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1.
J Fr Ophtalmol ; 47(2): 104070, 2024 Feb.
Article in French | MEDLINE | ID: mdl-38310692

ABSTRACT

INTRODUCTION: Rosai-Dorfman disease (RDD) is a sinus histiocytosis with massive lymphadenopathy. This rare condition is a benign disease of unknown etiology. Bilateral orbital localization of RDD is rare. OBSERVATION: The authors report the case of a 6-year-old child who presented with bilateral orbital-palpebral masses associated with chronic cervical lymphadenopathy. There were no laboratory signs of inflammation. Serological and tuberculosis screening tests were negative. Histopathological examination of a lymph node biopsy established a diagnosis of Rosai-Dorfman disease. The patient underwent surgical excision of the orbital lesions followed by long-term corticosteroid therapy. A favorable course was observed, with no sign of recurrence after one year of follow-up. CONCLUSION: Rosai-Dorfman disease is very rare in its bilateral orbital presentation. Histopathological diagnosis remains challenging. In Africa, the presence of chronic oculo-palpebral tumor associated with or without cervical lymphadenopathy must raise the suspicion of Rosai-Dorfman disease after ruling out tuberculosis and lymphoma.


Subject(s)
Histiocytosis, Sinus , Lymphadenopathy , Orbital Diseases , Tuberculosis , Humans , Child , Histiocytosis, Sinus/diagnosis , Histiocytosis, Sinus/complications , Histiocytosis, Sinus/pathology , Orbital Diseases/diagnosis , Orbital Diseases/complications , Biopsy , Tuberculosis/complications
2.
Med Sante Trop ; 29(2): 151-154, 2019 May 01.
Article in English | MEDLINE | ID: mdl-31379339

ABSTRACT

INTRODUCTION: The aim of our study was to evaluate the clinical, microbiological, and contributing factors of microbial keratitis in tropical environment. Materiel and methods: We performed a retrospective study of all patients admitted to the ophthalmology department of Principal Hospital in Dakar for infectious keratitis, over ten years from January 2006 to December 2015. Clinical, microbiological, and contributing factors as well as visual effects were studied. RESULTS: We collected data of 118 patients hospitalized for unilateral infectious keratitis in 10 years, for an average of 12 cases per year. The patients' mean age was 50 years. At least one local risk factor was found in 58.5% of cases. These were mainly ocular trauma (39%), followed by local treatment of glaucoma (16%), and recent eye surgery (14.5%). In 9 cases (8%), the only risk factor for abscess was an isolated general factor. This was diabetes in 7 cases. The clinical aspects described can be grouped according to topography, depth, and severity in pre-perforation state or perforation (45%), anterior chamber Tyndall effect greater than 1 cross, reaching a hypopyon stage (24%), stromal infiltrate larger than 2 mm (18%) and the abscess located within 3 mm of the corneal center (13%). The microbiological examination isolated a germ in 17% of cases, principally Pseudomonas aeruginosa (40%), followed by Staphylococcus aureus (20%). Prognosis was severe with visual acuity of less than 1/10 in 90% of cases and evisceration in 16% of cases. DISCUSSION: The most common risk factor was local ocular trauma by foreign bodies in the cornea. The poor prognostic factors were possible delay in consultation, low initial visual acuity, and low rate of positive microbiological examinations. CONCLUSION: Infectious keratitis is a potentially serious condition that can lead to blindness and eventually to loss of the ocular globe in tropical environments. Local risk factors are largely dominated by ocular trauma. Only early management based on the microbiological results improves the prognosis.


