Dakar medical最新文献

Aim: The purpose of this study was to assess the canal anatomy of mandiblar premolars in Senegalese population.

Materials and methods: Retroalveolar radiographs of mandibular premolars of 208 patients in Senegal were obtained. Two experienced practitioners using a long cone tube and the parallel plane technique with angulators took the radiographs. The canal morphology of each tooth was determined in terms of the number of canals radiologically visible to the apex. Any anatomic structure emanating from the pulp chamber or the principal canal to the apex and measuring more than 3 millimetres was considered to be a supplementary canal.

Results: For the 208 patients studied, 412 first premolars were present and 4 were absent.Among the 412 teeth, 335 (81.3%) had a single canal, 62 (15.1%) 2 canals, and 17 (3.6%) 3 canals. For the second premolars 408 were present. Of the 408 teeth, 352 (86%) had one canal, 49 (12%) 2 canals, and 8 (2%) 3 canals.

Conclusion: The prevalence of two or more canals in premolar mandibular from Senegalese patients was similar to that found in the others ethnic population.

Introduction: The Pulmonary emblism is a vascular disease which is characterized by the more or less complete obstruction of one or several pulmonary arteritis and/or their branches by an embol. Very polymorphic affection, mortal in the massiv form, it has in the average forms of the atypical or misleading aspects which make its clinical diagnosis difficult. The diagnostic strategy of the pulmonary embolism remains incompletely solved. The objectives of this work are: --to evaluate the prevalence with the autopsy of the pulmonary embolism and its distribution according to the age, --to appreciate the correlation enters the ante and the post-mortems diagnoses.

Patients and methods: It is about a retrospective study, over 10 years period, having inclued the files of all the patients died in the various services of medicine or surgery of the university hospital of Aristide Le Dantec but also those transferred from outside of the hospital and at which the pulmonary diagnosis post-mortem of embolism was retained.

Results: Sixty thirteen (73) cases of pulmonary embolism had been found during autopsies during the period of study (10 ans), that is to say a prevalence of 1.9%. The average was 35 years. The most representative age bracket was that ranging beetwin 21 and 30 years is 36% of the studied population. On the 73 indexed patients, 30 (41%) were transferred from outside of the hospital and 43 (59%) came from the servicies of medecine and surgery with a prevalance of the service of cardiology (26%). The correlation beetween ante-mortems diagnosis and the anatomical result was 11% for the whole of the patients incleded in the study. However, it was 42% for the sub-grup of patients comming from the service of cardiology.

Conclusion: The prevalence with the autopsy of pulmonary embolism is weak. The clinical diagnosis of this affection is difficult even in a specilised service with a high rate of negatif forgeries. This pathology is very under- evaluated even in these services.

Management of exocrine pancreatic tumors is very difficult: Their impact is in upsurge and their diagnosis is very often made to an advanced stage that only allows the therapeutic palliative. To value the management of these tumors to the surgical clinic of Aristide Le Dantec hospital, authors achieved a retrospective survey on 8years (October 1994 to October 2002). Hundred twenty nine (129) cases of exocrine pancreatic tumors had been counted. It was about 71 men and 58 women of middle age of 56, 96 years. The length of middle evolution of the illness was of 8 months. The most frequent sign was jaundice, recovered at 80.9% of patients. Followed the thinning (79%), the pain (69%), the digestive stenosis (35%). Ultrasonography, scanner and x-ray of lungs permitted to make the diagnosis and the balance of extension. A laparoscopy had been made at 13 patients. A clinic and radiological classification had been used to distribute the tumors in 3 stages. At 46 patients in III stage, a therapeutic abstention had been decided. Patients to the II stage (n=77) had benefitted a palliative surgical treatment. It was about 74 biliary and digestive shunt and 3 alcoholic splanchnicectomy. The 6 patient to the I stage had benefitted a surgical resection. The middle hospitalization length was of 10.75 days. The rate of morbidity was 45.78%. Mortality was 29%. The median survival was of 3.6 months. The palliative surgical treatment had again indications facing these obstructive and locally advanced tumors. But the salute will come from the precocious diagnosis of these tumors to hope for a curative gesture.

Introduction: Many studies were carried out in vivo and/or in vitro for better understanding toxic effects of exhausts or particles emitted by Diesel vehicles. Few studies were interested in Gazoline engines when progress of metrology made it possible to highlight the presence of small particles with a strong capacity of penetration within pulmonary tissue. The aim of this study is to compare the toxic impact of the emissions of Diesel and Gasoline engines of recent technology.

