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Journal des Maladies Vasculaires 03/2013; 38(2):123-4. · 0.54 Impact Factor
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ABSTRACT: Neurological complications of schistosomiasis remain exceptional even in hyperendemic area.
We report a 26-year-old Senegalese man, without past medical history, who was admitted for spastic paraplegia, acute retention of urine, and pain in low back and lower limbs. The final diagnosis was spinal cord schistosomiasis. Diagnosis was based on the endemic context, MRI medullar conus imaging, schistosoma serology in cerebrospinal fluid and blood, and the absence of other cause of myelopathy. Treatment was based on praziquantel, corticosteroids and physiotherapy. The outcome was favorable after a 2-year follow-up.
Schistosomiasis should be included in the differential diagnosis of myelopathy in patients living actually, or even traveled in the past, in endemic tropical areas.
La Revue de Médecine Interne 07/2012; 33(10):580-2. · 0.61 Impact Factor
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ABSTRACT: Biomedical waste is currently a real health and environmental concern. In this regard, a study was conducted in 5 hospitals in Dakar to review their management of biomedical waste and to formulate recommendations. This is a descriptive cross-sectional study conducted from 1 April to 31 July 2010 in five major hospitals of Dakar. A questionnaire administered to hospital managers, heads of departments, residents and heads of hospital hygiene departments as well as interviews conducted with healthcare personnel and operators of waste incinerators made it possible to assess mechanisms and knowledge on biomedical waste management. Content analysis of interviews, observations and a data sheet allowed processing the data thus gathered. Of the 150 questionnaires distributed, 98 responses were obtained representing a response rate of 65.3%. An interview was conducted with 75 employees directly involved in the management of biomedical waste and observations were made on biomedical waste management in 86 hospital services. Sharps as well as blood and liquid waste were found in all services except in pharmacies, pharmaceutical waste in 66 services, infectious waste in 49 services and anatomical waste in 11 services. Sorting of biomedical waste was ill-adapted in 53.5% (N = 46) of services and the use of the colour-coding system effective in 31.4% (N = 27) of services. Containers for the safe disposal of sharps were available in 82.5% (N = 71) of services and were effectively utilized in 51.1% (N = 44) of these services. In most services, an illadapted packaging was observed with the use of plastic bottles and bins for waste collection and overfilled containers. With the exception of Hôpital Principal, the main storage area was in open air, unsecured, with biomedical waste littered on the floor and often mixed with waste similar to household refuse. The transfer of biomedical waste to the main storage area was done using trolleys or carts in 67.4% (N = 58) of services and wheelbarrows in 33.7% (N = 29). Biomedical waste was disposed of in old incinerators or in artisanal ovens with a great deal of smoke emanating from these. Working conditions were deemed poor by 81.3% (N = 61) of employees interviewed and personal protection equipment was available in 45.3% (N = 39) of services. Knowledge about biomedical waste management was deemed satisfactory by 62.6% (N = 47) of interviewees and 80% (N = 60) were aware of the health risks related to biomedical waste. The poor management of biomedical waste is a reality in hospital facilities in Dakar. This can be addressed by increasing the awareness of managers for an effective application of the legislation, implementing realistic management programmes and providing the appropriate on-the-job training to staff members.
Bulletin de la Société de pathologie exotique 07/2012; 105(4):296-304.
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ABSTRACT: Résumé Les corps étrangers de l'oropharynx sont surtout rencontrés chez l'enfant. Ils posent rarement de problèmes diagnostiques et thérapeutiques. Les auteurs rapportent un cas insolite de corps étranger métallique pénétrant dans l'oropharynx et mesurant 16 cm de long, chez un garçon âgé de 6 ans. La radiographie du cou a été d'un intérêt capital dans le diagnostic et surtout dans la prise en charge de ce corps étranger métallique. L'extraction du corps étranger s'est faite par voie externe sous anesthésie générale.
Abstract Unusual foreign body of the oropharynx Oropharyngeal foreign bodies are most encountered in children. They rarely pose diagnostic and therapeutic problems. The authors report an unusual case of metallic foreign body penetrating the oropharynx and measuring 16 cm long in a 6 –year-old boy. A radiograph of the neck was great interest in the diagnostic and particularly in the management of this metallic foreign body. The extraction of foreign body was done by external approaches under general anesthesia.
