Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patients in treatment at the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a cross-sectional, descriptive, and analytical study from July 12 to October 10, 2021, at the Oueme-Plateau Provincial Teaching Hospital in Porto-Novo. ALL was screened by performing systolic pressure index (SPI) in all diabetic patients aged at least 18 years, seen in consultation or hospitalization during the study period and who had given their consent. Results: The study registered 165 diabetics and 98.2% of them were type 2. Subjects aged between 55 and 65 years were the most represented (33.9%), with an average age of 59.4 years. Women were in the majority (61.2%), with a sex ratio of 0.6. High blood pressure was associated with diabetes in 61.2% of patients. The prevalence of ALL was 48.5% (80 patients). Obliterative arteriopathy of the lower limbs (OALL) was observed in 70 patients (42.4%), mediacalcosis in 8 patients (4.8%), and mixed arteriopathy in 2 patients (1.2%). In 88.5% of patients, the pathology was symptomless. Factors significantly associated with ALL included advanced age (p = 0.01), the age of the glycemic imbalance (p = 0.03), lack of regular physical activity (p = 0.001) and dyslipidemia (p = 0.008). Conclusion: Pelvic limb arteriopathy is usual among diabetics at Oueme-Plateau Provincial Teaching Hospital. The use of SPI, which enables diagnosis, requires simple, low-cost means, and should be encouraged.
{"title":"Lower Limb Arteriopathy in Diabetics at the Oueme-Plateau Provincial Hospital in Porto-Novo: Frequency and Associated Factors","authors":"Finangnon Armand Wanvoegbe, Comlan Jules Gninkoun, Corine Houehanou, Kouessi Anthelme Agbodande, François Akotegnon, Hubert Dedjan, Rolande Quenum, Manchouhoud Alalade, Adebayo Alassani, Albert Dovonou, Angele Azon-Kouanou","doi":"10.4236/ojim.2023.134027","DOIUrl":"https://doi.org/10.4236/ojim.2023.134027","url":null,"abstract":"Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patients in treatment at the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a cross-sectional, descriptive, and analytical study from July 12 to October 10, 2021, at the Oueme-Plateau Provincial Teaching Hospital in Porto-Novo. ALL was screened by performing systolic pressure index (SPI) in all diabetic patients aged at least 18 years, seen in consultation or hospitalization during the study period and who had given their consent. Results: The study registered 165 diabetics and 98.2% of them were type 2. Subjects aged between 55 and 65 years were the most represented (33.9%), with an average age of 59.4 years. Women were in the majority (61.2%), with a sex ratio of 0.6. High blood pressure was associated with diabetes in 61.2% of patients. The prevalence of ALL was 48.5% (80 patients). Obliterative arteriopathy of the lower limbs (OALL) was observed in 70 patients (42.4%), mediacalcosis in 8 patients (4.8%), and mixed arteriopathy in 2 patients (1.2%). In 88.5% of patients, the pathology was symptomless. Factors significantly associated with ALL included advanced age (p = 0.01), the age of the glycemic imbalance (p = 0.03), lack of regular physical activity (p = 0.001) and dyslipidemia (p = 0.008). Conclusion: Pelvic limb arteriopathy is usual among diabetics at Oueme-Plateau Provincial Teaching Hospital. The use of SPI, which enables diagnosis, requires simple, low-cost means, and should be encouraged.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135317703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: COVID-19, an infectious viral disease, has caused a global health crisis. Most cases remain asymptomatic. The majority of patients have mild symptoms while about 15% develop a severe form. The clinical spectrum of SARS-CoV-2 infection appears broad, encompassing asymptomatic infection, upper respiratory tract symptoms, and severe viral pneumonia with respiratory failure that can lead to death. Laboratory tests play an important role in the management of COVID-19 patients. In addition to being essential for the diagnosis, several biological analyses make it possible to identify the inflammatory processes and the potential complications of this disease. This study attempted to identify biochemical assays that could help in the prognosis of the disease to ensure early management. Methods: This was a descriptive study. It focused on patients hospitalized for COVID-19 from March 19, 2020, to January 26, 2021, at the Infectious Disease Management Centre in Lomé (Togo). Medians were compared using the (Mann-Whitney and Wilcoxon) test and frequencies were compared using the Chi-square test or Fisher’s exact test. Results: We included 782 patients. The median age was 41 years IQR from 32 to 55. We observed several biochemical abnormalities in varying proportions for all biochemical parameters studied. Compared to non-serious patients, critically ill patients at admission had more frequently elevated urea, creatinine, transaminases, TG, GGT, CRP and blood glucose. Also, they had more frequent decreases in total cholesterol, HDL-c, blood chloride, and blood calcium. As for patients who died during hospitalization, compared with healed patients, they had more frequent elevations of urea, creatinine, AST, ALT, GGT. CRP and blood glucose. They also had a more frequent decrease in total cholesterol, HDL-c, blood chloride, blood calcium, and blood glucose (p = 0.025). Conclusion: This study shows that COVID-19 is a multi-organ systemic inflammatory viral disease that should be systematically investigated once the diagnosis is confirmed.
