Biomedical subjects

E Diouf

Publications and source records attributed to E Diouf.

At least 19 recordsLinked to original sources

PubMed2005

[Intensive care management of HELLP syndrome in Dakar].

OBJECTIVE: To evaluate the intensive management of HELLP syndrome in a intensive care unit in African setting. STUDY DESIGN: Descriptive and analytical retrospective study. PATIENTS AND METHODS: All patients hospitalized between June 1998 and June 2004 for HELLP syndrome were included in the study. Following parameters were studied: age, parity and gestity, term of pregnancy, delay before admission in ICU, data clinical, biological parameters, medical treatment, obstetrical treatment, maternal complications, maternal and foetal prognosis. RESULTS: Twenty patients of average age 26.3 years with seven primigeste and 13 pauci and miltigeste were admitted in ICU during the period of study for HELLP syndrome. The average time of admission was 1.35 days; 13 patients had HELLP syndrome in ante partum and seven patients in postpartum. Serious complications were noted at admission in the majority of patients with oligoanuric renal insufficiency in 11 cases, eclampsia in eight cases and intravascular coagulation disseminated in four cases. The mode of delivery in patients for HELLP syndrome occurring in ante partum was the Caesarean section under general anaesthesia in five cases and vaginal delivery in eight cases. All the patients for HELLP syndrome in the postpartum had been confined by low way. The maternal evolution was favourable in 13 cases. Seven patients of which five with HELLP syndrome who occurred in ante partum had died. The infant mortality was noted in eight cases primarily in cases of HELLP syndrome which occurred in ante partum.

Adolescent↗

PubMed2005

[Acute chloroquine poisonning in Le Dantec Teaching Hospital].

Chloroquine poisoning is an acute severe drug induce entity increasingly frequent in Senegal. This is due on one hand to its easy accessibility and its conditioning, on the other hand to its frequent use, in the voluntary attempt of ending pregnancy. The aim of this study is to assess the frequency and the severity of such poisoning in a senegalese intensive unit care. We undertook a descriptive retrospective study from January 1998 to December 2003 in the intensive care unit of Aristide Dantec Hospital. All patients admitted for voluntary or accidental acute intoxication to chloroquine were included. The parameters studied were: reason of admission, alledged ingested amount, delay of admission, hemodynamic modifications, therapeutic data and evolution. During the study period, forty-nine cases of chloroquine intoxication were listed out of 239 acute intoxications. Among these 49 cases, 16 files were not processable. These accounted for 1,48% of all admissions during this period. Women were more represented (78.78%). In 90.90% of the cases, the intoxication was voluntary, they were related to suicidal attempt in 57.57% of the cases. The willingness to end a course of a pregnancy was found in 33.33% of the cases. The average age was 22.69 years (11 years - 38 years). The average time of admission was 4 hours. with extremes of 1 and 8 hours. The clinical symptoms were dominated by hemodynamic, neuropsychiatric and respiratory disorders. Toxicological analysis was not carried out. Ionic disorders were dominated by hypokaliémies and electrocardiographic disorders by a widening of QRS. Symptomatic treatment systematic, was based on a vascular filling and the use of adrenalin. evacuation treatment consisted of a systematic gastric "lavage" and the use of activated charcol on (3.03%). Diazepam as treatment antidotic was seldom used. Psychiatric consultation was systematically carried out. Total mortality was 6%. The authors emphasize the nécessaty to: Inform the population on the absence of drugs being able to stop a pregnancy. Think on the urgency need to implement a medical emergency and reanimation departments (SMUR). Create poison control centers in Senegal.

Adolescent↗

PubMed2004

[The para-umbilical block in children: 75 cases report].

The objective of this study is to assess both intra and post operative analgesia in infants undergoing umbilical hernia repair under general anaesthesia with neither opioid nor muscle relaxant, associated with a para umbilical block. It's a prospective study covering a 15 months period. The study included 75 infants (age = 5 months - 13 years; body weith = 6 kg - 35 kg). General anaesthesia was induced with either thiopentone or halothane and, maintained with halothane in a N2O - O2 50 VOL % mixture. Para-umbilical block was obtained using 1 ml/kg of 0.25% marcaïne. Pain was assessed using time course of respiratory rate, heart rate and mean arterial pressure. A change of more than 20% in one of these variables was considered criterion of poor analgesia. Intraoperative analgesia was adequate in all patients but four, 5 minutes after incision. Surgical conditions were considered as being godd or satisfactory in 90.6% and 9.4% of cases, respectively. Post operative analgesia, assessed 1 and 6 hours after completion of surgery was convenient in 93.3% of infants. The block appears as simple, most after efficient and safe in umbilical surgery.

