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Biomedical subjects

M Ndiaye

Publications and source records attributed to M Ndiaye.

At least 37 records · Page 2Linked to original sources

[Sternoclavicular dislocations: clinical and therapeutic study. A report of 9 cases].

Sterno-clavicular dislocations represent an uncommon pathology in shoulder trauma. The authors describe the anatomical and clinical forms observed between January 1999 and December 2002, and evaluate the treatment process. The retrospective study addressed 9 patients (men only) with an average age of 26.6. Based on the duration of the consulting period, one could distinguish old forms from more recent ones. Diagnosis would help to see anterior forms from posterior forms. Evaluation criteria were: pain, mobility of the shoulder, visibility of the deformation of the sterno-clavicular joint. Six types of anterior dislocations were listed, including 4 recent and 2 old ones. There were 3 recent posterior forms. The anterior recent forms, which were treated in orthopedics, showed a positive evolution. As there was no functional disability, it was wiser to refrain from any treatment of the anterior old forms. The posterior forms, two of them were operated (osteosynthesis) revealed no functional deficit after treatment. However, one of the patients had a broken implant. Scanner facilitated the diagnosis of sterno-clavicular dislocations. The anterior forms, which are more frequent and benign, are different from the posterior forms, which are emergency cases due to the proximity of the aero-digestive and cardiovascular elements. Their surgical stabilization requires techniques related to ligamentoplasty rather than using osteo-synthesis equipment which may move away or break off.

Adolescent↗

[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↗

[Medico-legal conditions of recognition and compensation of occupational asthma in Sénégal].

The aims of this study were to appreciate how frequent asthma was named in the legal list of worker's compensation, state hazards and occupations involved and appreciate conditions required for a legal recognition of the disease. The study consisted of a review of the legal list of occupational diseases of all tables where asthma was stated. Medical, technical and administrative criteria allowing compensation were looked for. Asthma was listed in 12 among the 67 tables; causal substances listed were known as sensitizers and included mainly organic and metallic compounds. Numerous occupations were concerned in all primary, secondary and tertiary sectors. Medical conditions refered to "all asthma confirmed by functionally respiratory tests or regenerated by a new exposure". Time length of declaration was seven days. Variety of occupations concerned and numerous substances involved should invite to look for occupations in all patients with asthma. Physicians should be aware of theses legal conditions in order to recognize better occupational asthma and ease it legal compensation.

Asthma↗

[Specific immunotherapy for respiratory allergies. A modern treatment].

UNLABELLED: AN EFFICIENT AETIOLOGICAL TREATMENT: Specific immunotherapy or allergen vaccination currently constitutes the only aetiological treatment for allergic respiratory diseases and is more effective in children than in adults. Since its introduction in 1911, it has been much disparaged in spite of its effectiveness demonstrated in double blind placebo controlled studies, for the treatment of both allergic rhinoconjunctivitis and stable and controlled asthma. MECHANISM OF ACTION: Its mechanism of action varies depending on the type of allergen (venoms or pneumallergenes) and its administration route (subcutaneous or local) and recent studies indicate that the prevalent mechanism proceeds from a modification of the T cell response by an immunological deviation (stimulation of the Th0/Th1 lymphocytes) or T lymphocyte anergy (reduction in Th0/Th2) or both at same time. The IL-10, immunosuppressive cytokine secreted by the third population of T-Tr1 lymphocytes, would have an important role. IN PRACTICE: The indications for specific immunotherapy have been specified in international consensuses, and its practical administration must respect preconditions and a certain number of rules. Improvement in quality of allergenic extracts by standardization, better knowledge of its mechanism of action and the availability of local administration routes reinforce its place in the global therapeutic strategy for the management of respiratory allergies. A greater use of the sublingual route, together with biological and clinical research will allow the widening of its indications.

Allergens↗

[Homozygous sickle cell disease in patients above 20 years of age: follow-up of 108 patients in Dakar].

