Biomedical subjects

M Ndiaye

Publications and source records attributed to M Ndiaye.

At least 91 records · Page 5Linked to original sources

PubMed1996

Therapeutic trial of diazepam versus placebo in acute chloroquine intoxications of moderate gravity.

OBJECTIVE: Acute chloroquine intoxication is responsible for a membrane-stabilising effect which results in electrocardiographic (ECG) and hemodynamic disturbances. Diazepam is used in acute chloroquine intoxication on the basis of clinical and experimental observations, but its utility alone, in man, remains unproven. The goal of this study was to verify whether diazepam alone has an effect on the membrane-stabilising effect observed in moderately severe chloroquine intoxications. DESIGN: Prospective, multi-center, double-blind, placebo-controlled study. SETTING: Prehospital mobile intensive care units (Paris) and hospital intensive care units (paris and Dakar). PATIENTS AND PARTICIPANTS: Adults with moderately severe intoxication defined as: a suspected ingested dose of 2 or more but less than 4 g, systolic blood pressure (SBP) higher than 80 mmHg, QRS duration less than 0.12 s and the absence of dysrhythmia at inclusion. INTERVENTIONS: Patients received either a loading dose of 0.5 mg/kg diazepam followed by an infusion of 1 mg/kg over 24 h or an equivalent volume of placebo. MEASUREMENTS AND RESULTS: Outcome was measured by serial assessments of SBP, ECG (QRS and QT segments) and clinical deterioration. There were no significant differences observed in the initial or serial ECG or SBP measurements. There were no deaths and no patient had to be removed from the study due to clinical deterioration. CONCLUSIONS: Diazepam, at the dose studied, does not appear to reverse the chloroquine-induced membrane-stabilising effect in acute moderately severe chloroquine intoxication. Supportive intensive care of these intoxications appears to be all that is necessary.

Acute Disease↗

PubMed1996

Stenting in the carotid artery: initial experience in 110 patients.

PURPOSE: To evaluate the feasibility, safety, and efficacy of intravascular stents in the treatment of extracranial carotid artery occlusive disease. METHODS: According to protocol, stent therapy was offered to symptomatic patients with > or = 70% arteriographically defined carotid stenoses or ulcerative lesions and, after September 1994, to asymptomatic patients with > or = 75% stenoses. From April 1993 to September 1995, 110 nonconsecutive patients (79 males; mean age 72 years, range 45 to 85) consented to participate in the study. The majority (79 [72%]) were asymptomatic. Lesions meeting the treatment criteria were in the proximal common (n = 3); mid common (n = 12); distal common (n = 8); internal (ICA) (n = 92); and external (n = 2) carotid arteries. Seven patients had bilateral ICA stenoses, and 17 patients were treated for postsurgical recurrent disease. The mean lesion length and diameter stenosis for all lesions were 12.4 +/- 9.2 mm and 86.5% +/- 10.6%, respectively. The procedures were performed either via direct percutaneous access to the cervical common carotid artery or through a retrograde femoral artery approach. Standard balloon dilation preceded deployment of balloon-expandable stents in most cases. No postprocedural anticoagulation was used (aspirin only). RESULTS: In 110 patients (117 arteries) intended for treatment, 109 (99.0%) (116 arteries [99.1%]) were successfully treated with 129 stents (128 Palmaz, 1 Wallstent). One percutaneous procedure failed (0.9%) for technical reasons (stent could not be deployed) and was converted to carotid endarterectomy. Minor complications included 4 cases of spasm (successfully treated with papaverine); 1 flow-limiting dissection (stented); and 6 access-site problems. There were 7 strokes (2 major, 5 reversible) (6.4%) and 5 minor transient events (4.5%) that resolved within 24 hours. Three patients were converted to endarterectomy (2.7%) prior to discharge; 1 stroke patient expired (0.9%), and another patient died of an unrelated cardiac event in hospital. In the 30-day postprocedural period, 2 ICA stents occluded (patients asymptomatic). Clinical success at 30 days (no technical failure, death, endarterectomy, stroke, or occlusion) was 89.1% (98/110). Over a mean 7.6-month follow-up (range 2 to 31), no new neurological symptoms developed. Another stent occlusion at 2 months and one case of flow-limiting intimal hyperplasia at 7 months were detected on routine duplex scanning in asymptomatic patients. Life-table analysis shows an 89% cumulative primary patency rate. CONCLUSIONS: Based on this early experience, carotid stenting appears feasible from a technical standpoint, with good midterm patency. However, the incidence of neurological sequelae is a serious problem. Technical enhancements and a more aggressive antiplatelet regimen may have a positive impact on these events.