Médecine d'Afrique noire 06/2012; 59(6):293 - 6.
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M. Ndiaye,
E. E. M. Nao,
I. Thiam,
B. Loum,
M. M. Dieng,
M. Gaye,
A. Tall,
B. K. Diallo,
I. C. Ndiaye,
R. Diouf,
E. M. Diop
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ABSTRACT: Les chondrosarcomes sont des tumeurs cartilagineuses malignes à localisation maxillaire rare. Ils sont caractérisés par une
évolution généralement lente dans le temps et par une tendance élevée aux récidives locorégionales après traitement chirurgical.
Leur pronostic médiocre dépend de leur degré de différenciation et de la qualité de résection. Les auteurs rapportent un cas
clinique de chondrosarcome mandibulaire et précisent les particularités épidémiologiques, diagnostiques, thérapeutiques et
évolutives de ces tumeurs.
Chondrosarcoma is a malignant cartilaginous tumor rarely found in the jaw bone. Tumor progression is slow with strong propensity
to recurrence after surgical removal. The prognosis is poor and depends on the degree of differentiation and the quality of
resection. We report a case of mandibular chondrosarcoma and discuss the epidemiology, diagnosis, treatment, and follow-up
of these tumors.
Mots clésChondrosarcome–Mandibule–Tumeur cartilagineuse
KeywordsChondrosarcoma–Mandible–Cartilaginous tumor
Journal africain du cancer / African Journal of Cancer 05/2012; 3(1):82-84.
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ABSTRACT: Il est rare d’observer une infection à Morganella morganii du système nerveux central. Nous décrivons un premier cas diagnostiqué au Service de neurologie de l’hôpital universitaire
Fann de Dakar au Sénégal. Un garçon de 12 ans a été hospitalisé pour une méningoencéphalite aiguë. Le scanner était normal
et l’analyse du liquide céphalorachidien (LCR) avait mis en évidence des anomalies cytologiques et biochimiques, ainsi que
la présence de M. morganii. Les sérologies VIH et syphilitique étaient négatives et le taux sanguin de lymphocytes CD4 était de 354/mm3. Un traitement de six semaines par céfotaxime associé à la gentamicine a été efficace. L’issue de l’infection dépend de nombreux
facteurs, tels que la rapidité de mise en oeuvre et la qualité du traitement, la virulence du germe et l’état immunitaire
du patient.
A central nervous system infection due to Morganella morganii is uncommon. We report a case diagnosed at the neurological department of Fann teaching hospital in Dakar, Senegal. A 12-year-old
boy was hospitalized for acute meningoencephalitis. The CT scan was normal and the study of cerebrospinal fluid (CSF) revealed
cytological and biochemical abnormalities and M. morganii. HIV and syphilitic serologies were negative and blood CD4 lymphocyte count showed 354 per mm3. The treatment with cefotaxime associated with gentamicin for 6 weeks was successful. The outcome of infection depends on
many factors such as the onset and quality of treatment, the virulence of the germ and the status of immune system.
Mots clésMéningoencéphalite-
Morganella morganii
-Immunodéprimé-Hôpital-Dakar-Sénégal-Afrique intertropicale
KeywordsMeningoencephalitis-
Morganella morganii
-Immunocompromised status-Hospital-Dakar-Senegal-Sub-Saharan Africa
Bulletin de la Société de pathologie exotique 04/2012; 103(4):230-232.
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ABSTRACT: IntroductionL’utilisation du lambeau du grand pectoral en carcinologie cervicofaciale a permis l’exérèse de vastes lésions. Il constitue
aujourd’hui le lambeau le plus utilisé dans la reconstruction cervicofaciale.
Matériels et méthodesIl s’agit d’une étude rétrospective, qui porte sur une période de 13 ans, durant laquelle 37 lambeaux du grand pectoral ont
été réalisés à la clinique d’ORL de Dakar.
