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Biomedical subjects

A Ngom

Publications and source records attributed to A Ngom.

18 recordsLinked to original sources
PubMed2004

[Epidemiological, clinical and biological profile of resistant or recurrent pulmonary tuberculosis in Abidjan].

From August to December 1998, over a period of 5 months, a cross-sectional study had been carried out in Abidjan in order to analyze the epidemiological and microbiological features of BAAR+ TB patients in situation of failure or relapse after specific treatment. We investigated 79 patients enrolled in the departments of pulmonary disease of two general hospitals in Abidjan (CHU of Cocody and Treichville) and a TB outpatients' clinic. From 45 strains of Mycobacterium obtained by culture, 33 antibiograms were performed. The rate of multi-drug-resistance (MDR-TB) was 79%. Among MDR--TB patients, those aged of 20-40 years were the most concerned age group (72%) with a clear male predominant rate (sex ratio: 3). Among them 49/79 (62%) had an educational level lower or equal to primary school standarts and most of them lived in dwellings with common yard (67%). In their medical history only 40% had tuberculosis and 2 cases of self-medication were reported. MDR--TB prevailed among patients having at first a positive bacilloscopy. No link between HIV infection and MDR--TB was found.

Adult↗
PubMed2001

Benign mediastinal lymphadenopathy in congestive heart failure.

We report three cases of benign mediastinal lymphadenopathy revealed by chest radiography in patients ranging in age from 61 to 75 years. All three patients had severe coronary heart disease and a history of several episodes of acute cardiac decompensation. Chest CT scanning contributed to the diagnosis by revealing the existence of multiple enlarged lymph nodes, mostly 10 to 17 mm in short-axis diameter. CT scanning also confirmed the disappearance of the mediastinal lymph nodes in one patient on follow-up after treatment with diuretics and digitalis. Histopathology investigations of biopsy samples obtained by mediastinoscopy consistently revealed noninflammatory, benign lesions that did not affect the node structure. Our report draws attention to the particular nosology of left heart disease represented by benign enlarged lymph nodes of the mediastinum and pulmonary edema. The diagnostic approach to such lymphadenopathy should be guided by the radiologic regression seen on follow-up CT scanning while the patient was undergoing appropriate therapy for congestive heart failure, which constitutes a decisive argument for the congestive heart failure origin.

Aged↗
PubMed2001

[Evaluation of likely antibiotherapy in bacterial-like acute pneumopathies in patients hospitalized in Africa].

We conducted a retrospective analysis of 100 records of adult African patients hospitalised for bacterial-like acute pneumonia. The objective of the study was to evaluate the use and efficacy of probabilist antibiotherapy. The study population was made up of 57% men and 43% women. Serious clinical symptoms were found in 31% of the patients, with serious x-ray and biological anomalies for respectively 67% and 51% cases. Secondary morbidity was associated with pneumonia in 30% cases. In the first intention, the three (3) most prescribed antibiotics are beta-lactamins (84%), fluoroquinolons (25%), and aminosids (25%). Sulfamids, macrolids and imidazols were prescribed together in 18% cases. Monotherapy was prescribed in 53% cases and concerned especially amoxicillin (39/53) and fluoroquinolons (5/53). Double therapy was used in 42% of cases and consisted of amoxicillin + aminosid (21/42) and amoxicillin + fluoroquinolon (17/42). Three antibiotics were noted for 5 cases. The intravenous administration was frequently used (68%), either alone (27%), either associated with other modes of drug administration (41%). Mean duration of antibiotherapy was 12.71 days. 73% of patients improved, 22% failed to improve and 5% died. Antibiotherapy was influenced by the seriousness biological signs and by the mode of administration of antibiotherapy in monotherapy. Deaths occurred precociously and concerned HIV positive (4/5) patients presenting at least 2 factors of co-morbidity and having received beta-lactamin in monotherapy.

Adult↗
PubMed2001

[Role of pharmacists in the management of asthma in Africa. Survey among pharmacists from the city of Abidjan].

