[Home nutritional rehabilitation of severely malnourished children in Dakar suburbs].
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Ambulatory Care↗
Biomedical subjects
M Sarr
Publications and source records attributed to M Sarr.
[Sickle cell disease in children in Dakar, Senegal].
AIM OF THE STUDY: To determine the socioeconomic, clinical and biological aspects of sickle cell disease (SCD) in Senegalese children and adolescents, we retrospectively analysed all records of follow-up attending patients in the Albert Royer Children Hospital of Dakar (Senegal). RESULTS: Homozygous sickle cell (SS) was the most frequent genotype (307 cases). Sickle cell hemoglobin C (13 cases) and sickle cell beta-thalassemia (three cases) were uncommon. Patients were aged from five months to 22 years (mean age: eight years). Most of them came from poor families. The mean number of children was five in patients' families, with at least two cases of SCD in 60% of them. Immunization against hepatitis B virus (10.2%), Haemophilus influenzae b (8.4%), Salmonella (8.7%) and Streptococcus pneumoniae (21.4%) was insufficiently performed, because of its relatively high cost. Only 30% of the patients had received a blood transfusion. Painful crises occurred less than three times a year in 74% of the cases. Complications such as acute chest syndrome (1%), stroke (1%), cholelithiasis (9%), meningitis (0.4%), septicemia (2%) and osteomyelitis (6%) were rare. Mean steady state hemoglobin (Hb) and hemoglobin F(HbF) levels were 8.27 +/- 1.36 g/dL and 6.8 +/- 5.9% respectively among SS patients. No correlations were found neither between Hb and HbF nor between these parameters and the frequency of complications. Eleven patients (1.1% per year of follow-up) died, and infection was the main cause of death (73%). CONCLUSION: In comparison with published data, SCD seems to have mild severity in Senegalese children and adolescents in spite of poor follow-up conditions. In addition to genetic factors, environmental factors might have an important role in disease tolerance.
Adolescent↗
[Red cell parameters and iron status in 48 children with kwashiorkor in Dakar (Senegal)].
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Anemia, Hypochromic↗
[Taurodontism and the pyramidal tooth at the level of the molar. Prevalence in the Senegalese population 15 to 19 years of age].
This study was done to establish the prevalence of taurodontism and pyramidal molars in Senegalese people using the criteria of SCHIFFFMAN and CHANANNEL for taurodontism and the criteria of BRABANT for pyramidal molar, the first and second molars on the panoramic radiograph of 150 consecutive 15-19 year-old Senegalese people were assessed. Results have shown that taurodontism and pyramidal molars were present in 48.6% of patients (20% of teeth). Taurodontism was present in 48% (18.8% of teeth) of patients whereas prevalence of pyramidal molar was 4.6% (1.6% of teeth). Taurodontism was alone in 91.6% of case while pyramidal molar was alone in 8.6% of case.
Adolescent↗
[Prevalence of taurodontism at the level of the molar in the black Senegalese population 15 to 19 years of age].
This study was done to establish the prevalence of taurodontism using the criteria of SCHIFMAN and CHANANNEL, the first and second molars on the panoramic radiograph of 150 consecutive 15-19 year-old Senegalese people were assessed. Results have shown that taurodontism was present in 48% of patients (18.8% of teeth). Taurodontism was greater in females (% compared % in male) but the difference was not significantly, it was found that was significantly greater in the maxillary and in the second molar.
Adolescent↗
[A clinical study of composite restorations in anterior teeth using the Ryge criteria. Apropos of 120 cases performed at the University Hospital Center in Dakar].
In this two years retrospective study the authors determined the rate of survival composite restorations and evaluated clinically the remaining restorations by the Public Health Service (P.H.S.) criteria of Ryge. These restorations were performed by students using Heliomolar composite with scotchbond 2 adhesive dentin system. Results have shown that after two years, 98 (81.67%) out of 120 restorations were present and 51.2% were still working. Clinical evaluation of the remaining restorations needed replacement mainly because of severe color mismatch. Anatomic form and marginal adaptation were well scored after two years (score Alpha or Bravo). This study has shown that composite material is a valuable and effective technology for conservative treatment of anterior teeth in Senegal to avoid tooth extractions and prosthetic. However the knowledge about the type of composite material used must be improved and the operative procedures should be more controlled.
