Frequent Signs Research Articles

Joint Hypermobility and Clinical Correlates in a Group of Patients With Eating Disorders.

Background: The ability to move joints beyond the normal range of motion is called Joint Hypermobility (JHM). JHM has been associated with a plethora of physical problems and is a frequent sign of hereditary disorders of connective tissue. Neuropsychiatric conditions such as eating disorders (ED) have also been related to JHM. However, little is known about the clinical profile of people with ED and JHM. The aim of this study was to explore JHM in patients with ED and to compare the clinical characteristics of hypermobile ED patients with non-hypermobile ED patients.Method: Fifty-three outpatients diagnosed with ED were assessed using the Beighton score for JHM, the Eating Disorders Inventory 2, the Eating Disorder Examination, and the Detail and Flexibility Questionnaire. Information relating to patients' psychiatric and somatic comorbidities/symptoms was also collected.Results: Using the traditional Beighton score's cutoff of ≥4, 41.5% of the sample presented with JHM. Our results indicate that compared with non-hypermobile ED patients, those with JHM are significantly younger, suffer at a greater extent from joint pain and easy bruising, have a shorter duration of the ED, and have lower scores for cognitive rigidity. In addition, for those with anorexia nervosa, the restricting subtype represents a significantly lower proportion of hypermobile ED patients compared to non-hypermobile ED patients. Multivariate analyses showed that cognitive rigidity, age, and duration of the ED could predict the JHM status in this sample.Conclusion: These results suggest that JHM is frequent in patients with ED and is accompanied by signs of tissue fragility. Patients with ED and JHM seem to present a specific profile characterized by less cognitive rigidity and restricting behavior in the case of anorexia nervosa. Further research is needed in order to confirm these results.

Feline and Canine Cutaneous Lymphocytosis: Reactive Process or Indolent Neoplastic Disease?

Cutaneous lymphocytosis (CL) is an uncommon and controversial lymphoproliferative disorder described in dogs and cats. CL is generally characterized by a heterogeneous clinical presentation and histological features that may overlap with epitheliotropic lymphoma. Therefore, its neoplastic or reactive nature is still debated. Here, we describe clinicopathological, immunohistochemical, and clonality features of a retrospective case series of 19 cats and 10 dogs with lesions histologically compatible with CL. In both species, alopecia, erythema, and scales were the most frequent clinical signs. Histologically, a dermal infiltrate of small to medium-sized lymphocytes, occasionally extending to the subcutis, was always identified. Conversely, when present, epitheliotropism was generally mild. In cats, the infiltrate was consistently CD3+; in dogs, a mixture of CD3+ and CD20+ lymphocytes was observed only in 4 cases. The infiltrate was polyclonal in all cats, while BCR and TCR clonal rearrangements were identified in dogs. Overall, cats had a long-term survival (median overall survival = 1080 days) regardless of the treatment received, while dogs showed a shorter and variable clinical course, with no evident associations with clinicopathological features. In conclusion, our results support a reactive nature of the disease in cats, associated with prolonged survival; despite a similar histological picture, canine CL is associated with a more heterogeneous lymphocytic infiltrate, clonality results, and response to treatment, implying a more challenging discrimination between CL and CEL in this species. A complete diagnostic workup and detailed follow-up information on a higher number of cases is warrant for dogs.

COVID-19 Hastalarında Hastane İçi Mortalitenin Kardiyak Hasar ile İlişkisi: Retrospektif Kohort Çalışması

Objective: Coronavirus disease-2019 (COVID-19) emerged in late 2019 and has caused a pandemic, resulting in significant morbidity and mortality. However, the clinical significance of cardiac injury in patients affected by COVID-19 is still unknown. Therefore, our objective was to explore the association between cardiac injury and mortality in hospitalized patients with COVID-19. Material and Methods: The study included four hundred forty-three patients with laboratory values for troponin and follow-up. The mean age was 57.3±16.0 years. The male to female ratio was 1.53. Fever (45.6%) and cough (42.7%) were the most frequent sign and symptom at admission. Hypertension was the most common comorbidity, identified in 140 patients (31.6%). Results: In 143 (32.2%) patients, we determined cardiac injury. The median length of hospital stay was ten days. The mortality rate was 14.4%. The median length of hospital stay was longer in patients with cardiac injury (14 days vs. 9 days, respectively) (p<0.001). The mortality rate was 3.7% in the patients without cardiac injury, whereas the mortality rate was significantly higher among the patients with cardiac injury (37.7%, p<0.001). The multivariable model showed that cardiac injury was the only independent risk factor for death. There was a higher risk of death in patients with cardiac injury than in those without cardiac injury [hazard ratio, 4.01 (95% confidence interval, 1.85-8.72, p<0.001)]. Conclusion: In conclusion, cardiac injury is a common condition among hospitalized patients with COVID-19 and is associated with an elevated risk of in-hospital mortality. In addition, it is significantly more common in patients with known heart disease, complicating the treatment process.

