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Biomedical subjects

I P Ndiaye

Publications and source records attributed to I P Ndiaye.

At least 19 recordsLinked to original sources
PubMed2006

[Prognosis of stroke in department of neurology of Dakar].

INTRODUCTION: The general objective of this study was to determine the morbid-mortality of stroke followed in the Department of neurology of Dakar. MATERIALS AND METHODS: This prospective and longitudinal studywas carried out from August 2003 at May 2005 and concerned 170 patients hospitalized or seen in external consultation for cerebral vascular accident confirmed by the cerebral tomodensitometry. All the patients were subjected to a protocol allowing determining the sociodemographic data, the therapeutic itinerary, the nature and the mechanism of stroke. The follow-up was monthly for 12 months. RESULTS: The patients were old 25 to 90 years. The mean age was 61 +/- 13 years. The sex-ratio is 0.68. The ischemic cerebral vascular accidents represented 64.7% against 35.3% for the hemorrhagic vascular accidents. In 71.7 the AVCH was related to arterial hypertension. For the AVCI, a cardiopathy emboligene was objectified in 16.36% of the cases. The HTA constituted the principal factor of risk and was observed in 63.53% of the cases. The mortality rate was 28.8% (between j0 and j30) and 50.6% at one year. The age constitutes a factor of bad prognosis. For the sex the statistical analysis shows a no significant difference (p = 0.703). The repetition of stroke constitutes a factor of bad prognosis. 52.4% of the patients having an antecedent of stroke had died precociously. Mortality was higher in the AVCH with p = 0.043. The existence of disorders of conscience of start constituted a factor of bad vital prognosis. Among the 84 survivors after one year of follow-up, 49 had found their functional autonomy and 35 kept after-effects. CONCLUSION: Stroke is responsible for a strong mortality. The advanced age, the repetition of cerebral vascular accident, the hemorrhagic nature of the cerebral vascular accident constitutes factors of bad vital prognosis.

Adult↗
PubMed2005

[Functional prognosis of stroke in countries in the process of development: Senegal].

OBJECTIVE: To evaluate the functional outcome in patients followed in the department of neurology of Dakar for stroke. MATERIALS AND METHOD: Prospective longitudinal observational study from August 2003 to May 2005 included inpatients or outpatients with stroke one month or less from entry confirmed by computed tomography scan. Patients were followed monthly for 12 months. At each visit, data on functional autonomy measured by the Barthel index and the treatments received were collected. RESULTS: One hundred and seventy patients aged 25 to 90 years (mean 61+/-13 years) were evaluated. The sex ratio was 0.68. A total of 64.7% of strokes involved ischemic cerebral vascular accidents and 35.3% hemorrhagic vascular accidents. Right hemiplegia was present in 55.9%, left hemiplegia in 42.9% and bilateral paresis in 1.2% of patients. A total of 28.8% of patients died between d0 and d30, 50.6% within one year. At entry, the Barthel score was greater than 60 in only 4.7% of patients. After one-year follow-up, 58.3% of the patients had a Barthel score greater than 60, 19.1% had a score between 20 and 40 and 22.6% a score between 40 and 60. Only 53.5% received rehabilitation care. The parameters significantly associated with a functional recovery were age less than 55 years (P<0.05), hemorrhagic vascular accident as opposed to ischemic vascular accident (P<0.05), and earlier rehabilitation care under qualified personnel (P<0.01). DISCUSSION: Our study shows an important rate of mortality during the first year following stroke and the rather young age of our population. The parameters associated with a better functional recovery are comparable to most of the data in the literature. The results of our study suggest that it is possible to improve functional prognosis after stroke by setting measures of prevention of the risk factors and rehabilitation in the early management of hemiplegia.

Activities of Daily Living↗
PubMed2005

[A case of meningoencephalitis caused by Acanthamoeba sp. in Dakar].

Primary meningoencephalitis caused by free-living soil ameba is rare. We report the first diagnosed case of meningoencephalitis due to Acanthamoeba sp. in Senegal. The patient was a 24-year-old Senegalese woman hospitalized in the neurology department of Fann Hospital. Diagnosis was made 6 months after the onset of symptoms based mainly on headache with fever usually occurring in the evening, chills, and lumbar puncture demonstrating turbid fluid. Parasitological examination of cool cerebrospinal fluid sediment revealed the presence of free-living ameba trophozoites of the Acanthamoeba genus. Species determination by culture on 1.5% agar-agar enriched with Escherichia coli failed. The patient died one month following initiation of treatment using amphotericine B.