Adolescent↗

PubMed2003

[Intensive care management of 28 patients with severe eclampsia in a tropical African setting].

OBJECTIVE: To study the specific management problems of severe eclampsia under tropical latitudes. STUDY DESIGN: A two years retrospective study in a University hospital in the tropics. PATIENTS AND METHODS: In all patients admitted for eclampsia between January 1997 et December 1999, the following parameters were studied: age, parity, interval between disease et admission, post-eclampsia Glasgow Coma Scale (GCS), time of occurrence of eclampsia during pregnancy, delivery route, blood pressure data at admission, the occurrence of complications at admission or during hospital stay. RESULTS: Twenty-eight mainly primiparous patients (mean age: 26 +/- 6) were admitted with an average delay of 8.5 +/- 10.2 hours after the first symptoms. The time of occurrence was prepartum in 6, perpartum in 14 and postpartum in 8 cases. All patients were hypertensive and comatose with an average GCS of 8 +/- 2.2. Twenty patients had been previously intubated and ventilated. Delivery was natural in 22 and by caesarean section in 6 patients. The following complications were found: acute oliguric renal failure (9), HELLP-syndrome (4), cerebral haemorrhage (4), acute lung oedema (3) and acute respiratory distress syndrome (1). Maternal and child mortality were 35 and 42.8% respectively. CONCLUSION: Eclampsia is a major cause of both maternal and infantile mortality in developing countries. The authors insist that prevention and management require speedy transfers to adapted specialized obstetrical intensive care structures.

Adolescent↗

PubMed2003

[Assessment of the management of polytrauma patients at Le Dantec Hospital, Dakar].

Traumatisms represent the first reason of death in people less than 40 years in the developed countries. In Senegal, with the growth of urbanization, road accidents are more and more frequent and mortality by polytrauma is raised. The aim of this study was to evaluate the management of polytrauma patients in our hospital and to determine factors of mortality. This prospective study was carried out from January to June 2000 at the surgical emergencies department and the intensive care unit in Le Dantec Teaching Hospital of Dakar. One hundred and six polytrauma patients were taken care of during the study period. The mean age of patients was 30 years. There were 85 men and 21 women. Circumstances of trauma were dominated by road accidents (74.5%) and in 77.4% of cases patients were evacuated without prehospital care. The mean delay from the accident to the arrival at emergencies was 8 hours. Half of the patients presented to the admission a clinical picture of circulatory failure; respiratory distress was also present among 50% of patients and 53.8% of patients had a serious head injury with a Glasgow coma scale lower than 8. The global mortality was 69.8% and 80.6% of these deaths were attributable to serious head injury. Management of trauma patients in Dakar could be improved by setting up a medical transport system and by the improvement of the technical means in the hospitals. These measures, in combination with the prevention of road accidents, will surely allow to reduce the number of accidents, polytrauma and deaths.

Adolescent↗

PubMed2003

[Anesthesia in the pleuropulmonary complications surgery of tuberculosis: a 79 cases study].

Reported is a retrospective study carried out from Aristide Le Dantec Hospital in patients who underwent pleuropulmonary surgery after tuberculosis complication, from June 1995 to June 1999. The aim of this study was to evaluate the anaesthesiology procedures and outcomes of tuberculosis pleuropulmonary complications surgery. Seventy nine patients were studied. Their mean age was 34.63 years, and the sex ratio was 3.14. They all underwent general anaesthesia procedures with barbituric, morphinics et myorelaxants drugs. The peroperative complications noted were distributed as follow: 50 cases of haemorrhage needing transfusion, 18 cases of hypotension associated to the anaesthesia. In the intensive care period, we have noticed 30 atelectasia cases associated to a spastic bronchopathy, 3 cases of pulmonary oedema and 1 case of pulmonary infarctus. In the postoperative period, 8 cases of hemodynamic instability occurred, including 5 cases of cardiovascular collapsus treated by filling, and 2 septic shocks cases. An infectious bronchopneumopathy was noticed on 11 patients with two cases of septicaemia. The mortality rate was 6.3% (5 cases of death). The pleuropulmonary surgery in tuberculosis complication is very haemorrhagic, and therefore require an adequate preoperative preparation.

