Management of pituitary adenoma: Preliminary experience with endoscopic endonasal transphenoidal surgery in a developing country. Example of Senegal about 180 cases

Introduction: Endoscopic endonasal transsphenoidal surgery is currently the gold-standard therapeutic approach for pituitary adenomas. Although being spread worldwide, the endoscopic endonasal approach for pituitary adenomas is recently implemented in Senegal.This study aimed to report our results and the complications observed in the context of an under-equipped facility. Materials and methods: We conducted a retrospective study including all patients with a pituitary adenoma treated who underwent endonasal transsphenoidal resection under a single endoscopic approach from January 2014 to May 2022, in the Neurosurgery Department of Fann National Hospital Centre, Dakar. All patients were assessed according to clinical, radiological, and endocrinological criteria. They all were operated by the same team with an average follow-up of 24 months. Results: In this series of 180 patients, including 57.7 % women and 42.3% men with a mean age of 44.8 years (extremes of 18 and 76 years), the visual deficit was the most frequent onset symptom (69.4 %), followed by clinical forms of hormone hypersecretion (30.5 %). Twelve cases of pituitary apoplexy and 1 case of incidentaloma were reported. The most frequent tumors were non-functional tumors (61.6 %). Among the functional adenomas, the most frequent was prolactinoma (15.5 %). Regarding tumor size, 75 % were macroadenomas, 15.5 % were microadenomas, and 9.5 % were giants. Cavernous sinus invasion (Knosp grade ≥ 3) and suprasellar extension were noted in 14.4 % and 53.3 %, respectively. The resection was total in 80 % of cases, subtotal in 18.8 %, and partial in 1.2 %. Partial improvement of sight was observed in 91.1% and endocrine hypersecretion remission in 76.6 %. As for complications, the most frequent was transient diabetes insipidus (32.7 %). Conclusion: Despite the scanty resources, our results are similar to the best-reported series and strengthen scientific evidence on the efficacy and safety of performing this technique in an under-equipped setting context

Réactivation d’une hépatite B occulte chez un patient drépanocytaire homozygote: cas clinique et revue de la littérature

L'hépatite B occulte correspond à la présence de l'ADN du virus de l'hépatite B dans le sérum et/ou dans le foie d'un patient malgré la négativité de l'AgHBs. C'est une forme clinique habituellement asymptomatique. Sa réactivation est rare et survient en général chez le sujet immunodéprimé. Nous rapportons un cas d'un patient sénégalais de 21 ans, drépanocytaire homozygote, qui présentait un ictère de type cholestatique chez qui l'exploration biologique concluait a une réactivation d'une hépatite B occulte. Cette observation souligne la nécessité de rechercher systématiquement une réactivation d'une hépatite B occulte devant toute hépatopathie aigue chez le drépanocytaire

Hydroxychloroquine and Azithromycin Treatment of Hospitalized Patients Infected with SARS-CoV-2 in Senegal from March to October 2020

International audienceAs of today, little data is available on COVID-19 in African countries, where the case management relied mainly on a treatment by association between hydroxychloroquine (HCQ) and azithromycin (AZM). This study aimed to understand the main clinical outcomes of COVID-19 hospitalized patients in Senegal from March to October 20202. We described the clinical characteristics of patients and analysed clinical status (alive and discharged versus hospitalized or died) at 15 days after Isolation and Treatment Centres (ITC) admission among adult patients who received HCQ plus AZM and those who did not receive this combination. A total of 926 patients were included in this analysis. Six hundred seventy-four (674) (72.8%) patients received a combination of HCQ and AZM. Results showed that the proportion of patient discharge at D15 was significantly higher for patients receiving HCQ plus AZM (OR: 1.63, IC 95% (1.09–2.43)). Factors associated with a lower proportion of patients discharged alive were: age ≥ 60 years (OR: 0.55, IC 95% (0.36–0.83)), having of at least one pre-existing disorder (OR: 0.61, IC 95% (0.42–0.90)), and a high clinical risk at admission following NEWS score (OR: 0.49, IC 95% (0.28–0.83)). Few side effects were reported including 2 cases of cardiac rhythmic disorders in the HCQ and AZM group versus 13 in without HCQ + AZM. An improvement of clinical status at 15 days was found for patients exposed to HCQ plus AZM combinatio

Spatial distribution of COVID-19 positive cases at district level.

Spatial distribution of COVID-19 positive cases at district level.</p

Univariate and multivariate risk factors analysis according to "symptomatic/asymptomatic" status for Period 2 (from June 26 to October 31^st, 2020).

(DOCX)</p

Univariate and multivariable factors analysis according to "symptomatic/asymptomatic" status.

Univariate and multivariable factors analysis according to "symptomatic/asymptomatic" status.</p

S2 File -

(ZIP)</p

Univariate and multivariate risk factors analysis according to "uninfected/infected" status for Period 1 (from March 2 to June 25,2020).

(DOCX)</p

Cumulative incidence of COVID19 in Senegal by region.

(DOCX)</p

Epidemiological parameters comparison according to different periods.

Epidemiological parameters comparison according to different periods.</p