SAS Journal of Medicine最新文献

{"title":"Unanticipated Gangrenous Cholecystitis in a Healthy Young Adult: A Case Report Highlighting the Role of Advanced Imaging","authors":"I. Bounnite, S. Moussaoui, A. E. Ouali, M. Lebied, C. Mountassir, G. Lembarki, M. Sabiri, S. Lezar","doi":"10.36347/sasjm.2024.v10i07.017","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.017","url":null,"abstract":"Background: Gangrenous cholecystitis (GC) is a severe form of acute cholecystitis, usually seen in patients with risk factors like advanced age or diabetes. This report highlights a rare case of GC in a young adult with no identifiable risk factors diagnosed by ultrasound and MRI. Case Presentation: A 22-year-old male with no significant medical history presented with a 20-day history of right hypochondrial pain and vomiting. Clinical examination revealed tenderness in the right upper quadrant with a positive Murphy's sign. Laboratory tests showed mildly elevated liver enzymes and inflammatory markers. Ultrasound and MRI indicated a distended, multi-lithiasic gallbladder with irregular thickened walls, presence of floating membranes in the vesicular lumen and discontinuous enhancement post-contrast administration. An urgent laparoscopic cholecystectomy confirmed severe inflammation and necrosis. Histopathology validated the diagnosis of gangrenous cholecystitis. Discussion: The imaging findings were consistent with known indicators of GC, including gallbladder wall thickening and intraluminal membranes. MRI provided critical diagnostic information. This case underscores the importance of considering GC even in young, healthy individuals. Conclusion: Advanced imaging techniques are crucial for the early diagnosis and management of gangrenous cholecystitis, significantly impacting patient outcomes through timely intervention.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"122 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657048","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}

{"title":"Management of Strictures in Crohn's Disease: Surgery Versus Medical Treatment","authors":"F. Mghyly, H. E. Bacha, S. Mechhor, M. Cherkaoui, N. Benzzoubeir, I. Errabih","doi":"10.36347/sasjm.2024.v10i07.016","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.016","url":null,"abstract":"Introduction: Crohn's disease (CD) is a chronic inflammatory affection of the digestive tract that progresses towards intestinal destruction leading to a stenosing form, and the management of these stenoses is often multidisciplinary, medico-surgical. In the light of the data in the literature, we will study the efficacy of medical treatment and the place of surgery in the management of strictures in crohn's disease. Materials and Methods: This is a retrospective descriptive study over a 5-year period, including all patients with stenotic phenotype Crohn's Disease who are followed in our departement. Results: We included 109 patients with stenotic phenotype crohn's disease. The mean age of our patients was 43 years, there were 70 women and 39 men, with a sex ratio of 1.8. In terms of therapeutic management, 71 patients (65% of the total) received medical treatment as first-line therapy, including 22 patients (20.2%) who received corticosteroids first. Disease-modifying therapy was based on immunosuppressants in 45 patients (41.3%), and 26 patients (23.8%) received anti-TNF in mono or combination therapy. Progression was marked by a good therapeutic response without recourse to surgery in 35 patients (32% of all patients), while 36 patients (33%) did not respond and underwent surgery after failure of medical treatment. 38 patients (35%) underwent surgical treatment in the first instance, post-operative disease-modifying therapy consisted of Anti TNF, in mon or combination therapy, in 16 patients, immunosuppressive therapy in 20, while two patients remained clinically and endoscopically quiescent on no disease-modifying therapy. Discussion: In the absence of symptoms, simple monitoring is required, and consequently no treatment is recommended. But in the case of symptomatic stenosis, the management of small bowel stenosis depends on the intensity of occlusive symptoms, the association with immunosuppressive therapy and morphological criteria assessed ............","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141659559","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}

