Introduction: Antiphospholipid antibody syndrome (APS) is a condition that can affect obstetric prognosis. We conducted a study to determine the frequency of this condition in our hospital. Materials and methods: This was a prospective cross-sectional study conducted in the internal medicine department of Abdou Aziz Sy Hospital. We included all patients who had arguments in favor of APS. Results: We included 19 patients. The average age was 32 years, with extremes of 31 and 42 years. The average duration of the condition was 6.7 years, with extremes of 1 and 10 years. The average number of pregnancies was 5.79, ranging from 4 to 14 pregnancies. Obstetric manifestations included abortions (in all patients), retained dead fetuses in 3 patients, and intrauterine fetal death in 3 patients. Extra-gynecological and obstetric signs included inflammatory polyarthralgia (in 6 patients), erythematosquamous lesions (4 patients), and physical asthenia (4 patients). Antinuclear antibodies were positive in 13 patients, and anti-ECT antibodies were positive in 7 patients. Circulating lupus anticoagulant was found in 6 patients, anticardiolipin in 7 patients, and anti-glycoprotein I in 5 patients. APS was primary in 10 patients and seronegative in 2 patients. Abortions were more closely correlated with the presence of circulating lupus anticoagulant and the co-occurrence of antibodies. Treatment consisted of conventional immunosuppressants in patients monitored for secondary APS and curative heparin therapy in six patients who became pregnant during follow-up, with a favorable outcome in three patients. Conclusion: APS is an underdiagnosed condition with a serious obstetric prognosis that compromises the maternal-fetal prognosis.
We analyzed cases of hearing impairment in Japanese patients with ankylosing spondylitis (AS), as only two similar studies from Asia are found in the literature. Patients were diagnosed using the revised diagnostic criteria for AS as well as positive MRI findings of the sacro-iliac joints. Patients older than sixty years were excluded because of potential age-related hearing impairment. Four patients met the study criteria and were included in the analysis. Three patients were found to have high-frequency hearing impairment, presumably with cochlear dysfunction. In addition, the patients with AS are reported to have HLA B27 antigen positivity with high frequency in the European countries. Therefore, HLA B27 positivity is also studied. HLA B27 was only one patient positive. Hearing impairment in Japanese patients with AS is also frequently observed but not associated with HLA B27 positivity.
Date palm is known to be the oldest plant in the world. Both fruit and seeds are packed with powerful nutritious and therapeutic properties. Important in Muslim community due to mentioned in Quran and Hadith for its therapeutic and healing properties in reproductive age, which proved by Modern scientific studies for both fetus, infant, and mother. Play crucial role to increased energy stores for delivery, high content of potassium act as a vasodilator and presence of angiotensin-converting enzyme inhibitor and reduce risk of preeclampsia and eclampsia, promote breastmilk production during lactation. Rich bioactive profile acts as an antioxidant and suppresses oxidative damage and boosts up fertility as well as enhance immune response by increasing count of WBC and Nk cell. In short dates fruit might be considered one of the complete nutritional foods to fulfil the requirements of reproductive health. This review highlighted pharmacological and nutraceutical properties of dates fruit and its potential use as a non-pharmacological traditional medicine in reducing pregnancy, lactation, and infertility consequences.
Aromatase inhibitors (AIs) are the standard adjuvant therapy for hormone-receptor–positive breast cancer in postmenopausal women and are considered less thrombogenic than tamoxifen. However, rare autoimmune complications, including lupus-like syndromes, inflammatory arthritis, and hepatitis, have been described. Antiphospholipid syndrome (APS), an autoimmune prothrombotic disorder is exceedingly rare in patients taking aromatase inhibitors. We present the case of a 68-year-old woman with breast cancer treated with surgery, chemotherapy, and letrozole for 3 years who subsequently developed deep venous thrombosis, ischemic stroke, severe thrombocytopenia, severe gastrointestinal bleeding, and triple-positive antiphospholipid antibody profile consistent with primary APS. Laboratory and imaging work-up excluded secondary causes of thrombosis such as systemic lupus erythematosus, bone marrow disease, metastatic cancer and heparin-induced thrombocytopenia. Her course was further complicated by refractory gastrointestinal bleeding which continued even after discontinuation of low-molecular-weight heparin (LMWH). Bleeding resolved only after argon plasma coagulation (APC). Because of ongoing thrombosis risk, anticoagulation was transitioned from LMWH to warfarin, and hydroxychloroquine was initiated, resulting in platelet stabilization (23 → 145 × 109/L). She had no further bleeding, and no recurrent thrombotic events. This case presents the clinical course, diagnostic work-up, and management of primary APS emerging during prolonged aromatase inhibitor therapy and summarizes relevant considerations for evaluation of thrombosis and thrombocytopenia in patients treated with endocrine therapy for breast cancer.
