Le Dantec Hospital Research Articles

Breast Cancer and Pregnancy: Epidemiology and Prognosis

Objectives: To describe the epidemiological, therapeutic and prognostic aspects of pregnancy-associated breast cancer. Patients and Method: This was a one-year prospective study from 1 January to 31 December 2020 at the Joliot Curie Institute of the Aristide le Dantec Hospital, including all patients with histologically confirmed breast cancer during pregnancy or at 1 year postpartum during the study period. Results: Of 850 cases of breast cancer, 13 (1.5%) were associated with pregnancy, with an average age of 32 years. All our patients were diagnosed at an advanced stage, 46.2% at stage IIIB and 38% at stage IV. Invasive ductal carcinoma accounted for 92% of cases, with 84% SBRIII. They underwent primary chemotherapy with anthracyclines and taxanes and mastectomy. All pregnancies resulted in full-term delivery with an average birth weight of 3000 g, except for one case of late abortion and intrauterine growth retardation. Maternal prognosis was poor, with a 38% mortality rate. Conclusion: Breast cancer is the most common cancer in pregnant women. This study showed that it is diagnosed at an advanced stage, resulting in a poor prognosis with a 38% mortality rate at one year follow-up.

Immuno-allergic dermatoses in the Dermatology Department of Aristide LeDantec Hospital, Dakar, Sénégal: epidemiological, clinical, and etiological patterns

Background: Immuno-allergic dermatoses have been highly increasing for a decade in African settings. They are the first chief complaint of dermatological conditions in Senegal. Our objective was to describe their epidemiological, clinical, and etiological patterns. Methodology: We conducted a looking-forward descriptive study for 1 year ranging from April 2020 to April 2021 in the Dermatology Department of Aristide LeDantec Hospital in Dakar. We recruited both inpatients and outpatients. Results: Among 5633 patients received for consultation, 149 cases were pooled accounting for a prevalence of 2,6%. The mean age was 31,42 years old. Atopic dermatosis was the first immuno-allergic dermatosis representing 66,4%. They were followed by toxidermia in 16,1% of cases, contact dermatitis in 12,75% of cases, and urticaria in 4,69%. For patients with atopic dermatosis, a respiratory prick test was carried out in 14,1% of patients with a positivity in 57,1% of cases. Of the patients with urticaria and/or angioedema, the main triggering factor was drug use in 57,14% of cases. In our study, antibiotics were the first drug-related toxidermia in our patients accounting for 41,7% of cases. They were followed by herbal therapy in 29,2% of cases and paracetamol in 16,7% of cases. Conclusion: To date, immuno-allergic dermatoses constitute the first chief complaint in our structure and are by far dominated by atopic dermatitis. Automedication and herbal therapy are public health concerns. By causing toxidermia, often in their most serious patterns, they can have a vital prone-threat involvement.

Quality assessment of malaria microscopic diagnosis at the Aristide Le Dantec University Hospital of Dakar, Senegal, in 2020

BackgroundFollowing WHO guidelines, microscopy is the gold standard for malaria diagnosis in endemic countries. The Parasitology-Mycology laboratory (LPM) is the National Reference Laboratory and is currently undergoing ISO 15189 accreditation. In this context, we assessed the performance of the laboratory by confirming the reliability and the accuracy of results obtained in accordance with the requirements of the ISO 15189 standards. This study aimed to verify the method of microscopic diagnosis of malaria at the LPM, in the Aristide Le Dantec hospital (HALD) in Dakar, Senegal.MethodsThis is a validation/verification study conducted from June to August 2020. Twenty (20) microscopic slides of thick/thin blood smear with known parasite densities (PD) selected from the Cheick Anta Diop University malaria slide bank in Dakar were used for this assessment. Six (6) were used to assess microscopists’ ability to determine PD and fourteen (14) slides were used for detection (positive vs negative) and identification of parasites. Four (4) LPM-HALD microscopists read and recorded their results on prepared sheets. Data analysis was done with Microsoft Excel 2010 software.ResultsA minimum threshold of 50% concordance was used for comparison. Of the twenty (20) slides read, 100% concordance was obtained on eight (8) detection (positive vs negative) slides. Four (4) out of the six (6) parasite density evaluation slides obtained a concordance of less than 50%. Thirteen (13) out of the fourteen (14) identification slides obtained a concordance greater than 50%. Only one (1) identification slide obtained zero agreement from the microscopists. For species identification a concordance greater than 80% was noted and the microscopists obtained scores between 0.20 and 0.4 on a scale of 0 to 1 for parasite density reading. The microscopists obtained 100% precision, sensitivity, specificity and both negative and positive predictive values.ConclusionThis work demonstrated that the microscopic method of malaria diagnosis used in the LPM/HALD is in accordance with the requirements of WHO and ISO 15189. Further training of microscopists may be needed to maintain competency.

