Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in t...Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases;those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.展开更多
Liver cancer is the malignant transformation of liver cells. It develops in 90% of cases of cirrhosis, more rarely on chronic non-cirrhotic liver disease, and exceptionally in a healthy liver. This study aimed to inve...Liver cancer is the malignant transformation of liver cells. It develops in 90% of cases of cirrhosis, more rarely on chronic non-cirrhotic liver disease, and exceptionally in a healthy liver. This study aimed to investigate the clinical aspects of Hepatocellular Carcinoma (HCC). It was a retrospective descriptive study covering 10 years, focusing on HCC cases seen in outpatient and inpatient settings at the Internal Medicine Department. We recorded 153 cases out of 7021 patient records, resulting in a hospital frequency of 2.17%. The male-to-female ratio was 3.5. The mean age was 52.37 ± 14.34 years. The most common presenting complaint was pain in 16.3% of cases. A history of jaundice was found in 25.5% of cases. Alcohol consumption was observed in 15.38% of cases. The main physical sign found was hepatomegaly in 76% of cases. HBsAg was positive in 33.3% of cases. Alpha-fetoprotein levels were above 400 IU/ml in 50.81% of cases. Patients classified as CHILD PUGH A represented 39.72% of cases. Abdominal ultrasound revealed portal thrombosis associated with heterogeneous multinodular hepatomegaly in 11% of cases. Cytology confirmed HCC in four out of six patients who underwent the examination. We recorded 63 deaths out of 111 hospitalized patients. Complications included encephalopathy, hematemesis, and ascites in 48 patients. Hepatocellular carcinoma remains a significant public health issue. Its predominance in men and its occurrence in adults with factors such as viral infections and ethylism mean that prevention of this pathology could greatly reduce its incidence.展开更多
Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in ad...Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in adults, the second leading cause of dementia (after Alzheimer’s disease), and the third leading cause of death (after cancer and cardiovascular disease). It’s also a major cause of depression. The objective of our study was to describe the epidemiological, clinical and evolutionary aspects of stroke in the internal medicine department of Tivaouane Hospital. Material and Method: This is a retrospective study carried out from January 1, 2015 to December 31, 2018 on the files of patients hospitalized for stroke in the medical department of the EPS1 in Tivaouane. We took into account all the patients who had a brain CT (computed tomography) scan. We collected data related to socio-demographic characteristics, history, risk factors, reasons for admission, clinical signs, paraclinical examinations, as well as evolution. Results: Out of 1999 patients, 206 files of patients with stroke were collected, i.e. a proportion of 10.3%. Our study population had a mean age of 65.53 years [16 - 97 years]. We noted a clear predominance of women (50.5%). The majority of the population came from the outskirts of Tivaouane (56.7%). Risk factors for stroke were dominated by hypertension (90.3%), dyslipidemia (19.4%), previous stroke (18.9%), and diabetes (16%). The clinical signs were dominated by a motor deficit (94.1%), speech disorders (67.4%) and consciousness disorders (47%). Ischemic strokes were predominant (65%) over hemorrhagic strokes (34.5%). The outcome was generally unfavorable with 14.6% total recovery, 58.7% recovery with sequelae and a case fatality of 26.7%. Conclusion: It emerges from this study that strokes still remain a real public health problem. Knowledge of populations of risk factors as well as their proper management is fundamental in primary prevention strategies, the only guarantee for a reduction in the still very high morbidity and mortality of this disease.展开更多
Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% -...Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage IV, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.展开更多
Pernicious anemia in black people, is little known. Through this study we assess its diagnostic and evolutive aspects, and compare vitamin therapy B12 intramuscular and oral. Sixty six Biermer disease patients followe...Pernicious anemia in black people, is little known. Through this study we assess its diagnostic and evolutive aspects, and compare vitamin therapy B12 intramuscular and oral. Sixty six Biermer disease patients followed (January 2000-June 2014) at Internal Medicine Department of Aristide Le Dantec University Teaching Hospital (Senegal) are included. They were 26 men and 46 women (gender ratio: 0.65), who had a mean age of 47.84 years ± 15.25 years. Patients consulted for anemia (65 cases), acquired melanodermia (36 cases), gastrointestinal symptoms (30 cases), peripheral neuropathy (27 cases), venous thrombosis (2 cases), acute depression (1 case). Macrocytosis was observed in 52 cases. The mean hemoglobin in the vitamin B12 intramuscular group (52 patients) or oral group (14 patients) was the inclusion: 6.55 g/dl ± 3.12 g/dl vs 6.52 g/dl ± 2.18 g/dl (p = 0.04);and at day 8 treatment: 8.69 g/dl ± 2.49 g/dl vs 8.85 g/dl ± 1.9 g/dl (p = 0.43). Neurological and vascular presentations are unusual in contrast to macrocytic anemia. Oral administration of vitamin B12, simple and effective should be recommended in country with limited resources.展开更多
<strong>Introduction:</strong> Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study c...<strong>Introduction:</strong> Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. <strong>Objectives:</strong> To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. <strong>Materials and Methods:</strong> This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, <i>i.e. </i> duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. <strong>Results:</strong> We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, <i>i.e. </i> a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. Hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. <i>Escherichia coli, Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i> represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. <strong>Conclusion:</strong> Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.展开更多