RésultatsL’âge moyen de nos patients était de 51 ans avec un sex-ratio de 5,16. Au plan clinique, les lésions pharyngolaryngées prédominaient
dans 64,87 % des cas et les cancers du larynx étendus à la peau nécessitant une laryngectomie carrée étaient notre principale
indication (37,86 %); elles étaient suivies par la cure chirurgicale de pharyngostome (18,92 %). Au plan anatomique, nous
avons obtenu une cicatrisation de première intention chez plus de la moitié de nos patients (54,05 %).
ConclusionGrâce à ses qualités, le lambeau du grand pectoral a déjà supplanté les autres lambeaux et il trouve sa principale indication
chez nous dans la reconstruction après laryngectomie carrée.
Introduction: The use of pectoralis major myocutaneous flap in head and neck oncology allowed the excision of large tumors
Materials and methodsIt is a retrospective study which concerns a period of 13 years in the course of which, 37 pectoralis major myocutaneous flaps
were performed at the private hospital of ENT of Dakar.
ResultsThe mean age of our patients was 51 years with a sex ratio of 5.16. To the clinical plan, the pharyngo-laryngeal tumors prevailed
in 64.87% of cases. The cancers of larynx expanding into the skin and requiring a square laryngectomy were our main indication
(37.86%). It was followed by the surgical cure of pharyngostoma (18.92%). To the anatomical plan, we obtained a healing of
first intention in more than half of our patients (54.05%).
ConclusionThanks to its qualities, the pectoralis major myocutaneous flap has already supplanted the other flaps and it finds its main
use in the reconstruction after square laryngectomy.
Mots clésLambeau grand pectoral-Laryngectomie carrée-Pharyngostome
KeywordsPectoralis major myocutaneous flap-Square laryngectomy-Pharyngostoma
Journal africain du cancer / African Journal of Cancer 04/2012; 2(3):166-170.
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M S Diop-Sène,
L B Seck,
K Touré, M Ndiaye,
N S Diagne,
A D Sow,
A Basse,
B Mboup,
H Lontsi-Nambou,
P Y Bassong,
A G Diop,
M M Ndiaye
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ABSTRACT: Senegal, like many African countries is facing the so-called demographic and epidemiological transition leading to the development of neurological diseases. These diseases dominated by stroke and status epilepticus are public health priorities with a high prevalence, high lethality and high cost of care. These diseases are managed at the department of neurology, Fann Teaching Hospital, Dakar-Senegal (the only one) with a 65 beds capacity. Unfortunately, access care to the clinic is lately associated with human and material resource scarcity. To improve the management of patients at the clinic, it is important to increase resources (human and material), sensitize the population on early access to health services and prevention of risk factors.
Revue Neurologique 02/2012; 168(3):216-20. · 0.49 Impact Factor
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M Diallo,
S O Niang,
P M Faye,
F Ly,
A Ba,
A Diop,
A M Gaye,
B A Diatta,
I Thiam, M Ndiaye,
N G Diop,
M T Dieng,
A Kane
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ABSTRACT: Cutaneous schistosomiasis is extremely rare, even in endemic regions. It usually leads to non-specific papulonodular lesions in the perigenital area. We report a case of cutaneous schistosomiasis presenting as panniculitis.
An 8-year-old girl was admitted for a large multinodular, indurated plaque over the perineum that gradually spread over a year in a setting of hypereosinophilia. Ultrasonography showed thickening of the bladder and a significant bilateral ureteral hydronephrosis. Histological examination revealed numerous granulomas Schistosoma haematobium ova at their centre and within the hypodermis. Treatment with praziquantel 40 mg/kg resulted in regression of cutaneous lesions within 3 weeks.
We report a case of Schistosoma-induced granulomatous panniculitis that is noteworthy in terms of its clinical appearance, perineal location, association with severe urinary involvement and rapid regression under treatment. The current extent of endemic schistosomiasis and its severity justify greater awareness of this unusual cutaneous presentation, which to our knowledge has never previously been reported.
