ABSTRACT
The aim of this study is to perform phytochemical screening of the leaves of Piliostigma reticulatum and Piliostigma thonningii, to determine the phenolic, flavonoids, tannins, and sugars content in their methanolic extracts, evaluate their antioxidant activity using the DPPH and the ABTS tests, and test their anti-inflammatory effect in vitro using the heat-induced albumin denaturation inhibition method. Phytochemical screening revealed the presence of polyphenols and alkaloids in the leaves of both plants. Yields of the extracts in this study ranged from 7% to 18% for P. reticulatum and 4% to 16% for P. thonningii. The phenolic content in the methanolic extract of P. reticulatum is 74.66 ± 1.76 µg GAE/mL, which is significantly higher than that of P. thonningii (56.54 ± 1.24 µg GAE/mL). Both plants showed good antioxidant activity. In fact, for the DPPH test, the IC50 value is 8.88 ± 0.11 µg/mL for P. reticulatum and 17.64 ± 0.68 µg/mL for P. thonningii. For the ABTS assay, the IC50 values of the two plants are, respectively, 9.78 ± 1.83 µg/mL and 13.47 ± 2.62 µg/ml, statistically comparable and significantly higher than the IC50 of the standard 30.76 ± 0.18 µg/ml. Leaf extracts from both plants were effective against heat-induced denaturation of albumin. The activity of P. reticulatum is indeed comparable to that of the standard with an IC50 value of 121.43 ± 1.55 µg/mL and higher than that of P. thonningii with an IC50 value of 170.15 ± 1.09 µg/mL. These results show that both plants exhibit significant antioxidant and anti-inflammatory activities. Therefore, their chemical compounds could have potential applications as antioxidant and anti-inflammatory drugs.
ABSTRACT
Les manifestations cutanées au cours de l'infection à VIH étaient beaucoup rapportées, celles du cuir chevelu l'étaient moins. Notre objectif était de déterminer les types de dermatoses du cuir chevelu survenant au cours de l'infection à VIH. Une étude prospective était menée sur 10 mois (juillet 2008 - avril 2009) dans des structures de prise en charge de personnes vivant avec le VIH à Dakar. Était inclus, tout patient infecté par le VIH présentant une atteinte du cuir chevelu et suivi dans l'un des sites de l'étude durant la période de l'étude. Un total de 63 patients présentant 85 pathologies du cuir chevelu était colligé, dont 65 % de sexe féminin et 35 % de sexe masculin. L'âge moyen était de 38 ans. La prévalence des atteintes du cuir chevelu était de 5,7 % à la clinique dermatologique de l'hôpital Aristide Le Dantec et 22 % au Centre de Traitement ambulatoire (CTA) du CHU de Fann. La trichopathie soyeuse représentait 32 % des pathologies, la teigne 24 %, la dermite séborrhéique 15 %. La trichopathie soyeuse, était associée au stade C chez 19 patients et au stade B chez 8 patients. Parmi les 20 patients ayant la teigne, 8 patients avaient moins de 200 CD4/mm3. Le délai moyen avant le recours au soin était de 74 jours. L'atteinte du cuir chevelu entrainait un retentissement psychologique chez 63 % des patients. Le cuir chevelu était atteint en cas d'immunodépression sévère et de dénutrition importante
Subject(s)
Scalp , Scalp DermatosesABSTRACT
Hernia is described as the protrusion of an organ into the wall of its normal containing cavity. Internal hernia (IH) involves protrusion of viscera through: a peritoneal or mesentery defect, a normal or abnormal compartment of the peritoneal cavity. Hernias occurring in the pelvis cavity are usually classified according to the fascial margins breached and include sciatic, obturator and those through the rectouterin pouch: elytrocele and enterocele. Those hernias are defined by the protrusion of a viscus through the wall of the pelvis due to weakness of the pelvic fascia and/or muscles. Pelvic hernia through the pouch of Douglas (PD) involves the genital tract in female (elytrocele and enterocele). Sometimes described in the literature as Douglas hernia, this type of hernia must be distinguished from the conventional IH. As defined before, the borders to be considered for IH is the peritoneal membrane, which is not a real solid wall but delimitates the peritoneal cavity; and there is no peritoneal defect in elytrocele or enterocele. A PubMed search for IH through a defect in the peritoneal PD revealed only five female cases, making this an extremely rare condition. To our knowledge, we have presented here the only published case in a male. This probably congenital and morphologic anomaly (defect) of pouch of Sir Douglas must be distinguished as the real "Douglas IH". Authors discuss the concept of a new and more detailed classification of IH.