<strong>Introduction:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""> The metabolic syndrome is a clinical entity defined by the association ...<strong>Introduction:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""> The metabolic syndrome is a clinical entity defined by the association in the same subject of four of the following five factors: abdominal obesity (or android), type 2 diabetes, hypertension, hypo HDL cholesterolemia, hypertriglyceridemia. The aim of the work was to study the epidemiological, clinical-biological profiles and complications of patients in the cardiology and internal medicine department of the Mother-Child CHU “Luxembourg”. <b>Materials and Methods:</b> We carried out a cross-sectional study, from September 2019 to June 2020 in the cardiology and internal department of the mother-child CHU “Luxembourg”. All patients with metabolic syndrome admitted to the two departments who agreed to participate during the study period were included in the study. These patients meet the 2009 harmonization attempt criteria (IDF 2009). The variables studied were: socio-demographic characteristics (sex, age, profession), pathological history, clinical signs (functional signs, BMI, waist size), paraclinical signs (ECG, cardiac ultrasound, laboratory assessment) and complications. <b>Results:</b> A total of 104 patients were included. The female sex represented 58.65% of cases. The 60 to 69 age group was the majority with 40.78%, housewives occupied 41.34% of cases. Diabetes, arterial hypertension and dyslipidemia were the most represented cardiovascular risk factors with respectively: 80.77%, 79.81% and 53.85%. Visual blurring was the most common functional sign with 23.08% of cases. Moderate obesity was observed in 34% of patients. Waist circumference was high in 39.53% of male patients and 37.70% of female patients. Cardiac ultrasound found a severely collapsed ejection fraction in 25% of patients. HDL-c levels were low in 64.52% of male patients and 75% of female patients. The most observed complications were: dyslipidemia (53.85%), stroke and renal failure with 23% respectively</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">. </span><span style="white-space:normal;font-size:10pt;font-family:;" "=""><b>Conclusion:</b> The metabolic syndrome remains a real public health problem, constantly increasing in our populations and constitutes a danger by its constituent ele</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ments.</span>展开更多
Introduction: The COVID-19 pandemic has turned the global health system upside down. Senegal recorded its first case on 2 March 2020. As part of its control strategy, the internal medicine department was set up as an ...Introduction: The COVID-19 pandemic has turned the global health system upside down. Senegal recorded its first case on 2 March 2020. As part of its control strategy, the internal medicine department was set up as an epidemic treatment center (ETC). We report on our experience in the management of patients hospitalized in the said center. Material and Methods: Retrospective and descriptive study with analytical aim carried out at the ETC of the CHU Le Dantec of Dakar during the period from 29 April to 30 October 2020 (1st wave) then from 30 December 2020 to 30 April 2021 (2nd wave). All hospitalized patients who tested positive for RT-PCR were included. Epidemiological, clinical, paraclinical and evolutionary data were collected from a pre-established survey form and analysed using the software. Results: Five hundred and seventy files were collected: 379 patients (66%) in the 1st wave and 191 patients (34%) in the 2nd wave. There were 312 men and 258 women, i.e. a sex ratio of 1.22. The median age was 56 years [1.5 - 100 years]. Two thirds of the patients (66%) were over 50 years of age and 223 patients (39.1%) were over 65 years of age. Community transmission was reported in 72% of cases. The average length of hospital stay was 10 days [1 - 32]. Clinically, the mild form predominated (50.9%);the severe and critical forms were 32.6%. Comorbidity was noted in 68% of patients. The different comorbidities were: hypertension (36.1%), diabetes (28.2%), advanced CKD (9.8%). The case fatality rate was 17.2% with a mean age of 70 years. Conclusion: COVID-19 is responsible for respiratory but also systemic manifestations. This 3rd pandemic particularly affects vulnerable people with a significant morbidity and mortality, thus requiring the implementation of standardized CTE with multidisciplinary teams in the control strategies.展开更多
Objective: To describe clinical and biological characteristics of anemia in the Internal Medicine department of Borgou Departmental Hospital Center (DHC). Methods: This was a transversal and descriptive study for an a...Objective: To describe clinical and biological characteristics of anemia in the Internal Medicine department of Borgou Departmental Hospital Center (DHC). Methods: This was a transversal and descriptive study for an analytic purpose. All patients hospitalized in the Internal Medicine department of Borgou DHC who had a hemogram for their care were included in the study. Anemia was defined as a hemoglobin level lower than 12 g/dL for men and lower than 11.5 g/dL for women. Results: Frequency of anemia was 61.8% (76 of 123 patients). Anemia was moderate in 47.4% of the cases and severe in 27.6% of the cases. Basing on the mean corpuscular volume, microcytic anemia accounted for 36.8%, anemia was normocytic in 46.1% and macrocytic in 17.1% of cases. According to the mean corpuscular hemoglobin concentration, normochromic anemia accounted for 81.6% of the series and hypochromic in 18.4%. The most common pathologies found in anemic patients came from digestive origin (17%), the renal causes were also found in 17% of the cases. Cardiac pathologies were responsible for anemia in 13% of cases. Malaria and pulmonary pathologies were responsible for anemia in respectively 12% and 9%. The main factors associated with anemia were young age (young adult) and neurological pathologies. Conclusion: Anemia hospital prevalence is very high in the Internal Medicine Department of Borgou DHC. Awareness of populations and practitioners for the early management of various pathologies which provide anemia could improve this presentation.展开更多
