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Viral Hepatitis B and C: Epidemiological, Clinical and Paraclinical Aspects in the Internal Medicine Department of KARA University Hospital in Togo

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Open Journal of Internal medicine 2024年第1期14卷 131-139页

作者： Lihanimpo Djalogue Mossi Komi Edem El Hadj Yacoubou Tchamdja Toyi Djagadou Kodjo Agbeko Balaka Abago Djibril Mohaman Awalou Internal Medicine Department University of Kara Kara Togo Internal Medicine Department University of Lome Lome Togo Hepato-Gastroenterology department University of Kara Lomé Togo

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.

关键词： Hepatitis B Hepatitis C Internal medicine Kara University Hospital

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Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the medicine and Endocrinology department of the Mali Hospital

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World Journal of Cardiovascular Diseases 2024年第3期14卷 129-139页

作者： Konaté Massama Mamadou Touré Mariam Sako Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Elhaj Mahamane Maiga Coumba Adiaratou Thiam Youssouf Camara Hamidou Oumar Ba Asmao Keita Maiga Djenebou Traoré Zoumana Traoré Souleymane Coulibaly Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Ichaka Menta Faculty of medicine and Dentistry Bamako USTTB Department of Medicine Hospital of Mali Bamako Mali department of Cardiology CHU Gabriel TOURE Bamako Mali department of Cardiology CHU Point G Bamako Mali department of medicine Hospital of Timbuktu Bamako Mali department of Cardiology Hospital of Kati Bamako Mali department of Cardiology CHU Mother and Child Bamako Bamako Mali department of Internal medicine CHU Point G Bamako Mali

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the department of medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

关键词： Diabetes Echocardiography Mali Hospital

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Factors Associated with Haemolytic Anaemia in the Internal Medicine Department of the Douala General Hospital in Cameroon

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Open Journal of Blood Diseases 2023年第2期13卷 83-91页

作者： Eveline Ngouadjeu Dongho Brice Utrich Afana Clémence Olemba Jean Pierre Nda Mefo’o Cécile Ebongue Okalla Abdou Temfomo Jules Clement Nguedia Assob Henry Namme Luma department of Internal medicine Douala General Hospital Douala Cameroon department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon department of Microbiology Virology and Immunology Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaounde Cameroon

Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened life span of less than 120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our study was to investigate the factors associated with it for optimal management of patients hospitalised in internal medicine at the Douala General Hospital (DGH). Methodology: We conducted an analytical cross-sectional study, including all patients admitted to the internal Medicine Department of the DGH from 11 February to 20 May 2022, and excluding patients with non-compliant samples. The search for haemolytic anaemia was carried out by means of blood count, reticulocyte count, blood smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test. Sociodemographic, clinical and biological parameters were collected and analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group was 56 - 70 years (n = 49;33%) with extremes from 15 to 90 years. We counted 29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex ratio of 1.38;the most represented age group was 40 - 55 years, 37.2%. HA was associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS (OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58 - 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44], p = 0.01). Unconjugated bilirubin was elevated in all these patients. In multivariate analysis, factors associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and elevated reticulocyte count. Conclusion: Hemolytic anaemia is common in internal

关键词： Haemolytic Anaemia Internal medicine DGH

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Emergency department operations and management education in emergency medicine training

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World Journal of Emergency medicine 2012年第2期3卷 98-101页

作者： Bret A Nicks Darrell Nelson department of Emergency medicine Wake Forest Baptist Medical Center department of Emergency medicine Forsyth Medical Center

BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency medicine Residency programs.METHODS:Residency program directors at all US-based Emergency medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.

关键词： Core measures Operations management Emergency medicine residency Resident education

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The COVID-19 Pandemic in Senegal: Experience of an Internal Medicine Department as an Epidemic Treatment Center

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Open Journal of Internal medicine 2022年第1期12卷 13-21页

作者： Atoumane Faye Awa Cheikh Ndao Nafissatou Diagne Mouhamed Dieng Maimouna Sow Baidy Sy Kane Boundia Djiba Abdoulaye Pouye Internal Medicine Department University Hospital Center Le Dantec Dakar Senegal

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.

