Prevalence of Thyroid Dysfunction among Patients with Chronic Kidney Disease Attending Diagnostic Laboratory Services, Bulawayo, Zimbabwe

Chronic kidney disease (CKD), can alter thyroid hormone production, distribution, and excretion. Thyroid dysfunctions like hypothyroidism, hyperthyroidism, and euthyroidism are identified in renal failure patients. This study aimed to determine thyroid dysfunction prevalence among CKD patients who attended Diagnostic Laboratory Services in Bulawayo from January to December 2023. The study was analytical cross-sectional and archival data collection methods were to gather information from 118 CKD patients who underwent both thyroid function tests and urea and electrolytes tests. A descriptive and analytical statistic test was used to determine the prevalence of thyroid dysfunction among CKD patients Chi square test was used to test association between thyroid’s dysfunction in CKD setting with various risk factors, P< 0.05 was considered as statistically significant. Thyroid dysfunction (TD) prevalence was 53%, increasing with CKD severity, with stage 3B having a high prevalence of 37%. Major types include subclinical hypothyroidism (11%), overt hypothyroidism (16%), and subclinical hyperthyroidism (4.2%), with 36% of females presenting with thyroid dysfunction as compared to 31% of males. Prevalence of thyroid dysfunction increased with an increase in age Majors risk factor for CKD in TD setting were hypertension, diabetes, and heart failure. In conclusion, there was a high prevalence of thyroid dysfunction (53%) among chronic kidney disease patients. &nbsp

Etude de l’impact socio-économique du diabète à Niamey

Introduction: Le diabète est un problème majeur de santé publique par sa prévalence importante et croissante d’une part, et son impact socio-économique d’autre part.Méthodologie: Il s’agit d’une étude prospective de type transversal de Janvier 2013 à Septembre 2013, portant sur 152 patients vus en consultation ou hospitalisés à l’Hôpital National de Niamey (services de pôles de cardiologie, de médecine interne, et des urgences médicale et chirurgicale). Ont été inclus les patients admis dans les services cités ci-dessus, âgés d’au moins 15 ans, diabétiques connus pendant une durée supérieure à 1 an au moins.Résultats: Les femmes (58%) prédominent notre échantillon de 152 patients. l’Age moyenne a été de 53,82 ans (16 à 83 ans). Les patients résidant à Niamey sont plus représentés. L’acidocétose est la complication aigue la plus retrouvée dans 65,85%, tandis que les complications chroniques sont dominées par les complications cardiovasculaires dans 29,10% et les pieds diabétiques dans 29,10%. Le coût direct de la prise en charge est représenté par les frais mensuels des consultations, Examens complémentaires, médicaments, déplacement et hospitalisation a été de 23270,7 et 279298,2 annuellement.Les coûts indirects sont représentés par les absences répétées au travail pour cause de maladie ou de visite médicale, L’inaptitude au travail, Départ à la retraite anticipée pour cause d’invalidité, absences au travail de l’entourage, Le décès prématuré représentent respectivement 51,22% ; 23,2% ; 12,73% ; 8,55% ; 2%.Conclusion: le coût direct de la prise en charge du diabète reste élevé, alors que le revenu des patients est très bas. Les coûts indirects sont responsables d’une perte de productivité. Le coût de cette perte de productivité peut être aussi élevé, voire plus, que celui des coûts directs.Mots clés: Coût, diabète, NiameyEnglish Title: Study of the socio-economic impact of diabetesEnglish AbstractIntroduction: Diabetes is a major public health problem through its large and growing prevalence of hand, and its socio-economic impact on the other.Methodology: The survey forms have served us study materials. And we conducted a prospective, cross-sectional study from January 2013 to September 2013; covering 152 patients seen or admitted to the National Hospital of Niamey (service centers cardiology, internal medicine, and emergency medical and surgical). The inclusion criteria were: patients admitted to the services listed above, patients at least 15 years,  known for a period greater than one year at least diabetic patients who agreed to participate in the survey.Results: The women (58%) prevail our sample of 152 patients. The Age averages was of 53.82 years (16 - 83 years old). The patients living in Niamey are more represented. The acidocetose is the acute (sharp) complication the most found in 65.85%, whereas the chronic complications are dominated by the cardiovascular complications in 29.10% and feet diabetics in 29.10%. The direct cost of the coverage (care) is represented by the monthly expenses of the consultations, complementary (additional) Examinations, the medicine, the travel (movement) and hospitalization was 23270.7 and 279298.2 annually.The indirect costs are represented by the absences repeated to the work because of illness or of medical examination. The unemployability, Retirement anticipated because of incapacity, absences in the work of the circle of acquaintances, The premature death Represent respectively 51.22%; 23.2%; 12.73%; 8.55%; 2%.Conclusion: In our study, the direct cost of managing diabetes is high. Indeed, the annual health expenditure ranges between 50.000 to 300.000 FCFA, 69% of the sample and indirect costs are responsible for a loss of productivity. The cost of this lost productivity can be as high as or more than the direct costs.Keywords: Cost, diabetes, Niame

Testicular torsion in Sub-Saharan Africa: a scoping review

Abstract Testicular torsion is a surgical emergency caused by rotation of the vascular pedicle of the testicle around its axis. If left untreated, testicular necrosis can set in, necessitating orchiectomy and loss of the testicle. The authors of this article reviewed articles on testicular torsion published in sub-Saharan Africa. The aim of this work is to establish the patient profile, consultation delay and orchiectomy rate in the sub-Saharan context. Data from the review will be compared with large non-sub-Saharan series and journals. Twenty-three articles were selected for review. All these articles were published between 1985 and 2022. A total of 1410 patients were included in the review. The average age was 19.7 years. The majority of patients were from urban areas. Risk factors for torsion were identified in 9 publications. The mode of hospital admission varied. Acute scrotal pain was the main symptomatology reported. The mean time in hours between onset of symptoms and consultation was 52.5 h. The left side was affected in 46.04% and the right in 49.81%. Four authors reported referral to a health center, and 8 authors reported scrotal ultrasonography. The rate of orchiectomy performed was found in 21 publications, the mean for the review as a whole was 46.4% with extremes of 13.2 and 72%. The orchiectomy rate was 52.4% in studies that reported an initial referral to a health center (patient transfer), versus 36.9% in studies that did not. In studies reporting ultrasound, the orchiectomy rate was 52.5%, compared with 36.9% in those not reporting ultrasound. On the basis of these results, we can formulate the following recommendations and actions: (i) further study of this pathology in sub-Saharan countries; (ii) raise public awareness of this pathology; (iii) train and retrain community workers and health center managers; and (iv) train general practitioners and surgeons in emergency scrototomy, orchidopexy and orchidectomy