Comparative analysis of volatile organic compounds of breath and urine for distinguishing patients with liver cirrhosis from healthy controls by using electronic nose and voltammetric electronic tongue.

Advanced stage detection of liver cirrhosis (LCi) would lead to high mortality rates in patients. Therefore, accurate and non-invasive tools for its early detection are highly needed using human emanations that may reflect this disease. Human breath, along with urine and blood, has long been one of the three main biological media for assessing human health and environmental exposure. The primary objective of this study was to explore the potential of using volatile organic compounds (VOCs) assay of exhaled breath and urine samples for the diagnosis of patients with LCi and healthy controls (HC). For this purpose, we used a hybrid electronic nose (E-nose) combining two sensor families, consisting of an array of five commercial chemical gas sensors and six interdigitated chemical gas sensors based on pristine or metal-doped WO3 nanowires for sensing volatile gases in exhaled breath. A voltammetric electronic tongue (VE-tongue), composed of five working electrodes, was dedicated to the analysis of urinary VOCs using cyclic voltammetry as a measurement technique. 54 patients were recruited for this study, comprising 22 patients with LCi, and 32 HC. The two-sensing systems coupled with pattern recognition methods, namely Principal Component Analysis (PCA) and Discriminant Function Analysis (DFA), were trained to classify data clusters associated with the health status of the two groups. The diagnostic performances of the E-nose and VE-tongue systems were studied by using the receiver operating characteristic (ROC) method. The use of the E-nose or the VE-tongue separately, trained with these appropriate classifiers, showed a slight overlap indicating no clear discrimination between LCi patients and HC. To improve the performance of both electronic sensing devices, an emerging strategy, namely a multi-sensor data fusion technique, was proposed as a second aim to overcome this shortcoming. The data fusion approach of the two systems, at a medium level of abstraction, has demonstrated the ability to assess human health and disease status using non-invasive screening tools based on exhaled breath and urinary VOC analysis. This suggests that exhaled breath as well as urinary VOCs are specific to a disease state and could potentially be used as diagnostic methods.

Tramadol sensing in non-invasive biological fluids using a voltammetric electronic tongue and an electrochemical sensor based on biomimetic recognition.

Tramadol (TRA) is a weak opioid analgesic, prescribed to relieve mild to moderately severe pain. However, side effects of TRA overdoses, including vomiting, depression, tachycardia, convulsions, morbidity and mortality are often reported. In this study, an electrochemical sensor based on molecularly imprinted conductive polymer was firstly developed for the quantitative and non-invasive detection of TRA. Secondly, a voltammetric electronic tongue (VE-Tongue) combined with chemometric methods was used for the qualitative analysis. The MIP sensor was constructed by self-assembling a poly-aniline layer coated with silver nanoparticles (PANI-AgNPs) on a screen-printed gold electrode (Au-SPE). Then, 2-amino-thiophenol was polymerised in the presence of TRA. The electronic device exhibits, under optimal conditions, responses proportional to TRA concentrations (0.01-100 µg/mL) with detection and quantification limits of 9.42 µg/mL and 28.55 µg/mL, respectively. Moreover, its selectivity was proven by insignificant interferences of substances (paracetamol and citric acid). Spiked saliva and urine samples were used for the sensor practical application with a significant recovery above 90% and standard deviations below 4.5%. Besides, urine samples' analyses using VE-Tongue and pattern recognition methods show good discrimination, classification, and prediction results with scores above 95%. Correspondingly, both electro-analytical devices could be viable for monitoring drugs in biological matrices.

An electrochemical sensor based on chitosan capped with gold nanoparticles combined with a voltammetric electronic tongue for quantitative aspirin detection in human physiological fluids and tablets.

