Introduction: Type 1 diabetes can have acute complications, sometimes requiring hospitalization. The aim of this study was to describe the epidemiological, clinical and evolutionary aspects of type 1 diabetes in patie...Introduction: Type 1 diabetes can have acute complications, sometimes requiring hospitalization. The aim of this study was to describe the epidemiological, clinical and evolutionary aspects of type 1 diabetes in patients at the Abass Ndao National Hospital in Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from January 01, 2010 to December 31, 2021. It focused on hospitalized type 1 diabetic patients. Epidemiological, clinical and evolutionary data were evaluated. Results: Six hundred and fifty-nine (659) patients were enrolled, representing a frequency of 11.5%. The mean age was 29.47 years, giving a sex ratio (m/f) of 0.95. Average hospital stay was 6.1 days. One hundred and forty-four (144) patients (21.8%) had inaugural diabetes. The average consultation time was 14.89 days. Acute metabolic complications were ketoacidosis in 353 patients (56%), and hypoglycemia in 1.2%. Simple hyperglycemia was noted in 113 patients (18.0%). Infection was present in 522 patients (58.3%), of whom 95 (28.2%) had a skin infection.55 patients (16.3%) had a respiratory infection. 12.3% had a dietary imbalance.176 cases (27.7%) had no imbalance.26 patients (3.9%) died, with infectious pathologies accounting for the majority of decompensation factors among the deceased (57.7%). Conclusion: Type 1 diabetes is a cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.展开更多
Introduction: Macroangiopathy plays an important role, with a high prevalence of morbidity and mortality in diabetic patients. The aim was to study the epidemiological, clinical, paraclinical, therapeutic and evolutio...Introduction: Macroangiopathy plays an important role, with a high prevalence of morbidity and mortality in diabetic patients. The aim was to study the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of macroangiopathy in diabetic patients in the internal medicine department of the Abass Ndao hospital. Patients and methods: This was a descriptive and analytical cross-sectional study. Our investigations were recruited over a 7-year period (January 1, 2016 to December 31, 2022). Results: Three hundred and fifty-nine (359) patients (10.22%) were enrolled. The mean age was 62.83 years, with extremes ranging from 17 to 98 years. The [60 - 69] age group was more representative (37.32%). Women accounted for 180 cases (50.1%), with a sex ratio (m/f) of 0.99. The average duration of diabetes was 11.86 years. Average consultation time was 38.07 days, with extremes ranging from 1 to 368 days. Average hospital stay was 7.65 days. Inaugural diabetes was noted in 12 cases (3.34%). Type 2 diabetes accounted for 95.82% (n = 344) of patients. Hypertension was present in 150 patients (41.8%). Patients with 2 risk factors accounted for 173 cases (48.18%). Nineteen patients had already had a stroke (5.29% of cases). Fourteen (14) patients (4.2%) were amputees. Obliterative arteriopathy of the lower limbs (AOMI) was noted in 193 patients (54%). Stroke was noted in 101 patients (28%). Ischemic heart disease (IHD) was noted in 38 patients (11%). AOMI was more common in males (110 patients, 57%) than in females (43%). Seventy-three (73) patients (20.3%) died. Predictors of death were age over 60 and the existence of more than two cardiovascular risk factors. Conclusion: Diabetic macroangiopathy is a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.展开更多
Introduction: in adults, adenomas are the most frequent causes of pituitary tumours. The objective was to characterize its epidemiological and clinical aspects, as well as its therapeutic modalities in Senegal. Method...Introduction: in adults, adenomas are the most frequent causes of pituitary tumours. The objective was to characterize its epidemiological and clinical aspects, as well as its therapeutic modalities in Senegal. Methodology: this was a multicenter, retrospective, descriptive and analytical study carried out from the Senegalese register of pituitary adenomas (2008-2022). Results: 242 patients were collected with an average age of 42.4 ± 13 years and a sex ratio (M/F) of 0.91. The mean consultation time was 19.7 ± 23 months. The circumstances of discovery were pituitary apoplexy (11 cases, 4.54%), tumor syndrome (176 cases, 72.72%), gonadal manifestations (103 cases, 42.56%), dysmorphic syndrome (21 cases, 8.68%), hypercorticism (15 cases, 6.19%). Morphologically, it was a macroadenoma (197 cases, 81.40%), an extensive adenoma (22 cases, 9.10%). The hormonal profile was lactotropic hypersecretion (80 cases, 33.05%), somatotropic (13 cases, 5.39%), corticotropic (14 cases, 5.78%), mixed (9 cases, 