COVID-19 and its impact on Senegal’s macroeconomic structure

The spread of COVID-19 in 2020 and 2021 has caused high mortality and morbidity rates across the globe. Senegal, along with other developing countries, experienced the weakening of major economic sectors such as tourism, health, agriculture, banking, and transport. This led to the deterioration of the macroeconomic environment – despite fast gross domestic product (GDP) growth of 6% over the past five years (2014-2019). As with most sub-Saharan countries, Senegal implemented a series of fiscal policies, and these, along with the new monetary policies of the Central Bank of West African States, aimed to enhance overall economic performance while keeping inflation down and restoring GDP growth

Encephalopathies epileptogenes precoces avec suppression burst

IntroductionLes Encéphalopathies Epileptogènes précoces avec « suppression burst » sont graves du fait de leur pharmacorésistance et l’impact sur le développement psychomoteur des enfants atteints. Notre objectif est d’en identifier les déterminants chez des patients à Dakar.MéthodologieIl s’agissait d’une étude rétrospective et prospective à partir de dossiers médicaux allant de janvier 2013 à janvier 2015, réalisée à la clinique Neurologique du CHNU Fann et portant sur des enfants qui y sont suivis. Elle n’a intéressé que les patients avec épilepsie précoce, retard du développement psychomoteur et pattern de suppression burst à l’EEG. Les aspects anamnestiques, cliniques, électro- encéphalographiques et évolutifs sous traitement ont été évalués.RésultatsNous rapportons quatre observations d’enfants avec une notion d’épilepsie familiale non documentée chez deux, qui ont présenté une encéphalopathie précoce  avec des crises épileptiques polymorphes dominées par des crises toniques. Celles-ci ont débuté le premier jour de vie chez deux enfants, à 30 jours de vie et en début du troisième mois de vie chez les deux autres. L’EEG de sommeil réalisé au moment du  diagnostic a montré un pattern de suppression burst. Aucune  étiologie n’a été retenue du fait de la   limitation du bilan complémentaire à visée étiologique tel que l’IRM cérébrale ou les bilans métaboliques.  L’évolution électro-clinique est favorable pour certains patients avec le traitement entrepris, basé principalement sur le valproate de sodium à une dose de 20mg/Kg/jr en moyenne. Elle est marquée par la disparition des crises ou leur diminution en fréquence et par l’amélioration du tracé EEG de sommeil de  contrôle avec disparition des bouffées suppressives chez trois patients, tandis que chez le quatrième, l’évolution s’est faite vers un autre type  d’encéphalopathie épileptogène qu’est le syndrome de West. Le retard psychomoteur est resté patent chez la totalité des patients.ConclusionLes résultats de ce travail ouvrent la perspective à des études complémentaires notamment   longitudinales qui permettraient de mieux individualiser ces pathologies graves à début précoce d’autant plus qu’il existe des causes curables. IntroductionEarly epileptic encephalopathies with "suppression burst" are serious because of their drug resistance and the impact on psychomotor development of children  involved. Our objective is to identify the  determinants of this pathology in Dakar.MethodologyThis is a retrospective and prospective study from medical records from January 2013 to January 2015, performed on children who followed at the Neurological clinic of Fann University Hospital of Dakar. It has interested patients with early epilepsy, delayed psychomotor development and EEG pattern of  suppression burst. Anamnestic, clinical, electroencephalographic and progressive aspects under  treatment were evaluated.ResultsWe report four cases of children with epilepsy notion of family in two undocumented, who presented early encephalopathy with seizures polymorphic dominated by tonic seizures that began on the first day of life in two, 30 days of life and the beginning of the third month of life in the other two. The sleep EEG performed at diagnosis showed a pattern of suppression burst. No etiology was chosen because of the limitation of additional balance sheet etiological such as MRI cerebral or metabolic balance sheets. The electro-clinical evolution is favorable for some patients with the treatment undertaken, based mainly on sodium  valproate at a dose of 20mg/Kg/day in average. It is marked by the disappearance of seizures or  decreased in frequency and by improving the sleep EEG control monitoring with disappearance of  suppression burst in three patients, while in the fourth, the change was made to another type of epileptic encephalopathy that is the West syndrome. Psychomotor retardation remained evident in all patients.ConclusionThe results of this work open up the prospect for further studies including longitudinal that would better individualize these serious early diseases especially because it exists treatable causes

