Urinary Sphincter Disorders of Neurological Origin: Prognostic Aspects in the Neurology Department of the Ignace Deen National Hospital

Introduction: Complications of Urinary sphincter disorders of neurological origin can be life threatening. The objective of this study was to describe the prognosis of urinary sphincter disorders during neurological conditions. Methods: This was a six-month analytical study conducted at the neurological unit of the Hôpital national Ignace Deen. Including patients with urinary sphincter disorders following a neurological condition;Chi-square, Fischer, and Student’s t-tests were used for variables with a p value less than 0.10 and then included in a logistic model with a significance level set at 0.05 and a 95% confidence interval. Results: We collected 1081 patients among whom, 324 presented, that is to say a frequency of 30%, which concerned subjects aged 57.3 ± 16.4 years with a slight female predominance 50.3%. Urinary incontinence (80.6%) was associated with complications such as urinary tract infection with a high proportion of cerebral damage (92.3%). HIV infection (P = 0.015), bedsores (P = 0.049), and inhalation pneumonia (P = 0.001) were the main poor prognostic factors. Conclusion: Urinary sphincter disorders are elements of poor prognosis, both vital and functional, concerning elderly subjects with a predominance of urinary incontinence. HIV infection, bedsores, pneumopathy are poor prognostic factors.

Profile of Juvenile Idiopathic Arthritis in Guinea

Introduction: Juvenile Idiopathic Arthritis (JIA) is the most common rheumatoid disease in children. In Sub-Saharan Africa, little data is available on the prevalence of JIA. The objective of our study was to determine the frequency and describe the clinical profile of JIA in Guinean children seen at the Department of Neurology, Academic Hospital, University of Conakry (Guinea). Patients and Method: This was a retrospective study carried out at the Ignace Deen Academic Hospital, Conakry between January 2016 and December 2018. Patients were recruited through the Rheumatology and Paediatrics Department. Results: We collected forty (40) observations of JIA in 22 girls (55%) and 18 boys (45%). The median age at diagnosis was 14 years (range 7 - 18 years), compared to 7 years at onset (range 5 and 13 years). There were 3 cases of systemic arthritis (7.5%), 16 (40%) patients with persistent oligoarthritis, 3 patients (7.5%) that had extensive oligoarthritis, polyarthritis with positive RF in 8 cases (20%) and with negative RF in 4 cases (10%), psoriatic arthritis in 3 cases (7.5%), and enthesitis related arthritis in 2 cases (5%). There was one case of undifferentiated arthritis. A total of 23 (57.5%) received methotrexate, 9 (22.5%) were treated with salazopyrin. Conclusion: The profile of JIA in our study is different from that described in African studies with a predominance of oligoarticular JIA.

Secondary Hypertrophic Osteoarthropathy or Pierre-Marie Syndrome Bamberger: Clinical Case and Literature Review

Secondary hypertrophic osteoarthropathy, or Pierre-Marie Bamberger syndrome, is characterized by the association of digital clubbing, polyarthritis and periostitis affecting the long bones. Most commonly it is a paraneoplastic syndrome associated with lung cancer in 80% of cases. We report the case of a 49-year-old female patient who is actively smoking, one pack per day for 20 years. Seen in consultation for pain and swelling of the hands, elbows, knees, ankles, and feet evolving for about 5 months, associated with a poorly differentiated pulmonary adenocarcinoma. On history, she told us about a weight loss of about 8 kg, no fever, no cough, no family history of inflammatory rheumatism or cancer. Bilateral digital clubbing was noted. The diagnosis was based on imaging and histology. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and chemo-radiotherapy was started.

Tuberculous Sacroiliitis with Secondary Psoas Abscess: A Case Report

Tuberculous sacroiliitis secondary to a psoas abscess is rare, only a few sporadic cases were reported in the literature. Tuberculous sacroiliitis is rare, usually unilateral, its symptomatology is misleading, its diagnosis is often delayed or even confused with damage to the hip or lumbosacral hinge, most often related to difficulties exploration of the sacroiliac joint. We report the case of a 66-year-old diabetic patient with low back pain, unilateral right with inflammatory appearance, insidious installation, evolving for about 8 months. The diagnosis of tuberculous sacroiliitis was made after biopsy of the sacroiliac joint. CT and MRI are necessary for lesion diagnosis. Tuberculosis treatment was started and the abscess was surgically drained. The aim of this work was to describe the diagnostic pathway of a patient with tuberculous sacroiliitis in a tropical environment. Conclusion: Tuberculous sacroiliitis, secondary to an abscess of the psoas muscle is an unusual cause of hip pain and is likely to be overlooked due to its atypical presentation.