Introduction: Hypertension is a leading global health concern, characterised by chronic low-grade inflammation and oxidative stress that drive a vicious cycle of vascular dysfunction, endothelial damage, and end-organ injury. Aim: This study evaluated serum levels of inflammatory and oxidative stress biomarkers among hypertensive adults in Port Harcourt, Nigeria, to examine the variation in these biomarkers between untreated and treated hypertensive subjects. Methods: This cross-sectional study enrolled 150 participants aged 25-65 years, divided into three groups: 50 treated hypertensives on medication, 50 newly-diagnosed untreated hypertensives, and 50 normotensive controls. All participants underwent anthropometric and blood pressure measurements. Venous blood (5mL) was collected for the laboratory quantification of serum levels of inflammatory markers: C-reactive protein (CRP) and tumour necrosis factor-α (TNF-α), and oxidative stress biomarkers: malondialdehyde (MDA), reduced glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT). Results: Findings reveal that study participants were relatively age-matched across the groups. Our data show significantly elevated body mass index (BMI), MDA, CRP and TNF among the treated hypertensive subjects compared to both the untreated hypertensive and normotensive controls (p<0.05). Conversely, we observed significantly reduced levels of GSH, GPx, CAT and SOD among the treated and untreated hypertensive groups compared to the normotensive control (p<0.05). Conclusion: The current study demonstrates that hypertension is characterised by chronic immuno-inflammatory dysregulation mediated by reactive oxygen species (ROS), which drives endothelial dysfunction and arterial stiffness. The persistence of these inflammatory and oxidative stress markers in treated patients underscores the need for adjunct antioxidant and immunomodulatory supplementation to improve vascular outcomes in hypertension.
We did this study to determine the profile of anemia in the internal medicine department of the Lomé University Hospital campus. Then, we have done a retrospective and descriptive study which took place over the period from January 1, 2021 to December 31, 2022, i.e. a duration of 2 years in the internal medicine department of the Lomé University Hospital campus. Data were collected from a questionnaire completed using the records of patients hospitalized during the study period. During the study period, 190 files of anemic patients were collected from 2,249 hospitalized patients. The hospital frequency of anemia was 8.45%. The average age of the patients was 47 ± 20 years. The female gender was predominant with a sex ratio of 0.76. Most patients were admitted through the emergency department (56.8%). The main reasons for consultation were asthenia (41.6%) and severe pallor (17.9%). Hypertension, HIV infection and diabetes were the main medical antecedents in 22.6%, 22.6% and 15.3% respectively. The average hemoglobin level was 7 g/dl. Normocytic anemia and microcytic anemia were the most observed types of anemia (55.3% and 43.2% respectively). The main etiologies were severe malaria (26.3%), HIV infection (24.7%) and chronic renal failure (17.9%). The average length of hospitalization was 6±3 days. The mortality rate was 18.9%. The main causes of death were HIV infection, viral hepatitis B&C, chronic renal failure and hematologic malignancies. To concluate, anemia is a frequent symptom in our environment and constitutes a real challenge for the hospital practitioner. Its classification makes it possible to guide the etiologies in order to establish adequate care.
