Biomedical subjects

M Mbengue

Publications and source records attributed to M Mbengue.

At least 19 recordsLinked to original sources

PubMed2005

[Dakar physicians' therapeutic attitude towards non complicated peptic ulcer disease].

Peptic ulcer disease is topic of guidelines in developed countries. In South area, without consensus conference, physicians' attitude towards this disease is varied. So, we aimed to describe therapeutic decisions of physicians in Dakar, regarding literature and the role of Helicobacter pylori in gastro-intestinal diseases. From 2001 december first to 2002 January 31, a survey was made in a sample of 171 physicians in Dakar with a questionnaire. All generalists, internists and gastroenterologists working in public or private health places of Dakar were concerned. The rate of responses was 68%. 65.5% of physicians had not read guidelines about peptic ulcer disease and H. pylori but 89% of them had read articles on these topics. Most of the physicians (76%) ordered systematically or mainly treatment to eradicate H. pylori. 95% of them did not require proof of infection before treatment. Association of gastric antisecretory drug with amoxicillin and metronidazole was mostly used (77.5%). Double dose of antisecretory drug was prescribed by 51.5% of physicians. For 40.5% of them, the duration of treatment was 7 days while 53.5% prolonged duration to 10 or 14 days. Complementary antisecretory drug was systematic for most of physicians (83.5%). These multiple therapeutic options, sometimes not in accordance with recommandations, militate in favour of more intensive participation of Dakar physicians to scientific meetings, in order to rationalize their therapeutic attitude towards peptic ulcer disease and take into account local data.

Complementary Therapies↗

PubMed2004

[Portal and splenic veins thrombosis reveling a miliary tuberculosis of the liver].

The etiologies of the portal vein trombosis are dominated by the neoplasic forms with hepatocellular carcinoma; we report a rare case of portal and splenic veins thrombosis revealing a liver military tuberculosis occuring in a HIV 1 infected patient. A 42 years old senegalese woman with no personal or family history of thrombosis was admitted for abdominal upper right quadran, and epigastric pain, with fever and important weight loss. Ultrasound identified endoluminal echogenic images in the portal and splenic veins. There were no lymph nodes or liver tumor. Evaluations of proteins C and S were normal and there was no anticardiolipin antibody. In searching the aetiology of the thrombosis, a liver biopsy was performed, and showed a miliary tuberculosis. an HIV 1 infection was later on diagnosed. The antituberculosis treatment associated with heparine therapy was successful, the thrombosis resolved entirely. This portal and splenic veins thromboses occuring on a miliary tuberculosis of the liver seems to be an exceptional situation. We did not found in the literature a similar case.lt points out the interset of liver biopsy in searching the aetiology and the early heparine therapy set up

Adult↗

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

[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

[Gastrointestinal hemorrhage in cirrhosis at Dakar. Predictive factors study].

Our aim were to describe the epidemiological and clinical as well as therapeutical features and to look for predictive factors of occurrence of gastrointestinal hemorrhage among cirrhotic patients. We included all cirrhotic patients with acute gastrointestinal hemorrhage hospitalized in the Service of Internal Medicine of Aristide Le Dantec University Teaching Hospital from January 1990 to December 1999. The diagnosis of cirrhosis was established according to two situations: prebiopsic criteria with clinical, biological, ultrasound and endoscopic data or the histological criteria. Gastrointestinal hemorrhage was present in 28.9% of the patients with an average age of 38.7 years and a sex ratio of 1.4. It revealed the cirrhosis in 82% of the cases, whether alone in 45.2% or associated with other complications in 36.8%. Previous bleeding episodes were found in 76 cases (9.6%). Gastrointestinal hemorrhage is the first cause of death among our cirrhotic patients with an overall mortality of 29.4%. The gastrointestinal hemorrhage was significantly associated with the young age (< 40 years). On the other hand, the clinical and biological parameters did not seem predictive of bleeding. The risk of hemorrhage was positively correlated with the presence of esophageal varices and their stage, the gastric varices and the portal gastropathy. The other lesions (watermelon stomach and erosive gastritis) did not seem to play a role in gastrointestinal hemorrhage. However the CHILD-PUGH classification was a poor predictor of either first hemorrhage or re-bleeding in this present study. We conclude that gastrointestinal hemorrhage is frequent among cirrhotic patients in our country. It constitute in this study the first cause of death in this population. instrumental treatment methods might prevent most of gastrointestinal hemorrhages in patients with high risk.

Adult↗

PubMed2003

[Care management of lower gastric tumors at Dakar. Preliminary study of 60 cases].

