Annals of African Medicine最新文献

{"title":"Drug-induced Liver Injury Following Prolonged use of Nitrofurantoin.","authors":"Manthan Dhingra, Abhra Ghosh","doi":"10.4103/aam.aam_113_23","DOIUrl":"10.4103/aam.aam_113_23","url":null,"abstract":"<p><p>Nitrofurantoin is the antibiotic of choice for treatment and prophylaxis of recurrent episodes of lower urinary tract infections. Although adverse effects such as anorexia, vomiting, and pulmonary hypersensitivity are commonly reported with nitrofurantoin use, studies have demonstrated that rarely nitrofurantoin can also induce diverse forms of liver injury, spanning from mild hepatitis to severe and potentially fatal fulminant liver failure. These occur especially in elderly females with preexisting liver or renal impairment. Here, we present a case of a 62-year-old female in good health who exhibited symptoms of fatigue, abdominal pain, and dark-colored urine. Through investigation, she was diagnosed with a case of drug-induced liver injury associated with the prolonged use of nitrofurantoin.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"514-517"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Stroke-related Seizures and their Predictive Factors: A Tertiary Care Center Experience.","authors":"Erum Shariff, Saima Nazish, Azra Zafar, Rizwana Shahid, Danah Aljaafari, Nehad Mahmoud Soltan, Ahmed Mohamed Farhan, Fahd A Alkhamis, Mohammed AlShurem, Osama Faisal Hassan Basheir, Foziah Alshamrani, Aishah Ibrahim Albakr, Omar Al Ghamdi, Abdulla A AlSulaiman, Majed Al Abdali","doi":"10.4103/aam.aam_15_23","DOIUrl":"10.4103/aam.aam_15_23","url":null,"abstract":"<p><strong>Background and purpose: </strong>Various risk factors have been described in the literature that increase the risk of seizures associated with stroke. This study was aimed to determine the occurrence rate of poststroke seizures (PSSs) and the associated risk factors in Arab population.</p><p><strong>Materials and methods: </strong>Study included all stroke patients aged >18 years with a minimum follow-up of 24 months following stroke to identify seizure occurrence. Patient's hospital records for all admissions and clinic visits were reviewed. Seizures were classified into early PSS if they occur within 1 week of stroke, and late PSS if they occur after 1 week of stroke.</p><p><strong>Results: </strong>Out of 594 patients, 380 were males. Seizure occurrence was higher in anterior circulation infarctions (94.8%, P < 0.05), cortical location (80.5%, P < 0.05), large artery atherosclerosis (63.8%, P < 0.05), lower activated partial thromboplastin time (APTT) (P = 0.0007), patients with ischemic heart disease (IHD) (P = 0.01), and those who underwent craniotomy (P = 0.001). Nonhigh-density lipoprotein cholesterol was inversely related to PSS (P = 0.01). Higher stroke severity (89%) and confusion (67%) at the time of presentation were independently related to PSS.</p><p><strong>Conclusions: </strong>Eighty-two (13.8%) patients had PSS. Greater stroke severity at presentation with altered sensorium was independent risk factors for the development of PSS. Patients with underlying IHD, lower APTT, and undergoing neurosurgical intervention require vigilant monitoring for PSS.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"285-290"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperkinesias in Leigh-like Syndrome with Complex-I Deficiency Due to m.10191T>C in MT-ND3.","authors":"Shaundra M Newstead, Josef Finsterer","doi":"10.4103/aam.aam_32_23","DOIUrl":"10.4103/aam.aam_32_23","url":null,"abstract":"<p><p>Hyperkinesias in a patient with complex-I deficiency due to the variant m.10191T>C in MT-ND3 have not been previously reported. The patient is a 32 years-old female with multisystem mitochondrial disease due to variant m.10191T>C in MT-ND3, who has been experiencing episodic, spontaneous or induced abnormal movements since age 23. The abnormal movements started as right hemi-athetosis, bilateral dystonia of the legs, or unilateral dystonia of the right arm and leg. They often progressed to severe ballism, involving the trunk, and limbs. The arms were more dystonic than the legs. In conclusion, complex-I deficiency due to the variant m.10191T>C in MT-ND3 may manifest as multisystem disease including hyperkinesias. Neurologists should be aware of hyperkinesias as a manifestation of complex-I deficiency.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"512-513"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Small-bowel Obstruction: An Appraisal of Common Etiology and Management at the Federal Medical Centre, Keffi, North-central Nigeria.","authors":"Adeyinka A Adejumo, Mojirola I Alegbejo-Olarinoye, Shattah M Akims, Olusola O Akanbi","doi":"10.4103/aam.aam_111_23","DOIUrl":"10.4103/aam.aam_111_23","url":null,"abstract":"<p><strong>Background: </strong>Acute small intestinal obstruction is a common surgical emergency in the sub-Saharan region. Over the decades, complicated inguinal hernias have been identified as a leading cause. However, we observed from our clinical practice that complicated inguinal hernias were not the most common etiology.