SAS Journal of Medicine最新文献

{"title":"Pneumorenal Syndrome Complicating ANCA-Negative Pauci-Immune Vasculitis Associated with Atypical Mycobacteriosis: Case Report","authors":"Clément Havyarimana, Gérard Dalvius, H. Bothard, B. Bigirimana, B. N. Kaza, G. Medkouri, M. Zamd, S. Khayat, N. Mtioui, M. Benghanem","doi":"10.36347/sasjm.2023.v09i11.014","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i11.014","url":null,"abstract":"Among the forms of pneumorenal syndrome (PRS), one of the most urgent is characterized by the combination of diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis (RPGN). In 90% of cases, it is the manifestation of an autoimmune disease, such as pauci-immune vasculitis with anti-neutrophil cytoplasmic antibodies (ANCA) or Goodpasture's disease with the presence of antibodies directed against the basement membrane of the glomerular and alveolar capillaries (anti-GBM). These antibodies are absent in approximately 10% of cases with histological confirmation in the context of rare clinical situations. We report a case of a 66-year-old patient, with a history of alcoholism and active smoking, who was admitted to the hospital for respiratory distress with hemoptysis. The admission assessment showed severe renal failure requiring hemodialysis upon admission. ANCA and anti-GBM, as well as all other autoantibodies were negative. A renal biopsy revealed pauci-immune extra-capillary glomerulonephritis with the majority of chronic lesions. The orientation of the diagnostic approach in search of other causes of pauci-immune vasculitis with negative antibodies has been initiated. He was treated with glucocorticoids in combination with cyclophosphamide. The initial evolution was marked by the improvement of respiratory symptoms and a less considerable recovery of renal function. PRS can develop without the presence of ANCA or other autoantibodies. The diagnosis is then made by histology. Renal damage, such as extra-capillary glomerulonephritis (GN), is more severe and has a very poor prognosis with a high risk of mortality. The absence of ANCA should never delay diagnosis and treatment.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"19 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139277454","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":"Ultrasound Imaging: Differentiating Benign and Malignant Hepatic Tumors","authors":"Mada Elsheikh Hasan, Hala Khouri","doi":"10.36347/sasjm.2023.v09i11.012","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i11.012","url":null,"abstract":"Hepatic tumors, whether benign or malignant, pose significant health concerns and require accurate diagnosis for appropriate treatment planning. Among the various imaging modalities available, ultrasound plays a crucial role in the initial evaluation of hepatic lesions due to its widespread availability, cost-effectiveness, and lack of ionizing radiation. Ultrasound is a tomographic imaging technique that can provide anatomical and functional images with high resolution and great flexibility at low cost [22]. In ultrasound contrast is produced by the tissues’ structure at submillimeter level and is chiefly attributable to the differences in rigidity and density between fluids, watery tissue, connective tissue and fat. The tomograms are formed very rapidly, allowing real time imaging so that studies are quick and interactive. Immediate viewing of tissue motion is intrinsic to ultrasound imaging. The procedure is well tolerated, the only practical problem for the liver being abdominal tenderness that may make probe contact painful. This article aims to explore the utility of ultrasound in differentiating between benign and malignant hepatic tumors.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"71 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139280157","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":"CINCA Syndrome: about a Series of 5 Cases","authors":"O. Saidi, K. Mouaadine, A. Bentahilla, B. Chkirat","doi":"10.36347/sasjm.2023.v09i11.013","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i11.013","url":null,"abstract":"CINCA is a chronic auto-inflammatory syndrome of childhood characterized by a combination of skin, joint and neurological involvement, including sensory organs, due to a mutation in the NLRP3 gene responsible for uncontrolled activation of innate immunity. Our objective is to establish the epidemiological, clinical, genetic, therapeutic and evolutionary characteristics of the CINCA syndrome. Materials & Methods: Retrospective analysis spread over 16 years (2000 to 2016) of 05 cases of CINCA syndrome, followed up at the pediatric rheumatology department and consultation at the Rabat children's hospital. Results: There were 03 boys and 02 girls, the mean age at diagnosis was 2 years and 02 months. 01 patient was from consanguineous parents (1st degree). Clinical signs were recurrent fever in all patients, osteoarticular involvement in 80% with patellar hypertrophy in 01 patient, skin involvement in 80%, neurological involvement in 60%, no sensory involvement, dysmorphic facies in 60% of cases, and staturo-ponderal retardation in 60%. None of the patients had renal amyloidosis. Biological tests revealed an inflammatory syndrome in all our patients, and joint radiographs showed a modelling disorder of the lower femoral metaphyses associated with osteoporosis in one patient, and epiphyseal remodelling with irregular ossification of the patellae in another. A genetic study was carried out in only 01 cases, revealing a mutation in the CIAS 1 gene. Biotherapy was not used in view of the clinical and biological improvement with NSAIDs and/or corticosteroids. CINCA syndrome is rare but can be serious and often goes unrecognized. Diagnostic and therapeutic management must be rapid in order to avoid serious complications, particularly ocular and renal, and to improve vital and functional prognosis.