This questionnaire survey was conducted to assess delivery of asthma drugs in community pharmacies in Abidjan, Ivory Coast. Participation rate was 88.69%. All participants stated they provide care for asthma patients either during acute episodes or between acute episodes. It was found that a considerable number of patients come to community pharmacies for care without prior medical prescription. In case of acute episodes, care is provided by the pharmacist in 59.80% of the cases. Aerosol devices are the most widely used although the technical procedures required for correct inhalation were found to be poorly understood by pharmacists. Slow-release corticosteroids are widely delivered for chronic care. Pharmacists also provide information and advice on drug compliance and concerning the importance of regular medical care and eviction of allergens.

Anti-Asthmatic Agents↗
PubMed1999

[Epidemiology of tuberculosis in Abidjan, Ivory Coast: effects of HIV infection].

Despite the rising morbidity and mortality of tuberculosis in patients with HIV infection, epidemiology of tuberculosis in the Ivory Coast remains under-documented. The aim of this retrospective study of 1638 cases of tuberculosis diagnosed in the Pneumology Department of the Abidjan University Hospital was to collect current epidemiological data. From 1986 to 1992, a total of 4631 patients were hospitalized at University Hospital-Abidjan. Clinical and serological tests to detect HIV infection were performed in 982 patients. During hospitalization all patients received the same treatment for tuberculosis (2RHZ/4RH). Tuberculosis accounted for 42 p. 100 of diagnoses with a prevalence of 234 patients per year and a rate of increase was 4.5 p. 100 per year. Most patients were between the ages of 20 and 40 years (59 p. 100) and of male sex (72 p. 100). Overall HIV seroprevalence was 44.5 p. 100 with a rate of increase of 4.4 p. 100 per year. The proportion of patients tested for HIV grew from 11 p. 100 to 98 p. 100 over the seven-year study period and infection rates were consistently higher in men than in women (sex ratio: 3 to 1). The mean percentage of extrapulmonary or disseminated tuberculosis was sharply higher in the last three years of study (from 23.5 p. 100 to 46 p. 100 after 1989). This study demonstrates that seroprevalence rate has increased and that this increase has been correlated with a rising incidence of lethal and extrapulmonary tuberculosis.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Fatal asthma. Seven case reports observed in Black Africans and review of the literature].

This is a retrospective study based on a descriptive analysis of the case notes of seven asthmatics who died during hospitalisation over a period of eleven years. Our objective was to underline the potentially fatal character of asthma and to review the characteristics of asthma on the Ivory Coast. The seven cases of fatal asthma (five men and two women) representing 7 out of 1291 of the causes of death in the period under consideration (< 0.5%). The mean age was 32 years. Basic treatment was non-existent in 5 out of 7 cases (71.4%) and relied on only a Salbutamol aerosol in two cases (28.6%). In four cases the individuals were without jobs (57.13%), retired in two cases (28.6%) and a child in one case (14.27%). The death occurred on admission in three cases (42.8%). The asthma was type III as described by Marsac with the two clinical forms. The immediate cause of death was delayed treatment for the crisis (3 out of 7), acute cardiorespiratory decompensation (2 out of 7) and sudden death (2 out of seven). Fatal asthma is a reality on the Ivory Coast and the risk factors seem to particularly related to the precarious conditions of life there.

Adolescent↗
PubMed1998

[Prevalence of nocardiosis in an area of endemic tuberculosis].

This is a prospective study recruiting 120 patients successively who were admitted to the chest department in hospital for respiratory infections irrespective of their aetiology. The aim of the study was to assess the frequency of nocardiosis in respiratory pathology in the era of AIDS and in an area where tuberculosis is endemic. The HIV serology was carried out on all 120 patients. A systemic search was made for nocardiosis and Koch's bacillus in the sputum and also in the broncho-alveolar lavage liquid obtained by endoscopy. The HIV serology was positive in 74 patients (61.7%). Pulmonary nocardiosis was diagnosed in five patients (4.2%), of whom four patients were HIV positive (80%). Tuberculosis was diagnosed in 58 cases (48.3%) of whom 40 were HIV positive (70%). The association of nocardiosis and tuberculosis was present in only one patient. The radioclinical aspect of nocardiosis in our service was suggestive of tuberculosis. The prevalence of nocardiosis in our series at 4.2% is in agreement with that obtained in autopsy studies in the Ivory Coast. The similarity of the radioclinical appearance between tuberculosis and nocardiosis demands that a search is made for the latter on all HIV positive patients and in negative cases a search for Koch's bacillus and empirical antibiotic therapy ought to have a spectrum of activity that would include nocardia.