Echographic Screening for Fetal Malformations at the Gynecological and Obstetric Clinic of the Aristide Le Dantec Hospital: Review from 2016 to 2018

Introduction: Congenital malformations affect around 3% to 4% of live births and 20% of stillbirths. They represent 20 to 30% of the causes of infant mortality in the countries of the European Community. It is estimated that 5 to 10% of malformations are due to exogenous or environmental causes and 12 to 30% to genetic or endogenous causes (gene mutations or chromosomal anomalies). In almost 60% of cases, the actual origin of the malformation remains unknown. Nevertheless, the origin of these anomalies is still being researched, and numerous diagnostic tools are available to practitioners to improve antenatal screening and pregnancy monitoring. However, obstetric ultrasound remains the primary tool for antenatal screening and monitoring of congenital malformations. Methodology: Our main objective was to evaluate the practice of ultrasound screening for foetal malformations at the Gynaecology and Obstetrics Clinic at Hopital Aristide Le Dantec from 1 February 2016 to 31 December 2018. We conducted a retrospective study of ultrasound screening for foetal malformations. Results: At the end of our study, 869 obstetric ultrasounds met our inclusion criteria. We had 837 singleton pregnancies (96.3%), 31 twin pregnancies (3.6%) and 1 trimellar pregnancy (0.1%). We noted 35 cases of foetal malformations, an incidence of 4.02%. All cases of malformations were diagnosed in singleton pregnancies. The average age of the patients was 29 years, with extremes of 18 and 45 years. Primiparous women were the most represented in our study (62.5%). The majority of patients were from Dakar. A history of recurrent miscarriage was found in 7 patients (20%) and there was one case of fetal death in utero during the previous pregnancy. There was no family history of malformations. Consanguinity was found in 11 cases (31.4%). Only 2 patients were found to have taken medication, one for insulin and the other for an unspecified drug. There was no evidence of toxic intake. Fetal malformations were observed in the 3rd trimester in 23 cases (42.9%). There were 11 cases in the 2nd trimester (31.4%) and only 1 case in the 1st trimester. Cranioencephalic malformations were detected in almost half of the cases (42.8%), i.e. 15 cases. There were 8 cases of polymalformative syndromes, i.e. 22.8%. Digestive malformations were represented in 3 cases, i.e. 8.6%, as were cardiac malformations in 3 cases. Pulmonary malformations and limb malformations accounted for 5.7% and 2 cases each. Renal malformations and orofacial malformations also accounted for 1 case each, 2.9% respectively. Among the 15 cases of malformations of the nervous system, ventricular dilatation ranked first with 10 cases representing 66.6%, followed by anencephaly and cystic hygroma with 2 cases each representing 13.3% and finally dolichocephaly with 1 case representing 6.7%. We found 8 different cases of polymalformative syndromes. These syndromes were labelled in 2 cases and unlabelled in the 6 others. There was 1 case of trisomy 21 and 1 case of trisomy 13. The other cases of polymalformative syndromes were not clearly labelled. A combination of cerebral, $cardiac and/or renal malformations were reported. Digestive malformations were noted in 3 cases (8.6%), including 2 dilatations of the coves (megacolon) and 1 case of omphalocele. Pericarditis, atrial septal defect and transposition of the great vessels were the cardiac malformations found in a total of 3 cases (8.6%). Two cases of achondroplasia were found in our series (5.7%). They were all associated with oligohydramnios. There were 2 cases of pulmonary hypoplasia (5.7%). These were associated with anamnios and a medullary syndrome in one of the cases. Cleft lip and palate and polycystic kidney disease were present in one case each (2.9%). The pregnancy resulted in vaginal delivery in 21 cases (60%), caesarean section in 13 cases (37.1%) and in 1 case the mode of delivery was not specified. The main indication for Caesarean section was hydrocephalus (61.5%). The anomaly and the type of malformation were announced in 85.5% of cases. A referral for fetal ultrasound was suggested in 5.7% of patients and fetal MRI in 2.9%. Concordance between antenatal and postnatal diagnosis was achieved in 18 cases (51.4%). The pregnancy resulted in vaginal delivery in 21 cases (60%), caesarean section in 13 cases (37.1%) and in 1 case the mode of delivery was not specified. The main indication for Caesarean section was hydrocephalus (61.5%). The anomaly and the type of malformation were announced in 85.5% of cases. A referral for fetal ultrasound was suggested in 5.7% of patients and fetal MRI in 2.9%. Concordance between antenatal and postnatal diagnosis was achieved in 18 cases (51.4%). Neonatal mortality accounted for 62.9% of the series, with 22 cases. Conclusion: Fetal malformations were detected with a concordance of 51.4% between antenatal and postnatal diagnosis. Neonatal mortality was high. A major preoccupation should be the strengthening of cytogenetic diagnosis and management resources, and raising awareness of the origins of congenital malformations.

