AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year ret...AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.展开更多
Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of se...Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.展开更多
Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA...Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA) assay, digital rectal examination (DRE) and prostate biopsy, its incidence has increased significantly. The aim of our study was to analyse aspects of bone scintigraphy (BS) as part of the metastatic extension assessment of prostate cancer in Senegal. Patients and Methods: This was a retrospective descriptive and analytical study, running from January 1<sup>er</sup> 2022 to August 31 2023. Patients with histologically confirmed prostate cancer were included. Whole-body scans (WBS) were performed using a dual-head SPECT gamma camera (Mediso Nucline TM Spirit DH-V type), 3 hours after intravenous injection of 8 MBq/kg (555 to 740 MBq) of <sup>99m</sup>Tc-HMDP. Results: A total of 288 patients with a mean age of 68.37 ± 7.79 years were included. The median total PSA level was 97.6 ng/ml, with 144 patients having a level greater than or equal to 20 ng/ml. All patients had adenocarcinoma, and the Gleason score was available in 202 (70.13%) patients, 75.75% of whom had a score greater than or equal to 7. BS was contributory in 70.48% of cases, with 30.90% positive and 39.58% negative. The result was inconclusive in 85 patients (29.51%). The mean PSA for patients with a positive scan was 190.2 ng/ml and 40.6 ng/ml for those with a negative scan. Multiple metastatic lesions predominated (87.35% of cases). Metastatic lesions occurred preferentially in the axial skeleton, with a proportion of 68% versus 32% in the appendicular skeleton. Classification of bone metastases according to the SOLOWAY score revealed grade I (62.07%), grade II (35.63%) and grade IV (2.30%). Conclusion: In Senegal, prostate cancer is generally diagnosed in men of advanced age. The presence of bone metastases is frequent in its evolution, transforming a curable localized disease into a generalized disease with a compromised prognosis. Bone scintigraphy remains an essential part of the initial work-up and evaluation of response to treatment.展开更多
Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, ...Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .展开更多
Background: The anterior cruciate ligament (ACL) is the main structure that prevents the forward movement of the tibia about the femur Meniscus tear which is a common finding in patients with anterior cruciate ligamen...Background: The anterior cruciate ligament (ACL) is the main structure that prevents the forward movement of the tibia about the femur Meniscus tear which is a common finding in patients with anterior cruciate ligament (ACL) injury. Aim: To investigate the prevalence of types of meniscus tears in patients with Anterior Cruciate Ligament (ACL) Injury. Methods: A retrospective study was conducted among inpatients. Clinical evaluation included side-to-side difference in anterior tibial translation (ATT) as measured by a KT-1000 arthrometer (MEDmetric Corp) and a grade of pivot-shift test at final follow-up in all patients. Subsequent meniscal tear was defined by symptoms of joint line pain and/or locking or joint effusion requiring surgical treatment. Results: Most of patients were males (92.6%). The patients were categorized into 5 groups according to age with a mean of age 32.8 ± 10.6. The most common causes of ACL injury were falling down (43.2%), trauma (38.1%) or knee torsion (18.8%). Medial meniscal tear was found in 92 knees (55.7%), while lateral meniscal tear was found in 19 knees (10.8%) and the most common type was the longitudinal tear that was found in 31 knees (17.6%). Similarly, 66.7% of the meniscal flap tears and half of the meniscal bucket-handle tears were significantly associated with loose body (P Conclusion: The present study demonstrated that meniscus tears are more common in individuals with chronic ACL rupture. The main factors contributing to ACL injury were classified as falls, trauma, and knee torsion. Gender was identified as a critical determinant in the etiology of ACL injury. The occurrence of a ramp lesion was associated longitudinal meniscal tears, whereas chodoral injury was associated with the majority of meniscal flap tears and meniscal bucket-handle tears.展开更多
Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invagina...Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invaginations. These include nasosinusal polyps, pleiomorphic adenoma and inverted papilloma. The aim of our study was to investigate the epidemiological, clinical, morphological, therapeutic, and evolutionary particularities of these three clinical entities, including two tumors with the potential for progressive malignancy (pleiomorphic adenoma and inverted papilloma) and one strictly benign tumor with a favorable evolution (nasosinus polyp or Schneider polyp). Materials and Methods: This was a retrospective, analytical, cross-sectional study conducted from January 1, 2006 to December 31, 2019 (13 years), in the Department of Otolaryngology and Cervicofacial Surgery at Adolphe SICE Hospital, Pointe-Noire, Congo-Brazzaville. Results: During the study period, 74 patients were registered for a nasosinus tumor, of which 23 were benign tumors of epithelial origin (31%) distributed as follows: 15 cases of nasosinus polyp, 5 cases of pleomorphic adenoma and 3 cases of inverted papilloma. The mean age was 42.5 for polyps, with an estimated median of 38, and 42.9 for the other two entities (pleomorphic adenoma and inverted papilloma), with an estimated median of 41. Nasosinus allergy accounted for 17% of cases, followed by chronic sinusitis (12%);however, in 49% of cases, the patient’s history was not specified. There was no sexual predominance, the sex ratio being 1.08. Occupation, socio-economic level, and education had no impact on the development of these tumors. Most of our patients (52%, 12 cases) had a consultation delay of more than one (1) year, whatever the histological nature of the tumor. The complete nasosinus syndrome (NSS) included nasal obstruction, rhinorrhea, epistaxis, and anosmia, and was found in 19 cases (83%), most often reflecting a nasosinus polyp. CT scans were performed in all patients, with hyperdense images predominating in 22 cases. Management of benign nasosinus tumors was mainly surgical. Postoperative management was straightforward in 15 cases (65%). Conclusion: Benign nasosinus tumors are dominated by nasosinus polyps. Management of these tumors is essentially surgical, with the best clinical outcome.展开更多
Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Me...Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Mechanical instability and neurologic deficits resulting from spinal cord compression are the most common manifestations. Surgical intervention remains the most effective treatment for about 20% of patients who present with spinal cord compression. The prognosis is relatively poor. This work has as objectives to describe: the diagnostic tools, the different modalities of management and the prognostic elements of spine metastasis. Methodology: We conducted an ambispective cross-sectional descriptive study;with retrospective data collection from January 2015 to December 2021 and prospective collection from January to April 2022 in the “Neurosurgery” unit of the Yaounde Central Hospital and the “Oncology and Neurosurgery” units of Yaounde General Hospital. Result: We included 101 patients. The M/F sex ratio was 1.66. The average age of the participants was 56.44 years (±14.19 SD) with a median of 58 years. Metastatic spinal tumors were discovered in 61.39% of patients with a previously known primary tumor and 21.78% of patients had newly discovered tumors. The neurologic examination revealed a vertebral syndrome in 79.21% of cases, radicular syndrome in 60.40% and sub-lesional syndrome in 59.89%. Sensory disorders accounted for 39.60% and sphincter disorders accounted for 34.65%. According to the degree of severity, the lesions were classified as Frankel E (37.62%) followed by Frankel D (21.78%). Metastatic lesions were mostly found at the thoracic vertebrae (68.25%) and lumbar vertebrae (22.22%). The most represented primary tumors were: prostate tumors (41.58%) and breast tumors (23.76%);followed by malignant hemopathies (15.84%). Computed-tomography scan (CT-scan) was the most frequent diagnostic imaging technique used (71.28%). Analgesic treatment mostly involved level II analgesia (64.36%). High dose steroid therapy (greater than 80mg/24h) was used in more than half of the patients. Radiation therapy was performed in 24.75% of the patients, chemotherapy in 55.44% and specific surgical interventions performed in 20.79%. The most frequent surgical indication was complete motor deficit according to the Frankel classification (47.21%). One patient in four (23.76%) experienced improvement in functional prognosis with increased muscle strength after a period of 2 weeks to 5 months of treatment. About 1 in 10 patients (8.8%) rather had worsening of their neurologic status. We observed that there was a correlation between spine surgery and improvement in muscle strength (P-value less than 0.05). Patients (12) who had better recovery or preserved gait were those with partial compression (P-value = 0.0143). Four out of five patients (81.18%) of our series had an estimated survival of less than one year according to the Tokuhashi score. Conclusion: MSTs are frequent in our context. Most patients sought consultation late after the first symptoms appeared (principally back pain). The clinical examination revealed a high proportion of patients with spinal cord compression syndrome. Medical treatment was first-line for the management of pain and most patients who underwent surgical treatment had complete neurologic deficits. The functional prognosis was found to be improved by surgery and the vital prognosis depended on the Tokuhashi score, with better accuracy when the prediction is more than 12 months.展开更多
Introduction: The practice of cardiac surgery (CS) in sub-Saharan Africa faces a number of challenges. We report on the surgical activities of the first 17 months of the program launched at the Yaoundé General Ho...Introduction: The practice of cardiac surgery (CS) in sub-Saharan Africa faces a number of challenges. We report on the surgical activities of the first 17 months of the program launched at the Yaoundé General Hospital (YGH), describing the types of interventions and the early results. Patients and Methods: This was a descriptive cross-sectional study including patients who underwent CS from September 2022 to January 2024 at the YGH. Clinical, operative and postoperative data were collected and analysed retrospectively by R software. Results: A total of 37 patients underwent CS during the study period, divided into 23 (62.2%) open-heart and 14 (37.8%) closed-heart cases. Males predominated (sex ratio 1.17). The median age and interquartile range (IQR) were 36 years (9 - 51). Isolated valve surgery, in 15 (40.5%) cases, was the most common procedure in open-heart surgery cases. Closed-heart surgery involved closure of the patent ductus arteriosus in 9 (24.3%) cases, coronary artery bypass grafting in 3 (8.1%) cases, and pericardectomy in 2 (5.4%) cases. The median duration of extracorporeal circulation and aortic cross-clamping was 101 min (IQR 84 - 143) and 74 min (IQR 54 - 112) respectively. The median duration of mechanical ventilation was 2 hours (IQR 2 - 3). The median intensive care unit stay and median hospital stay were 2 days (IQR 2 - 3) and 7 days (IQR 5 - 8) respectively. Operative mortality was 2 (5.4%). Conclusion: Cardiac surgery remains a major challenge for African populations. The early results achieved by the local team are satisfactory. An increase in surgical activity should be strongly encouraged to facilitate local training and ensure the sustainability of the activity.展开更多
Introduction: Breast cancer is the most common cancer in women worldwide, accounting for an estimated 22% of all female cancers. It is the leading cause of cancer mortality in women, almost all of which is due to meta...Introduction: Breast cancer is the most common cancer in women worldwide, accounting for an estimated 22% of all female cancers. It is the leading cause of cancer mortality in women, almost all of which is due to metastases, with 73% of metastases occurring in the bone. In oncology, metastable technetium 99-labelled methylene bisphosphonate bone scintigraphy (BS) remains the standard examination for detecting and assessing the extent of bone metastases. The aim of this study was to assess the role of BS in the evaluation and follow-up of breast cancer in Senegal. Methodology: This was a retrospective study of breast cancer patients who underwent bone scintigraphy with <sup>99m</sup>Tc-HMDP in the nuclear medicine department of Idrissa Pouye General Hospital (IPGHO), from July 2009 to June 2022. Results: We enrolled 165 patients, mean age 46.79 years (27 - 87 years). BS was performed in 94.37% of cases for post-therapeutic monitoring and in 5.63% for pre-therapeutic assessment. Results were contributory in 131 patients (92.25%), of whom 72 cases (50.70%) were normal and 59 cases (41.55%) positive or presenting bone metastases;and non-contributory or doubtful in 11 cases (7.75%). Secondary bone locations were multiple in 57 cases (96.61%) and single or solitary in 2 cases (3.39%). The scintigraphic appearance of bone metastases was hyper-fixative in 58 cases (98.31%) and mixed in 1 case (1.69%). Bone lesions were quantified using the Soloway’s grading classification. Conclusion: BS with <sup>99m</sup>Tc-labelled bisphosphonates remains the examination of choice for skeletal exploration, in the detection and extension of bone metastases in breast cancer. Performance has been enhanced by the development of SPECT coupled with CT (SPECT-CT).展开更多
