A descriptive retrospective study on children with newly diagnosed nephrotic syndrome presented to Tripoli Children Hospital during the period between Jan. to Dec. 2014

Introduction: Nephrotic syndrome is a clinical picture characterized by severe proteinuria, hypoalbuminemia, edema and hypercholesterolemia. A retrospective study was carried out in order to describe disease pattern in newly diagnosed nephrotic syndrome of children admitted to Tripoli children hospital during the year 2014.Methods: The medical data of 56 patients aged between 1 year and 11 years diagnosed with idiopathic nephrotic syndrome were analysed using SPSS software. The data included gender differences, sensitivity to steroid therapy, relapses during six months of follow up and the effect of variable factors such as family history, hypertension, hematuria, serum urea on the degree of relapse.Results: Out of 56 patients with newly diagnosed nephrotic syndrome (NS), 60.7% were boys and 39.3% were girls, with a mean age 4.2±2.2 years. Age was related significantly to the response to steroid therapy, where 79.5% of patients aged between 2-8 years (group 1) had steroid sensitive nephrotic syndrome (SSNS) compared with only 41.7% of patients aged less than 2 years or more than 8 years (group 2) (P<0.001). Although girls relapsed more than boys (70.5% versus 57.1%) during six months of therapy, this difference was not statistically significant. Similarly, no other factors measured such as family history of NS, hypertension, hematuria, serum complement and urea had any effect on the percentage of relapse in patients with newly diagnosed NS. Conclusion: NS is one of the commonest reasons for admission to nephrology ward. It is more common in boys than girls. The age at presentation related significantly to the response to steroidal therapy. Regarding relapses, girls seems to relapse more frequent than boys and relapses was seen more in age group 1 than group 2, however, these differences were not significant. Other factors studied seems to have no effect on the relapse rate of children with newly diagnosed NS

Treatment of Hypercholesterolaemia in Patients with Diabetes Mellitus

Numerous studies have shown that statins reduce cardiovascular events; including stroke and mortality in diabetics. The American Diabetes Association 2013 guidelines recommend that diabetics at high risk for cardiovascular events should have their serum low-density lipoprotein (LDL) cholesterol reduced to 70 mg/dl (1.8 mmol/l) with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to 100 mg/dl (2.6 mmol/l). The 2013 American College of Cardiology/American Heart Association lipid guidelines recommend giving high-dose statins to adult diabetics aged ? 75 years with atherosclerotic vascular disease (ASCVD) unless contraindicated with a class I indication and moderate-dose or high-dose statins to diabetics with ASCVD ? 75 years with a class IIa indication. Diabetics ? 21 years with a serum LDL cholesterol of ? 190 mg/dl (4.9 mmol/l) should be treated with high-dose statins with a class I indication. For primary prevention in diabetics aged 40 to 75 years and serum LDL cholesterol between 70 and 189 mg/dl (1.8 and 4.9 mmol/l); moderate-dose statins should be given with a class I indication. For primary prevention in diabetics aged 40 to 75 years; a serum LDL cholesterol between 70 and189 mg/dl (1.8 and 4.9 mmol/l); and a 10-year risk of ASCVD of ? 7.5 calculated from the Pooled Heart Equation; high-dose statins should be given with a class IIa indication. For primary prevention in diabetics aged 21 to 39 years or older than 75 years and a serum LDL cholesterol between 70 and 189 mg/dl (1.8 and 4.9 mmol/l); moderate-dose statins or high-dose statins should be given with a class IIa indication. There is no additional ASCVD reduction from adding non-statin therapy to further lower non-high-density lipoprotein (HDL) cholesterol once an LDL cholesterol goal has been reached. Clinical trials have found no lowering of cardiovascular events or mortality in diabetics treated with statins with the addition of nicotinic acid; fibric acid derivatives; ezetemibe; or drugs that raise serum HDL cholesterol

Facteurs de risque cardiovasculaire majeurs selon le sexe en milieu hospitalier

Le but est de décrire les facteurs de risque cardiovasculaire selon le sexe en milieu hospitalier. Matériel et méthodes : L'étude prospective d'avril 2007 à mars 2008 a porté sur 146 patients hypertendus de 2 structures sanitaires à Bamako. La collecte et l'analyse des données ont été réalisées avec SPSS v.11 Résultats : 67% de l'échantillon était de sexe féminin, la moyenne d'âge de 48,82. L'IMC était significativement supérieur dans le sexe féminin ( p< 0,001 ) La répartition par tranche d'âge laissait reconnaître un pic à 30-44 ans dans le sexe féminin contre 45-59 ans dans le sexe masculin. Le surpoids et l'obésité étaient prédominants dans le sexe féminin et la tranche d'âge la plus représentée dans l'obésité est celle des 30-44 ans. L'HTA isolée était la plus fréquente avec 58,90%. 7,53% présentaient les 3 facteurs de risque majeurs. Conclusion : La présence de l'HTA isolée est de loin la plus fréquente. Les autres associations bien qu'augmentant le risque global sont rares et ne diffèrent pas fondamentalement selon le sexe. La tendance au surpoids et à l'obésité dans le sexe féminin mérite d'être confirmée par d'autres études

