African Journal of Internal Medicine

African Journal of Internal Medicine ISSN 2326-7283 Vol. 4 (2), pp. 355-358, July, 2016. © International Scholars Journals

Case Report 

A study on Erlotinib metabolism of phenytoin

Ariel Lin Yan^1,2,3, Vivian Yang Hsiao ^1,2,3, Takeshi N. Hsu¹ and Tsai Huang Yi^1,2*

¹Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, R.O.C.

²Department of Respiratory Therapy, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, R.O.C.

³Department of Respiratory Care, Chang Gung Institute of Technology, Chiayi, Taiwan, R.O.C.

E-mail: [email protected]

Accepted 28 June, 2016

Abstract

Seizure is a common manifestation of advanced non-small cell lung cancer (NSCLC) associated with brain metastasis. Anticonvulsants are usually required in addition to brain irradiation therapy for disease control. Concurrent chemotherapy or target therapy might have drug interactions with anticonvulsants and alter the effectiveness of such drugs. Such drug interactions are rarely recognized in clinical practice. We report a case with NSCLC complicated with brain metastasis in which the initiation of erlotinib treatment resulted in recurrence of seizure due to a decreased blood phenytoin level.

Key words: Erlotinib, anticonvulsant, brain metastasis, phenytoin, non-small cell lung cancer.

African Journal of Internal Medicine ISSN 2326-7283 Vol. 4 (1), pp. 348-354, January, 2016. © International Scholars Journals

Full Length Research Paper

Systemic lupus erythematosus in children: A study about 37 Tunisian cases

Y Thabet^1*, A Mankaï^1*, A Achour¹, W Sakly¹, A Trabelsi¹, A Harbi ², F Amri³, M T Sfar⁴, I Ghedira^{1, 5}

Research unit (03/UR/07-02), Faculty of pharmacy, Monastir, Tunisia.

Pediatric Department, Sahloul Hospital, Sousse, Tunisia .

Pediatric Department, Ibn El Jazzar Hospital, Kairouan, Tunisia.

Pediatric Department, Tahar Sfar Hospital, Mahdia, Tunisia .

Laboratory of Immunology, Farhat Hached Hospital, Sousse, Tunisia.

Corresponding author. E-mail: [email protected]

Accepted 13 May, 2016

Abstract

The objective of this study was to determine the clinical and serological characteristics of pediatric systemic lupus erythematosus (SLE). This retrospective study included 37 patients with SLE. All patients fulfilled the ACR revised criteria for SLE and diagnosed between 1994 and 2009. Anti-nuclear antibodies were detected by indirect immunofluorescence (IIF) on liver rat sections. Anti-dsDNA, anti-Sm, anti-nucleosome, anti-SSA, anti-SSB and anti-RNP antibodies were detected by ELISA. Anti-dsDNA antibodies were detected also by IIF on Chrithidia luciliae. The most common signs were anemia (86.5%), proteinuria (73%) and malar rash (67.6%). The frequency of arthritis and photosensitivity were 45.9% and 43.2% respectively. Leucopenia, thrombocytopenia and oral ulcer were present in 37.8%, 32.4% and 18.9% of cases respectively. The frequency of discoid rash was 13.5%. Anti-dsDNA antibodies were detected in 81.1%, anti-Sm and anti-RNP in 56.8%, anti-SSA in 43.2% and anti-SSB in 35.1%. The highest frequency of childhood SLE is situated at the age of puberty. Renal disease is very frequent in paediatric SLE.

Key words. Systemic lupus erythematosus, renal disease, children, Tunisia. 

African Journal of Internal Medicine ISSN 2326-7283 Vol. 3 (11), pp. 345-347, December, 2015. © International Scholars Journals

Case Report 

Systemic lupus erythematosus bullosa: A case reported in the Internal Medicine Department of National Teaching Hospital, Cotonou

AZON-KOUANOU Angèle¹, ZANNOU Djimon Marcel¹, AGBODANDÉ Kouessi Anthelme¹, KENMOE TCHOUANCHE-WENDEU ABESSOLO Christelle¹, ATADOKPEDÉ Félix², ADÉGBIDI Hugues², ADE Gabriel¹, HOUNGBÉ Fabien¹

¹Department of Internal Medicine and Medical Oncology, National Teaching Hospital (NTH) Hubert Koudougou Maga (HKM), Cotonou (Benin). Tel. (00229) 97 99 78 50

²Department of Dermatology and venereology, National Teaching Hospital (NTH) Hubert Koudougou Maga (HKM), Cotonou,  (Benin).

Corresponding Author. E-mail: [email protected]. 

