PubMed Health⌕ Search

Biomedical subjects

C T Cisse

Publications and source records attributed to C T Cisse.

At least 19 recordsLinked to original sources
PubMed2004

[Preeclampsia: current aspects of physiopathology, clinic and treatment].

Preeclampsia complicating 3-5 % of all pregnancies in the world. Its origin is abnormal placentation around 12th week pregnancy. It associates hypertension and proteinuria appeared after 20th week pregnancy. Many risk factors with various mechanism of action have been identified (primigravida, younger age, twin pregnancy...). The main consequence of placental ischemia is generalized endothelial dysfunction responsible for clinical symptoms and complications (eclampsia, placental abruption, HELLP syndrome). It's an important cause of maternal death and is associated with increased risk of neonatal mortality, particularly in developing country. There is no consensus with regard to management particularly utilisation of drugs and break indication of pregnancy. Low dose aspirin is the only efficient preventive strategy in high-risk subjects. The therapeutic aspects are discussed as many in the benefit and the modalities of the antihypertensive treatment, as the indications of pregnancy interuption. Prevention is an up coming way but for the moment, only acetylsalicylic acid has proven its efficacity among the high risk patients.

Abruptio Placentae↗
PubMed2004

[Epidemiology and prognosis of caesarean sections in University Hospital of Dakar].

Caesarean section is our first activity in obstetrical surgery. Due to his high frequency and the maternal and foetal prognostic, we have undertaken to do a prospective, longitudinal, exhaustive study concerning all women whose delivery necessitated a caesarean section, between 01 January and 31 December 2001 in Gynaecological and Obstetrical Clinic of University Hospital Center Le Dantec. Our objectives were: describe the epidemiological aspects, evaluate the maternal and foetal prognosis of caesarean sections performed in University Hospital Center. The study revealed that 25.1% of births necessitated a caesarean section. The average age was of 26; the mean parity of 2; the medium height of 161cm. 26.4% of patients were evacuated and coming from the health centers in majority (41.9%) with unmedicalised evacuation in 44.9% of cases. 78.7% of patients have realised at least 3 antenatal consultations. The mains indications were cephalopelvic disproportions (34.9%) and foetal distress (18.9%). The classification per indications group revealed that 37.2% were "prudence caesarean section", 40.1% were "obligator's caesarean section" and 22.7% "necessity's caesarean section". The mean Apgar's score at the birth was 6,5 at first minute. 12 maternal deaths were noted, means 0.8% of global lethality; the morbidity was at 10.5% of cases, represented mainly by postoperative infection (64.3%). The per natal mortality was estimated to 5.9% and neonatal morbidity to 32%. About the quality of caesarean sections, the temporal (24h/24) and financial(kit of caesarean section) accessibilities are more satisfying; otherwise the quality of surgical act and the postoperative follow-up was not optimal. An inflationist advancement is actually noted about the rate of caesarean section, and due to the widening of the indications to the foetal interest. Nevertheless, despite agreed efforts, the quality is still insufficient because the maternal and per natal morbidity and mortality are still high.

Adult↗
PubMed2004

[Epidemiology, prognosis and prevention of choriocarcinoma in University Hospital of Dakar].

The objective of this study was to define epidemiological profile of choriocarcinoma in Senegal, to evaluate its prognosis and to submit a better strategy of prevention. It's a retrospective cases-control study; all choriocarcinoma diagnosed from January 1st to December 31st 2000 at Dakar University Teaching Hospital. The control were chosen among patients who had molar abortion during the same time than the cases and did not developed the pathology after at least 12 months of medical follow up. The stability of association is checked by calculating 95 confidence interval by Miettinen method, and using Chi 2 test of Pearson with a p value of 5% or Fischer test; the prognosis survival factors was compared using logrank test. Among 1098 patients with medical care follow up of post molar abortion, 61 choriocarcinoma were diagnosed with an incidence of 5.5%. The epidemiological profile is a great multipare 40 years old or more with low socio-economical status, 51% of diagnosed cases was in metastasis stage. The prognosis was marked by a complete remission in 37.7% and by global lethality in 49.2%; the average survival was about 48 months. The risk factors of choriocarcinoma among patients who had a molar abortion are represented by an age superior or equal 40 years old, high multipare and preservation of the uterus after molar abortion. To improve the prognosis we recommend to widen preventive hysterectomy indications after molar abortion among patients with risk factors of choriocarcinoma.

Abortion, Spontaneous↗
PubMed2003

[Threatened preterm labour: assessment of its management at the Dakar University Teaching Hospital].

