PAMJ Clinical Medicine最新文献

{"title":"Embolie pulmonaire hydatique: rare complication du kyste hydatique du poumon: à propos d´un cas","authors":"K. Bouytse, Bouchra Daher, J. Achrane, M. Aharmim, J. Bourkadi","doi":"10.11604/pamj-cm.2021.6.28.25637","DOIUrl":"https://doi.org/10.11604/pamj-cm.2021.6.28.25637","url":null,"abstract":"L´embolie pulmonaire hydatique est une pathologie rare, Elle resulte le plus souvent de la rupture d´un kyste dans les cavites cardiaques droites et plus rarement de celle d´un kyste hepatique dans la circulation veineuse de retour. Son diagnostic est particulierement difficile, dont le traitement est mal codifie et dont le pronostic est generalement pejoratif. Nous rapportons uneobservation d´embolie pulmonaire provenant d´invasion directe de l´artere pulmonaire par un kyste hydatique, et dont l´evolution etait defavorable dans notre cas.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132675515","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":"Pregnant with a failing heart: an obstetrician's nightmare: a case report","authors":"A. Doku, A. Yakubu, T. Boafor, Winfred Baah, David Kwame Asare, D. Ahadzi, Perez Sepenu, Jeffrey Agyapong, E. O. Darkwa","doi":"10.11604/pamj-cm.2021.6.26.30568","DOIUrl":"https://doi.org/10.11604/pamj-cm.2021.6.26.30568","url":null,"abstract":"Pre-existing medical conditions can adversely affect pregnancy outcomes for women and their offspring, especially in resource-poor settings in Africa. Women with underlying severe medical conditions who choose to continue with their pregnancy or present late for antenatal care would require care by experienced physicians at tertiary care centers. Approximately 1% of pregnancies are complicated by cardiac disease which may deteriorate with the increased demands of pregnancy. We present a case to illustrate the challenges and dilemmas encountered in the management of pregnant women with severe pre-existing medical conditions and the role of an interdisciplinary team in the care of these women and their unborn babies.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121277742","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":"Primary intestinal lymphangiectasia associated to epilepsy: a case report","authors":"Jallouli Olfa, Ben Nsir Sihem, Bouchaala Wafa, Kamoun Fatma, T. Chahnez","doi":"10.11604/pamj-cm.2021.6.27.29503","DOIUrl":"https://doi.org/10.11604/pamj-cm.2021.6.27.29503","url":null,"abstract":"Seizures occur frequently in inflammatory diseases. Primary Intestinal Lymphangiectasia (PIL) is a systemic disorder but epilepsy was not reported before. In this paper, we presented the case of 17 years old boy, diagnosed for PIL, who developed by the age of 16 recurrent epileptic seizures. The epilepsy was confirmed, the patient was treated with carbamazepine with good outcomes. Epilepsy may occur in patients with PIL, and doctors should be aware and treat seizures when the diagnosis of symptomatic acute seizures is excluded.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126352027","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":"Un cas de syndactylie bilatérale complexe, complète et compliquée","authors":"I. Niang, Ndeye Bigué Mar","doi":"10.11604/pamj-cm.2021.6.24.29870","DOIUrl":"https://doi.org/10.11604/pamj-cm.2021.6.24.29870","url":null,"abstract":"Nous rapportons le cas d´une patiente de 21ans, nee avec une malformation bilaterale des mains consistant en une syndactylie des 3eme et 4eme rayons de chaque cote, sans autre anomalie congenitale associee. Dans le but de faire corriger le gene fonctionnel et esthetique cause par cette malformation, elle a consulte en orthopedie. Une radiographie des mains (A, B) a ete realisee pour determiner le type de syndactylie et les eventuelles anomalies osseuses des mains associees. Elle a permis de mettre en evidence une syndactylie bilaterale complexe, complete et compliquee avec a droite comme a gauche, une bifidite des phalanges du 4eme rayon formant une synostose avec le 3eme rayon. Le reste des os et articulations de la main sont d´aspect normal.