关键词： Pandemic COVID-19 Comorbidities Lethality

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Metabolic Syndrome in the Internal Medicine Department of Chu Point G

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Open Journal of Internal medicine 2023年第3期13卷 139-143页

作者： Djenebou Traoré Sy Djibril Nongoba Sawadogo Djeneba Sylla Sow Massama Konaté Nounga Romuald Nyanke Ayayi Edem D’Almeida Kaly Keita Sekou Landouré Nouhoum Koné Moussa Sangaré Mamadou Mallé Ibrahima Amadou Dembélé Mamadou Cissoko Yacouba Koné Aoua Diarra Assetou Kaya Soukho department of Internal medicine University Hospital Center of Point G Bamako Mali Faculty of medicine and Odontostomatology Bamako Mali Departement of Internal medicine Kaya Regional Hospital Kaya Burkina Faso department of Medical University Hospital Center from the Hospital in Mali Bamako Mali

Introduction: The metabolic syndrome according to the IDF (International Diabetes Federation) is at the origin of the double global epidemic of type 2 diabetes and cardiovascular diseases. This work aims to study the metabolic syndrome in the internal Medicine Department of CHU Point G. Methodology: This was a descriptive study of patients who presented a metabolic syndrome according to the definition of the IDF definition, hospitalized in the internal Medicine Department of the CHU du point G for the period from January 1 2010 to December 31, 2019. Results: During the study period, 4189 patients were hospitalized, including 60 with metabolic syndrome, representing a hospital frequency of 1.43%. The sex ratio was 0.36. The age group of 50 and 60 years accounted for 28.3%. Forty-six point six percent (46.6%) of our patients were diabetic, 45% obese, 60% hypertensive, 70% sedentary and 10% smokers. Our patients had in 53.3% of cases a blood pressure figure ≥ 130/85 mmHg, abdominal obesity in 100%, hypertriglyceridemia in 33.3%, HDL-C less than 0.40 g/l in 62.5% of men and less than 0.50 g/l in 77.27% of men, blood sugar ≥ 1 g/l in 88.3%. Conclusion: The metabolic syndrome, in view of the entities that compose it, is a real cardiovascular risk factor and therefore a major public health issue.

关键词： Metabolic Syndrome CHU Point G Internal medicine

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Potential role of tubulin glutamylation in neurodegenerative diseases

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Neural Regeneration Research 2024年第6期19卷 1191-1192页

作者： Abdullah Md.Sheikh Shatera Tabassum department of Laboratory medicine Shimane University Faculty of Medicine

The differentiation of neuronal stem cells into mature neurons is a complex process that involves both structural and functional changes. As cells undergo differentiation, there are notable functional changes, including the expression of various transcription factors, cytokines, and neurotransmitiers. Additionally, structural changes occur as the cells develop various processes from the cell body and establish synaptic contacts with other cells.

关键词： POLARITY

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Biermer’s Disease at the Donka National Hospital in Guinea—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department

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Open Journal of Internal medicine 2023年第3期13卷 218-224页

作者： Thierno Amadou Wann Mamadou Sarifou Diallo Djenabou Diallo Kadiatou Diallo Mamadou Lamine Yaya Bah Mamadou Diakhaby Mohamed Cissoko Amadou Kaké Djibril Sylla department of Internal medicine Teaching Hospital of Conakry Conakry Guinea department of Hepato-Gastroenterology University Hospital of Conakry Conakry Guinea

Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal Medicine Department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.

