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Although most individuals with sickle cell disease (SCD) live in sub‐Saharan Africa, the natural history of the disease on this continent remains largely unknown. Intravascular haemolysis results in activation of circulating blood cells... more
Although most individuals with sickle cell disease (SCD) live in sub‐Saharan Africa, the natural history of the disease on this continent remains largely unknown. Intravascular haemolysis results in activation of circulating blood cells and release of microparticles (MPs) that exert pro‐inflammatory effects and contribute to vascular damage. We designed a case‐control study nested in the CADRE cohort (Coeur‐Artère‐DRÉpanocytose, clinical trials.gov identifier NCTO3114137) and based on extreme phenotypes, to analyse blood cell‐derived MPs in 232 adult SS patients at steady state in Bamako and Dakar. Thirty‐six healthy adult controls matched by age and sex were recruited in Bamako. The MPs concentrations were higher in SS patients compared to AA controls with a predominance of erythrocyte‐ and reticulocyte‐derived MPs. These erythroid‐derived MPs were significantly lower in patients with retinopathy (P = 0·022). Reticulocyte‐derived MPs were significantly negatively and positively associated with a history of priapism (P = 0·020) and leg ulcers (P = 0·041) respectively. We describe for the first time the comparative patterns of plasma MPs in healthy subjects and
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In many sub‐Saharan countries, haemophilia exists in an environment of poor knowledge and poor access to treatment. To improve the quality of life of Persons with Haemophilia (PWH), understanding their unmet needs and the socio‐cultural... more
In many sub‐Saharan countries, haemophilia exists in an environment of poor knowledge and poor access to treatment. To improve the quality of life of Persons with Haemophilia (PWH), understanding their unmet needs and the socio‐cultural realities is essential.
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Introduction/ Background : Chronic lymphocytic leukemia (CLL) is a heterogeneous disease which can present as an aggressive and life threatening leukemia or as an indolent form that will not require treatment for decades. This... more
Introduction/ Background : Chronic lymphocytic leukemia (CLL) is a heterogeneous disease which can present as an aggressive and life threatening leukemia or as an indolent form that will not require treatment for decades. This heterogeneity has important consequences which will impact on clinical approaches, treatment strategies, and survival times from diagnosis. Prognostic markers such as expression of specific proteins in or on CLL cells (ie, CD38, 70-kD ζ-associated protein or CD49d), cytogenetic abnormalities (del 13q, del 11q, del 17p and trisomy 12) quantified by FISH and immunoglobulin heavy chain (IgVH) gene mutation have all been very useful. Futhermore, patients with early-stage disease, with biologically aggressive disease and shorter survival times can be distiguished. However, these prognostic tests are expensive and require considerable technical expertise and equipment and thus are not available to many patients with CLL living in developing countries. Therefore less...
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Introduction Sickle cell disease (SCD) is not only responsible for acute vaso-occlusive events but also for chronic vasculopathy that affects many organs including kidneys. Animal studies have suggested that SCD vasculopathy mainly... more
Introduction Sickle cell disease (SCD) is not only responsible for acute vaso-occlusive events but also for chronic vasculopathy that affects many organs including kidneys. Animal studies have suggested that SCD vasculopathy mainly results from chronic hemolysis. However hemolysis markers have not been consistently associated with clinical vascular complications. Moreover, SCD vasculopathy events have been almost exclusively studied in the USA or in Europe, although more than 80% of SCD patients are born and living in sub-Saharan Africa, a very different environment. We have settled the first multinational African SCD cohort to measure the incidence of SCD vascular complications and looked for their predictive factors in sub-Saharan Africa. We present here our first results, focusing on SCD nephropathy with glomerular involvement and urinary loss of albumin. Methods CADRE is an ongoing cohort of SCD patients in five African countries: Cameroon, Gabon, Ivory Coast, Mali, and Senegal....
