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D Dia

Publications and source records attributed to D Dia.

At least 19 recordsLinked to original sources
PubMed2006

[A mild blackwater fever].

We report a highly probable case of moderately severe blackwater fever. A French woman, living in Guinea Bissau, was used to taking self-medication halofantrine for malaria. On this occasion, she felt unusual chills and pyrexia after a non documented bout of malaria, followed by nausea, then jaundice with dark-red urines despite another treatment with halofantrine. A sepsis was eliminated by two negatives thick peripheral blood drop examinations. Hemolysis was noted with 8.1 g/dl of hemoglobin, Coombs positive, and LDH at 1,452 IU/l, associated to renal failure with 34 ml per minute of clearance. The outcome was favourable with rehydration. Blackwater fever has been described with the three aminoalcohols, but mainly in severe presentations. Clinicians are not familiar with this disease, even though it has major therapeutic implications: quinine, halofantrine, and mefloquine become strictly contra-indicated. Moderate forms may be unknown, and this observation should be taken into account to prevent mistreatment in future patients.

Acute Kidney Injury↗
PubMed2005

[Prescription of morphinics in the management of pain in Dakar teaching hospitals].

The correct management of pain is one of the most frequent problems in a daily medical practice. To achieve this goal physicians have to use many drugs. Among these drugs morphinics represent a special category with specific rules of administration. To assess the use of morphinics in the management of pain in Dakar teaching hospitals and to determine the reasons of under or over prescription, we carried out this study A questionnaire was sent to 200 medical doctors in two teaching hospitals in Dakar between February and April 1999. The response rate was 89.5% (179). According to 73.2% of medical doctors who answered the questionnaire, pain frequently leads to consultation but surprisingly only 14 physicians (7.8%) recognize a regular use of morphinics while 70.1% of them prescribe morphinics exceptionally Morphinics are mainly used to control pain in cancerology (37.2%) and post-operative pain (21.3%). The main reasons to explain the under-use of morphinics were: the fear of respiratory side-effects of morphinics (35.3%), the ignorance of prescription rules (23.5%). The training regarding prescription of morphinics was provided during medical studies and only 10 out of the medical doctors had an adequate postgraduate training in this domain. As expected 51.4% of physicians thought that their training during medical studies was inadequate. To improve the management of pain in our country we recommend a better training of medical doctors during medical studies and the promotion of postgraduate seminars on the use of these molecules. The legislation and rules of administration must be cleared and these drugs should be more available in drugstores and hospital pharmacies. All of these modifications are necessary to help medical doctors to overcome the fear of morphinics for a better management of pain in our country.

Adult↗
PubMed2005

[Liver arterial ischemia after cephalic pancreatico-duodenectomy. A case report].

Cephalic pancreaticoduodenectomy is the best treatment for cephalic pancreas cancers. A rare complication is the liver ischemia after the divison of gastroduodenal artery. This complication can occur when a celiac trunk stenosed by the median arcuate ligamentous is not recognised. We report the case of a 40 old woman who underwent cephalic pancreaticoduodenectomy for an adenocarcinoma of pancreas head. There was no complication immediatly. Two weeks later, she presented two episodes of angiocholitis. An abdominal tomodensitometry showed a liver arterial ischemia associated with a celiac trunk stenosis. There was a left hepatic artery wich came from the left gastric artery. Medical treatment of the angiocholitis was successful. Surgical revascularization was not necessary. Nine months after, arterial revascularization by the left hepatic artery and biological hepatic tests were restored. This case report talks about the importance of angioscanner before pancreatic surgery when celiac and mesenteric angiography is not available. Also, it underlines the importance of the gastroduodenal artery occlusion test before his ligation during pancreaticoduodenectomy.

Adenocarcinoma↗
PubMed2004

[Cutaneous leishmaniasis in hospital area: epidemiological and clinical aspects, about 16 cases].

