Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of ...Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of study is to report a case of late consultation and its consequences and make recommendations to improve: case of abdominal pregnancy with hemorrhagic placenta at the Health and Mother Center (CSME) in Zinder/Niger. Clinical Observation: We describe a case of abdominal pregnancy with hemorrhagic placenta in a 24-year-old woman, without profession, resident in the city of Zinder with a low economic level, consulted for abdomino-pelvic pain. She had a notion of amenorrhea for 5 months without any consultation made. She was pale, feverish and had abdominal pain. Ultrasound revealed a 23-week-old fetus and an empty uterus. The diagnosis was abdominal pregnancy. A laparotomy was performed and a The morbidity was hysterectomy and anemia. The postoperative period course was complicated with anemia. The patient was cured on the 9th day with a good vital prognosis. Conclusion: Abdominal pregnancy occurred in a patient who presented a risk factor. Ultrasound was the key diagnostic test. Surgery was the treatment of choice and the prognosis depends on the earliness of the consultation. Community awareness and early consultation with health services can improve the prognosis of abdominal pregnancy.展开更多
Traditional African medicine products are responsible for kidney damage that baffles both nephrologists and pathologists. Renal biopsies reveal acute or chronic inflammatory changes that cannot be explained by the pro...Traditional African medicine products are responsible for kidney damage that baffles both nephrologists and pathologists. Renal biopsies reveal acute or chronic inflammatory changes that cannot be explained by the progressive stage of the basic lesion of the nephropathy. The aim of this study is to analyze the lesions superimposed on 73 kidney biopsies from patients who took traditional herbal medications to treat the symptoms of kidney disease.展开更多
Contexte:?The fight against HIV/AIDS epidemics is one of the greatest challenges of this century. The epidemic affects generally under-developed countries, and Sub-Saharan Africa are the most concerned. The combined m...Contexte:?The fight against HIV/AIDS epidemics is one of the greatest challenges of this century. The epidemic affects generally under-developed countries, and Sub-Saharan Africa are the most concerned. The combined marketed form known as Triomune was used as first-line treatment in several sub-Saharan African Countries (60% of VIH infected people), including Chad. However, no evaluation has been done for that treatment in the country. Objective: To evaluate the efficacy and safety immuno-virological of Triomune at the General Hospital in N’Djamena/Chad. Methods: 48 HIV-1 positive patients eligible for ARV treatment were enrolled in our study, and they have been then followed for 8 months. We have measured in these patients the CD4 cell count before treatment and at the 8th month of treatment. After 8 months of treatment, we have also evaluated the Lymphocyte T CD4 and the plasma viral load (VL). Comparisons of means of CD4 lymphocytes and plasma CV (≥1000 copies/ml) were used to define treatment failure.?Results:?48 patients were under Triomune regime. The average CD4 count was decreased from 462 ± 179.22 [56 - 981] cells/mm3?before treatment to 327.23 ± 153.77 [10 - 1008] cells/mm3?at the 8th month of treatment. The mean plasma viral load for patients was 66008.62 copies/ml. The failure rate to Triomune was 43.75% (21/48).?Conclusion:?Aside from the side effects already described for Triomune, our study reveals a high treatment failure rate. Hence, there is the need of regular revisions of therapeutic regime administer in the first intention.展开更多
Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhu...Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhupus in Niger. Observation 1: This is a patient suffering from chronic polyarthritis in whom the diagnosis of active seropositive, erosive and deforming RA had been made according to the 1987 ACR criteria and SLE on the presence of 4 criteria according to the 1997 ARA criteria and putting under conventional synthetic DMARDs. The outcome was favorable with a remission achieved after 8 weeks with a disease activity score (DAS) 28 at 2.2. Observation 2: 58-year-old patient with known diabetes type 2 in whom the diagnosis of rhupus was made according to the ACR/EULAR 2010 criteria for RA with a DAS28 of 3.6 and the 2019 LES criteria at 18 points with a SLEDAI score of 6. The evolution was marked by the occurrence of a myocardial infarction with a favorable outcome under medical management. Conclusion: Rhupus is a rare entity that can be complicated by cardiovascular events with the presence of an independent cardiovascular risk factor.展开更多