3.71%). The factors significantly associated with prolactinoma were young age (p = 0.000), female sex (p = 0.000), long consultation delay (p = 0.000) and microadenoma (p = 0.001). Only arterial hypertension was associated with acromegaly (p = 0.000). We found a significant correlation between Cushing’s disease and microadenomas (p = 0.000). Non-secreting adenomas were significantly associated with advanced age (p = 0.000), long delay in consultation (p = 0.000), male gender (p = 0.000), tumor syndrome (p = 0.001) and macroadenomas (p = 0.000). Pituitary surgery was effective in 173 patients (71.49%) including 166 cases (68.59%) by transphenoidal approach. Postoperative incidents were transient diabetes insipidus in 82 cases (47.39%), cerebrospinal fluid leak (20 cases, 11.56%). Death was observed in 18 patients in the entire series (7.44%). The latter had a tumor syndrome (88.88%), a macroadenoma (83.33%) and had undergone pituitary surgery (72.22%). Conclusion: pituitary pathology has become a reality with clinical and secretory polymorphism. The diagnostic delay explains the predominance of macroadenomas which are sources of pre and post-operative complications.展开更多
Introduction: SARS-COV2 infection is a major public health problem and diabetes mellitus is a serious factor. The objective was to determine the characteristics of COVID-19 in diabetics at the Epidemic Treatment Cente...Introduction: SARS-COV2 infection is a major public health problem and diabetes mellitus is a serious factor. The objective was to determine the characteristics of COVID-19 in diabetics at the Epidemic Treatment Center (ETC) of the Abass Ndao Hospital Center. Observation: This was a retrospective, descriptive and analytical study carried out at Abass Ndao Hospital from March 01, 2021 to September 31, 2021. We evaluated the epidemiological, clinical and evolutionary characteristics. Results: Among 333 patients infected with COVID-19, 203 were diabetic (60.96%). The sex ratio was 0.70 and the mean age 60.18 years. Diabetes was type 2 (84.2%) and inaugural (15.8%). Arterial hypertension was the main comorbidity (86.96% of cases). The RT-PCR test was positive in 86.21% of cases. The main clinical signs were: asthenia (90.14%), dyspnea (78.81%), cough (52.21%) and body aches (52.21%). Oxygen saturation was alanced in 71.43% with an average blood sugar of 2.02 ± 4 g/l. At the paraclinical, the D dimer was ≥1000 ng/l (71.52%) and the C-reactive protein ≥100 mg/l (32.01%). Chest CT scan found mild to moderate (55.17%), severe (21.67%) and critical (17.24%) lung lesions. Pulmonary embolism was found in 4 diabetics. The treatment of diabetes was represented by insulin therapy (85.82%) and oral antidiabetics (24.11%). Anti-COVID-19 treatment was dominated by azithromycin (89.11%), corticosteroid therapy (92.11%), anticoagulants (99%), hydroxychloroquine (21.29%). Mortality was found in 14.36% (n = 29) and significantly correlated with age ≥ 60 years (OR = 3.013 [1.266 - 7.173], P = 0.005), short duration of hospitalization (OR = 3.154 [1.149 - 8.663], P = 0.009), C-reactive protein > 100 mg/l (OR = 6.370 [2.704 - 15.006], P < 0.001), lung saturation < 90% (OR = 6.331 [2.633 - 15.222], P [3.367 - 18.322], P Conclusion: Diabetes is one of the most important comorbidities linked to the severity of SARS-CoV-2 infection. The seriousness factors in this field remain age ≥ 60 years, lung damage ≥ 50%, CRP ≥ 100 mg/l, and oxygen saturation at 90%.展开更多
<strong>Background:</strong> In Graves’s disease, there is a lack of description specific to the gender and age among sub-Saharan African subject. The objective was to evaluate the impact of gender and ag...<strong>Background:</strong> In Graves’s disease, there is a lack of description specific to the gender and age among sub-Saharan African subject. The objective was to evaluate the impact of gender and age on the profile of Graves’ disease in Senegalese subject in order to understand the evolution and improve the therapeutic choices. <strong>Methods:</strong> This is a retrospective study conducted from January 1, 2010 to December 31, 2017 (07 years) at Abass Ndao University Hospital (Senegal), focused on patients with Graves’ disease followed up under antithyroid drugs treatment for at least 18 months. <strong>Results:</strong> There were 244 men, 404 subjects between [0 - 25 years], and 101 subjects more than 50 years old. Factors associated with goitre size were male gender (p < 0.001), young age (p < 0.001). Graves orbitopathy was correlated with male gender (p = 0.015), and young age (p < 0.001). Among 580 patients who had stopped medical treatment after more than 18 months of follow-up, relapse involved in 30.3%. Durable remission was achieved in 38.8% of all included patients and 69.7% of subjects who had a cessation of medical treatment. The factors associated with sustained remission were female gender (p = 0.049), absence of orbitopathy (p = 0.011), small goiter (p < 0.001), advanced age (p = 0.006) and early start of the maintenance treatment (p = 0.006). <strong>Conclusion:</strong> In our Senegalese study, men and young patients are particularized by a trend of voluminous goitre and low rate of remission. These data remain a basis for predicting the outcome of medical treatment and make timely use of radical treatments such as surgery or irratherapy in the presence of risk factors for recurrence.展开更多