Subject(s)
Keratitis/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Keratitis/diagnosis , Keratitis/etiology , Male , Middle Aged , Retrospective Studies , Risk Factors , Severity of Illness Index , Time Factors , Tropical Climate , Young Adult
3.
J Fr Ophtalmol ; 41(7): 637-641, 2018 Sep.
Article in French | MEDLINE | ID: mdl-30166236

ABSTRACT

OBJECTIVE: To describe the etiologies, clinical presentation and therapeutic management of neovascular glaucoma (NVG) in Senegalese patients. PATIENTS AND METHODS: We retrospectively studied the records of patients followed for NVG between 1993 and 2016. We included eyes with Iridis rubeosis with or without ocular hypertension. We recorded age, sex, medical and ophthalmologic history, results of the eye examination, treatment modalities broken up into hospitalisation, procedural interventions and number of antiglaucoma medications prescribed. The data analysis was performed by epi-info 7. RESULTS: Forty-eight eyes of 44 patients were included. The mean age was 59.7 years and sex ratio 2.1. Etiologies were type 2 diabetes in 31.8 % cases and central retinal vein occlusion in 16.6 % cases. All eyes were blind. Eye pain was present in 75 % of eyes, a limbal flush in 29.1 % of eyes and mydriasis in 31.25 % of eyes. Mean intraocular pressure was 49.7mmHg. Corneal edema occured in 54.1 % of eyes. Fundus examination showed proliferative retinopathy in 14.5 %. Treatment required hospitalisation for 43.75 % of patients. Therapeutic procedures were cyclocryoapplication for 31.25 % of eyes, retrobulbar xylo-alcohol injection for 14.5 % of eyes and panretinal laser photocoagulation (PRP) for 12.5 % eyes. Antiglaucoma preparations were used in dual therapy for 29 % of eyes, in triple therapy and quadruple therapy for 25 % of eyes each. DISCUSSION: The etiologies are comparable to those described in the literature. The diagnosis was late and treatment limited by adverse economic conditions. CONCLUSION: NVG in Senegalese patients is an affection of men in their sixties. It is responsible for irreversible painful blindness for which treatment is difficult - thus the interest in prevention by strict monitoring and prompt treatment of any retinal ischemia.


Subject(s)
Glaucoma, Neovascular , Adult , Aged , Aged, 80 and over , Comorbidity , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Diabetic Retinopathy/epidemiology , Female , Glaucoma, Neovascular/diagnosis , Glaucoma, Neovascular/epidemiology , Glaucoma, Neovascular/etiology , Glaucoma, Neovascular/therapy , Humans , Male , Middle Aged , Retinal Vein Occlusion/complications , Retinal Vein Occlusion/epidemiology , Retrospective Studies , Senegal/epidemiology , Vitreoretinopathy, Proliferative/epidemiology , Young Adult
5.
J Fr Ophtalmol ; 40(2): 118-121, 2017 Feb.
Article in French | MEDLINE | ID: mdl-28089222

ABSTRACT

INTRODUCTION: The aim of this work is to identify the main weapons causing eye injuries during the campaigns of the Senegalese army in the south of the country, as well as the prognosis of these traumas. PATIENTS AND METHODS: This study is retrospective and concerns soldiers wounded by the weapons of war during the exercise of their mission within the Senegalese armed forces of 1991 in 2005. They are mainly soldiers affected in the south of the country during a war, clashes with the rebels or in Guinea-Bissau during operation Gabou in 1998. And they were evacuated to the ophthalmology department of the Principal Hospital in Dakar, which is a level 3. RESULTS: Thirty-seven military all male, with an average age of 30.5 years. Forty-six eyes including 9 bilateral cases. The trauma agent is a burst of RPG7 shells in 62% of cases, mine explosion in 13.5%, offensive grenade 10.8%, assault rifle 5.7% and flame lance-roquette anti-char (LRAC) accounts for 8%. We noted a phthisis of the globe for 14 eyes (30.43%) and for 15 eyes (32.60%) a functional loss of the affected globe. Inability to fight was decided by 29 wounded soldiers (78.37% of the cases), sedentary employment in 27 cases (72.97%) and 10 cases (27.03%) of reformed soldiers. DISCUSSION: In the conflict in southern Senegal, the RPG7 shell burst causes 62% of eye injuries. This RPG7 shell called "rebel weapon" is frequently used in conflicts in Africa. The prognosis of trauma with these types of weapons is severe. CONCLUSIONS: The combat goggles systematically integrated in the equipment of the Senegalese combatant, would be an invaluable contribution on the prevention of the traumatisms of the eye.