Introduction: The acronym SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) is a syndrome combining osteoarticular and cutaneous manifestations. It occurs mainly between the ages of 30 and 50. Sternocosto...Introduction: The acronym SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) is a syndrome combining osteoarticular and cutaneous manifestations. It occurs mainly between the ages of 30 and 50. Sternocostoclavicular hyperostosis is one of the main distinguishing features. We report a case of SAPHO in Dakar diagnosed by bone scintigraphy. Observation: 28-year-old Senegalese women presented with left shoulder pain and relative functional impotence for over 2 years. Examination revealed right sternoclavicular hyperostosis and left shoulder pain on palpation. Questioning revealed a history of acne and hyperostosis of the right first toe. Bone scintigraphy, performed after injection of 630 MBq of <sup>99m</sup>Tc-HMDP, revealed: hyperfixation of the bilateral (right++) manubrio-sternal and sternoclavicular junction, producing the classic bull’s horn image;hyperfixation of the left shoulder with an inflammatory appearance;hyperfixation of the sacroiliac joints suggestive of bilateral sacroiliitis;hyperfixation of the right first toe;two mandibular hyper fixations probably related to dental damage. This scintigraphic appearance in one was strongly suggestive of SAPHO syndrome. Conclusion: SAPHO syndrome, related to spondyloarthropathy, associates cutaneous and osteoarticular signs. It is characterized by frequent delays in diagnosis due to poor recognition. Soy is an invaluable diagnostic tool, enabling us to assess the extent of the disease and its evolution.展开更多
Background: The absence of local data on the survival of hemodialysis patients complicates the optimization of their care in Cameroon, a country characterized by a high prevalence of chronic kidney disease (CKD). This...Background: The absence of local data on the survival of hemodialysis patients complicates the optimization of their care in Cameroon, a country characterized by a high prevalence of chronic kidney disease (CKD). This study, conducted at the hemodialysis unit of the General Hospital of Douala (GHGD), aimed to address this gap by assessing the 36-week survival of hemodialysis patients with CKD, thus providing essential data to enhance clinical practices and inform public health decisions. Methods: We conducted a prospective study at GHGD over a period of 9 months, monitoring 262 hemodialysis patients. Sociodemographic data, comorbidities, the presence of infections, adherence to regular hemodialysis sessions, and the week of death were collected using a structured survey form. The Kaplan-Meier estimator and Cox regression model were used to analyze patient survival. Results: The mean age of the patients was 49 ± 14 years. Adherence to hemodialysis sessions (HR = 0.19, p Burkholderia cepacia (p = 0.006), and for those who were divorced (p = 0.001). Conclusion: Strengthening infection prevention and providing psychosocial support for patients with CKD are crucial measures to improve patient care and develop public health strategies tailored to local needs.展开更多
Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at...Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at the Edith Lucie BONGO ONDIMBA general hospital (HGELBO). Patients, material and method: This was an analytical cross-sectional study conducted from January 1 to August 31, 2019 at the HGELBO. It concerned all patients admitted to the HGELBO with positive bacteriological samples. After a study of the sensitivity to isolated species, the patients were divided into two (02) groups: those MRB positive (+) and not MRB or negative (-). Epi Info software version 3.5.1 was used for the calculation of the rates and the comparison of the variables. The adjusted odds ratio (ORa) with a 95% confidence interval was used to measure the specific effect of each risk factor such as chronic kidney disease and diabetes, in order to rule out confounding factors. Multivariate analysis by binomial logistic regression was used. Results: There were 375 bacteriological samples from 258 patients, among them 247 patients with 235 positive samples or 63%. The eleven (11) are healthy patients. The median age was 33 with extremes ranging from 16 to 90. The female sex was predominant with a sex ratio of 0.6. The majority of MRB+ cases were found in internal medicine and nephrology with 12 cases (38.7%) and hemodialysis with 4 cases (12.9%). Urinary samples were in the majority with 74.5%. <i>Escherichia coli</i> was predominant in 30.3%. After studying the sensitivity to antibiotics of the 247 species included, 113 were MRB+ and 134 BMR- <i>i.e.</i> a frequency of 45.7%. Methicilin-resistant <i>Staphylococcus aureus</i> (MRSA) was predominant (51.3%). Multivariate logistic regression analysis showed that the main risk factor was antibiotic use (0Ra: 3.2 [1.9 - 5.4];p-value < 0.01). Chronic renal failure and diabetes were not risk factors for carriage. The other risk factors identified were: hospitalization of more than 7 days (prolonged), <i>S. aureus</i> infection and male sex. Conclusion: Probabilistic antibiotic therapy leads to the selection of BMRs. Long hospital stays, male sex, and MRSA are risk factors or determinants of antibiotic resistance, but not chronic kidney disease.展开更多
Background: Preterm birth defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation. The causes of preterm birth are complex and multifactorial, many risk factors that contribute in it. ...Background: Preterm birth defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation. The causes of preterm birth are complex and multifactorial, many risk factors that contribute in it. Knowledge of risk factors is crucial for predicting the incidence of preterm births. This study aimed to determine the factors associated with preterm birth at the Hasan Sadikin General Hospital. Method: This study was a cross-sectional analytic using secondary data. Data derived from medical records maternity patients in the Department of Obstetrics and Gynecology Hasan Sadikin General Hospital taken in 2015. 1944 patients’ medical records who gave birth met the inclusion criteria. Data analyses used were bivariate (chi square) and multivariate (logistic regression). Result: The result showed that the variables including age (p = 0.043, OR = 1.586), antenatal care (p p p p p p Conclusion: There is a significant relationship between age, antenatal care, preterm birth history birth, anemia, hypertension, and antepartum hemorrhage with preterm birth as risk factors.展开更多
AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily ad...AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.展开更多
Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylax...Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the Chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.展开更多
BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attend...BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital(JGH) in the southwest corner of Saudi Arabia.METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies.RESULTS: The mean age of the patients was 25.3±16.8 years. Most(45.1%) of the patients were at age of 18–30 years. Males(64.3%) were affected by trauma more common than females. More than half(60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury(60%), followed by blunt trauma(30.9%) and then penetrating trauma(9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority(48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority.展开更多
INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is ...INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is critically important to overcome these obstacles,especially when it comes to fostering the types of breakthrough biomedical science that benefit from diverse perspectives,methodologies and data sets.Moreover,the research underlying these breakthroughs unfolds over the course of years,and even decades.For these reasons,and more,the Department of Psychiatry at Massachusetts General Hospital(Mass General)and the Shanghai Mental Health Center(SMHC)are taking the long view:exploring and implementing numerous collaborative research and training projects that are leading to better care and treatments for patients,both in the USA and China,who suffer from a range of psychiatric disorders.展开更多
This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast can...This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast cancer between 1995 and 2007 was carried out at the Yaoundé General Hospital. Survival analysis was carried out with survival defined as the time between the date of unequivocal diagnosis of cancer and the date of last follow-up or death. Survival curves were plotted in R.3.1.1 software. Mean age of the patients was 47.5 ± 12.36 years. Most of the patients (67.9%) presented with advanced breast cancer disease (stage III and IV). Overall patient survival rate was 30% at 5 years and 13.2% at 10 years. Median overall survival time was 2 (1.9 - 3) years. There was a correlation between survival and the stage of disease. The highest survival rates were recorded in stages I and II while the lowest rates were recorded in stage IV. There was no statistically significant difference in survival among the age groups (p = 0.15). Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.展开更多
Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the...Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the ward,the nursing log and the hospitalization medical record of correlative patients were consulted.SARS-CoV in serum specimen from SARS patient was detected by PCR.Results The room where SARS outbreak occurred was on the 13th floor of the 16-story main ward building.There were 6 beds in the room,living with 6 female patients(aged 45-67)who were all hospitalized due to type2 diabetes.On March 24,2003,Patient 1 began to have a fever and cough,chest X-ray showed pneumonia.Five and six days later,Patient 2 and Patient 3 began to have a fever,respectively.Finally,all of these 3 patients died.Their beds were all at the same side of the room,and the other 3 patients at the opposite side were not infected.Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR.The daughter-in-law of Patient 1who accompanied Patient 1 by the bedside several days,mainly near the window,upwind of Patient 1,was not infected.Medical staff,family members and visitors of the 6 patients were not infected.Conclusions This outbreak was not transmitted by aerosol.The distance droplets travels could be up to 3.43 meters.Droplet spread has direction,and the droplets direction of propagation is closely related with the wind direction and speed.Those at the downwind position of SARS patients were susceptible to be infected.Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.展开更多
Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study i...Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study in Kampala revealed Tuberculosis prevalence among immuno-incompetent group at 10%. To assess the prevalence of Pulmonary Tuberculosis (PTB) infection in HIV/AIDS patients attending ART clinic in Bududa general hospital, Bududa district, a hospital-based, cross-sectional study was carried out. Methods and materials: Two hundred thirty eight (238) HIV/AIDS positive patients attending ART clinic were recruited using consecutive simple non-probability sampling on consenting. Data collection guide was used to capture the socio-demographic information from study participants and two sputum samples (spot and early morning samples) were obtained from each participant, and processed using Hot Ziehl Neelsen for Tubercle Bacilli. Data collected was entered into MS Excel spreadsheets and Statistical Package of Social Sciences was used for descriptive data analysis and outputs in form of percentages, figures and tables presented. Results: Out of 238 study participants recruited, 14/238 were positive for Acid Fast Bacilli (AFB);giving a prevalence of pulmonary tuberculosis at 5.9% (14/238) and the most affected age group was between 26 - 35 years with the prevalence of 3.4%. More females (65.6%) participated in the study than males (34.4%). Conclusion: Tuberculosis remains a health challenge in HIV/AIDS positive people in Bududa district and there is need for early screening of all HIV patients for TB as part of their routine and intensification to follow up TB positive patients. We recommend large-scale studies on the trends in TB/HIV co-infection and associated factors should be carried out in this area. In addition, we recommend intensification of public awareness campaign about TB infection in relation to its transmission, prevention and control.展开更多
文摘AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.
