[Hospital Management of Work-related injuries in informal sector: case of artisanal fishing in Saint-Louis (Senegal)]. / Prise en Charge Hospitalière des accidents de Travail dans le secteur informel : cas de la pêche artisanale à Saint-Louis (Sénégal).

OBJECTIVES: to determine the mechanisms, lesions and hospital management of work-related accidentduringtraditional fishing,an activity subject to vital occupational risks. MATERIALS AND METHODS: Descriptive retrospective study on occupational injury files in artisanal fishing professions, registered at the Saint-Louis Regional Hospital (Senegal), from January 2014 to December 2019. All complete records of trauma during any activity related to artisanal fishingwereincluded. Data on accident mechanisms, injuries observed, and hospital management were collected. RESULTS: 47 male workers were on average 28.4 years old. Direct shock from a pirogue was most frequent (68.10%), followed by sharp or blunt objects (16.27%). The lesions were characterized by bone fractures in 63.83% of cases (n=30); chest-abdominal-pelvic and limb contusions and wounds represented 12.67% and 21.27% of cases, respectively. Medical management was done in 21 cases (44.7%). Surgery was dominated by intramedullary nailing in 15 cases (31.9%). Two laparotomies were performed with intestinal sutures. A chest contusion death was reported. CONCLUSION: Traumatic occupational risks in traditional fishing are life threatening. A better understanding of these risks and their consequencesmakes it possible to ensure good prevention.

OBJECTIFS: déterminer les mécanismes, les lésions et la prise en charge hospitalière des accidents de travail maritimes au cours de la pêche artisanale. MATÉRIEL ET MÉTHODES: Etude rétrospective descriptive sur les dossiers de traumatismes par accident de travail de la pêche artisanale, recensés au niveau du Centre Hospitalier Régional de Saint-Louis (Sénégal), de janvier 2014 à décembre 2019. Etaient inclus tous les dossiers complets de traumatisme au cours de toute activité liée à la pêche artisanale. Les données sur le mécanisme des accidents, les lésions constatées et la prise en charge hospitalière étaient recueillies. RÉSULTATS: il s'agissait de 47 travailleurs masculins âgés en moyenne de 28,4 ans.Les chocs directs par une pirogue étaient les plus fréquents (68,10%), suivis des objets tranchants ou contondants (16,27%). Les fractures étaient prédominantes dans 63,83% des cas (n=30) ; les contusions thoraco-abdomino-pelviennes et de membres ainsi que les plaies représentaient respectivement 12,67% et 21,27% des cas. Le traitement était médical dans 21 cas (44,7%). La chirurgie était dominée par l'enclouage centro-médullaire dans 15 cas (31,9%). Deux laparotomiesétaient effectuées avec sutures intestinales. Un décès par contusion thoracique était noté. CONCLUSION: les risques professionnels traumatiques dans la pêche artisanale engagent le pronostic vital. Une meilleure connaissance de ces risques par les travailleurs permet d'en assurer une bonne prévention.

[Ultrastructural aspects of the spermatozoon abnormalities on infertile men in Senegal]. / Aspects ultrastructuraux desanomalies du spermatozoïde chez les hommes hypofeconds au Sénégal.

Oligo-astheno-teratozoospermia being frequently observed (44,1%) in male subjects among hypofertiles couples of the sample population, we studied it at the ultrastuctural level. Our investigations have shown that, in addition to morphological and functional abnormalities, spermatic cells in said persons also presented serious ultrasructural disorders which would cause sterility. However in the absence of specific codified treatment for the majority of abnormalities found in sperms and given the high cost of the utrastructural analysis, we propose to limit our study to precise cases of male sterility through routine sample evaluations.

[Primary lymphoma of the thyroid: a case report]. / Lymphome primitif de la thyroïde: a propos d'un cas.

Primary lymphoma of the thyroid is an uncommon disease. It diagnosis is difficult without immunohistochemestry. We report a case of thyroid lymphoma diagnosed at the A. Le Dantec Hospital of Dakar. A 22-year old young man presented anterior neck mass. Clinical examination showed a thyroid mass with a susclavicular palpable lymph node. The scintigraphy demonstrated that the mass was cold. Total thyroidectomy with cervical lymphadenectomy was the first treatment. Histological examination of the surgical specimen concluded that the mass was an anaplastic lymphoma (large cells type) involving the sus clavicular lymph nodes (stage IIE). Chemotherapy was administrated after one month with C-MOPP schedule. The patient presented no recurrent sign after 30 month. Fine needle aspiration and immunocytochemestry of the thyroid cold masses will contribute in an accurate diagnosis and the management of disease in our institution.

[Sodium fluoride controlled release system for intra buccal use]. / Système intra buccal delibèration contrôlée de fluorurede sodium.