Acrylic Resins↗
[Point of contact and cervical-proximal margin of occlusal-proximal restorations using amalgam. A clinical evaluation].
The occluso-proximal restorations should restore a coronary morphology permitting a normal physiology. The radiological evaluation of 55 occluso-proximal restorations with the amalgam done by 4th and 5th years students at the Odonto-Stomatology Institute, and judged clinically acceptable, has shown 63,63% of incorrect restorations with faults: of inter-dental contact (absence of contact or large contact area) and of cervico-proximal limit (hiatus or excess. The identified iatrogenic faults come from choice of matrixing material in accordance with the clinical situation, to use of separators or inter-dental wedges. The radiographic control of these restorations has permit an immediate correction of excesses and some big areas of contacts, by improving appreciably the success score (up to 20% without re-doing the obstrusion with the amalgam). The retro-alveolar radiography is a clinical evaluation instrument for a better periodontal integration of occlusoproximal restorations in the biological space and inter-proximal space.
Bicuspid↗
[Pain in intracanal treatment. A clinical study apropos of 150 cases].
This study was conducted to determine the incidence of pain during and after root canal treatment. Complete debridement and root canal preparation was performed in first visit. The frequency of pain was recorded and evaluated in 150 patients receiving root canal treatment. Results has shown that incidence of pain was 6.66% root canal preparation in vital teeth and 21% in non-vital teeth (necrosis). Post-obturation pain occurred in 18.75% for vital teeth and 13.15% non-vital teeth (necrosis).
Chi-Square Distribution↗
[Short-term course under beta blockers of clinical and echocardiographic parameters in mitral stenosis in sinus rhythm].
The purpose of this study is to evaluate the short-term benefit of a beta-blocker (atenolol) on clinical and echocardiographic parameters of patients presenting isolated or predominant mitral stenosis in sinus rhythm. It is a prospective study performed on 26 patients who have had a clinical and echocardiographic assessment before and 15 days after treatment by atenolol. After 15 days of beta-blocker treatment, there is a significant improvement of dyspnea (57.6% in class III or IV before beta-blockade versus 15.3% with atenolol; P = 0.001) and a significant decrease of the heart rate (83.3 +/- 15.2 versus 68.9 +/- 13.9; P = 0.001) and the diastolic blood pressure (8 mmHg +/- 1.3 versus 7.2 mmHg +/- 0.9; P = 0.01). The Doppler echocardiography shows a significant increase of the stroke volume calculated by the Doppler method (28.7 +/- 6.2 versus 38.6 +/- 9.7 mL; P = 0.04). There is an insignificant trend to an improvement of the left ventricular systolic function, an increase of cardiac output and the decrease of the mean transmitral gradient. The factors associated with the failure of beta-blocker treatment are: the right heart failure (P = 0.04) and the low diastolic blood pressure (P = 0.01). The beta-blockers could be a logical and effective treatment of patients with mitral stenosis waiting for balloon commissurotomy or surgery.
Adolescent↗
[Intraventricular thrombosis complicating peri-partum idiopathic myocardiopathy].
