Abstract Introduction: The transmission of infectious agents through the hands of nursing staff during care is the main cause of nosocomial infections. Hand hygiene has been recognized for over a century as an effective measure to prevent healthcare associated infections in healthcare settings, the objective of this study was to appreciate the practice of hand hygiene during care by health professionals in the medical-surgical emergency department of the Donka National Hospital. Methods: It was a cross-sectional, analytical study. Data collection took place from March 1 to April 30, 2021. The study covered all health professionals, namely doctors, nurses, laboratory technicians, radiography technicians, pharmacists, students, stretcher bearers, surfactants who were present at the time of the study period. Results: During the study period, out of a total of 104 registered health professionals, we surveyed 99, which is a rate of 95%. The most represented age group was [30 - 39 years] with an average of 37.17 ± 10.34 years, and extremes of 22 years to 65 years. The male sex was the most dominant or 59.60% compared to the female sex or 40.40% with a sex ratio of 1.47. The hand hygiene compliance rate was low at 21%. The practice of hand hygiene during care for 100% of health professionals was very low, at 8.08%. No factors influence the observance of the practice of hand hygiene and the socio-professional characteristics of the conditions of provision of care activities. Conclusion: Hand hygiene during care is an essential aspect that must be considered as an essential measure in the prevention of infections in this period of the COVID-19 pandemic.

Abstract Introduction: Unclassified inflammatory rheumatism is persistent inflammatory arthralgias with or without synovitis without sufficient classification criteria for an inflammatory rheumatism or a well-defined connective disease. Their outcome is variable and has been little studied in Africa. We report the epidemiological, paraclinical and evolutionary characteristics of seven cases of indeterminate polyarthritis. Material and Method: From January 2012 to May 2021, we selected all the files of patients followed up for unclassified inflammatory rheumatism and in whom a precise diagnosis was retained during the course of the disease. The diagnosis of unclassified inflammatory rheumatism was retained after biological, immunological and radiological explorations without specificities. Our study took place in the Internal Medicine Department of Aristide Le Dantec Hospital (HALD). Results: Seven cases out of 274 consulted were collected. They consisted of seven women with an average age of 39 years at the time of the first consultation (extremes: 19 and 67 years). All seven patients presented with inflammatory polyarthralgia or non-deforming, non-erosive peripheral polyarthritis, without extra-articular manifestations. A biological inflammatory syndrome was present in all seven patients. Autoantibodies (rheumatoid factor, ANA, anti-ENA and ACPA) were negative in all patients. The first-line treatments in all seven cases were hydroxychloroquine (200 - 400 mg/day) and prednisone (5 - 10 mg/day). Methotrexate was added in 3 cases. During follow-up, 2 cases progressed to Polyarthritis Rheumatoid (PR) after 3 and 4 years. Two cases progressed to Sjögren’s syndrome after 4 and 5 years. Two patients progressed to systemic scleroderma after 5 and 8 years. One patient progressed to lupus after 5 years. Conclusion: Regular follow-up is essential in IAN. It allows the early diagnosis of IJR or a well-differentiated connective tissue disease and ensures adequate management, especially early.

Abstract Introduction: The COVID-19 pandemic has turned the global health system upside down. Senegal recorded its first case on 2 March 2020. As part of its control strategy, the internal medicine department was set up as an epidemic treatment center (ETC). We report on our experience in the management of patients hospitalized in the said center. Material and Methods: Retrospective and descriptive study with analytical aim carried out at the ETC of the CHU Le Dantec of Dakar during the period from 29 April to 30 October 2020 (1st wave) then from 30 December 2020 to 30 April 2021 (2nd wave). All hospitalized patients who tested positive for RT-PCR were included. Epidemiological, clinical, paraclinical and evolutionary data were collected from a pre-established survey form and analysed using the software. Results: Five hundred and se venty files were collected: 379 patients (66%) in the 1st wave and 191 patients (34%) in the 2nd wave. There were 312 men and 258 women, i.e. a sex ratio of 1.22. The median age was 56 years [1.5 - 100 years]. Two thirds of the patients (66%) were over 50 years of age and 223 patients (39.1%) were over 65 years of age. Community transmission was reported in 72% of cases. The average length of hospital stay was 10 days [1 - 32]. Clinically, the mild form predominated (50.9%); the severe and critical forms were 32.6%. Comorbidity was noted in 68% of patients. The different comorbidities were: hypertension (36.1%), diabetes (28.2%), advanced CKD (9.8%). The case fatality rate was 17.2% with a mean age of 70 years. Conclusion: COVID-19 is responsible for respiratory but also systemic manifestations. This 3rd pandemic particularly affects vulnerable people with a significant morbidity and mortality, thus requiring the implementation of standardized CTE with multidisciplinary teams in the control strategies.

Abstract Acute kidney injuries (AKI) are a common problem encountered by internists in the inpatient and outpatient setting. Uncovering the etiology becomes important in tailoring treatment. Point-of-care ultrasound (POCUS), when used in conjunction with a patient’s history and physical exam, can quickly identify if hydronephrosis is present and shed light on the underlying etiology. In this article, we discuss how incorporating POCUS into the initial assessment of patients with an AKI can reduce the number of unnecessary and expensive formal renal ultrasounds and potentially expedite clinically appropriate treatment. The purpose of this review is to examine the benefits, reliability, and feasibility of POCUS to further evaluate and manage patients with AKI. An extensive review of the literature was performed and found POCUS to be a reliable and realistic method for internists to incorporate into their assessment of patients with AKI. In this article, we also provide instruction on how to perform a POCUS exam of the kidneys and how to identify hydronephrosis. Furthermore, we discuss the challenges we face and ideas for further practice including the emergence of hand-held ultrasounds.