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Biomedical subjects

A Niang

Publications and source records attributed to A Niang.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Chronic renal failure and pregnancy].

The women who are suffering from chronic renal failure in an advanced stage have a deficient fertility but they are not sterile. Hemodialysis has improved considerably the fertility of these patients. The aim of this study is to give the results of our experience, from 1990 to 1996, about pregnancies among the uremic patients, dialysed or no and to make a literature review about this subject. We have noticed that pregnancies in the dialysis patients are rare and their evolution is precarious. We have also noticed more miscarriage or pregnancy interruption. Complications are frequent. Mothers have a high risk of hemorrhagic accident (ablatio placentae), of anemia aggravation, of thrombosis of the vascular approach and a high risk of liver anomalies (gravidic cholestasis). The fetus suffers from the maternal anemia and from chronic hypoxia. He's threatened by hydramnios in the case of bad volemic supervision. The intra uterine delayed developement and the prematurity are usual. The absence of high blood pressure and a residual renal function are representing the favourable elements of the good march of pregnancy. A therapeutic intensification is necessary in order to lead this pregnancies to a viable term. The management is heavy not only for the nephrologic, the obstetrical and the neonatal physicians, but also for the patient who is the only one who can decide to continue or to interrupt the pregnancy. It seems better to inform the patient rather than to procure her abortion by proposing her an effective and inoffensive contraceptive method meanwhile to be pregnant after renal transplantation.

Adult↗
PubMed2001

[Smoking habits among physicians in Dakar].

A prospective cross-sectional study was conducted in March 1999 on the prevalence of smokers and smoking habits among physicians practicing in the Dakar region. The study population was composed of 163 physicians; 128 male (78.5%) and 35 female (21.5%). The prevalence of smokers was 27.6%. The average age of the smokers was 40.5 (+/- 6.2) years (extremes between 30 and 61 years) and an average duration of 18 (+/- 6.6) years in smoking. Men smoked more than women (93.9% versus 6.7%) with 56.4% of heavy smokers. Specialists represented 63.3% and generalists 36.4%. Initiating factors were stress (28.9%), circle of friends/acquaintances (24.4%), fashion (24.4%), pleasure (20%) and advertisements (2.2%). A little over 82% smoked in public places, 68.9% in their work places and 49.5% before children. The average time duration smoking was stopped followed by relapse was 15.7 (+/- 9.7) months. 97.7% of smokers manifested their intention to stop. Nicotine dependence according too the Fagerström questionnaire was average (37.9%), high (39.6%) and very high (12.6%). Smoking is a reality in the medical environment in Dakar. Specific campaigns aimed at physicians will be necessary to hope for a sustainable change in behavior and for a much more pronounced implication in the fight against tobacco addiction.

Adult↗
PubMed2001

[Localized benign pleural mesothelioma observed at the Dakar University Hospital].

We report two cases of localized benign pleural mesothelioma with different clinical features. Neuropsychiatric symptoms, including coma, hemiplegia, seizures and misbehavior predominated in the first case, associated with hypoglycemia. The symptoms in the second case were essentially respiratory (cough, dyspnea, and chest pain). Treatment consisted in thoracotomy and complete surgical resection. Histopathology revealed fusiform cells and collagen stroma. These two cases illustrate the diversity of clinical expression of benign localized pleural mesothelioma and confirm their complete resolution after surgical treatment.

Aged↗
PubMed2001

[Sclerosing peritonitis].

The case presented in this study illustrates the peritoneal changes observed in long-term peritoneal dialysis (PD) patients. This male patient was on peritoneal dialysis (CAPD) for seven months before and 86 months after renal transplantation. Two episodes of peritonitis occurred during that time. The patient developed symptoms (ascites, gastro-intestinal disturbances, deteriorating general condition, inflammatory syndrome) four months after starting hemodialysis, one month after ablation of the PD catheter. Other potential causes (infection, malignancy, hepatitis, etc.) of these symptoms were ruled out following an exhaustive etiological work-up. A final diagnosis of sclerosing peritonitis was made, and the patient was started on corticosteroid therapy. Both morphological and functional alterations of the peritoneal membrane associated with long term PD and the detection of such alterations in everyday practice are reviewed here, along with possible etiological factors and therapeutic measures discussed in the literature. A better understanding of the pathophysiological mecHanisms underlying these alterations would make it possible to develop preventive measures, such as more biocompatible dialysates.

Adrenal Cortex Hormones↗
PubMed2001

[Respiratory manifestations of malignant lymphomas: report of 5 cases].