CONTEXT: The progress realized in the treatment of sickle cell anemia has resulted to a better and longer life for these patients in developed countries. Ongoing challenge are to manage complication and social living for these patients. The purpose of this study was to determine morbidity, mortality and socioprofessional insertion of homozygous sickle cell patients, followed up in Dakar university hospital. PATIENTS AND METHODS: We performed a longitudinal and prospective study including 108 homozygous sickle cell anemia patients, whose age were above 20 years, followed in a regular basis (at least 3 times per year), during 5 years on average (3 to 12 years). All patients had a quarterly hematological check-up and a annual statement to detect chronic complications. Clinic and paraclinical data, as information in socioprofessional insertion were noted in medical records for analysis. RESULTS: Mean age was 27 years (20-51 years). The age between 20-29 years was represented by 67.5%, 26.9% aged 30-39 years and 5.6% were above 40 years of age. Men were slightly predominant with a sex-ratio of 1.25. Concerning morbidity, 96.3% of patients had at least 1 vaso-occlusive crisis per year, 26.9% were transfused and 64.8% had been hospitalized during the follow-up. A chronic complication was found in 49% of patients (53/108). The more frequent of these complications were gall stone (10%), femoral head necrosis (9.2%), priapism (11.6% of men), chronic leg ulceration (4.6%), ophthalmic involvement (3.7%), renal and cardiac complications (2.7% for each one). The presence of complications was not significantly influenced by patient's sex. Five patients died during a mean follow-up of 5 years. Concerning school attendance, 13% reach university level whereas 47% stop their education on the secondary level and 40% on primary level. Professionally, 36.2% of patients had no exercise any activity. CONCLUSION: Our results emphasize that life expectancy can be prolonged in sickle cell anemia patients in Africa, when they have a benefit of a regular follow-up. We show also the respective frequency of chronic complications and then, the necessity of multidisciplinary teams to optimize the take care of sickle cell anemia patients in Africa.

Adult↗

[Vascular dysplasia in vascular surgery in an African area: 28 cases at the Dakar teaching hospital].

This retrospective study was conducted to analyze the anatomic and clinical data concerning vascular dysplasia in vascular surgery patients seen in an African hospital and to assess its role in treatment. Twenty-eight patients (14 women and 14 men) were treated for vascular dysplasia between 1994 and 1998. There were 8 cases of hemangioma and 20 cases of vascular malformation. Average age of patients with hemangioma was 3.23 years, with a sex ratio of 0.33. There were 4 cases of mixed hemangioma, 3 of cutaneous hemangioma, and 1 of subcutaneous hemangioma. Cervicocephalic (n=4) and limb (n=3) localizations were the most frequent. Duplex Doppler did not reveal any signs of muscle disease. Four patients underwent surgery, for an early indication in 3 and a late indication in 1. Resection suture was performed in 3 cases and resection graft in one. Mean follow-up was 85.90 days. There was one case of early suppuration. There were no cases of recurrence or late complications and the operative wounds healed well. Vascular malformations concerned 20 patients (sex ratio 1.5, average age 15.55 years) with 16 cases of venous malformation including 4 patients with Klippel Trenaunay syndrome, three with arteriovenous malformation and one with capillary angioma. CT and arteriography were obtained in all cases. Limb localizations predominated (14 patients). In-depth extension was found in 6 cases of venous malformation. Sixteen patients underwent surgery for functional indications in 7. Resection suture was performed in 11 cases. Mean follow-up was 85.90 days. There were 4 early and 2 late postoperative complications. There has been no recurrence. Anatomic and clinical polymorphism of vascular dysplasia requires multidisciplinary collaboration in which vascular surgery plays an important role in complex or complicated forms of the disease in patients attending facilities with limited resources.

Adolescent↗

[Smoking habits, attitudes and knowledges of medical students of Medicine, Pharmacy and Odonto-Stomatology's Faculty of Dakar, Senegal].

INTRODUCTION: Smoking is a public health problem that does not spare the medical profession. We set out to determine the prevalence of smoking in medical students in Dakar and to assess their attitudes and knowledge in the face of this problem. METHODS: A cross sectional study was conducted by means of an auto-questionnaire among 1547 medical students between 3 and 31 May 2001. There were 1061 males (68.6%) and 486 females (31.4%). RESULTS: The overall prevalence of regular or occasional smoking was 34.6%, with 42.8% in the first cycle, 38% in the second and 19% in the third. It was significantly higher among males at 76.4%. The average age of starting smoking ranged from 10 to 22 years and average duration from 5 to 26 years. The influence of fashion was the most frequent initiating factor at 37.4% and 96.6% smoked commercial cigarettes. Nicotine dependence, assessed by the Fagerstrom score, was average in 59.3%, strong in 14% and very strong in 4.7%. 58.8% smoked in public places and 78.2% thought they could give up smoking within the next 5 years. 8.4% were unaware of the effects of tobacco on health and 20.5% of the relationship between tobacco and the diseases quoted. 37.7% of future doctors would not systematically avoid smoking in the presence of patients but 79% wished to ban advertising and 70.4% to ban the use of tobacco in hospitals. 94.4% of students wanted health care workers to be educated about the effects of smoking. CONCLUSIONS: Tobacco smoking among medical students has increased between 1989 (28.7%) and 2001 (35.6%). This observation should stimulate the establishment of a course on the pathology of tobacco smoking and the integration of education and prevention within the medical curriculum, increase the awareness of smokers and above all help them stop.