Hypercholesterolaemia in Children and Young Adults - Current Management

Atherosclerosis begins in childhood. Not uncommonly; the first presentation of atherosclerosis is sudden cardiac death. It therefore makes sense that risk-factor modification to prevent the development or delay the onset of atherosclerosis needs to begin early in life. Dietary intervention is the key component for the primary prevention of hyperlipidae- mia. However; if diet and lifestyle fail to correct hyperlipidaemia; drug therapy may have to be considered. All children and adolescents with high-risk lipid disorders such as familial hypercholesterolaemia (FH); those with diabetes mellitus or other cardiovascular disease risk factors or with a family history of premature coronary artery disease should be considered for lipid-lowering therapy if diet and lifestyle intervention are ineffective. There are now numerous studies that have documented the safety and efficacy of statin therapy in both children and young adults. Based on these studies; it is now recommended that statin therapy be initiated in all male FH children from the age of ten years and at the onset of menses in females with FH. The initiation of statin therapy could be considered even earlier in FH children at high risk

Lipid profile of healthy adult nigerians in Port Hacourt, Nigeria

Background: Hyperlipidaemia is a major cardiovascular risk factor for coronary artery disease, atherosclerosis, hypertension and stroke. It is thought that serum cholesterol levels are low in Nigerians as shown by results of a population survey done over twenty years ago. In addition the last national non communicable disease survey recorded a low prevalence of Hyperlipidaemia (4.0%) in Nigeria. With increasing urbanisation and socioeconomic improvement, changing population dynamics is expected to influence disease pattern and noncomminucable diseases are expected to rise. Thus there is a need to screen healthy adults for their lipid pattern in Port Harcourt a city with high population dynamics where such studies have not been previously reported. Method: A prospective descriptive population survey was carried out among healthy adults residing in Port Harcourt. A total of ninety two adults were screened after obtaining informed consent. Weight, height, blood pressure, fasting blood sugar and fasting lipid profile were measured. Results were analysed using simple statistical methods. Results: A total of ninety two subjects were recruited into the study. Fourty seven (51.1%) of the subjects were males while fourty five (48.9%) were females. The age range of subjects was 24-59 years with mean of 38.84 ± 8.36 years. The mean BMI was 28.76 ± 5.91 Kg/m2. There was no significant statistical difference between the mean BMI for males and females. The mean fasting blood sugar, mean total cholesterol and mean LDL cholesterol were 4.45 ± 0.89 mmol/L, 4.76 ± 1.06 mmol/L and 3.65 ± 0.89 mmol/L. The mean total triglyceride was 1.02 ± 0.30 mmol/L while the mean HDL was 0.90 ± 0.25 mmol/L. There was an increase in total cholesterol with increasing age and an increase in total cholesterol and LDL cholesterol with increasing social class. Subjects with total cholesterol above 6.5mmol/L constituted 31.52 % of study subjects. Subjects with BMI between 25-29 Kg/m2 made up 43.48% of subjects while 33.69% of subjects had BMI above 30Kg/m2. Conclusion: A high mean total and LDL cholesterol values were observed among healthy adults in Port Harcourt. The prevalence of obesity was also found to be high. There is a need for public health action to address these findings especially as high serum cholesterol levels have a direct correlation with coronary artery disease. Further large scale urban survey of non communicable diseases in the country is therefore necessary at this time

Control of Hyperlipidaemia; Hypercholesterolaemia and Hyperketonaemia by Aqueous Extract of Dioscorea Dumetorum Tuber

PURPOSE: Dioscorea dumetorum (Pax) used in traditional medicine for the treatment of diabetes mellitus possesses hypoglycaemic effect. The present study investigates the effect of oral administration of the aqueous extract of the tuber on blood lipid and ketone levels in alloxan - induced diabetic rats. METHOD: Wistar strain albino rats were made diabetic with the intraperitoneal administration of alloxan monohydrate. Consequently; an aqueous extract of Dioscorea dumetorum tuber was administered orally to the diabetic rats and their plasma and urine glucose; triacylglycerol; choles terol and a-hydroxybutyrate concentrations were estimated using standard procedures. Results were compared with untreated normal and diabetic control rats. Phytochemical screening of the extract of the tuber was also carried out. RESULTS: Treatment with the extract significantly (p less than 0.05) reduced elevated blood levels of triacylglycerol; cholesterol and Beta- hydroxybutyrate associated with alloxan-induced diabetes mellitus. The aqueous extract tested positive for flavonoids; alkaloids; saponins and cardiac glycosides. CONCLUSION: From this study; the tuber has proved not only to be an effective hypoglycaemic agent; but also possesses significant (p less than 0.05) hypolipidaemic and hypocholesterolaemic properties while also ameliorating ketosis