文摘Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.
文摘Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA) assay, digital rectal examination (DRE) and prostate biopsy, its incidence has increased significantly. The aim of our study was to analyse aspects of bone scintigraphy (BS) as part of the metastatic extension assessment of prostate cancer in Senegal. Patients and Methods: This was a retrospective descriptive and analytical study, running from January 1<sup>er</sup> 2022 to August 31 2023. Patients with histologically confirmed prostate cancer were included. Whole-body scans (WBS) were performed using a dual-head SPECT gamma camera (Mediso Nucline TM Spirit DH-V type), 3 hours after intravenous injection of 8 MBq/kg (555 to 740 MBq) of <sup>99m</sup>Tc-HMDP. Results: A total of 288 patients with a mean age of 68.37 ± 7.79 years were included. The median total PSA level was 97.6 ng/ml, with 144 patients having a level greater than or equal to 20 ng/ml. All patients had adenocarcinoma, and the Gleason score was available in 202 (70.13%) patients, 75.75% of whom had a score greater than or equal to 7. BS was contributory in 70.48% of cases, with 30.90% positive and 39.58% negative. The result was inconclusive in 85 patients (29.51%). The mean PSA for patients with a positive scan was 190.2 ng/ml and 40.6 ng/ml for those with a negative scan. Multiple metastatic lesions predominated (87.35% of cases). Metastatic lesions occurred preferentially in the axial skeleton, with a proportion of 68% versus 32% in the appendicular skeleton. Classification of bone metastases according to the SOLOWAY score revealed grade I (62.07%), grade II (35.63%) and grade IV (2.30%). Conclusion: In Senegal, prostate cancer is generally diagnosed in men of advanced age. The presence of bone metastases is frequent in its evolution, transforming a curable localized disease into a generalized disease with a compromised prognosis. Bone scintigraphy remains an essential part of the initial work-up and evaluation of response to treatment.
文摘Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .
文摘Background: The anterior cruciate ligament (ACL) is the main structure that prevents the forward movement of the tibia about the femur Meniscus tear which is a common finding in patients with anterior cruciate ligament (ACL) injury. Aim: To investigate the prevalence of types of meniscus tears in patients with Anterior Cruciate Ligament (ACL) Injury. Methods: A retrospective study was conducted among inpatients. Clinical evaluation included side-to-side difference in anterior tibial translation (ATT) as measured by a KT-1000 arthrometer (MEDmetric Corp) and a grade of pivot-shift test at final follow-up in all patients. Subsequent meniscal tear was defined by symptoms of joint line pain and/or locking or joint effusion requiring surgical treatment. Results: Most of patients were males (92.6%). The patients were categorized into 5 groups according to age with a mean of age 32.8 ± 10.6. The most common causes of ACL injury were falling down (43.2%), trauma (38.1%) or knee torsion (18.8%). Medial meniscal tear was found in 92 knees (55.7%), while lateral meniscal tear was found in 19 knees (10.8%) and the most common type was the longitudinal tear that was found in 31 knees (17.6%). Similarly, 66.7% of the meniscal flap tears and half of the meniscal bucket-handle tears were significantly associated with loose body (P Conclusion: The present study demonstrated that meniscus tears are more common in individuals with chronic ACL rupture. The main factors contributing to ACL injury were classified as falls, trauma, and knee torsion. Gender was identified as a critical determinant in the etiology of ACL injury. The occurrence of a ramp lesion was associated longitudinal meniscal tears, whereas chodoral injury was associated with the majority of meniscal flap tears and meniscal bucket-handle tears.
文摘Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invaginations. These include nasosinusal polyps, pleiomorphic adenoma and inverted papilloma. The aim of our study was to investigate the epidemiological, clinical, morphological, therapeutic, and evolutionary particularities of these three clinical entities, including two tumors with the potential for progressive malignancy (pleiomorphic adenoma and inverted papilloma) and one strictly benign tumor with a favorable evolution (nasosinus polyp or Schneider polyp). Materials and Methods: This was a retrospective, analytical, cross-sectional study conducted from January 1, 2006 to December 31, 2019 (13 years), in the Department of Otolaryngology and Cervicofacial Surgery at Adolphe SICE Hospital, Pointe-Noire, Congo-Brazzaville. Results: During the study period, 74 patients were registered for a nasosinus tumor, of which 23 were benign tumors of epithelial origin (31%) distributed as follows: 15 cases of nasosinus polyp, 5 cases of pleomorphic adenoma and 3 cases of inverted papilloma. The mean age was 42.5 for polyps, with an estimated median of 38, and 42.9 for the other two entities (pleomorphic adenoma and inverted papilloma), with an estimated median of 41. Nasosinus allergy accounted for 17% of cases, followed by chronic sinusitis (12%);however, in 49% of cases, the patient’s history was not specified. There was no sexual predominance, the sex ratio being 1.08. Occupation, socio-economic level, and education had no impact on the development of these tumors. Most of our patients (52%, 12 cases) had a consultation delay of more than one (1) year, whatever the histological nature of the tumor. The complete nasosinus syndrome (NSS) included nasal obstruction, rhinorrhea, epistaxis, and anosmia, and was found in 19 cases (83%), most often reflecting a nasosinus polyp. CT scans were performed in all patients, with hyperdense images predominating in 22 cases. Management of benign nasosinus tumors was mainly surgical. Postoperative management was straightforward in 15 cases (65%). Conclusion: Benign nasosinus tumors are dominated by nasosinus polyps. Management of these tumors is essentially surgical, with the best clinical outcome.