<strong>Introduction:</strong> Aging is associated with an anatomical and functional heterogeneity of the thyroid which varies according to the iodized status. The aim was to describe the clinical, etiolog...<strong>Introduction:</strong> Aging is associated with an anatomical and functional heterogeneity of the thyroid which varies according to the iodized status. The aim was to describe the clinical, etiology and therapeutic profile of dysthyroidism in elderly subjects in the internal medicine at the Abass Ndao University Hospital. <strong>Patients and methods:</strong> This was a retrospective, descriptive and analytical study, including all subjects aged 60 and over followed from January 1, 2010 to December 31, 2019 (10 years) for thyroid disease. <strong>Results:</strong> 371 Patients were collected with a prevalence of 3.8%. The sex ratio was 0.15 and the mean age was 65.3 years. The circumstances of discovery of the disease were a grade 2 - 3 goiter (62.5%), exophthalmos (24.5%), thyrotoxicosis (56.6%), a symptom of low metabolism (5.4%), a cervical compression (10.8% including 8% of dysphasia), and a cardiothyreosis (9.4%). It was hyperthyroidism (65.2%), and hypothyroidism (7.2%). The main etiologies were toxic multinodular goiter (33.2%), Graves’s disease (29.6%), euthyroidism nodular goiter (26.8%), toxic adenoma (2.4%), and Hashimoto’s thyroiditis (6.7%). The compressive manifestations were exclusive of nodular goiter. Among the 35 cases of cardiothyreosis, there was a rhythm and conduction disorder in 25 cases (6.7%) and the underlying thyreopathy was a toxic nodular goiter in 57.1%. Thyroidectomy involved 44.7% of patients, including 32.6% of Graves’ disease, 48.3% of toxic nodular goiter, and 61.8% of nodular goiter in euthyroidism. We found 02 cases of papillary carcinomas on multinodular goiter. <strong>Conclusion:</strong> In our hospital series, there is variability in the clinical manifestations of dysthyroidism in the elderly. Complications, mainly cardiac and compressive, remain a major reason for consultation. Toxic nodular goiter is preponderant and its management, especially radical, must be multidisciplinary and according to the profile.展开更多
Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective stud...Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective study in a descriptive and analytic view or way. It happened within 6 months. Diabetic patients who performed the nycthemeral urinary albumin dose and mentioned in the file were included. The last study is considered as a positive one from 30 to 299mg/24h: Microalbuminuria. The creatinine has been noted and the clearing of the creatinine is calculated through the formula of Cockcroft and Gault. The statistical analysis of data has been done thanks to software such as excel 2013 and SPSS VER 18.0. Results: 221 patients have been noted with 70% women and 30% men. The age varied between 30 years and 85 years with an average of 56, 62 against 9.97 years. Sixty three (63) patients have microalbuminuria (29%);creatinine has been regularized to 25 patients with 14.8% of cases. Among the microalbuminuria patients having completed the creatinine, 32 patients (42.7%) and 16 (21.3%) are respectively in a state of chronical renal failure, light and moderated. Conclusion: The microalbuminuria is frequent to diabetics. But in our series a starting renal insufficiency could precede that microalbuminuria.展开更多
Introduction: Metabolic and vascular emergencies constitute a risk of lethality in diabetic subjects admitted to hospital. The objective was to evaluate the factors associated with death in subjects admitted for a dia...Introduction: Metabolic and vascular emergencies constitute a risk of lethality in diabetic subjects admitted to hospital. The objective was to evaluate the factors associated with death in subjects admitted for a diabetological emergency to improve management. Materials and Methods: It was a 12-month retrospective, descriptive and analytical study at Dakar’s Marc Sankale Diabetes Center. The study concerned any type of diabetics subjects admitted for a diabetological emergency. We evaluated the profile of diabetes, the