Experience of Menopause for Women in the Niamey Region, Republic of Niger

Introduction: Menopause is poorly documented in Africa. For most of the women living there, the experience of this period does not seem to be very problematic. For women living in rural areas, other concerns are more prominent. Methods: The study was prospective, quantitative and qualitative about 500 cases collected over a period of 6 months. The study involved postmenopausal women in the Niamey region of public services, in certain residential areas, or accompanying people in health structures. Parameters taken into account were sociocultural, antecedents, experience, knowledge, and management of menopause. The data was entered and analyzed using Microsoft Office Word 2010 and Microsoft Office Excel 2010 software. Results: The average age was 56.4 years with extremes of 40 and 80 years; 57% were still living with their husbands and 39% widows; 60.2% housewives; 53% uneducated, 17% have higher education; 60.2% had had at least 6 children and 39.6% had used contraception. The comorbidities observed were arterial hypertension (24.4%) and diabetes (7%). As for the representation that women made of menopause, for all of them, this stage is the beginning of old age. The most frequent signs were asthenia (86.2%) and mood disorders (70.6%). Almost all of the patients (99.8%) had not used hormonal treatment for the menopause and among them 27% the management of the menopause was with traditional means. Conclusion: Menopausal disorders are certainly a reality in our socio-cultural context. They are not a primary concern either through ignorance or resignation of the women concerned.

Зрительная агнозия в клинике острого ишемического инсульта: частота встречаемости и связь с другими когнитивными нарушениями

Study Objective: To identify the frequency of the types of visual agnosia (VA), their association with one another and with other neuropsychologic disorders in patients with acute hemispheric non-lacunar ischemic stroke (IS). Study Design: retrospective study. Materials and Methods. We followed up 104 patients with acute IS (mean age: 66.7 ± 9.4 years old), who underwent neurological, neuropsychologic, neuroimaging and ophthalmological examination. Study Results. VA was diagnosed in 52% of patients; in the majority of cases, the condition was diagnosed on the basis of deep neuropsychologic tests only, and it was asymptomatic. VA structure was dominated by unilateral visual neglect (21%), apraxia (20%) and object VA (18%). Object VA was the most frequent clinical sign (8 (42%) out of 19 patients). Spatial VA (including neglect and apraxia) correlated with the rate of regulatory dysfunction and short-term visual memory impairment; object VA — with regulatory dysfunction; facial VA — only with a decrease in short-term visual memory. The cluster analysis allowed identifying relatively homogeneous groups of patients: 1) no VA; 2) impaired spacial gnosis; 3) with impaired objects and facial gnosis. Conclusion. VA is diagnosed in a half of patients with acute hemispheric non-lacunar IS and is mostly asymptomatic. Spatial VA is predominant. Spacial, object and facial VA have statistically significant association with frontal lobe dysfunction; spacial and facial — with short-term visual memory impairments. Two most common combinations of various VA types in acute IS were identified — visual and special disorders and impaired object and face recognition. Keywords: visual agnosia, visual and spacial disorders, stroke, cluster analysis.

