Physiology and Anatomy

Breast is a host to many diseases which present as lumps in the breast. Fine Needle Aspiration Cytology’ (FNAC) and ‘Core Needle Biopsy’ (CNB) are commonly used to obtain pathologic diagnosis. Total 104 patients presenting with palpable breast lumps were subjected to FNAC then Core needle biopsy in a single sitting. Finally the results of FNAC and Core Needle biopsy were compared in the light of excision biopsy results. Sensitivities of FNAC and Core Needle biopsy were 83.33 % and 95.83 % and specificities were 96.55 % and 100 % respectively showing that Core Needle biopsy was more accurate than FNAC.

Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract. Perineal manifestations are a marker for disease severity. Anal strictures result from fibrotic scarring after several inflammatory attacks and are responsible for impaired quality of life. The aim of our work is to study the epidemiological profile and the management of these lesions. This is a descriptive retrospective study over a 17-year period from January 2002 to January 2019, concerning a monocentric cohort of 1053 cases of Crohn's disease. 22 patients had anal stricture, a prevalence rate of 2.08%. The main symptoms were painful passing of stools in all patients, emission of pus in 12 patients (54.5%) cases, imperiosity in 5 patients (22.7%), abdominal pain in 10 patients (45.4%) and an Obstructed defecation syndrome in 3 patients (13.6%). Penetrating phenotype B3 and the colonic localization L2 were the most frequent. Pelvic MRI confirmed anal stenosis in all patients, associated with complex fistulas, PARKS grade 4 in 18% (n = 4) cases. The treatment of the stenosis consisted of finger dilatation in 21 patients (90%), associated with dilation by Hegar dilatators in 63.6% (n = 14) cases and by balloons in 31.8% (n = 7) cases; the stenosis biopsy revealed squamous cell carcinoma in only one case, 4.5%. The medical treatment for CD was based on immunosuppressants in 72.7% (n = 16) cases, anti TNF in 18.18% (n = 4) cases, and Combination therapy in 9% (n = 2) cases. The prevalence of anal strictures in our study remains low compared to literature series; these are young women with LAP, a Penetrating phenotype and pancolitis.

Urachal cyst is one of a spectrum of urachal abnormalities most commonly found in children. But it is a rare pathologic disease entity in the adult, which may present only with abdominal pain. We describe a case of a 49 year old male who presented with abdominal pain, fever and dysuria. Diagnosis of an infected urachal cyst was confirmed on Computed tomography of the pelvis. He was treated initially with broad spectrum antibiotics in order to allow sepsis to resolve prior to surgical excision of the cyst and fibrous tract. Histology of the excised specimen showed chronic inflammation with no evidence of malignancy. Postoperative recovery was uneventful. Urachal abnormalities are rare in adults. Clinical presentation is non-specific and must be considered as a rare differential for abdominal pain, when diagnosed, surgical excision is advised because of the risk of malignant transformation.

Sarcomas of the prostate are rare and represent less than 0.1% of cancers of this gland, represented mainly by leiomyosarcomas. It is a rare type of tumor, with a 5-year survival rate of approximately 53%. occur mainly in children and young adults. These tumours show predilection for bones and soft tissues in the paraspinal region and lower extremities . Its therapeutic means represent a real problem for the urologist. We report the case of a young patient admitted for urine disorder, the MRI showed that the diagnois was prostatic PNET.

Childhood cancers have been on the rise globally. There is insufficient data on patterns of childhood cancers in Kenya. We aimed at profiling and identifying the stages of these malignancies during 2016 and 2017 at Kenyatta National Hospital in Kenya. The age most affected with cancer was 0-4years (46.9%) followed by 5-9 years (31.1%) and 10-15 years (22%). 29.8% of the cancers were diagnosed at In-situ stage. CNS tumors were the most common and the least was lymphomas. The frequency was found to be higher in boys than girls.