Subject(s)
Douglas' Pouch/abnormalities , Hernia/diagnosis , Ileal Diseases/diagnostic imaging , Intestinal Obstruction/diagnostic imaging , Peritoneal Diseases/diagnosis , Abdominal Pain/etiology , Abdominal Pain/surgery , Anastomosis, Surgical , Bandages , Constipation/etiology , Constipation/surgery , Digestive System Surgical Procedures/adverse effects , Digestive System Surgical Procedures/methods , Douglas' Pouch/diagnostic imaging , Douglas' Pouch/pathology , Douglas' Pouch/surgery , Hernia/complications , Humans , Ileal Diseases/etiology , Ileal Diseases/pathology , Ileal Diseases/surgery , Ileum/pathology , Ileum/surgery , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Male , Middle Aged , Peritoneal Diseases/complications , Peritoneal Diseases/surgery , Surgical Wound Infection/drug therapy , Sutures , Tomography, X-Ray Computed , Vomiting/etiology , Vomiting/surgeryABSTRACT
BACKGROUND: In addition to antiretroviral therapy, non-antiretroviral drugs are necessary for the appropriate care of people living with HIV. The costs of such drugs are totally or partially supported by the people living with HIV. We aimed to evaluate the overall costs, the costs supported by the people living with HIV and factors associated with the prescription of non-antiretroviral drugs in people living with HIV on antiretroviral therapy in Senegal. METHODS: We conducted a retrospective cohort study on 331 people living with HIV who initiated antiretroviral therapy between 2009 and 2011 and followed until March 2012. The costs of non-antiretroviral drugs were those of the national pharmacy for essential drugs; otherwise they were the lowest costs in the private pharmacies. Associated factors were identified through a logistic regression model. RESULTS: The study population was 61 % female. At baseline, 39 % of patients were classified at WHO clinical stage 3 and 40 % at WHO clinical stage 4. Median age, body mass index and CD4 cells count were 41 years, 18kg/m2 and 93 cells/µL, respectively. After a mean duration of 11.4 months of antiretroviral therapy, 85 % of patients received at least one prescription for a non-antiretroviral drug. Over the entire study period, the most frequently prescribed non-antiretroviral drugs were cotrimoxazole (78.9 % of patients), iron (33.2 %), vitamins (21.1 %) and antibiotics (19.6 %). The mean cost per patient was 34 Euros and the mean cost supported per patient was 14 Euros. The most expensive drugs per treated patient were antihypertensives (168 Euros), anti-ulcer agents (12 Euros), vitamins (8.5 Euros) and antihistamines (7 Euros). The prescription for a non-antiretroviral drug was associated with advanced clinical stage (WHO clinical stage 3/4 versus stage 1/2): OR=2.25; 95 % CI=1.11-4.57 and viral type (HIV-2 versus HIV-1/HIV-1+HIV-2): OR=0.36; 95 % CI=0.14-0.89. CONCLUSION: Non-antiretroviral drugs are frequently prescribed to people living with HIV in developing countries; mainly those infected with HIV-1 and those at an advanced clinical stage. Their costs can be a barrier to appropriate care and necessary efforts must made to make them available. However, early initiation of antiretroviral therapy and the registration of some non-antiretroviral drugs on the list of essential drugs, as well as social protection systems, should reduce their use and costs.