关键词： Biermer’s Disease Donka Aspects Epidemiological-Clinical Therapeutics

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Mechanical circulatory support in cardiogenic shock and post-myocardial infarction mechanical complications

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Journal of Geriatric Cardiology 2022年第2期19卷 130-136页

作者： Daniel Rob Jan Bělohlávek nd department of medicine-department of Cardiovascular medicine First Faculty of MedicineCharles University and General University HospitalPragueCzech Republic

Despite advanced therapies,the mortality of patients with myocardial infarction(MI)complicated by cardiogenic shock(CS)remains around 50%.Mechanical complications of MI are rare nowadays but associated with high mortality in patients who present with CS.Different treatment strategies and mechanical circulatory support(MCS)devices have been increasingly used to improve the grim prognosis of refractory CS.This article discusses current evidence regarding the use of MCS in MI complicated by CS,ventricular septal rupture,free wall rupture and acute mitral regurgitation.Device selection should be tailored according to the cause and severity of CS.Early MCS initiation and multidisciplinary team cooperation is mandatory for good results.MCS associated bleeding remains a major complication and an obstacle to better outcomes.Ongoing prospective randomized trials will improve current knowledge regarding MCS indications,timing,and patient selection in the coming years.

关键词： mortality infarction rupture

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Contribution of Bone Scintigraphy in the Metastatic Extension Assessment of Prostate Cancer: A Study of 288 Cases in the Nuclear Medicine Department of Idrissa Pouye General Hospital, Dakar

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Open Journal of Biophysics 2024年第2期14卷 79-98页

作者： El Hadji Amadou Lamine Bathily Ousseynou Diop Mamoudou Salif Djigo Gora Thiaw Kalidou Gueye Mohamed Chekhma Olatounde Herbert Fachinan Boucar Ndong Omar Ndoye Mamadou Mbodj department of Nuclear medicine Idrissa Pouye General Hospital (HOGIP) Dakar Senegal Biophysical Laboratory FMPO Cheikh Anta Diop University (UCAD) Dakar Senegal department of Nuclear medicine Hospital Dalal Jamm Dakar Senegal

Introduction: Prostate cancer is the most frequently diagnosed male malignancy and the fifth leading cause of cancer death in men worldwide. Since the advent of screening methods such as Prostate Specific Antigen (PSA) assay, digital rectal examination (DRE) and prostate biopsy, its incidence has increased significantly. The aim of our study was to analyse aspects of bone scintigraphy (BS) as part of the metastatic extension assessment of prostate cancer in Senegal. Patients and Methods: This was a retrospective descriptive and analytical study, running from January 1er 2022 to August 31 2023. Patients with histologically confirmed prostate cancer were included. Whole-body scans (WBS) were performed using a dual-head SPECT gamma camera (Mediso Nucline TM Spirit DH-V type), 3 hours after intravenous injection of 8 MBq/kg (555 to 740 MBq) of 99mTc-HMDP. Results: A total of 288 patients with a mean age of 68.37 ± 7.79 years were included. The median total PSA level was 97.6 ng/ml, with 144 patients having a level greater than or equal to 20 ng/ml. All patients had adenocarcinoma, and the Gleason score was available in 202 (70.13%) patients, 75.75% of whom had a score greater than or equal to 7. BS was contributory in 70.48% of cases, with 30.90% positive and 39.58% negative. The result was inconclusive in 85 patients (29.51%). The mean PSA for patients with a positive scan was 190.2 ng/ml and 40.6 ng/ml for those with a negative scan. Multiple metastatic lesions predominated (87.35% of cases). Metastatic lesions occurred preferentially in the axial skeleton, with a proportion of 68% versus 32% in the appendicular skeleton. Classification of bone metastases according to the SOLOWAY score revealed grade I (62.07%), grade II (35.63%) and grade IV (2.30%). Conclusion: In Senegal, prostate cancer is generally diagnosed in men of advanced age. The presence of bone metastases is frequent in its evolution, transforming a curable localized disease into a generalized disease with a compromised prognosis.

关键词： Prostate Cancer Bone Metastasis Bone Scintigraphy Senegal

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