ABSTRACT
Precocious puberty is defined as the onset of secondary sexual characteristics in children at an unusually early age; When puberty begins before age 9 in boys, it is considered precocious puberty. Congenital adrenal hyperplasia (CAH) refers to a group of inherited diseases, due mostly to a deficiency in 21 hydroxylase, an enzyme involved in steroid hormone synthesis. All forms of CAH are transmitted in autosomal recessive mode. Partial 21-hydroxylase deficiency is most often asymptomatic among male subjects, but may be associated with shorter stature, precocious pubarche and prepubertal gyncomastia. We report the case of a male child with isosexuel pseudo precocious puberty revealing late-onset congenital adrenal hyperplasia with partial 21 hydroxylase deficiency.
ABSTRACT
Introduction: Lung resection is a surgical procedure to remove a lung lobe or a complete lung, usually following tumor or infectious diseases. It is often at risk of respiratory and non-respiratory complications that can result in a significant morbidity and mortality. Our objective was to describe the épidémio-clinical and outcomes of non-respiratory complications after lung resection. Method: We performed a descriptive retrospective study in the department of thoracic surgery of the CHU JRA over a period of 07 years, from January 2009 to December 2016. Patients who had undergone a major lung resection of non-traumatic origin were included. Results: Of the 88 patients retained, 76.14% were male, with a sex ratio of 3.19. The mean age was 48 years with extremes of 23 and 83 years. The main indications were infectious, lung aspergilloma (51.14%) and malignant tumor (30.68%). The most common procedures were lobectomy (62.5%) and pneumonectomy (26.13%), predominantly on the right side (78.40%). There were 84.09% of patients with post-operative complications, including 25% cardiovascular, 21.59% parietal, 21.59% infectious, 19.31% neurological and 1.14% digestive. These complications were mostly grade II according to the Clavien and Dindo classification (32.43%). The mortality rate was 11.36%, increasing with age and male predominance. Conclusion: Non-respiratory complications after lung resection are very common and often unfavourable. Improvement of the non-respiratory morbidity and mortality after lung resection requires early management before, during and after surgery.
ABSTRACT
Malignant otitis externa or necrotizing otitis is a serious infection, the starting point is the external auditory canal (EAC),It then diffuses towards the base of the skull, producing a real osteomyelitis and thus puts into play the vital prognosis. This is an infection that occurs mainly on weak terrain such as immunocompromised people, or most often elderly diabetic people. It is a serious infection in diabetics due to its complications. Its treatment is based on glycemic control, local treatment, prolonged antibiotic therapy, and rarely surgery.We report the case of an elderly diabetic patient hospitalized in the pharyngeal otorhino department for the management of multiple germ external otitis media: pseudomonas aerogeunosa, coagulasse staphylococcus negative, candida albicans, complicated by facial paralysis with undernutrition and hematoma under chronic dural.
ABSTRACT
Pulmonary pneumatoceles are thin-walled air-filled cystic lesions occurring in lung parenchyma. Pneumatocel is rarely seen in adults. Hyponatremia is defined as a serum sodium level being below 135 mEq/L. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of hyponatremia. SIADH is the most common cause of normovolemic (euvolemic) hyponatremia. Pneumatocele was detected in a 22 year old female patient who is presented with hyponatremia in this article.
ABSTRACT
Abnormal coronary artery birth is a congenital abnormality that remains rare. In some cases, congenital coronary abnormalities may be associated with the development of chest pain, syncope or sudden cardiac death. Our patient is 65 years old with a chronic smoking cardiovascular risk factor and as a history a right ventricular arrhythmogenic dysplasia discovered for 7 years. Our patient was admitted for acute Coronary Syndrome NSTEMI , a coronary angiogram was performed showing coronary arteries without significant stenosis. However, the right coronary artery had an abnormal birth in the left sinus more precisely in the left main. We are reporting the case of a patient who presented for acute coronary syndrome as revealed by typical anginal chest pain, highlighting that he is being followed for arrhythmogenic dysplasia of the right ventricle, with an abnormal birth of the right coronary artery at of the left main. Several studies have been conducted to establish the relationship between the patient’s symptoms, his history and this angiographic finding
ABSTRACT
Adenocarcinoma of the prostate has been known as a disease of the aging males. It is commonly diagnosed in the industrialized countries and becoming an increasing burden in the developing countries because of increasing health awareness and life expectancy. Diagnosis is made by digital rectal examination (DRE) of the prostate for malignant features beside an elevated prostate specific antigen (PSA) and positive prostate biopsy results on histology. Gleason score derived by adding the two (2) predominant histologic patterns helps in prognostication of individual patient. In this study, we retrospectively studied the relationship (correlation) between serum PSA and Gleason Score (GS) in Prostate Cancer (PCa) Patients. One hundred and ten (110) patients diagnosed with Pca between January 2016 and December 2017 were studied. Their case notes from the health records department were retrieved and data collected together with their histopathology reports of prostate biopsy from the pathology records department. Pre-biopsy PSA were correlated with Gleason score. Results showed that majority of the men presented with a serum PSA >50ng/ml with a corresponding high Gleason Score (Gs of 9). PSA also correlated positively with Gleason Score. Therefore patients with high PSA may likely harbor tumours with high Gleason scores indicating poor prognosis.
ABSTRACT
Ce travail a pour but d’évaluer, au moyen d’une méthode fiable, le statut nutritionnel protéinoénergétique des sujets adultes cirrhotiques. Méthodologie : il s’agit d’une étude transversale prospective, menée sur une période de 12 mois, portant sur des sujets âgés d’au moins 18 ans. Au cours de cette période, 120 malades ont été recrutés au total. Les principaux paramètres d’évaluation utilisés sont le pli cutané tricipital (PCT) et la circonférence musculaire brachiale (CMB), quelques autres paramètres étant associés (albumine). La classification de Child-Pugh a été utilisée pour évaluer le degré d’atteinte de la fonction hépato- cellulaire. Résultats : prévalence élevée de la dénutrition (46.6%) et que celle-ci est beaucoup plus marquée quand il s’agit d’un stade plus évoluée de la cirrhose. Conclusion : nos résultats montrent qu’il faut se préoccuper davantage du statut nutritionnel protéinoénergétique des patients hospitalisés en hépato-gastro-entérologie.
ABSTRACT
The association of Cushing syndrome and pregnancy are uncommon situation. We report a case of a 33 years old multigravida woman with 22 week of gestation that present a gestational diabete and a high blood pressure. the diagnosis of cushing syndrome was suspected due to the glycemic imbalance. The etiological diagnosis of adrenal adenoma was made by abdominal CT. A ablation by laparoscopic of the adenoma was made at 24 week of gestation
