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T Moreira Diop

Publications and source records attributed to T Moreira Diop.

14 recordsLinked to original sources
PubMed2006

[Polyarticular gout in young adults: a curable rheumatic disease].

Juvenile chronic gout in its polyarticular deformative form has rarely been described in medical literature. We report a rare case of destructive polyarticular tophaceous gout in a 31-year-old Senegalese man. He consulted for bilateral asymmetric polyarthritis with deformities of the hands and feet that had been ongoing in recurrent episodes since the age of 18 years in association with tophus. He had received no previous medication. All laboratory investigations were normal except hyperuricemia 104 mg/l. Radiographs of affected joints demonstrated evidence of destructive polyarthritis, i.e., articular narrowing and osteo-condensation of the left great toe. The patient responded favourably to colchicine, allopurinol and diet. Gouty arthropathy must be differentiated from rheumatoid arthritis, psoriasic arthritis and distal chronic osteoarthrosis. In our case, definitive diagnosis of gouty arthropathy was based on chronic polyarthritis associated with tophus, hyperuricemia and therapeutic response to colchicine. Polyarticular gout can be suspected in case of chronic seronegative polyarthritis and diagnosis can be confirmed on the basis of plain radiographs and laboratory investigations showing uricemia. Treatment is effective, well tolerated and inexpensive.

Adult↗
PubMed2006

[Senegalese case of thromboangeitis obliterans or Buerger's disease].

INTRODUCTION: Thromboangeitis obliterans (TAO) is an inflammatory, non atheromatous arteriopathy of smoking young adults. It is diagnosed on an association of non specific criteria that we discuss throughout this case. CASE REPORT AND DISCUSSION: A forty years old tabagical, Senegalese black man, had peripheral destructive lesions preceded by Raynaud phenomenon. He was admitted in our Internal Medicine department in November 2002. Actually this clinical presentation was evolving since 11 years. At that time, hypo aesthesia and ulceration of the fingers led to successive amputations in the leprology centre. The diagnosis of Hansen disease had been suspected but there were no evidence of mycobacterium. At the admission in our service, biological tests showed a moderated non-specific inflammatory syndrome. Ultra sound Doppler and arteriography showed a peripheral arterial stenosis without atheromatous lesions, in favour of TAO. To meet all the criteria the patient didn't have any thrombotic or systemic disease. The evolution was favourable after tobacco weaning. CONCLUSION: TAO can bring to difficulties of diagnosis by its way of presentation. Physicians should practice a systematic vascular screening in case of distal arteriopathy.

Adult↗
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

[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↗
PubMed2003

[Epidemiological and clinical features of the knee osteoarthritis].

The knee osteoarthritis is one of the most common causes of pain affecting elderly people. The main clinical features are pain and fonctional disability. The aim of this prospective study was to determine the epidemiological and clinical features of the knee in our regions. It was conducted from January 1st through June 30st 2002, on patients with gonarthrosis successively remited from the department of medicine, rheumatology out patient clinic. The diagnosis criteria was based on the Kellgreen and Lawrence scheme. The Lequesne functional index have been used to evaluate the patients disability. Fifty patients were included in the study, they were 33 females and 17 male (sex ratio of 0.51). The mean age was 61.96 years, ranging from 45 to 81 years. The aetiologic factors was dominated by a family history of inflammatory joint desease (72%) and the knees physical stress (60%). Constitutional abnormality were found only among women, with 4 cases of valgum, 3 cases of varum and one cases of the patella extrernal abnormality. Obesity appeared to be very common associated condition. Forty three patients got a body mass index greater than 25. The knee pain was unilateral in 52% of cases, mostly on the right knee and was a mechnical type with no particularity. The functional disability was proportional to average disease duration, and was not associated to the patients age.

Aged↗
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

[Chronical renal failure in one Dakar Hospital Department].

