Improvement of Na+-K+ ATPase Activity and Gene Expression Associated with Glomerular Ultrastructural Protection in Diabetic Nephropathy by Acacia senegal: Role of Oxidative Stress Disturbances / Mejora de la actividad Na+-K+ ATPasa y la Expresión Génica Asociada con la Protección Ultraestructural Glomerular en la Nefropatía Diabética por Acacia senegal: Papel de las Alteraciones del Estrés Oxidativo

SUMMARY: This study assessed the effects of Acacia Senegal (AS) combined with insulin on Na+/K+-ATPase (NKA) activity and mRNA expression, serum glucose, renal function, and oxidative stress in a rat model of diabetic nephropathy (DN). Sixty rats were equally divided into six groups: normal control, normal+AS, diabetic (DM), DM+insulin, DM+AS, and DM+insulin+AS groups. Diabetes mellitus (type 1) was induced by a single injection of streptozotocin (65 mg/kg), and insulin and AS treatments were carried until rats were culled at the end of week 12. Serum glucose and creatinine levels, hemoglobin A1c (HbA1c) were measured. Renal homogenate levels of NKA activity and gene expression, malondialdehyde, superoxide dismutase (SOD), catalase and reduced glutathione (GSH) were evaluated as well as kidney tissue histology and ultrastructure. Diabetes caused glomerular damage and modulation of blood and tissue levels of creatinine, glucose, HbA1c, malondialdehyde, NKA activity and gene expression, SOD, catalase and GSH, which were significantly (p<0.05) treated with AS, insulin, and insulin plus AS. However, AS+insulin treatments were more effective. In conclusion, combined administration of AS with insulin to rats with DN decreased NKA activity and gene expression as well as oxidative stress, and improved glycemic state and renal structure and function.

Este estudio evaluó los efectos de Acacia senegal (AS) combinada con insulina sobre la actividad Na+/K+- ATPasa (NKA) y la expresión de ARNm, la glucosa sérica, la función renal y el estrés oxidativo en un modelo de nefropatía diabética (ND) en ratas. Sesenta ratas se dividieron equitativamente en seis grupos: control normal, normal+AS, diabética (DM), DM+insulina, DM+AS y DM+insulina+AS. La diabetes mellitus (tipo 1) se indujo mediante una única inyección de estreptozotocina (65 mg/kg), y los tratamientos con insulina y AS se llevaron a cabo hasta que las ratas fueron sacrificadas al final de la semana 12. Se midieron niveles séricos de glucosa y creatinina, hemoglobina A1c (HbA1c). Se evaluaron los niveles de homogeneizado renal de actividad NKA y expresión génica, malondialdehído, superóxido dismutasa (SOD), catalasa y glutatión reducido (GSH), así como la histología y ultraestructura del tejido renal. La diabetes causó daño glomerular y modulación de los niveles sanguíneos y tisulares de creatinina, glucosa, HbA1c, malondialdehído, actividad y expresión génica de NKA, SOD, catalasa y GSH, los cuales fueron tratados significativamente (p<0,05) con AS, insulina e insulina más AS. Sin embargo, los tratamientos con AS+insulina fueron más efectivos. En conclusión, la administración combinada de AS con insulina a ratas con DN disminuyó la actividad de NKA y la expresión genética, así como el estrés oxidativo, y mejoró el estado glucémico y la estructura y función renal.

Étude des facteurs associés à la supplémentation en vitamine A en routine à l'âge de six mois au centre de santé de Thiès en 2019-2020 (Sénégal) / NA

Introduction :La supplémentation en vitamine A (SVA) est une intervention à haut impact en matière de survie de l'enfant. Le Sénégal, conformément aux recommandations de l'Organisation mondiale de la santé, préconise la SVA dès six mois et tous les six mois jusqu'à cinq ans. Cependant, les données sur le délai de la SVA sont limitées. L'objectif était d'identifier les facteurs associés à la SVA en temps voulu, c'est-à- dire juste à l'âge de six mois. Méthodes : Cette étude transversale a eu lieu à Thiès, une ville située à 70 km de Dakar, capitale sénégalaise. La population d'étude était constituée de 400 enfants âgés de 06 à 11 mois et vus lors des séances de vaccination de routine au centre de santé de référence du district sanitaire de Thiès. La collecte des données a eu lieu du 02 décembre 2019 au 21 janvier 2020 à l'aide d'un entretien individuel avec les mères et du carnet de santé mère-enfant. Le délai de SVA est déterminé en faisant la différence entre la date de naissance et la date où l'enfant a reçu la capsule de vitamine A. Une régression logistique a été réalisée de sorte à identifier les facteurs qui influent sur ce délai ; estimant l'odds ratio ajusté et son intervalle de confiance à 95% (IC95%). Résultats : Les enfants sont nés de mères âgées en moyenne de 27,08±6,34 ans. La proportion de ceux ayant reçu les capsules de vitamine A était de 97,24%. En revanche, seuls 59,28% avaient bénéficié de cette supplémentation en temps voulu, c'est-à-dire juste à l'âge de six mois. Les facteurs positivement associés à la SVA en temps voulu étaient la résidence en zone périurbaine (ORa= 3,81 ; IC95%=1,63 ­ 10,1 ; p-value=0,004), le statut maternel sans emploi (ORa=1,75 ; IC95% =11,12 ­ 2,75 ; p-value=0,015), l'âge maternel supérieur ou égal à 35 ans (ORa=2,94 ; IC95%=1,41 ­ 6,48 ; p-value=0,005), le sexe féminin (ORa=1,77 ; IC95%=1,15 ­ 2,74, p-value=0,009), la vaccination par le PENTA 3 juste à l'âge de 14 semaines (ORa=13,5 ; IC95%=2,67 ­ 247, p-value=0,012). Conclusion : La couverture en SVA à l'âge approprié est faible. Beaucoup d'enfants ont bénéficié de la SVA avec un retard ; ce qui les expose à la malnutrition. Les interventions de promotion de la SVA devraient inclure la distribution des suppléments de vitamine A à l'aide des visites à domicile dans la zone urbaine de Thiès, l'aménagement du temps de travail des femmes, la sensibilisation des jeunes mères, l'intégration desservices de vaccination et de supplémentation en vitamine A. Ces efforts de promotion devraient prendre en compte la dimension genre

