Introduction: Tramadol* is a synthetic opioid agonist used as an analgesic. Despite its minor potential of addiction, it created recently a lot of concern. Its misuse may be motivated by a need to control the pain or by looking for her euphoric character. The aim of our study was to proceed a psychopathological reading of a case of addiction to Tramadol in a sickle cell patient with histrionic personality traits. Methods: We report the case's management of a patient with addiction to Tramadol in a sickle cell patient with histrionic personality traits. The diagnosis was based on the DSM IV criteria. The review was done in the model of semi-structured interviews. Observation: Miss DP is 23 years old, sickle cell patient (AS profile). It is addressed to us for the management of an excessive consumption of Tramadol* started 4 years ago. Because of the difficulties of care in outpatient, we conducted hospitalization. The interviews highlight the histrionic personality traits and disruption of family dynamics. Discussion: Painful chronic diseases require a long analgesic treatment. It is a factor of dependence specially when the patient has a personality disorder. Multidisciplinary treatment between psychiatrist and addiction specialist and medical doctor is a guarantee of success.

No abstract

Introduction: Gallstone disease is a disorder characterised by the formation of stones in the biliary tract. It is the most common biliary condition accounting for more than 98% of all gallbladder and biliary tract disorders. In Africa, previous studies have shown a relative rarity of this condition with a prevalence less than 5%; since it is between 2 and 5 times higher in other continents. A good knowledge of the profile of patient with gallstone disease in a surgical setting could allow to reduce gallstone disease complications and to tailor better the treatment. To our knowledge, there was no previous study about gallstone disease in this region even if there is a high prevalence of metabolic factors of gallstone disease.Methods: This study objective is to describe the epidemiological, diagnostic and therapeutic profile of patients with gallstone disease at the Department of General Surgery of Saint-Louis Hospital (Senegal). It will be a single-centre retrospective cohort study in a period of 5 years (January 2015 -December 2020). The patients' record of the department of general surgery will be consulted and the patient contacted if there are missing data. Patients with gallstone disease diagnosed with imaging (ultrasonography and/or CT scan) regardless the presentation (asymptomatic, biliary colic, cholecystitis, common bile duct lithiasis, angio-cholitis, pancreatitis) will be included. Adults and paediatric patients will be enrolled. Patient records lacking sufficient data will be excluded. Studied parameters will be epidemiological, clinical, paraclinical and therapeutic aspects.Ethics and dissemination: Anonymity and confidentiality of information collected in patients will be respected. This research protocol will be submitted to the Ethics Committee of our institution for approval. The knowledge of the profile of patients with gallstone disease in a surgical setting could allow to reduce gallstone disease complications and to tailor better the treatment. Finally, it will help to reduce the burden of gallstone disease.

Introduction: Strokes are becoming more common in Africa, they are often accompanied by depressive symptoms, hence the need to investigate the factors associated with it for better management and prevention. Methodology: We conducted a prospective cross-sectional study amongst patients hospitalized with stroke at the Neurology/Neuroscience Clinic of the FANN UNHC (Dakar) in 2016. After a clinical diagnosis, patients are subjected to sociodemographic questionnaire and were administered with modified Rankin and MADRS scores. Results: Among the patients, 33.7% had Post-Stroke Depression, most were aged 50 to 70 years, male and married. History of stroke and depression was strongly associated with Post-Stroke Depression, while functional or cognitive impairment caused by stroke contributed to the development of Post Stroke depression. The type of ischemic or haemorrhagic stroke did not appear to affect the occurrence of the Post-Stroke Depression, but Post-Stroke Depression was more frequent in subjects with a left hemispheric lesion 47.8% (p < 0.05). Discussion: The occurrence of a Post-Stroke Depression is a factor of poor prognosis, early diagnosis and holistic care lead to improved quality of life.

Background Cases of cervical cancer are increasing steadily in sub-Saharan Africa, with over 75,000 new cases and nearly 50,000 deaths a year (Mboumba et al., 2017). In Senegal, pathologies such as cervical cancer are one of the top causes of death and the Human papillomavirus (HPV) is its aetiological agent (Steenbergen et al., 2005). Methods The aim of the study is to analyse the distribution of HPV among Senegalese women with cervical cancer. The main objective of this study is to identify the HPV types associated or “co-associated” with cervical oncogenesis in Senegal. The association with the risk factors of cervin carcinogenesis were analysed as well. Cervical biopsies were performed on the women admitted to Aristide Hospital Le Dantec-Julio Curie Institute. Three methods were used to detect HPV genotypes: SANGER sequencing genotyping (Applied BioSystems), PCR real-time approach technique (HPV 16 & 18 RealTime PCR kit) (www.bioneer.co.kr) and the genotyping approach from Chippron (HPV kit 3.5 LCDArray) (info@chipron.com).Results In this study, 24.16% of monoinfections and 75.83% of multiple infections (co-infections) were noted and the majority were at high risk (HR-HPV types). It appears that the HPV genotypes 16, 18 and 45 are the most found in tumors. The most common types of HPV in our study were HPV 16 (100%), 18 (83%), 45 (33%), 33 (31%), 59 (28%), 35 (12%), 31 (11%), 58 (8%), 39 and 73 (4%), 44, 54 and 68 (3%). In the Dakar region, which had the highest number of cases, a prevalence of 17.89% of HR-HPV co-infections was found and the majority of our patients were on a polygamous diet. Polygamy could therefore be a cofactor in the occurrence of cervical cancer in Senegalese women.Conclusion Polygamy could represent a cofactor in the occurrence of cervical cancer in Senegalese women. No association was found between high-risk HPV co-infections and cancer stages. However, an increase of our cohort would be necessary to affirm these hypotheses.