Aged↗

PubMed1996

[Cystic form of extralobar pulmonary sequestration. A propos of a case].

Case of bronchogenic cyst associated with extralobar pulmonary sequestration is presented in a 10-month-old baby. At thoracotomy, the tumor was an extralobar pulmonary sequestration with a central cyst surrounded by two pulmonary lobes vascularised by systemic vessels. Resection was easy. The cyst had a respiratory mucosa and was benign. The pathogenesis of the malformation is discussed.

Bronchogenic Cyst↗

PubMed1996

Spermatogenesis in mosquitoes (Diptera: Culicidae).

An ultrastructural study of spermatogenesis has been carried out on 18 species of mosquitoes of the Anophelinae, Culicinae and Toxorhynchitinae sub-families. In this spermatogenesis, which follows a classical way, primordial cells, primary and secondary spermatogonia, as well as primary and secondary spermatocysts are considered. We have identified 9 stages of development all along the spermiogenesis. This process ends up with the formation of a needle-like spermatozoon showing head and tail regions. After a treatment with tannic acid, the protofilaments of the axoneme of Culex tigripes are counted. For the first time we have carried out a complete study of spermatogenesis in mosquitoes.

Aedes↗

PubMed1996

[Pathologies associated with HTLV-1 virus in Dakar (1992-1995)].

A clinical and laboratory study was conducted in Dakar (Senegal) to assess the involvement of HTLV-1 virus (human T lymphotrophic virus type 1) in various diseases. Patients were enrolled at three locations: the Dermatology Department of the Fann University Hospital Center (845 patients) from 1992 to 1995, the Dermatology Department of the Le Dantec University Hospital Center and the Oncology Department of the Principal Hospital (7 patients) in 1994 and 1995. The incidence of involvement of human retroviruses in neurologic complications seemed low (HTLV-1: 2%, HIV: 3%) and only 6 cases of tropical spastic paraparesis associated with specific anti-HTLV-1 antibodies were diagnosed in 3 men and 3 women with a mean age of 51 years. These cases which were identical to those previously described cases in the West Indies and Japan confirms the existence of this disease in Senegal. In addition 3 cases of isolated facial paralysis were observed in HIV positive patients. Combined HIV/HTLV-1 infection was observed in 3 cases and was not associated with special clinical findings. Adult T-cell leukemia/lymphoma (ATL) was detected in 4 patients including leukemia with proliferation of CD4 and CD25 in two cases and lymphoma in one case. In one case of ATL two proviruses were identified in circulating tumor cells. These are the first cases of ATL to be reported in Senegal. Molecular characterization of part of the envelope gene (gp 21) from patients with PST hospitalized in a neurology ward showed that the virus present in Senegal belonged to the universal HTLV-1 A type. This study indicates that two types of diseases are associated with HTLV-1 infection in Senegal. Further epidemiologic studies will be needed to evaluate the incidence of the virus and of the diseases associated with it. Prevention will depend partly on screening blood donors as has now been started at the Blood Transfusion Center of Dakar.

Adult↗

PubMed1996

[Scanning electron microscope sudy of the morphology of fungi isolated from patients at the Aristide La Dantec Hospital in Dakar, Senegal].