Clinical outcome and incidence of inhibitor development in severe hemophilia patients receiving low-dose prophylaxis: a 3-year follow-up study in Senegal, West Africa

ABSTRACT Introduction: In Africa, where access to diagnosis and treatment of hemophilia is the lowest in the world, prophylaxis is rarely used in preference to on-demand treatment. There are limited data of prophylaxis treatment from sub-Saharan Africa. The aim of this study was to evaluate clinical outcomes and inhibitor development in people with hemophilia receiving low-dose prophylaxis (LDP) in a sub-Saharan African setting. Methods: We conducted a three-year prospective study. A once or twice weekly prophylaxis regimen of 25 IU/kg of rFVIIIFc or 30 IU/kg of rFIXFc was given to Hemophilia A and B, respectively. We evaluated clinical outcomes and inhibitors occurrence, determined by screening and titration using the Nijmegen technique. Results: A total of 15 patients were included in the LDP regimen. The mean age was 6.3 years (1.5 - 10). A significant reduction was noted in the annualized bleeding rate, from 7.53 to 1.33 (p = 0.0001); the annualized joint bleeding rate passed from 3.6 to 1.4 (p = 0.001) and the proportion of severe bleeding, from 86.1% to 16.7% (p = 0.0001). The Hemophilia Joint Health Score (HJHS) moved from 9.6 to 3.4 (p = 0.0001) and the Functional Independence Score in Hemophilia (FISH) improved from 25.8 to 30.9 (p = 0.0001). School absenteeism decreased from 7.33% to 2.59%. Adherence to prophylaxis was 89.5% versus 60%. Consumption was 580 IU/kg/year versus 1254.6 IU/kg/year before and after prophylaxis, respectively. Incidence of inhibitors was 23% (3 /13 HA). Conclusion: The LDP in Hemophilia improves the clinical outcome without a surplus risk of inhibitor development. Using extended half-life clotting factor concentrates (CFCs) is better for prophylaxis in resource-limited countries, as they allow better compliance in treatment.

Risk Factors Associated with Bacterial Vaginosis in Pregnant Women in Senegal

Background: Bacterial vaginosis (BV) is associated with a high risk of complications, particularly during pregnancy. Objectives: The aims of this study were to determine the prevalence of BV in pregnant women in Dakar, Senegal, and to identify its associated risk factors. Patients and Methods: This prospective cross-sectional study was conducted from July 2020 to March 2021 in pregnant women with 34 to 38 weeks of gestation and seen for their routine prenatal consultation at the Nabil Choucair health center in Dakar, Senegal. Vaginal swabs were taken and examined using the Nugent scoring system for the diagnosis of the BV. Data analysis on SPSS (version 25) was done using the chi-square test to measure the strength of association. A value of p ? 0.05 was considered statistically significant. Results: BV was found in 28.0% (112/400) of the screened women with a median age 24 (21-29) years. A pH >4.5 predictive of BV was found in 80.4% (90/112) of samples. BV was associated with vaginal candidiasis in 49.1% (55/112) while Trichomonas vaginitis was found in 1.8% (02/112). In 80.4% (90/112) of affected women, BV was caused by Gardnerella vaginalis. Mobiluncus spp. was found in 19.6% (22/112) pregnant women in association with G. vaginalis. Symptoms characterized by episodes of pruritus, pelvic pain, burning and/or dyspareunia were seen among 59.8% (67/112) of these women with BV while 40.1% (45/112) of them reported no symptoms. Conclusion: In view of these results and in order to reduce gestational complications and adverse outcomes in the newborn, screening for BV in pregnant women should be favored in developing countries.

