Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried ...Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried out. Its objective was to evaluate the effects of physical rehabilitation on cardiac function. Methods: Patients were evaluated at the beginning and at the end of cardiovascular rehabilitation by cardiovascular, biological, and echocardiographic parameters including the size of the heart chambers, the kinetics of the walls, and the systolic function of the ventricles. Results: The study involved 12 patients, 67% of whom were men. After cardiac rehabilitation, the mean hemodynamic constants had not been significantly modified. However, a significant decrease in Total-Cholesterol, LDL-Cholesterol and triglyceride levels was noted. Mean fasting blood sugar decreased from 1.25 ± 0.48 g/L to 0.92 ± 0.18 g/L and glycated hemoglobin from 7.72% ± 0.01% to 6.45% ± 0.008%. The echocardiographic parameters studied showed an improvement in the dilation of the heart chambers in 8.33% of the patients, the normalization of the ejection fraction of the left ventricle in 16% patients, the improvement of the kinetic disorders in 16% of patients and recovery of right ventricular systolic function in all patients. Conclusion: Cardiac rehabilitation as a secondary preventive measure for cardiovascular disease has contributed significantly to improving the clinico-biological parameters of the disease.展开更多
Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that m...Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that mimics septic arthritis caused by the deposition of lipid droplets in the joint. We present the case of a patient hospitalized for mono-arthritis, which revealed systemic lupus. Observation: The patient is a 19-year-old woman, single, without children, and with no previous medical history, who was hospitalized for fever and inflammatory polyarthralgia. The clinical examination revealed an inflammatory swelling of the right knee with patellar ballottement, yellow citrine synovial fluid, an inflammatory tumor on the left arm, which was round, mobile, and fluctuating with purulent content, edema of the lower limbs, and facial puffiness, along with a systemic inflammatory response syndrome. Paraclinical examination showed hyperleukocytosis with neutrophil predominance, microcytic anemia, thrombocytopenia, antistreptolysin O (ASLO) 3, suggesting inflammatory arthritis. Bacteriological tests did not isolate any pathogens. An arthrotomy with synovial biopsy was performed, and the histopathological examination supported non-specific synovitis. A joint ultrasound showed signs of arthritis with a septic appearance. During the third hospitalization for persistent fever, she presented with facial puffiness, anemia syndrome, systemic inflammatory response syndrome, and a malar rash across the bridge of the nose. Antinuclear antibodies returned positive with a titer of 1280 and a speckled fluorescence pattern, and anti-native DNA antibodies were positive at 60.1 (normal Conclusion: Pseudo-septic arthritis is a feature of lupus that can mimic septic arthritis. Monoarticular involvement is rare but possible. The absence of pathogens and the inflammatory nature of the synovial fluid should prompt consideration of a lupus-related etiology.展开更多
Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the freq...Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the frequency and etiologies of urinary tract infections in diabetics hospitalized at the department of medicine of Abass Ndao Hospital. Patients and Methods: This work was a cross-sectional, descriptive, and analytical study conducted from January 01, 2018, to December 31, 2018. It focused on hospitalized diabetic patients with urinary tract infection. Epidemiological, clinical, and evolutionary data of UTI were evaluated. Results: One hundred and twenty-eight (128) diabetic patients had a cytobacteriological urine exam (CUE). 44 of who had a positive CUE (34.4%). The age group [60 - 69] years was the most represented (31.8%). Women predominated (61.4%) with a sex ratio (m/f) of 0.63. Abdominal pain was the most frequent reason for consultation, followed by polydipsia. Fever was recorded in 21 patients (47.7%). Type 2 diabetes was found in most patients (70.5%). Glycemia above 2g/l was found in 34 patients (89.5%). Anemia accounted for more than half of the patients with 29 cases (65.9%). Leukocytosis was noted in 28 patients (63.6%) and a positive CRP in 33 patients (75%). An increase in urea-creatinine was noted in 23 cases (52.3%). The results of the CUE revealed Escherichia coli as predominant (43.2%, n = 19), followed by Candida with 22.7% (n = 10). Antibiotic therapy was given to all patients. The mostly used antibiotic in the treatment of UTI was Cefotaxime 27.3% (n = 12). Older age and female gender were associated with the presence of E. coli. Four (4) deaths were recorded (9%). They were all male over the age of 65. Conclusion: UTI in diabetes is an important cause of morbidity and mortality. The development and implementation of a prevention and management program are essential.展开更多