Chronic renal failure (CRF) is a polymorphic disease whose management need frequently multiple drugs administration and multidisciplinary approach. Thirteen years after the beginning of haemodialysis treatment in Senegal, we aimed to evaluate the management of chronic renal failure in Dakar University Hospital Internal Medicine Department. We analysed retrospectively 243 CRF in patients managed during the last three years in this department. Most of these patients (43.6%) were under 46 years old. The sex ratio (M/F) was 1.31. The clinical symptoms were distributed as follow: high blood pressure (85.6%), anorexia (61.73%), anaemia (83.9%) and pruritus (12.3%). More than one third (37.04%) of patients had a clearance of creatinine under 10 ml/mn, at the diagnosis, and therefore required chronic haemodialysis. Only 8.23% of cases had the opportunity to get a medical treatment. Five machines ware available at this unity). The deficience of dialysis and nephrology personal is obvious in our practice. The majority of CRF patients can not afford the treatment cost. Therefore, medical training, prevention and screening of renal diseases seem to be the best way to solve this public health problem in developing countries.

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

[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↗
PubMed1999

[First case of primary IgA glomerulonephritis (Berger's disease) in Senegal].

Berger's disease or IgA glomerulonephritis is the most common glomerular nephropathy in Europe and represent a rare event in blacks. Here, we describe the case of a 43 years old black Senegalese whose disease was discovered while investigating a persistent proteinuria with high blood pressure and chronic renal failure, but without hematuria. We point out the uncommon feature of this clinical presentation and the importance of bad prognostic factors presented by this patient. We obtained a good outcome by means of converting enzyme inhibitors and corticosteroid therapies: regression of renal failure and normalization of blood pressure. The generalization of renal biopsy practice would lead to a better knowledge of the incidence of this disease among Senegalese people. Indeed, renal biopsy is the main tool to diagnose glomerulonephritis and subsequently adapt the therapy aimed at preventing the possible evolution to end stage renal disease.

Adrenal Cortex Hormones↗
PubMed1999

[Description of a case of Cacchi Ricci disease associated with hyperparathyroidism in the setting of multiple endocrine disease].

The authors present a case of a 36 years old woman applied to them for a follow up of sponge kidney disease and in whom they discovered a primary hyperparathyroidism. Further investigations discovered a medullary thyroid carcinoma. So this patient present multiple endocrine neoplasia (MEN) type 2A confirmed by microscopic and genetic analysis. This observation enlarged the discussion upon the nature of the relationship between kidney disease and primary hyperparathyroidism. Elsewhere it recommended to check systematically genetic markers of MEN type 2A if there is an association with sponge kidney disease and primary hyperparathyroidism.

Adult↗
PubMed1997

[Nephronophtisis in Senegal: first 3 cases].

Nephronophtisis is a familial tubulo-interstitial nephropathy with an autosomic recessive mode of transmission. To our knowledge, it has not been yet reported in Black Africa. We report here the case of a 17-year old female from Senegal who presented with renal failure related to a chronic interstitial nephritis characterized by polyuria, hypocalcemia, natriuresis of 23 mmol/l and serum creatinine level of 1070 mumol/l. The parents of this patient were first-degree cousins. Among the 6 siblings, 2 other males were found to have a renal disease. Ultrasound examination of the kidneys showed medullary cysts in the 2 affected brothers and the renal biopsy in one case showed tubular atrophy, with thickening of the basal lamina and an interstitial fibrosis without glomerular involvement. Molecular genetic analysis confirmed the diagnosis of nephronophtisis, with a homozygous deletion of the NPH1 region. In order to recognize this disease early in life, one has to look for it in patients with tubulo-interstitial nephritis, polyuria, childhood enuresia especially when it is associated with growth retardation or tetany. This case raises the issue of consanguinity and endogamy which are frequently encountered in Africa. It also extends the geographic and ethnic distribution of nephronophtisis, being the first cases reported Black Africans.

Adolescent↗