Ventricular thrombosis can complicate the development and worsen the prognosis in any case of hypokinetic dilated cardiomyopathy. In the present article, a study has been made of 6 reports of ventricular thrombosis selected out of 58 medical files on women with peri-partum idiopathic cardiomyopathy. Patient age ranged from 22 to 55 years. The clinical picture showed hypokinetic dilated cardiomyopathy, complicated by cardiac failure; with its onset during the last trimester of gestation or in the 6 months post-partum. In all patients, overall cardiac failure was observed, and in all cases the diagnosis of intracardiac thrombosis was made by echocardiography. In all 6 patients, a left ventricular apical thrombosis was detected. In 2 subjects, 2 and 3 left ventricular thrombi were respectively found. In 1 case, a left ventricular thrombosis was present. In another case, a right thrombosis associated with a left ventricular thrombosis was detected. Treatment was initiated with a combination of anticoagulants (heparin and K antivitamins), diuretic and vasodilatory treatment. The clinical outcome was favorable, with the disappearance of thrombi and signs of cardiac failure (between the 15th and 54th day). No embolic complication was observed. These findings clearly show the importance of prescribing an anticoagulant treatment as a preventive measure during PPICM. Even if severe embolic complications are a potential risk, anitcoagulant treatment can ensure a favorable outcome.
Adult↗
[Protein-energy malnutrition in children less than five years old in a rural zone in Senegal (Khombole)].
A survey on 400 children less than five years old living in three villages of the sanitary district of Khombole has been realized from 17th to 25th April 1997 in order to evaluate the existence of malnutrition and the hazard factor linked to it. All children have been weighed and measured. The paraclinic assessment made up by a rate of haemoglobin and a parasitical test of the, motions have been realized on 275 children. The emaciation concerns 8% of the children and the statural backwardness 34.7% of them. The malnutrition is variable from one village to another. The percentage of children suffering from a severe malnutrition according to the classification of Gomez concerns 4.5%. Geophagy, intestinal parasitosis, and anaemia are closely related to chronic malnutrition. The results show the existence of a precarious nutritional situation in rural area requiring new policies of struggle against malnutrition.
Acute Disease↗
[Cri-du-chat syndrome. A case report].
We report a documented case in Senegal with cri-du-chat syndrome diagnosed in a 3 months old girl. Our patient benefited from clinical examination, ECG (15 derivations), chest X ray and standard laboratory tests. The cry has been recorded on a magnetic band. We performed also a pulsed-Doppler, two dimensional and TM echocardiography. Chromosomal analysis has been realized. These data are discussed and compared to the literature. At admission this patient presents characteristic cat like cry. At examination, there is a facial dysmorphy, important growth retardation and feeding dyspnea. Auscultation shows a 3/6 left sub-clavicular systolic murmur. Laboratory tests show anemia (hemoglobin = 7.8 g/dl). Chest x-ray showed a cardio-thoracic ratio at 0.61 with increased pulmonary vascular markings. ECG showed right ventricular hypertrophy. Echocardiography-Doppler revealed persistent ductus arteriosus (PDA). Chromosomal analysis shows deletion of the short arm of chromosome 5. After treatment with digitalis and diuretics there was an improvement of cardiac failure. Diagnosis of cri-du-chat syndrome is easy when characteristic cat-like-cry is present. Cardiovascular abnormalities are unfrequent in this syndrome (20% of the cases). They are dominated by ventricular septal defect and PDA. Hemodynamic failure and related growth retardation can lead to cardiac surgery.
Abnormalities, Multiple↗
[Permanent cardiac stimulation in Senegal: preliminary experience at the Cardiology Clinic of Dakar].
We report a prospective and descriptive study in 12 patients who had pacemaker implantation from may. 1996 and dec. 1997. Our patients benefited from complete clinical examination, ECG (12 derivations), standard laboratory tests, chest X ray. Pulsed-Doppler, two dimensional and TM echocardiography have been performed. Stimulation was achieved using endocardial lead introduced percutaneously. During the study, 12 patients over 22, representing 55% of the subjects with symptomatic conduction defects, had definitive pacemaker implantation. Mean age was 53.8 years +/- 18. Most of the patients lived in Dakar. Sex-ratio was 0.58 (7 males/5 females). Most of the patients (83%) had low socio-economical status. Before implantation mean heart rate was 47 bpm +/- 20.8. Mean blood pressure was 155 mmHg +/- 26.7 (systolic) and 71.6 +/- 20.8 mmHg (diastolic). Heart failure was present in 5 patients/12. Others symptoms were mainly syncope (83%). Mean cardiothoracic ratio was 0.56 +/- 0.09. Over a 14 months period we have implanted 7 double chamber stimulators (DDD) and 5 monochamber (VVI). Over a 210 days follow-up, main problems are infection of the pocket in 2 patients. In one of them culture was positive. In Senegal, it is necessary to develop cardiac stimulation. Pacemakers should be available for all patients with symptomatic conduction defects. A national center for electrophysiologic studies and pacemaker implantation is a priority.