Annales de Dermatologie et de Vénéréologie 02/2012; 139(2):132-6. · 0.72 Impact Factor
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ABSTRACT: Although neurological complications have been described after tetanus vaccinations, they are rare. The authors report a case of acute disseminated encephalomyelitis (ADEM) in a 28-year-old pregnant woman at a gestational age of 10 weeks, admitted 15 days after a tetanus vaccination, with spastic tetraplegia and sphincter disturbances. Corticosteroid treatment led to partial recovery of the neurological deficit. Differential diagnosis of infectious and demyelinating diseases of the central nervous system is difficult in view of clinical and laboratory aspects of post-vaccination ADEM. Without any specific diagnostic markers, the clinical examination, magnetic resonance imaging and negative etiological findings were key to this diagnosis. Medical staff must bear in mind the possible complications of this vaccine.
Médecine et santé tropicales. 02/2012; 22(1):103-5.
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A Thiam,
E S Diom,
M S Diouf,
C Ndiaye,
D A Boube,
R Deguenonvo, M Ndiaye,
A Tall,
B K Diallo,
I C Ndiaye,
R Diouf,
E M Diop,
Sce Orl,
Chnu Fann,
Dakar Sénégal
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ABSTRACT: Résumé Le carcinome basocellulaire (CBC) est très rare chez le sujet noir. La localisation du CBC au niveau de la face est plus fréquente. Le traitement de choix des carcinomes basocellulaires de la face, reste l'exé-rèse chirurgicale associée à une reconstruction. Notre étude a porté sur deux cas de carcinome basocellulaire de la face, chez des sujets de race noire, adressés par des dermatologues pour la prise en charge chirurgicale. Le traitement, chez les deux patients, avait consisté en une exérèse de la lésion associée à une reconstruction par lambeau fascio-cutané du pédicule temporal dans le même temps opératoire. L'évolution était marquée par une réci-dive tumorale pour l'un des malades après radiothérapie post-opératoire et elle était favorable pour l'autre. Nous faisons dans ce travail une revue de la littérature sur le sujet et soulignons les particula-rités épidémiologiques et thérapeutiques du carcinome basocellulaire du sujet noir. Abstract Management of basal cell carcinoma of the face in black patient : about two cases Basal cell carcinoma (BCC) is very rare in black patient. The location of the CBC at the face is more common. The treatment of choice for basal cell carcinomas of the face is surgical excision associated with reconstruction. Our study focused on two cases of basal cell carcinoma of the face, among black patients, addressed by dermatologists for surgical treatment. Treatment, of the two patients had consisted of excision of the lesion. We associated a reconstruction with fascio cutaneous temporal flap in the same operation. The evolution was marked by a recurrence for one patient after post-operative radiotherapy and was good for the second patient. This survey proposed to do an update on the epidemiological and thera-peutic aspects of basal cell carcinoma of the black skin and a literature review. Mots-clés : Carcinome baso-cellulaire, sujet noir, lambeau locorégional de la face Keywords: Basal cell carcinoma, black patient, loco regional flap face.
Médecine d'Afrique noire 01/2012; 59(1):28 - 32.
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ABSTRACT: The pectoralis major musculocutaneous flap constitutes a significant advance in cervicofacial carcinology. At our institution, it has allowed most surgical problems to be resolved in a single-stage procedure. The objective of this study was to report our experience with this flap.
This retrospective study includes 26 cases observed over a 10-year period (January 1994-December 2003). The parameters studied were clinical and paraclinical. All patients included in this study received a pectoralis major musculocutaneous flap. Patients treated using another type of flap were not included.
Mean patient age was 51 years (range, 20 to 74). The sex ratio was 12 (24 men and 2 women). At the time of admission, 73% of patients showed marked impairment of general condition. In 21 patients (81%), the effect of the pectoralis major musculocutaneous flap was observed immediately after surgery unlike pharyngostome (19%) in which the flap is used in a second stage procedure. With a mean follow-up of 7 years, failure has been observed in 4 cases (15%).
The pectoralis major musculocutaneous flap is an excellent tool for cervicofacial reconstruction after carcinological exeresis. It reduces the duration of hospitalization. Acquiring proper flap harvesting technique is an important factor in improving outcome.
Médecine tropicale: revue du Corps de santé colonial 10/2011; 71(5):457-9.