Absence of Wharton's jelly around an umbilical artery

Wharton's jelly is a mucoid, avascular and connective tissue which plays the role of umbilical vessels protection. Its absence exposes to poor neonatal outcomes or fetal death. We report a rare case of Absence of Wharton’s Jelly, diagnosed by examination of the placenta the examination with a live fetus

Selective attention of students suffering from primary headaches in a pain free period: a case control study

Background: Headache patients frequently complain about difficulties in attention and concentration, even when they are headache-free and psychometric studies concerning attentional deficits in headache patients between attacks are scarce.Objective: To evaluate selective attention of headache patients in a pain free period and compare them with healthy volunteers.Subjects and Methods: We performed, between February 2011 and July 2011, a case-control study, including 45 university students consulting for primary headaches, matched with 45 healthy students as controls. Headaches were classified according to the International Headache Society criteria (IHS, 2004). Subjects with a history of brain injury, epilepsy and visual disturbancies were excluded. Mood disorders were assessed using the Hospital Anxiety Depression (HAD) questionnaire. Selective attention was evaluated using the D-KEFS color-word interference test.Results: Mean age of patients was 23.29 ± 2.55 years, versus 22.89 ± 2.04 years for controls (p = 0.2). Migraine and tension-type headaches were the only diagnosed headache types, respectively 55.56% and 44.44%. The selective attention score was -4.04 ± 7.08 for patients, versus -1.31 ± 7.73 for controls (p = 0.02). The mean mental flexibility score was lower in headache sufferers compared to controls (36.67 ± 6.79 versus 41.33 ± 6.23, p = 0.001). Gender, anxiety and depression scores, and temporal features of headache had no correlation with selective attention score.Conclusion: Selective attention and mental flexibility capacities seem to be reduced in primary headache sufferers in pain free period. These findings could contribute to our understanding of the pathophysiology of primary headaches.Keywords: Selective attention, mental flexibility, neuropsychology, headache, migrain

Headaches in consultation in the workplace in Ouagadougou (Burkina Faso): impact on the quality of life and the patient’s professional performance

Objective: Headaches are a real public health problem. This study describes the impact of headaches on quality of life and job performance in a working population in Ouagadougou.Methods: This was a cross-sectional descriptive study from April to June 2011, conducted in six workplaces in the city of Ouagadougou and covering 110 workers. Workers with any headaches who consulted in health centers of workers during the study period were interested. The epidemiology, clinical aspect and impact of headaches were assessed using HIT-6 questionnaire and MIDAS test.Results: The prevalence of headaches was estimated at 8%. The average age was 38.5 years old. By correlating the total number of workers in society by gender and the number of patient who consulted for headaches, we found 8% of females against 7% for males. Seen the profile of different companies, headaches were found mainly among laborers (67.3%). Following the history and clinical examination of patients, the prevalence of primary headaches was 83.6% against 16.4% for secondary headaches. Headaches with most significant impact on daily life were observed respectively for 17.3% and 31.8% in the HIT-6 test. Grade III and IV of disability were recorded respectively for 21.8% and 9.1% in the MIDAS test. The correlation between the functional disability associated with headaches and the professional category found moderate and severe disability respectively for 54.1% and 70% of laborers while no senior executive had moderate or severe functional disability. The correlation between the impact of headaches on the activities of daily life and the professional category found substantial and severe impact respectively for 78.9% and 57.2% of laborers while 5.7% of senior executives had a severe impact. the correlation between functional disability related to headaches and the gender found 10,5% of severe disability for women and 8.8% for men. The correlation between the impact of headaches on daily life and the gender found 42.1 of severe impact for women and 29.7% for men.Conclusion: Headaches impose a heavy burden in the workplace especially for women and laborers. Their adequate care will improve the quality of life of workers with headaches for better work performance.Keywords: Headaches, Impact, Quality of Life, Performance, Workplace, Burkina Fas