背景:COVID-19是一种传染性病毒性疾病，已引起全球卫生危机。大多数病例仍无症状。大多数患者症状轻微，而约15%的患者病情严重。SARS-CoV-2感染的临床症状似乎很广泛，包括无症状感染、上呼吸道症状和可导致死亡的严重病毒性肺炎伴呼吸衰竭。实验室检测在COVID-19患者管理中发挥着重要作用。除了对诊断至关重要之外，一些生物学分析使识别炎症过程和这种疾病的潜在并发症成为可能。本研究试图确定生化分析，可以帮助疾病的预后，以确保早期管理。方法:本研究为描述性研究。该研究的重点是2020年3月19日至2021年1月26日期间在多哥洛洛伊莱传染病管理中心因COVID-19住院的患者。中位数比较采用(Mann-Whitney and Wilcoxon)检验，频率比较采用卡方检验或Fisher精确检验。结果:纳入782例患者。32 - 55岁的中位年龄为41岁。我们观察到一些生化异常在不同比例的所有生化参数研究。与非重症患者相比，危重患者入院时尿素、肌酐、转氨酶、TG、GGT、CRP及血糖升高的频率更高。此外，他们的总胆固醇、高密度脂蛋白c、血氯化物和血钙水平下降的频率也更高。住院期间死亡患者的尿素、肌酐、AST、ALT、GGT的升高频率高于痊愈患者。c反应蛋白和血糖总胆固醇、高密度脂蛋白c、血氯、血钙和血糖的下降也更频繁(p = 0.025)。结论:本研究提示COVID-19是一种多器官全身性炎症性病毒性疾病，一旦确诊应进行系统调查。
{"title":"Biochemical Profile of Patients Hospitalized for COVID-19 at the Infectious Disease Management Centre in Lomé in 2020","authors":"Lochina Feteke, Wemboo Afiwa Halatoko, Mamadou Alpha Prateaux, Aweréou Kotosso, Fagdéba David Bara, Komi Séraphin Adjoh, Mounerou Salou, Koumavi Didier Ekouevi, Mohaman Djibril","doi":"10.4236/ojim.2023.134026","DOIUrl":"https://doi.org/10.4236/ojim.2023.134026","url":null,"abstract":"Background: COVID-19, an infectious viral disease, has caused a global health crisis. Most cases remain asymptomatic. The majority of patients have mild symptoms while about 15% develop a severe form. The clinical spectrum of SARS-CoV-2 infection appears broad, encompassing asymptomatic infection, upper respiratory tract symptoms, and severe viral pneumonia with respiratory failure that can lead to death. Laboratory tests play an important role in the management of COVID-19 patients. In addition to being essential for the diagnosis, several biological analyses make it possible to identify the inflammatory processes and the potential complications of this disease. This study attempted to identify biochemical assays that could help in the prognosis of the disease to ensure early management. Methods: This was a descriptive study. It focused on patients hospitalized for COVID-19 from March 19, 2020, to January 26, 2021, at the Infectious Disease Management Centre in Lomé (Togo). Medians were compared using the (Mann-Whitney and Wilcoxon) test and frequencies were compared using the Chi-square test or Fisher’s exact test. Results: We included 782 patients. The median age was 41 years IQR from 32 to 55. We observed several biochemical abnormalities in varying proportions for all biochemical parameters studied. Compared to non-serious patients, critically ill patients at admission had more frequently elevated urea, creatinine, transaminases, TG, GGT, CRP and blood glucose. Also, they had more frequent decreases in total cholesterol, HDL-c, blood chloride, and blood calcium. As for patients who died during hospitalization, compared with healed patients, they had more frequent elevations of urea, creatinine, AST, ALT, GGT. CRP and blood glucose. They also had a more frequent decrease in total cholesterol, HDL-c, blood chloride, blood calcium, and blood glucose (p = 0.025). Conclusion: This study shows that COVID-19 is a multi-organ systemic inflammatory viral disease that should be systematically investigated once the diagnosis is confirmed.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135317705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4236/ojim.2023.134029
