BACKGROUND: Diabetes Mellitus is a strong cardiovascular risk factor in which acute coronary syndromes (ACS) are thought to have a particular feature. We aimed to determine the characteristics of acute coronary syndromes in diabetics compared with non-diabetics patients.
METHODS: We carried out a prospective, descriptive and analytical study comparing diabetic and non-diabetic patients admitted for acute coronary syndrome to the cardiology department of Idrissa Pouye general hospital over a period of one year by studying socio-demographic, clinical, paraclinical, therapeutic and evolutionary parameters. We performed a multivariable logistic regression analysis to identify factors associated with chest pain and triple vessels disease.
RESULTS: Our study included 139 patients, 61 with diabetes (44%) and 78 without diabetes (56%). Among diabetics, there was a predominance of women (p = 0.0001) in contrast to non-diabetics. The mean age was 62.7 ± 10.8 years in diabetics and 56.9 ± 13.5 years in non-diabetics (p = 0.006). Chest pain was found in 88.5% of diabetics and 97.4% of non-diabetics (p = 0.03). The mean HbA1c in diabetics was 9.4 ± 3.3%. ST elevation acute coronary syndrome was predominant in both groups. The mean GRACE score was 147 ± 29 in diabetics and 132 ± 28 in non-diabetics (p = 0.003). In multivariable analysis, only diabetes was associated with triple vessels disease (aOR (IC à 95%): 2,60 (1.29-6.83); p = 0.042). A total of 31% of diabetics and 43% of nondiabetics undergoes cardiac revascularization. There was no difference between the two groups in terms of complications. The mortality was 6.6% and 3.8% respectively among diabetics and non-diabetics (p = 0.49).
CONCLUSIONS: According to our study, diabetes is frequently encountered during acute coronary syndromes. It also shows that diabetics are more likely to be female and older, with more atypical symptoms and more severe coronary disease.

BACKGROUND: The reuse pacemakers is a beneficial technique for patients in countries with a low economic standard of living where health care is almost non-existent. We offered to share the experience of Senegal on the reconditioning of pacemakers.
METHODS: We conducted a retrospective study over a period from January 2015 to December 2020 including all patients who benefited from a reconditioned pacemaker for primary implantation or reimplantation. The criteria for reconditioning pacemakers are the absence of dysfunction or damage and a residual battery life of more than 5 years of the pacemaker. Refurbished pacemakers are acquired either from deceased families or from extraction centers. Sterilization is carried out using phenoxypropanol + benzalkonium chloride solution, 70% ethanol and ethylene oxide.
RESULTS: We collected 161 patients during the study period, including 77 men (48%) and 84 women (52%), i.e. a M/F sex ratio of 0.94. The average age of the population was 65 years. Functional symptomatology was dominated by syncope in 54%. Electrocardiographically, 72% of patients were in complete atrioventricular block. A primary implantation was noted in 91.5% of patients. The vascular approach most used during implantation was cephalic in 49.5% of cases. In our series, we noted that 58% of patients had benefited from temporary stimulation before implantation. At implantation, single-chamber stimulation was used in 60% of patients and 46.5% of patients had programming in VVI mode. We had 5.5% major complications with 3% box infection occurring between 3 and 6 months post-implantation and 2.5% pacemaker syndrome. We noted 1 case of death linked to underlying heart disease.
CONCLUSIONS: Reconditioning of cardiac pacemakers is a safe and beneficial therapeutic strategy for patients. In Senegal, reconditioning has shown satisfactory results. In our countries this technique can be an alternative for certain patients.

