Biomedical subjects
Publications and source records attributed to M Sangare.
We report a rare case of ovarian fibroma in a young woman. When ovarian masse is associated with Meigs' syndrome and elevated CA 125 serum level a malignant process may be suspected. But a negative cytological examination of ascitic effusion and absence of peritoneal implant recommend performing limited surgical procedures.
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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.
Granulated polyamide (PA) was tested for use as an external marker to estimate faecal DM (FDM) excretion of Zebu cattle (Bos indicus). The study was conducted in Mali, using seven and eighteen animals respectively in four field trials and six indoor experiments. Cattle ate fresh or dry pasture vegetation and half the animals were additionally supplemented with crop byproducts. Gelatine capsules containing 35, 40 or 45 g PA were administered orally at 12 h intervals. Estimates of FDM were based on the average marker concentration in faeces and were correlated with the actual excretion measured by total faecal collection. The pre-measurement period required to establish equilibrium for regular marker dosing was determined at 4 d. Except for diets with a N content of less than 9.26 g/kg organic matter, marker recovery averaged 98.1 (SE 0.93)% (n 62), and was not influenced by diet composition and the quantity of feed ingested (P > 0.05). Estimates of FDM based on average PA concentrations in faecal samples were correlated to the actual excretion with r 0.98 (n 62; P < or = 0.001). Since the PA concentration in individual faecal grab-samples is not correlated with either sample mass or sampling time, accurate estimates of FDM require a grab-sampling schedule that covers the 24 h day. However, estimates of FDM were found to be acceptable if calculations are based on the average PA concentration in the sub-total of samples collected during the day or during night respectively (r 0.95, n 29; P < or = 0.001 in both cases). It is concluded that the use of PA marker is a simple and inexpensive method resulting in reliable estimates of FDM. Since sophisticated analytical procedures are not required to recover PA in faecal samples, the marker is particularly suitable for application in extensive grazing systems and in studies conducted in less-developed countries.
Pupae and teneral flies of Glossina palpalis gambiensis originating from three successive reproductive cycles were compared for their size and weight. In general, pupal weight and fly weight increased, whereas fly size, measured as wing vein length, decreased with the number of reproductive cycles. The linear regression observed between weight and wing vein length of the fly demonstrated that, particularly for flies originating from the first and second larvipositions, small changes in wing vein length reflected substantial differences in weight. The results of these laboratory experiments were compared with some field data on Glossina morsitans from Zambia and related literature. The life span of the female tsetse, affecting the size of her progeny, could clarify partially some of the field observed seasonal changes in size, whereas the correlation between fly size and weight could eventually explain the differential mortality of some size classes of tsetse flies. However, whether these laboratory observations can be extrapolated to the field has still to be confirmed.
Infections represents 5% of our post-operative morbidity and result in the use of expensive antibiotics and longer hospital stays. As a less expensive alternative to systematic antibiotherapy for all patients, the authors propose a prospective and descriptive study of the effectiveness of antibioprophylaxis by administering 1 g of Cefotaxime pre-operatively. The study concerns a continuous series of 103 cases in gynaecology and obstetrics operated in the Dakar University Teaching Hospital, during a 13 months period (April 95-April 96). The average age of the patients is 30 years, the major types of surgery was cesarean sections, laparotomy for extra-uterine pregnancy and myomectomies. The duration of the surgery varied between 40 to 105 minutes with an average of 60 minutes. There was no intolerance to Cefotaxime. No cases of post operative infections were observed. All surgical wounds healed in 6 to 8 days except 2 minor cases of non-union of 1 cm. Antibioprophylaxis with Cefotaxime can therefore be considered as an effective means of preventing post-operative infections in clean surgery. It is easy to administer and also has the advantage of lower cost (4050 Fcfa compared to 29,000 Fcfa for classic antibiotherapy).
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Sexual assaults constitute a prominent fact of our societies to this end twentieth Century. Then its's very important for physicians to be informed about obstacles encoured to manage assaults victims. Our study presents 25 cases of sexual assaults listed in Obstetrics and Gynecology Clinics of University Center Hospital of Dakar. It works out that: there are adolescents in most cases (85%); delay of examination is too long (11 cases beyond 24 hours) and compromises cytologic exams; injuries evaluation is sometimes negative; no lesion of anal sodomy is found. The authors insist to provide more informations to physicians to overcome evaluation of assault victim which has an impact for legal proceeding against offender. They call gaps to fill up un senegalese jurisprudence about assault victim who gets an accidental pregnancy.
In an open clinical trial in phase IV, 856 onchocerciasis infected subjects received 150 micrograms/kg of ivermectin in May 1987. While 607 were included as witness. This cohort was revisited 7 and 12 months after. In June 1988, the same treatment was administrated to the previously treated subjects, and the witnesses received their first ivermectin' dose. The clinical tolerance of the treatment appears good and, even improved during the second dose one year after. Among the subjects treated in May 1987, 15.2% of them showed secondary reactions mostly discrete or moderate, precocious and quickly reversible after a second dose. Only 8 of them were incommodated in their daily occupations. A second treatment of these same subjects one year later, caused reactions of feeble intensity 3.7% only. The research of intolerance risk factors, incriminated the high density of microfilaremia. This incite to be careful in mass treatment of hyperendemic area.
As all developing countries Senegal keeps on paying a heavy tribute to, on the one hand, the high maternal mortality and morbidity, and on the other hand, infantile mortality. Family planning could have advantageous effect on health, welfare and development of all the family. Unfortunately, difficult over all socio-economical situation, lack of human resources, particularly maternal, and the coast of paraclinical exams brakes the access of population to family planning services. In this work, we tried with FHI/PSFP/Institute Pasteur to initial a prospective study who aimed to show that a good clinical exam with a complete medical interrogatory should be a good alternative to contraception preliminary paraclinical check-up.
Eleven cases of Kaposi's angiosarcoma (ASK) were observed in Bamako over a 2 year period, representing one third of all malignant cutaneous tumours. There was a clear cut male prevalence. The average age of the patients was 32 years. The commonest sites of involvement were cutaneous, osseous, lymphatic and gastrointestinal. Special features of this series included prurigo preceding skin lesions, a single gastric localisation and involvement of the cavum. Rapid progression was observed in 3 cases, 2 of which had fatal outcomes. Two patients had multifocal disseminated disease at the outset. These cases were similar to ASK in patients with AIDS but our patients were not immunodepressed and LAV serology was negative. The results of chemotherapy were incomplete and transient. This series demonstrates the presence of acute, polyvisceral forms of ASK in Mali which may be classified as intermediary between the classical European or African ASK and the ASK observed in AIDS with positive serology in Central Africa.
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