Cutaneous leishmaniasis, a chronic infectious ulcerative skin disease caused by a protozoan parasite of the genus Leishmania, is transmitted by the bite of sandflies. We report 16 cases of cutaneous leishmaniasis observed in Dakar from 1990 to 2000. The aim of this retrospective study was to determine the epidemiological and clinical features. Their age range was 10 to 78 years (mean 41.12 years). The sex ratio was 3. The most commun presentation was the ulcero-crusted lesions (bouton d'orient) observed in 56.25% of cases. The other clinical presentation are the sporotrichoid lesions (25%), the lupoid lesions observed in 12.5% and the cutaneous diffus leishmaniasis in 12.5%. In all these cases, there were many lesions. On treatment we observed 87.5% of total remission.

Adolescent↗
PubMed2004

[HIV associated nephropathy syndrome: a case report in Dakar].

HIV associated nephropathy syndrome ( HIVAN Syndrome ) is a recently identified entity and no study has been done in Senegal. So we report this observation. A 40 years old black patient was admitted for renal oedema syndrome and immunosuppressive signs. The biological investigations noticed a non-pur nephrotic syndrome and severe renal failure. Ultrasonography showed quite normal kidney sizes with hyper echogenicity and dediferenciation. HIV research was positive with 45 CD4 lymphocytes / mm3. This patient had no known causes of nephrotic syndrome ( diabetis, lupus ,amyloidosis.). So the diagnosis of HIVAN syndrome was determined with the clinical features and the bad outcome. We emphasize on the necessity to think about HIVAN in every black patient presenting a quickly progressive non-pur nephrotic syndrome. We expect prospectives studies to describe the clinical signs and the frequency of HIVAN syndrome in Senegal.

AIDS-Associated Nephropathy↗
PubMed2004

[DRESS syndrome to allopurinol: a case in Dakar].

We report a case of DRESS syndrome also called drug hypersensitivity reaction occurring a 47 years old Senegalese man who has been taking allopurinol for 3 months. That drug was prescribed for peripheric arthralgias associated to a hyperuricemia. He presented a generalised pruritus, cutaneous lesions, fever and facial oedema. On the biological examens, hyperleucocytosis with hypereosinophilia and hyperlymphocytosis associated to the presence of segmented basophiles. In addition, a hepatic cytolysis and cholestasis were documented. Liver ultrasound was normal. The hemocults were negative. These following serologies have been performed and were negative: hepatitis B and C, Epstein Barr-virus, cytomegalovirus, syphilis, toxoplasma and parvovirus B19. The anti-nuclear and anti-DNA antibodies were negative. A favourable clinical evolution was remarked after allopurinol treatment withdrawal. A desquamation occurred after 6 days and hemogram turned out to the normal as well as the hepatic tests after 2 weeks. The virologic examens performed 2 months later were unremarkable. This case point out the importance of the early diagnosis and quick withdrawal of the drug in order to prevent serious forms leading to the 10% of death.

Allopurinol↗
PubMed2004

[Diagnosis delay of multiple myeloma: report of 22 cases in an internal medicine department of Dakar].

Reported is a retrospective study conducted on in patients with multiple myeloma diagnosed from January 1990 to December 2000 in the departement of Internal Medicine I of Dakar University Hospital. Twenty-two patients were included. The mean age was 55 years (range 29-76). The sex ratio (male to female) was 2.6 (they were 16 males and 6 females). The presenting clinical features were dominated by bone manifestations with diffuse pain (41%) followed by pathologic fractures (22.27%) and lumbar pain (13.6%). At the hospital admission the type of clinical manifestations recorded were related to bone (91% general (60%), neurologic (36%) and infection (36%). The biological exams documented an anemia in 20 cases (91%) and increased serum protein in 13 cases (59%) and hypercalcemia in 11 cases (50%) and renal insufficiency in 6 cases (27%). Immunoelectrophoresis had been performed in 6 cases and revaled 4 cases of IgG and 2 cases of light chain myeloma. On the skeletal radiological exams it has been found lytic bone lesions in 66.6 % of cases. diffuse bone rarefaction (38.88%), pathological fractures (38.88%) and vertebral collapses (18.18%). The bone marrow aspiration showed in 17 cases over 19 a medullary dystrophic plasmocytosis. According to the Salmon and Durie classification 68% of the patients were pointed in stage III. Comparing our results to the series, we figure out our patients younger at the time of the diagnosis and an important diagnosis delay as previously suggested in the African litterature. This is confirmed by the fact that 68% of patients were one Salmon and Durie stage III. the frequency of severe anemia and pathological fractures We invite practitionners to conduct systematic exploration of mild symptoms like lumbar pain.