Subject(s)
Eye Injuries/diagnosis , Eye Injuries/etiology , Military Personnel , Warfare , Weapons , Adult , Blast Injuries/diagnosis , Blast Injuries/epidemiology , Blast Injuries/etiology , Eye Foreign Bodies/diagnosis , Eye Foreign Bodies/epidemiology , Eye Foreign Bodies/etiology , Eye Injuries/epidemiology , Eye Injuries, Penetrating/diagnosis , Eye Injuries, Penetrating/epidemiology , Eye Injuries, Penetrating/etiology , Humans , Male , Middle Aged , Military Personnel/statistics & numerical data , Prognosis , Retrospective Studies , Risk Factors , Senegal/epidemiology , Weapons/statistics & numerical data , Young Adult
6.
Int J Endocrinol ; 2015: 163641, 2015.
Article in English | MEDLINE | ID: mdl-26491437

ABSTRACT

Diabetes represents a challenging global health issue in the 21st century. Data from sub-Saharan African populations are scarce and are usually restricted to urban settings. The objective of this study was to compare prevalence and risk factors of diabetes in rural and urban areas in Senegal. Methods. In a community-based survey between January and May 2012, we included 1027 adults aged ≥18 years living in northern Senegal. Sociodemographic, clinical, and biological data were collected during household visits. Multivariate logistic regression was performed to identify factors associated with diabetes. Results. Mean age of participants was 48.0 ± 16.9 years and 65.7% were female. Participants from urban area represented 55.7%. The age-standardized prevalence of diabetes was 7.6% (6.0% in men versus 9.0% in women). Prevalence of diabetes was higher in urban areas (8.1%) compared to rural areas (4.6%). Disease awareness rate was 43%. After multivariate analysis, age (OR = 1.63, p = 0.001), familial history of diabetes (OR = 1.42, p = 0.001), and abdominal obesity (OR = 1.17, p = 0.05) were associated with diabetes. Conclusion. Diabetes is frequent in urban and rural areas in Senegal. Awareness rate is very low among populations. Age, family history of diabetes, and abdominal obesity are the main risk factors identified.

7.
Med Sante Trop ; 25(2): 160-4, 2015.
Article in French | MEDLINE | ID: mdl-26038955

ABSTRACT

INTRODUCTION: High blood pressure (hypertension) is a growing public health problem, and its impact on the overall health of patients in Africa is not well known. The objective of this study was to determine its prevalence and its influence on self-rated health among people living in rural areas of Senegal. POPULATION AND METHODS: This cross-sectional study was conducted over a two-week period in the rural communities of Labgar and Lougré Thiolly, located in the central northern region of Senegal, in an agricultural area. Randomly recruited volunteers were questioned during direct individual interviews about socio-demographic (age, sex, marital status, education, occupation) and lifestyle data (smoking or alcohol, physical activity). Clinical data (medical history, weight, height, blood pressure, course of treatment) were also collected. Self-rated health (SRH) was assessed by asking if they felt their health was bad or good. RESULTS: We included 627 patients with a mean age of 40.93 ± 17.2 years (range: 15-100 years), 59.9% of them women. Illiteracy and overweight were more common among women than among men, and smoking and alcohol consumption more frequent in men. The overall prevalence of hypertension was 23.4% and did not differ significantly between men (24.9%) and women (22.4%)(P = 0.50). Self-rated health was similar in men and women (with respectively 66.9% and 72.9% reporting good health, P = 0.10). On univariate analysis, the factors associated with perceived health status were age (OR = 1.34, P = 0.04), smoking (OR = 2.16, P = 0.03), educational level (OR = 1.21, P = 0.04), and the presence of hypertension (OR = 0.63, P = 0.05). The multivariate regression analysis showed that among women, advanced age (≥50 years) and hypertension (≥140/90 mmHg) were associated with poorer perceived health, whereas for men, only smoking was significantly correlated with poor health status (OR = 0.41, P = 0.01). CONCLUSION: This study shows that hypertension is common in this rural area of Senegal and is significantly associated with a lower self-rated health in women but not men. In the absence of longitudinal studies in these populations and given the predictive value of SRH, this correlation suggests higher morbidity and mortality in women with hypertension.