Profil épidémiologique et histologique des tumeurs du système nerveux central à Dakar

INTRODUCTION : Les tumeurs du système nerveux central sont rares. Elles sont responsables d’une mortalité et d’une morbidité importantes. Les types histologiques varient selon l’âge. L’objectif de cette étude était de déterminer le profil épidémiologique et histologique des tumeurs du système nerveux central au Centre Hospitalier National Dalal Jamm. MATERIELS ET METHODES : Nous avons mené une étude rétrospective descriptive concernant les patients pris en charge dans le service d’Oncologie-Radiothérapie du Centre Hospitalier National Dalal Jamm de Novembre 2018 à Octobre 2021. L’âge, le sexe, les principaux signes révélateurs, la tumeur d’origine pour les lésions secondaires, la topographie des tumeurs, et les types histologiques ont été étudiés. RESULTATS : Nous avons colligé 82 cas de tumeurs du système nerveux central. L’âge médian des patients était de 43 ans avec des extrêmes de huit et 73 ans. Soixante-treize virgule deux pour cent des cas trouvés étaient des femmes. Les enfants représentaient 8,5% de la population étudiée. Les signes cliniques les plus fréquents au diagnostic étaient les céphalées (68,3%,), la baisse de l’acuité visuelle (28%) et les nausées/vomissements (24,4%). Il s’agissait de 72% de tumeurs secondaires dont la majorité était d’origine mammaire (58,6%) et pulmonaire (5,2%). Les tumeurs primitives étaient dominées par le glioblastome (39,1%). CONCLUSION : Les tumeurs du système nerveux central sont rares au Sénégal et généralement observées chez l’adulte. Elles sont majoritairement secondaires d’un cancer du sein et le glioblastome est la tumeur primitive la plus fréquente.

Child’s Cardiopathies at the Hospital De La Paix in Ziguinchor (Senegal)

Introduction: Childhood heart disease consists of congenital and acquired heart disease. The aim of this study was to describe the epidemiological profile and the clinical and aetiological characteristics of childhood heart disease at the H?pital de la Paix in Ziguinchor. Method: This was a retrospective study from 1 January 2016 to 1 June 2020 in the cardiology and paediatrics departments of the H?pital de la Paix in Ziguinchor. We included in the study all patients aged 0 - 18 years, hospitalised with heart disease confirmed by cardiac ultrasound. Results: In total, we included 57 patients in the study. The hospital prevalence was 1.6%. The average age was 67.85 ± 65 months. The predominance was male with a sex ratio of 0.96. The majority of mothers (50%) were between 15 and 30 years old. In our study, 8.85% of patients had a history of previous angina. Trisomy 21 was present in 12.35% of our patients. Severe acute malnutrition was found in 21.05% of cases. Lower limb oedema (82.4%) and dyspnoea (59.6%) were the most frequent clinical signs. On cardiac ultrasound, 52.6% of patients had congenital heart disease and 47.4% of patients had acquired heart disease. Ventricular septal defect (33.33%) was the most common congenital heart disease. Among the acquired heart diseases, mitral insufficiency predominated with 70.8% of cases. Infective endocarditis was the main complication observed. Management was mainly drug-based with diuretics and ACE inhibitors. No patient had undergone surgery. The in-hospital evolution was favourable in 85.9% of cases and the mortality rate was 10.5%. Conclusion: Our study showed that congenital heart disease was more frequent than acquired heart disease and that management, particularly surgery, was lacking.

Clinical Characteristics, Treatment, and Prognosis of Patients with Obstructive Jaundice in Tertiary Care Facilities: A Prospective Study

Background: Obstructive jaundice can have a number of reasons, but choledocholithias is the most frequent. Obstructive jaundice patients frequently complain of pruritus, jaundice, pale faeces, dark urine, and yellow skin and eyes. Today, because to improvements in imaging technology over the years, a precise pre-operative diagnosis is nearly always attainable. The study's goals were to examine the clinical characteristics and treatment of patients with obstructive jaundice. Methods: Patients with obstructive jaundice who were admitted to the Department of Hepatology at SCB Medical College, Cuttack, Odisha, were the subject of the current hospital-based prospective interventional study. Patients of age greater than 12 years of either sex were studied during the study period of two years after providing written consent. Results: The mean age of the 50 patients was 51.10 years, with 29 (58%) female and 21 (42%) male patients. 19 (38%) of the patients had malignant obstructive jaundice, while 31 (62%) had benign causes. The most frequent symptoms and signs of obstructive jaundice were abdominal pain (100%) and icterus (100%) respectively. The most frequent cancer was cholangiocarcinoma (Ca) of the head of pancreas (Ca) of 2009 (18%), followed by cholangiocarcinoma of the distal common bile duct (CBD) of 2004 (08%), and hilar cholangiocarcinoma of 2003 (06%). The most frequent benign cause was choledocholithiasis 25 (50%) followed by benign stricture of common bile duct 03 (06%). Conclusion: One of the frequent reasons of surgically treatable jaundice is obstructive jaundice. Its cause is diverse, and the right imaging is typically required for diagnosis. As delayed diagnosis may result in permanent pathological alterations that increase morbidity and death, proper diagnosis and treatment are essential.

