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tion is an independent risk factor for an unfavourable outcome in patients with rifampicin-susceptible isoniazid-resistant disease treated with this regimen.While Africa has long seemed paradoxically partly spared from the COVID-19 epidemic that is engulfing the rest of the planet, we are witnessing an upward surge in the dynamics of the epidemic across the continent. How to account for this unprecedented reversal of the COVID-19 epidemic situation in Africa, initially delayed compared to other continents, then apparently contained and now difficult to control? In our opinion, at least two factors play a major role in the current spread of the COVID-19 epidemic in Africa the structural inadequacy of health systems and the serious deficiencies in the African approach to the response. We believe that political decision-makers must assume their responsibilities and inform their decisions on the basis of scientific facts, taking into account the specificities of our approaches to life, the only ones capable of containing fears and participating in the optimal management of crises and ultimately in the development of African nations. If Africa fails, the impact could be catastrophic not only from a health standpoint, but also from an economic standpoint and therefore from an overall human perspective. The great nations, like the great civilizations, know how to transform apparent challenges into undeniable opportunities to rise up. African scientists will similarly rise up, to meet the challenges of the COVID-19 epidemic.The occurrence of haemorrhagic pleurisy in patients with myeloma is most often related to a non-specific cause. Pleural myeloma is rare but this diagnosis should be excluded. We here report a rare case of haemorrhagic pleurisy due to the loosening of an osteosynthesis screw. The study involved a 55-year-old female patient who had been followed up for multiple myeloma since 2012. Diagnosis was confirmed by the presence of haemorrhagic pleural effusion, by chest computerized tomography scan which showed the loosening of left-sided osteosynthesis screw with tip located in the prevertebral region at the level of the pleural effusion and by negative etiological assesment.

multidetector computed tomography (MDCT) is a widely used cross-sectional imaging modality despite increasing concerns about radiation exposure and overuse. The aim of this study was to describe the socio-demographic characteristics of MDCT users in an urban city in Cameroon and to assess the clinical indications for appropriateness.

we conducted a survey of MDCT users and collected data on demographic attributes and socialization patterns, clinical indications for MDCT and time to obtain MDCT. MDCT appropriateness was assessed using the American College of Radiologists Appropriateness Criteria®. Frequencies, percentages, odds ratios and 95% confidence intervals were used to summarize the data.

with a response rate of 79%, 511 MDCT users were surveyed. #link# The mean (standard deviation) age was 45(19) years and male to female sex ratio 11. Seventy-eight percent (95% confidence interval [CI] 74-83%) of respondents reported not having any health insurance. link2 Head scans accounted for 52% (95%CI 47-56%) of all scans with trauma (19% [95%CI 15-22%]), low back pain (18% [95%CI 14-21%]) and suspected stroke (10% [95%CI 7-13%]) being the most frequent indications. Sixteen percent (95%CI 13-20%) of the scans were judged to be inappropriate. Predictors of MDCT appropriateness after multivariable logistic regression modeling were age (aOR=0.97; P=0.009; 95%CI=0.94-0.99), health insurance ownership (aOR=0.40; P=0.034; 95%CI=0.18-0.94) and being referred by non-specialist physicians (aOR=0.20; P<0.001; 95%CI=0.09-0.47).

people from all social strata use MDCT, mostly appropriately and especially for head scans after trauma in this urban setting. However, the proportion of inappropriate studies was considerable suggesting the need for control measures.

people from all social strata use MDCT, mostly appropriately and especially for head scans after trauma in this urban setting. However, the proportion of inappropriate studies was considerable suggesting the need for control measures.The present study aims to determine the various epidemiological characteristics among newly diagnosed patients with breast cancer in Casablanca during 2018. During that period, 668 cases were collected, the average age was 51.6 years, the female was the most represented with 662 cases (99.1%) and men with 6 cases (0.9%), a sex ratio (M/F) of 0.009. The average age of menopause was 49.8 years and the average age of menarche was 13.5 years, 31.7% had a history of cancer (breast 14.1%, stomach and 9% liver 7%). The average diagnosis delay was 10 months, the thyroid disease was the most represented pathology, the left breast was diagnosed in 50.2% and the right breast in 44.7% and 1.3% in the bilateral location. The most common histological type was invasive ductal carcinoma (73.2%). The vascular and lymphatic invasion was observed in 42.2%, axillary nodes were affected in 71.1% of cases. GW441756 research buy (SBR) revealed a predominance of grade II in 55.9% of cases. The Luminal B continues to be the most common phenotype (46%) followed by Triple Negative (15.3%) and Luminal A (14.2%) and HER2 (7.4%). The immediate prognosis is a cause for concern because of delayed diagnosis. It seems urgent to develop the health information policy and education.An unsuspected bull in a private herd of forty cattle heads in south-western Nigeria died suddenly following three days´ treatment against tick infestation. Post-mortem findings revealed multi-focal widespread nodules in all lobes of the lungs with markedly enlarged lymph nodes. Isolate from cultured sample was subjected to spoligotyping which confirmed the isolate as Mycobacterium bovis (M. bovis) belonging to the SB1027 clade with octal number 676773776277600 (Figure 1). This finding has implications on the health of the cattle handlers considering aerosol inhalation of disseminated bacilli from the lungs of the infected bull through cough sprays. Routine screening of cattle for tuberculosis is therefore emphasized.COVID-19 is a global pandemic ravaging the whole world with large numbers of reported cases globally. link3 It is a highly-contagious novel infectious disease that causes inflammation in the respiratory system. Chest imaging is a useful adjunct for diagnosis, documenting the extent of disease as well as observation of changes and is thus, strongly recommended in suspected COVID-19 cases, for initial evaluation, differential diagnoses and follow-up. Description of typical imaging findings abound worldwide with a dearth of similar publications in sub-Saharan Africa. This series documents the chest imaging findings from a single facility of four cases between the ages of 38 and 60 who all tested positive for COVID-19 with real-time, reverse transcriptase polymerase chain reaction of the nasopharyngeal swabs.