Subject(s)
Diagnostic Self Evaluation , Hypertension/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Rural Health , Senegal/epidemiology , Young Adult
8.
J Fr Ophtalmol ; 38(3): 238-46, 2015 Mar.
Article in French | MEDLINE | ID: mdl-25748106

ABSTRACT

INTRODUCTION: The purpose of our study was to evaluate in the short and medium term, intraocular pressure results after selective laser trabeculoplasty in black patients with chronic open angle glaucoma or isolated ocular hypertension. MATERIALS AND METHODS: We conducted a retrospective study with a mean 12.5-month follow-up in black patients who underwent SLT. Inclusion criteria were: an open iridocorneal angle greater than or equal to Schaeffer grade 3, data recorded and available on trabecular pigmentation, data on SLT parameters available, and intraocular pressure by Goldmann applanation tonometry recorded.A positive result was defined as a post-laser IntraOcular Pressure (IOP) less than 21 mmHg after 1-month follow-up. The main motivation was the reduction of number of eye drops used. Performed first was a treatment of the inferior 180° (3:00-9:00), possibly supplemented by a second session at 15 days or 1 month if a pressure decrease was noted after the first session. IOP results were evaluated prior to SLT, immediately following SLT and then depending on the drop in pressure. Statistical analysis was performed using the EPI.info 7 software. RESULTS: A total of 69 eyes of 40 patients treated with SLT were identified. The mean IOP prior to SLT was 18.3 mmHg ± 4. Our results showed 90% of patients who positively responded to the treatment (10% failure) with a mean IOP decrease of 2.3 ± 1 mmHg, that is 13%, by the second week. The mean pressure decrease continued to 4.78 ± 1 mmHg for patients (30%) in the group treated for 360°, that is 27% in the same period of time. SLT permitted discontinuation of a prostaglandin in 60% (42 cases). Eyes on triple-drug therapy went from 23 before SLT to 5 following SLT (a 26% decline), eyes on two medications went from 32 to 16 (24% decline). In result association tests, only pigmentation of the angle and visual field stage had a statistically significant probability. DISCUSSION: In our experience, SLT is indicated in black patients to potentiate less effective treatments, to reduce the number of drops in order to limit side effects, but also to avoid or delay monotherapy treatment-naïve, hypertensive eyes. CONCLUSION: In the short and medium term, SLT brought about an IOP decrease in 90% of black patients, and discontinuation of a prostaglandin in 60% of our patients. In addition, the iridocorneal angle in blacks appears to be less pigmented than previously thought, and a protocol systematically treating 360° seems to provide better results.


Subject(s)
Black People , Glaucoma, Open-Angle/surgery , Laser Therapy/methods , Ocular Hypertension/surgery , Adult , Aged , Female , Follow-Up Studies , Glaucoma, Open-Angle/diagnosis , Humans , Intraocular Pressure , Male , Middle Aged , Ocular Hypertension/diagnosis , Reoperation , Retrospective Studies , Senegal
9.
J Fr Ophtalmol ; 38(1): 41-5, 2015 Jan.
Article in French | MEDLINE | ID: mdl-25530349