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The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa, where sickle-cell trait (SCT) is also frequent. Although SCT is generally considered a benign condition, evidence suggests that SCT could exaggerate... more
The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa, where sickle-cell trait (SCT) is also frequent. Although SCT is generally considered a benign condition, evidence suggests that SCT could exaggerate vascular dysfunction in T2D. However, it remains unclear whether SCT could increase the risk of the development of T2D complications. Therefore, this study was conducted to determine whether T2D complications were more prevalent among Senegalese individuals with SCT and T2D than among those with T2D only. Rates of hypertension, retinopathy, peripheral neuropathy, peripheral artery disease, and impaired renal function as well as arterial stiffness, blood rheology, and concentrations of plasma advanced glycation end products (AGEs) and cytokines were compared between groups of Senegalese individuals with combined SCT and T2D (T2D-SCT) ( = 60), T2D ( = 52), SCT ( = 53), and neither T2D nor SCT (control) ( = 56). Human aortic endothelial cell (HAEC) express...
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Introduction Le CNTS organise une evaluation externe de la qualite (EEQ) lors des missions de supervision technique des banques de sang. Cette EEQ a pour but d’apprecier les niveaux de performance de depistage du VIH, du VHC, du VHB et de... more
Introduction Le CNTS organise une evaluation externe de la qualite (EEQ) lors des missions de supervision technique des banques de sang. Cette EEQ a pour but d’apprecier les niveaux de performance de depistage du VIH, du VHC, du VHB et de la syphilis dans toutes les banques de sang du pays. Materiels et methodes Entre 2012 et 2016, quatre echantillons des serums ont ete deposes tous les 6 mois dans 18 banques de sang. Il etait demande a chacune de rechercher l’Ag-HBs, les anti-VIH, les anti-VHC et les anti-Treponema pallidum (anti-TP). Les resultats ont ete compares avec ceux obtenus par le CNTS qui utilise un automate de type Architect (Abbott). Resultats Les performances annuelles obtenues par les banques de sang sont pour : – le VIH (90,6 %), le VHB (94,8 %), le VHC (90,2 %) et l’anti-TP (79,4 %) avec un taux de participation de 68,75 % en 2012 ; – le VIH (100 %) ; le VHB (98,2 %) ; le VHC (70,80 %) et l’anti-TP (98,7 %) avec un taux de participation de 77,7 % en 2013 ; – le VIH (100 %), le VHB (100 %), le VHC (91,6 %) et l’anti-TP (89,2 %) avec un taux de participation de 77,7 % en 2014 ; – le VIH (100 %), le VHB (100 %), le VHC (95,31 %), et l’anti-TP (93,75 %) avec un taux de participation de 88,8 % en 2015 ; – le VIH (100 %), le VHB (100 %), le VHC (100 %), et l’anti-TP (93,75 %) avec un taux de participation de 97,91 % en 2016. Conclusion L’evaluation externe de la qualite lors des missions de supervision technique des banques de sang a permis d’harmoniser les pratiques transfusionnelles dans l’ensemble du territoire.
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Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to specific treatment and the high cost of diagnosis and monitoring patients. The aim of this study was to report CML treatment response in a... more
Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to specific treatment and the high cost of diagnosis and monitoring patients. The aim of this study was to report CML treatment response in a developing country in the tyrosine kinase inhibitor era. We conducted a longitudinal study of our cohort of CML patients. Socio-demographic, diagnosis, therapeutic, and treatment response parameters were studied. Sokal score, disease phase at diagnosis, delay from diagnosis to treatment, and treatment response were analyzed for their impact on survival. Fifty-five patients with a diagnosis of CML and who received treatment with imatinib for a minimum of 3 months were included in this study. Median follow-up was 170 patient-years. The sex ratio (M/F) was 1.62 and median age at diagnosis was 42 years. At diagnosis, 85.5 % of the patients were in chronic phase (CP), 12.7 % in accelerated phase (AP), and 1.8 % in blast crisis (BC). Sokal risk score distribution was as follows: low risk 29.8 %, intermediate risk 38.3 %, and high risk 31.9 %. Median time from first symptoms to first medical visit was 6.2 months and median time from first medical visit to cytogenetic and or molecular confirmation was 12.4 months. Mean delay time from first medical visit to imatinib initiation was 12.5 months (95 % CI 6.3-18.7). The complete hematologic response (CHR) at 3 months, the major cytogenetic response (MCR) at 12 months, and the major molecular response (MMR) at 24 months were respectively 82.4, 75, and 25 %. The 2-year overall survival rate was 81 %. Advanced phase at the diagnosis, discontinuation of imatinib therapy over 15 % of the time, lack of CHR at 3 months, lack of MCR at 12 months, and progression of the disease during imatinib therapy were associated with a risk of death (p ≤ 0.05). Our data confirm the improved prognosis of CML treated with imatinib in the setting of a developing country. However, response rates are lower than in developed countries, and additional efforts should be made to facilitate early diagnosis and improve access to TKI, treatment compliance, and regular molecular monitoring of patients.