{"title":"When Religion Gets Involved in the Treatment of Scabies: About A Case in the University Clinic of Dermatology and Venerology of ‘Centre National Hospitalier Universitaire Hubert Koutoukou Maga’ of Cotonou","authors":"F. Akpadjan, BP Kitha, C. Balola, D. Tounouga, D. Assogba, E. Adégbidi, L. Dotsop, MC Legonou, F. Mastaki, B. Degboe, H. Adégbidi, F. Atadokpèdé","doi":"10.36347/sasjm.2024.v10i07.015","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.015","url":null,"abstract":"Scabies is a current and highly pruritic ectoparasitic infection caused by Sarcoptes scabiei var. Hominis. It is a highly contagious parasitic infection with specific lesions, like burrows, and non-specific lesions like papules, vesicles and excoriations. The typical regions touched are the palms, wrists, axillary folds, abdomen, buttocks, breast folds and, in men, the genitals. This disease is characterized by an intense nightly pruritus. Scabies is transmitted by close personal contact (parents, sexual partners, pupils, chronic diseases and over populated communities). The final diagnosis is made when the the scabies’ parasites or their eggs or fecal matter are identified in the optical microscope. New diagnostic approaches include the use of épiluminescence. For our case, it was 33-year-old patient, police officer and animist who consulted for a generalized pruritus with lesions evolving continuously since a week. The pruritus was more intense at night and a colleague was reported to have similar symptoms. As treatment he drank herbal tea. No particular medical background was noted. Before this clinical presentation, scabies was diagnosed. The HIV test was negative. No parasitology test was run. The patient was treated with topical benzyl benzoate, permethrine for his surrounding and ivermectine. Note should be taken that the patient categorically refused the topical treatment for religious purposes. We finally prescribed ivermectine for him and permethrine for his surrounding. Seen two weeks later, the evolution was favorable. The patient is whole, his spiritual dimension is very important for his equilibrium and it is important for us to know that and see him through. Let us remember that as concerns this patient, neglecting this aspect is synonym to losing track of him and lengthening the disease’s transmission chain (think of his other colleagues, his family, and especially the “patients” he cures with herbal medicine.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"44 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660124","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}

{"title":"Imaging Characteristics of the Spheno-Orbital Meningioma: Literature Review","authors":"J. Bouanani, S. Outaghyame, A. Diani, M. Bouroumane, M. Benzalim, S. A. Lj","doi":"10.36347/sasjm.2024.v10i07.012","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.012","url":null,"abstract":"Spheno-orbital meningioma is a subtype of ectopic meningiomas in which meningothelial cells invade the bone wall and lead to hyperostosis [1]. They originate from the meninge of the sphenoid ridge and invade the orbit after infiltrating the underlying sphenoid wings, and sometimes extend to involve the optic canal or the sphenoidal fissure. It is typically benign, with a slow evolution, asymptomatic, and often incidentally discovered during imaging evaluation, exophthalmos remains the predominant clinical sign. We report the case of a 49-year-old female patient who presents with progressive onset left unilateral exophthalmos. Examination reveals non-reducible, painless axial exophthalmos. The aim of this case is to describe imaging characteristics of spheno-orbital meningioma and to review the literature on this subject.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"48 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663133","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}

