Serious Burn by Sulfuric Acid: Case Report of Particular Therapeutic Strategy in a Non-Specialized ICU at Hôpital Principal de Dakar (HPD) Sénégal

Managing severe burns remains problematic due to the lack of specialized units, but also because of the delay in implementing emergency care. The aim is to show that an adapted strategy, can lead to satisfying management of chemical burns. The authors report retrospectively the case of a patient admitted for chemical burns, and treated in a non-specialized intensive care unit;a 38 years old male, referred for burns by sulfuric acid at his workplace. On admission to H15, the clinic did not reveal any vital organs failure. Burns were localized on two legs and soles of the two feet (18% TBSA). Treatment combined daily dressings with silver sulfadiazine. On day 14, the wound healing associated occlusive gauze dressing, iodine cream application, and mechanical debridement. On day 47, a 5% dermal autograft performed on right foot favored with good attachment grafts. On day 58, the patient was released after complete skin recovery. Then, in a non-specialized burn unit and without early surgery access, our wound healing adapted strategy was successful. In Senegal, chemical burns represent about 2.5% of burn cases. They are often from accidents on occupation job, while generally in Africa chemical burns result from criminal attacks. Patients with severe lesions are admitted in non-specialized environments after an extended time of transfer, and don’t have efficient initial care. This may explain the high morbidity and mortality after burns in our country. The lack of surgical facilities such as skin substitutes, in non-specialized unit on low or median income countries (LMICs), explains this long period of wound healing. The treatment of severe burn in LMICs is hazardous.

A COMPARATIVE STUDY OF CYTOTOXIC EFFECT OF VARIOUS HEMATOPORPHYRIN DERIVATIVES (HPD) BY LASER MICROIRRADIATION

Since HPD in combination with light for treatment of malignancy was used by Dougherty et al. (1978), recent progress of photodynamic therapy using laser as light source to excite HPD both in diagnosis and therapy of cancer is currently receiving consid-

FREE RADICALS GENERATED BY SPIN TRAPPING OF HPD-PHOTOSENTITIZATION

Hematoporphyrin derivative （HPD） photosensitization therapy both for diagnosis and cure of solid neoplasms has been shown to be hopeful. So far some molecular mechanisms of HPD-photosensitization have been reported. A single oxygen （1O2） mechanism is generally thought to be predominar, but contributions from a free

Atrial Fibrillation in Wolff Parkinson White Syndrome: About a Case in Senegal

WOLFF PARKINSON and WHITE (WPW) syndrome is the most common form of pre-excitation. It is associated in some cases with atrial fibrillation with a high risk of sudden death. We report the case of a 64-year-old hypertensive woman with a history of ischemic stroke. She presented with hyperkinetic palpitations without hemodynamics instability on admission. The electrocardiogram recorded a complete tachyarrhythmia by pre-excitation atrial fibrillation, with a mean rate of 300 beats per minute. Electrophysiological investigation revealed an accessory pathway located at the ostium of the coronary sinus, which was successfully ablated by radiofrequency. A drug treatment based on flecaine 100 mg was introduced. The patient was asymptomatic after one month of outpatient follow-up.

From Myeloma to Plasma Cell Leukemia, Persistent Inequalities

Multiple myeloma (MM) is both a complex and heterogeneous disease. Cytogenetic and molecular abnormalities lead to resistance to treatment and transformation to plasma cell leukemia, which is defined by the presence in circulating blood of plasma cells over 2 G/L, or more than 20% of leukocytes. It is an uncommon hematological malignancy with a poor prognosis. Against this backdrop, we report an observation of multiple myeloma transformed into plasma cell leukemia diagnosed at the Hôpital Principal de Dakar (HPD) that occurred on a 64-year-old man with a history of thyroidectomy followed for multiple myeloma presenting with Salmon et Durie stage IIIA and ISS stage I. Despite a marked improvement in management strategy, myeloma remains an almost invariably incurable disease. However, the development of genetic and molecular biomarkers is necessary to improve its prognosis.

Macrophage Activation Syndrome in a Context of Pre-B Type Lymphoblastic Acute Leucemia: A Case Report

Macrophage activation syndrome (MAS) is linked to inappropriate stimulation of macrophage cells in the bone marrow and lymphoid system, resulting in abnormal phagocytosis of figurative blood elements and the release of pro-inflammatory cytokines. It is a rare and serious hyper-inflammatory condition of diagnostic and therapeutic emergency. MAS is characterized by non-specific clinical and laboratory signs associated with images of hemophagocytosis. MAS is either “primary” (familial or pediatric forms), or “secondary/reactive” to infection, neoplasia, or autoimmune disease. Hemopathies dominate MAS secondary to neoplasia. B-type acute lymphoblastic leukemia (ALL) is a hematological malignancy characterized by the proliferation and accumulation of B lymphoid progenitors, blocked at an early stage of differentiation, leading to suppression of polyclonal hematopoiesis and subsequent development of signs associated with bone marrow failure. In this context, we report the observation of a macrophage activation syndrome (MAS) associated with ALL, diagnosed at Hôpital Principal de Dakar/Senegal, in a 69-year-old patient with a well-controlled type 2 diabetes under oral antidiabetic therapy (OAD) and good general condition.