L’atrophie multisystematisee a la clinique neurologique Ibrahima Pierre Ndiaye de Dakar, Senegal

Introduction:  L’atrophie multisystématisée (AMS) est une affection neurodégénérative d’évolution progressive et fatale. De cause inconnue, elle est classée en deux formes cliniques (AMS-P et AMS-C). Patients et Méthode: Nous avons réalisé une étude transversale portant sur neuf patients, membres de sept familles, répondant aux critères diagnostiques consensuels de l’AMS. Résultats: L’âge moyen de survenue était de 43,7 ans. Les syndromes parkinsonien et cérébelleux ont été retrouvés dans 5 cas, un syndrome pyramidal dans 4 cas et une dysautonomie dans 3 cas. Une dysarthrie était présente dans 5 cas, des troubles cognitifs et une dysphagie dans 4 cas, des mouvements anormaux dans 2 cas, des troubles du sommeil et une hypoacousie chez 1 cas. La forme AMS-P était prédominante dans 5 cas, la forme AMS-C a été retrouvée chez 4 cas. L’imagerie cérébrale a objectivé dans 100% des cas une atrophie cérébelleuse et une atrophie du tronc cérébral. L’ENMG était en faveur d’une polyneuropathie chez trois patients et une atteinte du VIII a été objectivée chez un patient. Les pedigrees des quatre familles ont mis en évidence un mode de transmission autosomique récessive. Conclusion: L’AMS considérée comme sporadique, peut aussi revêtir une caractéristique génétique. Nous avons rapporté des cas d’AMS chez des personnes issues de mariages consanguins, dont certaines ont des cas similaires dans la famille avec une prédominance de la forme AMS-P. Une cause génétique avec un mode de transmission autosomique récessive est fortement suspectée. Une étude génétique s’impose afin d’isoler les gènes. English title: Multiple system atrophy at the Ibrahima Pierre Ndiaye neurological clinic, Dakar, Senegal Background Multiple system atrophy (MSA) is a progressive and fatal neurodegenerative disease. Of unknown cause, it is classified into two clinical forms (AMS-P and AMS-C). Patients and Method We carried out a cross-sectional study of nine patients, members of seven families, meeting the consensus  diagnostic criteria of the AMS. Results The mean age of onset was 43.7 years. Parkinsonian and cerebellar syndromes were found in 5 cases, pyramidal syndrome in 4 cases and dysautonomia in 3 cases. Dysarthria was present in 5 cases, cognitive impairment and dysphagia in 4 cases, abnormal movements in 2 cases, sleep disturbances and hearing loss in 1 case. The AMS-P form was predominant in 5 cases, the AMS-C form was found in 4 cases. Brain imaging demonstrated cerebellar atrophy and brainstem atrophy in 100% of cases. The ENMG was in favor of polyneuropathy in three patients and VIII involvement was demonstrated in one patient. The pedigrees of the four families showed an autosomal recessive mode of inheritance. Conclusion: AMS, considered to be sporadic, can also have a genetic characteristic. We have reported cases of AMS in people from  consanguineous marriages, some of whom have similar cases in the family with a predominance of the AMS-P form. A genetic cause with an autosomal recessive mode of inheritance is strongly suspected. Genetic study is needed in order to isolate the genes

Epilepsie-absences de l’enfant et de l’adolescent au Senegal aspects epidemiologiques, diagnostiques, therapeutiques et pronostiques