Subject(s)
Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , HIV Infections/economics , Polypharmacy , Prescription Drugs/economics , Prescription Drugs/therapeutic use , Adult , Anti-Retroviral Agents/economics , Comorbidity , Costs and Cost Analysis , Drug Costs , Drug Therapy, Combination/economics , Female , HIV Infections/epidemiology , HIV-1 , HIV-2 , Humans , Male , Middle Aged , Practice Patterns, Physicians'/economics , Practice Patterns, Physicians'/statistics & numerical data , Retrospective Studies , Risk Factors , Senegal/epidemiologyABSTRACT
Primary hyperparathyroidism (PHPT) is rarely associated with the occurrence of acute or chronic pancreatitis. Hypercalcemia plays a major role in the pathogenesis. We report five cases of pancreatitis revealing PHPT. Patients and Methods. This is a retrospective study of 4 years, including all patients admitted to intensive care unit or gastroenterology department, for an acute or chronic pancreatitis revealing primary hyperparathyroidism. Results. We included 5 patients, all female, with mean age 54 years [40-76 years]. The PHPT was in all cases revealed by acute pancreatitis (AP). This one was oedematous in four cases and severe in one case. It occurred twice in calcified chronic pancreatitis (CCP). There was hypercalcemia in all cases. The PHPT was associated with a high rate of parathyroid hormone in 4 cases. The secreting lesion was an adenoma in 5 cases. Two patients had in addition bilateral renal calcifications. The outcome was favorable in 4 patients among whom 3 have had parathyroid surgery. A death was noted by superinfection of necrosis in the case of severe AP. Conclusion. The occurrence of pancreatitis during hyperparathyroidism is rare. Normal or elevated calcemia during acute or chronic pancreatitis should always get attention.
ABSTRACT
Adult-onset Still's disease is a uncommon form of inflammatory rheumatism. It has rarely been reported in black Africa. The purpose of this report is to describe a case in a 49-year-old woman from Dakar, Senegal.
Subject(s)
Still's Disease, Adult-Onset/diagnosis , Anti-Inflammatory Agents/therapeutic use , Female , Fever/diagnosis , Fever/drug therapy , Fever/etiology , Humans , Middle Aged , Prednisone/therapeutic use , Senegal , Still's Disease, Adult-Onset/complications , Still's Disease, Adult-Onset/drug therapyABSTRACT
A prospective study was carried out in two tertiary hospitals in Dakar to determine the main causes of sputum acid-fast bacillus (AFB) smear-negative pneumonia in HIV-infected patients. All clinical and microbiological records were reviewed by experts. Seventy patients were finally enrolled. Most of them were hospitalized at an advanced stage of AIDS. The median CD4 cell count was 62/mm(3) and the median body mass index (BMC) was 18 kg/m(2). Thirty-one patients (44 %) were known as seropositive for HIV infection prior to admission. Radiological opacities were localized in 70 % of patients and diffuse in 21 %. Fiberoptic bronchoscopy was performed in 50 patients (71 %). A definite or probable diagnosis was obtained in 55 patients (79 %). Bacterial pneumonia (usually due to Enterobacteriaceae and Pseudomonas aeruginosa), tuberculosis, Pneumocystis pneumoniae and other causes (Kaposi's sarcoma, atypical mycobacteria) were diagnosed in 67 %, 24 %, 5 %, and 13 % of these patients respectively. In conclusion, pneumonia of bacterial origin and tuberculosis can be incriminated in the majority of cases of AFB negative pneumonia observed in HIV patients in Dakar.
Subject(s)
HIV Infections/complications , Hospitalization , Pneumonia, Bacterial/microbiology , Decision Trees , Humans , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/etiology , Pneumonia, Bacterial/therapy , Prospective Studies , SenegalABSTRACT
Dermatopolymyositis (DPM) is a term describing a group of disorders comprising multiple distinct entities depending on interactions between genetic and environmental factor. There is a paucity of studies on DPM in black Africa. The purpose of this report is to describe epidemiological, clinical, laboratory and therapeutic aspects of dermatomyositis (DM) and polymyositis (PM) observed at the Principal Hospital in Dakar, Senegal. A retrospective review as conducted of patients hospitalized for DM and PM in Medical Departments of Principal Hospital. Diagnosis of DRM was based on the criteria of Bohan and Peter's in all cases. A series of 21 black African patients was compiled including 15 with DM and 6 with PM. Mean age was 52 years and the M/F sex ratio was 0.6. The mean delay for diagnosis was 6 weeks (range, 3 to 12 weeks). Initial signs were dermatological in 12 patients, pulmonary in one and muscular in the remaining cases. The most common dermatological sign was erythema characterized by a zebra-like aspect on the extended limbs. Erythema was frequently pruriginous with a flagellate aspect on the back. Muscular signs were observed in 18 patients and included pharyngeal manifestations in 10 patients. Amyopathic DM was not observed. Cardiac abnormalities included tachycardia (4 cases), AVB (1), ischemic lesion (1), relaxation disturbances (4), pericardial effusion (3), myocarditis (2) and pulmonary hypertension (1). The most common pulmonary manifestation was interstitial lung disease observed in 6 patients. Gastrointestinal signs were noted in 9 patients including endoscopic evidence of superficial erosion in 4 cases. Electromyography (EMG) tracings revealed myogenic disease in 14 cases including 2 associated with reduced peripheral nervous conduction speed. Severe lymphopenia was observed in 3 patients but HIV serology was negative in all cases. Paraneoplasic DM was observed in 3 cases. Death occurred in 5 cases due to the cancer-related, pulmonary and infectious complications. Based on the findings of this study, the three main features of DM and PM in Senegal are flagellated and often pruriginous erythema, cardiac and interstitial lung disease, and peripheral neural involvement.