Introduction: Coronavirus disease is a pandemic discovered in December 2019. It is a polymorphic, systemic zoonosis caused by a virus with predominant respiratory tropism. This work aimed to evaluate the epidemiologic...Introduction: Coronavirus disease is a pandemic discovered in December 2019. It is a polymorphic, systemic zoonosis caused by a virus with predominant respiratory tropism. This work aimed to evaluate the epidemiological, clinical, paraclinical, therapeutic, and evolutionary profile of patients with COVID-19 at Touba Ndamatou Public Hospital Hospital Establishment. Materials and Methods: This was a descriptive, retrospective, cross-sectional study of 114 cases hospitalized for COVID-19 at Touba Ndamatou Public Hospital Health Establishment, during the period from May 1, 2020, to September 30, 2021. Data were collected from patient medical records, entered using Epi Info Version 7 software, and analyzed using SSPS version 21.0 software. Results: The mean age of patients was 65 ± 14.5 years, with extremes of 25 and 92 years. The predominant age group was [46 - 65 years] with 39%. Males predominated with 65% (n = 74). The peak occurred in August 2021 with 57.8% of cases (n = 66). 68.15% of patients had at least one comorbidity, with hypertension and diabetes the most frequent comorbidities at 35.9% and 15.7% respectively. Dyspnea was the most frequent reason for consultation (70%), while the most common physical signs were pulmonary condensation syndrome (94%), respiratory distress (77%), and hypoxia (65%). Severe forms accounted for 32%. The most common CT images were ground-glass areas, predominantly in the basithoracic region. Azithromycin was used in all patients, oxygen therapy was used in 93%, and corticosteroids were used in 90%, although the average number of drugs taken per patient was eight (8). The average hospital stay was 4.54 days. The case fatality rate was 18.51% (n = 21). Advanced age (60 and over) and hypoxia were the main risk factors for mortality. Conclusion: The COVID-19 pandemic has been declared a global health emergency by the WHO. It has caused many deaths worldwide. Vaccination, the subject of much controversy in our context, would be the only means of preventing critical forms of the disease, especially among people at risk.展开更多
Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in ad...Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in adults, the second leading cause of dementia (after Alzheimer’s disease), and the third leading cause of death (after cancer and cardiovascular disease). It’s also a major cause of depression. The objective of our study was to describe the epidemiological, clinical and evolutionary aspects of stroke in the internal medicine department of Tivaouane Hospital. Material and Method: This is a retrospective study carried out from January 1, 2015 to December 31, 2018 on the files of patients hospitalized for stroke in the medical department of the EPS1 in Tivaouane. We took into account all the patients who had a brain CT (computed tomography) scan. We collected data related to socio-demographic characteristics, history, risk factors, reasons for admission, clinical signs, paraclinical examinations, as well as evolution. Results: Out of 1999 patients, 206 files of patients with stroke were collected, i.e. a proportion of 10.3%. Our study population had a mean age of 65.53 years [16 - 97 years]. We noted a clear predominance of women (50.5%). The majority of the population came from the outskirts of Tivaouane (56.7%). Risk factors for stroke were dominated by hypertension (90.3%), dyslipidemia (19.4%), previous stroke (18.9%), and diabetes (16%). The clinical signs were dominated by a motor deficit (94.1%), speech disorders (67.4%) and consciousness disorders (47%). Ischemic strokes were predominant (65%) over hemorrhagic strokes (34.5%). The outcome was generally unfavorable with 14.6% total recovery, 58.7% recovery with sequelae and a case fatality of 26.7%. Conclusion: It emerges from this study that strokes still remain a real public health problem. Knowledge of populations of risk factors as well as their proper management is fundamental in primary prevention strategies, the only guarantee for a reduction in the still very high morbidity and mortality of this disease.展开更多
The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a nec...The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a necrotic ulcer wound on the skin lasting 3 weeks amid a big neglected hetero-multinodular goitre, evolving since 20 years. The anatomopathological test showed a gallbladder thyroid carcinoma of the thyroid with severe inflammation. The treatment consisted of a complete thyroidectomy with recurrent bilateral dredging. There was a favourable evolution. Gallbladder carcinoma, in its aggressive aspect, may be linked to the occurrence of acute festered thyroiditis. Therefore, the prognosis of our patient was favourable.展开更多