Cardio-Renal Syndrome: Experience of A Nephrology and Cardiology Department in Senegal In West Africa

Introduction: Cardio-renal syndrome (CRS) is a complex physio pathological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can lead to acute or chronic dysfunction of the other organ. The objective of this work was to evaluate the profiles of patients with cardio-renal syndrome in the nephrology and cardiology departments of the Aristide Le Dantec Hospital (HALD) in Dakar. Patients and Methods: This were a prospective descriptive and analytical study over a period of 6 months. This study included any patient seen in consultation or hospitalized in the nephrology and cardiology departments and presenting with cardio-renal syndrome. Results: The hospital prevalence of CRS was 19.18%. The average age of the patients was 62.128 ± 16.27 years with a sex ratio of 1.54. Forty-three patients (37%) had type 1 CRS; 30 patients (26%) had type 5 CRS; 28 patients (23%) had type 2 CRS; 8 patients had type 3 and type 4 CRS (7% each). The etiologies were dominated by decompensated heart failure (42%) for type 1, ischemic heart disease for type 2, acute lung edema (50%) for type3, nephroangiosclerosis (62%) for type 4 and hypertension (66%) for type 5. Conclusion: Cardio renal syndromes are common in cardiological and nephrological hospitalizations and remain underdiagnosed.

Granulomatous Acute Interstitial Nephritis Revealing Multisystem Sarcoidosis Associated with Thyroiditis and Cushingoid Syndrome: Report of a Case and Review of the Literature

Introduction: Sarcoidosis can present with acute renal failure (ARF) due to granulomatous interstitial nephritis (GIN). We report the case of granulomatous acute renal failure (ARF) revealing multisystemic sarcoidosis in the nephrology department of the Aristide Le Dantec hospital in Dakar. Observation: Mrs. kD aged 54 with a past history of high blood pressure for 22 years, a multi nodular euthyroid goiter, referred to the nephrology department for impaired renal function. The clinical examination revealed at entry, deterioration in the general condition with weight loss and non-selective anorexia. Clinical anemia was also noted. The clinical examination also revealed Cushingoid syndrome and dry mouth syndrome. On biology, the blood count showed bicytopenia with anemia at 10.9 g/dl and leukopenia at 2620/mm3. There was an impairment of renal function with creatinine at 139.2 mg/l and blood urea at 1.76 g/l. The renal ultrasound became normal. Cervical ultrasound showed an aspect of abscessed thyroiditis of the right lobe. Chest computed tomography (CT) showed bilateral hilar adenomegaly and a band of bilateral basal linear atelectasis. The renal biopsy showed glomeruli of subnormal structure, the interstitium is riddled with tuberculoid follicles formed of epithelioid and multinucleated histiocytes of the Langhans type. The diagnosis of granulomatous acute interstitial nephritis revealing multisystemic sarcoidosis was kept. The evolution was favorable after 1 month of treatment with corticosteroid therapy with a clear improvement in renal function. Conclusion: Renal manifestations during sarcoidosis are rare. They can be indicative of the disease as in our patient. Renal biopsy is essential in any patient presenting with impaired renal function with extra-renal signs.

What are the Risks of Death in Elderly Patients after a Proximal Femur Fracture at Aristide le Dantec Hospital?

