Biomedical subjects
Publications and source records attributed to F Diadhiou.
The authors reviewed two cases of extra-uterine and intra-uterine pregnancies association. The frequency was higher than people expect. The diagnosis, usually done after surgery because of a very poor symptomatology, should benefit to the precious help of echography to make the prognosis better.
In a comparative study issued in 1989 in Gynecology in Dantec (a Medical Hospital School) in Dakar (Senegal), the authors made a retrospective analysis of 206 cases of abruptio placenta (3.3%) and 56 cases of eclampsia (0.9%). After a physiopathologic overview of the vascular renal syndromes, they point out the risk factors of paroxistic accidents represented mainly by the age and the parity, knowing that young age and primiparity appear as new risk factors for abruptio placenta. Finally, they insisted on the prevention of these accidents because of their impact on fetal and maternal mortalities.
We studied 152 healthy pregnant women and their 156 newborns for markers of hepatitis B virus (HBV) infection in Dakar, Senegal. Of these, 120 mothers (79%) had antibodies to the hepatitis B core antigen (anti-HBc), 21 (13.8%) were hepatitis B surface antigen (HBs Ag) positive, including 2/21 (9.5%) hepatitis B core-associated antigen (HBe Ag) positive and 1/21 (4.7%) HBV DNA positive. At birth, 11 (7%) infants were HBs Ag positive; 9/11 had an HBs Ag positive mother. Ten of these HBs Ag positive-born infants were investigated at 6-7 months: 5 were strongly HBs Ag positive and developed antibodies to HBs Ag, HBc Ag or HBe Ag; these 5 (3.2% of the total) probably became chronic carriers of HBV. The 5 others were HBs Ag negative and 4/5 did not develop antibodies against HBV Ag; HBs Ag positivity at birth was likely due to contamination of the mother's blood. Thirty-one of the 145 HBs Ag negative-born infants were studied at 6-7 months and remained HBs Ag negative. However, 5 (16%) showed evidence of HBV infection occurring between 0 and 6 months, as shown by the development of antibodies to HBs Ag, HBc Ag, and/or HBe Ag. Despite the low prevalence of HBV DNA and HBe Ag in HBs Ag positive African mothers, this study shows the occurrence of perinatal transmission of HBV in West Africa, in contrast with previous studies. Perinatal HBV transmission could explain the HBV vaccination failure recently reported in children in Senegal.
It is a prospective study of 1048 newborns incurring the risk of deafness in three hospitals in Dakar from March 14th to January 4th 1989. It comes out of this analysis that the most important causes of suspect cases are neonatal jaundices, congenital malformations, premature birth. The most frequent reactions are noticed in the members of a bilateral way, unlike the general assumption that reactions are noticed in the head. Out of a final population of 846 newborn, 839 were "normal", 7 were "suspect" (less than 1%). This evaluation would be higher for, among the 202 people we ultimately lost sight of (about 19.3%) were "suspect" without any associated pathology). Finally, the authors are then given the opportunity to draw the attention of the public authorities, the medical staff and the populations, on the importance of detecting early the infant's deafness.
By its many advantages, pills are one of the most used methods in the world and in Senegal. On the other hand, exist side effects which can limit their utilization. Our study concern 35 women using between 12 and 36 months mini pills, which might produce low side effects. In our users, biochemical parameters are modified but not pathologic. By our results, we think that in the following 5 or 10 years, these alterations might increase; so, we raise the alarm and propose a biological following up of the oral contraceptive users.
We have observed in our study that antithrombin III activity decreases very significatively in eclampsia (p < 0.0001). A level of 90% was defined as a threshold. All the rates which are under or equal to 90% have 78.3% as a positive predictive value and those over 90% have a 98.7% as a negative predictive value for the overcoming of eclampsia. We have concluded that the 90% antithrombin III activity represents the alarm level for over coming eclamptic crises. The determination of the antithrombin III activity must be systematically done in every hypertensive pregnancy with proteinuria.
The writers draw up the outcome of the medical management of infertiles couples at Dakar's teaching hospital over a period of 7 years (1983-1989). Restrictives factors (low rate incomes, social and psychological obstacles) make that médical management difficult. The responsibilities are shared among the couple with sex ratio of 1 man for 3 women. Among the women the etiologies dominated are the sterility of the Phaloppe tubes (81%) among men with the oligo and the azoospermy (32 and 27%). Sterility within married couples is a problem of public health that becomes more acute every day. A better handling of this problem through preventive medicine and elementary sanitary training is necessary.
