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Background: Dermatological manifestations are frequent and often constitute a circumstance of HIV discovery in 70% of cases [1]. They are observed in 83% of patients with AIDS and at an early stage in 75% [2,3,4,5]. The objective of this study was to describe the epidemiological, clinical, therapeutic, and evolutionary aspects of skin manifestations during HIV infection in children. Materials and Methods: We conducted a cross-sectional, multicentric, descriptive study over a period of ten years in two dermatology departments and one pediatric department in Dakar, Senegal. We included all HIV-seropositive children aged 0–15 years with mucosal cutaneous manifestations. A dermatologist and a specialist in the medical care of HIV performed the diagnosis of cutaneous manifestations. Data entry and analysis were performed with the SPSS software, version 9.05. Results: We collected 206 cases of cutaneous manifestations in 454 children followed for HIV infection. The hospital frequency was 45.3%. The children were male in 115 cases (55.83%) and female in 91 cases (44.17%), giving a sex ratio of 1.26. The mean age of the patients was sixty months, with extremes of one month to fourteen years. A mycotic dermatosis origin was noted in 47.37%, ringworm in 22.37%, dermatophytosis in 8.58%, oral candidiasis in 6.58%, seborrheic dermatitis in 6.58%, and perleche in 3.29%. Bacterial skin diseases were represented by furunculosis in 1.97%, and impetigo in 7.24%. Viral dermatoses included molluscum contagiosum in 10.53%, shingles in 9.21%, warts in 9.87%, and chickenpox in 3.95%. As for parasitic dermatoses, scabies was noted in 8.55, followed by larva migrans in 0.66% and cutaneous leishmaniosis in 0.66%. Immuno-allergic dermatoses accounted for 25% and included prurigo in 94.3%, atopic dermatitis in 1.90%, and fixed pigmented erythema in 1.90%. Conclusion: Cutaneous manifestations are a common discovery during HIV infection in children. They are marked by a predominance of infectious dermatoses in sub-Saharan Africa. Key words: skin diseases; HIV; children; Dakar

Introduction: The general objective was to determine the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of connectivitis in the dermatology department of the CHU Aristide Le Dantec. Patients and methods: This was a retrospective and descriptive study conducted in the Dermatology Department of the University Hospital Center (UHC) Aristide Le Dantec (HALD) of Dakar between January 2009 and December 2019. Their diagnoses were retained according to the international criteria validated in the course of connectivites Results: We identified 290 cases of connectivitis. Systemic scleroderma was the most frequent in 34.42% (n=94), followed by systemic lupus in 25.86% (n=75), mixed connectivities in 22,06% (n=64) and dermatomyositis in 19,32% (n=56). Cancer was associated with dermatomyositis in 11 cases and with systemic scleroderma in 3 cases. The mean age of our patients was 38.23 years. The sex ratio was 4.2 and the mean duration of evolution was 25 months. Dermatological manifestations were constant, found in all patients. In systemic lupus, they were dominated by discoid lupus lesions found in 40% and hypochromic spots (86%) in systemic scleroderma. In dermatomyositis, skin lesions were dominated by periorbital erythroedema (66.07%). Joint manifestations were found in 56.89% of cases (n= 165), muscular manifestations in 41.37% of cases (n= 120) and pleuropulmonary manifestations in 31.3% of cases (n=91). Neuropsychiatric manifestations were noted in 5.17% of cases (n=15). All our patients were treated with corticosteroid therapy and 12.06% of them had received immunosuppressive treatment, the most commonly used molecules being methotrexate (3.44%) and cyclophosphamide (8.27%). Hydroxychloroquine was prescribed in 59.31% of patients, while D-penicillamine was prescribed in 42.06% of patients, 100% of whom were treated for systemic scleroderma. The main complications encountered were infectious complications in 83 cases (28.6%). Visceral complications, a type of visceral insufficiency, were noted in 4.13% of cases. Conclusion: Our study demonstrates the frequency of connectivitis in the dermatology department. Its particularity was the predominance of systemic scleroderma over lupus which was classically the first connectivite in dermatology services. The delay in diagnosis noted is correlated with visceral attacks; hence the importance of a better knowledge of these affections for an early management.