ABSTRACT

INTRODUCTION: In this work, the authors aim to study clinical and epidemiological characteristics of ocular and orbital primary cancers in sub-Saharan African. PATIENTS AND METHODS: This is a retrospective study over a period of 21 years, from 1984 to 2004, including all cases of ocular cancer, histologically proven after surgery of the globe or the orbit. For each patient, we studied the following parameters: age, sex, reason(s) for consultation, the affected eye, and histological result of the operative specimen. These data were collected by studying the departmental surgical registry, patient medical records and the tumor registry of the anatomicopathology laboratory of a tertiary care hospital in sub-Saharan Africa. RESULTS: We collected data on 111 black patients, among whom 15 cases (13.5%) presented with bilateral involvement, for a total of 126 eyes. The sex ratio was 1.17. Presenting signs showed a predominance of leukocoria (30.2%) followed by proptosis (21.7%) and in third place, protruding conjunctival mass (10.8%). Retinoblastoma was found most frequently, representing 66.6% of the oculo-orbital tumors and 95.45% of the tumors of the globe; followed by epidermoid carcinoma, representing 15.08% of cases. Malignant melanoma was third most common, representing 4.76%, with 83% arising in the anterior uvea and 7% in the choroid. Basal cell carcinoma and rhabdomyosarcoma follow in fourth place. Basal cell carcinoma constituted half (50%) of the eyelid tumors. Rhabdomyosarcoma was the most common orbital tumor in our series (57%). Next were lymphomas with conjunctival localization (2.38%), acute leukemia with orbital localization (1.59%) and rare tumors, palpebral dermatofibrosarcoma (0.79%), an orbital angiosarcoma (0.79%), a glioblastoma of the globe (0.79%) and a malignant solitary fibrous tumor of the orbit (0.79%). CONCLUSION: Ocular and orbital primary cancers in blacks remain tumors of the young, equally distributed between the sexes. Retinoblastoma is the most frequent, followed by epidermoid carcinoma. The globe is the preferential localization of these cancers.


Subject(s)
Black People , Eye Neoplasms/ethnology , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Basal Cell/ethnology , Carcinoma, Squamous Cell/ethnology , Child , Child, Preschool , Conjunctival Neoplasms/ethnology , Eye Neoplasms/pathology , Eyelid Neoplasms/ethnology , Eyelid Neoplasms/pathology , Female , Hematologic Neoplasms/ethnology , Humans , Infant , Infant, Newborn , Male , Melanoma/ethnology , Middle Aged , Neoplasms, Multiple Primary/ethnology , Retinoblastoma/ethnology , Retrospective Studies , Rhabdomyosarcoma/ethnology , Senegal , Young Adult
10.
Sciences de la santé ; 1(2): 63-65, 2015.
Article in English | AIM (Africa) | ID: biblio-1271881

ABSTRACT

Introduction. L'echographie est une modalite d'imagerie medicale non irradiante avec une innocuite parfaite. Ce travail rapporte la premiere experience de formation en echographie a l'UFR des sciences de la sante de Saint-Louis. L'objectif etait de renforcer les connaissances et savoir-faire en echographie de 11 medecins generalistes et 11 sages-femmes. Methode La formation s'est deroulee sur 13 semaines; avec un tronc commun portant sur les connaissances de base; et la pratique de l'echographie gyneco-obstetricale. A la fin du tronc commun; les sages-femmes debutaient les stages et les medecins poursuivaient la formation en echographie abdomino-pelvienne avant leurs stages. Des tests ont precede et cloture la partie theorique qui s'est deroulee sous forme d'exposes illustres d'images et cas pratiques. L'evaluation reposait sur le nombre d'objectifs atteint et l'assiduite. Resultats : 19 apprenants sur 22 ont valide la formation. Entre le pre-test et le Post-test; il y'avait chez les sages-femmes une progression de la moyenne de 66;6 et de 85;7 chez les medecins. L'assiduite etait satisfaisante. Le meilleur score d'objectif atteint chez une sage-femme etait de 100; et le score minimale chez elles etait de 85;5; avec une moyenne de 97;1 et un ecart type de 4;6. Chez les medecins le meilleur score etait de 95; le plus faible etait de 4;8 avec une moyenne de 72 et un ecart type de 3;1.Conclusion : Cette experience enclenche le processus de regionalisation de la formation medicale continue dans les universites senegalaises facilitant l'acces aux agents de sante a la formation medicale continue


Subject(s)
Capacity Building , General Practitioners , Midwifery
11.
J Fr Ophtalmol ; 37(7): 535-9, 2014 Sep.
Article in French | MEDLINE | ID: mdl-24878176