{"title":"Study of Microalbuminuria in Type 2 Diabetic Patients in the Reference Health Center of Commune VI of the Bamako District","authors":"B. Berté, D. K, A. Koné, M. Bah, C. D, Koné, A. T, D. I, B. B, C. A, D. M, B. Maiga, G. H, F. N. Coulibaly, D. Sow","doi":"10.36347/sasjm.2024.v10i07.014","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.014","url":null,"abstract":"Introduction: Diabetes is a group of metabolic diseases characterized by chronic hyperglycemia of variable degree resulting from a defect in insulin secretion and/or its action. Diabetic nephropathy is a common complication of diabetes, which in the early stage is characterized by a slight increase in urinary albumin excretion. Objective: To study micro albuminuria in type 2 diabetics in the diabetology-endocrinology unit of the Reference Health Center of Commune VI of Bamako. Methodology: We carried out a retrospective and prospective analytical study for one year from November 2021 to October 2022. This study described the sociodemographic and clinical variables. It focused on the prevalence of micro albuminuria in diabetics apart from urinary infection in the diabetology-endocrinology service unit of the Reference Health Center of Commune VI of Bamako. All type 2 diabetic patients with micro albuminuria less than 300 mg/24 hours apart from any urinary infection with or without hypertension were included in this study. Result: During the study period, 100 type 2 diabetic patients, whether hypertensive or not, were recruited, among whom 38 presented micro albuminuria with a hospital frequency of 38%. The sex ratio was 0.61, the average age was 56.79 years with extremes of 40 and 79 years. In our study, 40% of patients were overweight, more than half were at the stage of diabetic nephropathy. HyperLDLdemia was (17%). Hypertension was the most common associated risk factor and affected 55% of patients. Smoking was present in 20%. Retinopathy was present in 18%. Neurological complications represent 67%. Cardiomyopathy was the most represented cardiovascular complication with 17%. Conclusion: Micro albuminuria can appear at any age of development of diabetes. Whether or not it is associated with other risk factors remains decisive; it is the first paraclinical sign of diabetic nephropathy.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"115 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665971","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}

{"title":"Psychological and Neurological Impact of Oral Isotretinoin in Jordanian Subjects with Acne Vulgaris","authors":"Shefaa Almashaqbeh, Salah Abdallat, Alsharif Mohammad Fawwaz, Waseem Alsaleem, Jehad Alassaf","doi":"10.36347/sasjm.2024.v10i07.011","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.011","url":null,"abstract":"Background: Acne Vulgaris is the most frequent skin disease worldwide, reaching 70–87%. Isotretinoin a first class synthetic 13-cis-retinoid originated from Vitamin A is used for the management of Acne Vulgaris. The incidence of overall major depressive diseases worldwide is 13–16%. The incidence of psychological adverse effects in subjects managed using oral isotretinoin is 25.16%. Aim: To assess the psychological and neurological influence of oral isotretinoin in Jordanian subjects with Acne Vulgaris. Methods: Our retrospective investigation included 185 Jordanian subjects, of both sexes, aged 16-24 years, with severe nodulocystic Acne Vulgaris and on oral isotretinoin for (A) determination of: (1) intensity of Acne Vulgaris using the visual analog scale score (VAS-S: 0-100), (2) psychological impact using the Hamilton anxiety rating scale score (HAM-ARS-S:0-56) with the Montgomery Asberg depression rating scale score (MADRS-S:0-60) and (3) neurological adverse effects, all through baseline up to the fourth interview during a period of 4 months, one month apart and (B) screening for the need of antipsychotic medication after withdrawal of oral isotretinoin, at Prince Talal military hospital, JRMS, Mafraq, JORDAN, during the period Mar.2021-Aug.2023. Results: There was a remarkable enhancement in VAS-S through baseline up to the fourth interview (P<0.005). At first interview, the average VAS-S increased from 0 to 22.65. There was a remarkable increase in MADRS-S through baseline up to the fourth interview (P<0.005) with mild depression in 3 subjects (1.6%) and moderate depression in 1 subject (0.5%). There was a remarkable reduction in HAM-ARS-S during all interviews. (P<0.005). At the 3rd interview, 11 subjects (5.9%) were in the range of moderate anxiety and at the fourth interview, 4 subjects (2.2%) were in the range of severe anxiety. The most common neurological adverse effect was headache with most frequency at the fourth interview (135(72.97%)). ............","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":" 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668464","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}

{"title":"Cardiac Hydatid Cyst of the Interventricular Septum, an Incidental Finding in a 6-Year-Old Girl: Case Report and Review of Literature","authors":"H. Dahman, S. Kirami, A. Hajjami, B. Boutakioute, M. Idrissi, N. E. Ganouni","doi":"10.36347/sasjm.2024.v10i07.010","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.010","url":null,"abstract":"Cardiac hydatid cysts are rare and represent less than 2% of all hydatid cases. They can occur as part of a widespread systemic infection or as an isolated event. Cardiac hydatic cysts rarely involve the interventricular septum, they also usually evolve slowly, explaining their rarity in children. We report in this work, an incidental finding of a cardiac hydatid cyst located in the interventricular septum in a 6-year-old girl, during an abdominal ultrasound exam performed after minor abdominal trauma.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672480","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}