The objective is to specify epidemiological profile of pre term labour birth and evaluate the efficiency of the tocolysis protocol of Dakar University Teaching Hospital. It's a retrospective study which included 155 cases of spontaneous premature birth registered from January 1st 2000 to December 31 2002 in obstetrician clinic. The incidence is 15 per 1000 childbirth. The epidemiological profiles on a pauciparous woman (mean age: 25 years), of low economic and social level (90%), admitted with a bad antenatal follow-up and a pathology associated with pregnancy dominated by arterial hypertension (25%). The mean age of gestation is 30 weeks; severe forms are prevalent and tocolysis score of Baumgarten is equal or higher than 4 in 71.6%. The three principal etiologists are toxaemia, premature rupture of membranes and infections. An association Salbutamol-Phloroglucinol is carried out in 28 cases (18%) or with Phloroglucinol in 25 cases (16.1%). In summary, 138 patients (89%) were finally confined by low way after 5 hours a median time. Perinatal mortality was 347.2 per 1000; it's related to the large premature ones particularly having a weight of birth less than or equal to 1300 grams (78%). The threats of pre term labour are often diagnosed tardily. The access to the tocolysis in emergency is limited and it's effectiveness practises very weak. Use of calcic inhibitors and the systematisation of corticotherapy should improve the forecast of prematurity.

Adult↗
PubMed2002

[Choriocarcinoma in Senegal: epidemiology, prognosis and prevention].

OBJECTIVE: The objective of this study was to define the epidemiological profile of choriocarcinoma in Senegal, to evaluate its prognosis and to submit a better way of prevention of this pathology in an area with poor medical care. MATERIAL AND METHOD: It was a retrospective case-control study of all choriocarcinomas diagnosed from January 1st to December 31st 2000 at Dakar university teaching hospital. The witnesses were chosen among patients who had had molar abortion at the same time as the cases at study and had not developed the pathology after at least 12 months of aftercare. The stability of association was checked by calculating the confidence interval in 95% by Miettinen method and using Chi 2 test of Pearson with a risk factor alpha under 5% or Fischer test; the prognosis survival factors were compared by using logrank test. RESULTS: Among the 1098 patients in follow-up treatment after molar abortion, 61 choriocarcinomas were diagnosed with an incidence of 5.5%. The epidemiological profile was a great multiparous (40 years old or more) with low socio-economical level, 51% of the diagnosed cases are made in the metastasis stage. The prognosis was marked by a complete remission in 37.7% and by global lethality in 49.2%; the average survival was about 48 months. DISCUSSION AND CONCLUSION: The risk factors of choriocarcinoma among patients who had a molar abortion were represented by an age superior or equal to 40 years old, high multiparity and preservation of the uterus after molar abortion. To improve the prognosis in a country with low medical care, we recommend to widen preventive hysterectomy indications after molar abortion among patients with risk factors of choriocarcinoma.

Adult↗
PubMed2002

[Uterine rupture in Senegal. Epidemiology and quality of management].

The purpose of this prospective longitudinal study was to analyze data concerning patients treated for uterine rupture at surgical maternity hospitals in Senegal between January 1 to December 31, 1996. A total of 50 cases of uterine ruptures were recorded during the study period, i.e., 1 rupture for every 45 cesarian sections. Typical epidemiological features were rural residence (68%), age over 30 years (66%), multiparity (64%), and presence of obstetrical risks factors (76%). In 96% of cases, rupture usually occurred after failure or natural delivery assisted by personnel with limited skills in non-surgical facilities. Treatment consisted of uterine suture in 22% of cases and obstetrical hysterectomy in 78%. As a result of poor facilities for emergency transportation (68% of cases), mean delay between the indication for operative treatment and intervention was 11 hours. Maternal mortality and morbidity were 16% and 14% respectively. Neonatal mortality was 95%. The incidence of uterine rupture could be lowered by improving emergency obstetrical care and identifying risk factors for dystocia during prenatal examinations.

Adolescent↗
PubMed2001

[Neonatal bacterial infections at the CUH of Dakar].

OBJECTIVES: It's a retrospective study in order to determine the epidemiology of neonatal bacterial infection and to evaluate the efficiency of the antibiotic protocol in University Teaching Hospital in Dakar. MATERIAL AND METHODES: From January 1st 1997 to December 31st 1998 we have registered 7461 live births, samples of blood are taken from 2312 new-born baby and they received antibiotherapy (beta-lactamine + gentamycin) at the first day based on infections risk evaluated by anamnestic criterias. The treatment is seven to one days long, the antibiotic was adapted according to the antibiogram result. RESULTS: The neonatal infection diagnosis is confirmed in 246 cases, about 33 per 1000 live births or 10.6% of newborn babies having on antibiotherapy. Most current risk factors are premature rupture of membranes (85%) and neonatal suffering (87.8%). Isolated gerras are: Klebsiella pneumoniae (61.5%), Enterobacteria (11.5 Staphylococcus (8.7%), colibacille (6%), Streptococcus (5.5%), Enterococcus (4.1%) and Pseudomonas (2.7%). Most of these germs are resistant to antibiotics currently used in first intention (ampicillin, cefotaxim, gentamycin), in particularly 95% of Klebsiella. Most efficient antibiotics are amikacin, colistin, ceftriaxon and ciprofloxacine. Deaths occurs in 48 cases with 36 in early neonatal period, 79% of mortality rate related to infection by Klebsiella. CONCLUSION: First intention antibiotherapy must be always adapted to the bacterial ecology evolution and must be more selective by using major infections risk factors. We promote early infection diagnosis by using biologic markers which reference is represented by C Reactive Protein.