pathologies found and factors associated with death. Results: We identified 697 cases of diabetic emergencies with a prevalence of 13.8%. The sex ratio (M/F) was 0.82, the mean age was 49.6 years, and the mean duration of diabetes was 7.1 years. The metabolic profile was hypoglycemia (11.3%), ketoacidosis (34.6%), and hyperosmolar hyperglycemia syndrome (5%). The associated pathologies were vascular (51.1%), infectious (65.3%), kidney function impairment (7.6%), anaemia (13.8%). During the follow-up, 94 patients died, as an annual frequency of 13.5% among diabetological emergencies. In univariate analysis, the factors significantly associated with death were age > 60 years [OR = 4.09 (2.6 - 6.41)], hyperglycemia [OR = 2.58 (1.50 - 4.4)], hyperosmolar hyperglycemia syndrome [OR = 10.5 (5.19 - 21.5)], septic diabetic foot [OR = 3.57 (2.24 - 5.66)]. Vascular pathologies that significantly associated with death were stroke [OR = 4.06 (2.10 - 7.81)], lower limb arteriopathy [OR = 3.25 (1.84 - 5.73)], cardiovascular collapse [OR = 6.85 (2.34 - 20)]. In addition to diabetes, the deceased patients had one (18%), two (34%) and at least three (45.7%) known factors of poor prognosis. Conclusion: Emergencies in diabetology remain frequent in our practice. The comorbidity (vascular and infectious) constitutes a risk of abnormally high death rate. A particular attention must concern on old diabetics subjects with several pathologies.展开更多
Aim: To evaluate the attitude practice and knowledge of pharmacists in the management of diabetes in the department of Dakar. Methodology: Cross-sectional study, conducted from 01 March to 30 September 2017 including ...Aim: To evaluate the attitude practice and knowledge of pharmacists in the management of diabetes in the department of Dakar. Methodology: Cross-sectional study, conducted from 01 March to 30 September 2017 including all pharmacists in the Dakar region who agreed to participate in the survey. Data was collected through a pre-established questionnaire. Results: A total of 144 pharmacists were included in the study, representing a participation rate of 87.58%. The average age was 33.90 years, with a sex ratio of 1.69. Pharmacists were single in 50.88% of cases, and a minimum experience of 5 years was found in 64.03% of cases. Pharmacist assistants accounted for 57.9% of our study population. The assessment of knowledge based on 16 items shows an average score of 9.02. The level of knowledge was low to insufficient in 37.21% of cases, average in (50%) half of cases and good for (13.16%). Less than half (34.21%) of pharmacists had received training and the average date of last training was 33.76 ± 24.6 months. Training was provided by medical representatives and academics in 66.66% and 26.67% respectively. The most felt positive feelings were respectively the need for help, the compassion in respectively 98.42%, 42.11%. Feelings felt and simultaneously cited were: need for help and compassion in more than 40% of respondents. Only 29% of pharmacists did not have a lot of difficulty with patient questions and the only reason was the lack of awareness (84.68%) of patients about their disease. Screening for diabetes by capillary blood glucose was performed by 57% of pharmacists. Dietary advice (76.15%) and referral to the hospital (94.41%) were the most common practices in case of blood sugar disruption. The dialogue with patients was impossible in 22.81% of pharmacists and the main reasons given were lack of time (53.85%) and lack of knowledge (34.62%). The method of delivery of insulin was done on: medical prescription (98.25%), presentation of the box (69.30%), on request of the patient (54.39%). Only one pharmacist recognized advising insulin (0.88%). The delivery of oral antidiabetic agents was: on medical prescription (96.49%), presentation of the box (67.54%), at the request of the patient (52.63%). The good level of knowledge was more found in the subjects after 40 years (p = 0.69), the female sex (p = 0.84), the assistants and holders (p = 0.24), after 5 years of professional experience (p = 0.13). Conclusion: Despite the lack of knowledge of pharmacists, attitudes and practices are considered satisfactory in the management of diabetics. Continuing medical education sessions could strengthen knowledge and consolidate the attitudes and practices of community pharmacists.展开更多
