Therapeutic Profile and Prognostic Factors of Patients Suffering from Upper Digestive Bleeding at Sikasso Regional Hospital

Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.

Lipid Profile among the Diabetic and Non-Diabetic Obese Patients

Objective: To study the lipid profile among the diabetic and non-diabetic obese patients. Methods: It was a descriptive and prospective study carried out over a period of 9 months from March to December 2010. It concerned all the patients who came for consultation in endocrinology at the internal medicine of Point G University Hospital Center and at the National Center for Diabetes Research. All the patients were included without any gender or age difference, voluntary and with a BMI ≥ 30 kg/m2. Results: Out of the 1543 patients received in consultation, we had identified 178 obese people that is to say 11, 53% of the cases. Among these cases 60 abided by our criteria with 30 diabetic patients and 30 non-diabetic ones. The average age was 45.83 ± 14.68 years old;73.3% were more than 40 years old. The sex ratio was 0.07. Two third (66.7%) of our patients limited their eating diet to the three main meals/day and 61.7% were sedentary. The notion of family obesity was found in 93.4% of the cases, of family diabetes in 58.3% of the cases, of past personal medical history of hypertension in 43.3% of the cases. It was about an android obesity in 91% and Gynoid in 9% of the cases. The BMI was 55% of the cases comprised between 30 - 34.9 kg/m2. The lipid profile noticed was: A hypertriglyceridemia: 33% of diabetic patients and 10% of non-diabetic patients, a high LDL cholesterol: 37% of diabetic patients and 30% of our diabetic patients, a HDL hypocholesterolemia: 40% of the diabetic patients and 20% of the non-diabetic patients, a total hypercholesterolemia: 37% of the diabetic patients and 23% of non-diabetic patients. A hyperglycemia was noticed in 13.3% of non-diabetic patients. Conclusion: The frequency of metabolic troubles was higher in obese diabetic patients compared to non-diabetic obese patients mainly the hypertriglyceridemia.

Profile of Endoscopic Lesions and Prevalence of <i>H. pylori</i>Infection at the Digestive Endoscopy Unit of Panzi General Reference Hospital in Bukavu

Introduction: Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of H. pylori infection. Material and Methods: This is a retrospective, descriptive and analytical study, ranging from the 16th of December 2014 to the 16th of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. Results: fifty-five percent of these patients were women. 66% of the patients were under 50 years of age. Their major symptom was epigastric pain (89.2%), the most observed endoscopic lesion was erythematous gastritis (82%) therefore we have noticed 21.5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, NSAID and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). Helicobacter pylori gastritis was the most frequent (61.30%) and Helicobacter pylori were present in 63% of gastric biopsies. Conclusion: Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.

Ischemic stroke:complication of hypertension in hospital west of Almeria in Spain

Objective:The aim of this paper was to analyse the etiologic,clinical,and therapeutic characteristics of the ischemic stroke in the comarca of Poniente,Almeria,Spain.Methods:An observational descriptive study was carried out from June 2005 to June 2006 in the Hospital of Poniente.We studied 243 patients admitted to Internal Medicine Department diag-nosed with ischemic stroke.We revised the clinical histories of patients using social,demographic,clinical,diagnostic,and therapeutic variables.A descriptive analysis of the variables was performed using SPSS V10.1 package.Results:A total of 172 patients(70.7%)were admitted to hospital.The time course of the stroke episode was less than 6 hours(40.6%);mean age of patients 73 years(50% males);94% were autochthonous workers,6% immigrants,72% hypertensive,and 35% had a history of previous stroke.The most common symptom was dysarthria(59%);brain CAT scan was performed in all of them within 6 hours after stroke onset,and antiplatelet drugs were given within 48 hours after stroke onset.About 30% of the patients received early rehabilitation,12% died within the first week.Conclusion:We found clinical and epidemiologic characteristics similar to those reported in the literature;we found a lower incidence of CVD and a higher time course than the national average.