Anti-Bacterial Agents↗
PubMed1999

[Delivery after scarred uterus at the University Hospital Center of Dakar].

The objective of this retrospective study was to analyze the prognosis of delivery after previous cesarean section in Dakar University Hospital from January 1, 1996 to December 31, 1997. For 9,068 registered deliveries, 134 were on scarred uterus (1.5% of all deliveries). Average age of these women was 29 years. Prophylactic cesarean was performed in 61 cases (45.5%). The main indications were multi-scarred uterus, breach presentation and macrosomy. A trial of labor was undertaken in the 73 other patients (54.5%), 85% were successful. Vaginal delivery rate was 46.3% on scarred uterus. There were no maternal deaths. Only one case of uterin rupture occurred in the prophylactic cesarean group. There were no perinatal deaths caused by trial of labor. These results confirm that trial of labor on scarred uterus should be the rule whenever possible, even when electronic cardiotocographic monitoring is not available.

Adult↗
PubMed1999

[Uterine perforation after an illegal abortion].

This study focuses on problems related to the management of peritonitis following non-medically assisted abortions in developing countries. Between January 1, 1997 and December 31, 1998, four cases of peritonitis due to perforation of the uterus occurred in a consecutive series of 101 women treated following non-medically assisted abortions at the Gynecology and Obstetrics Clinic of the University Hospital Center in Dakar, Senegal. Abortions were performed by untrained persons using dangerous instruments (wood or metal probes) for prices ranging from 5000 to 30,000 CFA francs. The mean interval between abortion and hospitalization was seven days. All patients presented in poor condition with low-grade symptoms of peritonitis. In 3 of 4 cases, the site of perforation was located in the isthmus (anterior, posterior, and lateral). Extensive necrotic lesions required hysterectomy. Postoperative complications occurred in 3 cases including parietal infection in one case, repeat peritonitis requiring re-operation in one case, and fatal iliomesenteric infarction in one case. Prevention could best be achieved by reducing unwanted pregnancies by better sex education and access to contraceptive techniques.

Abortion, Illegal↗
PubMed1998

[Tubal sterilization by minilaparotomy under local anesthesia].

Minilaparotomy under local anesthesia (ML/LA) is the most widely used technique of tubal sterilization in the world. Since 1993, the University Hospital Center of Dakar, Senegal has been the reference center performing 20 ML/LA a month. Most procedures (72%) are carried out for non-medical personal reasons. The remaining cases (28%) involve physical conditions incompatible with completion of normal pregnancy. In all cases, voluntary, informed consent is obtained from the couple and is documented in writing. Preoperative evaluation is performed to detect contraindications. The procedure consists of five steps: the vaginal phase, local anesthesia, abdomen incision, tubal ligation, and closure. Morbidity is less than 1%. The most common complications involve damage to visceral organs (intestine, bladder). These injuries are accessible to immediate repair and thus have a good prognosis. Failure rate due to technical error is low (average: 5.8/10,000). Current experience shows that ML/AL is a safe, effective, low-cost technique well suited to use in developing countries.

Adult↗
PubMed1998

[Vaginal injuries during coitus].

Based on a prospective study on a continuous series of women admitted on emergency for post-coitus hemorrhage. The authors present an epidemiology and prognosis of vaginal injuries in to coitus in the Dakar University Teaching Hospital. Over a period of 33 months (October 1991 to December 1994), 106 cases were recorded, giving an incidence rate of 32 cases per year. The average profile is that of young women (26 years), usually during the post-partum period (41.5%) or in the second phase of menstrual cycle (32%). The main influencing factors found included: chronic vaginal infection (74%), position during coitus (especially that dorsal decubitus with hyperflexion and abduction of the lower members (56%), sexual abstinence of 3 months on average (21 days to 2 years), and use of aggressive product "aphrodisiac" for vaginal mucus. The damage was most often located at the bottom of dead end of Douglas and could be estimated at 5 cm long and 5 mm deep. The immediate prognosis was favourable, after stitching with absorbable thread, healing was obtained within 8 to 15 days. Given a retrospective view about 2 to 5 years, morbidity was represented by 3 recurrent cases and 13% after effects of the deep dyspareunia type.