Introduction: The objective of that study was to evaluate diabetics knowledge, attitudes and practices on physical activity. Patients and Methods: That study has concerned 200 diabetics at Marc Sankale antidiabetic Ce...Introduction: The objective of that study was to evaluate diabetics knowledge, attitudes and practices on physical activity. Patients and Methods: That study has concerned 200 diabetics at Marc Sankale antidiabetic Center of Abass Ndao Hospital in Dakar. Women represent 76% with a sex ratio M: F0.13. The average age is 54 years with extremes of 4 to 84 years. The housewives are 29% and among them 15% haven’t any professional activity. 45.07% of the population is illiterate. In our study, 63.13% of patients have low socio economic level. In our series, the majority of patients is type 2 diabetes (89.5%). The diabetes evolution time is about 8 years inferior to 7% in 84 patients. In our study obesity is noted in 17.20% of cases. The HTA is present in 56% of cases. 54% of the studied population presents a dyslipidemia. Physical activity is practiced in 81% of patients. In our study the doctor’ advice motivates the half of our patients to practice physical activity (62.26%). The lack of time (43.2%) and volution (8.1%), the useless character of physical activity (2.7%) and the patients’ health state 45.9% are the obstacles to the practice of physical activity. The average frequency of physical activity practiced by patients is about 4 times a week with extremes ranging from 1 to 7 stages a week. The average time of activity practiced by patients is 39.72% with extremes ranging from 10 to 150 mn. 87% of patients practice physical activity at least 3 times a week. The main risks noted from intense physical activity in diabetics are hypertension 39.0%, ortestic hypertension 3.0%. In the contrary 58.8% of patients ignore the answer. Conclusion: Our study demonstrates the ignorance of diabetics on physical activity. Therefore it would be necessary to reinforce the training mainly therapeutic education in the patients taken into account.展开更多
文摘Introduction: Type 1 diabetes can have acute complications, sometimes requiring hospitalization. The aim of this study was to describe the epidemiological, clinical and evolutionary aspects of type 1 diabetes in patients at the Abass Ndao National Hospital in Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from January 01, 2010 to December 31, 2021. It focused on hospitalized type 1 diabetic patients. Epidemiological, clinical and evolutionary data were evaluated. Results: Six hundred and fifty-nine (659) patients were enrolled, representing a frequency of 11.5%. The mean age was 29.47 years, giving a sex ratio (m/f) of 0.95. Average hospital stay was 6.1 days. One hundred and forty-four (144) patients (21.8%) had inaugural diabetes. The average consultation time was 14.89 days. Acute metabolic complications were ketoacidosis in 353 patients (56%), and hypoglycemia in 1.2%. Simple hyperglycemia was noted in 113 patients (18.0%). Infection was present in 522 patients (58.3%), of whom 95 (28.2%) had a skin infection.55 patients (16.3%) had a respiratory infection. 12.3% had a dietary imbalance.176 cases (27.7%) had no imbalance.26 patients (3.9%) died, with infectious pathologies accounting for the majority of decompensation factors among the deceased (57.7%). Conclusion: Type 1 diabetes is a cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.
文摘Introduction: Macroangiopathy plays an important role, with a high prevalence of morbidity and mortality in diabetic patients. The aim was to study the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of macroangiopathy in diabetic patients in the internal medicine department of the Abass Ndao hospital. Patients and methods: This was a descriptive and analytical cross-sectional study. Our investigations were recruited over a 7-year period (January 1, 2016 to December 31, 2022). Results: Three hundred and fifty-nine (359) patients (10.22%) were enrolled. The mean age was 62.83 years, with extremes ranging from 17 to 98 years. The [60 - 69] age group was more representative (37.32%). Women accounted for 180 cases (50.1%), with a sex ratio (m/f) of 0.99. The average duration of diabetes was 11.86 years. Average consultation time was 38.07 days, with extremes ranging from 1 to 368 days. Average hospital stay was 7.65 days. Inaugural diabetes was noted in 12 cases (3.34%). Type 2 diabetes accounted for 95.82% (n = 344) of patients. Hypertension was present in 150 patients (41.8%). Patients with 2 risk factors accounted for 173 cases (48.18%). Nineteen patients had already had a stroke (5.29% of cases). Fourteen (14) patients (4.2%) were amputees. Obliterative arteriopathy of the lower limbs (AOMI) was noted in 193 patients (54%). Stroke was noted in 101 patients (28%). Ischemic heart disease (IHD) was noted in 38 patients (11%). AOMI was more common in males (110 patients, 57%) than in females (43%). Seventy-three (73) patients (20.3%) died. Predictors of death were age over 60 and the existence of more than two cardiovascular risk factors. Conclusion: Diabetic macroangiopathy is a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.