Objective: Describe the epidemiological, diagnostic, therapeutic and evolutionary profile of triple negative breast cancer at the Dakar Cancer Institute in Senegal. Patients and Methods: This was a retrospective study between January 1, 2011 and December 31, 2014. All patients with a triple negative molecular profile were included. The data were collected from the medical records of the patients. The data were entered and analyzed with SPSS edition 16 software under Windows 7. Results: Two hundred and twenty-five patients were selected. The mean age was 47.9 ± 12.5 years with extremes of 25 and 90 years. The main reason for consultation was dominated by the finding of a breast lump. The mean clinical tumor size was 8, 54 cm with a large majority of T3-T4 tumors 26% and 63% respectively, lymph node involvement in one hundred and seventy-two cases (76.4%); twenty eight patients (12.4%) were metastatic from the outset. Non-specific invasive carcinoma was the most common histologic type (78.2%), and more than half of the patients (53.3%) had an aggressive tumor (Scarff-Bloom-Richardson grading III). Neoadjuvant chemotherapy was performed in 65.78% of cases. We noted 27.7% total response and 41.7% partial response in patients who have received this neoadjuvant chemotherapy. The surgery was radical in 77% of cases, conservative in 14% and cleanliness surgery for palliative purposes in 9% of cases. Adjuvant radiotherapy is performed in 58.6% of operated patients. The mean time to follow-up was 20.63 months with extremes of 1 and 53 months. Overall survival was 69.8% at one year, 41.6% at two years and 25.6% at three years. Conclusion: The descriptive analysis of these results confirms the high frequency of triple-negative breast cancer in Senegal and its poor prognosis.

Background: Type 2 diabetes mellitus, beyond its well-known cardiovascular and neurological complications, is now increasingly recognized as having deleterious effects on bone tissue. It’s thus presented as an independent risk factor for bone fragility with a considerable fracture risk relating to many more or less intricate parameters. The general objective of our study is to assess bone mass during type 2 diabetes in Senegalese women. Methodology: We had carried out a cross-sectional and descriptive study. Socio-demographic characteristics were collected on the basis of a questionnaire. Then each of the subjects had undergone a complete clinical examination followed by a blood sample for a biological assessment of certain cardiovascular risk factors. Bone mass was measured using a bio-impedancemeter. Results: We recruited 88 women with type 2 diabetes and 83 healthy control women. The mean age of diabetic subjects was 52.7 years ± 6.8 (with extremes of 39 and 74 years). In control, the mean age was 51.0 ± 8.5 years (with extremes of 35 and 72 years). Among the diabetic subjects, 22 subjects or 25% practiced a regular walk against 27 (32.5%) in the control. Forty-three among the diabetic subjects (48.8%) were known hypertensive and followed. According to the body mass index, 71 patients (80.7%) were overweight compared to 59 (71.1%) controls. According to the waist size, 80 (90.9%) diabetic subjects had an elevated waist size compared to 69 control women (83.1%). Among diabetic subjects, 41 patients (46.5%) were hyperglycemic imbalance according to fasting blood glucose and 59 patients (67%) according to glycated hemoglobin level. Thirty-seven diabetics (42%), had both high fasting blood glucose and elevated glycated hemoglobin. The mean duration of diabetes was 8.68 ± 7.18 years. We found significantly higher bone mass in type 2 diabetic subjects (p = 0.03). Among diabetics, 27.3% had low bone mass compared to 36.1% of control. It’s noted that the subjects of the “low bone mass” group among the control subjects also have a significant drop in other anthropometric parameters (weight, body mass index, waist size, muscle mass). It should also be noted that the fat mass is significantly higher in diabetic subjects with normal or even high bone mass. In control subjects, bone mass was positively correlated with weight (r = 0.36; p = 0.001), muscle mass (r = 0.93; p < 0.0001) and fasting blood glucose (r = 0.26; p = 0.02); and negatively correlate with age (r = 0.22; p = 0.04). On the other hand, in type 2 diabetic subjects, bone mass is positively correlated with age (r = 0.22; p = 0.04), muscle mass (r = 0.89; p < 0.0001) and the diabetes duration (r = 0.44; p = 0.001). Conclusion: Bone mass is higher in type 2 diabetics compared to healthy controls. Chronic hyperglycemia and the diabetes duration are believed to be responsible for the increase in bone mass. In addition, an increase in muscle mass would lead to an increase in bone mass.