In order to improve the identification of fungi usually isolated among some patients at Dantec Hospital, a study by scanning electron microscopy has been carried out. It deals with four species of yeasts (Candida albicans, Candida parapsilosis, Rhodotorula rubra Sacharomyces cerevisiae) six species of dermatophytes (Trichophyton rubrum, Trichophyton soudanense, Trichophyton interdigitale, Microsporum canis, Trichophyton violaceum, Microsporum audouinii); two species of mildew, (Aspergullus flavus, Aspergillus niger) and one species of dimorphic fungi (Histoplasma duboisii). The yeasts get a smooth surface with, often, a mark of but on it. Microsporum canis presents some echinulate macroconidia. Trichophyton violaceum is characterized by the appearance of echinulate chlamydoconidium with a twofold bulge and Microsporum audouinii by a echinulate chlamydoconidium with a bulge only. Trichophyton rubrum presents macroconidia with smooth surface and in "sausage" form, as for Trichophyton soudanense it presents some arthroconidia that are cells which get more or less rectangular form and with smooth surface. Aspergillus flavus is characterized by the presence of a conidiophore with a verrucosis surface and an aspergillary head of about 36 microns having some spores with almost smooth inner surface. On the other hand, Aspergillus niger gets a conidiophore with smooth surface. As for Histoplasma duboisii, the surface of the chlamydoconidium presents some verrucosis that are real conidia in formation. The scanning electron microscopy enables use to discover the existence of characters that are likely to be used for the identification of fungi.

Dermatomycoses↗

PubMed1996

[Congenital heart disease surgery in Senegal. Indications, evaluation and perspectives].

In Senegal, congenital heart diseases (CHD) raise important issues. Their late detection makes more complicated the non yet resolved issue of the medico-surgical care. 108 patients with congenital heart diseases have been studied prospectively from February 1992 to May 1994. Epidemiological, clinical, paraclinical data are analysed. Prognosis and treatment are discussed. Congenital heart diseases represent 1% of the outpatient cardiovascular pathology. Diagnosis of the malformation based on echocardiography shows that most of congenital heart diseases are ventricular septal defect (25%); followed by Tetralogy of Fallot (13%). Average age of the patients is 6.86 years. 31% of the cases have heart failure. ECG is abnormal in 103 patients. On the radiologic side, average cardio-thoracic ration is 0.61. Because of heart failure, pulmonary hypertension and hypoxia, the spontaneous prognosis is cautious in 71 patients (66%) who should receive surgical treatment. Among them, 5 patients non operated died and 10 (14%) have been operated. Among the 10 patients who got surgery, 3 with wide persistent ductus arteriosus got in Dakar. All these patients have excellent operative results. In Senegal, only close heart surgery is available and prognosis of the vast majority of patients, including those with valvular and coronary heart diseases, is very cautious. Intervention of Europe-based aid organizations for evacuation is not useful. It is very important to promote, in Senegal, open heart surgery.

Adolescent↗

PubMed1996

[Rupture of a sinus of Valsalva aneurysm into the right ventricle. A case report in the cardiology clinic at the University Hospital Center of Dakar].

We report a case with ruptured aneurysm of the sinus of Valsava into the right ventricle, diagnosed during heart failure in a 22 years old patient. Etiology and prognosis based on our observation and the literature are discussed. Our patient benefited from clinical examination, ECG (15 derivations), pulmonary X ray and standard laboratory test. Pulsed-Doppler and contrast echocardiography have been realized with an ATL MK 600 echocardiograph. These data are discussed and compared to the literature. Cardiac examination revealed a continuous murmur predominantly diastolic 5/6 and an increase of peripheral artery pulsatility. Chest x-ray showed cardiomegaly and ECG bilateral atrial and left ventricular hypertrophy. Two-dimensional echocardiography revealed the diastolic prolapse of an aneurysmal right coronary sinus in the right ventricle. The rupture was confirmed by contrast echocardiography and pulsed-Doppler. Rupture which is a major complication of aneurysm of the sinus of Valsava, is the usual feature of detection. The consequences of rupture are heart failure and pulmonary edema. Our observation shows that conventional Doppler and contrast echocardiography are important for diagnosis and follow-up of aneurysm of the sinus of Valsava. Aortography, hemodynamic and angiocardiographic data, are also important for a precise diagnosis and the detection of associated malformations when pre-operative investigations of aneurysm of the sinus of valsava are needed.

