Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
Aim: To determine the epidemiological findings of acute rheumatic fever\n(ARF) and relationship with acute rheumatic heart disease (RHD). Patients\nand method: This cross sectional study was conducted from January 2012 to\nDecember 2016 (5 years) in the Department of Pediatrics. We had included\npatients aged from 5 to15 years old, admitted for ARF. Results: Twenty-nine\nblack African children, 15 boys (51.7%) were included. The incidence was 5.8\ncases/year. The mean age was 10.4 Â} 2.7 years. The mean age of parents was\n34.5 Â} 6.9 years (range: 24-48) for mother and 41.2 Â} 6.9 years (range: 28 -\n56) for father. Parents were low-income 10 (34.5%), the delay of consultation\nwas 17.7 Â} 19.5 days. The medical history was: frequent pharyngitis 22 (76%),\nprevious ARF 17 (58.6%), previous hospitalization 11 (38%). Signs were: polyarthralgia\n(n = 28, 96.6%), fever (n = 24, 82.8%), asthenia (n = 18, 62%),\nmigratory polyarthritis (n = 12, 41.4%). Organic heart murmur has been reported\nin 13 cases (44.8%), and heart failure in 7 cases. The anomalies of\nblood analysis were inflammatory syndrome (100%), elevation of streptococcal\nenzymes (n = 27, 93%), and anemia (n = 16, 55.2%). In cardiac ultrasound,\nanomalies were: thickened valve (n = 13, 44.8%), mitral regurgitation\n(n = 13, 44.8%), dilatation of left ventricle (n = 9, 31%), aortic regurgitation\n(n = 5, 17.2%). The nosology of pathology was acute RHD (n = 15, 51.7%),\nARF only (n = 14, 48.3%). Associated factors of acute RHD were: female sex\n(OR 1.52, 95%CI 0.35 - 6.6), low-income (OR 1.33, 95%CI 0.24 - 7.4), previous\nhospitalization (OR 2.7, 95%CI 0.58 - 13) and migratory polyarthritis\n(OR 1.12, 95%CI 0.25 - 4.9). Conclusion: The ARF remains prevalent in our\ncountries. Its complications lead to sequelae that are difficult to treat, because\nof the lack of cardiac surgery centers in many sub-Saharan African countries\nincluding Congo. Prevention and effective treatment of angina should be applied\nby practitioners....
Background: Duodenal fibrolipoma and duodenum-jejunum intussusception are both rare occasions in clinical\npractice. The diagnosis of duodenal fibrolipoma mainly depends on endoscopy examination, supplemented by CT\nand MRI. As the tumor grows, some severe symptoms need surgical intervention. As the development of endoscopic\ntechniques, the operation plan should be made individually.\nCase presentation: A 47-year-old female with the complaint of upper abdominal pain and melena was reported.\nAbdominal examination revealed upper abdomen lightly tender and blood test showed severe anemia. Image and\nendoscopy examination exhibited â??a giantmassâ? in the descending (D2) part of duodenum, dragged by the tumor\ninto the distal intestinal canal and causing intussusception. Intermittent blood transfusion treatment, enteral and\nparenteral nutrition were adopted to adjust her general state. Two weeks later, the mass was resected together with\nthe basement intestinal wall via the jejunum incision and then the intussuscepted D2 part was restored. The paraffin\npathological diagnosis correlated with the preoperative judgment of fibrolipoma and the patient was discharged\nhealthy on POD 14.\nConclusions: Duodenal fibrolipoma is a rare disease, infrequently causing intussusception and severe upper GIB.\nDuodenoscopy and endoscopic ultrasound contribute to making an appropriate diagnosis, and for patients with\nsevere symptoms needed surgical intervention, operation plan should be individualized depending on the size and\nlocation of the lesion....
Primary intracranial ependymomas originate from ependymal cells. They\nmay migrate mainly in the spinal cord but rarely metastasize outside the central\nnervous system. Metastases outside the central nervous system are rare.\nMetastatic diffusion from the central nervous system is low due to the unique\ninteraction of the brain and the tumor with the blood-brain barrier. Nevertheless,\nthree main hypotheses have been mentioned in the literature, the tumor\ngrowth, the surgical manipulation (which may be considered to be the\ncase in our patient), and the aggressiveness of the tumor according to the\nKi67 index. We report the case of a 16-year-old female, who underwent complete\nsurgical removal of a left occipital 2007 WHO grade II ependymoma. 3\nyears later, the patient presented multiple cervical and occipital indurated\nmasses. MRI showed a left hemispheric meningeal infiltration, with multiple\nnodules located on the neck, occiput and mastoid. Histopathological study of\na left temporal surgical biopsy and resection of an occipital subcutaneous\nnodule turned to be metastases of an anaplastic ependymoma. The ependymoma\nconsidered as a benign tumor could very quickly turn into malignancy\nby its metastatic potential. Early diagnosis and longer follow-up of patients\nwould be recommended for a rapid management....
Background and Aim: In hemodialysis patients, 24-hours interdialytic\nABPM better detects TOD than dialysis unit blood pressure. Therefore, the\npresent study was aimed to assess the diagnostic performance of 24-hours\nABPM vs. dialysis unit BPs for the diagnosis of ECG-LVH in steady state\nchronic hemodialysis black patients. Methods: From March 31 to September\n30, 2018, interdialytic ABPM was performed after a mid-week hemodialysis\nsession for 24 hours using a Spacelab 90207 ABPM monitor in the non-access\narm in 45 stable chronic hemodialysis black patients ......................
The Democratic Republic of Congo is one of the countries with a high prevalence\nof multidrug-resistant tuberculosis (MDR-TB) in Africa and worldwide.\nThis study aims to describe the trends and level of screening since 2013. This\nis a retrospective descriptive study based on quarterly reports from the provinces.\nThe number of cases, past histories, age, sex and HIV Co-infection was\nidentified. It emerges that the number of cases increases significantly but does\nnot reach the forecasts yet (912 cases of MDR/RR and XDR diagnosed in 2017\nout of 3948 cases expected with a gap of 77%). Patients with a history of TB\npredominate (63.5% in 2017); but the proportion of patients with no history\nof TB increases (36.5% in 2017). This suggests high rates among contacts.\nWomen (37.8%) and children under 15 (2.7%) are less represented. TB/HIV\nCo-infection is 12% as for sensitive cases. Efforts still need to be made to improve\nscreening....
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