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"25 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139280014","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":"Epidemiologic and Histopathologic Patterns of Head and Neck Cancers: A Single Institution Cohort of 1,702 Patients and a Review of the Literature","authors":"Mouna Khouchani, T. Igarramen, Youssef Darouassi, M. Darfaoui","doi":"10.36347/sasjm.2023.v09i09.005","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i09.005","url":null,"abstract":"Head and neck cancers (HNC) are the third most common cancers worldwide. They are a heterogeneous group of malignant tumors that affect various anatomical sites, including oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, thyroid gland, salivary glands, nasal cavity and paranasal sinuses. In Morocco, there is a lack of epidemiological data due to the absence of a national or regional cancer registry. The present study aimed to describe the epidemiological, anatomopathological and evolutionary aspects of HNC in the southern region of Morocco. The study evaluated data from 1702 patients with HNC between 2009 and 2019. Our results showed that the main anatomical site was the nasopharynx (33.02%), and the most common histopathological type was squamous cell carcinoma (55.76%). Our study clearly showed that smoking and poor oral hygiene were the main risk factors for HNC. Thus, the present study should be considered as a first attempt to develop a national cancer registry and to shed light on the evolutionary patterns of HNC epidemiology and histopathology in Morocco.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129291441","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":"Seizure Incidence in Patients under Clozapine","authors":"A. Tounsi, F. Azraf, Siham Belbachir, A. Ouanass","doi":"10.36347/sasjm.2023.v09i09.004","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i09.004","url":null,"abstract":"Clozapine can cause potentially fatal side effects, including seizures. In the absence of therapeutic alternatives, well-coded guidelines are required for the management of this adverse effect in order to maintain treatment. Our aim is to determine the incidence of seizures associated with clozapine use in our hospital, to study the factors associated with this side effect, and to establish a clear, unified attitude based on a review of the literature. Among 483 patients treated with clozapine, 11 cases of seizures were reported, with a rate of 2.27% and an incidence of 1.62 cases per 1000 person-years. 80% of these patients presented tonic-clonic seizures, preceded by myoclonus in 2 cases, and the average seizure onset dose was estimated at 560mg/day. The course of action varied from one psychiatrist to another. Clozapine was discontinued in the case of one patient after the first episode, and doses were reduced in 8 patients from 28 to 75% of the therapeutic dose reached before. Six patients received additional antiepileptic agent.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125163556","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":"Pulmonary Artery Aneurysm: Case Report","authors":"Nour Said, A. H. Keita, Y. Bouktib, A. E. Hajjami, B. Boutakiout, M. Idrissi, Najat Cherif Idrissi El Ganounin","doi":"10.36347/sasjm.2023.v09i09.003","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i09.003","url":null,"abstract":"Pulmonary artery aneurysm is a rare entity. It results from various etiologies, congenital or acquired. We present the case of a 62-year-old man with a history of congenital heart disease who presented with dyspnea for 3 years. Angioscan showed an aneurysmal dilatation of the pulmonary artery trunk and its right branch associated with an atrial septal defect with restenosis of the pulmonary valve. The restenosis of the pulmonary valve and the atrial septal defect were therefore considered to be the etiological factors responsible for the aneurysm in our patient.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"206 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134154855","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":"Giant Retroperitoneal Liposarcoma: Case Report","authors":"Nour Said, Asma Mourchad, A. E. Hajjami, B. Boutakiout, M. Idrissi, Najat Cherif Idrissi El Ganounin","doi":"10.36347/sasjm.2023.v09i09.001","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i09.001","url":null,"abstract":"Retroperitoneal liposarcoma is a rare, primitive, mesenchymal malignant tumour. It develops quietly in the retroperitoneal region due to the complacency of the space, with a huge mass compressing neighbouring organs being discovered at the time of diagnosis. We report the case of a retroperitoneal liposarcoma in a 36-year-old female patient who presented with abdominal distension and pain. The diagnosis was made on imaging and confirmed by pathology.