文摘Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Mechanical instability and neurologic deficits resulting from spinal cord compression are the most common manifestations. Surgical intervention remains the most effective treatment for about 20% of patients who present with spinal cord compression. The prognosis is relatively poor. This work has as objectives to describe: the diagnostic tools, the different modalities of management and the prognostic elements of spine metastasis. Methodology: We conducted an ambispective cross-sectional descriptive study;with retrospective data collection from January 2015 to December 2021 and prospective collection from January to April 2022 in the “Neurosurgery” unit of the Yaounde Central Hospital and the “Oncology and Neurosurgery” units of Yaounde General Hospital. Result: We included 101 patients. The M/F sex ratio was 1.66. The average age of the participants was 56.44 years (±14.19 SD) with a median of 58 years. Metastatic spinal tumors were discovered in 61.39% of patients with a previously known primary tumor and 21.78% of patients had newly discovered tumors. The neurologic examination revealed a vertebral syndrome in 79.21% of cases, radicular syndrome in 60.40% and sub-lesional syndrome in 59.89%. Sensory disorders accounted for 39.60% and sphincter disorders accounted for 34.65%. According to the degree of severity, the lesions were classified as Frankel E (37.62%) followed by Frankel D (21.78%). Metastatic lesions were mostly found at the thoracic vertebrae (68.25%) and lumbar vertebrae (22.22%). The most represented primary tumors were: prostate tumors (41.58%) and breast tumors (23.76%);followed by malignant hemopathies (15.84%). Computed-tomography scan (CT-scan) was the most frequent diagnostic imaging technique used (71.28%). Analgesic treatment mostly involved level II analgesia (64.36%). High dose steroid therapy (greater than 80mg/24h) was used in more than half of the patients. Radiation therapy was performed in 24.75% of the patients, chemotherapy in 55.44% and specific surgical interventions performed in 20.79%. The most frequent surgical indication was complete motor deficit according to the Frankel classification (47.21%). One patient in four (23.76%) experienced improvement in functional prognosis with increased muscle strength after a period of 2 weeks to 5 months of treatment. About 1 in 10 patients (8.8%) rather had worsening of their neurologic status. We observed that there was a correlation between spine surgery and improvement in muscle strength (P-value less than 0.05). Patients (12) who had better recovery or preserved gait were those with partial compression (P-value = 0.0143). Four out of five patients (81.18%) of our series had an estimated survival of less than one year according to the Tokuhashi score. Conclusion: MSTs are frequent in our context. Most patients sought consultation late after the first symptoms appeared (principally back pain). The clinical examination revealed a high proportion of patients with spinal cord compression syndrome. Medical treatment was first-line for the management of pain and most patients who underwent surgical treatment had complete neurologic deficits. The functional prognosis was found to be improved by surgery and the vital prognosis depended on the Tokuhashi score, with better accuracy when the prediction is more than 12 months.
文摘Introduction: The practice of cardiac surgery (CS) in sub-Saharan Africa faces a number of challenges. We report on the surgical activities of the first 17 months of the program launched at the Yaoundé General Hospital (YGH), describing the types of interventions and the early results. Patients and Methods: This was a descriptive cross-sectional study including patients who underwent CS from September 2022 to January 2024 at the YGH. Clinical, operative and postoperative data were collected and analysed retrospectively by R software. Results: A total of 37 patients underwent CS during the study period, divided into 23 (62.2%) open-heart and 14 (37.8%) closed-heart cases. Males predominated (sex ratio 1.17). The median age and interquartile range (IQR) were 36 years (9 - 51). Isolated valve surgery, in 15 (40.5%) cases, was the most common procedure in open-heart surgery cases. Closed-heart surgery involved closure of the patent ductus arteriosus in 9 (24.3%) cases, coronary artery bypass grafting in 3 (8.1%) cases, and pericardectomy in 2 (5.4%) cases. The median duration of extracorporeal circulation and aortic cross-clamping was 101 min (IQR 84 - 143) and 74 min (IQR 54 - 112) respectively. The median duration of mechanical ventilation was 2 hours (IQR 2 - 3). The median intensive care unit stay and median hospital stay were 2 days (IQR 2 - 3) and 7 days (IQR 5 - 8) respectively. Operative mortality was 2 (5.4%). Conclusion: Cardiac surgery remains a major challenge for African populations. The early results achieved by the local team are satisfactory. An increase in surgical activity should be strongly encouraged to facilitate local training and ensure the sustainability of the activity.