Fulgence Abdou Faye, Bachir Mansour Diallo, Awa Ba, Amina Dia Guèye, Abdou Khadre Mbaye, Zeinabou Marone, Adama Berthé, Papa Soulèyemane Touré, Madoky Magatte Diop, Bernard Marcel Diop, Mamadou Mourtalla Ka
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.
{"title":"Stroke (Cerebrovascular Accident): Epidemiological, Clinical and Evolving Aspects in the Internal Medicine Department of the Public Health Establishment 1 (EPS1) of Tivaouane","authors":"Fulgence Abdou Faye, Bachir Mansour Diallo, Awa Ba, Amina Dia Guèye, Abdou Khadre Mbaye, Zeinabou Marone, Adama Berthé, Papa Soulèyemane Touré, Madoky Magatte Diop, Bernard Marcel Diop, Mamadou Mourtalla Ka","doi":"10.4236/ojim.2023.134029","DOIUrl":"https://doi.org/10.4236/ojim.2023.134029","url":null,"abstract":"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.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135659776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4236/ojim.2023.133015
Seda Yilmaz, Özcan Çeneli
Objective: Acute myeloid leukemia (AML) is a heterogeneous, hematologic malignancy at which short survival may be seen. Our study aims to evaluate the effect of the neutrophil-to-lymphocyte ratio (NLR) on the course of the disease, response to therapy, and overall survival (OS). Materials and Methods: A total of 124 patients followed-up with the diagnosis of AML from 2016 to 2019 were retrospectively examined. Results: 69 of the cases (55.6%) were men and 55 (44.3%) were women. The average age at the time of diagnosis was 53.44 ± 30.3 years old. We determined the NLR as median 0.46 (0.16 - 1.1). In AML, 69 patients were responsive to the induction regimen (57.9%) while 46 patients were unresponsive (37.8%). 5 patients died before completing the regimen. D-dimer was found to be higher and fibrinogen was found to be lower in the responsive group. Lower OS was observed in cases of >60 years of age, male gender, non-APL AML, high NLR, and recurrence at diagnosis. Recurrences were detected in 23 patients (18.5%) and the median time to the recurrence was 416 (236 - 639) days. Fibrinogen level and the bone marrow blast ratio at the time of application were determined to be associated with recurrence. The median follow-up time was 856 (143 - 1276) days. Final condition analysis reveals that 74 patients (59.6%) are alive. Conclusion: We determined in our study that the NLR is effective on survival. Medical literature on this subject is scanty and prospective studies with large patient groups are needed.