What are the Risks of Death in Elderly Patients after a Proximal Femur Fracture at Aristide le Dantec Hospital?

What are the risks of death in elderly patients after a proximal femur fracture at Aristide Le Dantec hospital?

What are the risks of death in elderly patients after a proximal femur fracture at Aristide Le Dantec hospital?

Genital Infections and Associated Risk Factors in Women on Contraception Monitored at the Bacteriology and Virology Laboratory of Aristide Le Dantec Hospital

Background: Contraception is a strategy of choice for spacing births but also for avoiding early and unwanted pregnancies. However, through hormonal modification, this contraception constitutes a favorable state for the proliferation in the genital tract of agents responsible for vaginal infections. The objective of this study was to evaluate the prevalence of genital infections in women on contraception followed up at the bacteriology-virology laboratory of Aristide Le Dantec Hospital.
 Methods: This is a retrospective descriptive study conducted over a one-year period between January 2019 and December 2020. Microbial assessemnets were performed on genital secretions according to standard bacteriology laboratory procedures. Sociodemographic data and bacteriological examination results obtained were entered using File Maker Pro Advanced (version 16) software. Statistical analyses were performed using SPSS software (version 20).
 Results: This research studied 1771 women, of whom 1609 were on contraceptives. The most represented age group was over 40 years (27.06%). The majority of patients were women on oral contraceptives (32.07%). Women with secondary education (31.45%) and women with 1 to 3 children (43.03%) were most often on contraception. The germs most frequently detected in women on contraception were Gardnerella vaginalis (51.78%) and Candida albicans (24.19%) and the use of intrauterine device (IUD) as a means of contraception was statistically associated with vaginal infection (p=0.0004).
 Conclusion: This study showed a high frequency of vaginal infections in women on contraception and that the intrauterine device was significantly associated with the occurrence of these infections.

Primary oto-rhino-laryngological cancers: Epidemiological, clinical and therapeutic aspects about 231 cases in Senegal

Objective: establish the epidemiological, clinical and therapeutic profile of primary cancers of the oto-rhino-laryngological (ENT) sphere in a reference oncology service in Senegal. Methods: This is a retrospective descriptive study, conducted at the Joliot Curie Institute of Aristide le Dantec hospital over a 30 months period from January 1, 2020 to June 30, 2022. Results: 231 ENT cancers were collected in our study, with a mean age of 51 years [11; 93]. Females predominated with a sex ratio of 0.88. Alcoholism was noted in 15.1% of cases. Smoking was noted in 23.8%. Alcohol smoking predominated in laryngeal cancer. The oral cavity was the most frequent site (44.6%). The histological nature of the cancers was dominated by squamous cell carcinoma (93.5%). Stages III and IV were in the majority: 62.8% and 23.8% of cases respectively. Neoadjuvant surgery was performed in 11.9% of cases. Chemotherapy was used in 65.1% of cases (including 90.2% for induction). Radiotherapy was used in 42.9% of cases and associated with chemotherapy in 90.7% of cases. Conclusion: ENT cancers are common in Senegal and diagnosed at all ages. Females predominate. The most common cancers are those of the oral cavity. They are discovered at a locally advanced stage and are treated with induction chemotherapy followed by concomitant chemoradiotherapy.

Cutaneous Squamous Cell Carcinoma: A 7-year Review

Introduction: Cutaneous squamous cell carcinoma (SCC) is rare in sub-Saharan Africa. In Senegal, its prevalence was estimated at 0.09% in 2004. It occurs most frequently in pre-neoplastic acquired or genetic dermatoses. The aims of this study were to describe the epidemiological, clinical and therapeutic aspects of SCC, and to identify associated risk factors. Methodology: This was a descriptive cross-sectional study in the Oncology Department at the Joliot Curie Institute of the Aristide Le Dantec Hospital over a 7-year period (January 2015 to December 2021). We included all patients hospitalized and followed up for SCC. The diagnosis was confirmed by histopathology. Data entry and analysis were performed using epi-info software version 7.2.5.0 and Excel 365. Results: We recorded 189 cases of SCC, representing an incidence of 24 cases per year and a hospital frequency of 0.77%. The mean age was 51 and the sex ratio 1.28. The ulcero-budding form was predominant in 67.2% of cases. The majority of lesions were located on the lower limbs (30.6%) and 28.4% on the cephalic extremity. Squamous cell carcinoma was well-differentiated in 49.2%. Metastases were present in 40.2%. Pre-neoplastic dermatoses were noted in 28.6%. These were burn scars in 43%, chronic ulcer in 23.39%, discoid lupus in 2%, Buschke Lowenstein tumor in 4%. Geno dermatoses included albinism in 6 cases and xeroderma pigmentosum in one. Voluntary use of depigmenting cosmetics was noted in 11 cases. Patients underwent surgery in 32.3%, radiotherapy in 8.5% and chemotherapy in 32.8%. Favorable progression was in 20.6%. Recurrence was noted in 2 cases, metastasis in 3 and death in 5. Conclusion: Squamous cell carcinoma remains a serious tumor in Africa. There is a delay in diagnosis, with some tumors being very advanced. Early surgical management is the main factor in curing the cancer.