Acanthamoeba↗
PubMed2005

[Evaluation of the cost of stroke management in Dakar, Senegal].

The purpose of this one-year cross-sectional study conducted in 1997 was to estimate the direct cost of stroke management in the Neurology Department of Fann University Hospital in Dakar, Senegal. Data were collected about the type of care services required and related spending. Cost analysis was made in CFA Francs (CFAF), the Senegalese currency (1 USD = 500 CFAF in 1997). A total of 1260 patients were hospitalized in the department including 383 for stroke (30.4%). Mean age was 60.8 +/- 14.2 years and men accounted for 49.2% of the population. The mortality rate was 46.2% among hospitalized patients. A total of 33,573 medical acts were carried out including 12,052 (35.9%) for stroke management. The direct cost of stroke management was 32,614,442 CFAF with a mean cost of 78,426 CFAF per patient. The cost was 18,839 CFAF in the patient care unit (57.8%) and 4,954,635 CFAF in the neuroradiology unit (15.2%). The cost of health care personnel was 19,373,172 CFAF (59.4%) and the cost for drugs and other medical products was 8,253,246 CFAF. Health education programs aimed at increasing awareness of risk factors are needed to reduce the cost of stroke management in this difficult economic period.

Aged↗
PubMed2004

[A survey of school teachers' knowledge and behaviour about epilepsy, in a developing country such as Senegal].

Epilepsy is one of the most common disorders encountered in children of developing countries. In Senegal, as in many other African countries, the disease is enrobed in superstition, discrimination, and stigma. There is a clear-cut lack of information programs in the developing world about seizures and epilepsy. Academic achievement of children with epilepsy is hampered by social barriers in addition to the burden of the disease and its treatment. The aim of this study was to evaluate teachers'knowledge, awareness, and current attitudes about epilepsy in order to obtain baseline data for the development of a school health education program on epilepsy. The study was carried out in Dakar. It was conducted by sending self-administered and anonymous questionnaires to 400 elementary school teachers; the data were randomly mapped, stratified, and chosen to produce a statistically representative sample of the teacher population of Dakar. The questionnaires contained 22 items related to knowledge of epilepsy, the attitude of teachers towards epilepsy, and their ability to provide first aid in case of seizures. A total of 373 teachers (93p.cent) completed the questionnaires. For 69p.cent, epilepsy arises in the brain, for 28.7p.cent it is a subnatural affliction. Epilepsy was considered to be contagious for 24p.cent and could be cured for 73p.cent. Although 66p.cent would help an epileptic pupil during a seizure, 53p.cent mentioned harmful measures. Eighty-four percent noticed that an epileptic child could go to a normal classroom, while 62.5p.cent would prefer a special school. Eighty-four percent said their knowledge on epilepsy was not sufficient and the majority (99p.cent) desired training on epilepsy. For 25.7p.cent, better collaboration between parents, doctors, and teachers would b helpful to achieve better management of epileptic children. This study demonstrated encouraging knowledge of teachers about epilepsy. However, some of their wrong attitudes may be attributed to superstitions and could be improved by informative actions and better training about epilepsy. Such education might be provided by local health professionals with the collaboration of parents, teachers, and non-governmental organizations.

Adult↗
PubMed2004

[Epidemiological and clinical aspects of amyotrophic lateral sclerosis in neurological clinic of Dakar].

In Africa, little data has been published in Amyotrophic lateral sclerosis (ALS). We conducted a retrospective survey among the in-patients from December 1993 to March 2000 in the Department of Neurology of the University Hospital. This study reported epidemiological and clinical data of ALS. ALS has been diagnosed by El Escorial criteria. 33 patients were 16 to 77 years old. Parental consanguinity was found in 15.2%. On the basis of diagnosis criteria, ALS in our patients were established in 57.6% of cases, probable in 30.3% of cases, possible in 9.12% and suspected in 3% of cases. Evolution after hospitalisation is unknown for the majority of patients. Only one patient died after 12 months of evolution.

Adolescent↗
PubMed2004

[The therapeutic itinerapy of epileptics admitted by the Electoencephalographic Laboratory at CHU Dakar].

