Dakar medical最新文献

Hydroxyurea is an antineoplasic agent usually used in myeloproliferative syndromes, but also in other benign pathological circumstances. Several dermatological manifestations have been recognized as being secondary to its prolonged use, of which the leg ulcer. We report an observation. Mrs. L.D, 47 years, were hospitalized on July 14, 2004 for an ulcer of left ankle in a feverish context. She was followed since 2001 for a chronic myelogenous leukaemia, and took hydroxyurea at a rate of 1500 mg per day, with a good clinical and hematologic answer. She presented a painful ulcer compared to the left external malleolus, with purulent bottom, without signs of vascular attack. The hemogram showed a hyperleucocytosis with 24.000 white elements/mm3 with neutrophilic polynucleosis. Pus sample on the ulcer showed Pseudomonas aeruginosa, and the blood culture was negative. The cure was obtained two months after stopping hydroxyurea. The ulcer of leg related to hydroxyurea is a seldom described pathology. Its occurrence imposes the final stop of the treatment.

Background: Beckwith-Wiedemann syndrome is a congenital syndrome with variable phenotypic expression. It is less commonly described in Africa. We report a case in Dakar universitary hospital center.

Observation: This report is about a two month old child from Mauritania presenting an hemihypertrophy, macroglassia and an umbilical hernia. Glycemia was under normal level showing a mild hypoglycemia (0,6 g/dl). T3, T4 and TSH values were in normal range. Abdominal echography was normal. Our patient was stable at the first clinical examination.

Conclusion: we advocate for dietetic measures and rigorous clinical follow up, every 3 to 6 month, to screen for recurrent hypoglycaemia and the occurence of an eventual neoplasmic desorders.

Introduction: This study aimed to investigate the mechanism of action of acetonic and hexanic extracts of the leaves of Vernonia colorata on blood glucose regulation.

Materials and methods: Experiments were performed in normoglycaemic, type 1 and 2 diabetic rats. The effects of acetonic and hexanic extracts on blood glucose were evaluated. The antagonism effect of hexanic extract on the decrease of blood glucose induced with glibenclamide and metformin was also tested.

Results: The hexanic extract of the leaves of V. colorata (HELVC) dose dependently increased the blood glucose in normoglycaemic rats. At the dose of 30 and 100 mg/kg, the glycaemia varied from 0.84 +/- 0.02 to 1.11 +/- 0.10 g/l and 0.68 +/- 0.02 to 1.31 +/- 0.30 g/l (p<0.05, n = 5). Such glibenclamide, the acetonic extract of the leaves of V. colorata (AELVC) induced hypoglycaemia in normoglycaemic rats. The HELVC prevents significantly the AELVC and glibenclamide induced hypoglycaemia. The chronic administration of the AELVC and HELVC as well as glibenclamide in type 1 diabetic rats did not change significantly the level of blood glucose. In type 2 diabetic rats, the single dose administration of metformin (300 mg/kg, per os) decreased the glycaemia which is completely prevented by a HELVC pretreatment.

Conclusion: These results suggest that: i) The respective hypo- and hyperglycaemic effects of AELVC and HELVC require the presence of the pancreatic beta cells. ii) The AELVC would act by a sulfonylurea-like mechanism as glibenclamide to induce an hypoglycaemic effect.

Introduction: Hepatitis C virus (HCV) is an important problem of public health in the world according to its transmission mode and its pathogenesis. The risk of blood transmission has led to be the systematic screening of blood donors in the world. In Senegal no study about HCV prevalence on the general population and also has been done. The aim of our study was to determine HCV prevalence in blood donors and the rate of co-infection with hepatitis B (HCV/HBV) or with HIV infection (HCV/HIV).

Materials and methods: This study had been done in the National Blood Transfusion Centre (CNTS) in Dakar. Two different techniques has been used for the assessment HCV: 1/ ELISA technique and 2/ Immunoblot RIBA as confirmation test.

Results: Our study relates to 1565 blood donors recruited in CNTS during 2002. 369 of them were new blood donors with 365 females and 1200 males. The mean average was 30.5 +/- 9.5 years, ranged from 18 to 59 years. HCV ELISA test were positive in 22 plasma samples and one of them were co-infected with hepatitis B (HCV/HBV). Four out of these 22 samples have been confirmed positive to RIBA test and three of them were not determined. HCV seroprevalence were 1.4% after ELISA and 0.25% after RIBA testing. This seroprevalence were similar in male and in female and higher in new blood donors than in regular blood donors.

Conclusion: Our results reinforce the necessity to screen hepatitis C virus in all Senegalese blood transfusion centres.

Introduction: The treatment of hyperthyroidism includes different therapeutics means of which surgery. The objectives of this study were to evaluate the place of the surgery in the treatment of hyperthyroidism and to describes the complications.

Patients and methods: It is a retrospective study on 22 patients treated by thyroidectomy from March 2002 to April 2004. The biological confirmation was systematic. A medical preparation has been done in all the cases. A total thyroidectomy has been done in 13 cases and a subtotal in 9 cases.

Results: The mean age was 37 years. There were 20 women and 2 men. An euthyroidism has obtained after surgery. There complications were: 1/22 temporary palsy of recurrent nerve 1/22 acute hypoparathyroidism 1/22 post-operative death (haematoma)

Conclusion: Surgery seems to be a good alternative to antithyroid agents, which are constraining and often ineffective in the long term, and to radioactive iodine who leads to a long follow-up because of induced hypothyroidy. With increasing surgical skill, the risk of recurrent or parathyroid injury is greatly decreased.

