Consensual coital vaginal laceration in hypovolaemic shock: A report of two cases

Background:Certain life-threatening complications and morbidities may occur following consensual sexual intercourse which may not be commonly experienced in clinical practice. One of such complications is hypovolaemic shock resulting from profuse bleeding.AbstractMethods:Two cases of vaginal laceration complicated by hypovolaemic shock following consensual sexual intercourse are presented.Results:Both patients had resuscitation with intravenous fluid, blood transfusion and subsequent examination under anaesthesia with repair of laceration in theater. Post-operative recovery period was uneventful and they were both discharged after proper counselling. Conclusion:Bleeding from coital laceration could be life threatening. Prompt treatment should be instituted in such cases

Inflammatory bowel disease: pathogenetic mechanisms

Abstract Significant progress has been made in the understanding of ulcerative colitis and Crohn's Disease over the last decades.Despite this, the pathogenesis of inflammatory bowel disease (IBD) remains obscure, especially at molecular level. Various contributing factors have been identified so far, but their respective contributions are not entirely clear cut. In this review, we focus on the genetic and environmental factors linked with IBD pathogenesis. We also explore the role of pro-inflammatory cytokines on the molecular pathophysiology of IBD

Primary sclerosing cholangitis in a cohort of south african patients with inflammatory bowel disease at charlotte maxeke johannesburg academic hospital

Background: Primary Sclerosing Cholangitis (PSC) is a chronic, progressive cholestatic liver disease of unknown aetiology. Its incidence and prevalence vary considerably in Asian and Western studies.1 The differences in the recorded epidemiological data suggest that the presentation of PSC may vary in different populations. PSC has a strong association with Inflammatory Bowel Disease (IBD). The phenotype in patients with PSC alone can be different to that of patients with both PSC and IBD (PSC-IBD). There is a dearth of information on this topic from African countries in general and more specifically in the Black South African population

Nonspecific Colitis a Forgotten Entity in Central Sudan

Background: Nonspecific colitis is an inflammatory Bowel Disease (IBD) that runs a clinically benign course. Histopathologically it is characterized by superficial mucosal erosions with lymphocytic infiltration in the lamina propria with no granuloma. Aim of this study: is to describe the clinical presentation of Non-Specific Colitis (NSC); and to evaluate its response to 5-aminosalicylic acid (5-ASA) in Sudanese patients. Setting and Design: This study is a prospective cohort. A total of 26 patients presenting with bloody; mucoid diarrhoea; lower abdominal pain or colonic mass were included in the study. Methods and Materials: A total of 26 patients presenting with bloody mucoid diarrhoea; lower abdominal pain with or without colonic mass were included in the study. All patients underwent colonoscopy. Statistical analysis: A descriptive statistical analysis was done using SPSS. Results: 19 () of patients were males and 7 were females with male to female ratio of 3:1. The majority of patients 16 (61.6) had bloody diarrhea while 18 (69.2) opened their bowel 4-6 times a day. The majority 10 (38.8) had rectum and sigmoid involvement. All patients showed a good response to 5-ASA. Conclusions: This study showed that NSC has clinical features that are very much similar to mild UC with a rather good clinical response to oral 5-ASA

Bowel resection in Nigerian children

Background : Although bowel resections are commonly done for congenital malformations in children in developed countries; they usually follow neglected and preventable acquired diseases of the intestine in developing countries. Objectives : To determine the indications and outcome of bowel resections in children of a developing country in a university teaching hospital. Materials and Methods: Data of the patients operated (from birth to 15 years) was retrospectively collected over eight years (January 1999 to December 2006). The biodata of children included the following: Indications for operation; type of operations; duration of admission; and outcome of treatment including complications. Patients with Hirschsprung's disease were excluded from the study because bowel resection forms part of their definitive surgical management. Results : There were 70 patients (38 boys and 32 girls). The age ranged between four hours to 15 years (median; five months). There were 16 (22.9) neonates; 26 (37.1) infants; and 28 (40) grown children. The indications were congenital anomalies in the 16 neonates. Also; 23 (88.5) infants had intussusception; 2 (7.7) had midgut vovulusm and 1 (3.8) had congenital small intestine band. Among the grown children; typhoid ileal perforation (TIP) was seen in 14 (50.0); intussusception in 5 (17.9); and other causes in nine patients. Overall; intussusception was the most common indication for bowel resection; followed by TIP. A total of 24 patients developed 33 complications. Complications included wound infection in 47.8and anastomotic leak in 42.8. The duration of admission ranged between 4-35 days (median; 15 days). The overall mortality was 17.1-; which was highest among neonates (56.3); followed by the infants (26.9-). Conclusion : Bowel resections are mainly done for intussusception and complications of TIP at our centre. Late presentation; preexisting malnutrition; and nonavailability of parenteral nutrition contributed to unacceptable morbidity and mortality