Adult↗

PubMed1996

[Pulmonary tuberculosis in adults: radiological aspects before starting treatment].

We studied chest radiological images in 69 patients with tuberculosis, 4 of them were affected by HIV-infection. The sex ratio was 2.63. We observed 177 abnormal pulmonary images associated in different ways. Bilateral and diffuse radiological signs were noted. Tubercular cavern was the most frequent image (92.90%). It corresponded to a clear circular and oval image surrounded with a regular wall. It can locate in lesional source or healthy parenchyme. Caverns size was situated between 10 to 80 mm. The reticular and nodular infiltration (69%) as indicated associated linear and micro-nodular images. Lobar pneumoniae (44.90%) and segmental pneumoniae (4.30%) corresponded to alveolar lesions showing an opaque and homogeneous tonality image limited by seizures. They were retractile (P = 0.015). Principal mediastinal signs were relative to the presence of adenopathies (11.6%) associated with pleuropulmonary images. Four patients (5.79%) presented tuberculosis association with positive HIV serology. These patients did not present any radiological particularity. They did not show mediastinal adenopathies aspects. Pleural images better corresponded to a localize pachypleurite (13 cas) than a liquid extravasation (8 cases).

AIDS-Related Opportunistic Infections↗

PubMed1995

Extracellular and intracellular rickettsia-like microorganisms in gonads of mosquitoes.

The mosquitoes Culex tigripes, C. decens and C. quinquefasciatus have been investigated by electron microscopy. An intracytoplasmic rickettsia-like microorganism is present in ovaries and testes of the three species. An extracellular form of a rickettsia-like microorganism is described in the testis of C. tigripes in which it sometimes appears in great number. The extra- and intracellular forms present ultrastructural differences. The possibility they represent two different morphotypes of the same microorganism or simply two different types is discussed. They both disappear after treatment with tetracycline. This is believed to be the first electron microscope description of extracellular rickettsia-like cells in mosquitoes.

Animals↗

PubMed1995

[Closed traumas of the thorax. Assessment of two years activity at the Dakar Trauma Center].

Two years after opening the Dakar Trauma Center has received 179 cases of blunt chest trauma without prehospital treatment. Road accidents were the leading cause. The initial mortality was 29 patients (16.20%) and 150 patients arrived alive and were treated. The initial mortality was primarily due to the associated extrathoracic injuries mainly hemorrhagic with hemoperitoneum in 44.82% and brain hemorrhage in 24.14% of cases. Secondly, it was due to the thoracic injuries with 41.37% of anterior flail chest and massive hemothorax in 65.51% of cases. Among the 150 patients treated, 42% had extrathoracic injuries, mainly head trauma. 56% were admitted to intensive care units with 39 chest drainages and 6 thoracotomies were performed. The mortality in this group was about 11.33%. The very high initial mortality could be reduced by the organisation of prehospital treatment to take better care of patients involved in road accidents.

Accidents, Traffic↗

PubMed1995

[Pelvic ring fractures in children. Apropos of 47 cases].