Iatrogenic Bile Duct Injuries after Cholecystectomy, Is the Laparoscopic Approach a Good Idea?

Objective: The treatment of iatrogenic bile duct injuries is still a challenge for hepatobiliary and general surgeons. Roux-en-Y hepaticojejunostomy, one of the most appropriate techniques for the treatment of circumferential lesions, either occurring less than 2 cm from the bifurcation or in the bifurcation of the common hepatic duct, requires experience in advanced laparoscopy and hepatobiliary surgery. This study aims to present the results of laparoscopic hepaticojejunostomy (LHJ) for the treatment of iatrogenic bile duct injuries (IBDI). Methods: A retrospective study analyzing the medical records of patients diagnosed with IBDI and treated using LHJ of patients at the Hospital S&#227o José do Avaí (HSJA). Sex, age, previous cholecystectomy technique, signs and symptoms, postoperative complications, length of stay, injury classification, and time elapsed from injury to diagnosis were analyzed. Magnetic resonance cholangiography (MRC), endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography. Results: From March 2006 to December 2018, six patients underwent LHJ. In five cases (83.33%), the primary operation was a laparoscopic cholecystectomy (LC) and in one patient (13.66%) open cholecystectomy. The most frequent clinical sign was jaundice. The mean surgical time was 153.2 minutes (range: 115 to 206 minutes), and the hospital stay was 3 to 7 days (mean: 4.16 days). One patient had infection of the umbilical trocar incision and one patient presented with stenosis of the hepaticojejunal anastomosis and was treated with radioscopic pneumatic dilatation. Conclusion: LHJ for circumferential and total IBDI either diagnosed early (during surgery) or late, may be a safe and effective option, with similar results to the conventional technique, a low complication rate and all the known advantages of minimally invasive surgery.

Factors Associated with Splenomegaly amongst Patients with Sickle Cell Disease in Cameroon

Introduction: Sickle cell disease is the most common hemoglobinopathy in the world. Sickle cells are quickly fixed and destroyed by the elements of the reticuloendothelial system mainly in the spleen. It leads to a palpable increase in the volume of the spleen called splenomegaly. Splenomegaly is the cause of multiple complications that are relatively frequent and potentially serious in sickle cell disease, such as splenic sequestration seizures, spleen rupture, hypersplenism and splenic abscesses. We aimed at determining the prevalence of splenomegaly and to study the associated factors in patients with sickle cell disease. Materials and Methods: This was an analytical cross-sectional study, conducted from 1 January to 30 April 2019, at the Mother and Child Center of the Chantal BIYA Foundation. Patients were grouped into two groups: patients with splenomegaly (PS1) and patients without splenomegaly (PS0). As soon as we obtained the informed consent of the parents, we examined the children and recorded socio-demographic data, disease history and follow-up, documented complications, and clinical findings; then we performed the Rapid Malaria Diagnostic Test. The statistical analyzes were carried out using SPSS20 (Statistical Package for Social Sciences) and Microsoft Excel 2010 software. Results: We examined 403 children with sickle cell disease and 142 had splenomegaly (35%). Almost all of the study populations were homozygous SS. The Hackett 2 stage of splenomegaly was the most frequent (56.7%). The most common physical sign among PS1 was the presence of abdominal scarring (50.7% vs. 19.4%). PS1 had significantly lower levels of Hb (6.94 ± 1.67 vs 7.62 ± 1.43 p = 0.003) and platelets (297.45 ± 146.25 vs 398.70 ± 163.73 p tomegaly, thrombocytopenia and use of non-steroidal anti-inflammatory drugs. Conclusion: Splenomegaly is a frequent physical sign of sickle cell disease in children and factors associated are malaria, high hemoglobin F, low hemoglobin S, hepatomegaly, thrombocytopenia and NSAID use.