文摘Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of study is to report a case of late consultation and its consequences and make recommendations to improve: case of abdominal pregnancy with hemorrhagic placenta at the Health and Mother Center (CSME) in Zinder/Niger. Clinical Observation: We describe a case of abdominal pregnancy with hemorrhagic placenta in a 24-year-old woman, without profession, resident in the city of Zinder with a low economic level, consulted for abdomino-pelvic pain. She had a notion of amenorrhea for 5 months without any consultation made. She was pale, feverish and had abdominal pain. Ultrasound revealed a 23-week-old fetus and an empty uterus. The diagnosis was abdominal pregnancy. A laparotomy was performed and a The morbidity was hysterectomy and anemia. The postoperative period course was complicated with anemia. The patient was cured on the 9th day with a good vital prognosis. Conclusion: Abdominal pregnancy occurred in a patient who presented a risk factor. Ultrasound was the key diagnostic test. Surgery was the treatment of choice and the prognosis depends on the earliness of the consultation. Community awareness and early consultation with health services can improve the prognosis of abdominal pregnancy.
文摘Traditional African medicine products are responsible for kidney damage that baffles both nephrologists and pathologists. Renal biopsies reveal acute or chronic inflammatory changes that cannot be explained by the progressive stage of the basic lesion of the nephropathy. The aim of this study is to analyze the lesions superimposed on 73 kidney biopsies from patients who took traditional herbal medications to treat the symptoms of kidney disease.
文摘Contexte:?The fight against HIV/AIDS epidemics is one of the greatest challenges of this century. The epidemic affects generally under-developed countries, and Sub-Saharan Africa are the most concerned. The combined marketed form known as Triomune was used as first-line treatment in several sub-Saharan African Countries (60% of VIH infected people), including Chad. However, no evaluation has been done for that treatment in the country. Objective: To evaluate the efficacy and safety immuno-virological of Triomune at the General Hospital in N’Djamena/Chad. Methods: 48 HIV-1 positive patients eligible for ARV treatment were enrolled in our study, and they have been then followed for 8 months. We have measured in these patients the CD4 cell count before treatment and at the 8th month of treatment. After 8 months of treatment, we have also evaluated the Lymphocyte T CD4 and the plasma viral load (VL). Comparisons of means of CD4 lymphocytes and plasma CV (≥1000 copies/ml) were used to define treatment failure.?Results:?48 patients were under Triomune regime. The average CD4 count was decreased from 462 ± 179.22 [56 - 981] cells/mm3?before treatment to 327.23 ± 153.77 [10 - 1008] cells/mm3?at the 8th month of treatment. The mean plasma viral load for patients was 66008.62 copies/ml. The failure rate to Triomune was 43.75% (21/48).?Conclusion:?Aside from the side effects already described for Triomune, our study reveals a high treatment failure rate. Hence, there is the need of regular revisions of therapeutic regime administer in the first intention.
文摘Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhupus in Niger. Observation 1: This is a patient suffering from chronic polyarthritis in whom the diagnosis of active seropositive, erosive and deforming RA had been made according to the 1987 ACR criteria and SLE on the presence of 4 criteria according to the 1997 ARA criteria and putting under conventional synthetic DMARDs. The outcome was favorable with a remission achieved after 8 weeks with a disease activity score (DAS) 28 at 2.2. Observation 2: 58-year-old patient with known diabetes type 2 in whom the diagnosis of rhupus was made according to the ACR/EULAR 2010 criteria for RA with a DAS28 of 3.6 and the 2019 LES criteria at 18 points with a SLEDAI score of 6. The evolution was marked by the occurrence of a myocardial infarction with a favorable outcome under medical management. Conclusion: Rhupus is a rare entity that can be complicated by cardiovascular events with the presence of an independent cardiovascular risk factor.