Materials and methods: Biological material was constituted by an organotypic rat lung precision slice. It was exposed to a continuous flow exhausts thanks to a preparation and dilutions system of these emissions placed on the line of exhaust. A measurement of the biological markers involved in the process of the lung tissue reaction to the air-contaminants was carried out.

Results: With Diesel exhausts, the results showed a stability of the rate of ATP and an increase in enzymatic activities of the antioxydant system (GPx and catalase). Gazoline emissions, as for them, were responsible for a cytotoxic attack of the pulmonary tissue defined by a reduction in the rate of ATP as well as a deterioration of the system of detoxication with reduction in the antioxydant enzymatic activities.

Conclusion: These results show that toxicological profiles obtained with this system of exposure depends on the engine technology used, highlighting thus the specific response of the model in relation with the type of atmospheres which it is exposed.

Introduction: The powdered milk is a much appreciated food in Senegal. However no particular control is realized by authorities on the various marks of milk imported before their marketing. In the concern to protect the health of the consumers, but especially in front of the very big variety of the sources of supply in this product we determined the contents in fat, in protein and in vitamin D main variety show of marketed powdered milk Dakar.

Material and methods: Chemical methods were operated to determine the fat contents and in proteins. The liquid chromatography in high performance was used to identify and measure the vitamin D.

Results: The obtained results profits showed that all the studied samples of milk had contents in fat included between 25 and 31 g %, those in proteins were included between 23 and 25 g %. As regards the dosage of the vitamin D, a single sample had content weaker than that mentioned on the packaging by the manufacturer.

Conclusion: The results of this study allowed to notice most of the variety varieties of powdered milk marketed in Dakar were in accordance with the standards established for this food and are consequently good quality.

Introduction: Success of any program to fight AIDS passes through out quality of antiretroviral medicines. The control and follow-up of the quality of these medicines constitute essential levers to guarantee quality. Our study aims to evaluate the quality of antiretroviral medicines used in Senegal by means of a mini laboratory from the German Pharmaceutical Health Fund.

Materials and methods: The mini laboratory provides technical arsenal necessary for the analysis. To sum up, 43 samples of antiretroviral medicines have been submitted to three types of simple, quick and reliable tests which are physical and visual inspection, disintegration and thin layer chromatography.

Results: The obtained results give at physical and visual inspection, 9.3% of samples which are not similar. 30 samples out of 32 have a good disintegration time. About 11.6% of samples are not similar to thin layer chromatography.

Conclusion: The control of the quality of antiretroviral medicines is necessary if we consider the number of no conform cases which are relatively important. The mini laboratory can constitute an interesting tool for technical control facilities in developing countries that suffer from a real lack of materials.

Introduction: The study is transversal and descriptive. It take place in the odontology department in a public hospital in Dakar (Senegal), during 09 month (January-September 2005). The objective of this work was to determine the TP-INR value making possible to carry out an act of oral surgery without haemorrhagic risk. (INR = International Normalized Ratio).

Material and method: It concerned 32 patients referred to the Odontology service by the Cardiology They presented a cardiovascular pathology having required an anticoagulant therapy, and also need an act of oral surgery. We exploited the following parameters: identification of the patient, oral state, types of oral surgery, types of cardiopathy, AVK posology, value of TP-INR, haemostatics means.

Results: 81.25% of the patients were women (26), with a sex ratio of 0.23. The mean age was 53ans, with 21 and 84 years like the extremes. 56.25% of our patients had undergone a single extraction, 25% had beneficed multiple extractions, and 18.75% had profited from a scaling-curetting. The average value of the TP-INR was 2.22 with extremes between 2 and 2.84.

Conclusion: In favour of the haemostat means, no haemorrhagic complication post operational was revealed. It is allowed that the risk of thromboembolic accident by stopping the treatment is much more prejudicial than the hemorrhagic risk for the patient.

The authors report three (3) cases of choledoco-duodenal fistula due to perforating duodenal ulcer disease. All of them were male, aged from 35 to 55 years. The ulcer symptomatology summarised the clinical feature. They presented respectively a prestenosis, a stenosis and a chronic ulcer The fistula diagnosis was estasblished at the oesogastro-duodenal radiologic exploration showing an opacification of the common bile duct. The surgical treatment concerned bnly to the ulcer. A gastrectomy of exclusion with digestive continuity re-establishment according to FINSTERER in the pre-stenosis, vagotomy associated to gastrojejunostomy and the pylore closing at both other were performed. After 24, 23 and 5 months follow-up all the patients were disease free; classified VISICK I. Rarely reported among the complications of the duodenal ulcer the choledoco-duodenal fistula is a reality. Currently the majority of the authors recommend the respect of the fistula in the event of surgical operation.