文摘Introduction: Breast cancer is the most common cancer in women worldwide, accounting for an estimated 22% of all female cancers. It is the leading cause of cancer mortality in women, almost all of which is due to metastases, with 73% of metastases occurring in the bone. In oncology, metastable technetium 99-labelled methylene bisphosphonate bone scintigraphy (BS) remains the standard examination for detecting and assessing the extent of bone metastases. The aim of this study was to assess the role of BS in the evaluation and follow-up of breast cancer in Senegal. Methodology: This was a retrospective study of breast cancer patients who underwent bone scintigraphy with <sup>99m</sup>Tc-HMDP in the nuclear medicine department of Idrissa Pouye General Hospital (IPGHO), from July 2009 to June 2022. Results: We enrolled 165 patients, mean age 46.79 years (27 - 87 years). BS was performed in 94.37% of cases for post-therapeutic monitoring and in 5.63% for pre-therapeutic assessment. Results were contributory in 131 patients (92.25%), of whom 72 cases (50.70%) were normal and 59 cases (41.55%) positive or presenting bone metastases;and non-contributory or doubtful in 11 cases (7.75%). Secondary bone locations were multiple in 57 cases (96.61%) and single or solitary in 2 cases (3.39%). The scintigraphic appearance of bone metastases was hyper-fixative in 58 cases (98.31%) and mixed in 1 case (1.69%). Bone lesions were quantified using the Soloway’s grading classification. Conclusion: BS with <sup>99m</sup>Tc-labelled bisphosphonates remains the examination of choice for skeletal exploration, in the detection and extension of bone metastases in breast cancer. Performance has been enhanced by the development of SPECT coupled with CT (SPECT-CT).
文摘Introduction: The acronym SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) is a syndrome combining osteoarticular and cutaneous manifestations. It occurs mainly between the ages of 30 and 50. Sternocostoclavicular hyperostosis is one of the main distinguishing features. We report a case of SAPHO in Dakar diagnosed by bone scintigraphy. Observation: 28-year-old Senegalese women presented with left shoulder pain and relative functional impotence for over 2 years. Examination revealed right sternoclavicular hyperostosis and left shoulder pain on palpation. Questioning revealed a history of acne and hyperostosis of the right first toe. Bone scintigraphy, performed after injection of 630 MBq of <sup>99m</sup>Tc-HMDP, revealed: hyperfixation of the bilateral (right++) manubrio-sternal and sternoclavicular junction, producing the classic bull’s horn image;hyperfixation of the left shoulder with an inflammatory appearance;hyperfixation of the sacroiliac joints suggestive of bilateral sacroiliitis;hyperfixation of the right first toe;two mandibular hyper fixations probably related to dental damage. This scintigraphic appearance in one was strongly suggestive of SAPHO syndrome. Conclusion: SAPHO syndrome, related to spondyloarthropathy, associates cutaneous and osteoarticular signs. It is characterized by frequent delays in diagnosis due to poor recognition. Soy is an invaluable diagnostic tool, enabling us to assess the extent of the disease and its evolution.
文摘Background: The absence of local data on the survival of hemodialysis patients complicates the optimization of their care in Cameroon, a country characterized by a high prevalence of chronic kidney disease (CKD). This study, conducted at the hemodialysis unit of the General Hospital of Douala (GHGD), aimed to address this gap by assessing the 36-week survival of hemodialysis patients with CKD, thus providing essential data to enhance clinical practices and inform public health decisions. Methods: We conducted a prospective study at GHGD over a period of 9 months, monitoring 262 hemodialysis patients. Sociodemographic data, comorbidities, the presence of infections, adherence to regular hemodialysis sessions, and the week of death were collected using a structured survey form. The Kaplan-Meier estimator and Cox regression model were used to analyze patient survival. Results: The mean age of the patients was 49 ± 14 years. Adherence to hemodialysis sessions (HR = 0.19, p Burkholderia cepacia (p = 0.006), and for those who were divorced (p = 0.001). Conclusion: Strengthening infection prevention and providing psychosocial support for patients with CKD are crucial measures to improve patient care and develop public health strategies tailored to local needs.
文摘Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at the Edith Lucie BONGO ONDIMBA general hospital (HGELBO). Patients, material and method: This was an analytical cross-sectional study conducted from January 1 to August 31, 2019 at the HGELBO. It concerned all patients admitted to the HGELBO with positive bacteriological samples. After a study of the sensitivity to isolated species, the patients were divided into two (02) groups: those MRB positive (+) and not MRB or negative (-). Epi Info software version 3.5.1 was used for the calculation of the rates and the comparison of the variables. The adjusted odds ratio (ORa) with a 95% confidence interval was used to measure the specific effect of each risk factor such as chronic kidney disease and diabetes, in order to rule out confounding factors. Multivariate analysis by binomial logistic regression was used. Results: There were 375 bacteriological samples from 258 patients, among them 247 patients with 235 positive samples or 63%. The eleven (11) are healthy patients. The median age was 33 with extremes ranging from 16 to 90. The female sex was predominant with a sex ratio of 0.6. The majority of MRB+ cases were found in internal medicine and nephrology with 12 cases (38.7%) and hemodialysis with 4 cases (12.9%). Urinary samples were in the majority with 74.5%. <i>Escherichia coli</i> was predominant in 30.3%. After studying the sensitivity to antibiotics of the 247 species included, 113 were MRB+ and 134 BMR- <i>i.e.</i> a frequency of 45.7%. Methicilin-resistant <i>Staphylococcus aureus</i> (MRSA) was predominant (51.3%). Multivariate logistic regression analysis showed that the main risk factor was antibiotic use (0Ra: 3.2 [1.9 - 5.4];p-value < 0.01). Chronic renal failure and diabetes were not risk factors for carriage. The other risk factors identified were: hospitalization of more than 7 days (prolonged), <i>S. aureus</i> infection and male sex. Conclusion: Probabilistic antibiotic therapy leads to the selection of BMRs. Long hospital stays, male sex, and MRSA are risk factors or determinants of antibiotic resistance, but not chronic kidney disease.