Subject(s)
Dermatomyositis/epidemiology , Polymyositis/epidemiology , Adult , Dermatomyositis/diagnosis , Dermatomyositis/therapy , Erythema/etiology , Heart Diseases/etiology , Humans , Neoplasms/etiology , Polymyositis/diagnosis , Polymyositis/therapy , Retrospective Studies , Senegal/epidemiology , Skin Diseases/etiologyABSTRACT
The use of ritonavir as a protease inhibitor boost is rare in sub-Saharan Africa because a heat-stable formula is not available. We report the results of an open-label pilot trial with unboosted atazanavir in combination with lamivudine and didanosine as first-line therapy conducted in Senegal. Treatment-naive HIV-1 infected adult patients without active opportunistic disease were included. The primary endpoint was the proportion of patients with plasma HIV-1 RNA <400 copies/ml at week 48. Forty patients (12 men and 28 women; mean age +/- SD: 40 +/- 9 years) were included. Treatment was changed during the study for two patients (pregnancy, tuberculosis); one patient was lost to follow-up and one patient died (gastroenteritis with cachexia). At week 48, 78% [95% confidence interval (CI): 65-90%] and 68% (95% CI: 53-82%) of the patients had HIV-1 RNA <400 and <50 copies/ml, respectively (intent-to-treat analysis; not completer = failure). Among the seven patients with HIV-1 RNA >or=400 copies/ml at week 48, five were not compliant; genotyping analysis (n = 4) did not reveal a major mutation for protease inhibitors. The mean CD4 cell count change from baseline to week 48 was +238 +/- 79 cells/mm(3). The combination of unboosted atazanavir with lamivudine and didanosine was efficient and well tolerated in HIV-1-infected patients with results similar to those observed in Northern countries. These results suggest that unboosted atazanavir with its high genetic barrier could be a valuable alternative to NNRTIs in resource-limited countries in some HIV-1-infected patients in case of compliance issues with NNRTIs, intolerance to NNRTIs, resistance mutations to NNRTIs, in women with childbearing potential, or as a maintenance therapy in patients with virological suppression.
Subject(s)
Anti-HIV Agents , Didanosine , HIV Infections/drug therapy , Lamivudine , Oligopeptides , Pyridines , Adult , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/adverse effects , Anti-HIV Agents/therapeutic use , Atazanavir Sulfate , Didanosine/administration & dosage , Didanosine/adverse effects , Didanosine/therapeutic use , Drug Administration Schedule , Drug Therapy, Combination , Female , HIV Infections/immunology , HIV Infections/virology , HIV-1/drug effects , HIV-1/physiology , Humans , Lamivudine/administration & dosage , Lamivudine/adverse effects , Lamivudine/therapeutic use , Male , Middle Aged , Oligopeptides/administration & dosage , Oligopeptides/adverse effects , Oligopeptides/therapeutic use , Pilot Projects , Pyridines/administration & dosage , Pyridines/adverse effects , Pyridines/therapeutic use , RNA, Viral/blood , Reverse Transcriptase Inhibitors/administration & dosage , Reverse Transcriptase Inhibitors/adverse effects , Reverse Transcriptase Inhibitors/therapeutic use , Senegal , Treatment OutcomeABSTRACT
INTRODUCTION: We report two cases of squamous cell carcinoma (SCC) in two black women (phenotype VI) using bleaching compounds for cosmetic purposes over a period of 15 years. CASE REPORTS: Two women (aged 45 and 47 years) with a long history of cosmetic use of bleaching compounds consulted at a dermatology unit for skin tumours. A diagnosis of SCC was confirmed by histological examination of tumour biopsies. One patient was HIV-positive. Surgical treatment was performed in both cases: simple postoperative complications were seen in one patient but the other died at home following recurrence of carcinoma in the year following diagnosis. DISCUSSION: To our knowledge, theses two cases represent the first description of SCC occurring after prolonged cosmetic use of bleaching compounds. Carcinoma occurred in both cases in skin exposed to sun. In our patients, the mechanism of carcinogenesis may have involved melanin destruction, solar exposure and corticosteroid-induced immunosuppression. A direct carcinogenic effect of hydroquinone or other unidentified compounds is another possibility; the carcinogenicity of hydroquinone is well established in rodents. While these observations do not provide formal proof of any implication of depigmentation products in SCC, they emphasize the need for monitoring of dark-skinned women using skin lighteners.