Acacia senegal inhibits diabetic nephropathy ultrastructure alteration and renal biomarkers changes in rats / Acacia senegal inhibe la alteración de la ultraestructura de la nefropatía diabética y los cambios en los biomarcadores renales en rata

SUMMARY: Diabetic nephropathy (DN) is the most common complication of diabetes. Several studies have been done in a trial to protect against this problem at the ultrastructure level. This study investigates the protective effect of oral administration of Acacia senegal (AS) against the development of DN. Sixty male albino rats were randomly divided into six groups: control, Acacia senegal control, Diabetic untreated, diabetic insulin-treated, Diabetic AS treated, and Diabetic insulin and AS combined treated groups. Plasma glucose, HbA1c, serum Albumin, creatinine, urine creatinine was measured using specific kits. Determinations of creatinine clearance and blood pressure were done. The renal tissues of both kidneys were prepared to investigate under both light (LM) and electron microscope (EM). Ultrastructure examination of renal rats tissue of diabetic untreated rats showed the destruction of the glomerular basement membrane and endothelial cells together with hemorrhage in glomerular capsules (Bowman's capsules). On the other side, both LM and EM revealed improving the endothelial cells and the other glomerular capsules structures, especially with the combined treated group, which confirmed the improvement of the biochemical investigation in the study. In conclusion, from the present study, using the oral AS together with SC insulin could be protected against the development of DN.

RESUMEN: La nefropatía diabética (ND) es la complicación más común de la diabetes. Se han realizado varios estudios de ensayo para abordar esta dificultad a nivel de ultraestructura. Este estudio investiga el efecto protector de la administración oral de Acacia senegal (AS) contra el desarrollo de la ND. Se dividieron sesenta ratas albinas machos aleatoriamente en seis grupos: control, control de Acacia senegal, diabéticos no tratados, diabéticos tratados con insulina, diabéticos tratados con AS y grupos tratados con compuesto de insulina diabética + AS. Se midieron utilizando kits específicos, glucosa plasmática, HbA1c, albúmina sérica, creatinina en sangre y en orina. Se registraron la creatinina y la presión arterial. Los tejidos renales de ambos riñones se prepararon para investigar tanto con microscopio óptico (MO) como electrónico (ME). El examen de la ultraestructura del tejido renal de ratas diabéticas no tratadas mostró la destrucción de la membrana basal glomerular y las células endoteliales junto con hemorragia en las cápsulas glomerulares (cápsulas de Bowman). Por otro lado, tanto MO como ME revelaron una mejora de las células endoteliales y las estructuras capsulares glomerulares, en el grupo tratado con el compuesto, lo que confirmó la mejora de la investigación bioquímica. En conclusión, el uso de AS oral en combinación con insulina podría proteger contra el desarrollo de ND.

Smudge cells percentage on blood smear is a reliable prognostic marker in chronic lymphocytic leukemia

Abstract Objective We evaluated the relevance of using the smudge cell percentage in the blood smear as a prognostic marker in CLL. Methods In this prospective study, 42 untreated Senegalese patients with CLL were enrolled. The diagnosis was established, based on the peripheral blood count and flow cytometry using the Matutes score. Cytogenetic aberrations, assessed by fluorescence in situ hybridization (FISH), were available for 30 patients, while the immunoglobulin heavy chain genes (IGVH) mutation status was performed by next-generation sequencing (NGS) in 24 patients. The SC percentage was determined in the blood smear, as previously described. Statistical analyses were executed using the GraphPad Prism 8. Results The mean age was 63 years (48 - 85) and the male: female sex ratio was 4.66. A low SC (< 30%) percentage was correlated with Binet stage B/C (p= 0.0009), CD38 expression (p= 0.039), unmutated IGVH status (p= 0.0009) and presence of cytogenetic abnormalities (for del 13q, p= 0.0012, while for other cytogenetic aberrations, p= 0.016). An inverse correlation was found between the SC percentage and the absolute lymphocyte count (r= -0.51) and patients with higher percentage of SCs had a prolonged survival. However, there was no correlation between the SC percentage and age (p= 0.41) or gender (median, 19% for males vs. 20% for females; p= 0.76). Conclusion When less than 30%, the SC was associated with a poor prognosis in CLL. Easy and affordable, the percentage of SCs in a blood smear could be a reliable prognostic marker, accessible to all CLL patients, mainly those in developing countries.