Adolescent↗

PubMed2003

[Anesthesia in the surgery of hyperthyroidism at Le Dantec Teaching Hospital].

Authors report a study of 66 patients admitted to the clinic ORL of CHU Le Dantec between 1991 and 2000 for goiter and hyperthyroidism. They evaluate the perioperative management and underline the importance of the medical preparation. The age of patients varied between 15 and 74 years. There were 62 women and 4 men. Fifty three patients presented clinical and biological hyperthyroidism. Thirteen patients had functional hyperthyroidism without clinical signs of thyrotoxicosis. Exophthalmia was present in 20 patients. Twenty one patients have been addressed to the Internal Medicine service for preoperative management of hyperthyroidism. Forty five patients have been operated under general anaesthesia. The medical preparation comprised antithyroid drugs and beta-blockers. We found as complications 3 cases of difficult intubation, 7 cases of peroperative haemorrhage and 1 case of acute thyroid crisis. The anaesthesia for surgery of hyperthyroidism is currently well codified and operative outcome became simple. The medical preparation in case of hyperthyroidism allows to return the patient in euthyroidism and reduces considerably the acute thyroid crisis risk, the most fearsome complication and the most feared of the hyperthyroidism.

Adolescent↗

PubMed2003

[Acquired bacteraemias at the intensive care unit].

Acquired bacteraemias in intensive care unit (ICU) have some serious consequences in terms of morbidity, mortality and costs. The emergence of multiresistant germs in ICUs, and the therapeutic difficulties that ensue, participate in the aggravation of the prognosis of these infections. The aim of this work was to study the epidemiological aspects of acquired bacteraemias in ICU and the responsible germs sensitivity, to determine strategies of adequate antimicrobial treatment. During the period of study, 31 positive blood cultures collected from 19 patients were considered to be true bacteraemias, giving an incidence rate of 6.3 for 100 admissions. The mean age of our patients was 27.7 years old. There were 16 men and 3 women. Traumatology was the underlying pathology in 52.63% of cases. The origin of the infection was unknown in 84.2%. Flavobacterium spp was the most frequent germ (42%), followed by Pseudomonas aeruginosa (26.2%), and Staphylococcus negative coagulase (10.6%). Only one anaerobic germ was isolated. Flavobacterium spp and Pseudomonas aeruginosa were in general sensitive to most antibiotics used with the exception of aminosides. Staphylococci negative coagulase were methi - resistant. The sensitivity of the anaerobic germ was not tested. The antimicrobial treatment was adapted in 84.2% of cases; the association ciprofloxacine-cefotaxime could be a good alternative in serious infections to Gram negative bacteria. The global death rate among our patients was 42%. The death was directly related to bactereamia in only 15.3% of cases. The existing committee for nosocomial infections control should be more effective in our hospital. The role of this committee is to carry out microbiological surveillance, to recommand and make sure of the application of preventive measures against nosocomial infections, to promote the accessibility of antibiotics such as imipeneme, aztreonam, ceftazidime, vancomycine...., and to propose an appropriate antimicrobial treatment strategy; these measures could reduce notably the morbidity and mortality related to nosocomial infections in general and bactereamias in particular.

Adolescent↗

PubMed2002

[Emergencies at a hospital center and university in a tropical area. An anesthesiologist's point of view].

The purpose of this retrospective study was to determine the profile of medical emergencies and their management in a university hospital center in a tropical area. Between July 1 and December 31, 2001, all patients examined in a medical and surgical emergency room were included. Obstetrical emergencies, pediatric emergencies, emergencies admitted directly to the cardiology, ORL emergencies and urologic emergencies were not included. A total of 6740 patients were examined for medical/surgical emergencies during the 6-month study period. Mean patient age was 23 +/- 7 years. Most patients were male with a sex ratio of 3.4. Patients were from the city of Dakar in 50% of cases, suburbs of Dakar in 35% and other regions in 15%. The mean delay between the onset of emergency and admission was 17 +/- 9 hours. Patients were transferred to the hospital in 78% of cases by private transportation. Gastrointestinal events accounted for 20.23% of cases, cardiovascular events for 9.12%, respiratory events of 8.56%, metabolic events for 1.78%, trauma for 48.20% and infectious disease for 12.09%. Surgical mortality was 2.41%. Most problems facing the intensivist treating medical emergencies in a tropical setting involved resuscitation.

Adolescent↗

PubMed2002

[Post traumatic injuries of the duodenum and/or pancreas. Perioperative management].