Adolescent↗
PubMed1997

[Association of pneumocystosis and pulmonary tuberculosis in an HIV-negative patient].

Pneumocystis pneumonia occurring in the context of immunodepression induced by HIV is regularly described, although infrequent in Africa. Pneumocystis outside cases of AIDS is not common in Black Africa. We report a case of an association between tuberculosis and pneumocystis pneumonia in a patient whose sole risk factor seemed to be hepatic cirrhosis.

HIV Seronegativity↗
PubMed1997

[Bacterial lung diseases from common bacteria during HIV infection in African adults hospitalized in Abidjan, Côte d'Ivoire].

In this retrospective study, authors compare radiographic and clinical aspects in two groups of patients. They are hospitalized for bacterial pneumonia and distinguished by HIV serological profile (HIV+ or HIV-). Positif HIV serologic is observed in 60% among 96 patients included in this study. An african adult infected by HIV shows not much particularity. We notice however that dyspnoea is observed more frequently in the subject infected by HIV+: 74% against 26% of the groups HIV-. Reoccurring pneumoniae are only observed in the subject infected with HIV+: 12%. Extensive and bilateral radiographic lesions were more observed in HIV+ patients. Causative agent has been isolated in 11 cases (9 pneumococcus: 81%). The antibiotic treatment has a same result in two groups (HIV- and HIV+). Thus it is necessary to undertake research for further information concerning etiologies of bacterial pneumonia in HIV+ subjects in African countries.

Adult↗
PubMed1997

[Etiologies of pleurisies in African milieu. Experience of the Cocody Pneumology department (Abidjan-Côte d'Ivoire)].

We analyzed hospital files of 614 pleurisy patients at the Cocody University Hospital over a 5 year period (1990-1994). We searched for the main etiologies of pleural effusion in these patients in order to propose an empirical treatment. Pleurisy is involved in 23% of all respiratory patients seen each year. Pleural effusions are observed in 91% of the cases. Clear fluid was observed most frequently (65%), followed by purulent (31%) and hemorrhagic effusion (4%). The dominant etiology was tuberculosis (66%). Non-tuberculosis infections were found in 5% of the cases. Tumoral diseases were involved in 3% and ambiasis in 1%. The cause of the pleural effusion remained unidentified in 24%. In 59% of the cases treatment was initiated without a definitive diagnosis. The incidence of HIV infection was high: 167 seropositive patients (72%) among the 231 patients tested. In conclusion, infections are the predominant etiologies of pleurisy at the Cocody University Hospital (72%) and the high frequency of tuberculosis argues for empirical antituberculosis therapy if no cause is identified.

Adult↗
PubMed1997

[Trachomatous entropion trichiasis at the ophthalmologic clinic of Dantec CHU (apropos of 199 cases)].

In Senegal as well as others developing countries trachoma is a real public health problem. Entropion trichiasis is its most common and its most blinding complication. The authors made a retrospective study on 137 records of patients who underwent 199 surgical cures on a two years period. Epidemiologically, the average age is 49 years with a significative higher percentage of woman. Clinically, 51.5% of the patients had already complications, mostly on the cornea. The Trabut technique was the most used and its results was good in 82.4% cases. The authors underlined the duality of entropion trichiasis characterized by the ocular morbidity linked to the corneal damages and the simplicity of the surgical treatment which present definite advantages. Meanwhile they remind that the best treatment of the entropion trichiasis remains the prophylaxy of trachoma.

Adolescent↗