{"title":"Prognostic Value of Neutrophil to Lymphocyte Ratio in Acute Myeloid Leukemia","authors":"Seda Yilmaz, Özcan Çeneli","doi":"10.4236/ojim.2023.133015","DOIUrl":"https://doi.org/10.4236/ojim.2023.133015","url":null,"abstract":"Objective: Acute myeloid leukemia (AML) is a heterogeneous, hematologic malignancy at which short survival may be seen. Our study aims to evaluate the effect of the neutrophil-to-lymphocyte ratio (NLR) on the course of the disease, response to therapy, and overall survival (OS). Materials and Methods: A total of 124 patients followed-up with the diagnosis of AML from 2016 to 2019 were retrospectively examined. Results: 69 of the cases (55.6%) were men and 55 (44.3%) were women. The average age at the time of diagnosis was 53.44 ± 30.3 years old. We determined the NLR as median 0.46 (0.16 - 1.1). In AML, 69 patients were responsive to the induction regimen (57.9%) while 46 patients were unresponsive (37.8%). 5 patients died before completing the regimen. D-dimer was found to be higher and fibrinogen was found to be lower in the responsive group. Lower OS was observed in cases of >60 years of age, male gender, non-APL AML, high NLR, and recurrence at diagnosis. Recurrences were detected in 23 patients (18.5%) and the median time to the recurrence was 416 (236 - 639) days. Fibrinogen level and the bone marrow blast ratio at the time of application were determined to be associated with recurrence. The median follow-up time was 856 (143 - 1276) days. Final condition analysis reveals that 74 patients (59.6%) are alive. Conclusion: We determined in our study that the NLR is effective on survival. Medical literature on this subject is scanty and prospective studies with large patient groups are needed.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"174 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136138949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4236/ojim.2023.133022
Michel Assane Ndour, Demba Diédhiou, Djiby Sow, Boundia Djiba, Mouhamed Dieng, Ibrahima Mané Diallo, Fatou Kiné Gadji, Julie Borges, Muriel Diembou, Fama Mody Ndiaye, El Hadj Mouhamadou Moustapha Thioye, Charles Halim, Anna Sarr, Maïmouna Ndour Mbaye
Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study conducted from 1 January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals and the endocrinology department of the Abass Ndao Hospital. Results: We included 89 patients, representing a prevalence of 36.7% among all cases of pituitary adenoma. The mean age was 35.6 ± 10 years and the sex ratio was 0.34. The mean time to consultation was 27.1 ± 29 months. Clinical symptoms were dominated by gonadotropic disorders represented by galactorrhoea (71 cases, 79.8%), amenorrhoea (61 cases, 68.5%), and infertility in the couple (31 cases, 34.8%). Fifty-seven (58) patients presented with a tumour syndrome (65.2%, including 57 cases of headache (64%), 34 cases of visual disorders (38.2%) and 8 patients with a dysmorphic syndrome (8.9%). Imaging revealed a macroadenoma in 68.5% (61 cases) and extension of the adenoma in 11 patients (12.4%). The hormonal profile was isolated lactotropic hypersecretion (80 cases, 89.9%) and mixed in 9 cases (including concomitant secretion of GH in 8 cases and ACTH in 1 case). All patients had initially benefited? from dopaminergic agonist-based medical treatment. Pituitary surgery was effective in 45 patients (50.6%), including 44 cases by transsphenoidal approach. Postoperative incidents included transient diabetes insipidus (77.7%) and cerebrospinal fluid leakage (20%). We noted 7 cases (7.9%) of death presenting with a tumour syndrome (100%), a macro-adenoma (85.7%), having undergone pituitary surgery (42.9%). The factors significantly associated with prolactinoma were young age (p < 0.001), female sex (p < 0.001), long delay in consultation (p < 0.001) and a microadenoma (p < 0.001). Conclusion: This series also demonstrates the impact of prolactin adenomas on reproductive function. Delayed diagnosis explains the predominance of macroadenomas, which are a source of pre- and post-operative complications.