International audience; As a continuation of our interest in apoptosis-inducing triterpenoid saponins from Albizia genus, phytochemical investigation of the stem bark of Albizia chevalieri led to the isolation of three new oleanane-type saponins, named chevalierosides A–C (1–3). Their structures were established on the basis of extensive analysis of 1D and 2D NMR (1H-, 13C NMR, DEPT, COSY, TOCSY, ROESY, HSQC and HMBC) experiments, HRESIMS studies, and by chemical evidence. The pro-apoptotic effect of the three saponins was evaluated on two human cell lines (pancreatic carcinoma AsPC-1 and hematopoietic monocytic THP-1). Cytometric analyses showed that saponins 1–3 induced apoptosis of both human cell lines (AsPC-1 and THP-1) in a dose-dependent manner.

Background: The cost of treatments for cardiovascular diseases, in particular for populations in developing countries such as Senegal, requires an alternative which consists in developing research into new therapeutic approaches with the use of plants from the traditional pharmacopoeia. On the other hand, many of these plants have not been the subject of scientific studies. Aims and Objectives: In our study, we set out to study the effects on the vasomotricity of a plant from an in vitro model. As specific objectives, research of the vasorelaxant effects of the hydroethanolic extract of the leaves of Oxytenanthera abyssinica, on a model of pig coronary artery. Materials and Methods: The coronary artery rings were incubated with O. abyssinica (FOA) leaf extract at different concentrations (10–4 mg/ml, 5.10–4 mg/ml, 10–3 mg/ml, 5.10–3 mg/ml, 10–2 mg/ml, 5.10–2 mg/ml, 10–1 mg/ml, and 5.10–1 mg/ml) in an isolated organ system. The device comprises a set of devices including isometric tension sensors. The vessel rings to be studied are mounted on these. They are connected to metal rods that develop isometric tension. These sensors make it possible to measure the intensity of the voltage developed which reflects the vascular reactivity. After incubation, the rings are contracted with U46619 to produce a concentration-contraction curve with and without endothelium. The measured voltages are collected and represented in the form of a curve using the GraphPad software Prism version 6.01®. The results are expressed as means ± SEM of 08 experiments. The analysis of variance test (ANOVA) was used to compare the means. P < 0.05 was considered statistically significant. Results: The results obtained in this study showed that on isolated pig coronary artery rings, contracted at U46619, the hydroethanolic extract of O. abyssinica (FOA) leaves induces vascular relaxation. This vasorelaxation is obtained at concentrations ranging from 10−4 to 5.10−1 mg/ml with a relaxation percentage of approximately 100%. This percentage of relaxation is obtained both in the presence and in the absence of functional endothelium. These results suggest that the hydroethanolic extract of leaves of O. abyssinica possesses dose-dependent vasodilator properties on isolated pig coronary artery rings with endothelium-independent character. It thus appears that the raw extract of leaves of O. abyssinica can act on two ways. Conclusion: The results of our study made it possible to demonstrate a vascular relaxing effect of the hydroethanolic extract of the leaves of O. abyssinica. This vasorelaxant effect is dose dependent and endothelium independent.