Coronavirus Disease-19 (COVID-19) manifests itself by a respiratory attack that can go from mild to severe forms. The factors favoring the severe forms are age, arterial hypertension, diabetes mellitus, and cancer. We...Coronavirus Disease-19 (COVID-19) manifests itself by a respiratory attack that can go from mild to severe forms. The factors favoring the severe forms are age, arterial hypertension, diabetes mellitus, and cancer. We report 4 cases of COVID-19 on cancer, followed in the Department of Internal Medicine and Medical Oncology of National Teaching Hospital Center Hubert Kougougou Maga (NTHC-HKM). <strong>Case 1:</strong> A hypertensive 65-year-old female patient with a severe form of COVID-19 on an FIGO (International Federation of Gynecology and Obstetrics) IVB endometrioid adenocarcinoma with pulmonary metastasis: unfavorable evolution under treatment with death. <strong>Case 2:</strong> A 56-year-old hypertensive patient with severe COVID-19 with pulmonary metastatic recurrence of SBRIII, HER2 positive invasive ductal carcinoma of the left breast: favorable evolution with cure of COVID-19, subsequent death related to active tumor. <strong>Case 3:</strong> A 37-year-old patient with a moderate form of COVID-19 with hepatocellular carcinoma complicating post alcoholic cirrhosis, CHILD C: favorable evolution with cure of COVID-19, patient lost to follow-up. <strong>Case 4:</strong> A 56-year-old patient, hypertensive, type II diabetic, presenting a severe form of COVID-19 on a field of ovarian serous adenocarcinoma of high grade FIGO IV A with pleuropulmonary metastasis: favorable evolution with cure of COVID-19, subsequent stroke, patient followed in palliative home hospitalization. The diagnosis of COVID-19 in cancer with pulmonary metastases is difficult. The pulmonary location of tumors seems to be a factor favoring severe forms.展开更多
Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An ob...Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An observational descriptive prospective study involves Filipino patients, aged 19 years and older, with dyslipidemia. The Dutch Lipid Network (DLN) Criteria was used to diagnose FH. Prevalence data and categorical variables were expressed as percentages, while continuous variables were reported as mean and standard deviations. Results: 529 patients were included in the study. 302 were females, and 227 were males. 180 (34%) scored Unlikely, 100 (19%) scored Probable, 185 (35%) scored Possible, and 64 (12%) were classified under Definite Familial Hypercholesterolemia. Most of the patients diagnosed with definite FH did not have diabetes, cerebrovascular disease (CVD), and coronary artery disease (CAD). The diagnosis was not affected by gender, BMI, smoking, and alcohol consumption. Hypertension was significantly correlated to the diagnosis of FH, as most of them were already hypertensive at diagnosis. It was noted that hypertension, diabetes, CVD, and CAD were seen at an earlier age among patients with definite FH. Conclusion: The prevalence of heterozygous FH at 12% among dyslipidemia patients and 1.3% among the general population was described for the first time in our region. This result should raise the awareness of our healthcare providers that FH, which is a major risk factor for premature CAD and CVD, exists, and early detection and management are important.展开更多
Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract...Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.展开更多
Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, ...Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.展开更多
Introduction: The metabolic syndrome (MS) corresponds to the coexistence of several metabolic disorders including three (3) factors out of five (5) in the same individual. These five (5) major criteria are central or ...Introduction: The metabolic syndrome (MS) corresponds to the coexistence of several metabolic disorders including three (3) factors out of five (5) in the same individual. These five (5) major criteria are central or abdominal obesity, hypertriglyceridemia, low High-Density Lipoprotein cholesterol (HDLc), hyperglycemia, and elevated blood pressure. It has been the subject of various definitions over the past 10 years. It is a clinical-biological entity recognized by the World Health Organization (WHO) in 1998, the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) in 2001, the International Diabetes Federation (IDF) in 2005, then the IDF Harmonization Consensus in 2009. The objective of this study was to determine the prevalence of metabolic syndrome in the medico-surgical emergency department of the Donka national hospital. Methods: This was a descriptive study, data collection took place from February 5 to July 5, 2022 and, covering all patients aged 16 and over, without distinction of sex, origin received in consultation in the medical unit in the emergency department of Donka and having agreed to participate in the study. Anthropometric, clinical and biological data were recorded. Results: We recruited 107 patients whose age ranged from 20 to 94 years with a mean age of 58.92 ± 13.78 years. The prevalence of metabolic syndrome in our study population was 6.30% with a female predominance of 73.83%. The most frequent components of the metabolic syndrome were abdominal obesity (100%) followed by hyperglycemia (85.98%) and hypertension (85.05%). Among the complications related to the metabolic syndrome, diabetes was found with (46.73%), hypertension (43.93%) and stroke (16.93%). Conclusion: Our results show a significant prevalence of the metabolic syndrome and its main complications, which were diabetes, hypertension and stroke. These data justify early detection and treatment strategies.展开更多
Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Intern...Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all anemic patients hospitalized during the study period. Results: We identified 91 cases of anemia out of 200 patients admitted to the Unit that is a hospital prevalence of 45.5%. The age group of 26 to 35 years was the most represented, that is to say 29 cases (31.87%) with an average age of 43.55 years ± 17.48 years, the female sex predominated, 51 cases (56.04%) with a sex ratio of 0.78. Housewives represented 41 cases (45.05%). The majority of patients resided in rural areas 48 cases (52.75%). The main manifestations were: asthenia 75 cases (78.02%), vertigo 68 cases (74.72%), dyspnea 62 cases (68.13%), headaches 59 cases (64.83%), palpitations 55 cases (60.44%), conjunctival pallor 53 cases (58.24%), tachycardia 43 cases (47.25%), systolic murmur 18 cases (19.78%) and IMO 11 cases (12.09%). The associated pathologies were: infected diabetic wounds 25.27%, followed by bacterial pleuro-pneumopathy 18.68%. Biologically, microcytic anemia was the most frequent 49 cases (53.84%), followed by normocytic anemia 35 cases (38.46%) and macrocytic anemia 7 cases (7.7%). Anemia was hypochromic, 53 cases (58.24%) were more encountered compared to normochromic anemia 38 cases (41.76%). The anemia was: severe in 43 cases (47.25%), moderate 29 cases (31.87%) and mild 19 cases (20.88%). Inflammatory anemia is the most common etiological diagnosis in 60% of cases, followed by vitamin B12 deficiency anemia observed in 21% of patients and then blood diseases in 7.33% of cases. The main causes of death were HIV (50%) and kidney failure (33.33%). Conclusion: Anemia is a frequent symptom in internal medicine. It constitutes a real diagnostic challenge for the internist and this sometimes in an emergency context. The use of specialized examinations and labile blood products is essential in our hospital.展开更多
Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bl...Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.展开更多
In the context of global climate change, this study reviews and discusses the three aspects of ecology, economic development of surrounding communities, ecological balance and snow mountain activities in the Haba Snow...In the context of global climate change, this study reviews and discusses the three aspects of ecology, economic development of surrounding communities, ecological balance and snow mountain activities in the Haba Snow Mountain Reserve through literature collation and research. 1) The Hengduan Mountain Plate of Haba Snow Mountain is affected by the high altitude temperate monsoon and is sensitive to climate change. There has been continuous glacier melting and snow line fluctuations. Although there is no forest line movement, the vegetation at the junction of the forest line has increased. 2) Human activities in the Haba Snow Mountain Reserve have shown an active trend, and the Biomass in various ecosystems in the region is inversely correlated. 3) Climate change will have a negative impact on landscape attraction and tourism safety in snowy mountain areas. 4) Haba Snow Mountain Reserve needs more perfect biological species statistical research and dynamic vegetation research to support the establishment of a perfect ecological protection strategy and ecological early warning in the region. 5) As the frequency of tourist activities in the Haba Protected Area increases, corresponding environmental protection signage, garbage cleaning methods, and tourist education have not been synchronizedly improved.展开更多
Focused on“energy security”,US energy policies have undergone a multi-stage evolution.The main line has shifted from ensuring the oil and gas supply to achieving energy independence,and then to diversified developme...Focused on“energy security”,US energy policies have undergone a multi-stage evolution.The main line has shifted from ensuring the oil and gas supply to achieving energy independence,and then to diversified development under a broader concept of energy security.The development path of US oil and gas companies is guided and influenced by series of policies.Represented by ExxonMobil and Chevron,US oil companies are maintaining a long commitment to the oil and gas business,especially unconventional resources such as shale gas and shale oil.Different from their European counterparts,US oil companies have chosen CCS/CCUS as their primary method for achieving carbon neutrality.As for the new energy business,the US oil giants are showing more interest in raw materials such as lithium resources rather than the power generation business.展开更多
As countries around the world face common challenges in the course of seeking peace and development and making explorations towards modernisation,the call for solidarity,collaboration and dialogue is growing stronger ...As countries around the world face common challenges in the course of seeking peace and development and making explorations towards modernisation,the call for solidarity,collaboration and dialogue is growing stronger than ever.However,the deep-seated problems of suspicion,division and confrontation are still blocking international cooperation.Therefore,it is essential to step up inter-civilisation exchanges for closer people-to-people connectivity.The Global Civilisation Initiative(GCl),proposed by General Secretary Xi Jinping in his keynote address entitled"Join Hands on the Path Towards Modernisation"at the CPC in Dialogue with World Political Parties High-level Meeting on March 15,2023,is a sincere call to the world for in-depth inter-civilisation exchanges and dialogue to advance human civilisations through inclusiveness and mutual learning.展开更多
文摘Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases;those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.