Neonatal outcomes in twin pregnancies with the first twin in breech presentation according to the mode of delivery: A cohort study from Dakar Senegal

The objectives of this study were to compare perinatal outcomes in twin pregnancies where the first twin was in the breech presentation. To do so, we performed a 10-year retrospective cohort study in a single university center. All patients with a twin pregnancy with the first twin in breech presentation, a gestational age greater than or equal to 34 weeks' gestation, and a birth weight >= 1500 g were included. The main outcome measures were 5-minute Apgar score <7 and perinatal mortality. We included 353 pairs of twins which complied with the inclusion criteria. One hundred and fifty (150) patients delivered vaginally while 203 pairs of twins were delivered by caesarean section. Patients who delivered abdominally were similar to those who delivered vaginally with regard to age, parity, and gestational age. Six twins A delivered vaginally and 2 delivered by caesarean section had an Apgar score < 7 (p = 0.76) whereas 12 twins B delivered vaginally and 2 delivered abdominally had an Apgar score <7 (p = 0.001). Perinatal mortality did not differ significantly between twins delivered abdominally and those delivered vaginally. There was no evidence that vaginal delivery was risky with regards to depressed Apgar scores for Twin A and neonatal mortality for breech first twins that weighed at least 1500 g. However, Twin B delivered vaginally were more likely to present with a low 5-minute Apgar score. Along with the literature, the findings of this study do not currently allow to define a consensual obstetric attitude towards management of breech first twin deliveries. Until more prospective multicenter randomized controlled studies shed light on this problem, the skills, experience and judgment of the obstetrician will play a major role in the decision-making process. (Afr J Reprod Health 2022; 26[5]: 50-56).

Characteristics of oral health literacy in Senegal: A cross-sectional study among women in the Department of Pikine

Senegal having a significant prevalence of socially differentiated oral diseases, oral health literacy (OHL), an individual and social resource, should be considered alongside a remedial response. This work aimed to analyze women's OHL characteristics. A cross-sectional study on 315 women in Pikine County was carried out, using the Oral Health Literacy-Adult Questionnaire (OHL-AQ) for the OHL data collection and a questionnaire for the women's socioeconomic characteristics data. These women had an OHL average score of 6.5±3.1 and a median of 6. Among them, 56.5% had a seemingly low OHL level, a little over 68.9% had a score above the median as regards the "listening, communication and understanding" aspect, 58.4% to "decision making", 55.2% to "understanding numbers" and 33% to "reading and understanding". According to a multivariate analysis, secondary and higher educated women (p<0.001) with an active social network (p<0.023), in a wealthy household (p<0.0001) and of nuclear household type (p<0.036) had a higher OHL level. Women in Pikine have low OHL and are from working- class households. Therefore, oral health policies must take into account the women's social network contribution to the OHL improvement.

Apport du test expert MTBRIF dans le diagnostic de la tuberculose toute forme à Saint-Louis / contribution of the Xpert MTB / Rif test in the diagnosis of tuberculosis of any form in Saint-Louis

Introduction: le test Xpert MTB/RIF présente un double avantage d'une part le diagnostic rapide des cas mêmes difficiles par la technique standard de l'examen direct à la microscopie et d'autre part par la détection de la résistance à la rifampicine. Notre objectif était de déterminer l'apport du test Xpert dans le diagnostic de la tuberculose toutes formes confondues. Matériels et méthode : étude transversale, descriptive à collecte rétrospective menée dans le service de Pneumophtisiologie de CHRU de Saint-Louis. Tous les cas suspects de tuberculose qui avaient bénéficié d'un test Xpert de 2018 à 2020avec un dossier médical accessible et exploitable ont été inclus. Les paramètres étudiés étaient les données sociodémographiques, cliniques et biologiques. Résultats : Nous avions colligés 524dossiers de malades avec un sex-ratio de 1,3. L'âge moyen des patients était de 37 ans+/-15 ans. Il y'avait 285 prélèvements positifs au GeneXpert dont 224 d'origine pulmonaire et 61d'origine extra pulmonaire. Le nombre d'échantillons résistants à la rifampicine était de cinq, tous d'origine respiratoire. Conclusion: le test Xpert est une nouvelle technique moléculaire recommandée par l'OMS dans le diagnostic de la tuberculose pulmonaire. Toutefois il doit être évaluer dans le diagnostic de la tuberculose extra pulmonaire

Introduction: The Xpert MTB / RIF assay has a dual advantage on the one hand, the rapid diagnosis of even difficult cases by the standard technique of direct microscopic examination and on the other hand by the detection of resistance to rifampicin. Our objective was to determine the contribution of the Xpert test in the diagnosis of tuberculosis of all forms. Materials and method: retrospective, descriptive and analytical study carried out in the Pneumophtisiology department of the CHRU of Saint-Louis. All suspected tuberculosis cases who had received an Xpert test from 2018 to 2020 were included. The parameters studied were socio-demographic, clinical and biological data. Results: 524 patient records included in the study with a sex ratio of 1.3. The mean age of the patients was 37 +/-15 years. There were 285 positive GeneXpert samples, of which 224 were of pulmonary origin and 61 of extra-pulmonary origin. The number of rifampicin resistant samples was five, all of respiratory origin. Conclusion: the Xpert test is a new molecular technique recommended by the WHO in the diagnosis of pulmonary tuberculosis

Mise en place d'un centre de traitement des épidémies (CTE) pour COVID-19 dans un service de Médecine Interne; les leçons apprises / Establishment of an Outbreak Center for Covid-19 (OCC), in an Internal Medicine department

