SAS Journal of Medicine最新文献

{"title":"Is Hypovitaminosis D Associated with Increased Pain in Patients with Knee Osteoarthritis?","authors":"MK. Jnyah, I. E. Mezouar, N. Akasbi, T. Harzy","doi":"10.36347/sasjm.2024.v10i07.005","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.005","url":null,"abstract":"Objective: Osteoarthritis is considered the most frequent joint pathology mostly interesting the knee. Hypovitaminosis D, frequent during postmenopausal period, is usually found during osteoarthritis. The aim of this study was to investigate a possible association between hypovitaminosis D in patients followed for knee osteoartritis and an increase in pain. Material and Methods: This is a retrospective descriptive and analytical study including 228 patients followed up for knee osteoarthritis in rheumatology consultation between January 2021 and February 2023. Patients who received vitamin D supplementation were excluded. Results: Of 385 patients with knee osteoarthritis, 228 had a vitamin D dosage and were subject of our study. The average age was 60.15+/-11.17 years. 205 of these patients were women (91%) and 23 were men (9%). The mean duration of progression of knee osteoarthritis was 5.61+/-3.6 years. Vitamin D deficiency (<30ng/L) was observed in 89.5% and only 10,5% had normal vitamin D levels. 94.3% were on analgesic treatment and 54.2% on non-steroidal anti-inflammatory drugs. In univariate analysis, a low vitamin D level was strongly associated with painful knee osteoarthritis with the use of anti-inflammatory drugs and conventional analgesics with an Odds Ratio and a p respectively at OR=2.774(1.05-7.27) - p=0.03 and OR=3.44 (1.41-8.39) - p=0.004. Conclusion: According to our study, the association of hypovitaminosis D and knee osteoarthritis could be responsible of an increase in pain in our patients explaining an increased use of analgesics and anti-inflammatory drugs (NSAID).","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"102 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141682723","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":"Gastrointestinal Stromal Tumors: From Diagnosis to Adjuvant Therapy","authors":"K. Boualiten, S. Ouahid, S. Berrag, Fouad Nejjari, T. Adioui, M. Tamzaourte","doi":"10.36347/sasjm.2024.v10i07.004","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.004","url":null,"abstract":"Gastrointestinal stromal tumors (GISTs) represent a very rare form of digestive tract cancer belonging to the sarcoma family. The aim of this study is to establish the epidemiological profile, diagnostic challenges, and therapeutic difficulties of this malignant tumor in a developing country. A retrospective study, spanning 4 years from 2020 to 2023, was conducted in the Gastroenterology Department I at HMIMV in Rabat, identifying 37 cases of stromal tumors. The average age of our patients was 58 years. The average duration of disease progression was 4 months. Biopsy confirmed the diagnosis in 19 cases and surgery in 18 cases. The main histological form was spindle-shaped (67.6%). The GISTs in our series had an average tumor size of 8.4 cm, with C-Kit positivity in 36 cases. The risk of recurrence was established for all patients, with 17 being at high risk. In the staging evaluation, the tumor was localized in 83.8% of cases, locally advanced in 8.1%, and metastatic in 8.1%. Surgery was the primary treatment for the patients in our study. Drug treatment with imatinib was prescribed for 24 out of 37 patients in the series, accounting for 62.2% of cases. With an average follow-up of five years, the mean survival rate was over 70% at five years, with complete remission in 62.2% of cases, partial remission in 6.3%, tumor recurrence in 9.4%, and death in 15.6% of cases.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":" 97","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680329","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":"Wilson’s Disease in Children (About 52 Cases): Diagnostic and Therapeutic Difficulties","authors":"A. Afif, R. Kadraoui, M. Lagrine, R. Elqadiry, H. Nassih, A. Bourrahouat, I. Sab","doi":"10.36347/sasjm.2024.v10i07.006","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.006","url":null,"abstract":"Wilson's disease is an autosomal recessive inherited metabolic disease. It is characterized by toxic accumulation of copper in the body, mainly in the liver, central nervous system, and cornea. The aim of this work was to report our service's experience regarding the diagnostic, therapeutic, and evolutionary management of Wilson's disease. We conducted a descriptive and analytical retrospective study at the Pediatric B department of the Mohammed VI University Hospital Center in Marrakech over a period of 13years. Fifty-two cases of Wilson's disease were identified, with of which the average age at diagnosis was 10 years with extremes varying between 5 and 15 years. A male predominance of 54% was found, with a