PURPOSE OF THE STUDY: The aim of this study was to report the different anatomical types, associated injuries, morbidity and mortality of pelvic ring disruption in child in Dakar traumatological centers. MATERIAL AND METHODS: [corrected] Forty seven children were admitted in two of three traumatology centers in Dakar between 1968 and 1992. This retrospective and intermittent study excluded tendon-bone avulsions and acetabular fractures. Twenty eight boys and nineteen girls presented a fracture with or without ring disruption according to Ducloyer and Filipe classification. In this first group, they make difference between an isolated or combined fracture and distinguished an anterior and a posterior one. Forty five children were treated by a non-operative methods. RESULTS: Forty three boys and girls sustained their injuries in a pedestrian-motor vehicle accidents and 4 among were struck by a truck. A massive fracture-dislocation with complete pelvic disruption was found in 70.3 per cent. Half of them (34.4 per cent) presented an anterior isolated anatomic type. In the other group the high energy forces caused major pelvic instability and also various associated soft-tissue injuries. The majority of complications were open pelvic fractures (21.1 per cent), genito-urinary (34.4 per cent), vascular (16.6 per cent), neurological and perineo-rectal injuries. Four children (8.4 per cent) died. At the last review others presented orthopaedic, genito-urinary, neurological or perineo-rectal sequelae. DISCUSSION: The frequency of pelvic fractures in child present a peak between 6 and 12 years old. These types of fractures are the results of a high energy injury in pedestrian motor vehicle accidents in Dakar suburbs. The anatomo-radiographic types had an interesting bimodal pattern: Among the benign types: a double fracture of the iliopubic ramus is dangerous for the bladder (1 case), and leads to a dysplastic acetabulum with time (1 case). Unstable fractures (70.3 per cent): some of them (23.3 per cent) present a complex dislocation of the pelvis. The present review focuses on double urethral injuries (2 cases), open pelvic fractures (10 cases) and mortal hemorrhagic shock (4 cases). The morbidity rate is high (38.4 per cent) caused by skeletal and soft-tissue sequelae and also management difficulties. CONCLUSION: Pelvic fracture in children requires early diagnosis and management. In our countries, morbidity and mortality of these injuries must decrease with the popularization of road safety, multidisciplinary management and improvement of working conditions.

Accidents, Traffic↗

PubMed1995

[Prognostic value of nutritional indices for digestive tract cancer surgery in the African environment].

Malnutrition occurs in all patients digestive tract cancer and its effects on perioperative mortality have been well documented. However no study has assessed the predictive value of nutritional status within the context of facilities available in Africa. The purpose of this study was to determine the prognostic value of nutritional status for perioperative mortality in patients with digestive tract cancer i Dakar, Senegal. All patients that underwent surgery for digestive tract cancer were included. Preoperative assessment included physical examination (weight, mid-upper arm circumference, triceps skinfold thickness, and theoretical and real weight loss) and laboratory tests (serum albumin and creatinine/height index). The only evaluation criteria that was correlated was mortality at 14 days. Of the 40 patients included, 18 died (45%). In these 40 patients, 240 malnutrition tests were performed revealing 101 criteria of malnutrition. The results of laboratory tests were not correlated with mortality of clinical factors nor with each other. Physical findings were well correlated with each other but only real weight loss was correlated with postoperative mortality which ranged from 10% when weight loss was less than 10% to 100% when weight loss was 40% or higher. These findings emphasize the value of simply assessing real weight loss, which is difficult in Africa, for predicting perioperative mortality in patients with digestive tract cancer. Use of other physical criteria and especially more elaborate laboratory tests was not of further clinical value.

Digestive System Neoplasms↗

PubMed1995

[Left ventricular aneurysm of indeterminate etiology revealed by an episode of ventricular tachycardia].

INTRODUCTION: We present a case history of a 39 years old woman with parieto-apical left ventricle aneurysm of unknown etiology. The etiologies are being discussed in the light of our case and literature review. METHODS: We have analysed clinical data, 12 leads ECG recording, chest X-ray and biological data of our patient. We have used an ATL MK 600 for echo-Doppler examination. Coronaro-ventriculography has not been performed. The results are compared with data from the relevant literature. RESULTS: Our patient presents at admission tachycardia (150 beat per min) and congestive heart failure. ECG recording showed a sustained tachycardia with large QRS complex (140 msec). At oesophageal ECG recording, atrio-ventricular dissociation was present confirming ventricular tachycardia. The tachycardia has been stopped by lidocaine and amiodarone IV. Chest X-ray shows cardiomegaly (cardio-thoracic index: 0.70) and a protruding left cardiac border. At echocardiographic examination a left dyskinetic anterior and apical aneurysm of the left ventricle has been documented. Surgical repair has not been performed because of the large aneurysm and the reduced function of the non aneurysmal contractile zones. CONCLUSION: In our case, myocardial infarction was not evident, regarding history and examinations. In the etiologic discussion of left ventricle aneurysms, coronaro-ventriculography must be performed. Dilated cardiomyopathy complicated by left ventricle aneurysm can be postulated in our patient.

