RESUMO
Background: Meningovascular syphilis, a distinct classification of neurosyphilis, has gained attention for its association with cerebral ischemia, particularly among individuals living with HIV. This unique manifestation of syphilis affects the meningeal and vascular structures of the central nervous system, leading to cerebrovascular complications. In this case report, we present the case of a young man diagnosed with neurosyphilis and HIV after presenting with an ischemic stroke. We discuss the challenges associated with diagnosing neurosyphilis, given its frequent atypical presentations that can mimic other diseases. Furthermore, we explore the management approach for these coexisting conditions. Case Presentation: A right-handed male patient presented with a sudden paresis of the right upper and lower extremities, along with facial deviation to the left, and demonstrated low verbal output, limitation in constructing sentences, and conveying thoughts or ideas effectively. Upon admission, the patient's neurological examination revealed a FOUR coma scale of 16. He exhibited motor aphasia, right facial paralysis sparing the forehead, and right upper and lower extremity spastic hemiparesis with a strength of 3 out of 5 on the Medical Research Council scale. The Plantar reflex was positive on the affected side. Brain magnetic resonance imaging revealed left middle cerebral artery infarction (cortical and lenticulostriate territory acute infarction). Conclusion: This case highlights the need for treating physician to have a high index of suspicion towards meningovascular syphilis as a potential cause of stroke in young individuals. This is crucial, especially when there is also a concurrent HIV infection, as it requires specific treatment.
RESUMO
Background: Diabetes is a global health challenge with escalating prevalence rates. Cardiovascular complications represent the leading cause of mortality among individuals with diabetes. Notably, dyslipidemia stands as a prominent risk factor for cardiovascular disease in Type 2 diabetes mellitus (T2DM) patients. Timely detection and management of dyslipidemia in these patients hold the potential to deter its progression and substantially reduce the risk of cardiovascular-related morbidity and mortality. This study was aimed at assessing the burden of dyslipidemia and determinant factors among T2DM patients who were being followed at the Endocrinology clinic of Hawassa University Comprehensive Specialized Hospital (HUCSH). Methodology: An Institutional- based retrospective cross-sectional study was conducted, and samples of 228 patients were selected using a systematic random sampling technique. Data were collected through structured face-to-face interviews using a questionnaire. Bivariate logistic analysis was utilized, and variables with a p-value < 0.25 in this analysis were considered candidates for multivariate logistic analysis. Multivariate logistic regression was employed to identify factors associated with the prevalence of dyslipidemia, with a significance threshold set at p < 0.05. Results: The research revealed an overall prevalence of dyslipidemia among the study participants at 75.9%. The specific manifestations of dyslipidemia were observed as follows: hypertriglyceridemia in 43%, hypercholesterolemia in 25%, elevated low-density lipoprotein in 59.2%, and reduced high-density lipoprotein in 33.3% of the study participants. Factors significantly associated with dyslipidemia included longer diabetes duration, poor physical activity, elevated HbA1C, and obesity. Conclusion: This study underscores a notably high prevalence of dyslipidemia among T2DM patients. The findings highlight the advocate for clinicians to prioritize routine screening, and effective treatment concerning dyslipidemia and its associated risk factors among individuals with T2DM. It is worth mentioning that this study was conducted in a specific hospital setting and limited time, and hence the findings, and generalizability to other healthcare facilities should be taken cautiously.