sex ratio of 1.15. Consanguinity was present in 32 cases. Clinical signs at admission were predominantly cholestatic jaundice in 38% of patients. Neurological signs, within an extrapyramidal syndrome, were found in 18 patients. Kayser-Fleisher rings were found in 35 children. Five patients were diagnosed through family screening. Biologically, a decrease in prothrombin levels at the time of diagnosis was found in 46 patients with cytolysis in 50 cases. Serum ceruloplasmin level was lowered in 46 patients, serum copper level was decreased in 41 patients, and urinary copper excretion was increased in 49 patients. Hemolytic anemia was found in 14 patients. Abdominal ultrasound revealed signs of portal hypertension on cirrhotic liver in 26 patients. Genetic testing was performed in 12 patients, revealing six different homozygous mutations in the ATP7B gene, except for 2 patients in whom no mutations were detected. Regarding treatment, D-Penicillamine is the cornerstone of Wilson's disease treatment, initiated in all patients along with adjunctive therapy and a low-copper diet, except for patients diagnosed through screening who were directly started on zinc acetate.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"77 s342","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141682771","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":"Cytomegalovirus Meningoencephalitis in an Immunocompromised Patient: Case Report and Review of Literature","authors":"Khairoun Saad, Elkabbaj Abdelmajid, Benhlima Abdelkader, Elhamzaoui Hamza, Alilou Mustapha","doi":"10.36347/sasjm.2024.v10i07.002","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.002","url":null,"abstract":"Cytomegalovirus (CMV), is a common virus that stays dormant after the initial infection but can reactivate in immunocompromised individuals, such as those with AIDS, leading to severe conditions. CMV affects 30% to 100% of people worldwide. CMV encephalitis is seen in at least 6% of untreated advanced HIV cases. This article presents a 42-year-old HIV-positive woman who developed CMV meningoencephalitis, resulting in septic shock. CMV can cause cytomegalia and various diseases including pneumonia, gastrointestinal disease, hepatitis, and, rarely, retinitis and meningitis/meningoencephalitis. Diagnosis typically involves detecting CMV DNA in the cerebrospinal fluid (CSF) through PCR.CMV causes diverse central nervous system lesions, but MRI often fails to detect these infections, as seen in this case. Treatment involves Ganciclovir or Foscarnet, starting with induction doses for at least two weeks, followed by maintenance doses for three to four weeks until symptoms resolve and viral load is negative. In immunosuppressed patients, ongoing maintenance or close monitoring is necessary.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"13 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687481","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":"Mediterranean Spotted Fever: Epidemiological, Clinical, Paraclinical, and Evolutionary Aspects: About 12 Cases","authors":"Khadija Danaoui, R. E. Fargani, Wiame Ait Driss, M. Idalene, N. Tassi","doi":"10.36347/sasjm.2024.v10i07.003","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.003","url":null,"abstract":"Mediterranean spotted fever (MSF) is a disease caused by an obligate intracellular bacterium: Rickettsia conorii, which infects humans through a vector (the brown dog tick). The first case of this infection was reported in Tunis in 1910 [1], and the characteristic inoculation lesion of the infection, or \"black spot,\" was subsequently described in 1925 in Marseille. In 1930, the role of the brown dog tick Rhipicephalus sanguineus in transmitting the disease was discovered [2], and the causal bacterium, R. conorii, was identified [2]. Through this retrospective study, we present an analysis of all patients treated for rickettsiosis between 2008 and 2022 at the infectious diseases department of CHU Mohamed VI in Marrakech, addressing epidemiological, clinical, paraclinical, and evolutionary aspects. Diagnosis should prompt immediate treatment with doxycycline to prevent any progression of the disease to severe forms, especially in patients with comorbidities.