Pulmonary Complications in Children with Sickle Cell Disease Followed at the Pediatric Department of Gabriel Toure University Hospital

Objective: To study the pulmonary complications of major sickle cell syndromes in children aged 6 months to 15 years followed at the Department of Pediatrics of Gabriel Toure University Hospital. Materials and methods: This was a retrospective study from January 1st, 2017 to February 28, 2018 and a prospective study from March 1, 2018 to December 31, 2019, concerning sickle cell disease children followed at the Gabriel Touré University Hospital. All children with sickle cell disease confirmed by hemoglobin electrophoresis, aged 6 months to 15 years with a pulmonary complication and admitted to pediatrics were included. Were not included: 1) Infants and children with sickle cell disease not presenting a pulmonary complication coming only to their routine follow-up. 2) Sickle cell patients over 16 years of age and those whose parents do not consent. 3) Those who have not done electrophoresis. Results: During the study period, we were able to include 45 sickle cell children with a pulmonary complication. The frequency of pulmonary complications was 13.76%, involving homozygotes in 91.11% of cases. The age group 6 - 10 years predominated with 46.66% and the sex ratio was 0.45. Vaso-occlusive crisis was the most frequent reason for consultation with 35.56%. Respiratory distress (80%), fever (66.67%), crepitus rales (64.44%) and chest pain (60%) were the most frequent clinical signs. The main pulmonary complication was acute chest syndrome with 86.67%. Treatment was based on hydration (91.91%), analgesics (91.91%) and antibiotics (73.33%). Lethality was 4.44%. Conclusion: Pulmonary complications of sickle cell disease are serious and constitute the main cause of mortality in our context.

Cон как ресурс формирования здоровья школьника

Objective. To determine the spectrum and prevalence of sleep and sleep-related breathing disorders and the daytime/nighttime patterns associated with them in elementary school children. Patients and methods. A questionnaire was administered to parents of 262 schoolchildren aged between 7 and 10 years (142 boys and 120 girls). It comprised 76 questions on the features of nighttime sleep, factors influencing its disorders, as well as on complaints about various sleep and sleep-related breathing disorders. Signs of sleep disorders were assessed through verbal communication with children or were recorded by parents during their nighttime sleep. The questionnaire provided “yes”/”no”/”do not know” response options. Statistical analysis included the frequency analysis of sleep disorders and sleep complaints. The analysis was performed using Python software libraries: pandas 1.4.3, scipy.stats 1.8.1. Results. According to the results of the questionnaire, 46% of elementary school children had from 2 to 11 different complaints about sleep, and these were mainly 9-10-year-old children. The most frequent complaints were difficulty falling asleep (19%), sleep talking (18%), and nightmares (12%). Short sleep duration was noted in every fifth child due to late bedtime (р &lt; 0.001) and early awakening (р &lt; 0.001). It was significantly associated not only with fatigue, irritability, reduced cognitive performance, but also with indirect signs of sleep-disordered breathing: excessive morning thirst (р = 0.019) and morning dry mouth (р = 0.04). Complaints of nocturnal snoring (12% of children) and short sleep duration showed a strong correlation with frequent ARIs per year (р &lt; 0.001, р = 0.003, respectively). Daily screen time of more than four hours was registered in 13% of children, and 51% used electronic devices predominantly before bedtime. The following waking patterns were found to be the most significant for sleep disorders: late bedtime (р = 0.004), using gadgets at night (р = 0.028), and finishing using gadgets before bedtime (р &lt; 0.001). In addition, 31% of children took a meal before bedtime, which was significantly correlated with nightmares (р = 0.049) as one of the most frequent signs of sleep disturbance. Conclusion. Questioning elementary school children and their parents for early detection of signs of sleep disorders, prevention of ARIs, identification of children with sleep-disordered breathing and timely treatment of their causes, control over compliance with hygienic requirements for waking and sleeping regimes, especially with the recommended sleep duration, restriction of meals and using gadgets before going to bed are a set of measures for sleep normalization, promoting the development of a personalized approach to prevent a whole range of socially significant pathologies. Key words: sleep disorder, elementary school children, comorbidity, snoring, prevention

