Study of peripartum cardiomyopathy in a context with limited resources: case of the region of Zinder, Niger.

OBJECTIVE: To describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics of of peripartum cardiomyopathy (PPCM) in the internal medicine department of the Zinder National Hospital (ZNH). METHODS: This was a descriptive cross-sectional study carried out from 2018 to 2022 at the ZNH Department of Internal Medicine. Included were all patients admitted for PPCM who met National Heart Blood and Lung Institute criteria. The data collected was analyzed using Excel and EPI INFO v7. RESULTS: We had collected 100 cases of PPCM out of a total of 8706 hospitalized patients, i.e. a hospital prevalence of 1.14%. The mean age of the patients was 27.9 years ± 7.4 [17-45]. The majority of patients were from underprivileged social strata (n=64). The risk factors for PMPC found were essentially hot bath (n=66), home birth (n=40), natron porridge (n=35) and multiparity (n=57). Cardiac symptomatology appeared postpartum in 56% of patients. Dyspnea was the main symptom in 98% of cases. The physical signs were dominated by the functional systolic murmur (66%). Three quarters (75%) of the patients had congestive heart failure. Electrocardiographic signs were dominated by left ventricular hypertrophy (n=65). Cardiomegaly was present in 94% of patients. Left ventricular ejection fraction was altered in all patients. Impaired renal function was found in 31% of patients. Management was based on a low-sodium diet tripod, diuretics and converting enzyme inhibitors. Two cases of death were recorded. CONCLUSION: PPCM is common in the Zinder region. It affects young women with several risk factors and is revealed by signs of congestive heart failure. For a better understanding of this still poorly elucidated condition, it is necessary to pursue research efforts.

Covid-19-related right hip monoarthritis: A case report and literature review.

This article presents the case of a young patient with severe acute left hip pain who tested positive for COVID-19. The diagnostic approach and management are presented, followed by a review of the literature. This 11-year-old student was admitted for acute left hip pain of abrupt onset, inflammatory, evolving for 24 h in a febrile context with no change in general condition. The initial workup revealed a hyperleukocytosis in the blood count, CRP 198.52 mg/L, and a 95 mm SV. The pelvic X-ray was unremarkable, and the hip ultrasound showed synovial hypertrophy, with no effusion on Doppler examination. The situation worsened 24 h later with the onset of acute respiratory distress syndrome. The chest X-ray showed bilateral alveolar interstitial lung disease, and the CT scan showed hyperdensity and crazy paving. The COVID-19 RDT test on a nasopharyngeal sample came back positive, as did the RT-PCR. Death occurred a few hours later in acute respiratory distress. Our case is consistent with what has been reported in the literature, but requires further study on an international scale to better define the phenotype of the disease.