Adolescent↗

[Nonrecurrent inferior laryngeal nerve: review of 13 cases].

OBJECTIVE: This study reviews a rare and poorly understood anatomic anomaly of the thyroid region: non-recurrence of the inferior laryngeal nerve. METHOD: We describe thirteen cases of non-recurrence of the laryngeal nerve observed during 2128 surgical procedures on the thyroid gland. RESULTS: The malformation was right-sided in all thirteen patients (11 women, 2 men) and occurred at a frequency of 0.4% of all of the nerves explored. Only two complications were noted in this series of 13 cases: one case of temporary paresis and one case of irreversible vocal cord paralysis. CONCLUSION: A rare although not exceptional occurrence, non-recurrence of the inferior laryngeal nerve is an anomaly that Head and Neck surgeons should be familiar with so as to avoid nerve damage that can result in irreversible vocal cord paralysis.

Female↗

[Self-destructive behavior in African adolescents].

The purpose of this study was to analyze self-destructive behavior in adolescents in Senegal. Based on four case reports the authors stress the central importance of family breakdown in the process leading to this behavior as opposed to the first descriptions implicating an offense against the honor of the group. The vulnerability of teenagers in the absence of structural initiation is also advanced. Systematic intervention may be recommended in such cases.

Adolescent↗

[Purulent pleurisy at the surgical emergency service: retrospective study of 34 cases at Dakar Teaching Hospital].

The empyema thoracis remain a current pathology in under developed countries. The aim of this study was to evaluate the incidence of empyema thoracis in the Surgical Emergency Unit, to analyze their causes, therapeutic procedures and their results. Between 1997 and 1998, 54 patients were received in urgency for empyema thoracis; 34 of them had a complete and exploitable file. Mean age was 20 years (3 weeks and 83 years) with 64.70% of children (0 to 15 years) and the sex ratio 3.25. Fever (85.70%) and cough (73.52%) were the most frequent symptoms. Twenty nine patients (85.3%) had pleural empyema and 5 a hydropneumothoracic image. Empyemas were related to pneumonia in 11 cases, associated to tuberculosis in 5 cases and were primitive in 18 cases. Bacteriological exam of the pus performed in only 18 patients had revealed a pneumococcus in 4 cases (22.23%) and was negative in 9 cases (50%). Closed chest drainage associated with antibiotics, pleural washing and respiratory kinesitherapy was done in all the cases. The average duration of hospitalisation was 24.56 days (1 to 55 days). Five deaths (14.70%) occurred. Two cases of recurrence were noted requiring a second drainage. Three cases of pachypleuritis had required a thoracotomy for pleural decortication in average time of 6 months. The duration of follow-up was 1 year. For the other 24 patients (70.58%) the evolution was good. Urgent closed chest drainage of empyema thoracis combined with antibiotics, pleural washing and respiratory kinesitherapy allows a good evolution and reduces the risk of pachypleuritis.

Adolescent↗

[Anesthesia in the pleuropulmonary complications surgery of tuberculosis: a 79 cases study].

Reported is a retrospective study carried out from Aristide Le Dantec Hospital in patients who underwent pleuropulmonary surgery after tuberculosis complication, from June 1995 to June 1999. The aim of this study was to evaluate the anaesthesiology procedures and outcomes of tuberculosis pleuropulmonary complications surgery. Seventy nine patients were studied. Their mean age was 34.63 years, and the sex ratio was 3.14. They all underwent general anaesthesia procedures with barbituric, morphinics et myorelaxants drugs. The peroperative complications noted were distributed as follow: 50 cases of haemorrhage needing transfusion, 18 cases of hypotension associated to the anaesthesia. In the intensive care period, we have noticed 30 atelectasia cases associated to a spastic bronchopathy, 3 cases of pulmonary oedema and 1 case of pulmonary infarctus. In the postoperative period, 8 cases of hemodynamic instability occurred, including 5 cases of cardiovascular collapsus treated by filling, and 2 septic shocks cases. An infectious bronchopneumopathy was noticed on 11 patients with two cases of septicaemia. The mortality rate was 6.3% (5 cases of death). The pleuropulmonary surgery in tuberculosis complication is very haemorrhagic, and therefore require an adequate preoperative preparation.