Research Interests: Developing Countries, Treatment Outcome, Adolescent, Senegal, Humans, and 15 moreChild, Female, Male, Aged, Middle Aged, Adult, Cost of Illness, Disease Management, Antineoplastic Agents, Molecular Targeted Therapy, Protein Kinase Inhibitors, Delayed Diagnosis, Socioeconomic Factors, Imatinib Mesylate, and Cardiovascular medicine and haematology
Trois observations de cas feminins de maladie de Biermer diagnostiquee en Afrique sont rapportes. Les trois malades avaient toutes une anemie macrocytaire avec un medullogramme temoignant d’une megaloblastose. Les manifestations... more
Trois observations de cas feminins de maladie de Biermer diagnostiquee en Afrique sont rapportes. Les trois malades avaient toutes une anemie macrocytaire avec un medullogramme temoignant d’une megaloblastose. Les manifestations neurologiques du type sclerose combinee de la moelle, le caractere biermerien de ces megaloblastoses et une vitaminotherapie parenterale font l’originalite de ces observations. Cette affection parait insuffisamment diagnostiquee en Afrique au vu des observations rapportees dans les publications.
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OBJECTIVE It is predicted that Africa will have the greatest increase in the number of patients with type 2 diabetes mellitus (T2DM) within the next decade. T2DM patients are at risk for cardiovascular disorders. In Sub-Saharan African... more
OBJECTIVE It is predicted that Africa will have the greatest increase in the number of patients with type 2 diabetes mellitus (T2DM) within the next decade. T2DM patients are at risk for cardiovascular disorders. In Sub-Saharan African countries, sickle cell trait (SCT) is frequent. Despite the presence of modest abnormalities in hemorheology and oxidative stress, SCT is generally considered a benign condition. Little is known about vascular function in SCT, although recent studies demonstrated an increased risk of cardiovascular disorders, including venous thromboembolism, stroke, and chronic kidney disease. We hypothesized that SCT could accentuate the vascular dysfunction observed in T2DM. RESEARCH DESIGN AND METHODS The current study, conducted in Senegal, compared vascular function, hemorheological profile, and biomarkers of oxidative stress, inflammation, and nitric oxide metabolism in healthy individuals (CONT), subjects with T2DM or SCT, and patients with both T2DM and SCT (...
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Endemic Burkitt’s lymphoma (eBL) is the single most frequent and represents the vast majority of pediatric lymphomas in sub-Saharan Africa. Pathophysiology of eBL involves latent EBV infection and malaria. Thus far, chemotherapy-based... more
Endemic Burkitt’s lymphoma (eBL) is the single most frequent and represents the vast majority of pediatric lymphomas in sub-Saharan Africa. Pathophysiology of eBL involves latent EBV infection and malaria. Thus far, chemotherapy-based approaches remain the mainstay of the treatment of BL. Despite the major challenges posed to the treatment of BL in high-endemicity and low-income countries, progress has been made, and treatment should be proposed. Current therapy of eBL yields cure rates in the range of 30–50 %, still largely inferior to the 70–90 % achievable in higher-income countries.
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Sickle cell anemia exhibits significant variations in clinical presentation in different populations despite the homogeneity of the genetic defect which is involved. Genetic modulation of this disease is known but cannot explain alone... more
Sickle cell anemia exhibits significant variations in clinical presentation in different populations despite the homogeneity of the genetic defect which is involved. Genetic modulation of this disease is known but cannot explain alone such observations. Our objectives were to determine the effects of Hb F level, sociocultural and economic factors on disease severity in Dakar. Sixty homozygous sickle cell patients were followed up between october 1996 and April 1998 during which period the severity of the disease was assessed and a "severity index" was calculated for each patient. The factors which were identified with proved benefit were: Hb F > 15%, a high socioeconomic level, a good understanding of the disease, at least 4 medical visits per year. These results allow us to identify some potential targets to improve preventive and curative care of this disease.