Inflammatory diseases increase has recently sparked the research interest for drugs diagnostic tools development. At therapeutic doses, acetylsalicylic acid (ASA or aspirin) is widely used for these diseases' treatment. ASA overdoses can however give rise to adverse side effects including ulcers, gastric damage. Hence, development of simple, portable and sensitive methods for ASA detection is desirable. This paper reports aspirin analysis in urine, saliva and pharmaceutical tablet using an electrochemical sensor and a voltammetric electronic tongue (VE-Tongue). The electrochemical sensor was fabricated by self-assembling chitosan capped with gold nanoparticles (Cs + AuNPs) on a screen-printed carbon electrode (SPCE). It exhibits a logarithmic-linear relationship between its response and the ASA concentration in the range between 1 pg/mL and 1 µg/mL. A low detection limit (0.03 pg/mL), good selectivity against phenol and benzoic acid interference, and successful practical application were demonstrated. Qualitative analysis was performed using the VE-Tongue based unmodified metal electrodes combined with two chemometric approaches to classify urine samples spiked with different aspirin concentrations. Partial least squares (PLS) method provided prediction models obtained from the data of both devices with a regression correlation coefficient R2 = 0.99. Correspondingly, the SPCE/(Cs + AuNPs) electrochemical sensor and VE-Tongue could be viable tools for biological analysis of drugs.

Development of a molecularly imprinted polymer electrochemical sensor and its application for sensitive detection and determination of malathion in olive fruits and oils.

Malathion (MAL) is an organophosphorus (OP) insecticide. It is a cholinesterase inhibitor, which can pose serious health and environmental problems. In this study, a sensitive and selective molecular imprinted polymer (MIP) based on screen-printed gold electrodes (Au-SPE) for MAL detection in olive oils and fruits, was devised. The MIP sensor was prepared using acrylamide as the functional monomer and MAL as the template. Subsequently, the morphology of the electrode surface was studied by scanning electron microscopy (SEM) and atomic force microscopy (AFM). The electrochemical characterization of the developed MIP sensor was performed by cyclic voltammetry (CV), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS) techniques. The operational repeatability and stability of the sensor were studied. It was found to have a dynamic concentration range of (0.1 pg mL-1-1000 pg mL-1) and a low limit of detection (LOD) of 0.06 pg mL-1. Furthermore, the sensor was employed to determine MAL content in olive oil with a recovery rate of 87.9% and a relative standard deviation of 8%. It was successfully applied for MAL determination in real samples and promise to open new opportunities for the detection of OP pesticides residues in various food products, as well as in environmental applications.

A novel electrochemical sensor based on ion imprinted polymer and gold nanomaterials for nitrite ion analysis in exhaled breath condensate.

Human Exhaled Breath Condensate (EBC) contains markers of several inflammatory diseases. Its analysis is of interest to a number of researchers. Nitrite ions (NO2-), which are widely used in our daily lives, are nevertheless among these indicators. In this study, a simple, fast, portable, non-invasive and cheap electrochemical sensor is developed for the analysis of the nitrite profile in EBC. In this regard, sodium nitrite (NaNO2) was first immobilized on self-assembled 2-aminothiophenol (2-ATP) on a screen-printed gold electrode (Au-SPE). Then, a polymer matrix composed of polyvinyl alcohol (PVA) crosslinked with glutaraldehyde (GA) was combined with gold nanoparticles (Au-NPs) to cover the modified Au-SPE and complete the fabrication of the Ion Imprinted Polymer (IIP) sensor. The electrochemical behaviour of the sensor was monitored using Cyclic Voltammetry (CV), Electrochemical Impedance Spectroscopy (EIS) and Differential Pulse Voltammetry (DPV) methods, while the morphology and chemical composition of its layers were observed by infrared Fourier transform (FTIR), Atomic Force Microscopy (AFM) and Scanning Electron Microscopy coupled with energy dispersion X-Ray spectroscopy (SEM-EDS) techniques. In addition, after a successful control test using a Non-Imprinted Ion Polymer (NIIP) sensor, the obtained results demonstrated satisfactory sensitivity and selectivity to nitrite compared to co-existing interfering substances in EBC, such as nitrate, acetate and ammonium nitrate. Under improved experimental conditions, the nitrite IIP sensor exhibits responses proportional to nitrite concentrations (R2 = 0.96) over a concentration range of 0.5-50 µg mL-1 with a detection limit (LOD) of 4 µmol L-1 (signal-to-noise ratio S/N = 3). The proposed approach was well applied for the nitrite determination in EBC samples with a relative standard deviation (RSD = 4%) and could open clinical applications in respiratory medicine.

Clinical characteristics and outcomes of COVID-19 infection in nine pregnant women: a report from a sub-Saharan African country, Senegal.