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"131 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687052","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":"Paraplegia and Pregnancy: A Rare Case of Autonomic Dysreflexia","authors":"Khairoun Saad, Touih Chakib, Mahfoud Hounaida, Tligui Samia, Oudghiri Nezha, Tachinante Rajae","doi":"10.36347/sasjm.2024.v10i07.001","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i07.001","url":null,"abstract":"Paraplegia involves the loss of motor and sensory functions in the trunk, lower limbs, and pelvic organs. While primarily traumatic, paraplegia can also stem from medical conditions. Women with spinal cord injury (SCI) can still conceive, but pregnancy carries unique risks, particularly autonomic hyperreflexia (AHR), a serious condition due to disrupted hypothalamic control over spinal reflexes. AHR, occurring in about 85% of pregnant women with SCI at or above the sixth thoracic vertebra, manifests as severe hypertension, headache, and cardiac arrhythmia, and can cause significant maternal-fetal morbidity. Pregnancy in women with SCI sees a 25% higher complication rate, including urinary tract infections, pressure ulcers, impaired pulmonary function, anemia, and venous thromboembolism. Urinary complications are common; regular monitoring and self-catheterization are recommended. Vaginal delivery is preferred unless AHR necessitates a cesarean section. Neuraxial analgesia is advised to reduce spasticity and prevent AHR during labor. Postpartum, local anesthetics should be extended to prevent AHR, ensuring better outcomes for both mother and child.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"27 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684506","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":"Unusual Manifestation of Post-Infectious Erythema Multiforme","authors":"Kaoutar Danaoui, Marouane Jakani, Imane Fetoui, Soumia Mrhar, K. Fakiri, Noureddine Rada, Ghizlane Draiss, M. Bouskraoui","doi":"10.36347/sasjm.2024.v10i04.005","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i04.005","url":null,"abstract":"Erythema multiforme presents as an acute skin rash characterized by symmetrical, round-shaped erythematous papules. It is typically triggered by herpes infections, Mycoplasma pneumoniae, or certain medications. In this case report, we describe a 12-year-old boy with no significant medical history who was admitted with gingivostomatitis and a generalized rash persisting for 5 days, accompanied by an unnoticed fever and declining overall health. Upon examination, the patient exhibited a fever of 39.2°C, gingivostomatitis characterized by erythematous plaques covered with vesicles across the lips, oral thrush, a maculopapular skin rash resembling erythema multiforme in a cockade pattern, and crusty lesions on an erythematous background in the genital area (penis and glans). The diagnosis confirmed erythema multiforme and gingivostomatitis caused by Chlamydia pneumoniae through respiratory PCR test and serological testing, which revealed elevated levels of IgM antibodies. Treatment with Clarithromycin resulted in significant clinical improvement, with lesion regression and achievement of a fever-free state within 72 hours. This case highlights the potential for atypical manifestations of Chlamydia pneumoniae infection in children.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"335 11‐12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703481","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":"Assessing Maternal Management of Childhood Illnesses in Anaocha Local Government Area, Anambra State: A Study of Home-Based Practices and Strategies","authors":"Solomon Chukwuemeka Anulia, A. Obi-Nwosu, G. Edeh, O. Ekwebene, Christian Chukwunulu Nwoye, S. J. Obiekwe, Kenneth Okezie Nwafor, John Kelenna Iregbu","doi":"10.36347/sasjm.2024.v10i04.004","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i04.004","url":null,"abstract":"Background: Children under 5 years are especially vulnerable to infectious diseases like malaria, pneumonia, diarrhea, HIV, and tuberculosis which are also the major causes of death among this age group. In this study, the three most common under 5 illnesses will be studied which are malaria, pneumonia, and diarrhea. Objectives: To ascertain the home management of childhood illness among mothers in Anaocha local government area of Anambra state. Methodology: This cross-sectional study was conducted among women and data collected using pretested interviewer administered questionnaire among 320 respondents. Results were analyzed using SPSS 25.0. Results: A total of 320 women were interviewed. Their mean age was 28.40±6.07 years, more than half of the respondents were within the age range of 20-29 years. Respondents who had heard about these illnesses before the study were 99.4%, 62.5% and 80.9% for malaria, pneumonia, and diarrhoea respectively. Majority of the respondents had good knowledge of symptoms of childhood illness, 222(69.4%) with an average knowledge score of about 56.4±21.0%. The relationship between educational level of mothers and preventive measure was statistically significant but there was no association between age and preventive measures. The prevalence of home management of the different childhood illnesses was 0.90, 0.81 and 0.36 for malaria, diarrhoea and pneumonia respectively. More than two-third of the respondents visited the hospital to seek for external assistance. The factors identified to cause delays in seeking medical care include cost of health care, 178(55.6%); and transportation, 159(49.7%). With respect to age, highest educational level