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"58 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116433399","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":"Survival of asthma patients attended at Chitungwiza Central Hospital in Zimbabwe","authors":"Pisirai Ndarukwa, M. Chimbari, E. Sibanda","doi":"10.11604/pamj-cm.2021.6.19.27063","DOIUrl":"https://doi.org/10.11604/pamj-cm.2021.6.19.27063","url":null,"abstract":"INTRODUCTION: Asthma is a leading global public health problem. Itis estimated that 300 thousand people die annually from asthma worldwide. In Zimbabwe 9/100 000 population died from asthma in 2014, accounting for 1.02% of total deaths. The association between asthma survival and socio-demographic and pathologic factors has not been evaluated in Zimbabwe. The purpose of our study was to determine the survival of patients with asthma at Chitungwiza Central Hospital, Zimbabwe over a period of 20 years (1997 to 2017). METHODS: records for 158 asthma patients were analysed in this retrospective cohort study. The patient records were sampled from the computerised health information department at the hospital. Data were collected using a patient record checklist that was divided into four sections: (i) demographic information, (ii) clinical characteristics of asthma patients, (iii) health service utilization and (iv) asthma self-management. Descriptive data analysis was performed using the Kaplan Meier survival function curves. The Kaplan Meier survival curves were differentiated by the log-rank test, median survival times and mortality rates. Significant hazard ratios were used for multivariate cox regression model and a test on proportional hazards assumption based on Schoenfeld residuals were conducted. RESULTS: the total follow-up time was 2208 person years. The study showed that 94/153(61.4%) had since died. The median age at death was 25.5 years (IQR; 21-34). Smoking history [p=<0.001], presence of respiratory disease and cardiovascular disease [p=0.002] were significantly associated with a higher proportion of death in the cohort. A multivariate cox proportional hazards analysis after controlling for smoking history and history of rhinitis showed that seeing same doctor for asthma had a HR=0.22(CI 0.07-0.62; p=0.005 and being hospitalised in the past 2 years for asthma had a HR=3.61 (CI 1.42-9.16; p=0.007. CONCLUSION: the study concluded that having a history of smoking and presence of comorbidities such as respiratory and cardiovascular diseases could increase risk of death among the patients.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134358755","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":"Hope or desperation? A pseudocyesis in advanced maternal age in a woman with recurrent miscarriages: a case report and literature review","authors":"G. Murewanhema, A. Ziruma, M. Nyakanda, M. Madziyire","doi":"10.11604/pamj-cm.2021.6.18.30101","DOIUrl":"https://doi.org/10.11604/pamj-cm.2021.6.18.30101","url":null,"abstract":"A pseudocyesis, which is a false impression by a woman that she is carrying a foetus, with accompanying pregnancy-related changes, is a vexing psychological phenomenon. The condition is rare, and the underlying mechanisms are not yet fully elucidated. However, pseudocyesis more commonly occurs among women of lower socioeconomic status with a chronic history of subfertility. Disadvantaged socioeconomic circumstances can lead to delayed presentation, with disappointment for the woman when she is eventually informed that she is not pregnant. To contribute to the body of literature regarding pseudocyesis, we present and discuss the case of 44-year-old woman with a history of nine recurrent miscarriages who was referred from the local clinic with elevated blood pressures after late booking at 36 weeks, without prior antenatal care or ultrasound scan. Subsequent clinical examination and ultrasonography revealed an empty uterus, leading to a diagnosis of a pseudocyesis. The patient was appropriately referred to the psychiatrists and physicians for further management.