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Known since over than seventy years, von willebrand disaese is the most common herediary bleeding disorder. This condition was first described by Pr. Willebrand in 1926 in a family with (positive) history of excesive bleeding tendency.... more
Known since over than seventy years, von willebrand disaese is the most common herediary bleeding disorder. This condition was first described by Pr. Willebrand in 1926 in a family with (positive) history of excesive bleeding tendency. Von Willebrand desease is characterized by a lifelong tendency toward easy spontaneous mucosal or post operative bleeding. In females, excessive or prolonged menorrhagia could be a sign of von willebrand desease; symptoms that are often misunderstood to be gynecologic rather than hematologic problem. In the present work, we have tried to screen for this anomaly in females with menorrhagia, following a simple anamnestic, clinical and biological protocol. In a seventeen month study, fifty two procreating females with menorrhagia were recruited in the haematology laboratory of Aristide le Dantec hospital with the cooperation of gynecology and obstetric departements of Aristide Le Dantec, Abass Ndao and grand yoff Hospitals. Eight patients were revealed t...
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Monoclonal gammapathy of undetermined significance (MGUS) has rarely been reported in African literature. The purpose of this article is to describe 3 cases of MGUS observed in women aged 63, 54, and 44 years in Senegal. All three... more
Monoclonal gammapathy of undetermined significance (MGUS) has rarely been reported in African literature. The purpose of this article is to describe 3 cases of MGUS observed in women aged 63, 54, and 44 years in Senegal. All three patients had previously documented autoimmune disease, i.e., auto-immune thrombopenia, multiple auto-immune disease (comprising Sjögren's syndrome, polymyositis and vitiligo), and Sjögren's syndrome. Diagnosis of MGUS was made thanks to routine protein electrophoresis that demonstrated a monoclonal peak in the gammaglobulin area in all patients. Serum protein binding showed the IgG lambda subtype in one case and IgG kappa subtype in two cases. Medullogram findings were unremarkable with nondystrophic plasma cell rates ranging from 1 to 4%. Bisphophonate therapy was undertaken along with the recommended treatments for the associated autoimmune diseases, i.e., prednisone, hydroxychloroquine, and methotrexate. Treatment was successful in all three pat...
Research Interests: Medicine, Senegal, Humans, Autoimmune diseases, Female, and 3 moreFollow-up studies, Middle Aged, and Adult
Hepatitis C virus (HCV) is an important problem of public health in the world according to its transmission mode and its pathogenesis. The risk of blood transmission has led to be the systematic screening of blood donors in the world. In... more
Hepatitis C virus (HCV) is an important problem of public health in the world according to its transmission mode and its pathogenesis. The risk of blood transmission has led to be the systematic screening of blood donors in the world. In Senegal no study about HCV prevalence on the general population and also has been done. The aim of our study was to determine HCV prevalence in blood donors and the rate of co-infection with hepatitis B (HCV/HBV) or with HIV infection (HCV/HIV). This study had been done in the National Blood Transfusion Centre (CNTS) in Dakar. Two different techniques has been used for the assessment HCV: 1/ ELISA technique and 2/ Immunoblot RIBA as confirmation test. Our study relates to 1565 blood donors recruited in CNTS during 2002. 369 of them were new blood donors with 365 females and 1200 males. The mean average was 30.5 +/- 9.5 years, ranged from 18 to 59 years. HCV ELISA test were positive in 22 plasma samples and one of them were co-infected with hepatitis...