PNEUMOCYSTIS IN PATIENTS LIVING WITH HIV: EXPERIENCE OF THE INFECTIOUS DISEASES DEPARTMENT OF CHU MOHAMED VI-MARRAKECH

Pneumocystis is the most serious and common respiratory opportunistic infection after tuberculosis during HIV infection. To describe the epidemiological, clinical, therapeutic and evolutionary aspects of HIV-infected patients who presented with pneumocystis. Retrospective study of the records of 45 HIV-infected patients followed at the Department of Infectious Diseases of the CHU Mohamed VI and hospitalized for Pneumocystis jirovecii infection between January 2007 and March 2021. Out of 1286 HIV-infected patients followed at the department during the study period, 45 patients (3.5%) had pneumocystis. Pneumocystis was inaugural to HIV infection in 36 cases (80%). The predominance was male in 63% of cases (28 males to 17 females), with an average age of 35.5 years [16-64 years]. The mean TCD4 cell count was 74 cells/mm3 [0- 656 cells/mm3]. The mean LDH level was 874.89 IU/L. The clinical picture was marked by cough in 84% of cases and dyspnea in 64% of cases. The most frequent radiological signs were a diffuse interstitial syndrome in 84.4% of cases on chest X-ray and ground glass appearance in 63% of cases on chest CT. The diagnosis of pneumocystis was confirmed in 16 patients by the detection of Pneumocystis jIrovecii in sputum and BAL. All our patients were treated with Trimethoprim-Sulfamethoxazole combination. Antiretroviral treatment was started in 32 patients, i.e. 71% of the patients, with a favorable evolution in 24 patients, i.e. 53%. Pneumocystis is a serious infection in immunocompromised patients especially PLHIV. In Morocco, it is still frequent during HIV infection and is one of the main causes of death.

Evaluation by RT-PCR of the Nasopharyngal Carriage Rate of SARS-CoV-2 Among Travelers Leaving the Country (Senegal)

Introduction: The new SARS-CoV-2 coronavirus, discovered at the end of 2019, led to a pandemic as early as March 2020, affecting all areas of life, and travelers were not spared. The objective of this work was to estimate the frequency of nasopharyngeal carriage of SARS-CoV-2 by RT-PCR in travelers leaving the country (Senegal) and to determine the factors associated with this carriage. Materials and Methods: This was a cross-sectional study conducted at the National Public Health Laboratory (LNSP) of Thiès from December 2020 to February 2021. It included 500 travelers selected by the convenience non- random sampling method. Demographic and clinical data were collected using a standardized form. The RT-PCR test was performed using nasopharyngeal samples. Results: 480 patients were declared asymptomatic. The RT-PCR positivity rate was 6% overall. The majority of patients came from the Thiès region (80%).The average age of the patients was 39 years old. The majority of patients (60%) were male. 2% of travelers had at least one medical comorbidity (diabetes, asthma and / or obesity). The most frequent clinical signs were cold 10% and cough 3.3%. Conclusion: Our results showed a low proportion of COVID-19 positive travelers. These patients were mainly elderly, male and asymptomatic.

INFLAMMATORY BOWEL DISEASE, SOCIAL IMPACTS AND QUALITY OF LIFE: A LITERATURE REVIEW

Inflammatory bowel disease (IBD) is a continuous total or partial inflammation of the digestive tract, with Crohn's disease and ulcerative colitis being the most common forms of presentation. The most frequent signs and symptoms consist of abdominal pain, fatigue, bloody stools, diarrhea, weight loss, and vomiting, and there may be extra-intestinal manifestations. In developed countries, an increased incidence of IBD has been observed, particularly in young people of working age, impacting their quality of life as well as physical, social and psychological aspects. This is because once diagnosed with IBD, individuals encounter coping challenges, difficulties in acceptance, and lifestyle changes. Therefore, we sought to analyze the social impacts and quality of life of patients diagnosed with Inflammatory Bowel Disease. A literature review was conducted in PubMed, SciELO, BVS and LILACS databases, 20 articles met the established criteria, of which 10 were selected to compose the study. Articles published between 2016 and 2021 and relevant to the topic were included, and those that did not meet the inclusion criteria or did not comprise primary data, and were duplicates were excluded. The analyzed studies showed that there was a reduction in quality of life in patients with IBD, presenting as main factors associated with this restriction the disease activity, socioeconomic factors, and the patient's age. It was denoted that this negative aspect causes limitations, mainly in the biopsychosocial performance of patients with this condition. Therefore, it is noteworthy that biopsychosocial impacts result from the manifestation of Inflammatory Bowel Disease, which demonstrates the need for a qualified and humanized multidisciplinary follow-up during the evolution of these patients.