{"title":"Prolactin Adenomas in Senegal: Epidemiological, Diagnostic and Therapeutic Aspects of 89 Cases","authors":"Michel Assane Ndour, Demba Diédhiou, Djiby Sow, Boundia Djiba, Mouhamed Dieng, Ibrahima Mané Diallo, Fatou Kiné Gadji, Julie Borges, Muriel Diembou, Fama Mody Ndiaye, El Hadj Mouhamadou Moustapha Thioye, Charles Halim, Anna Sarr, Maïmouna Ndour Mbaye","doi":"10.4236/ojim.2023.133022","DOIUrl":"https://doi.org/10.4236/ojim.2023.133022","url":null,"abstract":"Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study conducted from 1 January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals and the endocrinology department of the Abass Ndao Hospital. Results: We included 89 patients, representing a prevalence of 36.7% among all cases of pituitary adenoma. The mean age was 35.6 ± 10 years and the sex ratio was 0.34. The mean time to consultation was 27.1 ± 29 months. Clinical symptoms were dominated by gonadotropic disorders represented by galactorrhoea (71 cases, 79.8%), amenorrhoea (61 cases, 68.5%), and infertility in the couple (31 cases, 34.8%). Fifty-seven (58) patients presented with a tumour syndrome (65.2%, including 57 cases of headache (64%), 34 cases of visual disorders (38.2%) and 8 patients with a dysmorphic syndrome (8.9%). Imaging revealed a macroadenoma in 68.5% (61 cases) and extension of the adenoma in 11 patients (12.4%). The hormonal profile was isolated lactotropic hypersecretion (80 cases, 89.9%) and mixed in 9 cases (including concomitant secretion of GH in 8 cases and ACTH in 1 case). All patients had initially benefited? from dopaminergic agonist-based medical treatment. Pituitary surgery was effective in 45 patients (50.6%), including 44 cases by transsphenoidal approach. Postoperative incidents included transient diabetes insipidus (77.7%) and cerebrospinal fluid leakage (20%). We noted 7 cases (7.9%) of death presenting with a tumour syndrome (100%), a macro-adenoma (85.7%), having undergone pituitary surgery (42.9%). The factors significantly associated with prolactinoma were young age (p < 0.001), female sex (p < 0.001), long delay in consultation (p < 0.001) and a microadenoma (p < 0.001). Conclusion: This series also demonstrates the impact of prolactin adenomas on reproductive function. Delayed diagnosis explains the predominance of macroadenomas, which are a source of pre- and post-operative complications.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"270 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.
{"title":"Biermer’s Disease at the Donka National Hospital in Guinea&lt;br/&gt;—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department","authors":"Thierno Amadou Wann, Mamadou Sarifou Diallo, Djenabou Diallo, Kadiatou Diallo, Mamadou Lamine Yaya Bah, Mamadou Diakhaby, Mohamed Cissoko, Amadou Kaké, Djibril Sylla","doi":"10.4236/ojim.2023.133023","DOIUrl":"https://doi.org/10.4236/ojim.2023.133023","url":null,"abstract":"Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135496047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4236/ojim.2023.133024
Christopher Miller, Rawan Sharari, Munira Ali, Jonathan Omana, Mirjana Milutinovic, Aleksandar Dusic
Objective: Anticoagulants have been approved and used for decades as highly effective blood thinners. The objective of this study is to analyze the clinical trials in order to determine if the Watchman reduces the risk of stroke in patients with atrial fibrillation compared to those prescribed the traditional anticoagulants. This will contribute to the current body of knowledge and possibly provide beneficial clinical guidance with respect to providing an alternative option for those suffering from non-valvular Atrial fibrillation. Methods: A systematic literature search through the Saint James School of Medicine library resources as well as PubMed, Medscape, Google Scholar was conducted. Studies were included if the literature examined the comparison between the Watchman device and four specific anticoagulants (Xarelto, Eliquis, Pradaxa, and Warfarin) in association with reduction of risks of strokes in an atrial fibrillation population. The study includes a qualitative sub-analysis to explore additional clinical aspects that may affect risk of stroke and response of treatment. Results: Outcomes were significant for similar stroke occurrence, when compared to published clinical trials. Alternatively, there was a significant reduction in risk of bleeding and all-cause mortality in the Watchman™ device compared to traditional NOACs and warfarin. While examining the studies and trials, overall, the Watchman™ device offers a better long-term outcome therapy for non-valvular atrial fibrillation populations who are not possibilities for extended anticoagulation. The studies used for analysis examining the dosage found higher fatality with increased use of NOACs and more hospitalizations with decreased use. Conclusion: From the presented data, it is safe to say that the Watchman™ device is a viable and effective alternative for stroke prophylaxis in certain patient populations. Compared to traditional anticoagulant therapies for non-valvular atrial fibrillation, these studies suggest that the Watchman™ device can reduce bleeding time and, in most cases, the risk of stroke is less than or equal to traditional anti-coagulants.