ABSTRACT

PURPOSE: To measure the central corneal thickness (CCT) in Senegalese melanoderms with primary open angle glaucoma (POAG) and to determine its effect on visual impairment, intraocular pressure, optic nerve and perimetric damage. PATIENTS AND METHODS: We studied retrospectively the records of patients followed for POAG between May and July 2012. We recorded CCT measured by ultrasonic pachymetry and results of the first clinical examinations, including best-corrected visual acuity (CVA), intraocular pressure (IOP) by Goldmann tonometry, cup-to-disc ratio (C/D), and visual fields by automated perimetry according to the classification of Hodapp. RESULTS: Two hundred and thirty-four eyes of 117 patients were enrolled. Mean age was 56.53 ± 11.29 years and gender ratio was 2.77. Mean CCT was 525.40 ± 39.63 µm for all eyes, right and left (P=0.734). Women had a mean CCT of 521.20 ± 36.20 µm and men 526.91 ± 40.79 µm (P=0.332). Corneas were thinner in patients over 50 years (P=0.0047), in eyes having a CVA<3/10 (P=0.01) or a C/D ≥ 0.8 (P=0.043). CCT had no correlation with frequency of ocular hypertension (P=0.16) or advanced visual field defect (P=0.33). CONCLUSION: CCT of glaucomatous Senegalese is independent of laterality and sex, but decreased with age. A thin cornea is a risk for visual loss and optic cup enlargement, thus the importance of systematic measurement of CCT.


Subject(s)
Cornea/anatomy & histology , Glaucoma, Open-Angle/complications , Aging , Corneal Pachymetry , Female , Humans , Hyperpigmentation/complications , Male , Middle Aged , Retrospective Studies , Senegal
13.
Saudi J Kidney Dis Transpl ; 24(6): 1203-6, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24231485

ABSTRACT

Encapsulating peritoneal sclerosis (EPS) is a rare but potentially lethal complication of peritoneal dialysis (PD). Peritoneal tuberculosis is considered an etiologic factor. We report a case of EPS in a 40-year-old man who was switched to hemodialysis because of peritoneal tuberculosis after 2 years of PD. Because of the persistence of gastrointestinal symptoms and cachexia, laparoscopic exploration was performed, which revealed an important thickening of the peritoneal membrane sheathing the intestinal loops. Accordingly, a diagnosis of EPS was made. Anti-tuberculosis treatment associated with a low dose of corticosteroids stabilized the disease.


Subject(s)
Peritoneal Dialysis/adverse effects , Peritoneal Fibrosis/etiology , Peritonitis, Tuberculous/complications , Adult , Anti-Inflammatory Agents/administration & dosage , Antitubercular Agents/therapeutic use , Humans , Male , Peritoneal Fibrosis/diagnosis , Peritoneal Fibrosis/drug therapy , Prednisone/administration & dosage
14.
J Fr Ophtalmol ; 36(5): 435-41, 2013 May.
Article in French | MEDLINE | ID: mdl-23357551

ABSTRACT

INTRODUCTION: Mycetomas are pathological processes through which exogenous fungal or actinomycotic etiological agents produce grains. These etiological agents live in the soil and plants of endemic areas. They are introduced traumatically, primarily into the foot. The orbital location is rare. OBSERVATION: We report the case of a 17-year-old student admitted for progressive left proptosis over 2 years, following penetrating trauma by a fork in a rural setting. Examination revealed a heterogenous orbital mass with multiple fistulae, producing pus and black grains, and suggested, due to the color of the grains, a diagnosis of fungal mycetoma. MRI revealed a destructive process at the level of the lamina papracea of the ethmoid and the orbital floor. Anatomopathological examination confirmed the fungal nature of the infection, while culture in Sabouraud's medium was inconclusive. The outcome was favorable after exenteration and debridementof the ipsilateral maxillary sinus and nasal cavities, along with 4 months of ketoconazole. No recurrence has been observed for 14 months after surgery. DISCUSSION: Mycetomas are endemic to northwest Africa. Most frequently located in the foot, they are seldom seen in the orbit. The color of the grains provides a clue as to the etiology. Black-grain mycetomas are always fungal and are treated surgically--essentially like cancer--as the persistence of a single grain will cause a recurrence. CONCLUSION: The orbital location of a mycetoma is rare. In the present case report, the concept of port of entry, the clinical appearance, and the color of the grains guided the diagnosis. The histological examination of the surgical specimen confirmed the diagnosis.