In Senegal, as in other under developed countries, the delays before seeking medical treatment are long varying from 2 to 12 according to studies. This is related to the fact that in traditional African communities, prejudices and believes delayed medical management which is seeked after failure of traditionnal treatments. The objectives of this study concerning therapeutic itinerary of epileptics in the EEG laboratory at the Neurology Department at CHU in Dakar were to evaluate the average latency of medical consultation and to identify the recourse path by patients receiving antiepileptic treatment. We conducted from March to may 2001, a cross disciplinary study, with a sample size of 212 patients. 79.2% of patients were less than 30 years old. They first seek treatment in hospitals in 36.8%, traditional practionners in 35.8%, health centers in 23%, and private clinics in 4%. The average delay of treatment in modern structures was by 13.4 +/- 4.7 months. The towards the healers was linked to faulty beliefs in 61.8% of the cases, lack of information (22.4%), or a lack of financial means (2.6%). The patients were refeared to traditional healers in 6.7% of the cases for reasons of confidence in traditional medecine. The orientation to neurology clinic was recommended by health personal in 83% of the cases, family (14.6%), or the healer (1.4%). The long and difficult journey of epileptics in Senegal remains marked by exclusion, absence or delay of medical attention.

Adolescent↗
PubMed2003

[Mixed aphasia with jargonographia in a right-handed patient].

We report a case of crossed aphasia with jargonagraphia in a forty-eight year old right handed monolingual man without family history of handedness or prior neurological illness. He developed a right temporo-insulo-parietal hamatomae documented by CT scan and accompanied by aphasia, left hemineglect, left hemiplegia, left lateral homonymous hemianopsia. The oral language was reduced and writing language was characterised by jargon. The writing and oral comprehension were preserved. This aphasia suggested a relationship between cerebral lateralization of language function and manual preference and the similarity between childhood aphasia and crossed aphasia in right-handed patients.

Aphasia↗
PubMed2002

[Cerebral palsy in Dakar].

The objective of the study was to describe risks factors of cerebral palsy and to determine clinical forms. From November 1998 to July 2000,we conducted a prospective study to select outpatients showing cerebral palsy symptoms: so 93 children with age between 5 months and 11 years old entered on this study. For 44.08% cerebral palsy was related on pregnancy abnormalities, 32.26% have central nervous system infection and 8.6% have convulsions unknown cause . The cause of cerebral palsy was untraceable in 13.98% of the cases. 82.8% of the children have cerebral palsy associated with other handicaps. The commonest type of cerebral palsy was spastic forms (74.2%) followed by hypotonic cerebral palsy (16.13%), dystoniaathetosis and ataxic forms in 5.37% and 4.3% of the cases respectively. The overall prevalence of epilepsy was 46.23%. The other handicaps were neurosensoriel abnormalities (visual impairment, deafness), speech disorders and behavioural problems. Computerised tomography (CT), performed in 45 cases showed cortical/subcortical atrophy as the commonest brain lesions. The electroencephalographic abnormalities were identified frequently.

Cerebral Palsy↗
PubMed2002

[Charcot-Marie-Tooth disease associated with a pyramidal syndrome: clinical, electrophysiological, and neuropathological study of neuro-muscular biopsies in 14 cases].

A rare clinical form of Charcot-Marie-Tooth (CMT) disease, estimated at less than 5% by a good many authors, it remains unknown at the neuropathological and genetic level. The prevalance of this form in our areas estimated at 16% allows to discuss its clinical, electrophysiological and neuropathological particularities. To define clinical electrophysiological and neuropathological criteria of neuromuscular biopsies of CMT associated with a pyramidal syndrome. forteen patients presenting a CMT disease associated with a pyramidal sign, sometimes sensory troubles pes cavus and ear and at times eye trouble, an electrophysiological exploration allowed to measure the motor conduction velocity (MCV) of the median nerve and the external popliteal sciatic. A neuromuscular biopsy on the peroneal nerve was performed in all patients with their free consent or that of their parents or relatives when necessary. Semi-thin cuttings coloured with toluidine hue were examined under photonic microscope with x10, x40, and x100 enlargements and the study of the dissociated nervous fibres (teasing) was curried out. The 14 patients aged 8 to 37 years (average 23+/-0.5). 7 females and 7 males clinically presented a CMT disease with a pyramidal syndrome Sensory troubles existed in 8 cases, a lesion of the cranial nerve was observed in 8 cases (II and VII) parental consanguinity existed also in 9 cases. The MCV of the median nerve were more > 40 m/sec in 8 cases whereas in 2 cases they were < 40) m/sec. All muscles showed an atrophy of neurogenous type. In 4 cases the nerves were histologically normal on semi-thin cuttings and < >. There were axonal degeneration lesions in 2 cases only and demyelinating lesions in 6 cases. No onion bulb lesion as observed nor images of regeneration (cluster). The CMT disease associated with a pyramidal syndrome is a clinical entity which constitutes a heterogenous group at the clinical, electrophysiological and anatomo-pathological and probably genetic level. A dominant autosomal transmission and some recessive forms were isolated but the chromosomic anomaly involved remains to be defined.

