Evolutionary Profile of Graves’ Disease in Children at Albert Royer National Children Hospital in Dakar

Graves’ disease is the most common cause of hyperthyroidism. Adequate management is an area of controversy, especially when it comes to children. The objective of our study was to assess the outcome of Graves’ disease treatment in Albert Royer Children Hospital of Dakar. This was a retrospective study conducted from 2001 to 2015, and which involved all children between 0 to 15 years of age who were being monitored in the Albert Royer National Children Hospital. The evolutionary modalities were: stability, remission, failure, relapse, lost to follow-up and death. The data were analyzed with SPSS software version 20.0. For the comparisons, the KHI 2 or Fisher test was used with a significance threshold (p < 0.05). During the study period, 88 children were enrolled. The average age was 8.6 years [ranging from 8 months to 15 years]. The consultation delay was 11.36 months. In our study, 61.4% of the patients were regular in the follow-up, the observance was good in 40.9% of the cases and 19 patients (21.6%) were lost to follow-up. Clinical courses of 69 children after treatment with Carbimazole for 37 months were promising in 21 cases (30.43%), with 17 cases of remission (24.63%) and 4 cases of stability (5.8%). Age older than 10, the initial ATD dose greater than 1 mg/kg/day and the initial free T4 lower than 50 pmol/l were significantly associated with remission with a p value of 0.01;0.024 and 0.004.

Epidemiological, Diagnostic and Therapeutic Aspects of Cardiogenic Shock in Children at the Albert Royer Children’s Hospital in Dakar

Introduction: The objective of this study was to evaluate the epidemiological, diagnostic and therapeutic aspects of cardiogenic shock in children at the Albert Royer Children’s Hospital in Dakar. Methods: This was a retrospective, descriptive and analytical study from January 2020 to February 2021, including all children aged 2 months to 16 years hospitalised for cardiogenic shock diagnosed on the basis of clinical and ultrasound criteria. Results: During the study, 38 patients were hospitalised for cardiogenic shock. The hospital prevalence was 4.2%. The mean age of onset of shock was 64 months, and there was a predominance of females with a sex ratio of 1.92. Consanguinity was found in 42% of the patients. Consanguinity was found in 42% of patients. Infection was identified as a trigger for cardiogenic shock in 18 (52.9%) of our patients. The most common type of heart disease was rheumatic heart disease in 12 (32%) of the patients. The mortality rate was 65.8%. Conclusion: Cardiogenic shock is a diagnostic and therapeutic emergency. Its prevalence and mortality are still high in developing countries.

From Fostering to Delusional Disorder of Filiation

Introduction: Fostering is a widespread practice in West Africa. It played an essential role in the circulation of children. The failure of its community regulation, not compensated by a legal framework, has made its practice precarious. Observation: A case study was conducted on Dior, who was hospitalised in a psychiatric ward for a delusional disorder of filiation. Dior was entrusted to her maternal grandmother and aunt at ages 2 and 9. During these fosterings, the place of the symbolic father was not substituted, causing a void that challenged her imagination. The outcome was an inscription in a genealogy where she had found herself with prestigious parents. Discussion: Fostering has strongly disrupted the family dynamics in Dior’s case. One of her options was to assume the paternal function, the use of which was perceived as a defiance or even a transgression. This same function would be a starting point of a psychosis whose filial character would only be an attempt at rectification where reality and imagination collide. Conclusion: Our study reveals the importance of stable parental figures at stake in fostering contexts, which constitute a risk factor for the development of a subsequent psychosis.

Congenital Abnormalities of Kidneys and Urinary Tract in Children at the Dakar University Hospital

Congenital abnormalities of the kidneys and urinary tract (CAKUT) represent all the morphological abnormalities associated with a disorder of the embryonic development of the kidneys and their excretory tract. Its prevalence is underestimated in developing countries compared to developed countries. This was a cross-sectional and descriptive study between January 1st, 2015 and February 28th, 2020, carried out in the pediatric department of Aristide Le Dantec Hospital. The prevalence of CAKUT was 8.77% for all pediatric nephrologic pathologies (n = 58), the median age at diagnosis was 77.28 months and the sex ratio was 1.6. The circumstances of the discovery of CAKUT were dominated by urinary tract infection (n = 21), the antenatal diagnosis was poor (n = 13) and confusion between cysts and calyx dilation in antenatal was noted. Ultrasound was the main postnatal imaging test requested. The most common renal abnormality was kidney cysts (n = 18) (cystic kidneys and multicystic dysplastic kidney) and the most common urological abnormality was the posterior urethral valves (n = 8). Kidney failure was a pejorative factor in the evolution of these CAKUT.