BACKGROUND: The Richard-Toll social security fund agency ranks second in terms of declaration of work accidents (WA) in Senegal. In view of this and in the absence of a study that is interested in this subject, we initiated this work, the aim of which was to study these WA declared in the said agency.
METHODS: This was a retrospective and descriptive study carried out from January 1, 2018 to December 31, 2020. The parameters studied were the socio-professional information of the victims and the characteristics of the accidents.
RESULTS: A total of 1,071 workplace accidents were recorded. The average age of the victims was 37.1 years old. Agricultural workers and laborers were more concerned (95.5%). Site accidents accounted for 95% of cases. Lesions were mainly wounds (83.3%) and were benign in 98.2% of cases. The machete was incriminated in 48.5% of cases. Accidents occurred while cutting sugar cane in 81% of cases. The Senegalese sugar company was the main reporter (99%) and 84.4% of accidents were recorded periodically from December to May.
CONCLUSIONS: Work accidents are a reality in the Senegalese sugar company. Studies are urgently needed to better understand this issue. The purpose was to strengthen pre-existing prevention programs.
BACKGROUND: L\'agence de la caisse de sécurité sociale de Richard-Toll occupe la seconde place en termes de déclaration des accidents de travail (AT) au Sénégal. Au regard de cela et en l\'absence d\'étude s\'y intéressant, nous avons initié ce travail dont le but était d\'étudier ces AT déclarés dans ladite agence.
UNASSIGNED: Il s\'agissait d\'une étude rétrospective et descriptive réalisée du 1er janvier 2018 au 31 décembre 2020. Les paramètres étudiés étaient les informations socioprofessionnelles des victimes et les caractéristiques des accidents.
UNASSIGNED: Au total, 1071 accidents de travail ont été recensés. L\'âge moyen des victimes était de 37,1 ans. Les ouvriers agricoles et les manœuvres étaient plus concernés (95,5%). Les accidents de site représentaient 95% des cas. Les lésions étaient essentiellement des plaies (83,3%) et étaient bénignes dans 98,2% des cas. La machette était incriminée dans 48,5% des cas. Les accidents survenaient lors de la coupe de canne à sucre dans 81% des cas. La compagnie sucrière sénégalaise était le principal déclarant (99%) et 84,4% des accidents étaient enregistrés périodiquement de décembre à Mai.
CONCLUSIONS: Les AT sont une réalité dans la compagnie sucrière sénégalaise. Il urge d\'y mener des études pour mieux cerner cette problématique. La finalité était de renforcer les programmes de prévention préexistants.

BACKGROUND: In Senegal, the main causes of death are the pneumonia, the diarrhea and the malaria. The malnutrition is an underlying factor in more than a third of the deaths, because it returns the more vulnerable children to the serious illnesses. The general objective of this research is to study the availability and the price of medicine in the therapeutic care of the children of less than 5 years old in the region of Dakar in Senegal.
METHODS: Our study is of transverse, descriptive concerned the public sanitary, the wholesalers, the private pharmacies, The population of study concerns the old children at least of 5ans. The methods used were the interviews by means of questionnaire.
RESULTS: The group of antibiotics, acid anti, antidotes, vitamins, diuretics, antiemetic\'s, and psychotropic were not available. As regards generic medicines, relatively low availability of 30,4 %, 23,8 % and 16,7 % is respectively observed in the public, private and denominational sectors. The availability of generic medicines in Dakar was from 81 % in the public sector and from 113 % in the private sector.
CONCLUSIONS: The findings make it imperative for all other relevant medicine drugs in order to reduce the mortality rate.
BACKGROUND: Au Sénégal, les principales causes de mortalitéchez les enfants de moins de 5ans sont la pneumonie, la diarrhée et le paludisme. La malnutrition est un facteur sous-jacent dans plus d\'un tiers des décès, car elle rend les enfants plus vulnérables aux maladies graves.
UNASSIGNED: Notre étude est de type transversal, descriptif et a porté sur les formations sanitaires publiques les grossistes, les pharmacies privées, L\'objectif général de cette recherche est d\'étudier la disponibilité et le prix des médicaments dans la prise en charge thérapeutique des enfants âgés de moins de 5 ans dans la région de Dakar au Sénégal. La méthode utilisée était des questionnaires et entrevues.
UNASSIGNED: Le groupe des antibiotiques, des anti acides, des antidotes, des vitamines, des diurétiques, des antiémétiques et des psychotropes n\'étaient pas disponibles. Concernant les médicaments génériques, des disponibilités relativement faibles de 30,4 %, 23,8% et 16,7% sont respectivement observées dans les secteurs public, privé et confessionnel. La disponibilité des médicaments génériques à Dakar était de 81% dans le secteur public et de 113% dans le secteur privé.
CONCLUSIONS: Les résultats prouvent l\'impérieuse nécessité de rendre disponibles les médicaments pédiatriques si nous voulons réduire la mortalité des enfants de moins de 5ans.