Adolescent↗
PubMed2000

[Vascular parkinsonian syndrome in 21 case studies, two of which were anatomic].

A clinicopathological study of parkinsonian syndrome witch occurred after stroke, is done by the authors. That is a retrospective study concerning 2 anatomic cases from 21 vascular parkinsonism. All the patients were admitted in the clinique neurologique de Fann from 1970 to 1990. They were 15 men and 6 women. Their age ranged between 45 to 75 years (mean 59.66). The 2 autopsied cases had lesions located in the thalamus as the superior part and a discreet cortical atrophy in the one case, and in the other case, we can see similar lesions in the right external capsule and in the inferior part of the putamen. Another lesion of haemorrhage infarct was located in the left temporal lobe. The locus niger was macroscopically normal in the 2 cases. Anatomical lesions observed have been localized in the putamen and in the external capsule in the associatical cerebral cortex in the second case and in the first one, lesions are located in the thalamus and in the cortex. These lesions were not well correlated with neurological signs. The different clinical aspects are discussed. From this study, it results that arterial damages associated with hypertension and atheromatosis might touch dopaminergic structures responsible of parkinsonism with sometime good sensitivity to levodopa.

Age Distribution↗
PubMed2000

[Guillain-Barre syndrome in children: experience in the neurology service of Dakar].

A retrospective survey has been conducted from january 1979 to january 1999 about the young inpatients file records of the department of neurology of Dakar. 19 cases of Guillain-Barré's syndrome have been collected, representing 2.3% of the children admitted in the department of neurology. The children were 18 months to 16 years old. The sex ratio was 1.4. Infectious disease has been reported in 68.4% of the cases during the 4 weeks preceding the neurological features. The notion of vaccination was found in 5.3% of the cases. The motor deficit was frequent, represented by paraparesis in 63.2% and quadriparesis in 36.8% of the cases. The mean duration of the hospitalisation was 28 days. 52.6% of the patients have completely recovered from their motor deficit and this recovery was unachieved in 36.8%. No fatal event has been detected. The therapeutical means were represented by vitaminotherapy B1B6B12 associated with kinesitherapy. Our results reveal a less severe evolution and better prognosis of Guillain-Barré's syndrome affecting children, instead of the absence of more appropriate means of treatment such as plasma exchange and intravenous immune globulin.

Adolescent↗
PubMed2000

[Friedreich's disease in the department of neurology in Dakar].

A retrospective study of Friedreich's ataxia was conducted from january 1960 to december 1997. Eighten cases had been collected. Friedreich's ataxia was the second disorder after Pierre Marie's ataxia among inherited ataxia. Parental consanguinity has been found in 27.77% of cases. The sex-ratio was 2.6 for males. 66,67% of Friedreich's ataxia cases began after 25 years. Clinical signs were: cerebellar ataxia, sensitive disorders in 70%, pyramidal syndrom and cardiomyopathy in 22.22%, bones dysmorphy in 50% of cases. Electromyography indicated severe axonopathy of members with decreased somesthesic potentials in six cases. Glycaemia was normal in all cases. Clinical future presented wide variation between one and fourth years old.

Adolescent↗
PubMed2000

[Epidemiological, clinical and progressive aspects of neurological manifestations associated with retroviral infections: eleven year retrospective study].