We make this study to determine the nature and frequency of the different groups of pathologies treated in hospitalization in the internal medicine department of the CHU Campus of Lomé from 2021 to 2022. Then, we done an retrospective study and a descriptive aim was carried out from January 1, 2021 to December 31, 2022 in the internal medicine department of the CHU Campus. Data were collected from a questionnaire completed using inpatient records during our study period. On end of the study, in 1978 patients selected for this study, 1096 (55.4%) were female and 882 (44.6%) were male, i.e. a M/F sex ratio of 0.8. The mean age of the patients was 50.2 ± 19.0 years (range 14 to 108 years). Asthenia (40.0%) and fever (29.9%) were the reasons for consultation frequently encountered. Hypertension (33.0%) and diabetes (21.6%) were the most common medical antecedents. The main groups of pathologies encountered were infectious pathology (38.6%), endocrine pathology (24.1%) and HGE pathology (6.9%). But taken in isolation, diabetes, malaria and HIV infection were the main pathologies diagnosed with respectively 22.1%, 12.9% and 6.3% of hospitalizations. In conclusion, we say that, the pathologies frequently encountered in the internal medicine department were infectious and endocrine.
Background: Japanese encephalitis (JE), Nipah virus encephalitis and some other viral encephalitis are endemic in northern districts of Bangladesh. Occasionally upsurge of hospital admission of encephalitis patients are reproted in the tertiary care hospitals which needs evaluation. In May 2015, Shahid Ziaur Rahman Medical College Hospital (SZMCH) in Bogura, Bangladesh, reported an increased admission of encephalitis patients. Due to the endemic nature of viral encephalitis in the region, including Japanese encephalitis (JE) and the Nipah virus, the hospital authority reached out to the Institute of Epidemiology, Disease Control and Research (IEDCR). Objectives: The investigation was performed to verify whether the event was an outbreak and to identify potential etiologies. Methods: A field investigation was conducted from June 2 - 5, 2015 in SZMCH. Hospital admission in Medicine wards from January 2014 to May 2015 were analyzed to determine baseline trends. A suspected encephalitis case was defined as any patient with acute onset of fever and unconsciousness or altered mental status, seizure, or other neurological symptoms. We interviewed the attendants of encephalitis patients admitted from June 3 - 4, 2015. Serum and cerebrospinal fluid (CSF) samples were collected and tested for JE virus IgM antibodies at IEDCR. Clustering and geographic distribution were assessed using an epidemic curve and mapping of cases by district. Results: A total of 17 suspected encephalitis cases were identified (mean age 37 years; 70% male; 41% mortality). The rate of encephalitis admissions in May 2015 (5.9/1000 hospital admission in Medicine wards) was not significantly higher than the baseline period (7.1/1000 hospital admission). No spatial or temporal clustering was observed. Four patients met the probable case definition based on CSF findings. Of these, one tested positive for JE IgM antibodies; the rest were seronegative. No epidemiological risk factors for Nipah virus were found. Conclusion: We conclude that the encephalitis was sporadic and had no spatial and temporal relation with each other. However, a confirmed JE case reveals ongoing viral encephalitis transmission in northern Bangladesh. We recommend to strengthen hospital-based surveillance, improve diagnostic capacity for rapid detection, confirmation and control of the outbreak.
Non-alcoholic fatty liver disease (NAFLD) is one of the most common fatty liver diseases, leading to biochemical and histological disorders in NAFLD. It is characterized by kinds of pathologies, ranging from simple non-alcoholic fatty liver (NAFL) to serious non-alcoholic steatohepatitis (NASH) with the complication of steatosis, fibrosis, NASH cirrhosis and hepatocellular carcinoma (HCC). The most important potential risk factors including insulin resistance and increased oxidative stress, especially vitamin E, have significant influence on the treatment for NAFLD. Vitamin E, as a key fat-soluble antioxidant, presents potential therapeutic value in the intervention of NAFLD. At present, there are differences in the intervention measures proposed by various studies, and the efficacy of corresponding intervention measures has not yet reached a unified conclusion. To analyze the relevant research on the combination therapy of vitamin E in NAFLD patients, and to explore the intervention effect of vitamin E combination therapy on their biochemical indicators and histological abnormalities. PubMed, EMBASE, Medline, Cochrane, ScienceDirect, Web of science, and Google Scholar Database were systematically searched to screen studies on the intervention effect of vitamin E combination therapy on NAFLD from January 2005 to April 2025. A total of 9 randomized controlled trials (RCT) were included, which included 885 participants with an average age of 35~48.04 years. The combination therapy of vitamin E had significantly improved liver function indicators (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma glutamyl transferase (GGT)) in NAFLD patients in most studies, and had also positive effects in improving liver histological parameters (NAFLD activity score (NAS), steatosis, fibrosis score, and inflammation), but there was heterogeneity among these studies. In addition, some studies did not observe significant improvement in ballooning, and only one study showed that combination therapy had no significant effect on liver function testing. The combination therapy of vitamin E has potential benefits in improving liver function indicators and some histological parameters in NAFLD patients, but its efficacy varies among studies. In the future, more high-quality and long-term RCT need to be conducted to further clarify the optimal regimen and applicable population of vitamin E in the treatment of NAFLD, providing a more comprehensive and reliable reference for clinical practice.