Child Deafness in Sub-Saharan Africa: Experience of Two ENT Services in Casamance, South of Senegal

Introduction: Hearing impairment is the most common sensory deficit at birth. It is a public health problem because of the repercussions on the communication development, on the education and subsequent social integration of the child. The objective of this study was to determine the epidemiological, clinical, audiometric and etiological profiles of child deafness in Casamance, South of Senegal. Materials and Methods: This was a retrospective multicenter study, which extended a period of 7 years from January 1st, 2012 to December 31st, 2019. All children aged between 1 to 18 years old and received during their first ENT consultations at the regional and PEACE hospital in Ziguinchor were included. Results: One hundred and seventy-eight records of children were collected during this period, that is a prevalence of 1.30%. The average age was 9 years old. Conductive hearing loss was found in 68% of patients, followed by reception hearing deafness in 24%. The deafness was acquired in the majority of cases (93%) and the predominant etiology was infectious. However, the cause was unknown in 7.51% of cases. Conclusion: Child deafness is common in Casamance and is most often underdiagnosed. The acquired forms are the most common, hence the importance of early detection after a rigorous family investigation.

A Severe COVID-19 Infection in Neonates: A Case Report

Coronavirus disease (COVID-19) is a highly contagious infectious disease. First case was reported at the end of 2019 in China. Children and neonate population appears to be relatively free of the virus. We reported a severe and fatal neonate case of COVID-19 in a 22 days old neonate female due to the delta variant strain during the third wave outbreak. She presented with fever, cough, grunting and diarrhea started 5 days before admission. Physical exam’s revealed severe respiratory distress, hypoxia and bilateral pulmonary condensation. PCR test for COVID-19 was positive. Chest X-ray found bilateral infiltrates. Chest CT showed diffuse ground glass images with 75% of lung parenchymal involvement. She was treated with antibiotics, corticostoid, respiratory support (CPAP and oxygen). Death occurred after 15 days of hospitalization in the context of multiple organ failure and pulmonary hypertension.

Pelvic Tuberculosis Simulating an Ovarian Tumor at a Stage of Peritoneal Carcinosis

Tuberculosis is a global public health problem with 10 million people developing an active form each year. The exact incidence of the pelvic form of tuberculosis is not known due to under-reporting of asymptomatic cases, vague symptomatology and lack of reliable diagnosis. We report a case of ovarian tuberculosis mimicking cancer and peritoneal carcinosis. The case involved a 15-year-old girl, hospitalized for severe pelvic pain and secondary amenorrhea. The examination showed an altered general state, a fever, a sensitive distended abdomen. The biology showed an elevation of Ca125 to 357 IU/ml. The CT scan showed a latero-uterine mass taking contrast in a heterogeneous way with an irregular and nodular thickening of the peritoneum making evoke a peritoneal carcinosis. Exploratory laparotomy found a bilateral ovarian mass with ileo-ileal, ileo-parietal and ileo-ovarian adhesions. Biopsy of the mass and the peritoneum showed a caseo-follicular gigantocellular epitheloid granulomatosis.

Surgical Treatment of Hyperparathyroidism Secondary to Chronic Renal Failure: Our Experience with the 7/8 Subtotal Parathyroidectomy Technique

Introduction: Surgical management takes place, after a certain period of evolution, on particularly severe forms of secondary hyperparathyroidism, resistant to medical treatment. Subtotal parathyroidectomy is an effective technique in the treatment of these disorders. Method: Our study is retrospective of 33 cases of hyperparathyroidism secondary to chronic renal failure in dialysis patients operated by the 7/8 technique. Identified over a period of 10 years (January 2010 to December 2019), in the ENT department of the Fann University Hospital. Results: Out of 33 cases of secondary hyperparathyroidism, the average age of our patients was 51.24 years with a sex ratio of 0.43. Causal nephropathy was dominated by nephro-angiosclerosis, which was found in 27.27% of cases. Bone pain found in 23 patients or 69.69% was the predominant clinical sign. The average calcemia was 92.7 mg/l. Parathormone was dosed in all our patients and the average was 1611.05 ng/l. The consequences were clinically marked by recurrent paresis in one patient. No case of hematoma or postoperative infection was found. On the biological level 10 patients or 30.30% had a transient hypocalcaemia. The results were marked by a drop in PTH in 23 patients or 78.78% of cases. Conclusion: Subtotal parathyroidectomy remains an effective and beneficial therapeutic method for kidney failure patients with secondary hyperparathyroidism.