In this study the authors report 5 cases of malignant lymphomas consisting in a Hodgkin's disease and 4 non Hodgkinian lymphomas. Patients aged from 16 to 55 years were 4 males and 1 female, consulting in Department of respiratory disorders of the University Hospital in Dakar, Senegal, West Africa, from 1986 thru 1992. Detoriation of the general status, cough, dyspnea and cervical adenopathy were remaked in all patients. Thoracic pain and syndrom of right pleurisy were diagnosed in one case of non Hodgkinian malignantlymphoma. X Ray exploration of the chest detected 4 cases of mediastinal adenopathies and 3 pleurisis in non Hodgkinian malignant lymphomas; and reticulonodular opacities of pulmonary basis in the Hodgkin's disease case. The diagnosis has been confirmed by pathologic anatomy studis of the biopsed ganglia. The endemic characteristic of tuberculosis in developing countries make necessary to evoke it in first of any adenopathy. When the clinical feature is atypical, a biopsy of ganglia must be performed to avoid diagnosis delay which could lead to agravate the prognosis of malignant lymphomas.

Adolescent↗
PubMed2001

[Analysis of 115 kidney biopsies performed in Dakar (Senegal)].

Few data are now avalable concerning renal pathology in black African. That is why we under took this study as a contribution to the better knowlege of pathological aspects of kidney disease in Dakar by analysing our 6 years's experience. It was a retrospective study concerning all the patients who underwent renal biopsyfrom January 1993 to December 1998. The samples were studied on light microscopy and immunoflorescence at the nephrology unit of Necker Hospital in Paris. We performed 115 renal biopsies during this period conceming 64 males and 51 females from 5 to 60 years old (mean age 28 years). Nephrotic syndrome represented 67% of the indications, followed by lupus nephritis (13%). We found primary glomerulonephritis in 75% of all cases. Anatomicaly, 54 cases of focal and segmental hyalinosis were found (47% of all biopsies). The other lesions were extra-membranous glomerulonephritis (8,6%), minimal change glomerulonephritis 6%, endo and extra-capillary glomerulonephritis 2,6%, Mesangial glomerulonephrits, extra-capillary glomerunephrotis, IgA nephropaty represented each 1,7%. In 5% of cases the lesions did not permit a precise classification. Focal and segmental hyalinosis is the main primary lesion and lupus nephritis the main secondary one in kidney deseases biopsied in Dakar.

Adolescent↗
PubMed2000

[Regulations on tuberculosis risk in workplaces in Senegal].

National immunization and control programs have not brought about a significant decline in tuberculosis, which remains a real public health concern in our regions. Prevention in the working environment should be part of an overall prevention program for the general population. Nevertheless, companies should play a leading role because they have the necessary structure and assets. We analyzed the epidemiology of tuberculosis in the working environment using demographic data on employees in Senegal, current medicolegal data on tuberculosis in Senegal and data on prevention of tuberculosis. Our analysis led to a proposed strategy for controlling tuberculosis spread and its prevention in the working environment in Senegal.

Adult↗
PubMed2000

[Prevalence of hepatitis B and C viruses in a chronic hemodialysis center in Dakar].

In endemic areas of hepatitis B and C, hemodialysis patients are highly exposed to these infections. So the authors studied the prevalence of hepatitis B and C viruses among chronic hemodialysis patients of CHU A. Le Dantec of Dakar in a cross study carried out from June 1996 to June 1997, in order to identify risk factors and suggest appropriate prophylaxis. The study concerned fifteen chronic hemodialysis patients in an unit of hemodialysis in Dakar. For each patient, clinical and biochemical data were collected serological markers of B and C viruses were tested and HCV-RNA in case of seropositivity to C virus. The mean age of patients were 48 years and average duration of hemodialysis was 40 months. Hepatic injury was silent in all cases. Only one patient (6.7%) was AgHBs carrier while 9 patients (60%) were positive for antibodies anti HBs without previous hepatitis B vaccine. Twelve patients (80%) were found to be HCV-antibody positive and half of them were HCV. RNA positive. Average value of alanine amino transferase was higher in HCV-viremic patients than in seropositive but non viremic patients, although normal. Genotype 2 ac was found in 3 HCV viremic patients but it could not be determined in 3 other patients. Hemodialysis duration and number of blood transfusions were found to be risk factors of HCV infection. The high prevalence of HCV seropositivity among chronic hemodialysis patients in Dakar has led to strengthen precautions in our hemodialysis unit. HCV serological screening in blood donors is advocated.

Adult↗
PubMed2000

[Etiologies of chronic renal insufficiency in a adult internal medicine service in Dakar].