Epidemiological, Clinical, and Therapeutic Aspects of Congenital Heart Disease in Two Teaching Hospitals in Yaounde-A Cross-sectional Study

The in-hospital prevalence, type, treatment, and outcome of Congenital Heart Disease (CHD) has not been described in our setting. We carried out a cross-sectional study in two teaching hospitals in Yaounde-The Yaounde University Teaching Hospital and the Chantal Biya Foundation (Mother-Child center). We retrospectively reviewed the records of all echocardiography confirmed cases of CHD seen between 2012 and 2018. A total of 105 patients (53 males and 52 females) were included in this study. The most frequent age groups were 1 to 6 months. The in-hospital prevalence of CHD was 8.7%. A heart murmur was the most frequent index sign in 97.1% followed by pneumonia in 41% of patients. Trisomia 21 was associated with 6.7% of cases. Non-cyanotic CHD was the most frequent in (74.4%), and these were mainly ventricular septal defect (42.9%) and atrial septal defect (25.7%) of all CHD. Tetralogy of Fallot was the most frequent cyanotic CHD in 13.3% of all cases. Complications due to CHD was seen in 38.1% of cases, and this mainly pulmonary hypertension in 22 (53.7%) cases. Surgical treatment was performed in 41.9% (all abroad) with a favorable outcome in all cases. CHD represents 8.7% of in-hospital pediatric admissions, and these were mainly acyanotic. Few patients had surgical correction abroad with a good outcome in all cases.

Clinical characterization of patients with inflammatory myopathy in 2 tertiary care hospitals in Colombia: A descriptive survey

BackgroundThere is little information on inflammatory myopathies in Colombia. The objective was to identify the demographic and clinical characteristics of these patients in two tertiary care hospitals between 2010 and 2015. Materials and methodsA descriptive, retrospective survey was carried out, by reviewing medical records and obtaining information on demographic and clinical variables. The qualitative variables were expressed using absolute and relative frequencies, and the quantitative with mean and standard deviation (SD), or median with interquartile ranges (IQR), depending on data distribution. The IBM SPSS 22 statistical package was used. ResultsA total of 105 patients with a mean age of 50.4 years (SD: 15.1) were included, with 76 (72.4%) women. In total, 50 subjects (48.5%) had a definitive diagnosis. The most common inflammatory myopathy was dermatomyositis (n = 66; 62.9%). The skin was the most commonly affected organ (n=66; 62.9%). Muscle weakness was present in 60 individuals (57.1%). The most frequent alarm sign was swallowing disorder (n = 28; 26.7%). Creatine phosphokinase was higher in polymyositis, with a median of 1800 IU/L (IQR: 365–6157). The most widely used drugs were glucocorticoids (n = 83; 79%). Some patients were refractory to immunosuppressive treatment, mainly in antisynthetase syndrome (n = 5; 35.7%). Five patients (4.8%) died of infections (pneumonia and bacteraemia). ConclusionsIn this cohort, the most common entity was dermatomyositis, and the most affected organ was the skin. There was a significant presentation of warning signs, refractoriness to immunosuppressive treatment, and lower muscle enzyme values compared to other cohorts. Mortality was mainly due to infectious complications.

Case Report on Benign Spindle Cell Tumour

Introduction: It's an extremely uncommon cancer. First, the epidermis, soft tissues, and connective tissues are impacted. Breast benign spindle cell lesions include a wide range of tumor-like or malignant fibroblastic and myofibroblastic entities. They should be made up entirely of Spindle cells (pure spindle cell lesions) are defined as lesions with no mixed epithelial component.&#x0D; Clinical Finding :&#x0D; Most Common Symptoms Of Spindle Cell Sarcoma.&#x0D; &#x0D; • Bone ache. The most frequent sign of spindle cell sarcoma is bone discomfort. The most often afflicted bones by spindle cell sarcoma are those of the...&#x0D; Swelling And Tenderness.&#x0D; Reduced Mobility.&#x0D; Fatigue And Malaise.&#x0D; Lump Or Mass.&#x0D; &#x0D; Diagnostic Evaluation: HB-6.7, TLC:-16, 200, PLT:-15, 000, MCV:-67.0, SR. BILIRUBIN:-0.7&#x0D; Therapeutic Intervention – Tab. Allopuraznol 300mg BD, Inj. Emset:- 1.8mg TDS. Inj. Pantop 12mg BD, Inj. Ceftraxon 20ml NS 1 mg BD.&#x0D; Outcome- Spindle cell tumours are uncommon cancers that develop in the peripheral and deep tissues of the body. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis.&#x0D; Conclusion: The patient is admitted to Acharya vinoba bhave rural hospital sawangi (meghe) wardha, under the USG department, where he will get ongoing medical and nursing care, and his health is currently stable and under monitoring.