{"title":"Paper Analysis of the WATCHMAN on the Reduction of Stroke Compared to Anticoagulants: A Systematic Review of the Literature","authors":"Christopher Miller, Rawan Sharari, Munira Ali, Jonathan Omana, Mirjana Milutinovic, Aleksandar Dusic","doi":"10.4236/ojim.2023.133024","DOIUrl":"https://doi.org/10.4236/ojim.2023.133024","url":null,"abstract":"Objective: Anticoagulants have been approved and used for decades as highly effective blood thinners. The objective of this study is to analyze the clinical trials in order to determine if the Watchman reduces the risk of stroke in patients with atrial fibrillation compared to those prescribed the traditional anticoagulants. This will contribute to the current body of knowledge and possibly provide beneficial clinical guidance with respect to providing an alternative option for those suffering from non-valvular Atrial fibrillation. Methods: A systematic literature search through the Saint James School of Medicine library resources as well as PubMed, Medscape, Google Scholar was conducted. Studies were included if the literature examined the comparison between the Watchman device and four specific anticoagulants (Xarelto, Eliquis, Pradaxa, and Warfarin) in association with reduction of risks of strokes in an atrial fibrillation population. The study includes a qualitative sub-analysis to explore additional clinical aspects that may affect risk of stroke and response of treatment. Results: Outcomes were significant for similar stroke occurrence, when compared to published clinical trials. Alternatively, there was a significant reduction in risk of bleeding and all-cause mortality in the Watchman™ device compared to traditional NOACs and warfarin. While examining the studies and trials, overall, the Watchman™ device offers a better long-term outcome therapy for non-valvular atrial fibrillation populations who are not possibilities for extended anticoagulation. The studies used for analysis examining the dosage found higher fatality with increased use of NOACs and more hospitalizations with decreased use. Conclusion: From the presented data, it is safe to say that the Watchman™ device is a viable and effective alternative for stroke prophylaxis in certain patient populations. Compared to traditional anticoagulant therapies for non-valvular atrial fibrillation, these studies suggest that the Watchman™ device can reduce bleeding time and, in most cases, the risk of stroke is less than or equal to traditional anti-coagulants.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135799362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To determine the prevalence of pulmonary tuberculosis in diabetics, to identify risk factors associated with pulmonary tuberculosis in diabetics, and to describe the clinical features of the association of pulmonary tuberculosis and diabetes. Materials and method: This was a cohort study that took place from November 18, 2015 to January 31, 2018 at the Department of Endocrinology, Diabetology and Metabolic Diseases of the University Hospital of Donka. Results: among the 1912 diabetic patients screened for tuberculosis, 46 had bacteriologically confirmed pulmonary tuberculosis, i.e. a prevalence of 2.4% and 01 had clinically diagnosed pulmonary tuberculosis with 0.1%. A female predominance was noted with a sex ratio of 0.8. The 45 - 54 age group was the most affected with a mean age of 46 years. Body Mass Index (p = 0.001), smoking (p = 0.0101) and history of infection (p = 0.001) were significantly associated with pulmonary tuberculosis. The history of smoking (p = 0.0101), the notion of contagion (p = 0.001), the cough (p = 0.001), the fever (p = 0.001), the nocturnal sweat (p = 0.001) and the hemoptysis (p = 0.001) were the clinical characteristics significantly associated with pulmonary tuberculosis. Conclusion: The results of this study show a remarkably high prevalence of tuberculosis in diabetic patients in Guinea highlighting the need for urgent action to better understand and treat the double burden of tuberculosis and diabetes.