DELAI DE CREATION DE LA PREMIERE FISTULE ARTERIO-VEINEUSE POUR HEMODIALYSE AU SENEGAL

SummaryBackground: Arteriovenous fistula (AVF) is the preferred type of access with better survival of hemodialysis patients. Senegal has only one vascular surgery referral center. The aim of this study was to evaluate the time to creation of the first AVF in our hemodialysis patients.Patients and Method: A multicenter retrospective study was conducted over three months between August and October 2019 with retrospective collection of data from the files of chronic hemodialysis patients who had a first functional AVF, whether still functional or not. The estimation of the regression coefficients made it possible to determine the average times for creation of the first AVF.Results: During the study period, 107 patients had a first AVF, representing a prevalence of 56.3%. Thirty-three patients came from Aristide Le Dantec hospital, 33 from Pikine hospital, 13 from Diourbel hospital, 17 from Thiès hospital and 11 from Ziguinchor hospital. They had a median age of 43 years, nephrology follow-up before starting dialysis in 58%, emergency start of dialysis in 52% and preemptive AVF in 8%. Forty-eight percent of patients had family support in their care. The median length of time on dialysis was 13 (7 – 19) months before the creation of the first AVF. The difference in AVF creation time between patients at the Aristide Le Dantec hospital (located 7.3 km from the vascular surgery referral center) and patients at the Ziguinchor center (located 494 km) was 24. 62 [95% CI 11.63 – 37.61] months. The effects of age, sex, comorbidity, starting dialysis in an emergency situation, socio-economic level and mode of care were not significant.Conclusion: The waiting time for the creation of the first AVF is longer for patients at Ziguinchor hospital (the remote center). These results suggest the need for capacity of nonvascular surgeons and nephrologists for the creation of AVF. Keywords: arteriovenous fistula, vascular surgery, delay, hemodialysis, Senega

Childhood-onset rheumatoid arthritis at a tertiary hospital in Senegal, West Africa

BackgroundChildhood-onset rheumatoid arthritis (CORA), known as rheumatoid factor (RF)-positive juvenile idiopathic arthritis is a type of juvenile idiopathic arthritis that shares the same genetic factors and clinical features as adult-onset rheumatoid arthritis. In Africa, CORA hasn’t been the subject of a specific study.ObjectivesThe aim of this study is to describe the clinical features, disease activity, functional disability, and treatment of CORA at diagnosis in Senegal and compare the findings to other CORA populations.MethodsWe conducted a mixed cohort study by reviewing the medical records of patients diagnosed with CORA with an age of symptom onset < 18 years according to the 2019 PRINTO provisional criteria for RF-positive JIA from January 2020 to December 2022 at rheumatology department of Aristide Le Dantec Hospital in Dakar, Senegal. We collected demographic, clinical, paraclinical and therapeutic data. Disease activity score was assessed by DAS28-ESR and DAS28-CRP. Functional disability was assessed using Health Assessment Questionnaire (HAQ) or Childhood HAQ.ResultsA total of 21 patients were included. Eighteen (85.7%) were Females. The mean age at symptom onset was 13.0 ± 3.0 years, and at diagnosis was 16.4 ± 4.2 years. Morning stiffness, joint swelling, and joint deformities were found in 20, 18 and 13 patients respectively. Four patients had a family history of rheumatoid arthritis. Five patients had extra-articular involvement such as rheumatoid nodules. Two patients had interstitial lung disease. The biological inflammatory syndrome was found in 90% of cases. 16 of 21 (76.2%) patients had positive RF, and 18 of 20 (90%) patients had positive Anti-CCP. Seven of 12 (58.3%) patients had positive anti-nuclear antibodies. The mean DAS28-ESR was 5.7 ± 1.0. Fifteen (71.4%) patients had high disease activity (DAS28-ESR > 5.1). The mean DAS28-CRP was 5.4 ± 1.1. The median HAQ was 2.12 with a mean HAQ of 1.9. Nineteen (90.5%) patients were treated with methotrexate, while 17 (81%) had a combination of methotrexate and hydroxychloroquine. Oral prednisone was used in 17 (81%) cases. Non-steroidal anti-inflammatory drugs were used in 4 cases (19%). After 6 months of treatment, mean DAS28-CRP was 2.9.ConclusionIn our study, CORA mainly affects 13-year-old girls, characterised by high disease activity with joint deformity and significant functional impairment. Treatment is mainly based on methotrexate, prednisone and hydroxychloroquine. Further studies are needed to determine the exact clinical phenotype of this disease.