Chronic renal failure (CRF) sets public health problems both as its prevalence and its morbidity. The treatment is costly, that's why developing countries must engage in preventive strategies. In this view, a retrospective study was led in Le Dantec Hospital from January 1st, 1998 to December 31st 1993. As a preliminary to a countrywide survey, it is necessary to find out the causes of CRF clarify the causes of CRF in a hospital setting and sketch out a preventive strategy. The patients included in this study were those with CRF. The diagnosis of CRF were based on medical history data, anemia, but mainly biological and ultrasound imaging: creatininima more than 18 mg/l, and/or creatinine clearance less than 80 ml/mn, whose diagnosis was little sized kidney. Of the 5276 in patients, 384 had CRF representing 7% of sample. Only 261 cases were retained broken down into 119 females and 142 males (sex-ratio: 1.19). Age span ranges from 15 to 88 years with a mean of 44 years. Etiologies were dominated by unknown causes, 89 cases (34.23%). Nephroangiosclerosis was the most common known cause, 65 cases (25%) followed by diabetes nephropathy with 54 cases (20.69%) and chronic glomerulonephretic representing 41 cases (15.76%). Other causes were identified in various proportions: cortical necrosis (4 casesà, hereditary nephropathies (2 cases), interstitial nephropathy (1 case), nephroponophteois, kidney polykystosis, prostate adenoma and bilharziosis were all found in one case each. This study pointed out to a need for a nation-wide survey to define the aetiologies of CRF. The study also showed that an early diagnosis and adequate treatment of high blood pressure, diabetes and GNC should certainly constitute the principal axes of investigation for prevention.

Adolescent↗
PubMed1999

[Evaluation of acute renal insufficiency in Dakar].

The acute renal failure (ARF) is a serious complication occurring commonly in gravidic toxemia. The aim of this retrospective study was to evaluate the treatments wed on patients presenting an ARF and hospitalized in the Dakar hemodialysis centers and emergency service of Hospital Principal. These patients should be aged over 15 years at present no history of chronic renal failure. The diagnosis of ARF was based on the presence of a creatinine clearance value < or = 80 ml/mn, a creatinemia > 176.8 mo/l, an azotemia > 9.99 mmol/l. Thirty patients aged form 16 to 56 years were studied, they were 6 males and 24 females. Among them, 22 (73.33%) present anuria, 5 (16.7%) were in oligo anuria, and 3 (10%) had a normal diuresis. An aetiologic treatment was instituted whenever necessary. The other treatments consisted in dietary measures, hydroelectrolytic balance, blood transfusion, diuretic therapy, and hemodialysis. All anuric patients had a diuretic regimen. Ten of them had recovered a diuresis, 16 underwent hemodialysis in a mean time of 4 days. None of latter recovered renal function 5 patients developed Chronic renal failure and 11 died, mainly by infectious complications. Acute renal failure has until now a poor prognosis in our regions because of a certain management delay. This management should include a guide and adequate volume replacement, and eventually diuretic therapy, and dialysis as soon as possible.

Acute Kidney Injury↗
PubMed1999

[First case of primary IgA glomerulonephritis (Berger's disease) in Senegal].

Berger's disease or IgA glomerulonephritis is the most common glomerular nephropathy in Europe and represent a rare event in blacks. Here, we describe the case of a 43 years old black Senegalese whose disease was discovered while investigating a persistent proteinuria with high blood pressure and chronic renal failure, but without hematuria. We point out the uncommon feature of this clinical presentation and the importance of bad prognostic factors presented by this patient. We obtained a good outcome by means of converting enzyme inhibitors and corticosteroid therapies: regression of renal failure and normalization of blood pressure. The generalization of renal biopsy practice would lead to a better knowledge of the incidence of this disease among Senegalese people. Indeed, renal biopsy is the main tool to diagnose glomerulonephritis and subsequently adapt the therapy aimed at preventing the possible evolution to end stage renal disease.

Adrenal Cortex Hormones↗
PubMed1999

[Fernand Widal syndrome: apropos of 2 cases].

The Fernand Widal syndrome combines a nasal polyposis, an asthma and aspirin sensitivity. It remains a nosological entity often unrecognized because of the trivialization of aspirin in-take on the one hand the other its etiopathogenesis which has not yet been clarified because of the inhibition of the cyclo-oxygenase. In actual fact the aspirin molecule has yet to reveal all its secrets (advantages and disadvantages). We report 2 cases of Fernand Widal syndrome observed in 2 women in their thirties with a notion of atopy in one at the Pneumophtisiology clinic at the Fann University Hospital in Dakar. The confirmed diagnosis was based on oral provocative test in addition to suggestive clinical signs which emphasize the classical triad with a chronological appearance more or less typical. The best treatment could combine inhaled corticotherapy, nasalization of sinus cavities, antihistaminics, no aspirin in take and educating the patient.