文摘Introduction: in adults, adenomas are the most frequent causes of pituitary tumours. The objective was to characterize its epidemiological and clinical aspects, as well as its therapeutic modalities in Senegal. Methodology: this was a multicenter, retrospective, descriptive and analytical study carried out from the Senegalese register of pituitary adenomas (2008-2022). Results: 242 patients were collected with an average age of 42.4 ± 13 years and a sex ratio (M/F) of 0.91. The mean consultation time was 19.7 ± 23 months. The circumstances of discovery were pituitary apoplexy (11 cases, 4.54%), tumor syndrome (176 cases, 72.72%), gonadal manifestations (103 cases, 42.56%), dysmorphic syndrome (21 cases, 8.68%), hypercorticism (15 cases, 6.19%). Morphologically, it was a macroadenoma (197 cases, 81.40%), an extensive adenoma (22 cases, 9.10%). The hormonal profile was lactotropic hypersecretion (80 cases, 33.05%), somatotropic (13 cases, 5.39%), corticotropic (14 cases, 5.78%), mixed (9 cases, 3.71%). The factors significantly associated with prolactinoma were young age (p = 0.000), female sex (p = 0.000), long consultation delay (p = 0.000) and microadenoma (p = 0.001). Only arterial hypertension was associated with acromegaly (p = 0.000). We found a significant correlation between Cushing’s disease and microadenomas (p = 0.000). Non-secreting adenomas were significantly associated with advanced age (p = 0.000), long delay in consultation (p = 0.000), male gender (p = 0.000), tumor syndrome (p = 0.001) and macroadenomas (p = 0.000). Pituitary surgery was effective in 173 patients (71.49%) including 166 cases (68.59%) by transphenoidal approach. Postoperative incidents were transient diabetes insipidus in 82 cases (47.39%), cerebrospinal fluid leak (20 cases, 11.56%). Death was observed in 18 patients in the entire series (7.44%). The latter had a tumor syndrome (88.88%), a macroadenoma (83.33%) and had undergone pituitary surgery (72.22%). Conclusion: pituitary pathology has become a reality with clinical and secretory polymorphism. The diagnostic delay explains the predominance of macroadenomas which are sources of pre and post-operative complications.
文摘Introduction: SARS-COV2 infection is a major public health problem and diabetes mellitus is a serious factor. The objective was to determine the characteristics of COVID-19 in diabetics at the Epidemic Treatment Center (ETC) of the Abass Ndao Hospital Center. Observation: This was a retrospective, descriptive and analytical study carried out at Abass Ndao Hospital from March 01, 2021 to September 31, 2021. We evaluated the epidemiological, clinical and evolutionary characteristics. Results: Among 333 patients infected with COVID-19, 203 were diabetic (60.96%). The sex ratio was 0.70 and the mean age 60.18 years. Diabetes was type 2 (84.2%) and inaugural (15.8%). Arterial hypertension was the main comorbidity (86.96% of cases). The RT-PCR test was positive in 86.21% of cases. The main clinical signs were: asthenia (90.14%), dyspnea (78.81%), cough (52.21%) and body aches (52.21%). Oxygen saturation was alanced in 71.43% with an average blood sugar of 2.02 ± 4 g/l. At the paraclinical, the D dimer was ≥1000 ng/l (71.52%) and the C-reactive protein ≥100 mg/l (32.01%). Chest CT scan found mild to moderate (55.17%), severe (21.67%) and critical (17.24%) lung lesions. Pulmonary embolism was found in 4 diabetics. The treatment of diabetes was represented by insulin therapy (85.82%) and oral antidiabetics (24.11%). Anti-COVID-19 treatment was dominated by azithromycin (89.11%), corticosteroid therapy (92.11%), anticoagulants (99%), hydroxychloroquine (21.29%). Mortality was found in 14.36% (n = 29) and significantly correlated with age ≥ 60 years (OR = 3.013 [1.266 - 7.173], P = 0.005), short duration of hospitalization (OR = 3.154 [1.149 - 8.663], P = 0.009), C-reactive protein > 100 mg/l (OR = 6.370 [2.704 - 15.006], P < 0.001), lung saturation < 90% (OR = 6.331 [2.633 - 15.222], P [3.367 - 18.322], P Conclusion: Diabetes is one of the most important comorbidities linked to the severity of SARS-CoV-2 infection. The seriousness factors in this field remain age ≥ 60 years, lung damage ≥ 50%, CRP ≥ 100 mg/l, and oxygen saturation at 90%.
文摘<strong>Background:</strong> In Graves’s disease, there is a lack of description specific to the gender and age among sub-Saharan African subject. The objective was to evaluate the impact of gender and age on the profile of Graves’ disease in Senegalese subject in order to understand the evolution and improve the therapeutic choices. <strong>Methods:</strong> This is a retrospective study conducted from January 1, 2010 to December 31, 2017 (07 years) at Abass Ndao University Hospital (Senegal), focused on patients with Graves’ disease followed up under antithyroid drugs treatment for at least 18 months. <strong>Results:</strong> There were 244 men, 404 subjects between [0 - 25 years], and 101 subjects more than 50 years old. Factors associated with goitre size were male gender (p < 0.001), young age (p < 0.001). Graves orbitopathy was correlated with male gender (p = 0.015), and young age (p < 0.001). Among 580 patients who had stopped medical treatment after more than 18 months of follow-up, relapse involved in 30.3%. Durable remission was achieved in 38.8% of all included patients and 69.7% of subjects who had a cessation of medical treatment. The factors associated with sustained remission were female gender (p = 0.049), absence of orbitopathy (p = 0.011), small goiter (p < 0.001), advanced age (p = 0.006) and early start of the maintenance treatment (p = 0.006). <strong>Conclusion:</strong> In our Senegalese study, men and young patients are particularized by a trend of voluminous goitre and low rate of remission. These data remain a basis for predicting the outcome of medical treatment and make timely use of radical treatments such as surgery or irratherapy in the presence of risk factors for recurrence.