文摘Liver cancer is the malignant transformation of liver cells. It develops in 90% of cases of cirrhosis, more rarely on chronic non-cirrhotic liver disease, and exceptionally in a healthy liver. This study aimed to investigate the clinical aspects of Hepatocellular Carcinoma (HCC). It was a retrospective descriptive study covering 10 years, focusing on HCC cases seen in outpatient and inpatient settings at the Internal Medicine Department. We recorded 153 cases out of 7021 patient records, resulting in a hospital frequency of 2.17%. The male-to-female ratio was 3.5. The mean age was 52.37 ± 14.34 years. The most common presenting complaint was pain in 16.3% of cases. A history of jaundice was found in 25.5% of cases. Alcohol consumption was observed in 15.38% of cases. The main physical sign found was hepatomegaly in 76% of cases. HBsAg was positive in 33.3% of cases. Alpha-fetoprotein levels were above 400 IU/ml in 50.81% of cases. Patients classified as CHILD PUGH A represented 39.72% of cases. Abdominal ultrasound revealed portal thrombosis associated with heterogeneous multinodular hepatomegaly in 11% of cases. Cytology confirmed HCC in four out of six patients who underwent the examination. We recorded 63 deaths out of 111 hospitalized patients. Complications included encephalopathy, hematemesis, and ascites in 48 patients. Hepatocellular carcinoma remains a significant public health issue. Its predominance in men and its occurrence in adults with factors such as viral infections and ethylism mean that prevention of this pathology could greatly reduce its incidence.
文摘Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in adults, the second leading cause of dementia (after Alzheimer’s disease), and the third leading cause of death (after cancer and cardiovascular disease). It’s also a major cause of depression. The objective of our study was to describe the epidemiological, clinical and evolutionary aspects of stroke in the internal medicine department of Tivaouane Hospital. Material and Method: This is a retrospective study carried out from January 1, 2015 to December 31, 2018 on the files of patients hospitalized for stroke in the medical department of the EPS1 in Tivaouane. We took into account all the patients who had a brain CT (computed tomography) scan. We collected data related to socio-demographic characteristics, history, risk factors, reasons for admission, clinical signs, paraclinical examinations, as well as evolution. Results: Out of 1999 patients, 206 files of patients with stroke were collected, i.e. a proportion of 10.3%. Our study population had a mean age of 65.53 years [16 - 97 years]. We noted a clear predominance of women (50.5%). The majority of the population came from the outskirts of Tivaouane (56.7%). Risk factors for stroke were dominated by hypertension (90.3%), dyslipidemia (19.4%), previous stroke (18.9%), and diabetes (16%). The clinical signs were dominated by a motor deficit (94.1%), speech disorders (67.4%) and consciousness disorders (47%). Ischemic strokes were predominant (65%) over hemorrhagic strokes (34.5%). The outcome was generally unfavorable with 14.6% total recovery, 58.7% recovery with sequelae and a case fatality of 26.7%. Conclusion: It emerges from this study that strokes still remain a real public health problem. Knowledge of populations of risk factors as well as their proper management is fundamental in primary prevention strategies, the only guarantee for a reduction in the still very high morbidity and mortality of this disease.
文摘Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage IV, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.
文摘Pernicious anemia in black people, is little known. Through this study we assess its diagnostic and evolutive aspects, and compare vitamin therapy B12 intramuscular and oral. Sixty six Biermer disease patients followed (January 2000-June 2014) at Internal Medicine Department of Aristide Le Dantec University Teaching Hospital (Senegal) are included. They were 26 men and 46 women (gender ratio: 0.65), who had a mean age of 47.84 years ± 15.25 years. Patients consulted for anemia (65 cases), acquired melanodermia (36 cases), gastrointestinal symptoms (30 cases), peripheral neuropathy (27 cases), venous thrombosis (2 cases), acute depression (1 case). Macrocytosis was observed in 52 cases. The mean hemoglobin in the vitamin B12 intramuscular group (52 patients) or oral group (14 patients) was the inclusion: 6.55 g/dl ± 3.12 g/dl vs 6.52 g/dl ± 2.18 g/dl (p = 0.04);and at day 8 treatment: 8.69 g/dl ± 2.49 g/dl vs 8.85 g/dl ± 1.9 g/dl (p = 0.43). Neurological and vascular presentations are unusual in contrast to macrocytic anemia. Oral administration of vitamin B12, simple and effective should be recommended in country with limited resources.