Subject(s)
Eye Infections, Fungal/diagnosis , Mycetoma/diagnosis , Orbital Diseases/diagnosis , Adolescent , Antifungal Agents/therapeutic use , Exophthalmos/diagnosis , Exophthalmos/drug therapy , Exophthalmos/etiology , Exophthalmos/surgery , Eye Enucleation , Eye Infections, Fungal/complications , Eye Infections, Fungal/drug therapy , Eye Infections, Fungal/surgery , Humans , Ketoconazole/therapeutic use , Male , Mycetoma/complications , Mycetoma/drug therapy , Mycetoma/surgery , Orbital Diseases/complications , Orbital Diseases/drug therapy , Orbital Diseases/surgery
15.
Indian J Nephrol ; 21(3): 201-3, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21886983

ABSTRACT

Schistosomiasis is the second most devastating tropical parasitic disease worldwide and is responsible for many urological complications. However, glomerular injury is a rare complication mainly described with Schistosoma mansoni. We report a case of membranoproliferative glomerulonephritis (MPGN) associated with Schistosoma hematobium infection in a young Senegalese boy living in a rural area. Clinical presentation was with steroid-resistant with nephrotic syndrome. Renal biopsy showed type 1 MPGN with the presence of S. hematobium eggs surrounded by a gigantocellular granuloma. Despite therapy with antihelminthic and immunosuppressive drugs, evolution was characterized by progression to end-stage renal disease over 1 year. More efforts should be made on the prevention and early detection of schistosomiasis among at-risk populations.

16.
Med Trop (Mars) ; 71(5): 468-71, 2011 Oct.
Article in French | MEDLINE | ID: mdl-22235619

ABSTRACT

INTRODUCTION: Chronic kidney disease is now regarded as amajor public health concern. This is especially true in developing countries where it accounts for significant morbidity, mortality and decreased life expectancy. The main problem for developing countries is the cost of dialysis. Indeed, the availability of peritoneal dialysis for renal replacement therapy is low in sub-Saharan Africa. Since March 2004 peritoneal dialysis has been available to some patients with end-stage renal disease in Senegal. The purpose of this study was to assess epidemiologic, clinical, technical patterns and outcomes in patients who underwent peritoneal dialysis in the first three years of the program. MATERIALS AND METHODS: This three-year retropective study identified 26 patients who underwent peritoneal dialysis for end-stage renal disease for a period of at least 15 days. Patients not meeting these criteria were not included. All patients had a Baxter type transfer set. Lactate-bicarbonate solution was used for countinuous ambulatory peritoneal dialysis. In 3 cases, Icodextrin- and amino-acid based-solutions were employed. In automated peritoneal dialysis, the Home Choice machine was used for all patients. Epidemiological, clinical/paraclinical data and outcomes were noted for each patient. RESULTS: Twenty-six patients were included in the study. Median age was 48 +/- 6 years with a M/F sex ratio of 1.17. Most patients (84%) were literate. Diabetic nephropathy and nephroangiosclerosis were the main causes of end-stage renal disease. The mean Charlson score was 3 (range, 2 to 5). Mean residual diuresis was 435 mL/day. The peritonitis rate was 1 per 20 patient months. Staphylococcus aureus and Pseudomonas aeruginosa were the most common germs. Six patients presented catheter infection: exit-site in 4 and tunnel in 2. Catheter obstruction occurred in three cases. At the end of the study, 6 patients were still in automated peritoneal dialysis and 8 in countinuous ambulatory peritoneal dialysis. Six 6 patients died and 6 were switched to hemodialysis. CONCLUSION: Peritoneal dialysis is available as a renal replacement therapy in Senegal. It has allowed end-stage renal disease patients greater autonomy in their working place.