{"title":"Prevalence and Risk Factors Associated with Pulmonary Tuberculosis in Diabetics in Conakry","authors":"Mamadou Dian Mamoudou Diallo, Amadou Kaké, Mamadou Chérif Diallo, Mamadou Mansour Diallo, Alpha Mamadou Diallo, Mamadou Alpha Diallo, Amadou Sy, Boubacar Bah, Oumou Younoussa Sow, Kadidiatou Bah, Abdoul Mazid Diallo, El’Hadj Zainoul Bah, Mody Abdoulaye Bsarry, Kadija Dieng, Amatoulaye Diallo, Amadou Bah","doi":"10.4236/ojim.2023.133018","DOIUrl":"https://doi.org/10.4236/ojim.2023.133018","url":null,"abstract":"Objectives: To determine the prevalence of pulmonary tuberculosis in diabetics, to identify risk factors associated with pulmonary tuberculosis in diabetics, and to describe the clinical features of the association of pulmonary tuberculosis and diabetes. Materials and method: This was a cohort study that took place from November 18, 2015 to January 31, 2018 at the Department of Endocrinology, Diabetology and Metabolic Diseases of the University Hospital of Donka. Results: among the 1912 diabetic patients screened for tuberculosis, 46 had bacteriologically confirmed pulmonary tuberculosis, i.e. a prevalence of 2.4% and 01 had clinically diagnosed pulmonary tuberculosis with 0.1%. A female predominance was noted with a sex ratio of 0.8. The 45 - 54 age group was the most affected with a mean age of 46 years. Body Mass Index (p = 0.001), smoking (p = 0.0101) and history of infection (p = 0.001) were significantly associated with pulmonary tuberculosis. The history of smoking (p = 0.0101), the notion of contagion (p = 0.001), the cough (p = 0.001), the fever (p = 0.001), the nocturnal sweat (p = 0.001) and the hemoptysis (p = 0.001) were the clinical characteristics significantly associated with pulmonary tuberculosis. Conclusion: The results of this study show a remarkably high prevalence of tuberculosis in diabetic patients in Guinea highlighting the need for urgent action to better understand and treat the double burden of tuberculosis and diabetes.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136216851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4236/ojim.2023.133025
Xu Zheng, Tianyao Zhang
Objectives: Stress hyperglycemia is a common complication of pancreatitis. This study aimed to determine optimal blood glucose control goals for patients with pancreatitis. Methods: We conducted a screening of adult patients diagnosed with pancreatitis who were admitted to the ICU using data from the Medical Information Marketplace for Intensive Care IV (MIMIC-IV) database. In total, 574 cases were enrolled in this study and were divided into four groups based on blood glucose levels. We investigated the effects of four groups on the prognosis of patients with pancreatitis. Results: The survival group exhibited lower Glu_mean and Glu_cv values, but there was no significant effect on mortality. Glu_cv and frequency of daily blood glucose monitoring were significantly correlated with length of hospital stay, but had no significant effect on length of ICU stay. Subgroup analysis showed that the mortality rate was the highest when the mean blood glucose was 7.8 - 10.0 mmol/L, and the lowest when Glu_mean was 6.1 - 7.8 mmol/L.
