication regularly. 78.4% of them thought they were taking too much medication. No factors were found to be statistically associated with poor adherence, but the proportion of poor adherence patients was higher in patients over 60 years of age, with low socio-economic status and low education. <strong>Conclusion:</strong> Low socio-economic status is the main barrier to good adherence. Recommendations have been formulated to improve this adherence.
文摘Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Methods: This was a descriptive cross-sectional study. Our investigations were recruited over a six-month period (October 17, 2021 to March 21, 2022). Results: Two hundred and twenty-six (226) patients were enrolled. The mean age was 45.9 years. The under-40 age group was the most represented with 37.2%. There were 129 men (57.1%), giving a male/female sex ratio of 1.33. The highest level was represented by 159 people (70.4%). Those who responded (heart disease) were in the majority (38.1%). Hypertension was the most common CVD for 101 people (44.7%). One hundred and ninety (190) people (84%) knew the risk factors for CVD. Good knowledge of risk factors concerned 103 people (54.2%). Obesity was the best-known risk factor in 156 cases (69%). The media was the most important source of information for 121 people (53.5%). Hypertensives were the most represented with 8.4%. One hundred and thirty (130) people (57.5%) had previously paid attention to these FDRCVs. Awareness campaigns were the most effective means of communication for 170 cases (75.2%). Sixteen (16) people (35.6%) were taking antihypertensive medication. Walking was the most popular physical activity for 102 people (45%). People with a balanced diet were in the majority, with 174 respondents (77.0%). Conclusion: NCDs are a major cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.
文摘Introduction: The objective of that study was to evaluate diabetics knowledge, attitudes and practices on physical activity. Patients and Methods: That study has concerned 200 diabetics at Marc Sankale antidiabetic Center of Abass Ndao Hospital in Dakar. Women represent 76% with a sex ratio M: F0.13. The average age is 54 years with extremes of 4 to 84 years. The housewives are 29% and among them 15% haven’t any professional activity. 45.07% of the population is illiterate. In our study, 63.13% of patients have low socio economic level. In our series, the majority of patients is type 2 diabetes (89.5%). The diabetes evolution time is about 8 years inferior to 7% in 84 patients. In our study obesity is noted in 17.20% of cases. The HTA is present in 56% of cases. 54% of the studied population presents a dyslipidemia. Physical activity is practiced in 81% of patients. In our study the doctor’ advice motivates the half of our patients to practice physical activity (62.26%). The lack of time (43.2%) and volution (8.1%), the useless character of physical activity (2.7%) and the patients’ health state 45.9% are the obstacles to the practice of physical activity. The average frequency of physical activity practiced by patients is about 4 times a week with extremes ranging from 1 to 7 stages a week. The average time of activity practiced by patients is 39.72% with extremes ranging from 10 to 150 mn. 87% of patients practice physical activity at least 3 times a week. The main risks noted from intense physical activity in diabetics are hypertension 39.0%, ortestic hypertension 3.0%. In the contrary 58.8% of patients ignore the answer. Conclusion: Our study demonstrates the ignorance of diabetics on physical activity. Therefore it would be necessary to reinforce the training mainly therapeutic education in the patients taken into account.
文摘Introduction: Bilirubin encephalopathy is a debilitating complication of severe neonatal unconjugated bilirubin jaundice. The aim of this study was to determine the frequency of occurrence of this complication and to describe the diagnostic and prognostic aspects in Senegal. Materials and Methods: This was a multicenter, descriptive and analytical study conducted in 32 neonatal units of various levels, with retrospective (January to December 2020) and prospective (January to August 2021) collection. All neonates hospitalized for acute bilirubin encephalopathy were included. The diagnostic criteria were the presence of jaundice associated with neurological signs (muscle tone disorders, abnormal movements, convulsions, etc.), with no other obvious etiology found. The data were entered and analyzed using SPSS version 23 software. The significance threshold was retained for a p-value Results: We registered 151 patients. The mean age was 6 days and the sex ratio was 2.5 (clear male predominance). The majority of newborns were from Dakar (51%). Twenty-two (22%) were premature and 32% had low birth weight. Half of the newborns (50%) came from home and 87% were exclusively breastfed. The average time to consult was 3 days. Neurological signs were dominated by decreased primitive reflexes (74%), abnormal movements (59%) and lethargy (50%). Dehydration (30%) and anemia (26%) were often associated. The mean bilirubin level was 416 umol/l. Neonatal infections (19%) and Rhesus (16.7%) and ABO (8.7) incompatibility were the main causes. One third (33%) of patients had received intensive phototherapy and only 2% had received exchange blood transfusion. The case fatality was 48.9%. Conclusion: Bilirubin encephalopathy remains a major concern in Senegal. It is associated with high mortality and numerous neurological sequelae. Progress in terms of early detection and appropriate management is urgently needed on a national scale.