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128539186","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":"Contribution of Molecular Biology in the Diagnosis and Follow-Up of Chronic Myeloid Leukemia","authors":"H. Bennani, A. E. Ouarradi, H. Lazrek, H. Yahyaoui, M. Chakour","doi":"10.36347/sasjm.2023.v09i08.018","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.018","url":null,"abstract":"Background: The advent of tyrosine kinase inhibitors and the evolution of molecular biology techniques have revolutionized the management and outcome of patients with chronic myeloid leukemia, it is currently considered a model of carcinogenesis and successful targeted therapy. Methods: Our study was retrospective, descriptive and observational, carried out within the hematology laboratory of the Avicenna Military Hospital in Marrakech, spread over a period of 6 years and included a total of 10 patients from the department of clinical hematology. The aim of our study was to highlight the impact of molecular biology, in particular the GeneXpert technique, on the diagnosis and monitoring of Chronic myeloid leukemia (CML), and to discuss afterwards the different techniques as well as their contribution. Results: Regarding the diagnostic data; all of our patients underwent a complete blood count, myelogram, and bone marrow karyotype. The complete blood count (CBC) showed leukocytosis in 100% of cases, thrombocytosis and anemia in 80% of cases. The myelogram showed a medullary blastosis with a rate <10% in 90% of the cases, thus classifying them in the chronic phase. At karyotype, all patients had the translocation (9; 22). Concerning molecular biology, quantification of the BCR-ABL transcript by GeneXpert was performed in 60% of patients, only 20% of cases benefited from both the quantitative study by GeneXpert and the qualitative study by multiplex PCR. During treatment, 80% of our patients were put on hydroxyurea pending confirmation of the diagnosis. Later on, all of our patients were treated with first-line imatinib, of which 3 (30%) had treatment failure requiring to be put on second-linenilotinib. Of these, 2 were treated with third-line dasatinib. GeneXpert was used for follow-up, a major molecular response (MMR) was achieved in 70% of the cases with an average delay of 9 months. The profiling of patients who obtained an MMR showed a male predominance ...........","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127571314","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":"The Epidemiological and Therapeutic Profile of Oropharyngeal Cancers: Experience of the Onco-Radiotherapy Department of the Mohamed VI University Hospital, Marrakech: A Report on 46 Cases","authors":"O. E. Kadiri, R. Ousalm, D. Slitine, M. Darfaoui, A. Omrani, Mouna Khouchani","doi":"10.36347/sasjm.2023.v09i08.017","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.017","url":null,"abstract":"Oropharyngeal squamous cell carcinoma (OPSCC), commonly known as throat cancer or tonsil cancer, is a type of head and neck cancer that refers to the cancer of the base and posterior one-third of the tongue, the tonsils, soft palate, and posterior and lateral pharyngeal walls. The incidence of OPSCC is increasing in both old and young populations at an alarming level. Radiotherapy is the traditional treatment for oropharyngeal cancer because of its ability to preserve anatomic form and function compared with other conventional curative options. The patterns of presentation, stage distributions, tumor bulk, biology and tolerance to intensive radical treatment may differ in developing countries and different ethnic populations.This activity aim to illustrate the evaluation and management of oropharyngeal squamous cell carcinoma in our context and highlights the role of conventional radical radiotherapy in the treatment.","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132807722","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":"Clinical and Diagnostic Findings Among Tubercular Meningitis Patients without Pulmonary Signs and Symptoms","authors":"Sayat Quayum, Md. Titu Miah, Tanzil Ferdous, S. Shahaly, S. Chowdhury, F. Yousuf, Syed Mohimeen Ahmed","doi":"10.36347/sasjm.2023.v09i08.015","DOIUrl":"https://doi.org/10.36347/sasjm.2023.v09i08.015","url":null,"abstract":"Background: Tubercular meningitis (TBM) is the most frequent one among the different forms of CNS tuberculosis. Early diagnosis, as well as treatment of tubercular meningitis (TBM), can give an excellent outcome with minimal residual morbidity. Clinical and diagnostic findings of patients without pulmonary signs and symptoms may be useful for the treatment of suspected tubercular meningitis patients. Aim of the study: This study aimed to make a patient profile on the clinical and diagnostic findings of tubercular meningitis patients without pulmonary signs and symptoms. Methods: This cross-sectional study was conducted in the Department of Medicine, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from September 2020 to August 2021. A total of 77 confirmed cases of tubercular meningitis without pulmonary signs and symptoms admitted to the mentioned hospital were enrolled in this study as the study population. A purposive sampling technic was used in sample selection. Along with the clinical and diagnostic findings, all relevant information was recorded in a data collection sheet. Results: In this study, 61% of the study population had a family history of TB. Among all the patients, all had fever, 80.5% had headache, 68.8% had altered sensation, 62.3% had anorexia and nausea, 55.8% had vomiting, 19.5% had a convulsion and 15.6% had neck stiffness. In our settings, the majority (46.8%) of the respondents had TBM Grade II. The mean WBC count was 134.80±34.59 106/L, Lymphocyte (%) was 79.49±11.77, Glucose was 26.49±5.43 mg/dl, Protein was 142.8±72.5 and ADA level was 12.08±1.29 U/L. In our settings, 58.4% of the respondents had Mantoux test and 36.4% showed chest X-ray positive. In this study, 22.1% of the respondents had CT scan or MRI findings normal. Conclusion: A family history of tuberculosis may be a potential factor for TBM. Fever, headache, altered sensation, anorexia/nausea and vomiting are very common clinical features in such patients. Chest X-ray ..","PeriodicalId":193141,"journal":{"name":"SAS Journal of Medicine","volume":"552 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133281910","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}