Childhood Inflammatory Bowel Disease in Libya: Epidemiological and Clinical Features

Background et Aims: Inflammatory bowel disease is thought to be rare in Libya. The aim is to determine the prevalence of juvenile onset inflammatory bowel disease in Libya. Setting: Al-Fateh childrens' hospital; Benghazi; Libya. Methods: This is a retrospective study of all cases diagnosed over 10 years (1997-2006) with either ulcerative colitis; Crohn's disease or indeterminate colitis. Inclusion criteria were age 15 years at time of presentation who were resident in the eastern part of the country and who diagnosed with inflammatory bowel disease. Clinical features were outlined using a proforma. Results: Sixteen cases were diagnosed with inflammatory bowel disease; of whom 11 were males (M:F ratio of 1.5:1). The prevalence and incidence rates in the year 2006 were 3.6 and 0.9 per 100;000 children; respectively. The incidence rate increased from 0.2 in 2002 to 0.9 in 2006 (Z score of 39.87; p); abdominal pain; anorexia and weight loss in 9 (56.2); anemia in 7 (43.75) and vomiting in 6 (37). Ileopancolitis was found in 3 patients whereas 6 patients had ileocecal disease. Conclusions: Childhood inflammatory bowel disease in this population is not so rare and it is increasing. The clinical pattern is similar to that reported by others

Les infections au cours des maladies inflammatoires chroniques de l'instestin

Pre-requis:les infections sont frequentes au cours des maladies inflammatoires chroniques de l'intestin.Elles sont associees a un risque eleve de mortalite.But:preciser les differentes infections survenants chez les malades atteints des maladies Crohn et de rectocolite hemorragique et leurs moyens de preventions .Materiel et methodes: revue de la litterature .Resultats: les infections survenant au cours des poussees peuvent expliquer la resistance aux traitements de la maladie. Il s'agit le plus souvent des infections a clostridium difficile et a cytomegalovirus.Les infections a Epstein -Barr virus majorent le risque de lymphomes chez les malades sous azathioprine. Les infections opportunistes sont relativement frequentes au cours des maladies inflammatoires chroniques de l'intestin; en particulier en cas de prise d'un ou de plusieurs immunosuppresseurs. prevention de ces infections opportunistes se base sur un bilan pre-therapeutique complet; les vaccinations chez les patients immunodeprimes et la chimioprophylaxie dans certaines situations .Conclusion: la connaissance des differentes infections pouvant survenir chez les malades attientes de maladies inflammatoires chroniques de l'intestin est primordiale.Le traitement de ces infections est associees a une meilleures reponse aux traitements de la maladie et a une reduction de la mortalite en cas d'infection opportuniste

Place de l'amniocentèse dans le dépistage anténatal à Cotonou

L'amniocentese est la technique de reference pour les prelevements fotaux destines a la recherche des mutations de l'ADN de l'hemoglobine ou des anomalies chromosomiques. Nous avons mene une etude transversale analytique sur 20 mois chez 21 gestantes de 16 a 24 semaines d'amenorrhee (SA) porteuses (avec le conjoint) de mutation C ou S sur l'une ou les deux chaines de l'hemoglobine ; les prelevements de liquide amniotique etaient indiques dans 19 et 2 cas respectivement pour le risque d'enfants drepanocytaires et les signes d'appel echographiques de malformations congenitales. L'age moyen etait de 29;81 ans. L'extraction de l'ADN des amniocytes par PCR avait revele 5 cas de double mutation homozygote S; 2 doubles heterozygotes SC; 3 et 6 cas respectivement d'hemoglobine AS et AA ; le caryotype avait revele deux fotus trisomiques 13 et 18. L'issue de ces grossesses etait marquee par la naissance a terme de 15 nouveau- nes vivants et respectivement par 1 et 2 cas d'interruption de grossesse; volontaire (IVG) et medicale (IMG). Aucune complication imputable a la technique n'etait enregistree. L'innocuite de la methode est un point fort pour la conseiller dans le cadre du diagnostic antenatal de la drepanocytose a Cotonou