Subject(s)
Carcinoma, Squamous Cell/chemically induced , Cosmetic Techniques/adverse effects , Skin Neoplasms/chemically induced , Sodium Hypochlorite/adverse effects , Administration, Topical , Black People , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Female , Humans , Middle Aged , Senegal , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Skin Pigmentation/drug effects , Sodium Hypochlorite/administration & dosageABSTRACT
Introduction. Le diagnostic de tuberculose cutanee est rendu difficile par son polymorphisme clinique. Notre objectif etait de preciser les donnees epidemiologiques; cliniques; paracliniques et evolutives de la tuberculose cutanee a Dakar. Materiel et methode :Une etude retrospective de Janvier 1972 a Octobre 2005 a ete effectuee au service de Dermatologie de l'Hopital Le Dantec de Dakar. Le diagnostic etait base sur des arguments epidemiologiques; cliniques; l'intradermo-reaction a la tuberculine; la bacteriologie et l'histologie. Resultats : Notre etude a recense 151 cas dont 78 hommes et 73 femmes. La tuberculose cutaneo-ganglionnaire etait majoritaire (84;76) suivie de la gomme (11;25). Le lupus tuberculeux (1;98); la tuberculose periorificielle (1;98); la tuberculose verruqueuse (2;64) et la BCGite (0;66) etaient plus rares. Les localisations viscerales (43) etaient pulmonaires (26;5); osteoarticulaires (8;6) neurologiques (0;66) et multiples (9;17). L'IDR etait fortement positive dans 65;15des cas; la bacilloscopie dans 12;5; l'histologie dans 66;22et la serologie VIH dans 14;28. La cicatrisation des lesions cutanees etait notee chez tous les patients apres 1 a 2 mois de traitement. Une recidive a ete notee dans 3 cas et un deces dans 3 cas chez des patients positifs au VIH. Une guerison a ete observee dans 23 cas apres 8 a 12 mois de traitement. Conclusion : La tuberculose cutanee demeure endemique au Senegal. Le scrofuloderme et la gomme sont les principales formes cliniques. L'IDR fortement positive et le granulome tuberculoide avec necrose caseeuse deviennent des arguments diagnostiques de grande valeur
Subject(s)
Case Reports , Tuberculosis, Cutaneous , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/epidemiologyABSTRACT
We report the results of a pilot open-label trial of a tenofovir (TDF)/emtricitabine (FTC)/efavirenz (EFV) combination conducted in Dakar, Senegal. Forty HIV-1-infected patients, naive of antiretroviral treatment and without active opportunistic disease, were included and followed through 96 weeks. At weeks 48 and 96, respectively, 82.5% and 85% of patients had HIV-1 RNA <400 copies/mL (72.5% and 77.5% with HIV-1 RNA <50 copies/mL). Between baseline and week 96, the mean (SD) CD4 count increased from 126 (102) to 338 (155) cells/mm(3). The mean (SD) creatinine clearance decreased from 92 (36) to 73 (19) mL/min (P = .001). Treatment adherence was at least 94% at all scheduled visits. The efficacy and tolerability of a TDF/FTC/EFV combination were high and similar to those observed in Northern countries. This drug combination can be recommended in limited-resource countries, as did the World Health Organization (WHO) and should be made readily available as a fixed-dose combination.