Through a cohort of 93 neuroaids which has been diagnosed at Dakar in our Neurology Department, the authors evaluated the hospital prevalence of retrovirus, detected socio-demographic factors, related AIDS outline the mean neurological picture and try to correlate survival and neurological involvement of these patients. Among 1151 patients who got retroviral blood test, 93 were seropositive (8.1%). On these repartitions 36 were females (38.7%) and 57 males (61.3%). The age goes from 19 to 76 years old. 45 patients (48.4%) have been found positive for HIV-1 blood test, 21 patients (22.6%) for HIV-2 blood test, 11 patients (11.8%) for both HIV2, 11 patients (11.8%) for HTLV1, 3 patients (3.2%) for both HIV-1 and HTLV1, and 2 patients (2.2%) for both HIV-2 and HTLV1. In our study the transmission of AIDS occur mainly through heterosexual inter course and multiple parternship is a high risk group. The central nervous system deseases represented 68.8% of cases. The pathology were dominated by stroke, myelopathies, meningoencephalotis and spinal cord compression. The peripheral nervous system desease were found in 7.5% of cases. The peripheral facial paralysis occupied the first place in HIV infections of peripheral nervous system deseases (57.1% of cases). When neurological involvement set up the letality is higher for HIV-1 (57% of global letality) and for central system nervous involvement (76.2%).

Adult↗
PubMed2000

[Aetiological aspects of neurological diseases in Dakar: follow-up after 10 years (1986-1995)].

Because of the apparition of new risk factors and numerous progresses in investigation methods, authors take stock of neurological diseases of patients admitted in Clinique Neurologique of Fann during the last ten years. The 8539 cases repartition is as followed: 4736 males and 3803 female. Their ages ranged between 3 and 80 years with 2130 deaths corresponding to 24.94%. Annual mean of admission is 853 +/- 42 cases. Aetiological data are: stroke (3910 cases 45.78% with 60.56% of death). The following is peripheral neuropathieswith 714 cases(8.61%) and the spinal cord compression with 692 cases (8.10%). Comparision of frequencies of different aetiologies with those of previous studies shows that the small capacity of the neurological department is a restricting factor for the entry frequencies of neurological patients; the principal pathologies got small variations from one decade to another. In the opposite, some aetiologies have disappeared (neurological syphilitis, trypanosomiasis, neurocyticercosis, cerebral mycosis). Some eatiologies remain unprecised (infectious diseases, peripheral neuropathies, degenerative diseases).

Adolescent↗
PubMed1999

[Drug resistant epilepsy in Senegal: therapeutic, clinical and socioeconomic factors].

The aim of our study was to emphasize factors which support pharmaco-resistance in Senegal. For this purpose, 23 patients with partial or generalized epilepsy were studied, after determining the plasmatic concentration of the antiepileptic drugs. The aetiologies were numerous: encephalitis, injuries, neonatal encephalitis. All patients were under traditional treatment before coming to the hospital. So antiepileptic drugs were taken a long time after the beginning of epilepsy later, they were Phenobarbital, Carbamazepine, Phenytoin, and Valproic acid. Only seven patients had sufficient plasmatic level of the antiepileptic drug. The low socio-economic conditions of patients which limit the choice of the most adapted drug in each case, is one of the most important reason of the pharmaco-resistance. Another factor of the pharmaco-resistance is cultural and is linked with the absence of notion of chronic disease necessitating long and regular treatment in senegalese traditional society.

Adolescent↗
PubMed1999

[Pott's spinal cord compression in the child].

Spinal tuberculosis is the first etiology of spinal cord compression in our areas. We are studying the epidemiological, clinical and therapeutic aspects of Pott's disease. We have collected all children aged from 0 to 15 years admitted for Pott's disease in department of Neurology in CHU Fann SenegaIL from January 1st 1983 to December 31st 1997 spinal tuberculosis. The diagnosis was both clinical and paraclinical. 27 children aged to 2-15 years were hospitalized for Pott's disease. The sex-ratio was equal to 2 in favour of boys. 77.77% of patients were consulted more than a month after the outbreak of the paraplegia. The notion of tuberculous contagion was found in 25.92% of the cases. The main clinical signs were paralysis of the limbs, sensory symptoms and bladder sphincter dysfunction. In 96.29% anomaly of disc and vertebra were recorded, more often affecting two vertebrae. The myelography, performed in 13 patients objectivized an epidural stop in 92.30% of the cases. There was a favorable evolution in 92% of patients under antituberculous chemotherapy. Spinal tuberculosis is an affection cheating all ages and it remains the first etiology of spinal cord compression in our areas. Therefore there is a necessity of primary safety by fighting against tuberculosis what is still in our areas.

Adolescent↗