Adult↗
PubMed1999

[Sharp syndrome complicating pulmonary tuberculosis: apropos of a case].

This study concerns a case-report about a 28 year old Senegalese woman suffering from a SHARP syndrome complicated by a bilateral bacillary pulmonary tuberculosis. The prevalence of this disease is underestimated but a female predominance is often reported. The mechanisms of this disease strongly depends upon the context in with it occurs. The diagnostic has been established by the ALARCON SEGOVIA criteria including clinical symptoms (Raynaud phenomenon, puffy fingers and myalgia) and biological features such as high positive immunofluorescent reactivity revealing the presence of anti RNP antibody at a level superior to 1/1000. The subsequent development figure of the disease emphasizes: persistence of polymyositis pattern revealed by higher limbs localized myalgia involving the thighs and symptoms of lupus including alopecia and glomerulonephritis remaining of the mixed characteristic comparable to the cases published in the literature. appearance of a bilateral bacillary pulmonary tuberculosis with a severe involvement of the right lung. The treatment composed by anti inflammatory and antituberculosis drugs lead to an early improvement of the clinical symptoms associated to a rapid cleaning of radiological manifestations. Sequelae were represented by cavities detected in the right lung and related to the pharmacological effects of corticosteroid drugs.

Adrenal Cortex Hormones↗
PubMed1998

[Tuberculosis among hemodialysis patients in Dakar, apropos of 2 cases].

Hemodialysis permits a long term survival to patients with End Stage Renal Disease (E.S.R.D.). However the patients ongoing hemodialysis presented a immunodeficiency and a important modification of drugs biodisponibility. Tuberculosis is an endemic disease in our countries. Extrapulmonary tuberculosis is reported from these two cases among 13 patients treated in C.H.U.A. Le Dantec hemodialysis center. Clinical symptoms are not specific bacteria is not found. Diagnosis is obtained by a bundle of arguments. Antituberculosis treatment need to be adjusted in this field. Even if Rifampicine can be administrated at normal dose. The others drugs must be adapted on their clearance and the underlying disease. The two patients presented psychiatrical symptoms motivating a reduction of isoniazide dose witch threshold toxicity is lowered by renal failure state. These observations must increase watchfulness on nephrologist of undeveloping countries, confronted with tuberculosis renewed out break.

Adolescent↗
PubMed1997

[Nephronophtisis in Senegal: first 3 cases].

Nephronophtisis is a familial tubulo-interstitial nephropathy with an autosomic recessive mode of transmission. To our knowledge, it has not been yet reported in Black Africa. We report here the case of a 17-year old female from Senegal who presented with renal failure related to a chronic interstitial nephritis characterized by polyuria, hypocalcemia, natriuresis of 23 mmol/l and serum creatinine level of 1070 mumol/l. The parents of this patient were first-degree cousins. Among the 6 siblings, 2 other males were found to have a renal disease. Ultrasound examination of the kidneys showed medullary cysts in the 2 affected brothers and the renal biopsy in one case showed tubular atrophy, with thickening of the basal lamina and an interstitial fibrosis without glomerular involvement. Molecular genetic analysis confirmed the diagnosis of nephronophtisis, with a homozygous deletion of the NPH1 region. In order to recognize this disease early in life, one has to look for it in patients with tubulo-interstitial nephritis, polyuria, childhood enuresia especially when it is associated with growth retardation or tetany. This case raises the issue of consanguinity and endogamy which are frequently encountered in Africa. It also extends the geographic and ethnic distribution of nephronophtisis, being the first cases reported Black Africans.

Adolescent↗
PubMed1997

[Echocardiographic data from chronic dialysis patients in Dakar].

The authors report the results of a prospective study about echocardiographic parameters of 14 chronic dialyzed patients. Mean age was 44.4 +/- 12 (extremes: 16 and 63). There are 12 men (86%) and 2 women (14%). The main renal disease responsible was nephroangiosclerosis (9 cases, 64.3%). Hypertension is found in all the patients, anemia in 13 (92.8%). The heart, as shown by echocardiography, was concerned in 13 patients (92.8%). The main abnormalities found were: left ventricular hypertrophy (13 cases: 92.8%), left ventricular dysfunction (4 cases: 28.5%), abnormality in left ventricular relaxation (3 cases: 21.4%), pericardial effusion (4 cases: 28.5%).

Adolescent↗