钙型卤水不净化MVR制高纯盐案例分析

文章提供了一个在美国的钙型卤水生产氯化钠结晶系统案例,料液卤水来自一个即将作为天然气储存洞穴。主要工艺技术是利用一个单级HPD MVR制盐结晶器,未经卤水净化,生产纯度99.85%且粒径分布窄的盐。该系统设计独特,不需要卤水净化。取消卤水净化环节可以降低系统的投资和运行成本。该系统不仅成本低,而且在线率高。

Cardiovascular and Cerebrovascular Prognosis at 5 Years of Patients Who Presented with an Ischemic Stroke at Principal Hospital of Dakar

Aims: To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. Methods: We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 2019 for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. Results: Overall, one hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%, with a sex ratio of 1.28. Patients’mean age was 66.33 ±13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0.6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke with a mean recurrence period of 8 months and extremes ranging from 1 to 24 months. Five (5) patients (2.92%) developed dementia with a score less than 28. A 30 years old patient presented with epilepsy 12 months after the ischemic stroke accounting for 0.58%. We registered ninety (90) deaths that occurred in a mean period of 24 months ± 9.8 after they presented their ischemic stroke, standing for 52.63% amongst which thirty-five (35) accounting for 39% were female patients and fifty-five patients (55) representing 61% were male patients. Mortality-related factors included: advanced age, past medical history of heart surgery, known as dyslipidemia, physical inactivity, obesity and recurrent ischemic stroke. Conclusion: Long-term prognosis of ischemic stroke remains unclear in Senegal. Therefore, a strategy for primary prevention is highly crucial and it requires the control of risk factors in general and that of high blood pressure in particular.

让脱硫废水实现零排放

在美国和欧盟地区，所有新建燃煤电厂都安装了涤气器，因为涤气器技术是被公认为最适合用于清除SO2的技术。而处理湿式涤气器废水的最好技术，就是一种零液体排放系统（ZLD）。由于未来很有可能会对发电厂用水施以更加严格的限制，能够浓缩涤气器冲洗水流的零液体排放系统，必将像ZLD冷却塔排污系统一样成为常用配置。

Variation in patient dose due to differences in calibration and dosimetry protocols

For precise and accurate patient dose delivery,the dosimetry system must be calibrated properly according to the recommendations of standard dosimetry protocols such as TG-51 and TRS-398. However, the dosimetry protocol followed by a calibration laboratory is usually different from the protocols that are followed by different clinics, which may result in variations in the patient dose.Our prime objective in this study was to investigate the effect of the two protocols on dosimetry measurements.Dose measurements were performed for a Co-60 teletherapy unit and a high-energy Varian linear accelerator with 6 and 15 MV photon and 6, 9, 12, and 15 MeV electron beams, following the recommendations and procedures of the AAPM TG-51 and IAEA TRS-398 dosimetry protocols. The dosimetry systems used for this study were calibrated in a Co-60 radiation beam at the Secondary Standard Dosimetry Laboratory(SSDL) PINSTECH,Pakistan, following the IAEA TRS-398 protocol. The ratio of the measured absorbed doses to water in clinical setting,D_w(TG-51/TRS-398), was 0.999 and 0.997 for 6 and15 MV photon beams,whereas these ratios were 1.013,1.009, 1.003, and 1.000 for 6, 9, 12, and 15 MeV electron beams, respectively. This difference in the absorbed dosesto-water D_w ratio may be attributed mainly due to beam quality(K_Q) and ion recombination correction factor.

世界最大的蒸发器

稳定可靠的蒸发器是纸厂平稳运行的基石，随着设备呈大型化趋势。

Etch Induction Time in CR-39 Detectors Etched in Na2CO3 Mixed NaOH Solution

Six different solutions of 6M NaOH, containing different amounts of Na2CO3 at 70℃ were used for the revelation of latent damage trails in CR-39 plastic track detectors. These detectors were earlier exposed to fission fragments from ^252 Cf source for 30 min in vacuum and were then etched in the respective solutions for different etching time intervals of 5-20 min starting from 5min up to 160min. The etch induction time in each detector was obtained by extrapolating the intersection of resulting curves of track lengths and track diameters with the time axis.

有力证据显示结构化的饮食和体育锻炼计划能够有效预防2型糖尿病和改善心血管健康

背景2型糖尿病是一个显著增长的医疗问题,在全球范围内影响了将近4亿人口^(1),几乎占美国人口的10%^(2),给社会带来了巨大的经济负担。除此之外,美国成人中有大约37%是2型糖尿病的高危人群,这使得2型糖尿病的一级预防成为一个重要的公共健康目标。