Accepted 01 December, 2015

Abstract

Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by a severe damage of skin, joint visceral and hematology systems. Its diagnosis is based on the criteria of the American College of Rheumatology (ACR). The bullous form of lupus is rare; it is less than 5% of lupus cases. We hereby report a particular clinical case of bullous lupus. Observations: The patient was a 21-year old woman with sickle cell symptoms. She was admitted for etiological research on a long fever. There were reflection upon several diagnoses including SLE. After six months follow up, she developed diffuse vesicular bullous lesions prevailing at the perineum, abdomen and upper limbs, also affecting the buccal mucosa. Bullous lupus diagnosis was conducted based on Camisa and Sharma criteria. The choice of treatment is corticosteroid therapy and Dapsone. The patient developed steroid-resistant during her monitoring. Therefore, a single 100 mg daily dose of Dapsone was given. The progression revealed the incidence of hemolysis, complicated by severe anemia requiring transfusions. The alternative was Colchicine with slow but good response. Conclusion: Bullous Lupus is a rare form of SLE. Its treatment was note easy in our case. Colchicine has been the alternative, with quite slow reaction.

Keywords: Systemic Lupus Erythematosus, bullous form of Lupus, Internal Medicine, CNHU-HKM, Cotonou, Bénin.

African Journal of Internal Medicine ISSN 2326-7283 Vol. 3 (10), pp. 338-344, November, 2015. © International Scholars Journals

Full Length Research Paper

An assessment of mental health services in two African countries: South Africa and Nigeria

*Charlize Tutu, Pistorius Nelson and Mbeki Noah

School of Nursing and Public Health, University of South Africa, Pretoria, South Africa.

*Corresponding author. E-mail: [email protected]

Accepted 04 August, 2015

Abstract

Mental health services in South Africa and Nigeria were compared using the reports of World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) of both countries. WHO-AIMS assessment reveals the extent of implementation and provision of mental health care services. South Africa has made considerable progress with restructuring its mental health care system that provides mental health care at the community level. Nigeria, in spite of adopting mental health care as part of its primary health care services and having a strong academic history in psychiatry, does not provide services in rural communities. It is important for Nigeria that mental health care nurses become advocates for mental health policy reforms to improve access, and that countries with similar challenges learn from each other about providing care for people who cannot care for themselves, namely, the mentally challenged.

Key words: Advocacy, integrated care, mental health policy, mental health services, primary health care.

African Journal of Internal Medicine ISSN 2326-7283 Vol. 3 (10), pp. 332-337, November, 2015.  © International Scholars Journals

Full Length Research Paper

Prevalence of overweight and obesity in medical consultation at the National Teaching Hospital “Hubert Koudougou Maga” of Cotonou / Benin

AZON-KOUANOU Angèle¹, KEREKOU Anelie², ZANNOU Djimon Marcel¹, AGBODANDE Kouessi Anthelme¹, BOCOVO Gbènandé Mylidia Alida¹, ADE Gabriel¹, HOUNGBE Fabien¹, HOUINATO Dismand Stéphane³

¹Department of Internal Medicine and Medical Oncology, ²Department of Endocrinology and Metabolic Diseases, ³Department of Neurology, National Teaching Hospital (NTH) “Hubert Koutoukou Maga” (HKM) of Cotonou / Benin.

Corresponding author E-mail: Email: [email protected]. Tel: (00 229) 97 99 78 50.

Accepted 31 October, 2015

Abstract

The objective was to assess the hospital prevalence of overweight and obesity outpatients medical consultation at NTH-HKM Cotonou. Methods: A cross-sectional descriptive and analytical study was conducted in medical consultation NTH-HKM Cotonou from June to September 2011. Overweight and obesity were identified from the Body Mass Index (BMI) calculated based on the formula weight (kg) / size (m)². Overweight was defined by a BMI between 25 and 29.9 kg / m² and obesity BMI> 30 kg / m². Results: Out of the 1,000 patients studied, 556 (55.6%) were females (sex ratio equal to 1.3). The average age of patients was 48.1 ± 14.5 years-old. Overweight was observed in 353 patients (35.3%) and obesity in 275 (27.5%). Male prevalence of overweight was 36.5% (162 out of 444 cases) against 34.4% for females (191 cases out of 556) (p = 0.48), while male prevalence of obesity was 16.9% against 36% for females (p <10^-7). These rates of prevalence increased significantly with age (p <10^-6). Occupation (housewife, unemployed) and marital status (married, divorced) were identified as associated factors. Conclusion: The high prevalence of overweight and obesity in our study calls for raising awareness about the lifestyle and the practice of physical activities among the population.

Keywords: Obesity, overweight, prevalence, internal medicine, NTH-HKM, Cotonou, Bénin.