The duodenal and/or pancreatic lesions rarely occur during abdominal contusions, this, because of the deep and retroperitoneal position of the duodeno-pancreatic entity. These lesions occur mostly in the young adults and occur mostly on violent trauma, hence the high frequency of associated lesions. Their management is well codified and the prognosis depends on the degree of pancreatic damage. The authors reporting of 3 cases of duodenaland or post-traumatic lesion, in a retrospective study. The after therapeutic management necessitated a pre-operative reanimation, simple duodenal suturing in the 3 cases with relearning gastrotomy, alimentation jejenostomy and closing of thepyloric sphincter,with association of cholostomy in one of the cases. The pancreatic lesions of type contusion observed in 2 cases necessitated simple drainage of the pancreatic sector without resection. The evolution was favourable in 2 cases. One case of death was noted in a patient who developed acute pancreatis.

Adolescent↗

PubMed2002

[Digestive system surgical emergencies in neonates at the University Hospital of Dakar].

The goal of this study was for the authors to evaluate their series of digestive surgical emergencies in the neonates. It is a retrospective study on 69 babies treated for a digestive surgical emergency between january 1998 and december 2000. Only 52 babies were born in a medical unit. There was one case of antenal diagnosis and 16 of immediate post-natal diagnosis. The babies ages in the delayed cases ranged from 1 to 17 days with a mean of 7 days and medium of 3 and 6 days. The following malformations were diagnosted: 41 anorectal malformations; 11 omphaloceles; 2 laparoschisis; oesophageal atresia in 8 cases; duodenalatresia in 5 cases; hirschsprungs disease in 2 cases. On presentation, 25 patients were dehydrated, 24 had respiratory difficulties, 5 a severe infection and 20 had hypothermia. The post operatives complications were mostly respiratory. Global mortality rate was 44.92%. The delay in diagnosis and hospital care, the occurrance of hypothermia and respiratory complications are the main reasons of this high mortality.

Digestive System Diseases↗

PubMed2002

[Esophageal foreign bodies at the Universitary Hospital in Dakar].

The diagnosis and the management of the foreign bodies of the oesophagus in the children have benefited from the digestive endoscopy and the anaesthesia progresses the last ten years. A 120 files review concerning children who suffered from foreign bodies of the oesophagus is reported. The average age was 4 years. The sex repartition showed that the boys where prevailing (62 %). The interrogation revealed a caustic old stenosis of the oesophagus among 4 children. In 91% of cases, the diagnosis was obvious on the X-ray prints. The endoscopy assessment found 124 foreign bodies mostly represented by coins (81,4 %). We recorded 2 oesophagus perforation cases and to deaths. The foreign body of the oesophagus is not always harmless. It can determine complications often revealing ones. It seems necessary to us to stress the prevention of that accident by a vast sensitising compaign of the parents.

Adolescent↗

PubMed2002

[Anesthesia for endoscopic extraction of lower respiratory tract foreign bodies in children].

Foreign body inhalation is a serious emergency which raises both diagnostic and therapeutic problems. Progress achieved in the domain of instrumentation and anaesthesia permit the endoscopic extraction with incontestable comfort and security However, child's anaesthesia often in respiratory distress can prove to be difficult. The aim of this study was to evaluate problems encountered during anaesthesia for endoscopic extraction of foreign bodies in lower respiratory tract and to submit an adequate management strategy. This retrospective study was about 161 cases of lower respiratory tract foreign bodies admitted to the clinic O.R.L. of le Dantec hospital from January 1986 to December 2000. Sixteen patients have had a tracheotomy immediately, before endoscopy. One hundred and fifty six patients have had endoscopy. All endoscopic procedures have been achieved under general anaesthesia with intubation by the bronchoscope. Three patients presented peroperative cardiopulmonary arrest and 8 patients died after endoscopy. The improvement of technical means will permit to reduce morbidity and mortality linked to foreign body inhalation.

Adolescent↗

PubMed2002

[Spinal anaesthesia for cesarean section: rate and management of complications in 110 Senegalese parturients].