BACKGROUND: Endometriosis is a gynecological pathology defined by the presence and abnormal development of endometrial tissue outside the uterine cavity. Our objective was to draw up an epidemiological profile and to describe the anatomical clinical forms of endometriosis in Dakar.
METHODS: This is a retrospective study of all cases of external and internal endometriosis diagnosed in an anatomy and pathology laboratory in Dakar over a period of twenty (20) years. The study parameters were collected from anonymous data sheets. Data entry and analysis were performed using version 22 of the EPI INFO and SPSS software.
RESULTS: Our study involved 104 female patients. The mean age was 47.3±10.0. Among the patients with an adenomyosis condition, the mean age was 49.8 years. Patients with an external endometriosis condition had a mean age of 37.6 years. The location of the endometriosis was statistically correlated with the age of patients and with parity. Anatomically and pathologically, the surgical specimen 89.4% (n=93) was the main type of sampling that was found. The uterine body was the main location of the pathology, with 78.9% (n=82), followed by the umbilical location with 9.6% (n=10). Leiomyomas 44.07% (n=26) were the main associated lesions.
CONCLUSIONS: Endometriosis is a gynecological pathology that is unfortunately not well known, and which is under diagnosed in Senegal.

BACKGROUND: Percutaneous coronary intervention (PCI) remains a major therapeutic tool in the management of acute coronary syndromes (ACS). However, it is not widely practiced in sub-Saharan Africa, particularly for the management of ACS. The availability of a catheterization laboratory for 24-hour management of ACS in Dakar is an important step in improving the prognosis of patients. The objective of our study was to evaluate the clinical and prognostic profile of patients presenting an ACS and treated by PCI.
METHODS: This is a retrospective study that included all patients who underwent PCI for ACS at hospital principal Dakar during the period from January 2019 to December 2020.
RESULTS: Our study included 112 patients with a mean age of 60 years (extremes 31-96 years) and a male predominance (sex ratio 4.09). Cardiovascular risk factors were dominated by hypertension (47.3%) and smoking (39.3%). Chest pain was present in 97% of patients. Left ventricular systolic function was impaired in 56 patients with a mean of 50% and extremes of 20 and 78%. Thrombolysis with streptokinase was used in 13 patients with STEMI. The majority of coronary angiogram (95%) were performed between 8 am and 5 pm. The radial route was the most commonly used (85.7%). Double vessel coronary artery disease was predominant (39,3%) and the left anterior descending artery was the most affected (60.7%). The PCI was performed in all patients and in more than half of the cases (55%) within 12 hours of delay. The PCI success rate was 96.4%. Sixty-seven patients (59.8%) underwent balloon predilation. PCI was performed with a drug-eluting stent in the majority of patients (92.8%). The outcome was favorable in 96.4% of the patients, but there were 3 deaths (2.7%).
CONCLUSIONS: Treatment of ACS by PCI is a reality in Senegal with a considerable success rate. However, intervention delays remain one of the major challenges of this management.

Pulmonary tuberculosis is still a global scourge, especially in developing countries, despite the control measures that have been in place for decades. The aim of this work was to describe the epidemiological, clinical radiological and evolutionary aspects of PMPT at the Saint-Louis Regional Hospital Center. This was a retrospective descriptive study on 191 PMPT files, hospitalized in the medical department from January 1, 2016 to December 31, 2017.
METHODS: Were included in the study, all cases of pulmonary tuberculosis proved by the presence of bacillus Koch on direct examination of sputum. Were excluded from the study, cases of pulmonary tuberculosis with negative microscopy and cases of pulmonary tuberculosis in patients younger than 14 years.
RESULTS: Of 1417 hospitalizations, 191 patients had a PTPM. The average age was 36.5 years with extremes of 14 to 81 years. The sex ratio was 2.2 in favor the male. Fishermen were the most affected with 34% of cases. A family tuberculosis was noted in 61 patients. One hundred and forty-six new PMPT cases were noted.
CONCLUSIONS: Positive microscopy pulmonary tuberculosis remains a public health problem in Senegal. Much work remains to be done in Saint-Louis, which a region with a high burden of tuberculosis.
BACKGROUND: la tuberculose pulmonaire demeure encore un fléau mondial en progression surtout dans les pays en voie de développement, malgré les actions de lutte mises en place depuis des décennies. Le but de ce travail était de décrire les aspects épidémiologiques, cliniques radiologiques et évolutifs de la TPM (+) au centre hospitalier régional de Saint-Louis. Il s\'agissait d\'étude descriptive rétrospective portant sur 191 dossiers de TPM+, hospitalisés au service de médecine du 1er Janvier 2016 au 31 Décembre 2017. Étaient inclus dans l\'étude, tous les cas de TPM+ prouvée par la présence de BAAR à l\'examen direct des crachats. Étaient exclus de l\'étude les patients de moins de 14 ans, les cas de TPM(-) Résultats : Sur 1417 hospitalisations, 191 patients avaient une TPM+. L\'âge moyen était de 36,5 ans avec des extrêmes de 14 à 81 ans. Sex-ratio de 2,2. Les pêcheurs étaient les plus touchés avec 34 % des cas. Un contage tuberculeux familial était noté chez 61 malades. Cent quarante six nouveaux cas de TPM(+) ont été notés. Conclusion : la TPM(+) demeure un problème de Santé Publique au Sénégal. Beaucoup d\'efforts restent à faire dans la région de Saint-Louis à forte charge de tuberculose.