Adult↗
PubMed2003

[Systemic scleroderma: 92 cases in Dakar].

We performed a retrospective study in order to characterize epidemiological data and signs of systemic scleroderma in Sénégal. All patients with the diagnosis according the ACR's criteria of scleroderma were recruited. We included 92 patients, the mean age was 33 years and sex ratio male to female was 0.19 (15 men and 77 women). There were 8 children in our series (8.9%). The initial complaints were cutaneous manifestations (64%) and Raynaud's syndrome (16.3%). Clinical manifestations at admission were muco-cutaneous (100%), osteo-articular and muscular (59%) and Raynaud's syndrome (57%). Focal hypopigmentation was common (70%). Anti-nuclear antibodies were present in 67.4% of patients. Skin biopsy was contributive in all patients in which it was performed (79 cases). Electrocardiogram was abnormal in 55%, non specific inflammatory syndrome was present in 44% and pulmonary function was abnormal in 52%. Our data suggest that systemic scleroderma is more common in younger people in black population. Disorders of pigmentation are common and Raynaud's syndrome is uncommon.

Adolescent↗
PubMed2003

[Ultrasound-guided puncture and biopsy in the diagnosis of chronic liver diseases: report of 447 cases].

Our aim was to evaluate practices of percutaneous liver biopsies over the last 11 years in our center in focal or diffuse liver disease. Records of 447 patients who underwent ultrasound-guided liver biopsy between 1998 and 1999 were reviewed. Three experienced physicians performed all liver biopsies with a Menghini needle or fine needle. In all cases the puncture site was determined using prebiopsy ultrasound. Liver biopsies were performed on 423 hospitalized patients and 24 outpatients. The suspicion of primary liver cancer was the indication in 72.7% of the cases. In 75.2% patients definitive or indicative pathological diagnosis were obtained. 208 biopsies out of 229 (90.8%) and 215 cytological punctures out of 239 (89.9%) were interpretable. Histological diagnosis obtained were primary malignamt tumor in 235 cases (58.2%), cirrhosis in 26 cases (6.4%), chronic hepatitis in 32 cases (7.9%), and normal tissue in 56 cases (13.9%). Only 2 hemorrhagic complications requiring blood transfusion (0.4%) and one needle-tract tumor seeding (0.2%) occured 42 months later. We concluded that ultrasound-guided percutaneous liver biopsy is a quick method of assessment increasing the diagnosis yield by this procedure and maintaining low complications.

Adolescent↗
PubMed2003

[Diabetic ketoacidosis at an internal medicine service].

Ketoacidosis as usual inaugural manifestation and the high frequency of infectious precipating events have been reported in our department on 1986. These same aspects were found in other African series. In this retrospective study of 34 patients presenting an ketoacidosis and managed from, July 1st 2001 to December 31st 2001, we have evaluated the precipating events, and analysed the evolution in comparison with our previous study. Age range was 15 to 74 years with a mean of 43.9. Sex ratio was 2.4. Ketoacidosis inaugurated the disease in 41.17% of cases. Diabetic type 2 was the most frequent one, with an evolution mean duration of 8.1 years. The presenting picture of admission was varied. In addition to the disturbance of consciousness, dehydratation and compensatory hyperventilation were common. With 82.3% in our series versus 43.22% in previous one, infection remain the main precipating cause in our internal medicine department and in tropical area. The disease course was favorable under therapy in 32 patients (94.1%) versus 64.32% on 1986. This might be explained by the lack of hypoglycemic episodes in this present series. The average hospitalisation duration was 20 days. This fact point out the importance of diabetic patients education and screening programs.

Adolescent↗
PubMed2003

[Gastroduodenal peptic ulcer: descriptive study].