Introduction: High blood pressure is the most prevalent cardiovascular risk factor worldwide. It considerably increases the risk of cardiovascular events through the involvement of well-defined target organs. The objective of this study was to study the epidemiological, diagnostic, and evolutionary aspects of arterial hypertension, and to assess the prevalence of other associated risk factors. Methodology: This is a cross-sectional, descriptive and analytical study carried out at the level of the outpatient internal medicine and cardiology consultations of the Mame Abdou Aziz SY Dabakh Hospital in Tivaouane, from January 1, 2021 to December 31, 2021. Patients aged 18 years or older and with hypertension treated and monitored for at least 6 months without an immediate threat to life were included. Patients with gestational hypertension and those who had expressed a refusal to participate in the study were not included. Results: During the study, 705 hypertensive patients out of 2192 were received, i.e. a prevalence of 32.16%. Of these, 110 patients were recruited, 8 non-included and 102 included. The average age was 61.3 ± 11.41 years with a predominance of the age group of 46 to 65 years which accounted for 52%. The female sex was predominant, accounting for 70.59%. 24.51% of patients had well-controlled blood pressure. The most prescribed therapeutic protocol was dual therapy accounting for 46.53%, followed by triple therapy (29.7%) and monotherapy (23.76%). Physical inactivity was the predominant risk factor accounting for 48.04%, followed by dyslipidemia (44.11%) and diabetes (37.25%). Stress was present in 38.23% of patients and obesity in 13.7%. Smoking accounted for 1.96% and a family history of cardiovascular disease was reported by 29.41% of patients. Cardiovascular complications were the most frequent, accounting for 68.61%, followed by renal complications (6.86%), and strokes (5.88%), all of which were ischaemic. The overall cardiovascular risk was low in 0.9% of cases, moderate in 41.2% of cases, and high in 57.9% of cases. Conclusion: Cardiovascular morbidity and mortality in rural areas is increasing and deserves special attention. A good knowledge of high blood pressure and other cardiovascular risk factors is the key to prevention.
Pasteurella multocida, a zoonotic gram-negative coccobacillus commonly found in the oral flora of domestic animals like cats and dogs, is a rare cause of pneumonia, particularly in immunocompetent individuals. This case report describes a 55-year-old immunocompetent woman who presented with a two-month history of worsening shortness of breath, fatigue, low-grade fever, night sweats, loss of appetite, and weight loss, alongside a six-year history of intermittent respiratory symptoms. She reported prolonged close contact with her pet dog and cat and a 20-year history of indoor biomass fuel exposure. Physical examination revealed diminished breath sounds in the right middle lung field and oxygen saturation of 90% on room air. Chest CT showed right middle lobar bronchus stenosis, segmental atelectasis, bilateral bronchial wall thickening, ground-glass opacities, and mild centrilobular emphysema. Bronchoalveolar lavage culture confirmed Pasteurella multocida, sensitive to Amoxicillin-Clavulanate, leading to a diagnosis of P. multocida pneumonia. Treatment with a 10-day course of oral Amoxicillin-Clavulanate resulted in significant clinical improvement, with resolution of respiratory and systemic symptoms and a 2 kg weight gain by day 15. This case underscores the importance of considering zoonotic pathogens in the differential diagnosis of community-acquired pneumonia in patients with animal exposure, even without typical risk factors like immunosuppression or chronic lung disease. It highlights the role of environmental factors, such as biomass fuel exposure, in predisposing to pulmonary infections and the value of early bronchoscopy for definitive diagnosis. Patient education on pet hygiene and avoidance of respiratory irritants is crucial for prevention, emphasizing the need for a thorough exposure history to manage rare zoonotic infections effectively.