Clinical and Laboratory Diagnostic Features of Kyasanur Forest Disease: A Study From Wayanad, South India

BackgroundKyasanur forest disease (KFD), also known as monkey fever, was first recognized in the Shimoga district of Karnataka, India, in 1957. This study was conceived to address the paucity of medical literature on KFD, to describe the clinical and laboratory features of real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) confirmed cases of KFD, and to detect any change in the clinical picture and presentation of the disease over the last 30 years.AimThe study sought to document the clinical and laboratory features of Kyasanur forest disease (KFD), a tick-borne arboviral disease, now emerging in many parts of southern India.Material and methodsThis was a retrospective study using secondary data of patients with real-time reverse transcription-polymerase chain reaction (rRT-PCR)-confirmed KFD in a secondary care hospital in Wayanad, Kerala, India.ResultsSixty rRT-PCR-proven KFD patients were included in the study. Commonly noted clinical symptoms were fever (98%), headache (80%), body ache (86%), vomiting (61%), and prostration (83%). Relative bradycardia, hypotension (45%), and oral lesions (23%) were the frequent physical signs. The median total leukocyte count and median platelet count at admission were 2600 per μL and 1.62 per μL, respectively. The median erythrocyte sedimentation rate was 10 mm/hr. Urinary sediments and albuminuria were seen in 66% and 60% respectively. The major complications observed were neurological complications (23%), bleeding manifestations (20%), and persistent shock (20%). The common neurological complications were seizures, altered sensorium, aseptic meningitis, and focal neurological deficits. The case fatality rate in the study was 6.7%.ConclusionsThe clinical picture of a prostrating viral syndrome in an epidemiological setting of KFD with marked leucopenia, moderate thrombocytopenia, low erythrocyte sedimentation rate (ESR), albuminuria, urinary sediments, and moderately elevated transaminases help in making an early diagnosis of KFD. Neurological complications in the initial two weeks are associated with poor outcomes.

COVID‐19 and older adults with Down syndrome: Presentation, complications and risk for mortality

BackgroundHealth conditions (including high rates of Alzheimer's disease, AD), immune dysfunction, and premature aging associated with trisomy 21 (Down syndrome, DS) may impact the clinical course of COVID‐19.MethodThe T21RS COVID‐19 Initiative launched an international survey for clinicians or caregivers on patients with COVID‐19 and DS. Data collected between April and October 2020 (N=1046) were analysed and compared with the UK ISARIC4C survey of hospitalized COVID‐19 patients with and without DS.ResultMortality rates in individuals with DS diagnosed with COVID‐19 showed a rapid increase from age 40 and were considerably higher in patients with DS (T21RS DS versus non‐DS patients: risk ratio (RR)=3.5 (95%‐CI=2.6;4.4), ISARIC4C DS versus non‐DS patients: RR=2.9 (95%‐CI=2.1;3.8)) even after adjusting for known risk factors for COVID‐19 mortality. Similar to the general population, the most frequent signs and symptoms of COVID‐19 were fever, cough, and shortness of breath. Joint/muscle pain and vomiting or nausea were less frequent (p<0.01), whereas altered consciousness/confusion were more frequent (p<0.01). Risk factors for hospitalization and mortality included age, male gender, diabetes, obesity, and AD, with the addition of congenital heart defects as a risk factor for hospitalization.ConclusionIndividuals with DS and COVID‐19 present with significantly higher rates of medical complications and mortality compared to general population peers, especially from age 40. The signs/symptoms of COVID‐19 and risk factors for severe disease course are similar to the general population. Those with dementia are at even greater risk, despite being younger than typical patients with AD. Individuals with Down syndrome should be prioritised for SARS‐Cov‐2 vaccination at younger ages than their peers in the general population.