Our goals were to describe the epidemiological, clinical and endoscopic aspects of gastrointestinal ulcer and to determine the frequency of H. pylori, we included 140 gastrointestinal peptic ulcers from January 1999 to June 2000. Diagnosis of ulcerous disease delt with the presence of an ulcer discovered during a high digestive endoscopy. Gastro-duodenal ulcers bleeding or with stenosis have been excluded as well as patients who were under anticoagulant treatment or antibiotics or under pump of protons inhibitors during the previous month. Data were collected from a unique questionnaire specifying the sociodemographic characteristic, the history of the ulcerous disease, the antecedents, the style of life, and the endoscopic findings. Five biopsies were done using sterile grips and a fast urease test and the direct exam of the smear. The prevalence of gastro-duodenal ulcers in our population of survey was 6.2%. One hundred twenty eight duodenal ulcers (91.4%), and 12 gastric ulcers (8.6%) were found. The average of age was of 37.1 years +/- 15.3. The sex ratio was 2.9. The gastro-duodenal disease had begun for more than 5 years at 40.8%. No difference in the characters of the pain and signs has been found between duodenal and gastric localization of the ulcer. Hp was associated in 91.4% (91.4% when duodenal ulcers, 88.9% when gastric ulcers and all gastric and duodenal ulcers). We conclude that gastrointestinal ulcers occupies an important place in our gastroenterological practice and the infection rate with H. pylori infection is so high during gastro-duodenal ulcers in our country that the eradication of Hp could be proposed in any case of gastro-duodenal ulcer diagnosed by endoscopy.

Adult↗
PubMed2003

[Behçet's disease in Dakar (Senegal): epidemiological and clinical features].

We report epidemiological and clinical characteristics of 17 consecutives patients with Behçet disease during 26 years in Dakar(Sénégal). All the patients were black, with a mean age of 27.5 years (11- 42 years) and the disease was more common between 20 and 30 years. The sex ratio was 2.4 (12 men -5 women). The majority live in cost area (64.7). Clinical features frequencies were as follow muco-cutaneous (94.11%), ocular (58.82%) neurological (47.05%) articular (47.05) psychiatric (41.17%) vascular (35.29%) digestives (11.76%). Epidemiological characteristics of Behçet disease in Sénégal are common however, the important frequency of neuropsychiatrics manifestations is remarkable.

Adolescent↗
PubMed2002

[An incomplete form of pachydermoperiostosis. Diagnosis of finger clubbing].

INTRODUCTION: The finger clubbing is most of the time associated with cardiovascular and pulmonary diseases. Pachydermoperiostosis also known as osteodermopathic syndrome, an hereditary disorder, is a rare cause of finger clubbing which might be difficult to diagnose in an incomplete form. EXEGESIS: We report a 36 years old black man presenting over many years polyarthralgias, broadening of fingers and clubbing of the fingers and toes extremities. This was mentioned on other family members. The physical examination was otherwise unremarkable. There were no skin thickening, no psoriasis-like and cardio-pulmonary disease features. These following exams were normal; Hemogram, fibrinogen, C reactive protein, rheumatoïd factor, serum calcium and phosphorus, thyroid hormones, growth hormone, chest X-ray, gastroduodenoscopy, electrocardiogram. The skeletal X-ray documented a widespread bone formation, a sacro-iliac osteosclerosis and interosseous ossifications betwen tibias and fibulas. CONCLUSION: Pachydermoperiostosis diagnosis was set up on 3 out of the 4 Borochowitz criteria. The absence of pachyderma defines this incomplete form. The osteoarticular manifestations lead mainly to differential diagnosis with the secondary hypertrophic osteoarthropathy and chronic inflammatory rheumatisms. The underlying pathogenic mechanism of this disease remains still unclear.

Adult↗
PubMed2002

[Gastro-esophageal reflux in adults: clinical and endoscopic features at the Le Dantec Hospital of Dakar].

We carried out a prospective study in the digestive endoscopy unit of Medical Clinic of the University Hospital Le Dantec, in order to better clarify the clinical and endoscopic features of gastro-esophageal reflux ( GER ) in our country. Patients whose endoscopy was indicated by symptoms of GER and those who presented oesophagitis were concerned in this study. We so included 317 patients, representing 16.75% of all patients undergoing upper gastro-intestinal endoscopy from september 1999 to august 2000. Clinical symptoms could be analysed in 164 patients (51.74%). Mean age was 40 years and sex-ratio 0.83. The most frequent digestive symptoms were epigastric pains ( 72.6 % ), heartburn ( 60.4 % ), and acid regurgitations ( 56.7% ). Non gastro-intestinal symptoms were present in 43.9% of cases for Ear Nose and Throat signs. 36.6% for chest pains and 14.6% for pulmonary manifestations. Peptic oesophagitis was present in 40.69% of patients with a mean age of 44 years. Savary and Miller grade IV was rare and was represented by oesophageal ulcers only. GER aspects in our departement are characterized by high frequency of epigastric pains and atypical symptoms, and rarity of severe forms of oesophagitis.