Menière's disease (MD) is a chronic inner ear disorder characterised by vertigo, fluctuating hearing loss, and fullness, frequently associated with migraine. The aetiology of MD is multifactorial but unclear. Endolymphatic hydrops (EH) is the histopathological marker. The correlation between venous disorders and MD is described in the literature. Our study aims to evaluate the incidence of Transverse Sinus Asymmetries (TSA) in patients with Menière Disease (MD) and non-migrainous headaches to test a physiopathological hypothesis. Materials and Methods: We conducted a retrospective study of 32 patients with symptoms of MD and non-migrainous headaches who presented to TSA on Magnetic Resonance Imaging (MR). Each patient underwent clinical evaluation, Audiometry, impedanceometry, VHIT, VEMPS, RM Angiography (RMA), transcranial colour doppler ultrasound (TCD) to study the intracranial venous system and vascular flow. Results: All patients were diagnosed as probable in 41% and certain in 59%. On RMA results, 91% showed TSA. We propose four TSA stages. RMA showed 83% left TS hypoplasia and 17% right TS hypoplasia. All patients with TSA showed MD. Patients with left TSA showed right MD; patients with right TSA showed left or bilateral MD. We used TCD in 15 patients: 10 patients showed alteration or flow reversal. In 5 subjects was not possible due to mastoid ossification. Conclusions: Ultimately, a clear association exists between TS absence or hypoplasia in many Menière’s patients with non-migrainous headaches. Moreover, there is a correspondence between the side of MD and TSA, which is contralateral. Our study suggests to follow-up patients with TSA to prevent the onset of EH.
Mallory-Weiss tear (MWT) is a frequent cause of acute upper gastrointestinal (AUGI) bleeding and is defined as a longitudial superficial mucosal tear that usually occurs at the gastroesophageal junction. MWT is usually associated with increased abdominal pressure. 50 to 70% of patients diagnosed with MWT have a history of heavy alcohol intake. MWT usually presents with bright red or coffee-ground vomitus, black tar-like stool, signs of anemia, chest pain, abdominal pain, or signs of shock. Bleeding from MWT can stop on its own, however, significant bleeding may require endoscopic management. Here, we present 2 cases of life-threatening upper GI bleeding secondary to MWT. Case 1 is a 55-year-old male with known Obesity Hypoventilation Syndrome who presented with a violent cough and was initially admitted with respiratory distress. He became hypoxic and hypercarbic while on the ward and was transferred to the Intensive care Unit (ICU). A copious amount of fresh blood was drained upon passage of a nasogastric tube. The second case is a 31-year-old male who abuses alcohol. He presented with five episodes of vomiting followed by 4 episodes of hematemesis. Initially, conservative management failed to stop the bleeding in both cases; hence, an upper Gastrointestinal (GI) endoscopy was done, which diagnosed a MWT in both cases. Haemostasis was achieved in both cases using monopolar coagulation forceps. The use of monopolar coagulation forceps is a safe and effective tool in combination with other endoscopic modalities in managing significant bleeding from MWT. Monopolar coagulation forceps are much easier to use over the bipolar heater probe.
This study aimed to explore the potential role of smoking and canned material consumption in the development of gastric ulcer disease. Researchers compared 104 gastric ulcer patients with a control group matched for age, sex, and social status. The analysis examined exposure to these factors during three periods: over a lifetime, within five years, and in the year preceding the onset of symptoms. Results revealed a significant link between smoking, regular canned material consumption, and a higher risk of gastric ulcers across all time frames. Since these exposures occurred prior to symptom onset, the findings suggest a possible causal relationship. If confirmed, these factors could account for up to 80% of gastric ulcer cases. smoking with a corresponding increase in rate of development of gastric ulcer allowing to become more prominent. In the early 20th century physician’s believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for “surgical disease. We show that while smoking and canned materials remained common and virulent in Egypt and the Middle East, environmental changes resulted in changes of the pattern of gastric ulcer producing a change in the manifestations. The consumption of many of canned materials, mainlyFava beans, fava beans, chickpeas and mortadella, increase risk. Many of these canned material contain presentatives cause diseases, which were also inversely related to gastric cancer risk. The intake of smoking was positively associatedwith gastric cancer risk, but primarily in men.