文摘<strong>Introduction:</strong> Aging is associated with an anatomical and functional heterogeneity of the thyroid which varies according to the iodized status. The aim was to describe the clinical, etiology and therapeutic profile of dysthyroidism in elderly subjects in the internal medicine at the Abass Ndao University Hospital. <strong>Patients and methods:</strong> This was a retrospective, descriptive and analytical study, including all subjects aged 60 and over followed from January 1, 2010 to December 31, 2019 (10 years) for thyroid disease. <strong>Results:</strong> 371 Patients were collected with a prevalence of 3.8%. The sex ratio was 0.15 and the mean age was 65.3 years. The circumstances of discovery of the disease were a grade 2 - 3 goiter (62.5%), exophthalmos (24.5%), thyrotoxicosis (56.6%), a symptom of low metabolism (5.4%), a cervical compression (10.8% including 8% of dysphasia), and a cardiothyreosis (9.4%). It was hyperthyroidism (65.2%), and hypothyroidism (7.2%). The main etiologies were toxic multinodular goiter (33.2%), Graves’s disease (29.6%), euthyroidism nodular goiter (26.8%), toxic adenoma (2.4%), and Hashimoto’s thyroiditis (6.7%). The compressive manifestations were exclusive of nodular goiter. Among the 35 cases of cardiothyreosis, there was a rhythm and conduction disorder in 25 cases (6.7%) and the underlying thyreopathy was a toxic nodular goiter in 57.1%. Thyroidectomy involved 44.7% of patients, including 32.6% of Graves’ disease, 48.3% of toxic nodular goiter, and 61.8% of nodular goiter in euthyroidism. We found 02 cases of papillary carcinomas on multinodular goiter. <strong>Conclusion:</strong> In our hospital series, there is variability in the clinical manifestations of dysthyroidism in the elderly. Complications, mainly cardiac and compressive, remain a major reason for consultation. Toxic nodular goiter is preponderant and its management, especially radical, must be multidisciplinary and according to the profile.
文摘Introduction: To describe the epidemiologic profile, clinical and paraclinical of diabetics presenting microalbuminuria at Marc Sankale center. Patients and methods: We have done cross-sectional and retrospective study in a descriptive and analytic view or way. It happened within 6 months. Diabetic patients who performed the nycthemeral urinary albumin dose and mentioned in the file were included. The last study is considered as a positive one from 30 to 299mg/24h: Microalbuminuria. The creatinine has been noted and the clearing of the creatinine is calculated through the formula of Cockcroft and Gault. The statistical analysis of data has been done thanks to software such as excel 2013 and SPSS VER 18.0. Results: 221 patients have been noted with 70% women and 30% men. The age varied between 30 years and 85 years with an average of 56, 62 against 9.97 years. Sixty three (63) patients have microalbuminuria (29%);creatinine has been regularized to 25 patients with 14.8% of cases. Among the microalbuminuria patients having completed the creatinine, 32 patients (42.7%) and 16 (21.3%) are respectively in a state of chronical renal failure, light and moderated. Conclusion: The microalbuminuria is frequent to diabetics. But in our series a starting renal insufficiency could precede that microalbuminuria.
文摘Introduction: Metabolic and vascular emergencies constitute a risk of lethality in diabetic subjects admitted to hospital. The objective was to evaluate the factors associated with death in subjects admitted for a diabetological emergency to improve management. Materials and Methods: It was a 12-month retrospective, descriptive and analytical study at Dakar’s Marc Sankale Diabetes Center. The study concerned any type of diabetics subjects admitted for a diabetological emergency. We evaluated the profile of diabetes, the pathologies found and factors associated with death. Results: We identified 697 cases of diabetic emergencies with a prevalence of 13.8%. The sex ratio (M/F) was 0.82, the mean age was 49.6 years, and the mean duration of diabetes was 7.1 years. The metabolic profile was hypoglycemia (11.3%), ketoacidosis (34.6%), and hyperosmolar hyperglycemia syndrome (5%). The associated pathologies were vascular (51.1%), infectious (65.3%), kidney function impairment (7.6%), anaemia (13.8%). During the follow-up, 94 patients died, as an annual frequency of 13.5% among diabetological emergencies. In univariate analysis, the factors significantly associated with death were age > 60 years [OR = 4.09 (2.6 - 6.41)], hyperglycemia [OR = 2.58 (1.50 - 4.4)], hyperosmolar hyperglycemia syndrome [OR = 10.5 (5.19 - 21.5)], septic diabetic foot [OR = 3.57 (2.24 - 5.66)]. Vascular pathologies that significantly associated with death were stroke [OR = 4.06 (2.10 - 7.81)], lower limb arteriopathy [OR = 3.25 (1.84 - 5.73)], cardiovascular collapse [OR = 6.85 (2.34 - 20)]. In addition to diabetes, the deceased patients had one (18%), two (34%) and at least three (45.7%) known factors of poor prognosis. Conclusion: Emergencies in diabetology remain frequent in our practice. The comorbidity (vascular and infectious) constitutes a risk of abnormally high death rate. A particular attention must concern on old diabetics subjects with several pathologies.