Introduction: La fulgurante progression de la pandémie à covid -19 a imposé au Sénégal l'adoption de stratégies de riposte parmi lesquelles la mise en place de centres de traitement des épidémies (CTE) au sein des hôpitaux . Nous nous proposons d'évaluer les activités d'un CTE Covid-19 implanté dans un service de médecine interne et les leçons tirées de ce vécu. Méthodologie : Le CTE Covid -19 a été installé dans le service de médecine interne de l'Hôpital Régional de Thiès (HRT), mais avec conservation de lits dédiés aux patients non atteints de Covid-19. Les étudiants en année de doctorat affectés dans le service de médecine interne étaient responsables de la gestion quotidienne du CTE sous la supervision des spécialistes en médecine interne Ce service était subdivisé en deux parties: le CTE qui prenait en charge les cas de Covid -19 et le reste du service qui devait continuer à accueillir les patients atteints d'autres affections ou qui y étaient régulièrement suivies. Résultats : Du 1er mai au 30 octobre 2020, 237 patients ont été admis dans le CTE. Ils étaient âgés de 7 à 88 ans avec une moyenne d'âge de 53,41 ans et un sexe ratio de 1,60. Les motifs d'admission étaient une désaturation en oxygène inférieure à 90%, la présence d'au moins une comorbidité (autres infections, diabète , hypertension artérielle , obésité, maladies auto-immunes, cancers…). L'âge avancé mais aussi les patients ne pouvant être à domicile faisaient également partie des critères d'admission . Trois (3) cas de co-infection Covid-19 et tuberculose pulmonaire ont été relevés et trois (3) patients avaient un portage chronique du virus de l'hépatite B. Dans le cadre des hospitalisations non Covid -19, les affections suivantes ont été retrouvées : 8 cas de diabète déséquilibrés et autant d'hépatopathie (6,10%); l'accès palustre dans 3, 05% (n=3) ; la tuberculose pulmonaire (3,81%, n=3) ; 3 cas (2,29 %) d'anémie de type biermerien et de lupus érythémateux systémique. De même, 1 cas (0,76%) d 'empyème cérébral ; une polyarthrite rhumatoïde (0,76 %), une (01) maladie rénale chronique , 1 cas de défaillance cardiaque ont également été enregistrées. Cinq (5) cas (3,81 %) non affectés par l'infection à Covid -19 , à leur admission l'ont été au cours de leur hospitalisation et donc transférés au niveau de la zone rouge du CTE. Conclusion: La mise en place du CTE au niveau du service de Médecine interne , a permis une adaptation efficiente dans la prise en charge des patients concernés mais aussi de ceux qui étaient suivis pour des pathologies chroniques comme les urgences médicales reçues durant la période. La continuité des soins a été assurée et les liens avec les autres secteurs de la pyramide sanitaire du Sénégal ont été raffermis.

Introduction : The fast progression of covid -19 throughout the world has forced Senegal to adopt response strategies including the establishment of Outbreak Center for Covid- 19 (OCC ) within hospitals . We propose to evaluate the activi ties of an OCC implemented in an internal medicine department and the lessons learned from this experience. Methodology: The center for care of Covid-19 has been installed in the Internal Medicine department of the Thies Regional Hospital (HRT ), but with dedicated beds for patients non affected by the pandemic . Fifteen doctoral students were assigned, by local medical school , to the Department of Internal Medicine in order to be responsible for the day-to-day management of the OCC. They were supervised by internal medicine specialists . This service was divided into two parts: the OCC that handled Covid -19 cases and the rest of the service , which was to continue to take care of patients with other conditions or who were regularly monitored. Results: From May 1 to October 30, 2020, 237 patients were admitted to the CTE They ranged from 7 to 88 years old with an average age of 53.41 and a sex ratio of 1.60 .The reasons for admission were an oxygen desaturation of less than 90%, the presence of at least one comorbidity (other infections, diabetes, arterial hypertension, obesity, autoimmune diseases, cancers, etc .). Advanced age but also patients who could not be at home were also part of the admission criteria. Three (3) cases of Covid -19 co -infection and pulmonary tuberculosis were identified and three (3) patients had a chronic carriage of the hepatitis B virus. In the context of non -Covid -19 hospitalizations, the following conditions have been found: 8 cases of unbalanced diabetes and as many hepatopathy (6.10%); malaria access in 3.05% (n = 3); pulmonary tuberculosis (3.81%, n = 3); 3 cases (2.29%) of biermeric type anemia and systemic lupus erythematosus. Similarly, 1 case (0.76 %) of cerebral empyema; rheumatoid arthritis (0.76%), one (01) chronic kidney disease, 1 case of heart failure were also recorded Five (5) cases (3.81%) not affected by Covid-19 infection, on admission, were during their hospitalization and therefore transferred to the red zone of the CTE. Conclusion : The establishment of the OCC in the internal medicine service allowed an efficient adaptation in the care of the patients affected by covid disease but also of those who were followed for chronic pathologies or admitted for other medical emergencies This strategy has improved and strengthened the links with other sectors of Senegal 's health pyramid.