INTRODUCTION: To investigate the clinical characteristics of COVID-19 in pregnancy in Senegal. METHODS: This was a cross-sectional and descriptive study of all cases of COVID-19 including nine pregnant women who were admitted in COVID-19 treatment centers in Senegal from March 2 to May 15, 2020. SARS-COV-2 infection was confirmed by PCR. Patients' characteristics, clinical features, treatment and outcome were obtained with a customized data collection form. RESULTS: The frequency of the association COVID-19 and pregnancy was 0.5%. The age range of the patients was 18-42 years with an average 28 years, and the range of gestational weeks at admission was 7 weeks to 32 weeks. None of the patients had underlying diseases. All the patients presented with a headache and only four of them had fever. Other symptoms were also observed: two patients had a cough, two had rhinorrhea, and two patients reported poor appetite. The median time to recovery was 13.6 days, corresponding to the number of days in hospital. None of the nine pregnant women developed severe COVID-19 pneumonia or died. CONCLUSION: Pregnant women appear to have the same contamination predispositions and clinical features of SARS-COV-2 infection as the general population. This study shows no evidence that pregnant women are more susceptible to infection with coronavirus.

Clinical characteristics and outcomes of COVID-19 infection in nine pregnant women: a report from a sub-Saharan African country, Senegal

Introduction: to investigate the clinical characteristics of COVID-19 in pregnancy in Senegal. Methods: this was a cross-sectional and descriptive study of all cases of COVID-19 including nine pregnant women who were admitted in COVID-19 treatment centers in Senegal from March 2 to May 15, 2020. SARS-COV-2 infection was confirmed by PCR. Patients' characteristics, clinical features, treatment and outcome were obtained with a customized data collection form. Results: the frequency of the association COVID-19 and pregnancy was 0.5%. The age range of the patients was 18-42 years with an average 28 years, and the range of gestational weeks at admission was 7 weeks to 32 weeks. None of the patients had underlying diseases. All the patients presented with a headache and only four of them had fever. Other symptoms were also observed: two patients had a cough, two had rhinorrhea, and two patients reported poor appetite. The median time to recovery was 13.6 days, corresponding to the number of days in hospital. None of the nine pregnant women developed severe COVID-19 pneumonia or died. Conclusion: pregnant women appear to have the same contamination predispositions and clinical features of SARS-COV-2 infection as the general population. This study shows no evidence that pregnant women are more susceptible to infection with coronavirus

[Sexuality in postmenopausal women in sub-Saharan Africa: example from Senegal]. / Sexualité des femmes ménopausées en Afrique sub-saharienne: exemple du Sénégal.

INTRODUCTION: In Africa, sex life after menopause remains an under-explored topic due to the fact that it is a taboo. This study aims to evaluate the quality of couple's sex life during menopause. METHODS: We conducted a cross-sectional survey of a representative sample of 320 postmenopausal women. The inclusion criteria were natural menopause. Patients who had experienced early or iatrogenic menopause were excluded. Investigation form was divided into 4 sections: social and cultural characteristics, clinical data, psycho-sexual data and therapeutic data. Comparison of proportions and chi-squared test with a significance threshold of less than 0.05 were used. RESULTS: The average age of women was 60 years; the average age of onset of menopause was 48 years and the age of the menopause was 11.3 years. All woman suffered from climacteric syndrome. Hot flushes occured in 85.9% of women, vaginal dryness in 62.8% and urinary disorders in 52.5%. Only married women reported having sex with their partner (62.1%). Women had sex occasionally in 68.9% of cases, while 18.1% of women reported no sexual activity. Decreased sexual activity was due to partner's erectile dysfunction (62% of couples) and the lack of sexual desire (83.5% of women). Lack of sexual appetite and orgasm were also reported in 92% and 100% of cases. However, 93.5% of married women thought their life was bearable. CONCLUSION: Marital status, dyspareunia, vaginal dryness and partner's erectile dysfunction have a significant impact on sexuality of menopausal women in Senegal.

A nonenzymatic electrochemical glucose sensor based on molecularly imprinted polymer and its application in measuring saliva glucose.