文摘Background: Preterm birth defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation. The causes of preterm birth are complex and multifactorial, many risk factors that contribute in it. Knowledge of risk factors is crucial for predicting the incidence of preterm births. This study aimed to determine the factors associated with preterm birth at the Hasan Sadikin General Hospital. Method: This study was a cross-sectional analytic using secondary data. Data derived from medical records maternity patients in the Department of Obstetrics and Gynecology Hasan Sadikin General Hospital taken in 2015. 1944 patients’ medical records who gave birth met the inclusion criteria. Data analyses used were bivariate (chi square) and multivariate (logistic regression). Result: The result showed that the variables including age (p = 0.043, OR = 1.586), antenatal care (p p p p p p Conclusion: There is a significant relationship between age, antenatal care, preterm birth history birth, anemia, hypertension, and antepartum hemorrhage with preterm birth as risk factors.
文摘AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.
文摘Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the Chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.
文摘BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital(JGH) in the southwest corner of Saudi Arabia.METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies.RESULTS: The mean age of the patients was 25.3±16.8 years. Most(45.1%) of the patients were at age of 18–30 years. Males(64.3%) were affected by trauma more common than females. More than half(60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury(60%), followed by blunt trauma(30.9%) and then penetrating trauma(9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority(48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority.
文摘INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is critically important to overcome these obstacles,especially when it comes to fostering the types of breakthrough biomedical science that benefit from diverse perspectives,methodologies and data sets.Moreover,the research underlying these breakthroughs unfolds over the course of years,and even decades.For these reasons,and more,the Department of Psychiatry at Massachusetts General Hospital(Mass General)and the Shanghai Mental Health Center(SMHC)are taking the long view:exploring and implementing numerous collaborative research and training projects that are leading to better care and treatments for patients,both in the USA and China,who suffer from a range of psychiatric disorders.
文摘This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast cancer between 1995 and 2007 was carried out at the Yaoundé General Hospital. Survival analysis was carried out with survival defined as the time between the date of unequivocal diagnosis of cancer and the date of last follow-up or death. Survival curves were plotted in R.3.1.1 software. Mean age of the patients was 47.5 ± 12.36 years. Most of the patients (67.9%) presented with advanced breast cancer disease (stage III and IV). Overall patient survival rate was 30% at 5 years and 13.2% at 10 years. Median overall survival time was 2 (1.9 - 3) years. There was a correlation between survival and the stage of disease. The highest survival rates were recorded in stages I and II while the lowest rates were recorded in stage IV. There was no statistically significant difference in survival among the age groups (p = 0.15). Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.
文摘Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the ward,the nursing log and the hospitalization medical record of correlative patients were consulted.SARS-CoV in serum specimen from SARS patient was detected by PCR.Results The room where SARS outbreak occurred was on the 13th floor of the 16-story main ward building.There were 6 beds in the room,living with 6 female patients(aged 45-67)who were all hospitalized due to type2 diabetes.On March 24,2003,Patient 1 began to have a fever and cough,chest X-ray showed pneumonia.Five and six days later,Patient 2 and Patient 3 began to have a fever,respectively.Finally,all of these 3 patients died.Their beds were all at the same side of the room,and the other 3 patients at the opposite side were not infected.Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR.The daughter-in-law of Patient 1who accompanied Patient 1 by the bedside several days,mainly near the window,upwind of Patient 1,was not infected.Medical staff,family members and visitors of the 6 patients were not infected.Conclusions This outbreak was not transmitted by aerosol.The distance droplets travels could be up to 3.43 meters.Droplet spread has direction,and the droplets direction of propagation is closely related with the wind direction and speed.Those at the downwind position of SARS patients were susceptible to be infected.Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.
文摘Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study in Kampala revealed Tuberculosis prevalence among immuno-incompetent group at 10%. To assess the prevalence of Pulmonary Tuberculosis (PTB) infection in HIV/AIDS patients attending ART clinic in Bududa general hospital, Bududa district, a hospital-based, cross-sectional study was carried out. Methods and materials: Two hundred thirty eight (238) HIV/AIDS positive patients attending ART clinic were recruited using consecutive simple non-probability sampling on consenting. Data collection guide was used to capture the socio-demographic information from study participants and two sputum samples (spot and early morning samples) were obtained from each participant, and processed using Hot Ziehl Neelsen for Tubercle Bacilli. Data collected was entered into MS Excel spreadsheets and Statistical Package of Social Sciences was used for descriptive data analysis and outputs in form of percentages, figures and tables presented. Results: Out of 238 study participants recruited, 14/238 were positive for Acid Fast Bacilli (AFB);giving a prevalence of pulmonary tuberculosis at 5.9% (14/238) and the most affected age group was between 26 - 35 years with the prevalence of 3.4%. More females (65.6%) participated in the study than males (34.4%). Conclusion: Tuberculosis remains a health challenge in HIV/AIDS positive people in Bududa district and there is need for early screening of all HIV patients for TB as part of their routine and intensification to follow up TB positive patients. We recommend large-scale studies on the trends in TB/HIV co-infection and associated factors should be carried out in this area. In addition, we recommend intensification of public awareness campaign about TB infection in relation to its transmission, prevention and control.