Subject(s)
Adenine/analogs & derivatives , Anti-HIV Agents/therapeutic use , Benzoxazines/therapeutic use , Deoxycytidine/analogs & derivatives , HIV Infections/drug therapy , HIV-1/drug effects , Organophosphonates/therapeutic use , Adenine/pharmacology , Adenine/therapeutic use , Adult , Alkynes , Anti-HIV Agents/pharmacology , Benzoxazines/pharmacology , CD4 Lymphocyte Count , Cyclopropanes , Deoxycytidine/pharmacology , Deoxycytidine/therapeutic use , Drug Therapy, Combination , Emtricitabine , Female , HIV Infections/immunology , HIV Infections/psychology , Humans , Male , Medication Adherence , Middle Aged , Organophosphonates/pharmacology , Pilot Projects , Quality of Life , RNA, Viral/blood , Senegal , TenofovirABSTRACT
To slow the spread of bacterial resistance and promote safety in the use of medicines, development of quality control tools is indispensable. The purpose of this study was to evaluate the quality of several antibiotic agents used in Senegal and to assess the utility of the mini laboratory as a quality control tool. The mini laboratory and all materials necessary for this study were provided by the German Pharma Health Fund. A total of 34 antibiotic samples were submitted to a battery of tests including physical and visual inspection, disintegration, and thin layer chromatography designed for identification and semiquantitative evaluation. Non-conformities detected by physical and visual inspection were found mainly in products from the illicit sector (80%) but some non-conformities were also found in products from licit private sector (20%). Based on thin layer chromatography findings, non-conformities in product identity and dosage involved mainly erythromycin (45%) followed by amoxicillin and ciprofloxacin (22% each). Again this type of non-conformity was most frequent in products from the illicit sector (45%) but it was also observed in products from the private and public sectors (33% and 22% respectively). These findings show that follow-up is necessary to ensure the quality of medicines, especially antibiotics. In this study the mini laboratory was a highly useful quality control tool.
Subject(s)
Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/standards , Drug Resistance, Bacterial , Amoxicillin/administration & dosage , Chromatography, Thin Layer , Ciprofloxacin/administration & dosage , Developing Countries , Erythromycin/administration & dosage , Pharmaceutical Preparations/standards , Quality Control , SenegalABSTRACT
Introduction :La Reticulohistiocytose Multicentrique (RHM) est une affection peu decrite dans la litterature. Nous rapportons deux observations de RHM faites a Dakar; caracteristiques par l'agressivite des lesions et la presentation cutanee pure dans un cas.Observations : La premiere observation concernait une patiente agee de 34 ans admise pour des papulo nodules dissemines; une polyarthrite bilaterale asymetrique destructrice n'epargnant pas les inter-phalangiennes distales et un epanchement sero-hematique aux genoux. La deuxieme observation etait faite chez une patiente agee de 26 ans qui avait des papulo-nodules dissemines depuis 10 ans. L'examen histologique en faveur de la RHM dans les deux cas; montrait une infiltration intradermique d'histiocytes multinucleees sans plasmocytes ni polynucleaires ni cellules xanthomisees. La corticotherapie etait decevante dans la premiere observation. La surveillance etait indiquee dans le deuxieme cas. Conlusion : La RHM est une maladie rare chronique handicapante a localisation tegumentaire diffuse isolee exceptionnelle en Afrique
Subject(s)
Arthritis, Rheumatoid , Case Reports , Histiocytosis , Rheumatoid NoduleABSTRACT
Pour ralentir la propagation de la resistance bacterienne et promouvoir un usage securise des medicaments; il s'avere necessaire de developper des outils de controle et de gestion de leur qualite. Notre travail a pour objectifs d'evaluer la qualite de quelques molecules antibiotiques utilisees au Senegal et de demontrer la pertinence de l'utilisation du mini laboratoire comme outil de controle de cette qualite. Le mini-laboratoire de la German Pharma Health Fund fournit l'ensemble du materiel necessaire a l'etude.Au total; 34 echantillons d'antibiotiques ont ete soumis a une batterie de tests comportant l'inspection physique et visuelle des echantillons; le test de desagregation et la chromatographie sur couche mince pour l'identification et l'appreciation semi quantitative. Sur l'ensemble des non-conformites a l'inspection physique et visuelle; 80proviennent du secteur illicite (non officiel) et 20du secteur prive (officiel). Les non-conformites a l'identification et au dosage concernent l'erythromycine; suivie de l'amoxicilline et de la ciprofloxacine pour 22des cas chacune. Le secteur illicite est egalement le plus touche par ce type de non conformite (45); les secteurs prive et public ne sont pas non plus epargnes avec respectivement 33 et 22des echantillons non-conformes. Il est ainsi important d'assurer un suivi de la qualite desmedicaments en particulier des plus sensibles comme les antibiotiques. En cela ce mini-laboratoire peut etre d'un grand apport