文摘Introduction: Constipation is the infrequent emission of hard stools. It is common, most often of functional origin, with a prevalence ranging from 0.7% to 29.6%. The aim of our study was to investigate the prevalence of constipation in children undergoing paediatric gastroenterology. Methodology: This was a bi-centric retrospective study carried out at the Albert Royer Children’s Hospital and the Dalal Jamm Hospital Pediatrics Department. Children followed in the pediatric gastroenterology consultation during the period from January 1, 2013 to February 29, 2020 were included. Results: A total of 337 children (205 boys;60.83%) were included, representing a prevalence of 25%. The median age was 3 years 6 months. The 13 - 24 months age group was the most frequent (27.6%). Rare stools were the main reason for consultation (92.8%). Rare stools were noted in 92.88% of cases. Bristol types 1 and 2 accounted for 6.53% and 54.60% respectively. The main associated signs were abdominal pain (29.4%), followed by abdominal bloating (20.96%). Abdominal pain was functional in 73.58% of cases. Under treatment, 90.19% of children had a favorable outcome. Conclusion: Constipation is common in Senegalese children with a prevalence close to that reported in Western countries. In most case, it is functional with good prognostic.
文摘Introduction: Systemic diseases are a variety of heterogeneous autoimmune and/or autoinflammatory diseases and syndromes usually affecting multiple systems and resulting from immune system dysregulation. We evaluated risk factors for depression and anxiety in an autoimmune disease cohort compared with diabetic patients. Patients and Methods: We conducted an observational, cross-sectional, case-control survey comparing two groups: individuals with connective tissue disease (CTD) and diabetic controls who were followed within three Dakar University hospitals during the period from April to June 2023. Results: The sample comprised 106 participants, of whom 51 (48%) had CTD and 55 (52%) served as diabetic controls. In the CTD group, the majority had lupus (19) and rheumatoid arthritis (23). The CTD patients had a mean age of 41.0 years (SD 16.9), while the diabetic patients had a mean age of 55.9 years (SD 11.7), with a significant difference observed (p Conclusion: Compared to a chronic disease, devastating in Africa and evolving over the long term, autoimmune diseases are more strongly and more frequently associated with anxiety and depression. This is a factor to be taken into account in the holistic management of these patients.
文摘Introduction: Multiple myeloma (MM) is characterized by the abnormal proliferation of a plasma cell clone invading the bone marrow, with secretion of a monoclonal immunoglobulin (Ig), detectable by serum protein electrophoresis. The aim of our work was to study the electrophoretic profile of patients with MM. Methods: This is a retrospective descriptive and analytical study including 76 patients with MM, whose serum samples were received at the Biochemistry Department of the Dalal Jamm National Hospital during the period from January 1, 2021 to April 30, 2023. For each patient, we studied epidemiological data (age, sex, service) and biochemical variables (proteinemia, electrophoresis and serum protein immunofixation). Results: The mean age of our patients was 58 ± 10.24 years, with a sex ratio of 0.9, with a female predominance (52.6%). The majority of cohort (71.1%) were consulted as outpatients. Hyperproteinemia was observed in 27.6% of patients, with a mean average of 91.2 ± 25.2 g/L, while hypoalbuminemia was found in 43.4% of patients. A monoclonal peak was noted at the Serum protein electrophoresis (SPEP) in all patients in our series, 75% of whom were in the gamma zone and 22.4% in the beta zone. Immunofixation had objectified kappa-type IgG myeloma in the majority of patients (77.8%). Conclusion: Among the biological markers of MM, serum protein electrophoresis remains the most characteristic for detecting monoclonal immunoglobulin.