Objectif Apprecier les conditions de transfert medical des nouveau-nes malades dans la region de Dakar.

Resume Introduction Les nouveau-nes de faible poids de naissance (FPN) ( Materiel et methodes Il s’agissait d’une etude retrospective, descriptive et analytique, du 1er janvier 2011 au 31 decembre 2012, concernant les nouveau-nes de FPN, admis en neonatologie. En plus des donnees sociodemographiques, obstetricales et perinatales, nous avons recueilli toutes les donnees concernant l’alimentation et la nutrition, la croissance ponderale postnatale, comparees aux courbes de croissance de reference. Les donnees ont ete saisies et analysees avec le logiciel Epi Info version 3.5.1. Resultats Nous avons etudie 98 nouveau-nes de FPN, dont 78 prematures (79,6 %) et 20 a terme (20,4 %). L’âge gestationnel moyen etait de 34,08 SA (28 a 39 SA) et le poids de naissance moyen de 1643,7 g (700 a 2480 g). L’alimentation enterale etait debutee en moyenne a 2,5 jours de vie (0 a 13 jours). A j3 et j7 de vie, les apports caloriques (respectivement 53 ± 23 kcal/kg/j et 86 ± 37 g/kg/j) et protidiques (respectivement 0,9 ± 1,1 g/kg/j et 2,3 ± 1,6 g/kg/j) etaient insuffisants. L’âge moyen de reprise du poids de naissance etait de 13,11 jours (0 a 41). Le gain ponderal quotidien etait en moyenne de 7,85 g/kg/j. L’incidence du retard RCEU a 40 SPC etait de 85,7 %, celle de l’insuffisance ponderale a 3 mois d’âge corrige (AC) de 60,5 % et celle de l’insuffisance ponderale a 6 mois d’AC de 41,2 %. Les variables significativement associees au risque de RCEU etaient : un PN Conclusion Le RCEU est tres frequent chez les nouveau-nes de FPN admis dans notre unite. Il semble etre lie a des apports caloriques et nutritifs deficitaires dans les premiers jours de vie. Il parait urgent de corriger la nutrition des 7 premiers jours par la nutrition parenterale et l’enrichissement precoce de l’alimentation enterale.

Background: High blood pressure (BP) (hypertension) is one of the leading causes of death and cardiovascular disease worldwide. In 2001, hypertension, considered both pathology in its own right and a risk factor for other diseases, was responsible for more than 7.6 million deaths. A 2014 study in Dakar showed that the prevalence of hypertension was 27.50%. Aim and Objective: The objective of this study is to assess the involvement of the community pharmacist in the management of high BP with regard to screening, counseling, and treatment and to assess the difficulties encountered in these stains. Materials and Methods: This is a descriptive and analytical cross-sectional study of all community pharmacists who meet our eligibility criteria. The survey took place from April 15, 2019, to June 10, 2019, and involved 100 pharmacies in the Dakar region. The questionnaire was designed on the basis of the following headings: Presentation of the pharmacy; BP screening and measurement; tips for primary and secondary prevention of high BP; tertiary prevention; and difficulties encountered by pharmacists. Results: The results showed that 46% of pharmacists gave a false definition of ATH. No pharmacist had the three types of armbands (adults, children, and obese). The rest time before measuring the BP, namely, 5–10 min, was respected by 94.12% of the pharmacists respected. The patient’s position at the measurement and the grip on both arms were not respected by most of the respondents who disagreed with the recommendations. Hygienic-dietary measures were not recommended enough. However, the sodium diet and smoking cessation have been recommended by all pharmacists. Concerning the drugs to avoid in hypertensive patients, only 35.29% of pharmacists advised against non-steroidal anti-inflammatory drugs and 47% for sympathomimetics. Most pharmacists referred patients to the doctor when the BP was abnormally high, whether he was on or without treatment with a compliance check for patients on treatment. Conclusion: At the end of this study, the results obtained certainly show a certain mastery of the management of average handle time but are not very satisfactory. Indeed, many gaps and shortcomings in terms of knowledge and practice have been highlighted.