Research Interests: Adolescent, Hepatitis C, Senegal, Hepatitis B, Humans, and 5 moreFemale, Male, Adult, Blood Donors, and HIV infections
Antiphospholipids antibodies (APL) are autoantibodies found in lupus erythematosus and disorders like. Their frequency varies between 2 and 62% according to the literature. An increased frequency of cardiac disorders in antiphospholipids... more
Antiphospholipids antibodies (APL) are autoantibodies found in lupus erythematosus and disorders like. Their frequency varies between 2 and 62% according to the literature. An increased frequency of cardiac disorders in antiphospholipids (APL) positive lupus has been reported. The aim of our study was to evaluate the role of APL as an independent risk factor of cardiac disorders in patients with systemic lupus erythematosus. A prospective study during 14 months has been designed with the cooperation of dermatologic, internal medicine and cardiology departments of the Aristide Le Dantec hospital of Dakar. Platelets count (Beckmann Coulter analyzer), activated partial thromboplastin time (Diagnostiga stago analyzer) and antiphospholipids antibodies (Elisa) were determined. 37 patients affected by lupus were included in this study with a net feminine prevalence (89%); 8 (14.6%) had APL's significant results and 20 presented an echographic heart abnormality. The analysis of our data...
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The cytological study of bone marrow aspirate, is a useful technique in diagnosis and epidemiological surveillance of hemopathies. Between January 1991 and February 1999, we realized 1000 bone marrow puncture in Dakar hospitals, this... more
The cytological study of bone marrow aspirate, is a useful technique in diagnosis and epidemiological surveillance of hemopathies. Between January 1991 and February 1999, we realized 1000 bone marrow puncture in Dakar hospitals, this study aims to analyze the frequency of diagnosed hemopathies, and to appreciate justification of prescription. Mean age was 31.6 (1 to 88 years). Bone marrow puncture was safe because no incident was observed. Interpretation was possible in 937 cases while the 33 authors was diluted by blood. Bone marrow was normal in 550 cases (57.3%) whereas abnormality was detected in 417 cases (42.7%). The more frequent pathology were quantitative or qualitative defect of bone marrow production with respectively 25.8% and 20.1%, followed by chronic myeloid leukemia (16%), lymphoproliferative disorders (16%), acute leukemias (13.9%), bone marrow metastasis (5.9%), and storage diseases (1.9%). The best justification of the prescription was obtained when done on the ba...
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Protein C, Protein S and Antithrombin III were screened in one hundred patients admitted for abruptio placentae and one hundred women who delivered normally in Dakar university hospital. We found a reduction of Protein S at normal... more
Protein C, Protein S and Antithrombin III were screened in one hundred patients admitted for abruptio placentae and one hundred women who delivered normally in Dakar university hospital. We found a reduction of Protein S at normal delivery which is linked to hypercoagulation activity during this process. PC and PS were significantly decreased during abruptio placentae in relation with the disseminated intravascular coagulation which was found in our study. We recommend to include these tests to explore aetiologies of abruptio placentae and to confirm their congenital deficit two months after delivery.
Research Interests: Adolescent, Medicine, Senegal, Pregnancy, Humans, and 4 moreFemale, Adult, protein S, and Abruptio placentae
Our objectives were to describe hemato-immunological abnormalities encountered in tuberculosis patients HIV seropositive (TBVIH+, n = 67) or not (TBVIH-, n = 39) and in HIV asymptomatic patients (aSVIH+, n = 40). We found: a great... more
Our objectives were to describe hemato-immunological abnormalities encountered in tuberculosis patients HIV seropositive (TBVIH+, n = 67) or not (TBVIH-, n = 39) and in HIV asymptomatic patients (aSVIH+, n = 40). We found: a great reduction of mean value of RBC and Hb in TBVIH+ and TBVIH-; a reduction of mean value of leucocytes, total lymphocytes and CD4+ lymphocytes in TBVIH+ and aSVIH+; an inversion of [formula: see text] ratio, more important in TBVIH+ than in aSVIH+. HIV and tuberculosis association, HIV1 serotype and CD4 < 200/mm3 were found to promote significantly hemato-immunological abnormalities.