The aim of this study was to evaluate the short-term results of our therapeutic attitude about the surgical treatment of lower gastric tumours in our departement. It was a prospective study including all patients hospitalized in our department for gastric tumour whose malignancy was strongly presumed by the clinical symptoms, the paraclinical one, the surgical exploration and/or confirmed by histology. Tumours of the cardia were excluded from this study. Laparotomy was carried out among all patients. When the tumour was resecable, we had carried out a lower partial gastrectomy passing at least than five centimeters with the top of the higher limit of the tumour, associated with lymphadenectomy including the first and second relay. This study was undertaken from January 1994 to June 1997 and concerned 39 men and 21 women. Mean age was 57.6 years. The abdominal mass was present in 38.3% of the cases. The histological confirmation for malignancy was obtained in 38.3% of the cases which all were adenocarcinomas. We had proceded to 38% of partial gastrectomy, 54% of gastrojejunostomy and in 8% of the cases no surgical gesture was practised during laparotomy. Morbidity was 13.3% and mortality 21.7%. The average retreat was 12.4 months after partial gastrectomy, 8.3 months after gastrojejunostomy and 3.5 months after laparotomy without gesture. The total rate of surival at one year was 20%. The rate of survival at one year after partial gastrectomy was 39.1%. We recommend partial gastrectomy associated with lymphadenectomy whenever its realization is possible. This surgical attitude associated to early diagnosis could allow a clear improvement of the rate survival in the short and medium term for lower gastric tumors, in our context.

Adult↗

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

[Multicentric reticulohistiocytosis with a 20-year follow-up ].

INTRODUCTION: Multicentric reticulo-histiocytosis also known as lipoid dermoarthritis is a rare systemic disease leading to a massive osteoarticular destruction and systemic complications. EXEGESIS: This case report is a 44 year old black woman who was first seen with a rheumatoid arthritis clinical presentation associated with the presence of rheumatoïd factor. Five years later the diagnosis has been reconsidered after skin nodules histological examination. After that the patient has been lost from the follow up clinic. After a twenty years evolution she presented a complex clinical picture including: a cutaneous syndrome with a non pruriginous and hyperchromic papulonodular rash on the arms and fore-arms; a very destructive polyarthritis with major handicap; and systemic manifestations like cardiomyopathy with heart failure. The heart failure treatment associated first corticosteroids and secondary chloroquine was successful. CONCLUSION: The rheumatoid factor presence should not avoid to consider the possibility of multicentric reticulohistiocytosis in case of polyarthritis associated with a papulonodular rash. Then skin biopsy must be performed. The severity of osteoarticular and systemic lesions require an early prescription of a treatment for which there is so far no compromise.

Adrenal Cortex Hormones↗

PubMed2002

[Pancreatic abscess].

With the report of a pancreatic abscess, the authors make a review of the literature. A 70 years old female patient was seen with peritoneal syndrome lasting 72 hours. Surgical exploration done 3 weeks later after a medical treatment found a purulent collection in the omental bursae. A surgical drainage of the collection associated with an antibiotherapy improved perfectly the general conditions of our patient seen 5 months later without any infectious recurrence. The ultrasound exam, revealed a pseudocyst and an uncomplicated cholecystic lithiasis for which an operation is planed. They emphasized the nosologic problems with this pathology, the rarity of this particular complication and the diagnostic and therapeutic difficulties. In spite of the progress in antibiotherapy, pancreatic abscess never heals without surgical drainage.

Abscess↗

PubMed2002

[Nodular euthyroid goitre: value of ultrasonography versus scintigraphy in the initial assessment].

PURPOSE: The aim of this study was to show that in exploration of nodular goiter with euthyroidy ultrasonography was higher than scintiscanning. MATERIAL AND METHODS: It was to show that when it was necessary to specify the topography and the number of thyroid nodules, the proportion of right results was larger with ultrasonography than with scinticanning. These proportions being respectively indicated Pe and Ps, hypothesis of search was formulated H1: Pe > Ps. Null hypothesis was written H0: Pe < Ps. Twenty three patients (21 women and 2 men with an average age of 41 years) carrying thryroïd nodules with euthyroidy had respectively undergone a scintiscanning (scintiscanning with sweeping after ingestion of iode 131) and an ultrasonography (conventional ultrasonography with a probe of 7.5 MZ) of the thyroid gland between February 26, 1996 and June 19, 1997. Per-operativedatahaving beenused as references from which the results of scintiscanning and ultrasonography were appreciated nominally, discreet: right results or false results. In this way, proportions of right and false results were collected respectively for scintiscanning and for ultrasonography, which made it possible to test null hypothesis (H0: Pe < Ps). The results were distributed on a 2 x 2 cotigence table. The chi 2 test was applied with a risk error of 5%. RESULTS: For all patients the scintiscanning found on the whole a minimum number of 39 nodules contrary with ultrasonography and surgical exploration which respectively found a minimum number of 56 and 59 nodules. Comparison of right and false results had shown a superiority of ultrasonography (17 right and 6 false) on the scintiscanning (10 right and 13 false) with statistically significant difference (P < 0.05). CONCLUSION: Ultrasonography is more precise when it is necessary to specify the number and the topography of the thyroid nodules. In addition ultrasonography is alleviating and less expensive compared to scintiscanning.

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

[Treatment of chronic anal fissures: report of 31 cases].