The goal of this prospective work is to study the per- and post-operative complications of spinal anaesthesia for cesarean and to evaluate their management. We included in the study all parturients undergoing cesarean section to the maternity of hospital Aristide Le Dantec since December 1998 to March 1999. Patients presented contra-indications of spinal anaesthesia, arterial hypertension and/or acute fetal distress were excluded. After a vascular preload of 1000 ml of Ringer lactate, a spinal anaesthesia was realized through a 25 G needle between L3 and L4 in a sitting position with 12.5 mg of 0.5% bupivacain associated with 1 ml of 10% dextrose. Patients were installed after a left light lateral position and oxygenated via a facial mask with 3 1 per mn until the extraction of the child. Studied parameters are following: the sensitive level block before surgical incision, per- and post-operative complications and their management. Sensitive level block was up to T4 in 14.9%, between T4 and T6 in 74.6% and at T8 in 23.6%. Maternal hypotension was the only per-operative complication in our study: 52% with 2 cases of cardiac arrest who needed tracheal intubation and injection of epinephrine. Post operative complications were represented by post-dural headaches about 5.4% and no epidural blood-patch were necessary for their management. We have noted any neurological or infectious complication during supervision of our patients.

Anesthesia, Obstetrical↗

PubMed2001

The recovery of Senegalese African blacks from intravenous anesthesia with propofol and remifentanil is slower than that of Caucasians.

UNLABELLED: Differences in sensitivity to anesthetic drugs have already been described among races. This study was designed to comparatively investigate the anesthetic requirements of two different ethnic groups: Caucasians and African blacks. Forty-five Caucasians from Italy and 45 African blacks from Senegal, who underwent general IV anesthesia with propofol and remifentanil, were comparatively evaluated for anesthetic depth and time lapsed before recovery. We used an electroencephalographic-derived index of depth of anesthesia, the bispectral index (BIS), and evaluation of clinical variables to assess the depth of anesthesia and the recovery trend. Mean BIS values from Caucasians after propofol discontinuation returned to baseline (92-100) in approximately 8 min, whereas in African blacks BIS values remained <80 for some 30 min. Time to eye opening was 10.6 +/- 4.8 min in Caucasians versus 16.9 +/- 8.8 min in African blacks (P < 0.001). Time to respond to loud verbal commands was 14.8 +/- 9.1 min in African blacks versus 9.1 +/- 4.2 min in Caucasians (P < 0.01). During anesthetic induction, the mean arterial pressure decreased by 20% in Caucasians and by only 10% in African blacks. We conclude that the recovery from general anesthesia with propofol was slower in African blacks compared with Caucasian patients. IMPLICATIONS: This study demonstrates statistically significant differences between Caucasians and African blacks in the arousal time from IV anesthesia with propofol and remifentanil. The authors conclude that the recovery from general anesthesia was slower in African blacks compared with Caucasian patients.

Adult↗

PubMed2001

[Traumatic tracheobronchial rupture: importance of early respiratory resuscitation and bronchoscopy].

Traumatic tracheobronchial rupture is a rare and serious complication of blunt chest trauma. Authors report the case of a 9 years old girl who was hit by a car. She presented to the admission, a respiratory distress with subcutaneous emphysema, hemoptysis, bilateral pneumothorax and pneumomediastinum. Apparently persistent pneumothorax in spite of clinic improvement after oxygenoterapy and pleural drainage, had made consider tracheobronchial rupture. The bronchoscopy achieved in emergency, had shown a low lesion of the trachea and a desinsertion of the left main bronchus. A right thoracotomy had permitted to repair the lesions. Post-operative outcome was good and authors insist in interest of early management.

Bronchi↗

PubMed1999

[Oro-dental treatments in the child under general anesthesia (apropos of an initial case)].

Oro-dental treatments under General Anesthesia (G.A.) depend on precise indications and the expected results in some cases in Pediatric Dentistry. In this report we have an indication case of oro-dental treatment under G.A. That clinical case has allowed us to record the difficulties that we face in Dakar in order to realize effectively that technics. That case has also allowed us to ascertain the necessity to integrate that practice in the training board in Pediatric Dentistry. Actually, the clinical indications of oro-dental treatments under G.A. are more and more numerous, and in some cases, the dentist intervention becomes a necessity. Moreover, the technics of intervention under G.A. for some patients is the more indicated technics to reach the expected objectives.

Anesthesia, Inhalation↗

PubMed1998

[Evaluation of preoperative complementary examination ordering].

The ordering of tests is often done in a systematical way. In spite of the studies which have proved that these tests are not useful, and despite the advice of the SFAR (1992) the ordering remains excessive, and is a source of expenses for the population. In that study we have done an evaluation for the ordering of preoperative tests in our structure and we have tried to see if the advice of the SFAR were followed, if they were sufficient to modify the habits of ordering the tests.

Adolescent↗