Diagnostic and Therapeutic Challenges of NON-ST-Elevation Myocardial Infarction in Sub-Saharian Africa

Introduction: Non-ST-elevation myocardial infarction (NonSTEMI) is most often associated with a non-occlusive coronary lesion. However, mortality remains high. The aim of this study was to evaluate the diagnostic and evolutionary aspects of patients presenting with NonSTEMI. Patients and methods: This was a descriptive cross-sectional study conducted from January 01, 2021 to June 31, 2021 in the cardiology department of Aristide Le Dantec Hospital It included all patients hospitalized for NonSTEMI in the study period. The data studied were clinical, paraclinical, therapeutic and evolutionary. Results: A total of 52 patients were included. Mean age was 60.69 years, with extremes of 32 and 86 years. The most common risk factors were hypertension (58.85%), diabetes (34.62%) and smoking (30.7%). Chest pain was the main symptom (73.1%). On physical examination, signs of heart failure were noted in 19.2% of cases. Troponinemia was positive in 94.2% of patients. Repolarization disorders occurred most frequently in the lateral territory (55.4%). ST-segment depression was most common (75%). Doppler echocardiography revealed segmental kinetic disorders in 22 patients (42.3%). Coronary angiography was performed in 36 patients. Significant lesions were found in 63.8% of cases, most often tri-truncular (56.5%). Fourteen patients underwent angioplasty. In-hospital mortality was 3.8%. Conclusion: NonSTEMI is a frequent clinical form of acute coronary syndrome, occurring most often in high-risk patients. It is the expression of coronary lesions that are often severe.

Predictive factors of malunion and nonunion at the Aristide le Dantec hospital

Background: Malunion and nonunion are late complications that can occur during the fracture healing process. The aim of this study was to determine the predictive factors for malunion and nonunion Methods: This was a retrospective study over a period of 43 months. Predictive factors were sought from patient, fracture and initial management data Results: We recorded 72 consolidation disorders in 69 patients. malunion accounted for 54.1% and nonunion for 45.9%. The study population was divided as follows: 53 men and 16 women. The average age was 37.8 years. The patients lived in urban areas in 81.2% of cases. Comorbidities were present in 14.5%. The circumstances of fracture occurrence were dominated by traffic accidents, especially for 39 patients. The initial fracture was closed in 91.3%. Long bones were involved in 97.2% of cases, with a diaphyseal location in 52.8%. The fracture was simple in 79.1%, with 84.7% of the fractures being transverse. The tibia was the bone most affected by malunion (53.8%). Nonunion occurred in the humerus, femur and tibia in 27.3% each. Initial treatment was undertaken in 91.3% of patients. Conclusions: Malunion and nonunion are a reality in our daily practice. These consolidation problems occur in young patients who are victims of road traffic accidents. Diaphyseal fractures of long bones with a transverse line have been the most frequently incriminated. conservative treatment and traditional practice have favoured the development of these complications.