Diabetes mellitus (DM) is often diagnosed by invasive or enzymatic methods being progressively somewhat undesirable. If salivary glucose (SG) level correlates with blood glucose (BG), it could be useful for early DM detection. In this work, a molecular imprinted polymer (MIP) approach was used to develop an electrochemical non-enzymatic sensor to determine SG in micro-molar levels. The MIP based Screen printed gold electrode (Au-SPE) was prepared by electropolymerizing Acrylamide/Bis-Acrylamide (AAM/NNMBA) in the presence of glucose (G) as a template. The Cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS) techniques were employed for the electrochemical measurements with Ferri/Ferrocyanide as redox probe in phosphate buffer saline. Morphological characterizations of the elaborated sensors were performed by using atomic force microscopy (AFM) and scanning electron microscopy coupled with energy dispersive X-ray spectroscopy (SEM-EDS). Important parameters influencing the MIP sensor performances such as extraction, incubation time, potential range and number of CV cycles, were studied and optimized. Under optimum conditions, the sensor could effectively detect glucose avoiding interferences of structural similar substances like lactose and sucrose. In a working range from 0.5 to 50 µg/mL, it exhibits a detection and quantification limits of 0.59 µg/mL and 1.9 µg/mL, respectively. Additionally, the real saliva glucose determination was compared to those of finger prick blood with satisfactory results (R2 = 0.99) by using partial least squares (PLS) statistical technique. Correspondingly, this work has demonstrated a cheap, simple and effective sensing platform for non-enzymatic glucose detection thus making it a promising tool for future evolution of accurate and reliable non-invasive DM diagnosis.

[Pregnancy and delivery in patients with a personal history of cesarean section in Dakar: epidemiological, clinical, therapeutic and prognostic aspects]. / Grossesse et accouchement des patientes ayant un antécédent de césarienne à Dakar: aspects épidémio-cliniques thérapeutiques et pronostiques.

The aim of our study was to determine hospitalization rate for vaginal birth after cesarean section in Pikine, to evaluate the quality of the management of pregnant women with previous cesarean section and to determine prognostic factors of the outcome of a trial of scar. We conducted a retrospective study based on medical records and operational protocols of patients who underwent vaginal birth after cesarean section over the period 1 January 2010 - 31 December 2011. We analyzed socio-demographic data, pregnancy follow-up, therapeutic modalities and prognosis. Data were collected and analyzed using Microsoft Office Excel 2007 software and SPSS software 17.0. The frequency of vaginal births after cesarean section was 9.6%. The average age of our patients was 29.4 years. Primiparous women accounted for 54%. Short spacing interval between births was found in 52.6% of cases. Based on the number of cesarean sections, the breakdown was as follows: patients with a history of one previous cesarean section (79.8%), patients with a history of two previous caesarean sections (17.9%) and patients with a history of three previous caesarean sections (2.3%). The number of antenatal consultations performed was greater than or equal to 3 in 79.8% of cases. Patients undergoing evacuation accounted for 54.2% and they were already in labor at the time of admission in 81.7% of cases. Trial of scar was authorized in 177 patients (34.3%) and, at the end of this test, 147 patients (83%) had vaginal birth, of whom 21.7% by vacuum extraction. Cesarean section was performed in 71.4% of cases with 245 emergency cesarean sections and 93 scheduled cesarean sections. A history of vaginal birth was a determining factor in normal delivery (p = 0.0001). There was also a significant relationship between mode of admission and decision to perform a cesarean section (p = 0.0001). Maternal mortality was 0.4%. Perinatal mortality rate was 28.2‰ of live births. We are witnessing a dramatic increase of deliveries after cesarean section in our SONUC Health Centre. The quality of management should be enhanced through a better strategy in preparation for delivery. Trial of scar is a procedure to encourage in order to reduce the rate of iterative cesarean sections.

Surgical Treatment of Complication of Female Genital Mutilation in Pikine Hospital, Senegal.

We share our experience on reconstructive for surgery female genital mutilation. This is a retrospective study of all cases of female genital mutilation surgery performed in Pikine National Hospital. We have reviewed the various indications and surgical techniques used. We collected 8 cases of clitoral cyst and 6 cases of closed vaginal opening. The surgery of clitoral cysts was to perform cystectomy followed by nymphoplasty. The closing of the vaginal opening required defibulation together with clitoroplasty according to the wishes of the patient. The anatomical and functional outcomes were satisfactory. Female genital mutilation surgery requires a good knowledge of vulvar anatomy. The various surgical indications must meet the expectations of patients to guarantee their satisfaction.