attained, occupation of mothers and their relationship to visiting the hospital within 24hours of onset of illness, there was significant association with a p-value <0.05. Conclusion: It was found that mothers were able to recognise symptoms of childhood illnesses. Misconceptions about .............","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140717060","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":"Treatment of Ulnar Collateral Ligament Fracture-Avulsion of the Thumb: A Case Report","authors":"Liliana Sofia Amaral Domingues, João Duarte Gardete Gameiro, Rui Duarte Teixeira Cunha, InêsFilipa da Silva Domingues, João Miguel Fernandes Neves, Ana Catarina Bispo","doi":"10.36347/sasjm.2024.v10i04.003","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i04.003","url":null,"abstract":"Ulnar collateral ligament (UCL) injuries of the thumb, often termed \"gamekeeper's thumb,\" can result from falls or repetitive thumb abduction, predominantly affecting males. The severity ranges from stretching (grade I) to complete tearing (grade III), occasionally accompanied by avulsion fractures. Surgical intervention is advocated in some cases to restore joint stability and prevent osteoarthritis. The authors present a case report of a 51-year-old male with a displaced avulsion fracture at the UCL's distal attachment. Surgical treatment was performed. A lazy S dorsomedial approach over the first metacarpophalangeal joint was made, with careful protection of the dorsal cutaneous branches of the radial sensory nerve. An anatomic reduction of the fracture was achieved with the use of a suture passing k wire that was inserted through the avulsed fragment and then the phalanx and a non-absorbable suture (fiberwire) was passed. The free ends of the suture were securely tied on the distal radial side of the proximal phallanx, ensuring a stable fixation. Postoperative immobilization and rehabilitation led to a successful outcome, with the patient returning to work within 6 weeks, without complications. This case underscores the importance of surgical techniques in managing UCL injuries, emphasizing the restoration of joint stability to prevent long-term complications such as osteoarthritis, chronic pain and stiffness. The described method offers a viable option for treating UCL avulsion fractures, facilitating early recovery and preserving joint function.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"126 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140725734","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":"Prevalence and Associated Factors of Multimorbidity among Elderly People of Bangladesh","authors":"Manzila Manzur, Shahana Akter, Taslima Rahman, Sheikh Mahmood Hasan","doi":"10.36347/sasjm.2024.v10i04.002","DOIUrl":"https://doi.org/10.36347/sasjm.2024.v10i04.002","url":null,"abstract":"Background: Human aging is a dynamic and progressive natural process which is depends on interacting hereditary, biological, social, environmental, historical and cultural factors that determine the quality of life of an older individual. Multimorbidity was defined as the co‐occurrence of at least two chronic diseases in a person whether as a coincidence or not. Little attention has been paid to the study of the prevalence of multimorbidity among the elderly in Bangladesh. The study aimed to find out the prevalence and associated factors of multimorbidity among elderly people of Bangladesh. Methods: It was a hospital-based cross-sectional study, conducted in Department of Community Medicine, International Nursing College, Tongi, Bangladesh from January to December 2022. Data were collected from 250 participants. Categorical data were presented as proportion, and continuous data were presented as mean (SD). The Chi-square test and multivariate logistic regression were used to find out the association between frailty and other variables. Results: Total Two hundred fifty eligible elderly persons were approached for the study. So, were analysed (response rate = 85%). The mean age (SD) of the participants was 70 (7.0) years. About half (55.2%) of them were female, 48% were living in a rural areas, and 68% were Muslim by religion. About two-thirds (58%) of participants were married (currently in union), and were living with either their spouses or children. Nearly one-third (64.4%) of participants were illiterate. The prevalence of multimorbidity was significantly higher among women than among men, among illiterate than among literate persons, among persons who belonged to the non-poorest quintiles than among the poorest quintile, and also significantly higher among single than among married persons. The most common disorders were arthritis (57.2%) and hypertension (38.4%). The prevalence of arthritis was significantly higher among the illiterate than among the ..........","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737277","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}