文摘<strong>Introduction:</strong> Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. <strong>Objectives:</strong> To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. <strong>Materials and Methods:</strong> This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, <i>i.e. </i> duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. <strong>Results:</strong> We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, <i>i.e. </i> a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. Hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. <i>Escherichia coli, Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i> represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. <strong>Conclusion:</strong> Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.
文摘<strong>Introduction:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""> The metabolic syndrome is a clinical entity defined by the association in the same subject of four of the following five factors: abdominal obesity (or android), type 2 diabetes, hypertension, hypo HDL cholesterolemia, hypertriglyceridemia. The aim of the work was to study the epidemiological, clinical-biological profiles and complications of patients in the cardiology and internal medicine department of the Mother-Child CHU “Luxembourg”. <b>Materials and Methods:</b> We carried out a cross-sectional study, from September 2019 to June 2020 in the cardiology and internal department of the mother-child CHU “Luxembourg”. All patients with metabolic syndrome admitted to the two departments who agreed to participate during the study period were included in the study. These patients meet the 2009 harmonization attempt criteria (IDF 2009). The variables studied were: socio-demographic characteristics (sex, age, profession), pathological history, clinical signs (functional signs, BMI, waist size), paraclinical signs (ECG, cardiac ultrasound, laboratory assessment) and complications. <b>Results:</b> A total of 104 patients were included. The female sex represented 58.65% of cases. The 60 to 69 age group was the majority with 40.78%, housewives occupied 41.34% of cases. Diabetes, arterial hypertension and dyslipidemia were the most represented cardiovascular risk factors with respectively: 80.77%, 79.81% and 53.85%. Visual blurring was the most common functional sign with 23.08% of cases. Moderate obesity was observed in 34% of patients. Waist circumference was high in 39.53% of male patients and 37.70% of female patients. Cardiac ultrasound found a severely collapsed ejection fraction in 25% of patients. HDL-c levels were low in 64.52% of male patients and 75% of female patients. The most observed complications were: dyslipidemia (53.85%), stroke and renal failure with 23% respectively</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">. </span><span style="white-space:normal;font-size:10pt;font-family:;" "=""><b>Conclusion:</b> The metabolic syndrome remains a real public health problem, constantly increasing in our populations and constitutes a danger by its constituent ele</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ments.</span>
文摘Introduction: The COVID-19 pandemic has turned the global health system upside down. Senegal recorded its first case on 2 March 2020. As part of its control strategy, the internal medicine department was set up as an epidemic treatment center (ETC). We report on our experience in the management of patients hospitalized in the said center. Material and Methods: Retrospective and descriptive study with analytical aim carried out at the ETC of the CHU Le Dantec of Dakar during the period from 29 April to 30 October 2020 (1st wave) then from 30 December 2020 to 30 April 2021 (2nd wave). All hospitalized patients who tested positive for RT-PCR were included. Epidemiological, clinical, paraclinical and evolutionary data were collected from a pre-established survey form and analysed using the software. Results: Five hundred and seventy files were collected: 379 patients (66%) in the 1st wave and 191 patients (34%) in the 2nd wave. There were 312 men and 258 women, i.e. a sex ratio of 1.22. The median age was 56 years [1.5 - 100 years]. Two thirds of the patients (66%) were over 50 years of age and 223 patients (39.1%) were over 65 years of age. Community transmission was reported in 72% of cases. The average length of hospital stay was 10 days [1 - 32]. Clinically, the mild form predominated (50.9%);the severe and critical forms were 32.6%. Comorbidity was noted in 68% of patients. The different comorbidities were: hypertension (36.1%), diabetes (28.2%), advanced CKD (9.8%). The case fatality rate was 17.2% with a mean age of 70 years. Conclusion: COVID-19 is responsible for respiratory but also systemic manifestations. This 3rd pandemic particularly affects vulnerable people with a significant morbidity and mortality, thus requiring the implementation of standardized CTE with multidisciplinary teams in the control strategies.