A prospective study evaluating the surgical technique used in the treatment of chronic anal fissures, which is fissurectomy, partial sphincterotomy and anoplasty, was carried out in University Teaching Hospital Dakar. Thirty one patients with chronic anal fissures (20 males and 11 females) with average age 38 years and mean consultation period of 3 years, were treated with this technique. The delay of healing was between 4 to 12 weeks for a mean period of six weeks with 27 cases healed before 2 months and 4 cases after. One patient developed transitory faecal incontinence, recurrences, anal stenosis, haemorrhoidal relapses. noticed after simple lateral sphincterotomy were not found in our study as written in the medical literature. The surgical treatment of chronic anal fissures by fissurectomy, partial sphincterotomy and anoplasty is an important corner stone in this pathology. However lately healing may be a source of discomfort for the patient.

Adult↗

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

[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↗

PubMed2001

[Nasal carriage of Staphylococcus aureus at a hemodialysis unit in Dakar].

Infectious diseases are the most common complications of the hemodialysis unit patients. Staphylococcus aureus (SA) is the main cause and is supposed to be lodged in the nostrils. The purpose of this study is to assess the importance of the SA presence in the patients and the medical staff nostrils in a senegaleese hemodialysis unit. In this regard, we performed a six-month prospective study on 12 patients on going hemodialysis (11 males and 1 female) and 7 medical agents (4 nurses, 2 physicians, and 1 nurse assistant). On patients we reported the initial nephropathy, the problems of vascular access, the infectious episodes prior to the study, and the duration of dialysis. Three sample series of nostril swabbing were carried out on patients and medical staff at a rate of one series every other month. Blood culture was systematically carried out on patients, with body temperature higher than 38 degrees C, every two months and. Sensibility to several antibiotics was tested for each stain. We found six cases of clinical nephroangiosclerosis, one Wegener granuloma and five unknown causes. All patients had Brescia Cimino arteriovenous fistula vascular and the mean time underdialysis was 36 months (from 7 to 55). Bacteriologically, 124 nostril specimens were performed, 80 on patients, 44 on medical staff. SA was isolated in 64 specimens (52 %) on patients and 34 specimens (24.4 %) on staff. Strains from forty five patients (70.32 %) were sensitive to methicillin versus 23 stains from staff ( 67.6 %). The difference was not statistically significant. Sensibility profil for other antibiotics was the same for patients and staff. All blood culture were negative. Despite nostril carriage noted on patients and staff, there were no infections during this period. However, the presence of permanent infection sites make it mandatory to be on the alert in order to control some of the behavioral changes of the germs, and to put into place an adequate prevention system.

Adult↗

PubMed2001

[Evaluation of surgical treatment of anal fistula].

Second reason for consultations in proctology in our department after hemorroïds-linked illnesses, fistulas in ano constitute a chronic disease which causes therapeutic difficulties linked mainly to the futur functionning of the sphincter, especially in its most complex types. In our group of 43 patients in whom surgical exploration with stylet was the key of the diagnosis, the anorectoscopy and even less chirurgical examination were not often contributive, the fear of post-operative incontinence forced us to prefer ligation-section with rubber every time that the sphincter was involved. With our results, the majority of patients (41/43) healed in normal periods with a sufficient functionning of the anus. This result confirmed our attitude towards the sphincter: that is to save if possible.

Adolescent↗

PubMed2001

[Duodenal ulcer: truncal vagotomy with celioscopy. Report of 53 cases].

The recent introduction of laparoscopic surgery in the therapeutic arsenal of duodenal ulcer enabled us to carry out these interventions by abdominal route in order to appreciate the early results. It concerned a prospective study from March 1999 to August 2000 of 53 cases of which were 47 men and 6 women, aged from 16-75 years average age 52 years. Twenty six patients had pyloro-duodenal stenosis, the rest, chronic duodenal ulcer. Vagotomy was carried out on a patient on dorsal decubitus under general anesthesia with oro-tracheal intubation operator within the legs of the patient and the monitor at the right hand side. The process required four trocars depending on the morphology of the patient. A pneumoperitoneum of 3-5 litres permitted to attain the oesophagial hiatus by collapsing the pars-flaccida of the minor epiploon, the reperation of the right diaphragmatic pillar and the discovery of the posterior vagus nerve which was coagulated and sectioned. The traction of the body of the stomach towards the ombilious exposed the anterior portion of the stomach, thanks to the coagulator, the anterior branches of the vagus nerve are sectioned. Drainage by minilaparotomy terminates the intervention if only stenosis existed. Mortality was nul. The time of intervention was 35 to 135 minutes with an average of 71 minutes. The hospital stay was between 3 and 12 days with an average of 5 days. Three conversions to laparotomy (difficultdissection, liver cirrhosis, breakdown of materials), pleural wound consisted the morbidity. Two cases of re-operation due to evacuaton poorly appreciated in pre-operation period were observed. The results according to Visick criterias were: 1 : 51; II : 0; III : 0; IV: 2 patients for a follow up of 3-17 months. Vagotomy under coelioscopy is an intervention which permits to obtain results comparable to those of conventional surgery.

Adolescent↗

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↗