Background: Our work is part of the enhancement of plants of Senegalese pharmacopeia with cardiovascular aim, among which Terminalia avicennioides. Aim and Objective: The aim of this study was to determine whether a hydroethanolic bark extract of T. avicennioides (TAE) is able to induce a relaxant effect in porcine coronary, rat mesenteric artery, carotid, femoral arteries, and thoracic aorta and to determine the mechanism underlying this effect. Materials and Methods: Porcine coronary, rat mesenteric, carotid, femoral arteries, and thoracic aorta rings were suspended in organ chambers for the recording of changes in isometric forces. Rings with endothelium were incubated or not with L-Nitro Arginine to block nitric oxide (NO) synthase, MnTMPyP, polyethylene glycol catalase (CAT), an inhibitors of intracellular production reactive oxygen species; CAT, an inhibitor of extracellular reactive oxygen species; Wortmannin, an inhibitor of redox-sensitive pathway PI3 kinase/Akt; PP2 (4-amino-5-(4-chlorophenyl)-7-(t-butyl)pyrazolo [3,4-d]pyrimidine), an inhibitor of Src kinase; apamin (APA) an inhibitor of small conductance potassium channels calcium-dependent (SKCa) and Tram-34 an inhibitor of intermediary conductance potassium channels calcium-dependent (IKCa); and indomethacin (INDO), an inhibitor of cyclooxygenase before contraction with U46619 or phenylephrine (PE) and a concentration relaxation curve to TAE. In some experiments, the endothelium was removed before contraction with U46619 or PE and concentration relaxation to TAE. The phosphorylation level of Akt and eNOS was assessed by Western blot analysis. Results: The hydroethanolic bark TAE induces a vasodilatory effect in porcine coronary artery precontracted with U46619. This effect is endothelium-dependent and is mediated by NO, prostaglandin, and endothelium-derived hyperpolarizing. TAE also induces vasorelaxant effects in superior mesenteric arteries, carotid arteries, thoracic aorta, and femoral arteries from rat. Conclusion: TAE-induced sustaining phosphorylation of Akt and eNOS in endothelial cells. T. avicennioides induces vascular relaxation which can explain the benefic effect of this plant in the treatment of high blood pressure in Senegal.

Resume Introduction L’hematome sous-galeal (HSG) ou hematome sous-aponevrotique est un epanchement sanguin peri-crânien, souvent lie a un traumatisme obstetrical ou un accouchement instrumental. Son pronostic est beaucoup plus severe que le cephalhematome et la bosse serosanguine. Patients et methodes Nous avons analyse retrospectivement 7 dossiers de nouveau-nes hospitalises au centre hospitalier national d’enfants Albert Royer pour un HSG, sur une periode de 6 mois. Nous avons recueilli les donnees concernant les circonstances de l’accouchement, le delai du diagnostic d’HSG, la description clinique de l’hematome, les principales complications observees, le traitement administre et la letalite. Resultats Une notion d’accouchement dystocique ou d’asphyxie perinatale etait retrouvee chez tous les patients. Il n’avait pas de manœuvres instrumentales, mais une notion d’expression abdominale etait retrouvee chez 4 patients. Tous avaient presente une encephalopathie anoxo-ischemique de stade variable. L’hematome etait passe inapercu en maternite dans les sept cas et le diagnostic etait tardif, apres quelques heures de vie. Chez tous nos patients, l’hematome avait un aspect etendu, recouvrant tout le vertex et diffusant au cou, au front et decollant les oreilles lateralement. Le perimetre crânien moyen a l’admission etait 40 cm. Les principales complications observees etaient la detresse respiratoire (7 cas), l’anemie (6 cas), le choc hemorragique hypovolemique (6 cas), la coagulation intravasculaire disseminee avec thrombopenie (5 cas) et l’hypertension arterielle pulmonaire persistante (2 cas). Malgre les moyens de reanimation, quatre nouveau-nes sont decedes. Conclusion L’hematome sous-galeal est une lesion grave mais largement meconnue dans notre contexte. Une meilleure surveillance des nouveau-nes apres accouchement dystocique ou instrumental pourrait permettre leur diagnostic plus precoce et l’amelioration de leur pronostic. L’expression abdominale pour aider a l’accouchement devrait etre abandonnee.