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G Agodokpessi,
A Diatta,
H Mbatchou,
N Rangar,
Y Dia,
N Toure,
O Ba,
K Diallo,
S Nassurt,
B Ali,
A A Hane, M Ndiaye
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ABSTRACT: A prospective, multicenter was conducted in all specialized centers in the city of Dakar. The objective was to describe the epidemiology to assess the management of lung cancer. 45 patients were included. The sex ratio M/F = 8. The average age of patients was 57.5 years. Smoking was found in 84.4% of cases. The average time for consultation after the onset of symptoms was 6 months. The average time to diagnosis was 2 months. Two out of three patients (66%) had seen beyond the stage III B. Improved diagnostic performance for early diagnosis of cancer is needed. Emphasis should be on prevention through tobacco control.
Médecine tropicale: revue du Corps de santé colonial 10/2011; 71(5):511.
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Archives de Pédiatrie 09/2011; 18(11):1230-1. · 0.30 Impact Factor
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ABSTRACT: Cryptococcal meningitis is much less common in children than adults. The purpose of this report is to describe 3 cases of cryptococcal meningitis observed in children admitted to the Neurology Department of the Fann University Hospital Center in Dakar, Senegal between July 2003 and November 2008. There were 2 girls whose ages were 8 and 15 years and one 9-year-old boy. All 3 patients presented acute or chronic meningoencephalitis. Diagnosis was based on direct microscopic examination of India ink preparations of cerebrospinal fluid (CSF) showing Cryptococcus neoformans at direct exam. Two patients were immunocompromised including one presenting severe protein-caloric malnutrition and one infected by HIV-1. The third patient was immunocompetent. All 3 patients were treated by intravenous Fluconazole. The immunocompetent boy died after 1 month of hospitalization due to cardiovascular and respiratory insufficiency. Both girls survived with severe neurosensory sequels. Cryptococcal meningitis that is relatively frequent in adulthood may be underestimated in children and should be tested for in any children presenting meningoencephalitis of undetermined cause.
Médecine tropicale: revue du Corps de santé colonial 04/2011; 71(2):176-8.
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ABSTRACT: We report a case of cervical Pott's disease revealed by parapharyngeal abscess.
A seven-year-old boy was admitted with a three-week history of painful fluctuating left lateral cervical swelling, associated with night sweats. Examination found trismus, through which a lateral pharyngeal bulge could be observed. Incision and drainage of the abscess on a combined cervical-oropharyngeal approach was performed under general anesthesia, associated to non-specific antibiotherapy by parenteral route. Bacteriology was negative. After one week of antibiotherapy, fever persisted with onset of torticollis. A diagnosis of tuberculosis was considered. Tuberculin skin test was positive at 16.5 mm. A second sample by pharyngeal aspiration showed caseous pus with acid-fast bacilli. Cervical spine CT found a retrostyloid abscess with atlantoaxial lysis. Cervical Pott's disease complicated by Grisel syndrome was diagnosed. Antituberculosis therapy was initiated. Results at five months' follow-up were satisfactory.
Parapharyngeal abscess with an etiology of Pott's disease is rare. Modern imaging is highly contributive to diagnosis and follow-up of lesion regression under treatment.
European Annals of Otorhinolaryngology, Head and Neck Diseases 03/2011; 128(3):151-3.
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ABSTRACT: The presentation of pulmonary aspergilloma is dominated by haemoptysis, the results of medical treatment are disappointing and there is significant morbidity and mortality following surgery; the only really curative treatment. These facts emphasise the gravity of this condition. We undertook a study to estimate the current profile of the disease and its management in Senegal.
A retrospective study took place between January 2004 and September 2008 including all the cases of pulmonary aspergilloma diagnosed in private practice and\or the thoracic and cardiovascular surgery service of the Fann Hospital, Dakar.
Thirty-five patient records were collected. The sex ratio was four males to one female. The average age of the patients was 43.7 years. All the patients had a history of pulmonary tuberculosis. Serology was positive for Aspergillus fumigatus at 22 patients out of 29 (75.86%). Histological examination of surgical biopsies confirmed the diagnosis in 88.46%. The treatment was essentially surgical with no recorded mortality. Nine cases of haemorrhage and eight of suppuration were reported.