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Our objectives were to determine aetiology and localisation of infection in sickle cell anaemia patients. The origin of fever was malaria in 47% of cases, 50% of bacterial infections and 3% of viral infections. Respiratory infections were... more
Our objectives were to determine aetiology and localisation of infection in sickle cell anaemia patients. The origin of fever was malaria in 47% of cases, 50% of bacterial infections and 3% of viral infections. Respiratory infections were concerned in 61% of cases, versus 24% of osteomyelitis. Salmonella were found in 37%, Haemophilus (16%), Staphylococcus (14%), Streptococcus (10%) and Pneumococcus (9%). We found more bacterial infection in anaemic forms (SS and SFA2) and more bacterial infection anemic forms (SC, SAFA2). In view of these findings, we preconize malaria prophylaxis and vaccination against Salmonella, Haemophilus and Pneumococcus in sickle cell anemia patients.
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Hairy cell leukemia is a rare lymphoproliferative disorder which affect predominantly older males. Typical presentation includes pancytopenia, splenomegaly, presence of malignant cells with hairy projections, and some difficulty to... more
Hairy cell leukemia is a rare lymphoproliferative disorder which affect predominantly older males. Typical presentation includes pancytopenia, splenomegaly, presence of malignant cells with hairy projections, and some difficulty to perform a bone marrow aspiration. Reported is a 78 year - old female patient, who presented only neutropenia. There was no splenomegaly and the bone marrow aspiration was easy. Diagnosis was based on the presence of characteristic cells in a second bone marrow aspiration, whereas a treatment by recombinant human G-CSF was introduced for a suspicion of an idiopathic neutropenia. Confirmation was done with immunostaining by DBA 44 monoclonal antibody. This is the first case of hairy cell leukemia reported in Dakar, and with an uncommon clinical presentation making it difficult to be recognized.
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Sickle cell disease and G6PD deficiency have similar prevalence of 8 to 10% in Senegalese population. Our objectives were to determine the prevalence of G6PD deficiency in Hb S carriers and normal subjects, and to assess the interaction... more
Sickle cell disease and G6PD deficiency have similar prevalence of 8 to 10% in Senegalese population. Our objectives were to determine the prevalence of G6PD deficiency in Hb S carriers and normal subjects, and to assess the interaction of G6PD deficiency on clinical severity of sickle cell disease. G6PD activity was measured in 319 sickle cell patients and in 318 subjects without HbS. Clinical severity was compared in male homozygous sickle cell patients (11 with G6PD deficiency and 19 without deficit). In homozygous sickle cell patients, the G6PD status was assessed after correction of reticulocyte count following the micro-centrifugation method of Herz. We found that prevalence of G6PD deficiency was higher in sickle cell disease patients (21.6 %) than in normal subjects (12.3 %) (p = 0.001). No difference was found in the two groups of male sickle cell disease patients concerning number of vaso-occlusive crisis, number of transfusion, frequency of infectious episodes, number of ...
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Context. – The progress realized in the treatment of sickle cell anemia has resulted to a better and longer life for these patients in developed countries. Ongoing challenge are to manage complication and social living for these patients.... more
Context. – The progress realized in the treatment of sickle cell anemia has resulted to a better and longer life for these patients in developed countries. Ongoing challenge are to manage complication and social living for these patients. The purpose of this study was to determine morbidity, mortality and socioprofessional insertion of homozygous sickle cell patients, followed up in Dakar
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Little is known about the biological, epidemiological, and clinical risk factors for thrombosis and venous thromboembolism (VTE) among Black Africans. We undertook a study of the prevalence of VTE risk factors for thrombosis in a... more
Little is known about the biological, epidemiological, and clinical risk factors for thrombosis and venous thromboembolism (VTE) among Black Africans. We undertook a study of the prevalence of VTE risk factors for thrombosis in a Senegalese population. A three-year cross-sectional and case-control study involving 105 cases and 200 controls was conducted in various hospitals in Dakar (Senegal). Our results demonstrate that oral contraception, immobilization by casts, surgery, and blood group were significantly associated with VTE occurrence. Additionally, 16 cases and 2 controls had protein S (PS) values of less than 48.4% (M-2SD), exhibiting a highly significant difference ( P < 1 x 10−4). The number of cases with a low protein C (PC) level was significantly higher than the respective number of controls. Using logistic regression methods, we established a correlation between significantly associated variables and deep venous thrombosis (DVT) occurrence. Age, obesity, sickle cell ...