[Issues involving breast cancer management in Senegal: a cross-sectional study]. / Problématique de la prise en charge des cancers du sein au Sénégal: une approche transversale.

At a time when innovative therapies in breast cancer multiply, poorer countries such as Senegal are still lag far behind in the overall management of this type of cancer. In Senegal, although the treatment of advanced breast cancer is now well codified, survival and morbidity outcomes are still mediocre in view of diagnostic delays and of sometimes expensive and poorly tolerated mutilating treatments become necessary. With respect to advanced cancers, the challenges will lie in building of palliative care centres and in developing multidisciplinary approaches to improve quality of life and to support patients. On the other hand, with respect to preclinical or potentially curable cancers, the challenges are immense given the importance of early detection, localisation and diagnosis (stereotactic or ultrasound guided biopsy) but also of precision surgery and of complete resection (indexing - excision ensuring a margin of healthy tissue and specimen radiograph) while minimizing complications such as those of classic dissection (sentinel lymph node biopsy). Our health structures are not always prepared to achieve these goals. This is a situational analysis of the contextual obstacles that still exist and add a burden on the overall management of breast cancer in Senegal.

Apport de l'echographie dans le diagnostic de l'engagement de la tete foetale au cours du travail

Objectifs : Evaluer la sensibilite et la specificite de l'echographie transperineale par rapport au toucher vaginal dans le diagnostic d'engagement de la tete foetale au cours du travail.Patientes et Methodes : Etude pilote prospective et descriptive menee a la maternite du CHN de Pikine; durant la periode allant du 01 Mars au 30 Juin 2012. Toute parturiente admise respectant les criteres d'inclusion avait beneficie a la fois d'un examen vaginal et d'une echographie transperineale afin de definir la notion d'engagement. Une distance seuil inferieure ou egale a 60 mm entre le perinee et la tete foetale avait ete retenue comme signe echographique de l'engagement Resultats : L'evaluation conjointe etait realisee chez 55 parturientes. L'age moyen etait de 26 ans; la parite moyenne de 1;47. L'echographie avait permis de poser le diagnostic d'engagement de la presentation avec une sensibilite de 93;1% et une valeur predictive positive de 81;25%. La specificite de cette exploration etait de 76;92% avec une valeur predictive negative de 90;91%. Le toucher vaginal permettait de predire l'accouchement par voie basse dans 96;4% des cas contre 77;2% pour l'echographie. Conclusion : Le toucher vaginal est un parametre subjectif et peut etre limite dans certaines situations (bosse sero-sanguine; oedeme vulvaire) et l'echographie peut s'averer interessante. L'echographie transperineale parait simple et reproductible. Une valeur seuil de 60 mm revet une bonne sensibilite et une bonne valeur predictive negative pour le diagnostic d'engagement. La diffusion de la technique doit aller de pair avec la vulgarisation de l'echographie en salle de travail dans les maternites de notre pays afin de valider cette technique sur un echantillon beaucoup plus significatif

[Maternal Mortality At The Centre De Sante Roi Baudouin (Dakar - Senegal): About 308 Cases]. / Mortalite Maternelle au Centre de Sante Roi Baudouin de (Dakar ­ Senegal): à propos de 308 cas.

OBJECTIVES: - To determine the epidemiologic profile and private clinics of the cases of maternal mortality at the centre de santé Roi Baudouin.- To identify the etiologies of the cases of maternal death at the centre de santé Roi Baudouin; - To determine the assumption of responsibility of the cases of maternal death at the centre de santé Roi Baudouin. MATERIAL AND METHODS: It was about a longitudinal descriptive retrospective study relating to 308 cases of maternal death from January 1998 to December 2005 at the centre de santé Roi Baudouin; de Guédiawaye, in suburbs of Dakar. We had included in the study all the patients died during the time of the gravido-puerperality during the study period. The studied parameters related to the socio-epidemiologic data, the clinical data on the pregnancy and the childbirth, the quality of the assumption of responsibility, the causes of maternal death and the forecast neonatal. The data were analyzed with the software Epi information-version 6. RESULTS: The ratio of maternal death was of 615.8 per 100.000 live births. The Middle Age of the deaths was 28.4 years with extremes of 14 and 52 years. The average gestity was of 4 with extremes of 1 and 25. As for the parity, it was of 3.9 with extremes of 1 and 22. The multipares were the section most concerned, followed first calf cows. A woman on four had made more than 3 antenatal consultations. The majority of our patients were evacuated (53.6%), but only 18.2% of the patients had profited from a medicalized transport. The reasons for evacuation were dominated by the vasculo-renal haemorrhages (49%) and syndromes (19%). The majority of the patients (n=234) had been confined, that is to say 76% of the cases; by natural way (45%) and Caesarean (32%). The patients had died of direct obstetrical causes in 80%, the indirect causes accounted for only 17,5%. The obstetrical causes death were dominated by the abrupto placentae, the haemorrhage of the postpartum and the uterine rupture. The maternal death was associated in more half of the cases of a fetal death (51.3%). The maternal age, the parity, the quality of the antenatal consultations, the hemorrhagic pathology coupled with the way of childbirth influenced occurred of maternal death. CONCLUSION: Maternal mortality remains a major concern at the centre de santé Roi Baudouin. The reduction of this mortality passes by operation correct 24 hours a day hours of the other ONEC centers of the area of Dakar, the availability of blood and its derivatives and the creation of a functional service of intensive care.