Adult↗

PubMed1994

[Arterial vascularization of the sinoatrial and atrioventricular node (preliminary study apropos of 15 anatomic parts].

Arterial supply to the sino-atrial and atrioventricular node is studied after coronary RHODOPAS injection on 15 adult hearts taken off during autopsy. Both coronaries were injected in 7 cases, left ostium in 2 cases and the right on in 6 cases. The sino-atrial node is supplied by the right sino atrionodal artery (S.A.N.A) in 6 cases upon 7 and in 3 cases by the left S.A.N.A. Anastomoses exist in 2 cases between the right S.A.N.A. and the left S.A.N.A. The atrio-ventricular nodal artery arises from the retro-ventricular trunk branching from the right coronary artery mainly. The authors emphasize that care must be taken to protect the vascular supply to the conduction tissue during cardiac surgery.

Adult↗

PubMed1994

[Intestinal parasitic diseases and tinea of the scalp in Dakar school population: influence of environmental factors on the infestation level].

We carried out a study during February 1993 in a french and three coranic schools in order to evaluate the incidence of the economical level on the prevalence of intestinal parasites and tinea's scalp. Infection rate by intestinal parasites were 67.4% and 84% respectively in french and coranic schools with significant differences: X2 = 10.8. Infection rate by dermatophytes were 10.6% and 48.8% respectively in francophone and coranic schools with significant differences: X2 = 29.3. Ascaris was predominant through all ages in coranic schools, while amaeba were the main parasites in the upper ages in the french school. Bad environmental features observed in coranic schools as well as in popular areas are risk factors to the infection and contribute to increase the prevalence of intestinal parasitic diseases and tinea's scalp.

Child↗

PubMed1994

[Cardiovascular manifestations of Marfan's syndrome apropos of 6 cases].

We reported six patients with Marfan's syndrome, studied retrospectively from May 1990 to April 1992 in the department of Cardiology in Dakar. Morphological, cardiovascular, skeletal and ocular abnormalities have been reviewed. All the patients had been evaluated by echocardiography. Prevalence of Marfan's syndrome among congenital heart diseases during this period was 4.8%. The mean age was 27.6 years. The mean height was 1.80 m (range 1.38-2.02 m) for a mean weight of 62.8 kg. All the patients had dolichostenomely and arachnodactyly. Kyphosis or scoliosis was present in 5 cases. Chest deformities (pectus carinatum and excavatum) were present in 5 cases. 5 patients had hyperextensible joints. 5 patients had ocular abnormalities. Cardiac pathology was found in 5: mitral prolapse with insufficiency in 2; mitral prolapse with aortic dystrophy in 2; and isolated dilatation of ascending aorta in an other. One patient with diffuse Marfan's syndrome died of cardiac failure. Our study confirm polymorphic manifestations of Marfan's syndrome and the frequency of cardiac abnormalities which are the major determinants of life-prognosis in these patients. Echocardiography is very useful as a noninvasive method for defining the extent of cardiovascular involvement and following its course, for more appropriate treatment.

Adult↗

PubMed1993

Process of nuclear envelope reduction in spermiogenesis of a mosquito, Culex tigripes.

When the Culex tigripes spermatid begins to elongate, the nucleus exhibits on its surface invaginations of the nuclear envelope. These invaginations have a uniform diameter of 0.3 microns. They separate from the envelope of the nucleus and form spherical intranuclear vesicles. In the old spermatids these vesicles are imprisoned in the condensed chromatin. The spermatozoon also possesses these vesicles which are then ovoid in shape. This process of vesiculation permits the diminution of the surface of the nucleus when it decreases in volume during spermiogenesis.

Animals↗