{"title":"Intracranial Dural Arteriovenous Fistula with Perimedullary Venous Drainage: A Case Report","authors":"I. Bounnite, A. Bencheikh, S. Moussaoui, A. E. Ouali, M. Lebied, C. Mountassir, G. Lembarki, M. Sabiri, S. Lezar","doi":"10.36347/sasjm.2024.v10i07.007","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.007","url":null,"abstract":"Intracranial dural arteriovenous fistulas with perimedullary venous drainage are indeed very rare cerebral vascular malformations. They can present with symptoms such as rapidly progressive ascending myelopathy associated with dysautonomia, complicating the diagnostic process and delaying therapeutic intervention. We present the case of a 26-year-old patient admitted to the neurosurgical department for an evolving medullary syndrome caused by an intracranial dural fistula with perimedullary venous drainage. The diagnosis was suspected on a cerebro-medullary MRI, which visualized an arteriovenous shunt at the level of the left superior petrosal sinus and at the level of the ipsilateral internal cerebral vein. The MRI also showed signs of edematous distress of the pontine and tiered medullary regions.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":" 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676009","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}

{"title":"Neonatal Mortality: Experience of Pediatric Emergency Department","authors":"R. Dahni, S. E. Moussaoui, W. Lahmini, M. Bourrous","doi":"10.36347/sasjm.2024.v10i07.009","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.009","url":null,"abstract":"Introduction: Neonatal mortality is a global health problem that has been at the heart of World Health Organization (WHO) programs for more than 30 years. In Morocco, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. We conducted this study to assess the prevalence of neonatal mortality, determine its causes and risk factors, and propose preventive measures to reduce this rate. Methods: This was a retrospective descriptive and analytical study conducted over a period of four and a half years, from January 2016 to June 2020, in the Pediatric Emergency Department of the Centre Hospitalier Universitaire Mohamed VI in Marrakech. Results: We recorded 268 deaths, representing a neonatal mortality rate of 18.3%, with a preponderance of early neonatal deaths (73.9%). The sex ratio was 1.45 in favor of males. Mean age at death was 6.5 days. 70% of pregnancies were poorly attended, medical deliveries accounted for 86% in our serie, and 90.5% of deliveries were vaginal. The majority of deaths occurred in parturients aged between 20 and 29 years (57.3%), and 28.5% of deaths occurred in primiparous women. The prematurity rate was 49.2%, and 58% of the newborns who died had a low birth weight. Prematurity was the leading cause of neonatal mortality (49.2%), followed by neonatal infection (38.5%) and perinatal asphyxia (12.3%). Conclusion: Effective management of pregnancy and the newborn in the first week of life should improve neonatal prognosis.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673808","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}

{"title":"Imaging of Gliomatosis Peritonei Following an Immature Ovarian Teratoma: A Case Report","authors":"I. Bounnite, A. Benamara, A. E. Ouali, S. Moussaoui, M. Lebied, C. Mountassir, G. Lembarki, M. Sabiri, S. Lezar","doi":"10.36347/sasjm.2024.v10i07.008","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.008","url":null,"abstract":"Peritoneal gliomatosis is defined by the implantation of mature glial tissue on the surface of the peritoneum or intraperitoneal organs, very often found in association with mature or immature teratoma. The report the case of a 23-year-old woman presenting a surgical history of left ovariectomy for immature ovarian teratoma five years prior followed by chemotherapy, presents for abdominal pain for which an abdominal ultrasound and MRI were performed and showed a right hepatic mass in connection with a peritoneal gliomatosis.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676116","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}