文摘Cardiac rehabilitation helps improve the prognosis and quality of life for patients with heart disease. To show its interest in the African context, in the management of heart disease, a prospective study was carried out. Its objective was to evaluate the effects of physical rehabilitation on cardiac function. Methods: Patients were evaluated at the beginning and at the end of cardiovascular rehabilitation by cardiovascular, biological, and echocardiographic parameters including the size of the heart chambers, the kinetics of the walls, and the systolic function of the ventricles. Results: The study involved 12 patients, 67% of whom were men. After cardiac rehabilitation, the mean hemodynamic constants had not been significantly modified. However, a significant decrease in Total-Cholesterol, LDL-Cholesterol and triglyceride levels was noted. Mean fasting blood sugar decreased from 1.25 ± 0.48 g/L to 0.92 ± 0.18 g/L and glycated hemoglobin from 7.72% ± 0.01% to 6.45% ± 0.008%. The echocardiographic parameters studied showed an improvement in the dilation of the heart chambers in 8.33% of the patients, the normalization of the ejection fraction of the left ventricle in 16% patients, the improvement of the kinetic disorders in 16% of patients and recovery of right ventricular systolic function in all patients. Conclusion: Cardiac rehabilitation as a secondary preventive measure for cardiovascular disease has contributed significantly to improving the clinico-biological parameters of the disease.
文摘Introduction: Joint manifestations are common in systemic lupus, affecting multiple joints or just one. These manifestations are present in 95% of patients. Pseudo-septic arthritis is a subset of systemic lupus that mimics septic arthritis caused by the deposition of lipid droplets in the joint. We present the case of a patient hospitalized for mono-arthritis, which revealed systemic lupus. Observation: The patient is a 19-year-old woman, single, without children, and with no previous medical history, who was hospitalized for fever and inflammatory polyarthralgia. The clinical examination revealed an inflammatory swelling of the right knee with patellar ballottement, yellow citrine synovial fluid, an inflammatory tumor on the left arm, which was round, mobile, and fluctuating with purulent content, edema of the lower limbs, and facial puffiness, along with a systemic inflammatory response syndrome. Paraclinical examination showed hyperleukocytosis with neutrophil predominance, microcytic anemia, thrombocytopenia, antistreptolysin O (ASLO) 3, suggesting inflammatory arthritis. Bacteriological tests did not isolate any pathogens. An arthrotomy with synovial biopsy was performed, and the histopathological examination supported non-specific synovitis. A joint ultrasound showed signs of arthritis with a septic appearance. During the third hospitalization for persistent fever, she presented with facial puffiness, anemia syndrome, systemic inflammatory response syndrome, and a malar rash across the bridge of the nose. Antinuclear antibodies returned positive with a titer of 1280 and a speckled fluorescence pattern, and anti-native DNA antibodies were positive at 60.1 (normal Conclusion: Pseudo-septic arthritis is a feature of lupus that can mimic septic arthritis. Monoarticular involvement is rare but possible. The absence of pathogens and the inflammatory nature of the synovial fluid should prompt consideration of a lupus-related etiology.
文摘Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the frequency and etiologies of urinary tract infections in diabetics hospitalized at the department of medicine of Abass Ndao Hospital. Patients and Methods: This work was a cross-sectional, descriptive, and analytical study conducted from January 01, 2018, to December 31, 2018. It focused on hospitalized diabetic patients with urinary tract infection. Epidemiological, clinical, and evolutionary data of UTI were evaluated. Results: One hundred and twenty-eight (128) diabetic patients had a cytobacteriological urine exam (CUE). 44 of who had a positive CUE (34.4%). The age group [60 - 69] years was the most represented (31.8%). Women predominated (61.4%) with a sex ratio (m/f) of 0.63. Abdominal pain was the most frequent reason for consultation, followed by polydipsia. Fever was recorded in 21 patients (47.7%). Type 2 diabetes was found in most patients (70.5%). Glycemia above 2g/l was found in 34 patients (89.5%). Anemia accounted for more than half of the patients with 29 cases (65.9%). Leukocytosis was noted in 28 patients (63.6%) and a positive CRP in 33 patients (75%). An increase in urea-creatinine was noted in 23 cases (52.3%). The results of the CUE revealed Escherichia coli as predominant (43.2%, n = 19), followed by Candida with 22.7% (n = 10). Antibiotic therapy was given to all patients. The mostly used antibiotic in the treatment of UTI was Cefotaxime 27.3% (n = 12). Older age and female gender were associated with the presence of E. coli. Four (4) deaths were recorded (9%). They were all male over the age of 65. Conclusion: UTI in diabetes is an important cause of morbidity and mortality. The development and implementation of a prevention and management program are essential.