OBJECTIFS: - Déterminer le profil épidémiologique et clinique des cas de décès maternel au centre de santé Roi Baudouin.- Identifier les étiologies des cas de décès maternel au centre de santé Roi Baudouin.- Déterminer la prise en charge des cas de décès maternel au centre de santé Roi Baudouin. MATERIEL ET METHODES: Il s'agissait d'une étude rétrospective descriptive longitudinale portant sur 308 cas de décès maternel de janvier 1998 à décembre 2005 au centre de santé Roi Baudouin de Guédiawaye, en banlieue Dakaroise. Nous avions inclus dans l'étude toutes les patientes décédées dans la période de la gravido-puerpéralité durant la période d'étude. Les paramètres étudiés sont co les données socio-épidémiologiques, les données cliniques sur la grossesse et sur l'accouchement, la qualité de la prise en charge, les causes de décès maternel et le pronostic néonatal. Les données ont été analysées avec le logiciel Epi info-version 6. RESULTATS: Le ratio de mortalité maternelle est de 615,8 pour 100.000 naissances vivantes. L'âge moyen des décès est de 28,4 ans avec des extrêmes de 14 et 52 ans. La gestité moyenne est de 4 avec des extrêmes de 1 et 25. Quant à la parité, elle est de 3,9 avec des extrêmes de 1 et 22. Les multipares constituent la tranche la plus concernée, suivies des primipares. Une femme sur quatre a fait plus de 3 consultations prénatales.La majorité de nos patientes ont été évacuée (53 ,6%), mais seules 18,2% des patientes ont bénéficié d'un transport médicalisé. Les motifs d'évacuation sont, les hémorragies (49%) et les syndromes vasculo-rénaux (19%). La majorité des patientes (n=234) ont accouché, soit 76% des cas; par voie naturelle (45%) et par césarienne (32%). 80% des patientes sont décédées de causes obstétricales directes , les causes indirectes ne représentaient que 17,5%. Les causes obstétricales décès étaient dominées par l'hématome rétroplacentaire, l'hémorragie du post-partum et la rupture utérine. Le décès maternel est associé dans plus de la moitié des cas d'une mort fœtale (51,3%). L'âge maternel, la parité, la qualité des consultations prénatales, la pathologie hémorragique couplée à la voie d'accouchement ont influencé influençaient la survenue de décès maternel. CONCLUSION: La mortalité maternelle reste une préoccupation majeure au centre de santé Roi Baudouin. La réduction de cette mortalité passe par le fonctionnement correcte 24 heures sur 24 heures des autres centres de Soins Obstétricaux Néonatals d'Urgence de la région de Dakar, la disponibilité du sang et de ses dérivés et la création d'un service de soins intensifs fonctionnel.