cytomegalovirus (CMV) infection has been reported to be associated with onset/exacerbation of systemic lupus erythematosus (SLE). In an attempt to verify this, we studied CMV infection in SLE patients.

forty-two SLE patients were studied at 3-time points; disease onset/flare, at peak of immunosuppression (at 6 weeks) and at low doses of immunosuppression (at 6 months). We studied healthy blood donors as controls, only once. Clinical assessment and SLE Disease Activity Index scoring were done at each visit. RT-PCR and ELISA were performed to detect CMV viral-load and anti-CMV antibodies (Ab) respectively.

nine of 106 patients had detectable viral-load (145-50,000 copies/ml). Of these nine, three patients had significant viral-load, 6 patients had low viral-loads of doubtful clinical significance. None of the patients developed CMV disease. Six of 42 cases were positive for IgM Abs. All controls were negative for CMV DNA as well as CMV IgM Abs. All samples from patients and controls were positive for CMV IgG Ab indicating widespread prevalence.

significantly, a higher seroprevalence of CMV IgM Abs against CMV observed in SLE patients when compared to controls, indicating possible reactivation due to immune modulation.

significantly, a higher seroprevalence of CMV IgM Abs against CMV observed in SLE patients when compared to controls, indicating possible reactivation due to immune modulation.Splenic rupture is a potentially life-threatening condition, often associated with chest or abdominal trauma. Spontaneous rupture is very rare and is usually reported as being secondary to underlying pathological conditions. We report a case of atraumatic splenic rupture in a patient with no underlying disease pathology. This case should remind the emergency physician spontaneous splenic rupture should be considered in the differential diagnosis of unexplained acute abdominal pain.Double diabetes otherwise known as hybrid diabetes, a new variant, is a combination of both type 1 and type 2 diabetes in children and adolescents. It is a diabetes variant increasing in prevalence in developed countries because of epidemic obesity among children and adolescents but extremely rare in developing countries. Double diabetes is characterized by features of both type 1 (diabetes auto-antibodies) and type 2 (obesity and insulin resistance). This occurrence can either develop on a background of type 1 diabetes due to an abnormal increase in weight from physiological growth spurt in adolescents or from high insulin dosage developing on a background of type 2 diabetes. The variant has been linked to possible increased cardiovascular risks and worsened morbidity including poor glycaemic control. Here, we report a case of a 17-year-old girl who developed features of type 2 diabetes on a background of type 1 diagnosed 6 years after T1D diagnosis.Takayasu´s disease (TD) is a chronic inflammatory arteriopathy affecting the aorta, its main branches and the pulmonary arteries. It was first described in 1908 by the Japanese ophthalmologist Mikito Takayasu. The study involved a 78-year-old patient with no known history of cardiovascular disease, admitted with abdominal pain, pain in the right lower limb when walking, insomnia. These symptoms had progressed over 1 year. Physical examination showed normal heart rate of 87 beats per minute without pathological noises, with absence of right pedal pulse, blood pressure 120/78 mmhg, free lungs, flexible abdomen, and a beating mass in the right iliac fossa whose auscultation showed continuous murmur. The remainder of the physical examination was normal. Abdominal CT angiography confirmed extensive aortic dissection at the abdominal aorta with synchronous opacification of both channels, thrombotic aneurysm of the primitive iliac arteries measuring 48mmx100mm on the right and 38mm x 90mm on the left, with no visible fissurization. We report a case abdominal aorta dissection associated with thrombus formation in the primary iliac arteries revealing Takayashu´s disease treated in the Department of Cardiology at the Ignace Deen National Hospital. The rate of abdominal aorta dissection in patients with Takayasu´s disease is rare. It is most often diagnosed in the occlusive phase. Prognosis depends on possible complications.