As all developing countries Senegal keeps on paying a heavy tribute to, on the one hand, the high maternal mortality and morbidity, and on the other hand, infantile mortality. Family planning could have advantageous effect on health, welfare and development of all the family. Unfortunately, difficult over all socio-economical situation, lack of human resources, particularly maternal, and the coast of paraclinical exams brakes the access of population to family planning services. In this work, we tried with FHI/PSFP/Institute Pasteur to initial a prospective study who aimed to show that a good clinical exam with a complete medical interrogatory should be a good alternative to contraception preliminary paraclinical check-up.
From 1/04/1985 to 12/02/1990 the authors have treated 49 pregnant women with eclampsia symptoms. Keeping in mind the foetal neonatal results, the following has been noted: 26 live births including on case involving twins, 20 still-births, two foetal abortion and two patients who had never returned. 90.47% of the deliveries were effected vaginally against 09.53% by means of cesarean; patients of whom we lost track are not accounted for, together with 05 foetuses who were extracted during the maternal autopsy. Among the live births, 52.84% weighed less than, 2500 grams and had an APGAR score lower than 07 during the first minute in 69.23% of the cases observed. Six newborns died during the neonatal period because of infection and/or premature birth. Perinatal mortality of this short sample is of 63.07%. This leads the authors to conclude that the improvement of the foetal prognosis of the eclampsia is necessary. This improvement will necessarily go through the broadening of the indication of cesarean.
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This prospective study seeks to define the epidemiological, clinical and biological boundaries of the danger of urinary infection in women, with a view to facilitating therapy where bacteriological competition is absent. 238 samples taken over a 4 month period revealed 57 bacteriologically positive, i.e. 24%. Urinary infection is particularly associated with women in their 30s, poor, and from a low socio-economic class, with little urinary history. Risk increases for pregnant women during the second quarter. Typical, classical symptoms, each for what it is worth, are to be found in over 75% of the positive samples. The most common germs are enterobacteria particularly sensitive to quinolones, aminosides and 3rd generation cephalosporines.
It exists, essentially, in two, epidemiological forms: recurrent fever (FR) carried by fleas, resulting in wide scale epidemics; recurrent fever carried by ticks (soft ticks) of the ornithodorus type which results in localized, endemo-sporadic manifestations throughout the world. The second type is the main one in these regions, but the first is not uncommon. The report covers a peculiar case of flea-borne borreliosis occurring in a pregnant woman and associated with the presence of HBS antigen and plasmodium falciparum malaria. Although the review of literature is not exhaustive, the affliction, notably its obstetric implications, are highlighted.
Hydatic Cysts, or Hydatidosis, is the result of an intermediary host to VON SIEBOLD's Taenia Echinococcus larva turning into a cyst within the organism. Hydatic sickness combines all the toxic and allergic symptoms produced by the hydatic cyst. Echinococcosis is the anthropozoonosis of parasitic origin responsible for repercussions on the organism, development of the hydatic cyst and the hydatic sickness. It can come from dogs, sheep or cattle or, exceptionally, humans. Based on a case of hydatic cyst in the uterus, the authors underline gyneco-obstetrical aspects of the affliction. They recall diagnostic difficulties which may occur outside the endemic zones this very rare localization, and propose a practical solution based on echography.
The authors present 3 cases of vesical tumours discovered during pregnancy, which, according to literature, very rarely happens. These women from the low socio-economic strata had many children and were seen at a late stage when diagnosis of vesical tumours is easily distinguished from haematuria, recurrent cysts and hypogastric tumours. The prognostic is bad, resulting most frequently in death due to kidney failure with purulent peritonitis from perforation of the tumour or its evolving towards the vertebral metastasis, and chronic suffering for the foetus. The need for early discovery through urinary indications is stressed, as is the need for public health education and easy accessibility to the medical services.
The authors report two cases of female, genital tuberculosis with predominantly abdominal symptomatology, which required a laparotomy. In one case, the affliction was discovered during the gynecological period, whereas the second was found during the gravidic period and led to an abortion. The authors cover the classical clinical, biological and radiological aspects of this affliction, which is still current in their region. They stress the need to intensify anti-tubercular prophylaxis as the only means of improving obstetrical prognostic for the genital localization.
The etiological characteristics of one case of acute, necrotic haemorrhagic pancreatitis linked with pregnancy are stressed, as are the difficulties of diagnosis accentuated by poor laboratory conditions, even for emergency cases. Hence, this combination is, unfortunately, found in the hospitals, usually in the course of systematic, necropsy verification.