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128857198","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":"Sécurité de l´anesthésie générale hors bloc opératoire pour la réalisation des gestes diagnostiques et thérapeutiques chez l´enfant","authors":"Z. Addou, N. T. Aoul, A. Dali-Ali, A. Douah, N. Aouffen","doi":"10.11604/pamj-cm.2021.6.17.26772","DOIUrl":"https://doi.org/10.11604/pamj-cm.2021.6.17.26772","url":null,"abstract":"Prodiguer une anesthesie generale hors bloc pour les gestes diagnostiques et therapeutiques chez l´enfant permet de diminuer la douleur generee par ses actes. L´objectif de notre etude est de determiner la nature, la frequence et les facteurs predictifs de survenue d´effets indesirables. C´est une etude prospective observationnelle realisee au niveau de l´hopital pediatrique d´Oran de janvier 2012-decembre 2015. Les donnees recueillies etaient les caracteristiques demographiques, les gestes realises, les produits anesthesiques et les effets indesirables de l´anesthesie hors bloc. Dans l´etude 663 enfants etaient inclus. L´âge moyen etait de 5,48±0,34 ans. Les gestes etaient realises pour l´hemato-oncologie (36,3%) suivis de la radiologie (23%) et de la bronchoscopie (21%). Le propofol etait utilise seul dans 38% et associe aux opioides dans 21,2%. La ketamine etait utilisee dans 29,6% et 14,4% des enfants avaient presente des effets indesirables. Les risques majeurs representaient 1,6%. Ils comprenaient une desaturation severe (1,6%), une apnee prolongee (0,6%) et un cas a presente un arret cardiaque. Les interventions majeures etaient realisees dans 0,3% des cas. Deux (2) patients etaient intubes et un cas a necessite un massage cardiaque. Les facteurs de risques de survenue d´effets indesirables en analyse multivariee etaient la presence de pathologie cardiaque (Odds ratio adjuste (ORa) 3,7 : (intervalle de confiance (IC) 95% 1,03-13,79 ; P<0,05), l´adjonction du fentanyl au propofol (ORa) 2,3 : IC 95% 1,30-4,27 ; p<0,001) et la bronchoscopie (ORa) 4,06 : IC 95% 2,22-7,44 ; p <0,001). L´anesthesie hors bloc realisee dans un environnement sur par une equipe specialisee a comporte un risque faible d´effets indesirables. Une prise en charge optimale de ces complications n´a entraine aucune consequence majeure.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122856634","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":"Aspects épidémiologiques et thérapeutiques de l´insuffisance cardiaque au Service de Cardiologie du CHU de Kati","authors":"Coumba Thiam Doumbia, A. Maiga, D. Fofana, B. Sonfo, S. Diallo, S. Daffe, Abdoul Wahab Terra, S. Sidibé, S. Sidibé, M. Konaté, H. Bâ, Y. Camara, M. Camara, Zoumana Sangare, I. Menta, M. Diarra","doi":"10.11604/PAMJ-CM.2021.6.1.24183","DOIUrl":"https://doi.org/10.11604/PAMJ-CM.2021.6.1.24183","url":null,"abstract":"L´insuffisance cardiaque est une pathologie frequent au sein de notre population. Son incidence n´a cesse de croitre dans nos pays en voie de developpement. Il s´agit de decrire les aspects epidemiologiques, therapeutiques, et de determiner les facteurs influencant l´observance therapeutique des patients suivis pour insuffisance cardiaque dans le Service de Cardiologie du CHU de Kati. Il s´agit d´une etude transversale descriptive, concernant tous les patients admis en hospitalisation ou suivis en ambulatoire dans le service pour insuffisance cardiaque, de janvier a avril 2018. Au total 93 cas ont ete inclus, le sexe masculin a ete predominant (52 cas) soit un sex ratio de 1,26. La tranche d´âge (60 - 74 ans) a ete la plus representee 30,1 % des cas. Les menageres ont represente 25,8 % de l´echantillon, plus de la moitie des patients (68,8%) n´ont pas eu de subvention de leur prise en charge. L´ecart de regime a ete la principale cause de decompensation (34,4%), les raisons economiques etaient le principal motif de rupture therapeutique (40,6%). Les diuretiques (91,30%) ont ete les plus prescrits. Le cout global moyen d´hospitalisation a ete de 203.289 francs CFA. L´insuffisance cardiaque constitue une affection frequente en pratique cardiologique au Mali, le diagnostic doit etre precoce, pour mettre en œuvre les therapeutiques efficaces, avec des couts raisonnables et accessibles au cas par cas.