OBJECTIVE: The objective of this study was to evaluate the sexuality of SS sickle cell patients with a history of priapism.
METHODS: This was a case-control study of adult SS sickle cell patients. The occurrence of priapism as well as the nature of the priapism had been investigated. The patients were subdivided into three groups: Group 1 (no priapism), Group 2 (intermittent priapism) and Group 3 (acute priapism). The patients\' sexuality was studied using the IIEF-15 questionnaire.
RESULTS: We interviewed 191 SS sickle cell patients. The mean age was 27.1±7.1 years. Priapism was observed in 43.5 %. Only 77 patients were eligible for the IIEF15 questionnaire. Groups 1 and 2 performed significantly better than group 3 on erectile function (EF) and orgasmic function (OF) scores. There was no significant difference in the EF and OF scores between groups 1 and 2. No significant difference was observed between the three groups for the scores of sexual desire (SD), intercourse satisfaction (IS), and overall satisfaction (OS). The impairment of erectile function in group 2 was related to the age of the first episode of priapism and the last episode. The impairment of erectile function in group 3 was related to the duration of evolution (P<0.05).
CONCLUSIONS: This study shows that priapism is responsible for impaired erectile function in SS adult sickle cell patients. A program to prevent intermittent episodes of priapism should be put in place.

BACKGROUND: Three months after the first appearance of the new coronavirus (COVID-19), Senegal recorded its first case on March 2, 2020. Faced with this pandemic, the State reacted quickly with public measures : instituting a curfew, placing a ban on travel between regions, and closing shops and places of worship. This research aims to study the acceptability of these non-pharmaceutical measures by the Senegalese population.
METHODS: This study was a cross-sectional and analytical survey conducted in June and July 2020 among Senegalese over 18 years old. Sampling by the representative quota method was distributed proportionally to age, gender and region. We constructed the questionnaire using the theoretical framework of acceptability of health interventions. Through a telephone call center synchronised to an internet server, we collected data on personal characteristics, knowledge of the disease, trust in information sources, trust in government, concern about the pandemic, and the seven dimensions of acceptability. We performed descriptive analysis and structural equation with R software version 4.0.2.
RESULTS: This study included a total of 813 individuals. The average age was 34.7 years ( ± 14.2 years). They were predominantly male (54.6 %), with no education (42.6 %). The increased level of knowledge of the disease was associated with confidence in national media information sources provided by the administrative and health authorities (β=0.11, p<0.01). The increase in the level of trust in the government in response to COVID-19 was positively related to the acceptability of curfew (β=0.16, p<0.001), travel ban between regions (β=0.11, p<0.001), and closure of places of worship (β=0.1, p<0.01) and markets (β=0.09, p<0.01).
CONCLUSIONS: In Senegal, the acceptability of the measures depended on knowledge of the disease, perception of the risk of the disease, and trust in the government. There is a need to strengthen awareness and risk communication of COVID-19.