Aim of this study: to evaluate the efficacy of kangaroo method on thermoregulation and weight gain of a cohort of preterm.

Methods: it is a retrospective study based on files of preterm baby weighting below 2000 g, included after discharge to neonatal unit of Aristide Le Dantec maternity for kangaroo method care. Efficiency was appreciated on thermic curve evolution and daily weight gain.

Results: 56 preterm babies were including. Mean gestational age was 33 +/- 7,6 weeks and mean birth weight, 1488 +/- 277,6 g (median = 1500 g). Mean temperature was satisfying during follow up and was stable around 37 +/- 0,5 degrees C at discharge of program with mean daily weight gain of 33 +/- 7,6 g. We had only one case of death.

Conclusion: The results of this study point out efficacy of kangaroo method on thermoregulation, weight gain and survival of preterm babies. We advocate for promotion in developing countries because of its low cost.

Introduction: Antimicrobial-resistant Escherichia coli and others pathogens bacteria can be transferred from animals to humans through consumption of contaminated food and foods products and thus present a public health risk. The increase in E. coli resistance to commonly used antimicrobials both in the public health and veterinary sectors is one of the major threats of health care worldwide. The present study was undertaken to estimate the antimicrobial resistance of E. coli isolates from raw chicken meat in Dakar.

Material and method: Levying of skin and muscle have been carried out on 120 chicken carcasses bought from 13 sale points and 23 flocks beetween November 2003 and April 2004. 102 Escherichia coli strains have been isolated, among which, 90 were tested for their susceptibilities to 16 selected antibiotics by agar diffusion method.

Results: All Escherichia coli strains (100%), were resistant to one or more antibiotic; 60 strains (66.66%) being resistant to more than five antibiotics. Those frequently encountererd are: ampicillin, trimethoprim, trimethoprim-sulfametoxazole, tetracycline, sulfonamides, streptomycin, nalidixic acid. Multiple resistances to 12 antibiotics were also observed. The lowest resistances were noted with gentamicin (3.33%) and neomycin (5.56%).

Conclusion: This study showed the significance of chicken meat as source of Escherichia coli strains with a simple or multiple resistance to various antibiotics tested. Further studies are necessary in order to determine bacterium mechanisms of resistance.

Introduction: To appreciate vitamin B1 status in normal and pathophysiological states in local ivorian populations, a high-performance liquid chromatographic method for the simultaneous determination of thiamine and its phosphate esters: thiamine monophosphate and thiamine diphsophate or cocarboxylase in whole blood has been developed.

Methods: The method involves extraction with diethylether, followed by pre-column alkaline derivatization by bromide cyanogen. The extract was analysed by isocratic reversed-phase isocratic high performance liquid chromatography with fluorescent detection. System suitability tests were applied to assess the method's continuing suitability for use. The main tests of method validation: linearity, precision, accuracy and sensibility were applied to the analytical procedure.

Results: Thiamine and its esters were eluted within 10 minutes with a good resolution. System suitability tests showed that the chromatographic system was suitable for continuing use. Results of validation tests show the reliability of the method : linearity domain, satisfying precision and accuracy, detection limits between 0.067 pg/l et 0.92 pg/l (0.160 fmol/l et 1.822 fmol/l).

Conclusion: The proposed method is suitable for determination of thiamine and its phosphate esters in whole blood.

Introduction: Histopathological studies relating to last instars larvae of mosquitoes treated with neem products are very few. The objective were to study the action of Neem products on larvae mosquitoes of Culex quinquefasciatus.

Materials and methods: The neem products (Neemix, Formulated neem oil, Pure neem oil and Neem powder) are tested on 4 instars larvae of Culex quinquefasciatus. Moribund and witness larvae were fixed, for histopathologic study.

Results: The results showed the following facts: an intestinal epithelium, a bross border, a fat body and others tissues are normals at the level of the untreated larva; Fat body and muscle are not touched during the treatment of the larva with Pure neem oil; Intestinal epithelial cells slightly hypertrophied with beaches of lysis on the level of the larva treated with Neem powder; a lysis of the microvilli of brush border on the level of the witness-solvent; a destruction of the epithelial cells recorded in larva treated with a Neemix; a disappearance of the food column and a destruction of the epithelial cells remarked on the level of the larva treated with Formulated neem oil.

Conclusion: The neem products used in this study have a Larvaecidal action on Culex quinquefasciatus larvae.

Introduction: Cranial and intracranial complications can be observed during middle ear cholesteatoma's evolution. We report our experience of management of infectious cholesteatoma's cranioencephalic complications.

Material and methods: In a three year period, we had consecutively admitted 4 patients with cranioencephalic complications of middle ear cholesteatoma, in the Ear Nose and Throat (ENT) department of the university teaching hospital of Dakar. After preoperative investigations with computed tomography scan (CT scan) of brain and temporal bone. The patients had been operated after paraclinic assessment.

Results: The finding showed one case of temporal bone otogenic extensive osteomyelitis with multifocal extradural empyema, 3 cases of brain abscess associated with subdural empyema and meningitis in 1 case. For 3 patients (75%), neurosurgical drainage and mastoidectomy were performed, associated with antibiotic treatment. The mastaidectomy was performed in the same time of the surgical procedure or delayed. One patient, with brain abscess, died before surgical intervention. With a follow up of 15 months, we have noticed stable mastoidectomies cavities and no neurological recurrence symptoms.

Conclusion: These complications can be prevented by early treatment of chronic otitis media diseases. The appropriated management of these complications necessitate collaboration between otorhinolaryngologists and neuro surgeons.