Subject(s)
Kidney Failure, Chronic/therapy , Peritoneal Dialysis , Catheter-Related Infections/microbiology , Developing Countries , Female , Humans , Kidney Failure, Chronic/etiology , Male , Middle Aged , Peritonitis/microbiology , Retrospective Studies , Senegal
17.
Indian J Nephrol ; 19(3): 122-4, 2009 Jul.
Article in English | MEDLINE | ID: mdl-20436734

ABSTRACT

A 42-year-old black African patient was admitted in the emergency department with severe headache, dizziness, and visual problems. He had been treated for hypertension diagnosed eight months ago after a similar episode. He was taking atenolol 100 mg /day, amlodipine 10 mg/day, and a combination of lisinopril 20 mg/hydrochlorothiazide 12.5 mg daily but experienced several hypertension peaks and hypotension. He adhered to treatment and was neither using traditional herbal medication nor illicit drugs. He did not smoke, but used to drink 1-2 glasses of wine after dinner. At admission, his blood pressure was 235/145 mm of Hg. His body mass index was 25.5 kg/m(2) and the waist/hip ratio was 0.9. Physical examination was unremarkable. Fundoscopic examination revealed hypertensive retinopathy. Biochemical and imaging explorations were compatible with diagnosis of pseudopheochromocytoma. Evolution was favourable after treatment with alpha-1 and beta-blokers.

18.
Dakar Med ; 53(2): 127-30, 2008.
Article in French | MEDLINE | ID: mdl-19634547

ABSTRACT

INTRODUCTION: Auto-immune cholangitis appears by a table of cholestatic jaundice without anomalies of the hepatic bile ducts. It is a primitive biliary cirrhosis without antimitochondrial antibodies. This disease is reported at adult women in 90 % of cases. We report a 59 years old man case. OBSERVATION: The patient was admitted for a diffuse melanodermy, a physical asthenia and a slimming which preceded 4 months by a pruritus with cholestatic jaundice. Biology showed a normal rate of transaminase. Alkaline phosphatases and direct bilirubine were high. Hepatitis (B and C) and HIV serologies were negative. Abdominal ultrasound showed a homogeneous liver. There were no dilations of the bile ducts. Antimitochondrial antibodies were negative and the histological examination confirms diagnosis. CONCLUSION: Progress was good with ursodesoxycholic acid even if interval is short (5 months of evolution).


Subject(s)
Autoimmune Diseases/diagnosis , Cholangitis/diagnosis , Cholangitis/immunology , Alkaline Phosphatase/analysis , Autoimmune Diseases/drug therapy , Bilirubin/analysis , Cholagogues and Choleretics/therapeutic use , Cholangitis/drug therapy , Humans , Male , Middle Aged , Ursodeoxycholic Acid/therapeutic use
19.
Dakar Med ; 52(3): 175-9, 2007.
Article in French | MEDLINE | ID: mdl-19097398

ABSTRACT

INTRODUCTION: Pulmonary hypertension (PH) is a complication of autoimmune diseases which worsen the prognosis. In Senegal, a few cases of PH have been previously reported in patients with systemic sclerosis. CASE REPORTS: We report two cases of patients with PH that revealed autoimmune diseases (Sharp' syndrome and Sjögren syndrome). Epidemiological, clinical, evolutive and laboratory data were analyzed. Evolution of disease was favourable for one patient and fatal for the other. CONCLUSION: These two cases show necessity of early diagnosis of systemic diseases in our countries. PH should be screened in each patient with autoimmune disease before installation of irreversible pulmonary arterial lesions that respond to treatment. New therapy used in idiopathic PH are not yet accessible for our patients.


Subject(s)
Hypertension, Pulmonary/etiology , Mixed Connective Tissue Disease/diagnosis , Sjogren's Syndrome/diagnosis , Adult , Female , Humans , Middle Aged , Mixed Connective Tissue Disease/complications , Sjogren's Syndrome/complications
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