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Original Research Article
Rheumatological Manifestations in Chronic Hemodialysis Patients at the National Hospital of Zinder
Hassane Moussa Diongole, Alkassan Yacouba, Zeinabou Maiga Moussa Tondi, Moussa Taofik, Abdoul Aziz Garba, Maman Salissou Garba, Illiassou Aboubacar, Chaibou Laouali, Bonkano Djibril, Abdoul Aziz Serib
EAS J Med Surg, 2022; 4(5): 114-117
DOI: 10.36349/easjms.2022.v04i05.006
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ABSTRACT
Introduction: Hemodialysis can be used restoratively for patients with end-stage chronic renal failure [1, 2]. However, patients with chronic kidney disease (CKD) can develop rheumatological complications that cannot be or only poorly controlled by hemodialysis. Indeed, rheumatological manifestations that develop in hemodialysis patients can be multiple and varied, and can occur early and then worsen depending on the duration of dialysis therapy [3,4]. Other complications, some not yet fully elucidated, can also adversely affect quality of life. Rheumatological abnormalities can result in clinical polymorphisms within bones and joints, but also entheses, muscles and tendons. Pathophysiologically, these manifestations can be associated with various abnormalities: e.g., calcium-phosphate metabolism disorders, immunological disturbances with increased susceptibility to infections, induced auto-inflammatory pathologies, microcrystalline arthritis, β2 microglobulin amyloidosis, etc…Despite scientific progress, there is a paucity of detailed knowledge on the many mechanisms involved and, in particular, on their multiple interactions. Overall, these conditions can lead to a significant deterioration in quality of life, and increased morbidity and mortality. Worldwide, rheumatological manifestations are found in hemodialysis patients with a frequency of between 47 and 72% in the West and in North Afric[5,6,7]. Although they have been the subject of several studies, few data are available from sub-Saharan Africa. Thus, we conducted a study in the Nephrology Department of the National Hospital of Zinder (Niger) to determine the epidemiological profiles and diagnostic characteristics of end-stage kidney disease (ESKD) patients receiving hemodialysis.
ABSTRACT
Endometriosis usually occurs in menstruating women up to 15%. Most common gastrointestinal involvement of endometriosis is found in the sigmoid colon, rectum and terminal ileum in 3%–37% of women. Terminal ileum is rarely involved in endometriosis. Patients with appendicular endometriosis constitute <1% cases of all pelvic endometriosis cases. Surgery is the choice of treatment for intestinal endometriosis in most cases.
ABSTRACT
Primary biliary cholangitis may be another hepatobiliary association of ulcerative colitis, and although less common than primary sclerosing cholangitis should be considered as a cause of cholestasis in these patients. Here, we report a case of A 26-year-old female patient.
ABSTRACT
Deep vein thrombosis is one of the rare reactions that can occur after bee envenomation. A 40-year-old female presented at our facility for evaluation and management of a left lower limb swelling two weeks after suffering a bee sting. She was diagnosed with deep vein thrombosis (DVT). The development of DVT was attributed to thrombogenic properties of bee venom and endothelial injury caused by released inflammatory cytokines. The patient’s mainstay treatment was with anticoagulants.
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Introduction: Data on kidney lesions during ophidian envenomation in Niger are rare. The aim of the study was to describe a case of severe renal failure secondary to ophidian envenomation occurring in our hemodialysis nephrology department. Observation: This is a 53-year-old patient, resident in a rural town near the city of Niamey. She was referred to us from the National Hospital's Internal Medicine Department for severe renal impairment secondary to a snakebite. Clinical examination showed poor general condition, impaired consciousness with a Glasgow 10/15, severe uremic syndrome, hemorrhagic syndrome and metabolic dyspnea. On biology, severe anemia was noted at 5.3 g/dl, thrombocytopenia at 32,000 elements/µl, white blood cells at 18,109/L, urea level at 50 mmol/l and serum creatinine at 1009 µmol/l i.e. an eGFR= 4 ml/min. Despite the initiation of hemodialysis and transfusions, the patient died in a picture of septic and hemorrhagic shock. Conclusion: ARF secondary to ophidian envenomation is accompanied by a considerable risk of mortality, especially in the event of delay in treatment.
ABSTRACT
Introduction: Conception on chronic hemodialysis (CHD) is a rare and high-risk maternal--fetal event. We report on the first case of pregnancy with birth of a live child in our hemodialysis center in Kaolack (Senegal). Observation: A 35-year-old woman had been on chronic hemodialysis for 18 months. Amenorrhea (AS) was identified at week 22 of pregnancy. Control of blood pressure, dry weight, an acceptable hemoglobin level, and intensification of dialysis sessions, enabled a natural delivery at 32 weeks of a live newborn weighing 1200g. Conclusion: Close collaboration between nephrologists, obstetricians, neonatologists, and nutritionists determined the success of pregnancy with CHD.
ABSTRACT
A peculiar case of ischuria secondary to Zinner syndrome. A complete excision via laparoscopic approach given a 100 percent symptomatic relief is a safe and effective. Symptomatic congenital cysts require an appropriate management.
Case Description: Case of 21 years male presented in urology unit with features of obstructive uropathy, acute urinary retention and severe lower abdominal pain on evaluation found to had left kidney agenesis and left seminal vesical cyst [1]. A Three port laparoscopic transperitoneal approach performed and left side seminal vesical cyst removal done. The peritoneum was incised between the bladder and the rectum to reveal the left seminal vesicle, which was resected from the surrounding tissue and removal of the cyst done.
Discussion: Aim of the study was to show the advancement and usefulness of the laparoscopic approach with short hospital stay and painless procedure, minimal blood loss. Procedure lasted for 60 mins. Unrecordable post intraoperative complications. Patient had been discharged after 36 hours after the procedure, on follow up patient is asymptomatic for 24 months of the procedure. Symptomatic Zinner syndrome with appropriate identification and laparoscopic approach and magnified view better than open and other invasive techniques should be a method of choice in treatment of the congenital seminal vesical cyst and currently a golden surgical standard.