文摘Introduction: Coronavirus disease is a pandemic discovered in December 2019. It is a polymorphic, systemic zoonosis caused by a virus with predominant respiratory tropism. This work aimed to evaluate the epidemiological, clinical, paraclinical, therapeutic, and evolutionary profile of patients with COVID-19 at Touba Ndamatou Public Hospital Hospital Establishment. Materials and Methods: This was a descriptive, retrospective, cross-sectional study of 114 cases hospitalized for COVID-19 at Touba Ndamatou Public Hospital Health Establishment, during the period from May 1, 2020, to September 30, 2021. Data were collected from patient medical records, entered using Epi Info Version 7 software, and analyzed using SSPS version 21.0 software. Results: The mean age of patients was 65 ± 14.5 years, with extremes of 25 and 92 years. The predominant age group was [46 - 65 years] with 39%. Males predominated with 65% (n = 74). The peak occurred in August 2021 with 57.8% of cases (n = 66). 68.15% of patients had at least one comorbidity, with hypertension and diabetes the most frequent comorbidities at 35.9% and 15.7% respectively. Dyspnea was the most frequent reason for consultation (70%), while the most common physical signs were pulmonary condensation syndrome (94%), respiratory distress (77%), and hypoxia (65%). Severe forms accounted for 32%. The most common CT images were ground-glass areas, predominantly in the basithoracic region. Azithromycin was used in all patients, oxygen therapy was used in 93%, and corticosteroids were used in 90%, although the average number of drugs taken per patient was eight (8). The average hospital stay was 4.54 days. The case fatality rate was 18.51% (n = 21). Advanced age (60 and over) and hypoxia were the main risk factors for mortality. Conclusion: The COVID-19 pandemic has been declared a global health emergency by the WHO. It has caused many deaths worldwide. Vaccination, the subject of much controversy in our context, would be the only means of preventing critical forms of the disease, especially among people at risk.
文摘Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in adults, the second leading cause of dementia (after Alzheimer’s disease), and the third leading cause of death (after cancer and cardiovascular disease). It’s also a major cause of depression. The objective of our study was to describe the epidemiological, clinical and evolutionary aspects of stroke in the internal medicine department of Tivaouane Hospital. Material and Method: This is a retrospective study carried out from January 1, 2015 to December 31, 2018 on the files of patients hospitalized for stroke in the medical department of the EPS1 in Tivaouane. We took into account all the patients who had a brain CT (computed tomography) scan. We collected data related to socio-demographic characteristics, history, risk factors, reasons for admission, clinical signs, paraclinical examinations, as well as evolution. Results: Out of 1999 patients, 206 files of patients with stroke were collected, i.e. a proportion of 10.3%. Our study population had a mean age of 65.53 years [16 - 97 years]. We noted a clear predominance of women (50.5%). The majority of the population came from the outskirts of Tivaouane (56.7%). Risk factors for stroke were dominated by hypertension (90.3%), dyslipidemia (19.4%), previous stroke (18.9%), and diabetes (16%). The clinical signs were dominated by a motor deficit (94.1%), speech disorders (67.4%) and consciousness disorders (47%). Ischemic strokes were predominant (65%) over hemorrhagic strokes (34.5%). The outcome was generally unfavorable with 14.6% total recovery, 58.7% recovery with sequelae and a case fatality of 26.7%. Conclusion: It emerges from this study that strokes still remain a real public health problem. Knowledge of populations of risk factors as well as their proper management is fundamental in primary prevention strategies, the only guarantee for a reduction in the still very high morbidity and mortality of this disease.
文摘The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a necrotic ulcer wound on the skin lasting 3 weeks amid a big neglected hetero-multinodular goitre, evolving since 20 years. The anatomopathological test showed a gallbladder thyroid carcinoma of the thyroid with severe inflammation. The treatment consisted of a complete thyroidectomy with recurrent bilateral dredging. There was a favourable evolution. Gallbladder carcinoma, in its aggressive aspect, may be linked to the occurrence of acute festered thyroiditis. Therefore, the prognosis of our patient was favourable.