Diabete et hyperlidemies en Cote d'Ivoire

Notre travail est une etude transversale menee sur une periode de douze ans (1986-1997) et relatif a l'association Diabete et hyperlipidemies en Cote d'ivoire. Il a concerne 1264 diabetiques regulierement suivis a la consultation d'Endocrinologie et Maladies Metaboliques du CHU de Treichville. Les resultats sont les suivants. Sur le plan epidemiologique : prevalence de l'association diabetehyperlydemies : 33 pour cent avec 38;1 pour cent d'hypercholesterolemie pure; 41 pour cent d'hypertriglyceridemie et 20;9 pour cent d'hyperlipidemie mixte; la tranche d'age 45-60 ans est la plus atteinte (61;6 pour cent); la morbidite est sensiblement la meme chez l'homme (51;2 pour cent) et la femme (38;8 pour cent); les patients de niveau socio-economique bas predominent (53 pour cent); le groupe ethno-culturel Kwa (Akan) est apparemment le plus touche; sans doute en raison de sa predominance dans la population Ivoirienne. Sur le plan bioclinique : Le DNID predomine avec 83;7 pour cent et l'hyperglycemie chronique est en correlation avec l'hyperlipidemie chez le diabetique; -baisse du HDL-cholesterol dans 26 pour cent des cas et elevation du LDL-cholesterol dans 38;2 pour cent des cas. Sur le plan evolutif : Les complications infectieuses urinaires ont une correlation avec le statuts lipidique et le diabetique hyperlipidemique semble faire plus de coronaropathie que le non hyperlipidemique. Repartition des facteurs de risque cardiovasculaire associes : 68;6 pour cent d'UTA; 43;2 pour cent d'obesite et 18 pour cent d'hyperuricemie. Sur le plan therapeutique : Le regime hypolipidique predomine (75;8 pour cent). Il est d'autant plus favorable qu'il s'agit d'un cas d'hypercholesterolemie pure (66;7 pour cent); la qualite de l'observance du traitement est d'autant plus mauvaise qu'il s'agit d'un patient de niveau socio-economique bas; en raison de son faible pouvoir d'achat (76;8 pour cent). L'association Diabete et hyperlipidemies; relativement frequente; vient alourdir les mesures de prise en charge deja difficiles et couteuses des diabetiques en cote d'Ivoire

Dyslipidemie et risque atherogene au sein d'une population a risque a Cotonou (Benin)

La conjonction des evenements conduisant a la plaque d'atherome est complexe; cette complexite est majoree chez le malade diabetique chez qui les troubles du metabolisme des lipides sont aggraves par cet etat morbide. Dans ces conditions; l'etude du risque atherogene lie au cholesterol (RAC) est utile pour apprecier l'importance du risque cardio-vasculaire encouru par le malade et servir aussi comme un indice de la normalisation metabolique du diabete

Etude de la prevalence des troubles lipidiques au sein d'une population saine a Cotonou (Benin)

Sur une population rigoureusement selectionnee; indemne de tout facteur de risque en rapport avec les parametres du bilan lipidique de routine pratique a Cotonou; les auteurs ont determine la prevalence des dysfonctionnements du metabolisme des lipides. Il est important de parfaire ce travail par le dosage; aujourd'hui possible localement; des apolipoproteines et des lipoparticules qui sont des marqueurs plus sensibles et plus fiables de l'atherosclerose (7; 10; 13). Seule une etude multicentrique; bien conduite; peut permettre de faire le point de la question en Afrique afin de determiner le risque encouru par les populations et de moduler la conduite a tenir devant les depassements anormaux des lipides a potentialite atherogene chez l'Africain

Les anevrysmes aux Cliniques Universiatires de Kinshasa : a propos de 30 cas

Les auteurs rapportent 39 cas d'anevrysmes diagnostiques sur une base d'explorations invasives et non invasives. L'etiologie est retenue apres examens biologiques; histopathologiques et paracliniques. En dessous de 50 ans les femmes sont les plus atteintes (1H/2F) surtout par la panarterite specifique (Maladie de Takayasu). Au dela de cet age c'est l'atherosclerose qui est plutot masculine (2H/1F). L'hypertension arterielle et l'hyperccholesterolemie totale sont presentes chacune dans 8 cas (32 pour cent). 24 patients sont operes avec succes: 17 protheses en Dacon ou Teflon et 3 autogreffes veineuses

Stroke in Sierra Leoneans

The clinical and laboratory data of eighty-seven Sierra Leoneans with clinical stroke are presented. Male predominance and younger age distribution are consistent with other African series. Hypertension was present in 60 per cent of cases and tended to be more severe in fatal cases. Hypercholesterolaemia was also common. A larger and more detailed longitudinal study is required to determine fully the role of these and other risk factors of this condition in the Sierra Leone