Buerger's disease is a systemic vasculitis strongly correlated with tobacco use. It entails a heavy socio-occupational impact. We report the case of a 26-year-old patient with ischemia of the lower limbs revealing Buerger’s disease. He is known smoker with passive exposure to Indian hemp. He was seen for ischemic foot pain that had been progressing for a year. Involvement began in the left big toe. Subsequently, hyperalgesic necrotic lesions were observed on the 3rd, 4th and 5th toes of the foot. Biological investigations revealed an inflammatory syndrome with normocytic anemia and increased C-reactive protein. Retroviral, syphilitic, Hepatitis B and C viruses and SARS-CoV-2 serologies were negative. Antinuclear antibodies were initially borderline at 100 IU with speckled fluorescence, then negative on control. Neutrophil cytoplasmic antibodies and antiphospholipid antibodies were negative. Investigation of thrombophilia was non-contributory, notably factor V mutation testing, antithrombin III assay, proteins C and S and fibrinogen. An arterial ultrasound revealed extensive arterial thrombosis with thickening of the femoral arterial vessel walls. Thromboangiitis obliterans was confirmed and the patient was put on corticosteroids and adjuvant therapy. Surgical treatment was performed 4 months later. Buerger's disease is a serious vascular disorder which must be diagnosed very early in order to prevent complications. Early smoking cessation leads to remission in the early phase.
Introduction: Adult-onset Still's disease is a rare systemic inflammatory disease in Africa. Observations have been published in Senegal. Materials and Methods: We conducted a retrospective descriptive study to establish the epidemiological profile of patients presenting with adult-onset Still's disease (AOSD) in a health center. The patients included met the diagnostic criteria of Fautrel and/or Yamaguchi. Results: During our study (2020-2024), we included 10 patients with a hospital incidence of 2 patients per year. The average age of the patients was 29.5 years ±11.9, ranging from 15 to 49 years. Females predominated with a sex ratio of 0.67. Clinical manifestations were polymorphic, dominated by fever (100%), inflammatory polyarthralgia (60%), tachycardia (80%), physical asthenia (70%), altered general condition (50%), and erythema (30%). The biological inflammatory syndrome was found in all patients. The glycosylated fraction of ferritin was depleted in all patients. We noted a good outcome after treatment with prednisone 1 mg/kg/day in all patients, methotrexate in six patients, and hydroxychloroquine in one patient. Conclusion: Adult-onset Still's disease is a rare condition, unknown to most practitioners. Its prognosis is severe, especially with visceral involvement.
Dengue fever is a mosquito-borne viral infection caused by the dengue virus, belonging to the Flavivirus genus and primarily transmitted by Aedes mosquitoes. It is prevalent in tropical and sub-tropical regions, affecting millions of people globally each year. The World Health Organization (WHO) estimates that about 390 million dengue infections occur annually, with approximately 96 million manifesting clinically. The epidemiology of dengue is influenced by several factors, including climate change, urbanization, and globalization, which facilitate the spread of the vector and the virus. While the typical presentation of dengue includes high-grade fever, headache, myalgia, arthralgia, and rash, the disease can escalate to more severe forms, such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). These severe forms can lead to life-threatening complications, necessitating prompt recognition and intervention. DHF is characterized by plasma leakage, thrombocytopenia, and hemorrhagic manifestations, which can culminate in significant morbidity and mortality. The pathophysiology underlying these severe manifestations is complex and involves the interplay of the virus, host immune response, and genetic predisposition. Additionally, neurological involvement, such as dengue encephalitis, and gastrointestinal (GI) complications, such as upper GI bleeding, are rare but increasingly recognized complications. This case report describes the clinical course of a young adult male who initially presented with typical dengue symptoms but developed severe complications during hospitalization. His clinical course included the development of dengue encephalitis and upper GI bleeding, both of which were primarily driven by plasma leakage and dengue hemorrhagic fever. Through this case, we aim to shed light on the atypical manifestations of dengue fever and the importance of early recognition and management of these complications.