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One case of acute panmyelosis with myelofibrosis (APMF) is being reported. A 45 year old male presented with abrupt onset of rapidly progressing low backache, weakness and pancytopenia. On examination there was no organomegaly. Peripheral... more
One case of acute panmyelosis with myelofibrosis (APMF) is being reported. A 45 year old male presented with abrupt onset of rapidly progressing low backache, weakness and pancytopenia. On examination there was no organomegaly. Peripheral blood examination revealed normocytic normochromic red blood cells with 10% circulating blasts. Flowcytometric examination of peripheral blood revealed blasts which were positive for CD 34 ,HLA- DR and myeloid associated antigens (i.e. CD13 and CD33).Blasts were negative for anti MPO. Bone marrow aspirate resulted in a dry tap. Bone marrow biopsy revealed panmyeloid proliferation with scattered blasts which were CD 34 positive on imunohistochemistry and negative for anti MPO. Reticulin stain showed grade III myelofibrosis (WHO). Differential diagnosis considered included AML-M7, MDS-RAEB II and AML with myelodysplasia . He was started on chemotherapy [idarubicin and cytarabine; 3+7 induction regimen followed by three cycles of HIDAC (High dose cyto...
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The goal of the present study was to test whether fasting during the holy period of Ramadan may disturb blood rheology in sickle cell trait (SCT) carriers more than in a group of subjects with normal hemoglobin. Twenty African male... more
The goal of the present study was to test whether fasting during the holy period of Ramadan may disturb blood rheology in sickle cell trait (SCT) carriers more than in a group of subjects with normal hemoglobin. Twenty African male students participated in the study: 10 SCT carriers and 10 subjects with normal hemoglobin (CONT). Biochemical parameters (plasma glucose and lipids levels), hematocrit, blood viscosity, and urine specific gravity were measured in the two groups on the 14th day of the Ramadan period (Ramadan condition) and 6 wks after the end of Ramadan (baseline condition). All the measurements were performed twice for each experimental day to measure intraday variation: 8:00 and 18:00 h. Plasma glucose level and lipid profile were not significantly different between the two groups. Although Ramadan did not affect the lipid profile, the plasma glucose concentration was lower during the Ramadan period compared with the baseline condition in the two groups. Hematocrit and urine specific gravity did not differ between the two groups and was greater in the evening than in the morning, independently of the condition. SCT carriers had higher blood viscosity than the CONT group. However, whereas blood viscosity remained unchanged through the day in the CONT group, whatever the condition, SCT carriers were characterized by a large increase of blood viscosity in the evening during the Ramadan period, indicating higher risk for microcirculatory blood flow impairments. Specific medical recommendations are needed for SCT carriers engaged in religious fasting.
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Research Interests: Biology, Brazil, Medicine, HIV, Molecular Epidemiology, and 15 morePhylogeny, Humans, Female, Cluster Analysis, AIDS, Clinical Sciences, Prevalence, Middle Aged, Genotype, Adult, Cross Sectional Studies, Enzyme Linked Immunosorbent Assay, Molecular Sequence Data, Sequence homology, and HIV infections
Chronic complications of sickle cell disease (SS) usually involve irreversible organ damage. Several genetic factors have been shown to have predicative value for chronic complications but these data are not always available. The purpose... more
Chronic complications of sickle cell disease (SS) usually involve irreversible organ damage. Several genetic factors have been shown to have predicative value for chronic complications but these data are not always available. The purpose of this study was to assess the value of sociodemographic and clinicobiological features in predicting chronic complications. This study included a total of 229 adult SS patients who underwent quarterly follow-up examinations for at least 10 years (range, 10 - 16). All sociodemographic and clinicobiological data were recorded. Screening for complications was performed at least once every three years. The risk of developing chronic complications was analyzed in function of patient follow-up data. Mean patient age was 28.6 years (range, 20 - 57) and sex ratio was 1.3. Prevalence of chronic complications was 34.9% (80/229). The most common complication was bone necrosis in 27 cases (11.7%) followed by gallstones in 24 (10.4%). The only sociodemographic...