Characterization of a novel antifungal protein from Acacia senegal seeds

Aim: The aim of the present study was to isolate antifungal protein from seeds of Acacia senegal in order to develop a new, effective and environmental friendly biofungicide.Methodology: Antifungal protein from A. senegal seeds was extracted and purified through ammonium sulphate precipitation, dialysis, ion exchange and gel filtration chromatography. The novel antifungal was characterized employing SDS-PAGE, chitinase activity and antifungal efficacy. The purified protein was also characterized through MALDI-TOF MS/MS. Results: The yield of purified antifungal protein was estimated to be 0.96 mg 25 g-1 seeds and its molecular mass determined by SDS PAGE was 52.9 kDa. The purified protein exhibited antifungal activity against phytopathogenic fungi viz., Macrophomina phaseolina and Fusarium oxysporum also possessed chitinase activity. The purified protein was characterized through MALDI-TOF MS/MS and its spectra revealed 14 peptides with their specific amino acid sequences. Interpretation: The antifungal protein isolated from A. senegal seeds has broad-spectrum antifungal activity with chitinase activity against pathogenic fungi that can be exploited for management of fungal disease as biopesticide to promote sustainable agriculture

Completeness of information in electronic compared with paper-based patients’ records in a maternity setting in Dakar, Senegal

Background: Evaluate the consistency of information in paper-based records when registered in parallel with an electronic medical record.Methods: The study was performed at PMSHC in Dakar Senegal. From the end of year 2016, patients’ files were recorded on both paper-based and electronically. Additionally, previous records were electronically registered. To investigate the completeness of records before and after the electronic recording system has been implemented, information about some maternal and fetal/neonatal characteristics were assessed. When the variable was recorded, the system returned 1, unrecorded variables were coded as 0. We then calculated, for each variable, the unrecorded rate before 2017 and after that date. The study period extended from 2011 to June 2019, a nearly ten-year period. Data were extracted from E-perinatal to MS excel 2019 then SPSS 25 software. Frequencies of unrecorded variables were compared with chi-squared test at a level of significance of 5%.Results: A total of 48,270 unique patients’ records were identified during the eight-year period.  Among the study population, data for patients’ age, address and parity were available most of the time before and after 2017 (0.5% missing data versus 0.3% for age and 2.6% versus 1.3% for home address and from 0.3% to 0.0% for parity). However, phone number, maternal weight, maternal height, last menstrual period and blood group were found to be missing up to 96% before 2017. From 2017, these rates experienced a sudden decrease at a significant level: from 82.4% to 27.8% for phone number, from 96% to 56.3% for maternal weight and from 60.1% to 21.3% for blood group. Regarding newborns’ data, it was found that fetal height, head circumference and chest circumference were missing up to just under 25% before 2017. After that date, their completeness improved and flattened under 5%.Conclusions: Structured and computerized files reduce missing data. There is an urgent need the Ministry of health provides hospitals and health care providers with guidelines that describes the standardized information that should be gathered and shared in health and care records.

Laparoscopic management of cervical and endometrial cancer in Africa: experience of the National Hospital Centre of Pikine

Background: Laparotomy represents the standard historical surgical approach to these cancers. Process of treatment of benign adnexal pathologies to the emergence of a new pathway for the management of these cancerous pathologies.Methods: Our prospective study from December 2016 to December 2018 included 10 patients with early-stage uterine cancer and endometrial cancer confirmed by MRI. The characteristics of patients, their cancer, their intervention and morbidity were revealed.Results: Our results show that the average age of the patients was 63 years; There were 2 cases of cervical cancer and 8 cases of endometrial cancer. For cervical cancer, it was essentially squamous cell carcinoma; one patient was at stage Ia2 and the other at stage Ib1. For endometrial cancers, squamous cell carcinoma was 80%; 6 patients were in stage IB and 2 in stage IC. Of the 10 patients undergoing surgery, 9 had laparoscopic colpohysterectomy and lymphadectomy and one complementary laparoscopic lymphadenectomy. The average number of lymph nodes removed was 9 and no lymph node metastasis was found. In the immediate postoperative period, one patient had transient urinary incontinence and another had vaginal slice lymphorhea.Conclusions: The main interest of this practice is to be the least morbid possible for patients at the early stage. With our short experience, we obtained a reduction in operating time, a reduction in hospital stay, a decrease in the consumption of analgesics and antibiotics postoperatively and a reduction in per and postoperative complications.