End-stage liver disease (ESLD) represents the terminal phase of chronic liver injury, characterized by overt clinical manifestations and severe complications that significantly impair the quality of life. The condition often culminates in a variety of symptoms, including jaundice, ascites, and hepatic encephalopathy, which reflect the liver's inability to perform its essential functions. Liver transplantation remains the definitive treatment for ESLD; however, limitations in donor organ availability necessitate exploration of alternative therapeutic strategies. we present a case of a 71-year-old Asian male with decompensated post-hepatitis B cirrhosis, who had a one-year history of hematemesis and melena. Endoscopic evaluation confirmed the presence of esophageal-gastric varices, further corroborating portal hypertension and hypersplenism. This patient underwent treatment with autologous bone marrow-derived mesenchymal stem cell (BM-MSC) transplantation. Following the procedure, the patient demonstrated significant clinical improvement, suggesting the safety and potential feasibility of BM-MSC transplantation for patients with ESLD. The field of BM-MSC transplantation has witnessed significant progress in recent years, emerging as a promising therapeutic approach for ESLD. This innovative treatment modality harnesses the regenerative capabilities of stem cells to promote liver repair and function. Notably, BM-MSCs possess immunomodulatory properties that may mitigate inflammation and fibrosis in the liver, thereby addressing some of the underlying pathophysiology associated with ESLD. This case presentation highlights the potential application of BM-MSC therapy in patients with decompensated cirrhosis. The findings underscore the need for further research and refinement of clinical application techniques to fully realize the broad therapeutic possibilities of BM-MSC transplantation for ESLD. As we advance our understanding of stem cell therapies, it is crucial to conduct larger studies to evaluate long-term outcomes and establish standardized protocols for treatment.
Hyperthyroidism, a disorder characterized by excessive thyroid hormone production, typically presents with many symptoms including weight loss, tremors, and heat intolerance. However, in rare instances, it can manifest solely as chronic diarrhea, posing a diagnostic challenge. This case study aims to highlight an unusual presentation of hyperthyroidism and underscore the importance of considering thyroid disease in the differential diagnosis of chronic gastrointestinal symptoms. We present the case of a fifty-year-old woman who, six months prior to her ER visit, had been experiencing severe weight loss and diarrhea along with anemia. Despite her lack of typical hyperthyroidism symptoms, a thorough investigation revealed that hyperthyroidism was the underlying cause of her gastrointestinal issues. This case illustrates that hyperthyroidism can present atypically, solely as chronic diarrhea. The patient's anemia was linked to iron deficiency, worsened by chronic gastrointestinal loss and the hyper metabolic state induced by hyperthyroidism. Treatment of the hyperthyroidism led to significant improvement in her gastrointestinal symptoms and correction of the anemia. This case underscores the critical need to include thyroid disease in the differential diagnosis for patients with chronic diarrhea and weight loss, even in the absence of typical hyperthyroid symptoms. Early recognition and appropriate management of hyperthyroidism can significantly improve patient outcomes by alleviating gastrointestinal manifestations and correcting associated anemia. Clinicians should maintain a high index of suspicion for thyroid dysfunction in patients presenting with unexplained chronic diarrhea and weight loss to ensure timely and accurate diagnosis and treatment.
Viral hepatitis B, defined as inflammation of the liver caused by the hepatitis B virus, is a major public health problem worldwide. The aim of this study was to assess the knowledge and practical attitudes of pregnant women concerning viral hepatitis B. This was a descriptive cross-sectional study conducted over six months in two hospitals in the city of N'Djamena. Pregnant women attending antenatal clinics at the Hôpital de l'Amitié Tchad-Chine or the Hôpital de District Sud de N'Djamena were included. Data were collected using pre-administered questionnaires administered during antenatal consultations. A total of 350 pregnant women were interviewed, of whom 51 had a positive HBsAg result, representing a prevalence of 14.57%. The mean age was 26.4 ±5.6 years. All school levels were represented. In terms of transmission routes: 37.3% of women cited the sexual route, versus 29.4% for the blood route. Mother-to-child transmission was known by 33.3% of pregnant women across all levels of education. However, knowledge was higher (over 70%) among pregnant women with higher levels of education. Nearly 80% of women surveyed were aware of the existence of the vaccine, but less than 1% had been vaccinated. Pregnant women's knowledge of the vaccine remains limited, despite the efforts made in recent years to improve the management of viral hepatitis.