Hydroxyapatite which has the same elemental chemical composition as natural bone and teeth is one of the promising raw material for the design of drug controlled release system in intrabuccal use. It is stable and biocompatible and widely used in orthopedics and odontology. So, in order to improve the administration of drugs for intrabuccal use, we have developped a fluoride controlled release delivering system. We have formulated tablets of 160 to 200 mg to be fixed on the vestibular face of a molar or a premolar and permitting to reach high enough local concentrations for desirable therapeutic effect. The tablets have a granular matrix composed of hydroxyapatite and fillers, ethylcellulose and/or Eudragit. For all tablets, the pharmacotechnical values support the pharmacopoeia norms. On fragments of tissue maintained in culture, the sodium fluoride is released at constant rate. The release profiles observed are predictable. No disintegration of tablets have been observed during release studies and after. Histological analyses performed after release studies showed the biocompatibility qualities of the tablets.

[Scintigraphic imaging of macrophages involved in lung vasoreflex: rat model]. / Scintigraphie des macrophages impliqués dans la vasoréactivité pulmonaire: modélisation chez le rat.

At time of pathological situations, a pulmonary fixation of labelled substances injected by intravenous way is observed. This fixation would result from a phagocytosis of these substances by abnormal cells whose presence was induced in the endothelium: Pulmonary Intravascular Macrophages (PIM's). After activation by phagocytosis, these cells are able to secrete powerful vasoactive mediators capable of inducing cardiopulmonary accidents. Hepatic cholestase was induced in Wistar rats by ligation and section of common bile duct. The recruitment of PIM's was followed in vivo by phagocytosis scintigraphic imaging after labelled colloid injection. During the 35 days of evolution of the pathology, we observe a pulmonary fixation of the colloid agents which progresses up to 70% as well as a concomitant decease in the hepatic activity. Histologic examination showed numerous cells related to pulmonary capillaries' endothelium belonging to mononuclear phagocytes line and expressing an activated phenotype of monocytes. The scintigraphic and histological tests carried out enabled us to validate the model of induction of PIM's in rat by ligation of the choledoque one. The study of the vasoactive response via certain mediators can from now be approached, a Doppler technique on the pig aorta is being in the course of evaluation.

[Sickle cell disease neonatal screening. First evaluation]. / Dépistage néonatal de la drépanocytose au CHU de Dakar: premier bilan.

A neonatal screening allows a preclinical diagnosis of major sickle cell syndromes and an early management of the affected children. That would improve their life quality and expectancy. The preliminary program was set up on 518 senegalese newborn aged from 1 to 4 days, and coming from all the country ethnic groups. Isoelectrofocalisation is the test used on dried blood eluate and the positive control on citrate agar gel. 478 samples out of 518 (92.5%) have been analysed. Haemoglobinopathy have been found in 11.1% of cases, distributed as follow: heterozygoty FAS and FAC: 9%, double heterozygoty FSC: 0.2% and homozygoty FSS: 1.9%. Sickle cell neonatal screening should be imperatively implemented, with regards in economical considerations. It would be relevant to integrate it in a larger program including information, training and genetic counselling in order to avoid homozygotes birth and to lower the spread of this disease.

[Dysthyroidism after 60 years of age]. / Dysthyroïdies à partir de 60 ans.

This work has been conducted on 162 subjects, aged over 60 years, living in Senegal, investigated in the Departement of Biophysics and Nuclear Medecine of Dakar for suspicion of dysthyroidism. The levels of T3, T4 and TSH US hormones were determined by a radio-immunological method. This technique, exhibiting good functionnal sensitivity and its high specificity, is likely to be beneficial to the diagnosis of dysthyroidisms. Besides, this experiment leads us to consider that the dosage of TSH remains an useful first intention examination for the old patients and could notably improve the screening of dysthyroidisms with a decrease in the cost of the investigation. However, because of the therapeutical implications, some biological profiles schould be interpreted cautiously. The equipment for the determination of the free fractions (T3 and T4) with the brought additional accuracy could allow to dismiss some diagnostci uncertainties.

[Serum cortisol level variations in thyroid diseases]. / Variations de la cortisolémie au cours des dysthyroidies.

This work studies the thyroid disorders impact on adrenals glands by measuring total cortisol. Radioimmunoassays of thyroid hormones and cortisol were performed in 108 subjects, aged 20-52 years, with thyroid diseases. Our results show low cortisol values (80.35 nmol/L) in 4.77% of hyperthyroids, high values in 3.57% of hyperthyroids (1348.18 nmol/L) and 12.5% of hypothyroids (969.05 nmol/L). In hyperthyroidism, thyroid hormone stimulates the secretion of 11 ceto metabolites biologically inactive, unable to slow pituitary activity, inducing an increased production of endogene cortisol. Excessive catabolism can lead to the exhausting of overstimulated adrenal glands, and therefore to a decreased cortisol. In hypothyroidism, high cortisol results of increase cortisol half life and decrease of metabolic clearance. Control mechanisms often allow normal cortisol values. These alterations in functional activity of adrenal glands, seen in nearly 10% of these subjects, sometimes command a specific attitude in diagnosis and therapy.