The Journal of Middle East and North Africa Sciences

1-5

Authors: Samy M. L. Dadah; Ousmane Cisse; Soumaila Boubacar; El Hadji M. Ba; Mohamed L. M. Bagher; Lala B. Seck; Mohameth Faye; Ngor side Diagne; Kamadore Toure; Mouhamadou B. Diagana; Moustapha Ndiaye; Amadou G. Diop; Mouhamadou M. Ndiaye

Introduction: Strokes are frequent and severe, because of the involvement of vital and functional prognosis of patients,especially in young patients living in developing countries. Objective: The main objective of the current study is to identify epidemiological, clinical, paraclinical and etiological predictors of adverse evolution in young adult ischemic stroke. Methodology: Authors conducted a retrospective study at the neurological department of University hospital Fann, Dakar, Senegal, on the records of hospitalized patients from 01 January 2010 to 31 December 2011. Patients aged from 15-55 years in whom the diagnosis of ischemic stroke was selected on the basis of clinical findings and confirmed by a brain scan were included in our study. Results: Authors gathered 116 cases. Mean patient age was 43.5 years with extremes of 19 to 55 years. The main risk factors found in the medical history of patients were hypertension (57.7%), diabetes (19%), and history of stroke(10.3%). Clinical signs were dominated by hemiplegia (95.7%) and language disorders (61.2%). The average length of stay in hospital was 16 days. A death rate of 28.4% was observed. The main predictors of adverse evolution identified were the length of stay in the hospital, age, Glasgow Coma Scale (GCS), blood glucose level. Patients with a GCS lower than 10 had a risk of death multiplied by 5. Patients with blood glucose level ≥ 2 had 4 times greater risk of death than others. Conclusions: Glucose acute phase and state of consciousness seem to be predictors of cerebral ischemia. A quick and appropriate management will improve the vital prognosis and better recovery.

22-24

Authors: Ibrahima M. Diallo; Soumaila Boubacar; Ousmane Cisse; Mansaré M. Lelouma; Marie E. Y. Ndong; Japhari Nyassinde; Lala B. Seck; Kamadore Touré; Moustapha Ndiaye; Amadou G Diop; Mouhamadou M. Ndiaye

Guillain-Barre syndrome is a rare complication of typhoid fever and only a few such cases have been reported in the pediatric age group. Authors report here the first documented case of Guillain-Barre syndrome associated with typhoid fever in Senegal. It was an old boy of 10 years without a specific personal history with psychomotor development and a status update. No family history had been reported. He was hospitalized for motor deficit of 4 members of progressive and backward installation on approximately 1 week. The beginning of the symptomatology was marked by episodes of nausea, sometimes late post-prandial vomiting and diarrhea, abdominal pain in a feverish context. Neurological examination was objectified a peripheral neurogenic syndrome. There were no abnormalities of the cranial nerves or sensory impairments evident. The rest of the clinical examination was normal. The Electroneuromyography had objectified maximum diffuse axonal degeneration in the lower limbs with discrete lesions of demyelination in places. Blood biology showed a mild leukocytosis predominant neutrophil. Lumbar puncture with cerebrospinal fluid analysis showed an Albuminocytological dissociation moderate with a cellularity to 12 items per mm³ and protein levels to 1.25 g per liter. In the course of a normal comprehensive etiological account, the diagnosis of polyradiculoneuritis acute (Guillain-Barre syndrome) on the highlighting of Salmonella Typhi by serology Widal and Felix, but also of the culture which had highlighted the germ Salmonella Typhi. The stool culture and the gastric biopsy had not been carried out. Evolution after 3 weeks had been marked by a slight improvement in the clinical signs of a discrete regression of the engine following a made essentially supported deficit of ceftriaxone (80 mg/kg/day for 7 days), physiotherapy and symptomatic treatment. Typhoid fever is a common infection in the tropics but its complications on the peripheral system are very rare. A multidisciplinary collaboration is necessary for the treatment of these conditions in the tropics in general and in particular typhoid fever.

30-38

Authors: Mohamed Abdulwahab Ahmed

The importance of this paper comes from the essential role is played by the organizational structure and departmentalization in any organization or businesses to grow and be profitable. This paper is addressing the relationships between the organization structure and staff performance, and draw distinctions between “hard” and “soft” performance criteria, by examining the direct and indirect influences of organizational structure and internal communication between the employees. This paper provides guidance to all employees by laying out the official reporting relationships that govern the workflow of the organization to provide a flexible and ready means for growth. The current paper aims to evaluate the relationship between organizational structure and continuous improvement and success in any organization and link it to the staff goals and area of responsibilities, and to know the impact of the Organizational Structure and departmentalization, and to determine the benefits of national and international organizations.