Background: Ceiba pentandra (L.) Gaertner (Malvaceae) a plant widely spread in the world, particularly in sub-Saharan Africa where it is used to handle several pathologies like high blood pressure without scientific evidence by experimental scientific works. Aim and Objective: The purpose of this study is to show how a hydroethanolic leaves extract of Ceiba pentandra (FCP) produces relaxant effects in porcine coronary, rat mesenteric artery, carotid, femoral arteries, and thoracic aorta and to determine the mechanisms which lie beneath this effect. Materials and Methods: Porcine coronary, rat mesenteric, carotid, and femoral arteries and thoracic aorta rings were suspended in organ chambers for recording of changes in isometric forces. Rings with endothelium were incubated or not with L-nitroarginine to block nitric oxide (NO) synthase, manganese (III) tetrakis(1-methyl-4-pyridyl)porphyrin, polyethylene glycol catalase (CAT), an inhibitors of intracellular production reactive oxygen species (ROS); CAT, an inhibitor of extracellular ROS; wortmannin, an inhibitor of redoxsensitive pathway phosphoinositide 3-kinase (PI3 kinase)/Akt; (4-amino-5-(4-chlorophenyl)-7-(t-butyl)pyrazolo [3,4-d] pyrimidine), an inhibitor of Src kinase; apamin, an inhibitor of small conductance potassium channels calcium dependent (SKCa) and tram-34, an inhibitor of intermediary conductance potassium channels calcium dependent (IKCa); and indomethacin, an inhibitor of cyclooxygenase before contraction with U46619 or phenylephrine and a concentration-relaxation curve to FCP. Results: Some experiments show that endothelium was taken away before contraction with U46619 and concentration relaxation to FCP. The hydroethanolic leaves extract of C. pentandra produces a vasodilatory result in porcine coronary artery pre-contracted with U46619. This effect is endothelium dependent and is mediated by NO. FCP generates, as well, vasorelaxant results in superior mesenteric arteries, carotid arteries, thoracic aorta, and femoral arteries from rat. C. pentandra generates vascular relaxation which can be the explanation of the benefic effect of this plant in the treatment of high blood pressure (HBP) in Africa. Conclusion: C. pentandra holds vasorelaxants properties on pig coronary artery, thoracic aorta, the main superior mesenteric artery, and femoral and carotid artery from rat justifying its utilization in the treatment of the arterial HBP. This effect necessitates the presence of a functional endothelium and passes by the redox-sensitive pathway Src kinase and PI3-kinase/Akt.

L’hypothyroïdie de l’enfant é été peu étudiée au Sénégal. Le but de cette étude était d’évaluer les aspects épidémiologiques, diagnostiques et évolutifs de l’hypothyroïdie congénitale. Il s’agissait d’une étude rétrospective descriptive et analytique portant sur tous les enfants suivis pour hypothyroïdie congénitale au Centre Hospitalier National d’Enfants Albert Royer sur la période de 2001 à 2014 (14 ans). A partir des dossiers des malades, nous avons recueilli et analysé les données sociodémographiques, cliniques et évolutives. Au total, 28 patients ont été inclus, soit une moyenne de 2 cas par an. L’âge moyen de découverte de l’hypothyroïdie était de 54,25 ± 43 mois avec une prédominance féminine (Sex- ratio 0,47). Seuls 2 cas d’hypothyroïdie ont été diagnostiqués dans la période néonatale. La consanguinité était présente chez 68% des patients. Les signes cliniques étaient dominés par le retard des acquisitions psychomotrices (96%), l’hypothermie (46%), la dysmorphie cranio-faciale (43%) et le goitre (39%). Le retard statural était constant au-delà de 6 mois. Les étiologies étaient dominées par les troubles de l’hormonosynthèse (84,21%). Dans l’évolution, la taille moyenne des patients était passée de -3,5 DS à -2,25 DS pour une durée de traitement moyenne de 28 mois. La débilité mentale était présente dans 73% des cas. Le retard de croissance et la débilité mentale étaient d’autant plus sévères que le diagnostic était tardif. Nos résultats confirment l’insuffisance d’une prise en charge précoce des patients. Il urge de mettre en place un système de dépistage néonatale systématique, afin d’améliorer le pronostic mental de cette affection. The Pan African Medical Journal 2016;25