What are the Barriers to Antenatal Care Utilization in Rufisque District, Senegal?: a Bottleneck Analysis

BACKGROUND: This study aimed to analyze the barriers affecting the utilization of antenatal care (ANC) among Senegalese mothers. METHODS: Health facility staffs were surveyed to examine the availability coverage of ANC (infrastructural capacity of health posts to handle maternal and newborn healthcare). A total of 113 women of childbearing age were surveyed to identify factors associated with the accessibility coverage (physical, economic, and information accessibility factors), acceptability coverage (socio-cultural features, social acceptance, and language), and effectiveness coverage (ratio of mothers having completed 4 visits) of ANC. Further, to identify the socio-cultural factors and the specific characteristics of the barriers, 5 focus group discussions were conducted with women of childbearing age, their husbands and mothers-in-law, community health workers, and health facility staff. The effectiveness coverage of ANC was analyzed by reviewing materials from the District Health Information System 2 of Senegal. RESULTS: Key barriers of ANC utilization were associated with acceptability coverage. ANC during early pregnancy was avoided owing to the negative social stigma surrounding miscarriage. The survey results indicated an extremely high miscarriage rate of 30.9% among the participants. The social stigma towards unmarried mothers caused them to hide their pregnancy, which deterred ANC utilization. The husband was the final decision maker and social supporter on ANC utilization. CONCLUSION: To promote the utilization of ANC services among pregnant women in Senegal, it is important to alleviate the social stigma towards miscarriages and unmarried mothers, and to provide greater social support for pregnancies and newborn deliveries within family.

Contribution to the Knowledge of Fungal Biodiversity in Senegal by a Study of Basidiomycete Species of the Order of Agaricales in the Dakar Region

Agaricales is one of the most diverse orders of Basidiomycete leaf mushrooms. Most species of this order are of great scientific interest and economic interest. Despite this huge diversity, Agaricales and mushrooms, in general, have been the subject of very few studies in Senegal. This study was undertaken to contribute to a better knowledge of fungal biodiversity in Senegal, particularly Basidiomycetes species of the order of Agaricales in the Dakar region. For this, observations were carried out in four sites namely; the Botanical Gardens of the Faculty of Science, the Botanical Gardens of the Faculty of Medicine, the Mbao Classified Forest and the Hann Forest Park. The description and identification of the samples were made based on both the macroscopic and ecological characteristics of the harvested mushrooms. This work enabled to make an inventory of seven species of Agaricales from which three were identified. Among the 4 unidentified species, some could probably be new species. All of these inventoried species belong to three genera (Agaricus, Leucoagaricus and Leucocoprinus) and two families (Agaricaceae and Lepiotaceae). This preliminary work also permitted to elaborate keys of the determination of harvested species, and a basic list of mushrooms belonging to the order of Agaricales.

Effect of Natural Emulsifier Acacia Senegal on in vivo and in vitro Performance of Chlorogenic Acid Self-microemulsion / 中国药房

OBJECTIVE:To study the effect of natural emulsifier acacia senegal on in vivo and in vitro performance of chloro-genic acid self-microemulsion. METHODS:Chlorogenic acid self-microemulsion containing acacia senegal(new chlorogenic acid self-microemulsion)was prepared by using acacia senegal to gradually replace polysorbate 80 in chlorogenic acid self-microemul-sion containing nonionic emulsifier (traditional chlorogenic acid self-microemulsion). The appearance,morphology,particle size,conductivity,pH value,stability,in vitro release and intestinal absorption kinetics of the 2 kinds self-microemulsions were evaluated. RESULTS:50％of polysorbate 80 was replaced by acacia senegal in new chlorogenic acid self-microemulsion. The tradi-tional and new chlorogenic acid self-microemulsions had clear appearance,and approximately spherical drops. Particle sizes were (24.53 ± 3.03),(35.51 ± 5.91) nm;dectrical conductivities were (195.6 ± 0.3),(189.5 ± 0.4)μs/cm;and pH were 3.87 ± 0.02, 4.08 ± 0.03 (n=3),respectively. Compared with traditional chlorogenic acid self-microemulsion,the absorption rate constant,ef-fective permeability coefficient and absorption amount of the new one in duodenum,jejunum,ileum were increased a little (P>0.05);the above indexes in colon were obviously decreased (P<0.05). CONCLUSIONS:The new chlorogenic acid self-micro-emulsion can maintain the performance of traditional one,and increase absorption of chlorogenic acid in small intestine.

Epidemiology of snakebites in Kédougou region (eastern Senegal): comparison of various methods for assessment of incidence and mortality

Background Although considered a public health issue in Senegal, the actual incidence and mortality from snakebite are not known. In the present study, an epidemiological survey was carried out in Kédougou region, southeastern Senegal, where envenomations, particularly by Echisocellatus, are frequent and severe. Methods Three sources of data were used: records from health centers and reports by health professionals; traditional healers; and household surveys. Results The annual incidence and mortality provided by health centers were 24.4 envenomations and 0.24 deaths per 100,000 population, respectively. The annual incidence recorded by traditional healers was 250 bites per 100,000 inhabitants, but the number of deaths was unknown. Finally, the household surveys reported an annual incidence of 92.8 bites per 100,000 inhabitants and an annual mortality rate of 2.2 deaths per 100,000 inhabitants. The differences in incidence and mortality between the different methods were explained by significant bias, resulting in particular from the complex patient's healthcare-seeking behavior. The incidence provided by health records should be used to specify the immediate quantitative requirements of antivenoms and places where they should be available first. Conclusion Mandatory reporting of cases would improve the management of envenomation by simplifying epidemiological surveys. Patients' preference for traditional medicine should prompt health authorities to urge traditional healers to refer patients to health centers according to defined clinical criteria (mainly edema and bleeding or neurotoxic symptoms). Finally, household surveys were likely to reflect the actual epidemiological situation. Poison Control Center of Senegal should continue its work to sensitize stakeholders and train health staff.(AU)