Age Distribution↗
[Chronic cor pulmonale: a study of 34 cases in the Dakar University Hospital Center Cardiology Department].
The authors report the results of a study on patients with chronic cor pulmonale hospitalized in the Departement of Cardiology (Dakar), from 1990 to 1998. The hospital prevalence is 0.9% with a male predominance (73.5%). The clinical signs were dominated by dyspnea and cough. The right heart failure is noted in 85.29% of cases. As far as the biological factor is concerned, it exists an polycythemia about 75% of cases, hypoxia (88.8%), hypercapnia (55.5%) and a respiratory acidoses (55.5%). The spirometry showed in 66% of cases, a mixed syndrom with obstructive predominance. The echocardiography showed in all cases right heart dilatation with pulmonary hypertension. The etiological factors are dominated by tobacco (21 cases). The hospital evolution has been favorable in 19 cases underoxygentherapy, lowdosediuretic, expectorant, bronchodilatators and salt restriction. However, 14 patients have died.
Academic Medical Centers↗
[Peripartum heart failure: the underestimated role of frequent diseases in the Sudan-Sahelian area].
Peripartum cardiomyopathy is rare in developped countries, but still frequent in Africa. It is defined as a heart failure occurring during peripartum, without any underlying etiology. Authors present 3 cases showing that heart failure before or after delivery may be due to causes which are frequent in the Sahelian area but generally misdiagnosed. Anemia, hypertension and rheumatic fever were the causes of heart failure in these 3 patients, but they were not apparent when the initial diagnosis was made. These observations emphasize that, despite the complex hypothesis trying to explain heart failure during the peripartum period, one should think about some frequent causes which can be misdiagnosed because of the pregnant state or the heart failure itself.
Adult↗
[Biventricular thrombus complicating peripartum cardiomyopathy. A case report].
The authors report a case of a biventricular thrombus complicating peripartum cardiomyopathy in a 38 years old female. The diagnosis was done by bidimensionnal transthoracic echocardiography which showed 2 thrombi in the apical region of the right ventricle and in the anterior and lateral wall of the left ventricle. With treatment associating salt restriction, diuretics and angiotensin-converting-enzyme- inhibitors, the evolution was good: the thrombi disappeared at the first month for the left ventricular thrombi and after 45 days for the rignt ventricular thrombi. The patient didn't experience any embolic complication.
Adult↗
[Delayed root canal therapy. Data on the frequency and complications].
This retrospective study of 118 teeth receiving root canal treatment was conducted to determine the frequence and complications of delayed root canal treatment. Teeth were categorised into prompt treatment group and delayed treatment group according to the length time of treatment; prompt treatment group was defined as a group where root canal treatment was achieved within a period of 4 months or less, and delayed treatments group, a group where period of treatment was greater than 4 months or where canals were never obturated. Two types of complications were studied: postobturation pain and fracture involving tooth extration. The results of this study have shown that 34.5% of treatments were delayed. In this group we found also a higher rate of fractures involving tooth extraction, but the difference was not significant. The results have also shown that disappearance of pain was the essential factors in the frequence of delayed treatment, but the dental chair breakdown had some responsability. As well as in the two groups, the first reason of extractions was fracture and not pain. These results emphasize the necessity of focusing the patient's motivation on the risk of losing the tooth.
Adolescent↗
Re: "Alcohol consumption and coronary heart disease morbidity and mortality".
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Alcohol Drinking↗