</p><p><strong>Aims and objectives: </strong>This study aimed to evaluate the common etiology of acute small bowel obstruction in the study center and compare our findings with that from other centers and existing literature.</p><p><strong>Materials and methods: </strong>This was a retrospective, cross sectional study carried out over a period of five years (January 2017 to December 2021). This study looked at the patients presenting with acute, mechanical, small bowel obstruction that did not respond to conservative treatment in our hospital facility. Relevant information were extracted from patients' clinical details and entered into the proforma prepared for this study.</p><p><strong>Results: </strong>A total of 147 patients were recruited into this study out of which 85(57.8%) were males and 62 (42.2%) were females (M:F=1.44:1). Majority (80.3%) of the patients that presented with post-operative bowel adhesion had previous appendectomy. Simple bowel obstruction was seen in 93 (63.3%) patients while strangulated obstruction and gangrenous bowel were seen in 26 (17.7%) patients and 22 (15.0%) patients respectively. Majority (47.6%) of the patients had adhesiolysis done while others had bowel resection.</p><p><strong>Conclusion: </strong>The common cause of acute small bowel obstruction as observed in this study is post-operative adhesions arising from previous appendectomy and laparotomies.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"313-316"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of P-selectin Levels in Psoriasis, Vitiligo, and Nonskin Disease in a Tertiary Care Hospital: A Case-Control Study.","authors":"Jeetendra Kumar, Sunita Tiwari, Swastika Suvirya, Narsingh Verma, Monika Chaudhary, Shyam Kumar Gupta","doi":"10.4103/aam.aam_132_23","DOIUrl":"10.4103/aam.aam_132_23","url":null,"abstract":"<p><strong>Introduction: </strong>The role and function of P-selectin levels in various inflammatory and immune-mediated diseases have been established. Whether they have an association with inflammatory skin diseases such as vitiligo and psoriasis needs to be established.</p><p><strong>Objective: </strong>The objective of this study was to assess P-selectin levels in psoriasis and vitiligo and to compare them with matched controls without skin disease.</p><p><strong>Materials and methods: </strong>The study included a total of 90 subjects with age- and sex-matched - 30 each in psoriasis, vitiligo and 30 controls without skin disease. Psoriasis and vitiligo severity was assessed using the Psoriasis Area and Severity Index and the Vitiligo Area Scoring Index scores. P-selectin levels were assessed and compared among the groups. P-selectin levels were also compared with the severity of psoriasis and vitiligo. Chi-square and analysis of variance tests were used to compare the data.</p><p><strong>Results: </strong>The mean age of subjects was 36.28 ± 11.80 years. Majority of the subjects were males (65.6%). The three groups were matched for age, sex, and other demographics. The mean P-selectin levels were 610.43 ± 134.19, 292.52 ± 60.99, and 158.97 ± 34.76 ng/ml, respectively, in the psoriasis, vitiligo, and control groups, respectively (P < 0.001). No significant association of P-selectin levels was observed with psoriasis severity; however, with increasing vitiligo severity, there was a significant increase in P-selectin levels (P < 0.001).</p><p><strong>Conclusion: </strong>Patients with skin diseases have raised P-selectin levels. Within skin diseases, inflammatory diseases such as psoriasis have higher P-selectin levels as compared to autoimmune diseases such as vitiligo. A significant association of P-selectin levels was observed with vitiligo severity but not with psoriasis severity.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"307-312"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stokes-Adams Syndrome as a Presenting Feature of Hypoadrenalism: A Rare Presentation.","authors":"Kanishka Kumar, Rupam Kumar, Mahima Pandey, Rajeev Verma","doi":"10.4103/aam.aam_154_22","DOIUrl":"10.4103/aam.aam_154_22","url":null,"abstract":"<p><p>Addison's disease is known to cause hyperkalemia. However, heart block as a result of such hyperkalemia is very rare. We report one such case where Addison's disease presented with hyperkalemia and resultant heart block and Stokes-Adam's syndrome along with other features of hypoadrenalism.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"509-511"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of Community-acquired Acute Kidney Injury and Hospital-acquired Acute Kidney Injury from a Tertiary Care Hospital in North India.","authors":"Munna Lal Patel, Rekha Sachan, Rahul Kumar","doi":"10.4103/aam.aam_110_23","DOIUrl":"10.4103/aam.aam_110_23","url":null,"abstract":"<p><strong>Background: </strong>In this observational study, clinical characteristics, etiologies, and outcomes of patients admitted to the hospital with community-acquired acute kidney injury (CAAKI) have been compared in contrast to those who hospital-acquired Acute Kidney Injury (HAAKI).