Epidemiology of snakebites in Kédougou region (eastern Senegal): comparison of various methods for assessment of incidence and mortality

Although considered a public health issue in Senegal, the actual incidence and mortality from snakebite are not known. In the present study, an epidemiological survey was carried out in Kédougou region, southeastern Senegal, where envenomations, particularly by Echisocellatus, are frequent and severe. Methods Three sources of data were used: records from health centers and reports by health professionals; traditional healers; and household surveys. Results The annual incidence and mortality provided by health centers were 24.4 envenomations and 0.24 deaths per 100,000 population, respectively. The annual incidence recorded by traditional healers was 250 bites per 100,000 inhabitants, but the number of deaths was unknown. Finally, the household surveys reported an annual incidence of 92.8 bites per 100,000 inhabitants and an annual mortality rate of 2.2 deaths per 100,000 inhabitants. The differences in incidence and mortality between the different methods were explained by significant bias, resulting in particular from the complex patient's healthcare-seeking behavior. The incidence provided by health records should be used to specify the immediate quantitative requirements of antivenoms and places where they should be available first. Conclusion Mandatory reporting of cases would improve the management of envenomation by simplifying epidemiological surveys. Patients' preference for traditional medicine should prompt health authorities to urge traditional healers to refer patients to health centers according to defined clinical criteria (mainly edema and bleeding or neurotoxic symptoms). Finally, household surveys were likely to reflect the actual epidemiological situation. Poison Control Center of Senegal should continue its work to sensitize stakeholders and train health staff.

Correlation of Clinical and Pathological Parameters with the Diversity and Genetic Evolution of Breast Cancer in Senegalese Women.

Aims: The purpose of this study was to assess the hypothesis that genetic diversity of breast cancer is related to clinical and pathological tumors characteristics. Study Design: Representative sequences of mitochondrial Cytochrome b gene of cancerous tissues were analyzed to determinate diversity and genetic evolution of breast tumors in Senegalese women. Place and Duration of Study: Department of biology Animal (University Cheikh Anta Diop), laboratory of molecular biology (IRD-CBGP), 2011-2013. Methodology: Genetic diversity of breast tumors in 57 Senegalese patients was estimated by analyzing sequences of the Cytochrome b mitochondrial coding gene. The Cytochrome b sequences from cancerous tissues were aligned using BioEdit version 7.0.8. Number of polymorphic sites, parsimony informative sites, the rate of transitions/transversions and the nucleotide frequency were calculated using MEGA 5.05. Genetic distance (d) was calculated with MEGA 5 using the Kimura 2-parameter (K2P) model. The index of genetic differentiation (Fst) used to describe the distribution of the genetic diversity between sub-groups was calculated with the software DnaSP version 10.5.01. The significance level (P-value) was 0.05. Results: Analyses have revealed a high score of haplotype (Hd=0.991+/-0.008) and nucleotide diversity (Pi=0.15650+/-0.01326). Statistical correlations have shown a positive association between the risk factors (age of the patients, appearance of the first menstruation beyond 12 years, number of gestation) and nucleotide diversity of tumors (P<0.0001). Statistical analyses based on t-test showed a positive association between age, date of onset of the first menstruation and nucleotide diversity (Pi), between healthy and cancerous tissues for each patient (P<0.0001). Conclusion: Our results have shown an important genetic diversity in breast tumors. A strong genetic differentiation was noted depending on the number of gestations.

Implication of the Cytochrome B nucleotide and protein mutations in the occurrence of Breast Cancer in Senegal.

The reports provided by OMS in 2011 have showed that cancer is a major cause of death in the world, causing 7.6 million deaths in 2008. Breast cancer is in the world, the most common neoplasia of women, and it appears that low penetrance genes, but frequently mutated in the general population play an important role in the development of this cancer. The objective of this study is to evaluate the involvement of Cytochrome b mutations (mitochondrial gene) in the occurrence of breast cancer in the Senegalese women. We have analyzed by PCR-sequencing the variability of the Cytochrome b gene in thirty Senegalese patients suffering from breast cancer. The results of molecular analysis of a portion of Cytochrome B indicate the existence of nucleotide variability at intra and interindividual with a genetic differentiation between healthy and cancerous tissue, as well as the existence of a correlation between this genetic differentiation at the age of the patients and location of tumors (right breast or left breast). Changes of one or more Tryptophan to other amino acids, ranging normal tissue to cancerous tissue, are noted in some individuals with a penetrance of 72.41%. Our results also show a significant increase (79.3%) the number of Phenylalanine in cancerous tissues with very different proportions between individuals. Any increase in the rate of Tryptophan and Phenylalanine in cancerous tissues could be correlated with an increased risk of developing breast cancer.