English

Disorders of sex development (DSD) when diagnosed early is important as it pose a real public health problem in Senegal. Among the supporting tools, molecular ones, which are not available everywhere are very useful. In this context, cytogenetic and molecular analyses were implemented in cytology laboratory at the Aristide Le Dantec hospital to enhance the DSDs diagnosis as well as evaluate the impact of the parents&#39; age on such abnormalities. 55 cases of DSD have been received in the cytology laboratory for which cytogenetic (Barr chromatin and GTG karyotype) and molecular (SRY gene research) techniques have been used to characterize these anomalies according to the standards described in the international nomenclature. Three categories of DSD were found, namely 46,XX DSD, 46,XY DSD and chromosomal DSD. SRY is present in 4 patients 46,XX and absent in 3 patients 46,XY and results showed that the diagnosis is made earlier than previously (about 07 years). The study thus suggests the importance of complementarity (cytogenetics and molecular biology) in the diagnosis of DSD but also and especially the importance of early diagnosis from birth. Analysis of the epidemiological data also showed a slight correlation between maternal age and DSD. This showed us that a better characterization of DSD via increasingly powerful tools helps understanding on such pathologies and allows good medical care for patients. &nbsp; Key words: Disorders of sex development (DSD), karyotype, SRY, hermaphroditis.

Anemia: Prevalence and Characteristics Among Koranic School Children in Dakar, Senegal

Background and objectives: Anemia are highly prevalent among two billion people in the world. It affects especially low-middle income countries where prevalence of 50% are found in children under 4 years old and 45% in school children. This study aimed to determine the prevalence of anemia and iron deficiency among children in Koranic schools. Materials and methods: We led a retrospective, cross-sectional study, from January 2018 to October 2018, conducted in some Koranic schools of Dakar (Capital of Senegal) and at Hematology and Biochemistry departments of Aristide Le Dantec Hospital. Statistical analysis of the data was performed using SPSS software (version 20). Results: Our sample contained 833 boarders from Koranic schools in the urban and semi-urban areas of Dakar, aged between 3 and 15 years and predominantly male. Asthenia was the most common sign found in 44.7% followed by perleche and pruritus in respectively 37.8% and 20.8% of cases. Out of 833 Koranic school residents, 98 had a hemoglobin level below the WHO threshold, accounting for a prevalence of anemia at 11.76%. The anemia was mild in the majority of cases (60.2%) and severe in only 2.04% of cases. The risk of anemia did not depend on the age or sex of the child, but its severity was significantly associated with the female sex (p = 0.019). The anemia found in the children was predominantly hypochromic microcytic (67.3%). Serum iron and Ferritinemia performed in 54 of the 66 cases of microcytic anemia showed iron deficiency anemia in 59.26% of cases and inflammatory anemia or hemoglobinopathy in the other cases of microcytic anemia. Conclusion: At the end of this study, we found a prevalence of anemia of about 11.76% among children in Koranic schools in the Dakar region. This shows that anemia is still a public health concern.

Management of High Complicated Genital Infections at the Aristide De Le Dantec Hospital: Apropos of Six Cases

Management of High Complicated Genital Infections at the Aristide De Le Dantec Hospital: Apropos of Six Cases

Epidemiology of Digestive Surgical Emergencies in a Sub-Saharan African Country: A Multicentre Pilot Study Protocol.

Digestive surgical emergencies remains one of the main general surgery activities. Despite the associated mortality rate in low income countries, epidemiologic data about this subject is rare and multicenter studies are even more. We aimed to study an epidemiology of digestive surgical emergencies in Senegal by multicenter protocol. it will a prospective multicenter pilot study from May to July 2022. The patients were from General surgery departments of these teaching hospital in Senegal: Dakar Principal Hospital, Aristide le Dantec Hospital, Dalal Jamm hospital and Saint-Louis Regional Hospital. The Schwartz formula was used. We used a proportion of abdominal surgical emergency of 20%. We had a sample size of 246 patients. this research protocol will be submitted to Ethics committee of four hospital that included. The results of this study can help to get better the management of our digestives emergencies and at the same time improve mortality rate. Digestive surgical emergencies is a public health issueBecause of high mortality rate in poorest countries, epidemiological data in Senegal must be knownThese information can help to lower associated mortality.

Acute Renal Failure in the Elderly in the Nephrology Department of Aristide Le Dantec Hospital in Senegal: About 45 Cases

Acute Renal Failure in the Elderly in the Nephrology Department of Aristide Le Dantec Hospital in Senegal: About 45 Cases