[Cytomegalovirus retinitis: clinical and therapeutic aspects]

CYTOMEGALOVIRUS [CMV] is a frequent infection, which is usually asymptomatic. It is a significant pathogen in terminal acquired immunodeficiency syndrome [AIDS] patients causing major opportunistic events. Retrospective study of 5 AIDS patients with CMV retinitis treated between 1990 and 2001 in the department of ophthalmology in Sfax Hospital centre was conducted to determine clinical and therapeutic featuring, and efficacy of intraveinous and intravitreal ganciclovir to control retinitis in AIDS patients. The results showed that retinitis was controlled in 4 cases and visual acuity improved within three weeks. Serious ocular complications were encountered in 1 case. Concomitant tritherapy was used in 3 cases. In 1 case we noted necrotizing retinitis at the periphery enlarging centrifugally and progressing to the fovea. In immunocompromised patients, Ganciclovir may offer good alternative to control CMV retinitis. Fortunately, with the use of highly active antiretroviral therapy very few patients have disease related to CMV

[Closure of patent ductus arteriosus by indometacin in the preterm infant a case report]

We report the case of a preterm neonate presenting with a respiratory distress syndrome and hemodynamic failure. Cardiac examination reveals a continuous murmur. Echocardiography showed a patent ductus arteriosus. This newborn received indometacin during three days. A spectacular improvement was noticed. Echocardiographic control revealed the closure of the ductus

unusual presentation of Hydatid disease

Hydatid disease or echinococcosis is a parasitic condition of worldwide distribution. The parasite usually completes its life cycle between the domestic dog and the sheep. Human being seems to be an accidental or incidental intermediate host and from parasitic point of view a dead end. Hydatid cyst can occur in any organ of the body but most commonly involves the liver. Here we are reporting a case where patient presented with obstructive jaundice of 15 days duration and the investigations carried out showed the suspicion of malignancy. Patient was operated and it turned out to be a case of hydatid cyst of liver which had ruptured into the biliary tree

Floating left atrial thrombus and dysfunction of mitral prosthetic. A case report

Echocardiographic evidence of parietal atrial thrombus is frequently and easily diagnosed in mitral valve diseases. In the opposite, mobile left atrial thrombus is rare; its diagnosis require special attention. Our case report is about a 52 years old lady, with prothetic mitral valve and atrial fibrillation who presented with ischemic cerebral stroke. Oral anticoagulation was inappropriately observed. Transthoracic and transesophageal echocardiography showed an organised intra left atrial appendage thrombus with two floating thrombus into the left atrial cavity. In spite of adequate intravenous anticoagulation, the patient died within 48 hours after a massive second ischemic cerebral stroke. This case report shows the therapeutic challenge of left atrial thrombus management in the acute phase of ischemic cerebral stroke

[Association hyperlipidemia and retinal hard exudates in diabetic retinopathy]

Diabetes mellitus is usually accompagned with dyslipide-mia, which can be correlated with diabetic retinopathy [DR]. The aim of the study is to determine the relation between DR and hyperlipidemia. We studied prospectively 64 diabetic patients classified into 2 groups: the first associated diabetics having dyslipidemia [n=34] and the second without dyslipidemia [n=30]. The mean follow up was II months. We observed a high frequency of retinal hard exudates in diabetics with dyslipidemia in comparison with the second group [32% versus 10%]. The control of dyslipidemia is recommended in diabetic patients

Adverse effect profile of patients receiving anti viral treatment for chronic hepatitis C virus infection

Chronic hepatitis C virus infection is present in 3 - 10% of Pakistani population and genotype 3 is the most prevalent subtype in our patients. In a suitable candidate interferon along with Ribavirin is the main stay of treatment for these patients. These drugs have short as well as long term safety problem. Morbidity and frequency of discontinuation of therapy correlate directly with the frequency of adverse events while on treatment. This observational study has been conducted to find out the adverse effect profile of anti viral treatment for our Chronic HCV patients. From 1st March 2005 to 30th March 2005, 100 consecutive patients suffering from chronic HCV infection receiving standard interferon alpha 2 b and ribavirin were included. All of them were inquired on a questionnaire about the adverse events and then analyzed. In as many as 65% of the patients receiving anti viral treatment complained of an adverse event. The events were in the form of Flu like symptoms, abdominal pain, sleep disturbance, lack of appetite, dry cough and breathlessness, Depression, persistent fever, anemia, thrombocytopenia, neutropenia and skin rash. A high number of pts receiving anti viral treatment for ch. HCV infection suffer from adverse events