Adolescent↗
PubMed1998

[Indications and prognosis of forceps delivery at the University Hospital Center of Dakar].

Based on a study of 382 cases registered in a five years periods (1992-1996), the prevalence of forceps delivery is evaluated at 16 per 1000 deliveries. Averagely these are young (24.5 years), primipare (63%) at term and having problems of abnormal labour. The mains indications are: assistance of expulsion (47.1%), severe foetal distress (15.6%), scarred uterus (15.2%) and eclampsia (8.9%). The most frequent applications are the occipito-pubic grasp (51.3%) and left anterior occipito-iliac grasp (34.8). The maternal morbidity prognosis (6%) is represented by cervical or vaginal traumas and infections. The neonatal prognosis is marked by neonatal mortality rate of 50 per 1000 of life deliveries and by a morbidity rate of 3.4% essentially represented by cutaneous lesions.

Adolescent↗
PubMed1998

[Emergency obstetrical hysterectomy].

Hysterectomy on pregnant uterus is a mutilating procedure used by obstetrician only when he haven't choice in case of major complications of pregnancy or delivery. This retrospective study worked on 35 cases of obstetrical hysterectomy performed on 22 months period (January 94-October 95). The frequency of the procedure among all the in hospital deliveries was 0.45%. The mean age of the patients was 31 years, and the mean parity was 7. 77.5% of the women were referred from over surrounding hospitals where natural deliveries had failed. We performed the hysterectomy because of uncontrolled haemorrhage in 71.7%, and infection in 25.8%. Sub-total hysterectomy was performed in 82.8%. Maternal mortality was 20%. Hysterectomy is very mutilating, but is a life rescueing procedure behind a lifethreatening complication of pregnancy or delivery. The best strategy to prevent the necessity of hysterectomy, is to develop the early obstetrical reference program that unfortunately is not yet in practice in our health care system.

Adolescent↗
PubMed1998

[Pregnancy after tubal sterilization. Experience at the University Hospital Center of Dakar].

Between January 1991 and December 1996, 856 women had a tubal sterilization by minilaparotomy under local anesthesia in obstetric and gynaecologic clinic of University Teaching Hospital of Dakar. Among her 5 became pregnant after 7 to 54 months (mean 19 months). The failure rate is 5.84 per 1,000; all 5 women had intra-uterine pregnancy. The women were age 35-43 years (mean 38 years) and multiparity with 8 children. The main causes of failure was technical error and tubal peritoneal fistula. Favorables factors has been represented by inexperience of surgeons and also per-operations difficulties particularly dues to strucked fallopian tubes. 4 has delivered a healthy child with one by cesarean section, in 3 cases she decided to be sterilized again after delivery.

Adult↗
PubMed1998

[Spontaneous and complete uterine rupture on a scarred gravid uterus].

Uterine rupture is a complication occurring mostly during labour. Spontaneous rupture on gravid uterus is rare. We report the 1st case observed on a scarred uterus in 32 week gestation in Gyn/Obs clinique at Dakar University Hospital. Favorable factors found were: segmento-corporeal scar time, poor technical repair. Then, we pose the problems of follow up of these pregnancy involving scarred uterus and discuss the interest of evaluating prognosis of the quality of the uterine scar.

Adult↗
PubMed1997

[Sexually transmitted diseases and female sterility at the University Hospital Center of Dakar: management and prevention].

It is a retrospective study supporting 82 cases continued series of feminine sterility and which objective is to evaluate the nursing management quality of genital infection in exploration and treatment of sterility. Women mean age is 26 years old, sterility is most primary frequently (68%) and from fallopian origin (80%). Followers examinations have been asked: vaginal taking (100%), urines cytobacteriology examination (56%), syphilis serology (23%), chlamydia serology (57%), mycoplasma serology (03%). Genital infection have been diagnosed in 75% of cases, in 33% of cases positive Chlamydia serology was found. Three molecules have been used principally in treatment: cyclines 50%, imidazoles derived 47%, lactamines 15%. The upper cost of diagnostic and treatments produce a wishest of prevention which based is the tracking and the precocious treatment of STD.

Adolescent↗
PubMed1997

[Complications of tubal sterilization by minilaparotomy under local anesthesia].

Between January 1, 1991 and June 30, 1996, physicians performed 800 cases of tubal ligation via minilaparotomy under local anaesthesia in the Obstetrics and Gynecology clinic of the Dakar University Teaching Hospital (Senegal). There were complications in 7 (0.87%) cases (bladder and bowel injuries: 6 cases, and post operative infection: 1 case). The most frequent risk factors were: surgeon skill (lack of experience of surgeon in minilaparotomy), type of patients (obesity, previous abdominal surgery). It was concluded, proper training and experience of the surgical team is needed to minimize sterilization related complications.

Adult↗