L’hypothyroïdie de l’enfant é été peu étudiée au Sénégal. Le but de cette étude était d’évaluer les aspects épidémiologiques, diagnostiques et évolutifs de l’hypothyroïdie congénitale. Il s’agissait d’une étude rétrospective descriptive et analytique portant sur tous les enfants suivis pour hypothyroïdie congénitale au Centre Hospitalier National d’Enfants Albert Royer sur la période de 2001 à 2014 (14 ans). A partir des dossiers des malades, nous avons recueilli et analysé les données sociodémographiques, cliniques et évolutives. Au total, 28 patients ont été inclus, soit une moyenne de 2 cas par an. L’âge moyen de découverte de l’hypothyroïdie était de 54,25 ± 43 mois avec une prédominance féminine (Sex- ratio 0,47). Seuls 2 cas d’hypothyroïdie ont été diagnostiqués dans la période néonatale. La consanguinité était présente chez 68% des patients. Les signes cliniques étaient dominés par le retard des acquisitions psychomotrices (96%), l’hypothermie (46%), la dysmorphie cranio-faciale (43%) et le goitre (39%). Le retard statural était constant au-delà de 6 mois. Les étiologies étaient dominées par les troubles de l’hormonosynthèse (84,21%). Dans l’évolution, la taille moyenne des patients était passée de -3,5 DS à -2,25 DS pour une durée de traitement moyenne de 28 mois. La débilité mentale était présente dans 73% des cas. Le retard de croissance et la débilité mentale étaient d’autant plus sévères que le diagnostic était tardif. Nos résultats confirment l’insuffisance d’une prise en charge précoce des patients. Il urge de mettre en place un système de dépistage néonatale systématique, afin d’améliorer le pronostic mental de cette affection.

Le syndrome hémolytique et urémique (SHU) est une cause fréquente d’insuffisance rénale aiguë (IRA) organique chez l’enfant. C’est une complication évolutive des gastroentérites aiguës (GEA) en particulier à Escherichia coli de l’enfant. Notre objectif était de décrire les aspects cliniques, thérapeutiques et évolutifs de cette affection chez quatre enfants. Nous avions colligé quatre cas de SHU. L’âge moyen était de 10,5 mois (5-15mois) exclusivement des garçons. L’examen clinique retrouvait une anémie de type hémolytique (pâleur et ictére), un syndrome oedémateux avec oligo-anurie (2 cas), une hypertension artérielle (1 patient), une GEA avec déshydratation sévère et choc hypovolémique (2 patients), des troubles de conscience. L’IRA était notée chez tous les patients de même que la thrombopénie et les schizocytes au frottis. Le Coombs direct était négatif. Il y avait une hyperkaliémie (3patients) dont 1 patient supérieure à 9,2 mmol/l, une hyponatrémie à 129mmol/l(1 patient) et une hypernatrémie à 153mmol/l (1 patient). Le shu était secondaire à une pneumonie à pneumocoque (1 patient), une GEA à E. coli (1 patient). Le traitement était essentiellement symptomatique et comprenait la restriction hydrique, la transfusion de concentrés érythrocytaires, les diurétiques, la dialyse péritonéale et l’hémodialyse. L’évolution était marquée par la survenue d’une insuffisance rénale chronique (1 patient) après 6 mois de suivi et la guérison (1 cas). Nous avions noté 3décés.Le SHU est la cause la plus fréquente d’IRA organique du nourrisson. Le diagnostic est essentiellement biologique, le traitement est surtout symptomatique. The Pan African Medical Journal 2016;24