文摘Aim: To evaluate the attitude practice and knowledge of pharmacists in the management of diabetes in the department of Dakar. Methodology: Cross-sectional study, conducted from 01 March to 30 September 2017 including all pharmacists in the Dakar region who agreed to participate in the survey. Data was collected through a pre-established questionnaire. Results: A total of 144 pharmacists were included in the study, representing a participation rate of 87.58%. The average age was 33.90 years, with a sex ratio of 1.69. Pharmacists were single in 50.88% of cases, and a minimum experience of 5 years was found in 64.03% of cases. Pharmacist assistants accounted for 57.9% of our study population. The assessment of knowledge based on 16 items shows an average score of 9.02. The level of knowledge was low to insufficient in 37.21% of cases, average in (50%) half of cases and good for (13.16%). Less than half (34.21%) of pharmacists had received training and the average date of last training was 33.76 ± 24.6 months. Training was provided by medical representatives and academics in 66.66% and 26.67% respectively. The most felt positive feelings were respectively the need for help, the compassion in respectively 98.42%, 42.11%. Feelings felt and simultaneously cited were: need for help and compassion in more than 40% of respondents. Only 29% of pharmacists did not have a lot of difficulty with patient questions and the only reason was the lack of awareness (84.68%) of patients about their disease. Screening for diabetes by capillary blood glucose was performed by 57% of pharmacists. Dietary advice (76.15%) and referral to the hospital (94.41%) were the most common practices in case of blood sugar disruption. The dialogue with patients was impossible in 22.81% of pharmacists and the main reasons given were lack of time (53.85%) and lack of knowledge (34.62%). The method of delivery of insulin was done on: medical prescription (98.25%), presentation of the box (69.30%), on request of the patient (54.39%). Only one pharmacist recognized advising insulin (0.88%). The delivery of oral antidiabetic agents was: on medical prescription (96.49%), presentation of the box (67.54%), at the request of the patient (52.63%). The good level of knowledge was more found in the subjects after 40 years (p = 0.69), the female sex (p = 0.84), the assistants and holders (p = 0.24), after 5 years of professional experience (p = 0.13). Conclusion: Despite the lack of knowledge of pharmacists, attitudes and practices are considered satisfactory in the management of diabetics. Continuing medical education sessions could strengthen knowledge and consolidate the attitudes and practices of community pharmacists.
文摘Introduction: The objective of that study was to evaluate diabetics knowledge, attitudes and practices on physical activity. Patients and Methods: That study has concerned 200 diabetics at Marc Sankale antidiabetic Center of Abass Ndao Hospital in Dakar. Women represent 76% with a sex ratio M: F0.13. The average age is 54 years with extremes of 4 to 84 years. The housewives are 29% and among them 15% haven’t any professional activity. 45.07% of the population is illiterate. In our study, 63.13% of patients have low socio economic level. In our series, the majority of patients is type 2 diabetes (89.5%). The diabetes evolution time is about 8 years inferior to 7% in 84 patients. In our study obesity is noted in 17.20% of cases. The HTA is present in 56% of cases. 54% of the studied population presents a dyslipidemia. Physical activity is practiced in 81% of patients. In our study the doctor’ advice motivates the half of our patients to practice physical activity (62.26%). The lack of time (43.2%) and volution (8.1%), the useless character of physical activity (2.7%) and the patients’ health state 45.9% are the obstacles to the practice of physical activity. The average frequency of physical activity practiced by patients is about 4 times a week with extremes ranging from 1 to 7 stages a week. The average time of activity practiced by patients is 39.72% with extremes ranging from 10 to 150 mn. 87% of patients practice physical activity at least 3 times a week. The main risks noted from intense physical activity in diabetics are hypertension 39.0%, ortestic hypertension 3.0%. In the contrary 58.8% of patients ignore the answer. Conclusion: Our study demonstrates the ignorance of diabetics on physical activity. Therefore it would be necessary to reinforce the training mainly therapeutic education in the patients taken into account.