Mortalite maternelle au centre de sante Roi Baudouin de (Dakar - Senegal) : a propos de 308 cas

Objectifs Determiner le profil epidemiologique et clinique des cas de deces maternel au centre de sante Roi Baudouin -Identifier les etiologies des cas de deces maternel au centre de sante Roi Baudouin ; Determiner la prise en charge des cas de deces maternel au centre de sante Roi Baudouin. Materiel et methodes : Il s'agissait d'une etude retrospective descriptive longitudinale portant sur 308 cas de deces maternel de janvier 1998 a decembre 2005 au centre de sante Roi Baudouin de Guediawaye; en banlieue Dakaroise. Nous avions inclus dans l'etude toutes les patientes decedees dans la periode de la gravido puerperalite durant la periode d'etude. Les parametres etudies sont co les donnees socio epidemiologiques; les donnees cli niques sur la grossesse et sur l'accouchement; la qualite de la prise en charge; les causes de deces maternel et le pronostic neonatal. Les donnees ont ete analysees avec le logiciel Epi info version 6. Resultats: Le ratio de mortalite maternelle est de 615;8 pour 100.000 naissances vivantes. L'age moyen des deces est de 28;4 ans avec des extremes de 14 et 52 ans. La gestite moyenne est de 4 avec des extremes de 1 et 25. Quant a la parite; elle est de 3;9 avec des extremes de 1 et 22. Les multipares constituent la tranche la plus concernee; suivies des primipares. Une femme sur quatre a fait plus de 3 consultations prenatales. La majorite de nos patientes ont ete evacuee (53 ;6 ); mais seules 18;2 des patientes ont beneficie d'un transport medicalise. Les motifs d'evacuation sont; les hemorragies (49) et les syndromes vasculo renaux (19). La majorite des patientes (n= 234) ont accouche; soit 76 des cas ; par voie naturelle (45) et par cesarienne (32). 80 des patientes sont decedees de causes obstetricales directes; les causes indirectes ne representaient que 17;5. Les causes obstetricales deces etaient dominees par l'hematome retroplacentaire; l'hemorragie du post partum et la rupture uterine. Le deces maternel est associe dans plus de la moitie des cas d'une mort fotale (51;3 des patientes sont decedees de causes obstetricales directes; les causes indirectes ne representaient que 17;5). L'age maternel; la parite; la qualite des consultations prenatales; la pathologie hemorragique couplee a la voie d'accouchement ont influence influencaient la survenue de deces maternel. Conclusion : La mortalite maternelle reste une preoccupation majeure au centre de sante Roi Baudouin. La reduction de cette mortalite passe par le fonctionnement correcte 24 heures sur 24 heures des autres centres de Soins Obstetricaux Neonatals d'Urgence de la region de Dakar; la disponibilite du sang et de ses derives et la creation d'un service de soins intensifs fonctionne

[Results of gynecologic laparoscopy in the Central University Hospital (CHU) of Dakar: prospective series of 128 cases]. / Premiers résultats de la cœlioscopie gynécologique au Centre hospitalier universitaire (CHU) de Dakar : série prospective de 128 cas.

OBJECTIVES: To analyze the results of, and to evaluate, gynaecologic laparoscopy in Dakar Teaching Hospital. METHODS: This exploratory and descriptive study deals with a continuous series of 128 gynaecologic laparoscopies carried out between January 1, 2006, and December 31, 2009. In each operative case, sociodemographic and clinical parameters,operative data, and outcomes were studied. RESULTS: Laparoscopies represented 14.37% of the programmed operative activities. The average age of the patients was 32 years,and the average parity was 1.2. The interventions were most frequently undertaken because of infertility (78.9%). A history of pelvic infections was found in 39.8% of the cases. The most frequent pathologies were tubal anomalies (70% of infertility cases) followed by ovarian cysts (10.1%) and endometriosis. The operative interventions included adhesiolysis in 35.1% of cases,and tubal surgery in 30.4%. A conversion, necessary in 7% of cases, was necessitated by the extent of adhesions (3 cases),the treatment of an associated pathology (4 cases), or a technical difficulty (2 cases).The main complications were vascular wounds and uterine perforations. The average operating times for diagnostic and operative laparoscopies were 56 minutes and 107 minutes,respectively. Outcomes were simple in 91.8% of cases. During the immediate postoperative period, a death occurred due to an acute pneumopathy. The average length of hospital stay was 3 days. We observed a pregnancy rate of 4.6%. Assisted reproduction was indicated in 28.7% of infertility cases. CONCLUSION: Given its many advantages, diagnostic and operative laparoscopy must be integrated and developed by gynaecology departments in developing countries. This necessity is emphasized by the prevalence of tubal infertility of infectious origins, which, if diagnosed and treated early by laparoscopy,could have a better prognosis.