Description: L’épilepsie-absence est un syndrome épileptique généralisé, fréquent, de cause présumée génétique, caractérisé par la survenue d’épisodes fréquents de rupture brutale et complète du contact sans perte de tonus.Objectif: L’objectif était de décrire l’épidémiologie et les caractéristiques cliniques de l’épilepsie-absence chez l’enfant et l’adolescent.Méthode: Nous avons mené une étude transversale longitudinale, portant sur 53 patients, de décembre 2003 à mars 2014 en colligeant les données épidémiologiques, diagnostiques, thérapeutiques et évolutives. L’analyse des données s’est faite avec le logiciel statistique CSPro 5.0 avec calcul de fréquences et moyennes.Résultats: Cinquante trois patients dont 42 enfants et 11 adolescents ont été colligé avec un âge moyen de 10 ans. L’âge moyen de début des crises était de 6,8 ans chez les enfants et 12,4 ans chez les adolescents. On notait une prédominance féminine à 52,4 % chez les enfants et masculine à 63,6 % chez les adolescents. Une consanguinité parentale était retrouvée dans 55,5 % chez l’enfant et 37,5 % chez l’adolescent. Quarante pourcent des enfants présentaient des antécédents familiaux d’épilepsie. Les crises survenaient spontanément dans 86,8 % des cas avec une durée moyenne de 10 secondes environ. Le Valproate de sodium a été utilisé chez tous nos patients avec une maitrise dans 81,6 % à trois mois. L’évolution de l’épilepsie-absence était globalement satisfaisante avec des difficultés d’apprentissage observées chez 22,6 % des patients.Conclusion: L’épilepsie-absence est fréquente, de causes multifactorielles et peut retentir sur le devenir psychosocial.Mots clés: adolescent, enfant, épilepsie-absence, prise en charge, SénégalEnglish Title: Absences epilepsy of children and teenager in Senegal epidemiological, diagnostic, therapeutic and prognostic aspectsEnglish AbstractBackground: Absence-epilepsy is a generalized epileptic syndrome, frequent, of presumed genetic cause, characterized by the occurrence of frequent episodes of sudden, profound impairment of consciousness without loss of body tone.Objective: The objective was to describe the epidemiology and clinical features of absence-epilepsy in children and adolescents.Methods: We conducted a longitudinal cross-sectional study of 53 patients from December 2003 to March 2014, collecting epidemiological, diagnostic, therapeutic and evolutionary data. Analysis of data was done with CSPro 5.0 statistical software with frequency and averaging calculations.Results: Fifty-three patients including 42 children and 11 adolescents were enrolled with an average age of 10 years. The mean age of onset of seizures was 6.8 years in children and 12.4 years in adolescents. We found female prevalence of 52.4% in children and male prevalence of 63.6% in teenagers. Parental consanguinity was found in 55.5% in children and 37.5% in adolescents. Forty percent of children had a family history of epilepsy. Seizures occurred spontaneously in 86.8% of cases with an average duration of about 10 seconds. Sodium valproate was used in all our patients with a mastery in 81.6% at three months. The evolution of absence-epilepsy was generally satisfactory but learning difficulties were observed in 22.6% of patients.Conclusion: Absence-epilepsy is common, have multifactorial causes and can affect the cognitive outcome.Keywords: care, children, absence epilepsy, Senegal, teenage

Experimental Studies of the Electrical Nonlinear Bimodal Transmission Line

After a few years of calm, the investigations on the dynamic, especially nonlinear, systems returned to the front of the research in non-linear physics. We propose, in this chapter, a study of an electrical nonlinear transmission line, realized in a previous work, to use the latter to highlight certain properties (modulation instability—MI, Fermi-Pasta-Ulam (FPU) recurrence, fragmentation of solitons in wave trains, multiplication(increase) and division of frequencies, etc.), which are observed in several domains in applied physics: hydraulic, artificial neuronal, network physical appearance (physics) of the plasma, and the circulation

Meckel-Gruber syndrome: about a case identified during deliver

Meckel-Gruber syndrome is an autosomal recessive disorder, usually lethal, most commonly characterised by the classic triad of polycystic kidneys, occipital encephalocele and polydactyly. Antenatal diagnosis can be made by ultrasound between 10 and 14 weeks of amenorrhoea. Recognition of this syndrome is important in order to establish the diagnosis and provide genetic counselling. Finally, well supervised termination of pregnancy should be the rule for lethal fetal malformations in order to relieve the psychological suffering of patients. However, in certain situations or working conditions, the diagnosis can be made late or even discovered during childbirth. We report a case of Meckel Gruber syndrome discovered at birth