Adolescent↗
PubMed2002

[Two unexpected cases of hepatobiliary fascioliasis in Dakar (Senegal)].

The authors report two hepatobiliary distomatosis cases on patients living in Senegal and Cape Verde islands. No similar case has been reported in Senegal so far. The first case was a 41 years old woman who presented enlarged, painful liver with hypereosinophilia. There was no fever. Ultrasound and CT Scan demonstrated the presence of three poorly limited and heterogeneous masses, located on the liver right lobe. The percutaneous biopsy was not suggestive. Because of the fear ofhepatocellular carcinoma, a hepatectomy was performed and eosinophilic abcesses were found in the piece of resected liver with Fasciola eggs. The second case was a 32 years old man who presented a febrile enlarged liver with hypereosinophilia. Ultrasound revealed an heterogenous process of the liver fourth segment Serology study using Fasciola hepatica antigen was positive. The treatment with Praziquantel was successful. The clinical and epidemiological inquiry in both cases has found stays in Cape Verde islands before the disease. This was consistent with a contamination in that region. In both cases either F hepatica or F gigantica could be responsible since the serological tests are not able to differentiate these two species. Parasitic hepatopathies should be recognised particularly when a painful liver process is associated to hypereosinophilia. The serological tests will help to establish the diagnosis

Adult↗
PubMed2001

[Peripartum idiopathic myocardiopathy: prospective echocardiographic study].

Still frequent in Africa, the idiopathic peripartum cardiomyopathy (PPC) is the subject of only few prospective studies. The aim of this prospective work was to assess the echocardiographic abnormalities of the PPC and to determine on 26 patients the evolution and the prognostic factors of this disease. Six women had mild to moderate pericardial effusion. The abnormalities of the wall motion, constantly found, were diffuse in 20 cases (77.1%) and localized or prevalent on the interventricular septum or the left ventricular posterior wall in the other cases. The cardiac chambers were dilated in 24 cases (92.3%). Left ventricular hypertrophy was noted among 16 patients (61.5%); it was eccentric in 15 cases. The left ventricular systolic dysfunction was constant. The other abnormalities were: the abnormal left ventricular relaxation (one case), low mitral and aortic flow (12 cases), the mitral (21 cases) and tricuspid regurgitation (five cases). One noted a septal hypertrophy and an isolated dilatation of the right ventricle. The mean follow-up was 7.3 +/- 1 month (1-18 months). Two patients died at the 4th and 8th month. Among the 24 survivors, 11 had normalized were: the gestity (p = 0.01), the parity (p = 0.01), the cardiothoracic ratio (p = 0.04), the left ventricular volumes (p = 0.02), and the parameters of left ventricular function. The echocardiography of patients with PPC usually shows a pattern of dilated and hypokinetic cardiomyopathy, but many variations are possible. Most of the patients keep echocardiographic abnormalities after mean term follow-up.

Adolescent↗
PubMed2000

[Tetanus: epidemiological aspects at the Infectious Disease Clinics at the Fann University Hospital Center in Dakar].

This retrospective study was carried out to assess the recent epidemiological aspects of tetanus in Senegal. Based on the records of tetanus cases admitted at the Infectious Diseases Clinic in Dakar over a 7-year periode (1990-1996), this study showed that tetanus is still a major public health concern in Senegal. A global prevalence rate of 18.8% was found. Portals of entry were noticed to be: dirty wounds (48%), the umbilical stumps (19%), non sterile intra-muscular injections (4.5%), surgery (3.3%) and traditional practices (4.2%). Nevertheless, in a high proportion of cases (13.3%), the portal of entry was not found. A 30.3% case fatality rate was observed, that varied significantly according to portals of entry, reaching 60.4% in umbilical tetanus. It is recommended here that the immunization programme against tetanus be reinforced and supported by I E C Strategies together with retraining of medical personnel.

Academic Medical Centers↗