Replasing Polychondritis and Geriatrics: Report of Two Cases
Nassima Dekdouk,
Djennette Hakem,
Lakhder Amine Betaimi,
Djamel Eddine Benkali,
Taous Hadded,
Abdelkrim Berrah
Issue:
Volume 6, Issue 2, March 2018
Pages:
29-33
Received:
5 March 2018
Accepted:
2 April 2018
Published:
17 May 2018
Abstract: We report two cases of geriatric replasing polychondritis [RP] observed in internal medicine; and the problems posed by the therapeutic management of this condition at this phase vulnerable of life. The first case was a70- years old women without antecedents, presents a diffuse and painful and bilateral increase of both ears, and painful red eyes with blurring of vision. The set of disorders evolves in a context of fever and deterioration of the general state and poly arthralgia of mixed schedule.The objective clinical examination finded a deformed ears ‘Cauliflower ear’; and a breath of aortic insufficiency in cardiac auscualtation; and bilateral episcleritis in the tow eyes objective in ophtalmic examination; associated with a biological inflammatory syndrome; the echocardiography objective, the moderate aortic regurgitation.The second case was a67 year old male presented,with a history of pain and swelling of both ears lobes, with recurrent red left eye painless.He has a history of type 2 diabetes and hypertension, clinically he was noted to have a swollen exquisitely tender erythematous upper cartilaginous part of the right pinna with sparing of the earl obule,episcleritis in the left eye in a ophtalmologic examination associated a frank inflammatory syndrome, the echocardiography objective a mild oartic regurgitation.The diagnosis of RP is retained according to the criteria of michet et al in both patients.The 2 patients evolve favorably under corticotherapy instituted at a rate of 1mg / Kg / day.Corticotherapy treatment exposed the patient (case 1) to the appearance of osteoporosis with high risk of fracture and the appearance of controllable hypertension under treatment; and the patient (case 2) at imbalance of his hypertension and diabetes which led us to change his therapeutic arsenal to avoid metabolic and cardiovascular complications. The rarity of the disease and the variability of its clinical spectrum explain the lack of a therapeutic trial controlled and empirical nature of the therapeutic recommendations. Evolution is by pushing successive, whose frequency and severity are extremely variable. Complications Cardiovascular diseases are common and responsible for the death of one out of four patients, which clinician to screen them so as not to delay a sometimes difficult treatment.
Abstract: We report two cases of geriatric replasing polychondritis [RP] observed in internal medicine; and the problems posed by the therapeutic management of this condition at this phase vulnerable of life. The first case was a70- years old women without antecedents, presents a diffuse and painful and bilateral increase of both ears, and painful red eyes w...
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Diabetic Ketoacidosis Treatment Outcome and Associated Factors Among Adult Patients Admitted to Medical Wards of Adama Hospital Medical College, Oromia, Ethiopia
Dagim Assefa Kassaye,
Worku Dugassa Girsha,
Godana Jarso Guto,
Haji Aman Deybasso
Issue:
Volume 6, Issue 2, March 2018
Pages:
34-42
Received:
1 December 2017
Accepted:
11 April 2018
Published:
19 May 2018
Abstract: Diabetic Ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus. The mortality rate remains high in developing countries and among misdiagnosed and treated patients. Therefore targeting early diagnosis and effective treatment programs is vital to save the life of patients. The aim of the study is to assess diabetic ketoacidosis treatment outcome and associated factors among adult patients at Adama Hospital Medical College emergency department and medical wards, Oromia region, Ethiopia. Cross sectional study based on record review of 357 adult diabetic ketoacidosis patients was selected using simple random sampling. Data was collected using checklist from medical registrations. The data was entered and analyzed using SPSS version 20 and EPI-info version 7 statistical packages. Majority of the patients (65.30%) had two or more episodes of diabetic ketoacidosis and the main reasons for recurrent diabetic ketoacidosis were infectious illness (69.50%) and insulin discontinuation (14.80%). Regarding treatment outcomes of diabetic ketoacidosis patients, majority of them (84.90%) discharged with improved. Those diabetic ketoacidosis patients treated with more than six liters fluid replacement in the 1st 24 hours had better treatment outcome by two times as compared to less than three liters fluid replacement (AOR=2.41 (1.58-10.02). Similarly, those patients who got more than sixty international unit insulin doses in the 1st 24hrs had better treatment outcome by ten times (AOR=10.68 (3.88- 20.64)) when compared to less than forty international unit insulin administration. In addition, DKA patients who got supplemental potassium showed five times treatment outcome improvement (AOR= 5.30 (2.11-13.32) than for those potassium replacement was not done. Even if majority of diabetic ketoacidosis patients treated at Adama Hospital Medical College emergency room and medical wards were discharged with improvement, early treatment of infection, ample fluid replacement and insulin dose adjustment during illness need to be encouraged.
Abstract: Diabetic Ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus. The mortality rate remains high in developing countries and among misdiagnosed and treated patients. Therefore targeting early diagnosis and effective treatment programs is vital to save the life of patients. The aim of the study is to assess diabetic k...
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