文摘Objective: To describe clinical and biological characteristics of anemia in the Internal Medicine department of Borgou Departmental Hospital Center (DHC). Methods: This was a transversal and descriptive study for an analytic purpose. All patients hospitalized in the Internal Medicine department of Borgou DHC who had a hemogram for their care were included in the study. Anemia was defined as a hemoglobin level lower than 12 g/dL for men and lower than 11.5 g/dL for women. Results: Frequency of anemia was 61.8% (76 of 123 patients). Anemia was moderate in 47.4% of the cases and severe in 27.6% of the cases. Basing on the mean corpuscular volume, microcytic anemia accounted for 36.8%, anemia was normocytic in 46.1% and macrocytic in 17.1% of cases. According to the mean corpuscular hemoglobin concentration, normochromic anemia accounted for 81.6% of the series and hypochromic in 18.4%. The most common pathologies found in anemic patients came from digestive origin (17%), the renal causes were also found in 17% of the cases. Cardiac pathologies were responsible for anemia in 13% of cases. Malaria and pulmonary pathologies were responsible for anemia in respectively 12% and 9%. The main factors associated with anemia were young age (young adult) and neurological pathologies. Conclusion: Anemia hospital prevalence is very high in the Internal Medicine Department of Borgou DHC. Awareness of populations and practitioners for the early management of various pathologies which provide anemia could improve this presentation.
文摘Coronavirus Disease-19 (COVID-19) manifests itself by a respiratory attack that can go from mild to severe forms. The factors favoring the severe forms are age, arterial hypertension, diabetes mellitus, and cancer. We report 4 cases of COVID-19 on cancer, followed in the Department of Internal Medicine and Medical Oncology of National Teaching Hospital Center Hubert Kougougou Maga (NTHC-HKM). <strong>Case 1:</strong> A hypertensive 65-year-old female patient with a severe form of COVID-19 on an FIGO (International Federation of Gynecology and Obstetrics) IVB endometrioid adenocarcinoma with pulmonary metastasis: unfavorable evolution under treatment with death. <strong>Case 2:</strong> A 56-year-old hypertensive patient with severe COVID-19 with pulmonary metastatic recurrence of SBRIII, HER2 positive invasive ductal carcinoma of the left breast: favorable evolution with cure of COVID-19, subsequent death related to active tumor. <strong>Case 3:</strong> A 37-year-old patient with a moderate form of COVID-19 with hepatocellular carcinoma complicating post alcoholic cirrhosis, CHILD C: favorable evolution with cure of COVID-19, patient lost to follow-up. <strong>Case 4:</strong> A 56-year-old patient, hypertensive, type II diabetic, presenting a severe form of COVID-19 on a field of ovarian serous adenocarcinoma of high grade FIGO IV A with pleuropulmonary metastasis: favorable evolution with cure of COVID-19, subsequent stroke, patient followed in palliative home hospitalization. The diagnosis of COVID-19 in cancer with pulmonary metastases is difficult. The pulmonary location of tumors seems to be a factor favoring severe forms.
文摘Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An observational descriptive prospective study involves Filipino patients, aged 19 years and older, with dyslipidemia. The Dutch Lipid Network (DLN) Criteria was used to diagnose FH. Prevalence data and categorical variables were expressed as percentages, while continuous variables were reported as mean and standard deviations. Results: 529 patients were included in the study. 302 were females, and 227 were males. 180 (34%) scored Unlikely, 100 (19%) scored Probable, 185 (35%) scored Possible, and 64 (12%) were classified under Definite Familial Hypercholesterolemia. Most of the patients diagnosed with definite FH did not have diabetes, cerebrovascular disease (CVD), and coronary artery disease (CAD). The diagnosis was not affected by gender, BMI, smoking, and alcohol consumption. Hypertension was significantly correlated to the diagnosis of FH, as most of them were already hypertensive at diagnosis. It was noted that hypertension, diabetes, CVD, and CAD were seen at an earlier age among patients with definite FH. Conclusion: The prevalence of heterozygous FH at 12% among dyslipidemia patients and 1.3% among the general population was described for the first time in our region. This result should raise the awareness of our healthcare providers that FH, which is a major risk factor for premature CAD and CVD, exists, and early detection and management are important.
文摘Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.
文摘Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.
文摘Introduction: The metabolic syndrome (MS) corresponds to the coexistence of several metabolic disorders including three (3) factors out of five (5) in the same individual. These five (5) major criteria are central or abdominal obesity, hypertriglyceridemia, low High-Density Lipoprotein cholesterol (HDLc), hyperglycemia, and elevated blood pressure. It has been the subject of various definitions over the past 10 years. It is a clinical-biological entity recognized by the World Health Organization (WHO) in 1998, the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) in 2001, the International Diabetes Federation (IDF) in 2005, then the IDF Harmonization Consensus in 2009. The objective of this study was to determine the prevalence of metabolic syndrome in the medico-surgical emergency department of the Donka national hospital. Methods: This was a descriptive study, data collection took place from February 5 to July 5, 2022 and, covering all patients aged 16 and over, without distinction of sex, origin received in consultation in the medical unit in the emergency department of Donka and having agreed to participate in the study. Anthropometric, clinical and biological data were recorded. Results: We recruited 107 patients whose age ranged from 20 to 94 years with a mean age of 58.92 ± 13.78 years. The prevalence of metabolic syndrome in our study population was 6.30% with a female predominance of 73.83%. The most frequent components of the metabolic syndrome were abdominal obesity (100%) followed by hyperglycemia (85.98%) and hypertension (85.05%). Among the complications related to the metabolic syndrome, diabetes was found with (46.73%), hypertension (43.93%) and stroke (16.93%). Conclusion: Our results show a significant prevalence of the metabolic syndrome and its main complications, which were diabetes, hypertension and stroke. These data justify early detection and treatment strategies.