{"title":"Optimal Glycemic Control for Patients with Pancreatitis in the Intensive Care Unit: A Retrospective Study Based on a Large Intensive Care Unit Database","authors":"Xu Zheng, Tianyao Zhang","doi":"10.4236/ojim.2023.133025","DOIUrl":"https://doi.org/10.4236/ojim.2023.133025","url":null,"abstract":"Objectives: Stress hyperglycemia is a common complication of pancreatitis. This study aimed to determine optimal blood glucose control goals for patients with pancreatitis. Methods: We conducted a screening of adult patients diagnosed with pancreatitis who were admitted to the ICU using data from the Medical Information Marketplace for Intensive Care IV (MIMIC-IV) database. In total, 574 cases were enrolled in this study and were divided into four groups based on blood glucose levels. We investigated the effects of four groups on the prognosis of patients with pancreatitis. Results: The survival group exhibited lower Glu_mean and Glu_cv values, but there was no significant effect on mortality. Glu_cv and frequency of daily blood glucose monitoring were significantly correlated with length of hospital stay, but had no significant effect on length of ICU stay. Subgroup analysis showed that the mortality rate was the highest when the mean blood glucose was 7.8 - 10.0 mmol/L, and the lowest when Glu_mean was 6.1 - 7.8 mmol/L.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135799590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: SARS-COV-2 infection is a real public health challenge for the World Health Organization and for our country. It is responsible for numerous hematological abnormalities in infected patients. Objectives: To describe the haemogram abnormalities in patients infected with SARS-COV-2 and to determine which ones are associated with death. Material and Method: We conducted a retrospective, descriptive, analytical, cross-sectional study from March 2020 to September 2021. The study included all patients hospitalized with RT-PCR-confirmed COVID-19 who performed a blood count. We evaluated the blood count profile, the pathologies found and the associated blood count abnormalities. Results: A total of 263 patients were included. The mean age of the patients was 63.77 years (range 12 - 90 years). The male sex represented 54.75% (n = 144) while the female sex was 45.25% (n = 119) (sex ratio = 1.21). The most common pathologies were: diabetes: 30.03% (n = 79), high blood pressure: 41.04% (n = 108), and Chronic kidney disease: 7.98 (n = 21). The abnormalities of the haemogram found were essential: anaemia 28.13% (n = 121), hyperleukocytosis with neutrophilic predominance: 29.3% (126), lymphopenia: 34.41% (n = 148), thrombocytopenia: 8.16% (n = 35). The search for hematological factors associated with death in patients showed a significant difference between hyperleukocytosis (p = 0.000) and lymphopenia (p = 0.0001). Conclusion: SARS-COV-2 disease was a mortality factor when associated with lymphopenia and hyperleukocytosis in our series.
{"title":"Blood Count Abnormalities Associated with Death in Patients Infected with SARS-COV-2 at the Ziguinchor EpidemicTreatment Center (ETC)","authors":"Coly Mame Ngoné, Diallo Kalilou, Sarr Habibou, Diop Abdoulaye, Manga Noel Magloire, Diatta Alassane","doi":"10.4236/ojim.2023.134028","DOIUrl":"https://doi.org/10.4236/ojim.2023.134028","url":null,"abstract":"Introduction: SARS-COV-2 infection is a real public health challenge for the World Health Organization and for our country. It is responsible for numerous hematological abnormalities in infected patients. Objectives: To describe the haemogram abnormalities in patients infected with SARS-COV-2 and to determine which ones are associated with death. Material and Method: We conducted a retrospective, descriptive, analytical, cross-sectional study from March 2020 to September 2021. The study included all patients hospitalized with RT-PCR-confirmed COVID-19 who performed a blood count. We evaluated the blood count profile, the pathologies found and the associated blood count abnormalities. Results: A total of 263 patients were included. The mean age of the patients was 63.77 years (range 12 - 90 years). The male sex represented 54.75% (n = 144) while the female sex was 45.25% (n = 119) (sex ratio = 1.21). The most common pathologies were: diabetes: 30.03% (n = 79), high blood pressure: 41.04% (n = 108), and Chronic kidney disease: 7.98 (n = 21). The abnormalities of the haemogram found were essential: anaemia 28.13% (n = 121), hyperleukocytosis with neutrophilic predominance: 29.3% (126), lymphopenia: 34.41% (n = 148), thrombocytopenia: 8.16% (n = 35). The search for hematological factors associated with death in patients showed a significant difference between hyperleukocytosis (p = 0.000) and lymphopenia (p = 0.0001). Conclusion: SARS-COV-2 disease was a mortality factor when associated with lymphopenia and hyperleukocytosis in our series.","PeriodicalId":19579,"journal":{"name":"Open Journal of Internal Medicine","volume":"164 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135317712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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