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124651284","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":"Opacités pulmonaires multiples révélant une bilharziose : à propos d´un cas malgache","authors":"M. Randrianarivony, S. Ratsimbazafy, Hitsy Andraina Razafindrazaka, Ida Marie Rahantamalala, Anjara Marie Nandimbiniaina, Yves Imbert, H. Vololontiana","doi":"10.11604/PAMJ-CM.2021.5.44.21891","DOIUrl":"https://doi.org/10.11604/PAMJ-CM.2021.5.44.21891","url":null,"abstract":"Madagascar est un pays endemique de la bilharziose. Dans la plupart des cas, les patients sont diagnostiques au stade des complications de la bilharziose. Peu d´observation d´une atteinte pulmonaire de bilharziose etait rapporte malgre l´endemicite du parasite dans le pays. Notre objectif est de rapporter le cas et d´inciter la recherche bilharziose pulmonaire en cas de poumon eosinophile. Une femme malgache de 41 ans est hospitalisee pour une toux seche febrile. Elle n´est pas asthmatique, ni d´allergie et ne fume pas. L´interrogatoire revele une notion de baignade dans une riviere dans la region sud-ouest du pays. L´examen clinique restait normal. Un scanner thoracique montrait des multiples lesions nodulaires, diffuse, intra-parenchymateuses. L´hyper eosinophilie sanguine associee a un Polymerase Chain Reaction (PCR) positif a Schistosoma Mansoni permet de poser le diagnostic de la bilharziose pulmonaire. L´evolution clinico-biologique est favorable apres traitement par pranziquantel. Le scanner pulmonaire de controle a deux mois montre la disparition des nodules intra-parenchymateux.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114477237","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":"Agénésie pulmonaire droite : rapport de 2 cas dans le Service de Pédiatrie de l’Hôpital du Mali de 2015-2019","authors":"B. Kané, M. Camara, Seydou Togo, B. Touré, Mohamed Traoré, M. Ouattara, B. Togo","doi":"10.11604/PAMJ-CM.2021.5.16.23232","DOIUrl":"https://doi.org/10.11604/PAMJ-CM.2021.5.16.23232","url":null,"abstract":"L´agenesie pulmonaire est une anomalie congenitale rare definie par l´absence totale de parenchyme, des bronches et des vaisseaux. Elle est souvent associee aux malformations. Nous rapportons 2 cas d´agenesie pulmonaire droite diagnostiques dans le Service de Pediatrie de l´Hopital du Mali. Le premier patient etait un nourrisson de 2 mois, de sexe masculin, ne a terme par cesarienne. Il n´a pas ete reanime a la naissance. Il a ete hospitalise pour detresse respiratoire aigue. Le diagnostic d´agenesie pulmonaire droite a ete confirme par le scanner thoracique. Il n´ y avait pas d´autres malformations associees. Le second patient etait un nourrisson de 3 mois, de sexe feminin, ne a terme par voie basse avec une bonne adaptation. Il est admis pour dyspnee aigue. Le diagnostic a ete confirme par le scanner thoracique. L´agenesie pulmonaire droite etait associee aux anomalies squelettiques. L´agenesie pulmonaire unilaterale une cause rare de la detresse respiratoire. Le scanner thoracique est essentiel pour son diagnostic. Son traitement consiste a traiter et a prevenir les infections broncho-pulmonaires du poumon controlateral.","PeriodicalId":397112,"journal":{"name":"PAMJ Clinical Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134488392","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}