Surgery remains the reference treatment for pulmonary aspergilloma. In view of the morbidity of this condition we emphasize the importance of early screening and correct treatment of tuberculosis, particularly in endemic countries, to achieve clinical cure and prevent serious after effects.
Revue des Maladies Respiratoires 03/2011; 28(3):322-7. · 0.59 Impact Factor
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ABSTRACT: Oncology of the parotid region is rich and varied, like its components. During his career, the ENT surgeon may come across such an exceptional tumor as osteolipoma. The aim of this study was to describe the rarity and the etiopathogeny of osteolipoma with parapharyngeal location.
We had the opportunity to find this uncommon tumor in a 21-year-old female patient. The mass located in the parotid region was hard, barely mobile and at first looked like a parotid tumor. Total parotidectomy with facial nerve preservation was performed. It revealed a stony and dented tumor inside the internal lobe of the parotid located in the parapharyngeal space between the vertical portion of the mandible anteriorly and the styloid apophyse posteriorly. Macroscopic examination of the piece evidenced a lipomatous mass with hard as bone nodes in its middle. Histology revealed an osteolipoma.
A review of the literature shows the uncommon occurrence of this type of tumor. A few rare cases were reported among which two involving the parapharyngeal space.
European Annals of Otorhinolaryngology, Head and Neck Diseases 01/2011; 128(1):34-6.
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ABSTRACT: A central nervous system infection due to Morganella morganii is uncommon. We report a case diagnosed at the neurological department of Fann teaching hospital in Dakar, Senegal. A 12-year-old boy was hospitalized for acute meningoencephalitis. The CT scan was normal and the study of cerebrospinal fluid (CSF) revealed cytological and biochemical abnormalities and M. morganii. HIV and syphilitic serologies were negative and blood CD4 lymphocyte count showed 354 per mm(3). The treatment with cefotaxime associated with gentamicin for 6 weeks was successful. The outcome of infection depends on many factors such as the onset and quality of treatment, the virulence of the germ and the status of immune system.
Bulletin de la Société de pathologie exotique 10/2010; 103(4):230-2.
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A Thiam, M Ndiaye,
E S Diom,
S Adguidgue,
R E A Deguenonvo,
M S Diouf,
D A Boubé,
C Ndiaye,
E E M Nao,
A Tall,
B K Diallo,
I C Ndiaye,
R Diouf,
E M Diop
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ABSTRACT: Résumé Ojectifs : Analyser les données épidémiologiques, diagnostiques et thérapeutiques des lithiases de la glande sous mandibulaire opérées à la clinique d'ORL de l'hôpital Aristide Le Dantec de Dakar. Patients et méthodes : Il s'agit d'une étude rétrospective menée sur 16 ans et ayant porté sur 30 dossiers de lithiases sous mandibulaire. Ont été retenus tous les patients porteurs de lithiase de la glande sous maxillaire documentée aux plans clinique, radiologique, per opératoire et/ou histologique. Résultats : L'âge moyen des patients était de 45 ans avec des extrêmes de 13 ans et 80 ans. Le sex-ratio était de 0,76. La durée moyenne d'évolution de la lithiase était de 3,5 ans. Au plan clinique, la tuméfaction sous maxillaire était retrouvée chez tous nos patients (100 %) alors que les notions de colique et d'hernie salivaire ont été notées respectivement dans 70 % et 46,67 %. Une radiographie en profil strict réalisée dans 63,33 % et une échographie des loges sous maxillaires faite dans 23,33 %, ont permis de confirmer l'origine lithiasique dans la majorité des cas. Une sous maxillectomie était réalisée chez tous les patients. Des complications post opératoires ont été notées chez 5 patients. Le recul moyen était de 18 mois. Conclusion : Cette série démontre la relative fréquence des lithiases de la glande sous maxillaire dans notre pratique. Elles font surtout l'objet d'un traitement radical (une sous maxillectomie) avec des suites relativement simples.
Médecine d'Afrique noire 10/2010; 57(10):478 - 84.