Background: Chronic obstructive pulmonary disease (COPD) is characterized by high mortality. The latter is strongly attributed to cardiovascular events whose onset is endothelial dysfunction and vascular remodeling. Aims and Objectives: The aims were to evaluate the endothelial function during COPD and the factors involved with possible endothelial dysfunction in Senegalese Black men aged at least 18 years. Materials and Methods: This was a prospective and cross-sectional study. After a complete clinical examination and evaluation of the body composition by a bioimpedancemeter, the endothelial function was evaluated by EndoPAT2000®. Results: the mean age was 61.50 years ± 6.62. Of the subjects, 70% were smokers and 50% had limited chest enlargement. According to the body mass index and the percentage of body fat, underweight was 30% and 40%, respectively. The 75.5% of the meager could not be evaluated by bio-impedancemeter due to extreme thinness. Endothelial dysfunction involved 70% of subjects. In addition, 86% of subjects with endothelial dysfunction were smokers. The reactive hyperemia index was positively correlated with body mass index (P = 0.017 and r = 0.73), body fat percentage (P = 0.016 and r = 0.73) and visceral fat level (P = 0.008 and r = 0.78). Conclusion: The evolution of COPD would be laced with serious cardiovascular complications often fatal. The assessment of nutritional status and endothelial function is fundamental for better management of the disease.

Introduction Les publications sur les accidents vasculaires cerebraux de l’enfant (AVC) sont relativement rares en Afrique alors que les principaux facteurs etiologiques rapportes par la litterature sont presents sur le continent. Objectifs Cette etude a pour objectif principal de determiner l’epidemiologie, les etiologies et les aspects cliniques, paracliniques et evolutifs des accidents vasculaires cerebraux de l’enfant a Dakar (Senegal) Methodes Nous avons collige les dossiers du « registre multicentrique des AVC de l’enfant » mis en place depuis decembre 2009. Ce registre concerne tous les services de pediatrie et de neurologie des centres hospitaliers universitaires de Dakar. Tous les dossiers des enfants âges de moins de 18 ans, admis pour un accident vasculaire cerebral entre decembre 2009 et novembre 2014, ont ete inclus. Resultats Nous avons collige 84 cas d’accident vasculaire cerebral dont 71 cas d’ischemie et 13 cas d’hemorragie. Dans les ischemies cerebrales, les etiologies principales etaient la drepanocytose, l’anemie et les cardiopathies. Dans les AVCH, les etiologies identifiees etaient des malformations arterio-veineuses, la thrombopenie severe, une hypertension arterielle. Huit patients etaient decedes en phase aigue et la majorite des patients (90,47 %) presentaient des sequelles neurologiques a leur sortie d’hospitalisation Discussion Dans notre serie, les ischemies cerebrales sont beaucoup plus frequentes que les accidents hemorragiques. D’autres auteurs rapportent egalement une incidence annuelle plus elevee des ischemies cerebrales. Les principales etiologies identifiees dans les ischemies comme les hemorragies cerebrales sont conformes aux donnees de la litterature. Le deces survient entre 2,9 et 18,8 %, avec une mortalite majoree dans les AVCH. Conclusion Un suivi precoce et multidisciplinaire des drepanocytaires, la prevention des cardiopathies rhumatismales, la lutte contre les anemies et la malnutrition contribueraient a reduire considerablement l’incidence des accidents vasculaires cerebraux. Informations complementaires Cette etude n’a pas fait l’objet d’un financement particulier.