Cardiac Rehabilitation in the Elderly

Introduction: The purpose of cardiac rehabilitation is to improve the effects of aging and maintain a good quality of life for older individuals. This study aims to assess how cardiac rehabilitation affects the autonomy and quality of life of older adults. Patients and Method: This was a longitudinal, descriptive and comparative before-and-after cardiovascular rehabilitation study conducted over a two-year period from January 2019 to December 2021. This study was conducted at four cardiac rehabilitation units in Dakar: the Aristide Le Dantec Hospital (HALD), National Dalal Jamm Hospital, and the General Idrissa Pouye Hospital (HOGIP). We compared the degree of autonomy, dependence and quality of life of subjects aged over 65 before and after the cardiac rehabilitation program using the Katz index, the Lowton index and the SF12 quality-of-life questionnaire. Results: Over a two-year period, a total of 345 patients had benefited from a complete cardiovascular rehabilitation program in the four cardiovascular rehabilitation units in Dakar, and 86 patients, or 24.92% of the population, were at least 65 years old. The patients were predominantly male (sex ratio M/F = 4.73). The mean age was 70.35 ± 4.55 years for men and 69.27 ± 4.59 years for women. The main pathology motivating cardiac rehabilitation was ischemic heart disease, which was found in 73 patients (84.88%). Initial assessment revealed exertional dyspnea in 35 patients (40.69%), followed by residual exertional angina in 21 patients (4.41%). Mean functional capacity increased from 5.81 ± 2.38 Mets in pre-cardiac rehabilitation to 8.68 ± 2.28 Mets in post-cardiac rehabilitation (p < 0.001). The mean distance covered in the 6-minute walk test increased from 330.42 ± 170.50 m in pre-cardiac rehabilitation to 524 ± 98.54 m in post-cardiac rehabilitation (p = 0.119). The Lowton dependency index in pre-cardiac rehabilitation was 44.18% versus 36.04% in post-cardiac rehabilitation (p = 0.0156). The mental quality of life score was 42.15 ± 10.27 in pre-cardiac rehabilitation versus 52.94 ± 10.86 in post-cardiac rehabilitation (p Conclusion: This study demonstrates the effectiveness of the cardiac rehabilitation program in elderly subjects. In fact, this well-managed, well-structured and well-supervised program enables this population to regain their autonomy, improve their quality of life and functional capacities, and consequently their prognosis.

Isolated esophageal tuberculosis:A case report

BACKGROUND Tuberculosis is endemic in Senegal.While its extra-pulmonary localization is rare,esophageal tuberculosis,particularly the isolated form,is exceptional.We report here a case of isolated esophageal tuberculosis in an immunocompetent patient.CASE SUMMARY A 58-year-old man underwent consultation for mechanical dysphagia that had developed over 3 mo with non-quantified weight loss,anorexia,and fever.Upper digestive endoscopy showed extensive ulcerated lesions,suggesting neoplasia.The diagnosis was confirmed by histopathology,which showed gigantocellular epithelioid granuloma surrounding a caseous necrosis.Thoracoabdominal computed tomography scan did not show another localization of the tuberculosis.The outcome was favorable with treatment.CONCLUSION Esophageal tuberculosis should be considered when dysphagia is associated with atypical ulcerated lesions of the esophageal mucosa,in an endemic area.

Coronary Angioplasty in a Low Income Sub-Saharan Country: Situational Analysis

Introduction: Coronary angioplasty is not widely conducted in sub-Saharan Africa in general and Senegal in particular. The objective of this work was to describe the indications, techniques, results and difficulties of coronary angioplasty in Senegal. Patients and Methods: We prospectively included all patients who underwent coronary angioplasty between July 2012 and November 2014. We evaluated the clinical characteristics, techniques used, and the peri-procedural complications. Results: 110 coronary angioplasties were performed at the cardiac catheterisation unit of the Clinique du Golf in Dakar. The average age of patients was 60.41 ± 10.93 years. A male predominance was noted with a sex ratio of 6.3. Hypertension was found in 57% of patients. The principal indications for coronary angioplasty were for the management of acute coronary syndromes with or without ST elevation, in 29 and 39 patients respectively. The femoral artery was the puncture site in 104 patients. The lesions treated were type A/B1 or B2/C in 53 and 57 cases respectively. The success rates of coronary angioplasties and 30-day mortality were 91% and 0.9% respectively. Conclusion: In sub-Saharan Africa, Senegal in particular, the practice of coronary angioplasty is low. Indeed, many factors linked to socioeconomic status limit the development of coronary angioplasty in Senegal.

DEXA Contribution in Bone Densitometry Evaluation on Osteoporosis in Senegal: Results of a Study Realized in African Black Populations

Osteoporosis, a public health problem is able to occur severe fractures and its prevalence increases in developing countries. Several factors involved in its pathogenesis. These factors are: Heredity, elderly, race, ethnicity, hormones, physical inactivity, sunlight exposure, vitamin D deficiency and certain drugs. In Africa, few data are available and the disease prevalence is maybe underestimated. In Senegal, measure of bone mineral density is recent. In this study, our objective was to determine DEXA patients profile and epidemiological, clinical characteristics of patients for densitometry examination. Thus, 43 cases were collected;lumbar and femoral sites were evaluated. Median lumbar T-score was 0.91 and the femoral T-score was 0.16. Osteopenia was found in 35% of patients and osteoporosis in 26%. Bone Mineral Density was abnormal in 60% of cases. This study is another proof of documented reality of osteoporosis in Senegal. It determines frequency in a population at risk. For the future, it opens way for further larger studies to get better profile of the patients and prevalence osteoporosis in Senegal.