</p><p><strong>Methods: </strong>This was a prospective study of adults aged 18 years or above diagnosed with acute kidney injury (AKI) over a period of 17 months at a tertiary care hospital.</p><p><strong>Results: </strong>230 patients had AKI with the mean age of the study population being 45.33 ± 12.68 years. 178 (77.4%) patients were enrolled from medical unit, 25 (10.7%) from surgical unit, and 27 (11.7%) from obstetrical unit. The observed incidence of AKI was 15/1000 admissions. About 58.2% had CAAKI and 96 (43.7%) had HAAKI. Out of 230 patients, 170 (73.9%) patients were male and 60 (26.1%) were female. Sepsis was the most common (52.1%) etiology of AKI among the medical cases. Urosepsis, scrub typhus, and pneumonia were the most common causes of AKI. Sixty percent of AKI was Kidney Disease Improving Global Outcomes Stage 1 or 2 and 40% was in Stage 3. Oliguria was seen in 56.5%, hyperkalemia in 34.7%, fluid overload in 6.1%, and metabolic acidosis in 22.6%. The majority of patients had multiple organ involvement (52.1%) at the time of enrollment. About 116 (50.4%) had lung injury requiring mechanical ventilation and 95 (41.3%) were on inotropes. Mortality occurred in 19.5%. Anemia, the use of vasopressor drugs, and the need for intensive care support were independent predictive factors for mortality.</p><p><strong>Conclusion: </strong>AKI was common in hospitalized patients and leads to significant inhospital mortality. AKI is largely a CAAKI, and the lesser extent is due to HAAKI. Many causes are potentially preventable. Early fluid resuscitation, effective antibiotics, appropriate antidotes, and timely referral of established AKI patients to centers with dialysis facilities can improve AKI outcomes.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"420-428"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It Physician or Individual or Both: Whose Preference Matters Finally?","authors":"Mrinalini Verma, Sanjay Singhal, Divya Kukreja","doi":"10.4103/aam.aam_115_23","DOIUrl":"10.4103/aam.aam_115_23","url":null,"abstract":"","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"525-527"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Teachers' Roles from the Students' Perspective: A Moroccan National Survey-based Study.","authors":"Youness Touissi, Ayoub Kharkhach, Ghita Hjiej, Abderrazak Hajjioui, Maryam Fourtassi","doi":"10.4103/aam.aam_14_23","DOIUrl":"10.4103/aam.aam_14_23","url":null,"abstract":"<p><strong>Background: </strong>The present study aimed to explore medical students' expectations from their teachers in Moroccan medical schools, regarding their primary educational roles.</p><p><strong>Methods: </strong>An online questionnaire was distributed to medical students from the five main public medical schools in Morocco using a snowball sampling strategy.</p><p><strong>Results: </strong>Two thousand four hundred and eighteen complete answers were collected and analyzed. The respondents gave the highest scores to \"information provider\" and the lowest scores to \"Planner.\" When asked about their most preferred role they would want to see in their teachers, 40.6% of the respondents chose \"Facilitator.\"</p><p><strong>Conclusion: </strong>These results highlight that Moroccan medical schools should become more invested in training their faculty members to meet the rapidly changing demands and requirements of modern medical education.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"291-294"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Venous Sinus Thrombosis Secondary to Vitamin B12 Deficiency - A Case Series with Emphasis on Food Fortification.","authors":"Neena Baby, Minu George, Arjun Rajasekharan, Sachin Ajith, Mohammed Zabeer, Sureshkumar Radhakrishnan","doi":"10.4103/aam.aam_138_23","DOIUrl":"10.4103/aam.aam_138_23","url":null,"abstract":"<p><p>The etiology of cerebral venous sinus thrombosis (CVST) is multifactorial. Although many acquired and genetic factors have been recognized as risk factors, hyperhomocysteinemia (hHcy) is independently associated with CVST. We describe three cases of CVST in this case series. All of them presented with headache. Two patients had papilledema and visual disturbances. On evaluation, there was CVST, and prothrombotic workup showed hHcy. In addition, two of them reported very low Vitamin B12 levels. All of them were treated with low-molecular-weight heparin followed by oral anticoagulation and Vitamin B6, B9, and B12 supplements. All of them responded to treatment, and follow-up imaging studies in two of them showed resolution of thrombosis. hHcy should be considered in the evaluation of CVST, especially in the setting of a pure vegetarian diet. Fortification of the diet with Vitamin B12 may be considered the majority of Indians consume predominantly vegetarian food.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"23 3","pages":"496-500"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}