Subject(s)
Anti-Bacterial Agents , Drug Resistance, Bacterial , Quality ControlABSTRACT
INTRODUCTION: The powdered milk is a much appreciated food in Senegal. However no particular control is realized by authorities on the various marks of milk imported before their marketing. In the concern to protect the health of the consumers, but especially in front of the very big variety of the sources of supply in this product we determined the contents in fat, in protein and in vitamin D main variety show of marketed powdered milk Dakar. MATERIAL AND METHODS: Chemical methods were operated to determine the fat contents and in proteins. The liquid chromatography in high performance was used to identify and measure the vitamin D. RESULTS: The obtained results profits showed that all the studied samples of milk had contents in fat included between 25 and 31 g %, those in proteins were included between 23 and 25 g %. As regards the dosage of the vitamin D, a single sample had content weaker than that mentioned on the packaging by the manufacturer. CONCLUSION: The results of this study allowed to notice most of the variety varieties of powdered milk marketed in Dakar were in accordance with the standards established for this food and are consequently good quality.
Subject(s)
Fats/analysis , Milk Proteins/analysis , Milk/chemistry , Vitamin D/analysis , Animals , Chromatography, High Pressure Liquid , Indicators and Reagents , Milk/standards , SenegalABSTRACT
Renal involvement determines the prognosis of systemic lupus erythematosus (SLE). The aims of this study were to assess the clinical, laboratory and therapeutic aspects of lupus nephritis (LN) in Senegal in order to improve its management. We included all patients presenting with SLE followed-up in the Internal Medicine and Dermatology Clinics of the Aristide Le Dantec University Teaching Hospital of Dakar, from January 1993 to December 2002. Patients with SLE without evidence of LN (defined by proteinuria more than 0.5 g/24 hours and/or hematuria) were excluded. A total of 74 patients with a diagnosis of SLE were studied, 42 of whom (56.75%) had features of LN. Their mean age was 29.6 years and male-female ratio was 0.13. The nephrotic syndrome was seen in 45.23% of the cases and renal insufficiency in 37.71%. Renal biopsy was performed in 52.38% of the cases, which showed predominantly WHO classes IV and V lesions. The main treatment modality employed was corticosteroids, while immunosuppressive drugs in addition were used in 35.71% of the patients. The short-term prognosis was favorable but in the middle-term, many patients were lost to follow-up. We conclude that early diagnosis by systematic urine screening, good patient information, percutaneous renal biopsy and use of appropriate immunosuppressive therapy will help improving the prognosis of LN in Senegal.
Subject(s)
Lupus Nephritis , Adolescent , Adult , Child , Child, Preschool , Humans , Lupus Nephritis/diagnosis , Lupus Nephritis/drug therapy , Middle Aged , Retrospective Studies , SenegalABSTRACT
BACKGROUND: Whereas teledermatology is an emerging discipline, to date, no teledermatology service has been developed, which is specifically dedicated to black skins. OBJECTIVES: To create and develop a teledermatology service that provides a complete range of communication, information, telediagnosis and teaching services. METHODS: A multilingual clinical description of the lesion was provided for each photograph using a five-level disease classification from the 10th revised International Classification of Diseases. In parallel, a usability study to assess and improve the functionality of the platform was also conducted. RESULTS: A web prototype has been developed which integrates image acquisition, submission, clinical description, translation as well as validation, security and data protection aspects and almost 2000 images were obtained from which 600 have been integrated in the 'store and forward' telemedicine system (http://www.black-skin.org). Initial usability tests with native French medical students show good perceived usefulness, perceived usability and internal consistency (Cronbach's alpha = 0.80 and 0.84). CONCLUSION: The Black Skin project (North and South collaboration project) offers possibilities for continuous medical education (pedagogical cases), teleteaching (educational quiz) or asking for a second opinion ('Ask a specialist' item).