Adolescent↗

[Acute chest syndrom in a patient with homozygous sickle cell anemia].

The Acute Chest Syndrome (ACS) is defined by the association of chest pain with dyspnea, fever, a recent radiological abnormality and hyperleucocytosis. Acute pulmonary complications are the primary cause of mortality in sickle cell patients. We report a 19-year old male patient with homozygous sickle cell anemia who consults for respiratory symptomatology and bone algia. The diagnosis of ACS by left pneumopathy due to pneumococcal infection was based on the clinical tests, chest x-ray and blood culture. The appearance of pneumopathy in patients suffering from sickle cell anemia is explained by the functional asplenia and the inability of phagocyte cells to destruct bacteria. These incidents are triggered by alveolar hypoventilation, fat embolism from bone infarction, infections, pulmonary oedema and thrombosis. The evolution of these ACS by pneumopathy depends on their early diagnosis and treatment but also on the sensitivity of the germs to antibiotics.

Acute Disease↗

[Long term course after thyroidectomy for euthyroid nodular goiter].

Every patient operated for nodular goiter by a partial surgery is exposed to recurrence. In order to verify this idea, the authors followed 36 patients operated on for nodulargoiterat least 10 years ago. A clinical examination for all the patients and echographic study for 24 of them allowed the detection of recurrence and the evaluation of survival and recurrence without any opotherapy. It seemed that clinical recurrence is observed in 16.65% of cases whereas echographic study revealed recurrence in 50% of patients examined. Only two patients were reoperated on. The predictive factors of the recurrence are geographic endemic origin and ethny, partial surgery and vesicular goiters. With 66.65% of survival without recurrence at 18 years without opotherapy, the authors argue about the utility of such treatment.

Adult↗

[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↗

[Role of elastic compression in the treatment of postphlebitic leg ulcers at the University Hospital of Dakar: report of 20 cases].

Varicose disease and venous thrombosis were reputed exceptional among black africans and almost all leg ulcers were called "tropical". We have treated 20 cases of postphlebitic ulcers in the teaching hospital of Dakar between march 1989 and december 1992. There were 12 men and 8 women. Mean age was 40 years (24 to 60 years). The initial venous thrombosis dated at mean 8 +/- 3 years. It was confirmed in a hospital in 10 cases and found in the medical history of all patients. All patients presented leg ulcers with non systematised venous varicose and trophic troubles. The ulcers treated only by dressings lasted a duration of 4 months (2 weeks to 9 months) without healing. In view of this failure we have added an ambulatory elastic contention with elastic bandage putted on at hospital after that biweekly dressing until cicatrisation followed by putting elastic socking with degressive compression. We have observed a quickly cicatrisation in mean time of 4 weeks (2 to 6 weeks) with good tolerance of socking. Only 3 patients showed recurrence. Elastic contention has a great place in the treatment of postphlebitic ulcers which are not that exceptional among black Africans.

Adult↗

[Esophageal foreign bodies at the Universitary Hospital in Dakar].

The diagnosis and the management of the foreign bodies of the oesophagus in the children have benefited from the digestive endoscopy and the anaesthesia progresses the last ten years. A 120 files review concerning children who suffered from foreign bodies of the oesophagus is reported. The average age was 4 years. The sex repartition showed that the boys where prevailing (62 %). The interrogation revealed a caustic old stenosis of the oesophagus among 4 children. In 91% of cases, the diagnosis was obvious on the X-ray prints. The endoscopy assessment found 124 foreign bodies mostly represented by coins (81,4 %). We recorded 2 oesophagus perforation cases and to deaths. The foreign body of the oesophagus is not always harmless. It can determine complications often revealing ones. It seems necessary to us to stress the prevention of that accident by a vast sensitising compaign of the parents.

Adolescent↗

[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↗