Sjögren\'s syndrome (SS) is an autoimmune epithelitis, rarely described in black Africa. We report its epidemiological, diagnostic, therapeutic and evolutionary aspects in a Senegalese hospital environment. A retrospective, crosssectional study was carried out in the rheumatology and internal medicine departments of Aristide-Le-Dantec University Hospital of Dakar, between January 2012 and September 2016, where the observations of SS whose diagnosis, in line with the American-European consensus criteria of 2002, were enrolled. We collected 370 observations of SS, 327 women and 43 men, a sex-ratio of 1:9. These were 251 primitive forms (pSS) and 119 secondary forms (sSS). The hospital prevalence of pSS was 5%. The mean age was 42 ± 15 years and the time taken for diagnosis was 7 years. The familial forms totaled 47 index cases with a relative risk of occurrence of the disease estimated at 6.3% for firstdegree relatives. The juvenile forms totaled 7 cases of pSS. Dry syndrome was constant: oral (87%) and ocular (84%). Extra glandular manifestations were present in 87%. Arthritis was erosive in 75 cases and secondary to Rheumatoid arthritis. Autoantibodies (rheumatoid factors [49/147], anti-CCP [24/79], Sjögren\'s syndrome autoantigen A [anti- Ro/SSA] 41/140, Sjögren\'s syndrome autoantigen B [anti-La/SSB] [22/140], anti-nuclear [14/55] and cryoglobulin 1) were objectified. The histology practiced in 253/370 patients was contributory in 229 of them. According to the ESSPRI score (Eular Sjögren\'s Syndrome Patient Reported Index), 77% of patients had unbearable symptoms. NHP (Nottingham Health Profile) and SF-36 (Short Form [36] Health Survey) confirmed this deterioration in the quality of life. The ESSDAI score (Eular Sjögren Syndrome Disease Activity Index) showed persistent activity of the disease. The evolution was overall favorable. The hospital prevalence of pSS was 5%. It is predominant in women with an average age of 42 years. Glandular and systemic manifestations are frequent. The functional repercussions and the alteration of the quality of life are notable.
Le syndrome de Sjögren (SS) est une épithélite auto-immune, rarement décrite en Afrique noire. Nous rapportons ses aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs en milieu hospitalier sénégalais au travers d’une étude rétrospective, transversale, réalisée dans les services de rhumatologie et de médecine interne du CHU Aristide-Le-Dantec de Dakar, entre janvier 2012 et septembre 2016. Le diagnostic des observations de SS colligées était en accord avec les critères américano-européens modifiés en 2002 (critères de Vitali). Nous avons colligé 370 observations de SS chez 327 femmes et 43 hommes, soit un sex-ratio de 1/9. Il s’agissait de 251 formes primitives (SSp) et de 119 formes secondaires (SSs). La prévalence hospitalière du SSp était de 5%. L’âge moyen était de 42 ans ± 15. Le délai du diagnostic était de sept ans. Les formes familiales totalisaient 47 cas index, avec un risque relatif de survenue de la maladie estimé à 6,3 % pour les apparentés de premier degré. Les formes juvéniles totalisaient sept cas de SSp. Le syndrome sec était constant : buccal (87 %) et oculaire (84 %). Les manifestations extraglandulaires étaient présentes dans 87 % des cas. Les arthrites étaient érosives dans 75 cas, secondaires à une polyarthrite rhumatoïde. Les autoanticorps (facteurs rhumatoïdes [49/147], anticorps antipeptides cycliques citrullinés [anti-CCP] 24/79, Sjögren’s syndrome autoantigen A [anti-Ro/SSA] [41/140], Sjögren’s syndrome autoantigen B [anti-La/SSB] [22/140], antinucléaires [14/55] et cryoglobuline [1 cas]) étaient objectivés. L’histologie pratiquée chez 253/370 patients était contributive chez 229 d’entre eux. Selon le score ESSPRI (Eular Sjögren’s Syndrome Patient Reported Index), 77 % des patients avaient des symptômes insupportables. Le NHP (Nottingham Health Profile) et le SF-36 (Short Form [36] Health Survey) confirmaient cette altération de la qualité vie. Le score ESSDAI (Eular Sjögren Syndrome Disease Activity Index) objectivait une activité persistante de la maladie. L’évolution était globalement favorable. La prévalence hospitalière du SSp était de 5 %. Il prédominait chez les femmes d’âge moyen de 42 ans. Les manifestations glandulaires et systémiques étaient fréquentes. Le retentissement fonctionnel et l’altération de la qualité de vie étaient notables.