The incidence of stenosis of the subclavian artery represents 3 to 4% of the general population [1]; atherosclerosis is the most common cause. We conducted this study to review the stenocclusive pathology of the subclavian artery, and to expose our experience in surgical and endovascular management. It is a retrospective and analytical study conducted within the department of vascular surgery of Mohammed VI CHU. Surgical treatment consisted of subclavio-carotid transposition in 2 cases, carotid-bypass grafting in one case and angioplasty with stent placement in the latter case. It is important for the surgeon to have a thorough understanding of the anatomy and etiology of subclavian artery stenosis, while considering the surgical options. This case series presents some of the treatment options available to vascular surgeons for the management of symptomatic subclavian artery disease.

Hip dislocation is a therapeutic emergency, which results from violent trauma often associated with local or general lesions. Objective: In this study, we aimed to assess the treatment outcome of the follow-up of hip dislocation in Bamako, Mali. In our retrospective study, we recruited patients with traumatic hip dislocation from January 2012 to December 2016 and followed them up at the orthopedic and trauma department of the University Hospital (CHU) Gabriel Toure. In total, 81 patients (69 men and 12 women) with traumatic hip dislocation were included in our study with a sex-ratio of 5.7. The average age was 31.83 years old a standard deviation of 13.68 years old and extremes of 9 years old and 70 years old. Trauma was due to Public Road Accidents in 93.82% of the cases. The most frequent traumatic hip dislocation was anatomo-radiologic type I dislocation from steward and Milfrod with 62.96 %. Associated lesions were noticed in 67.90% of cases. In 97.53% of the patients underwent orthopedic treatment. Patients were followed up for at least a year. Complications were characterized by chronic pain in 48.14%. Outcomes were favorable in 51.85% of cases. Traumatic hip dislocation is common in young people in Mali. It is serious and may engage the functional prognosis of the hip, especially in case of associated lesions. The treatment has to be urgent and appropriate for a better outcome.

The abnormal right coronary artery originating from the left coronary system is an extremely rare variation of isolated single coronary artery. It is often a benign entity and the patients remain asymptomatic. Nevertheless, it can lead to sudden death during exertion. The treatment of this coronary anomaly may be medical, percutaneous and/or surgical. We present here a right coronary artery originating from the proximal left anterior descending artery in the first case and from the left main coronary artery in the second case. Both patients were seen to have an acute coronary syndrome with multi-vessel coronary artery disease.

Stress echocardiography (DSE) is an investigative technique that is perfectly integrated into the diagnostic and prognostic assessment of many heart diseases, including coronary disease based on cardiac ultrasound images. Dobutamine stress echocardiography (DSE) is very useful as a first-line test to detect a contractile reserve to better specify the potential benefit of revascularization This is a retrospective, descriptive and analytical study on patients collected in the laboratory of non-invasive Cardiology explorations hospitalized and/or followed in consultation or referred to the CARDIOLOGY B department IBN SINA university hospital, over a period of 2 years between January 2018 and December 2019. Method: Our service admitted 218 patients for pharmacological stress echocardiography with Dobutamine for viability. Objectives: The objective of our study is to report the activity of our service concerning the assessment of Myocardial Viability with Dobutamine Stress Echocardiography by specifying the clinical, electrical, echocardiographic and angiographic aspects as well as the results of the stress echocardiography. Results: Men and an average age of 64 years dominated the epidemiological profile of our patients; hypertension is the most common risk factor. Coronary arteriography shows: 43% of our patients had bitruncated coronary lesions. All our patients benefited from the same protocol in the assessment of myocardial viability with low-dose dobutamine stress echocardiography, 46% of viability positive in our series. None of our patients went through complications. These are probably explained by the low doses of dobutamine.

Pheochromocytomas are catecholamine producing tumors arising mostly from chromaffin cells of the adrenal medulla. The prevalence of the tumor is 0.1%-0.6% in the hypertensive population, It has been called 'the great mimic’, capable of presenting itself as many other medical conditions. The most common clinical presentation is hypertension, mainly in the form of paroxysmal episodes. Cardiovascular manifestations include malignant arrhythmia and catecholamine cardiomyopathy, mimicking acute coronary syndromes and acute heart failure. We report a case of pheochromocytoma revealed by angina, and acute myocardial infarction without coronary artery disease (CAD).