文摘Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all anemic patients hospitalized during the study period. Results: We identified 91 cases of anemia out of 200 patients admitted to the Unit that is a hospital prevalence of 45.5%. The age group of 26 to 35 years was the most represented, that is to say 29 cases (31.87%) with an average age of 43.55 years ± 17.48 years, the female sex predominated, 51 cases (56.04%) with a sex ratio of 0.78. Housewives represented 41 cases (45.05%). The majority of patients resided in rural areas 48 cases (52.75%). The main manifestations were: asthenia 75 cases (78.02%), vertigo 68 cases (74.72%), dyspnea 62 cases (68.13%), headaches 59 cases (64.83%), palpitations 55 cases (60.44%), conjunctival pallor 53 cases (58.24%), tachycardia 43 cases (47.25%), systolic murmur 18 cases (19.78%) and IMO 11 cases (12.09%). The associated pathologies were: infected diabetic wounds 25.27%, followed by bacterial pleuro-pneumopathy 18.68%. Biologically, microcytic anemia was the most frequent 49 cases (53.84%), followed by normocytic anemia 35 cases (38.46%) and macrocytic anemia 7 cases (7.7%). Anemia was hypochromic, 53 cases (58.24%) were more encountered compared to normochromic anemia 38 cases (41.76%). The anemia was: severe in 43 cases (47.25%), moderate 29 cases (31.87%) and mild 19 cases (20.88%). Inflammatory anemia is the most common etiological diagnosis in 60% of cases, followed by vitamin B12 deficiency anemia observed in 21% of patients and then blood diseases in 7.33% of cases. The main causes of death were HIV (50%) and kidney failure (33.33%). Conclusion: Anemia is a frequent symptom in internal medicine. It constitutes a real diagnostic challenge for the internist and this sometimes in an emergency context. The use of specialized examinations and labile blood products is essential in our hospital.
文摘Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.
文摘In the context of global climate change, this study reviews and discusses the three aspects of ecology, economic development of surrounding communities, ecological balance and snow mountain activities in the Haba Snow Mountain Reserve through literature collation and research. 1) The Hengduan Mountain Plate of Haba Snow Mountain is affected by the high altitude temperate monsoon and is sensitive to climate change. There has been continuous glacier melting and snow line fluctuations. Although there is no forest line movement, the vegetation at the junction of the forest line has increased. 2) Human activities in the Haba Snow Mountain Reserve have shown an active trend, and the Biomass in various ecosystems in the region is inversely correlated. 3) Climate change will have a negative impact on landscape attraction and tourism safety in snowy mountain areas. 4) Haba Snow Mountain Reserve needs more perfect biological species statistical research and dynamic vegetation research to support the establishment of a perfect ecological protection strategy and ecological early warning in the region. 5) As the frequency of tourist activities in the Haba Protected Area increases, corresponding environmental protection signage, garbage cleaning methods, and tourist education have not been synchronizedly improved.
文摘Focused on“energy security”,US energy policies have undergone a multi-stage evolution.The main line has shifted from ensuring the oil and gas supply to achieving energy independence,and then to diversified development under a broader concept of energy security.The development path of US oil and gas companies is guided and influenced by series of policies.Represented by ExxonMobil and Chevron,US oil companies are maintaining a long commitment to the oil and gas business,especially unconventional resources such as shale gas and shale oil.Different from their European counterparts,US oil companies have chosen CCS/CCUS as their primary method for achieving carbon neutrality.As for the new energy business,the US oil giants are showing more interest in raw materials such as lithium resources rather than the power generation business.
文摘As countries around the world face common challenges in the course of seeking peace and development and making explorations towards modernisation,the call for solidarity,collaboration and dialogue is growing stronger than ever.However,the deep-seated problems of suspicion,division and confrontation are still blocking international cooperation.Therefore,it is essential to step up inter-civilisation exchanges for closer people-to-people connectivity.The Global Civilisation Initiative(GCl),proposed by General Secretary Xi Jinping in his keynote address entitled"Join Hands on the Path Towards Modernisation"at the CPC in Dialogue with World Political Parties High-level Meeting on March 15,2023,is a sincere call to the world for in-depth inter-civilisation exchanges and dialogue to advance human civilisations through inclusiveness and mutual learning.
