Physiology and Anatomy

The bladder Adenocarcinoma is an extremely rare urological entity. We report the case of an 80 year old patient. The Cystoscopic exploration found a solid tumor located at the anterior side, the rest of the bladder mucosa was featureless. The anatomopathological study showed the presence of an adenocarcinoma with glandular architecture. The immunohistochemical study showed a positive labeling of the tumor cells by the anti CK 20, with an absence of nuclear labeling of ?-catenin, thus confirming the primitive bladder character of the mucinous Adenocarcinoma. Due to the localized appearance of the tumor an anterior pelvectomy with drainage type cutaneous ureterostomy was performed.

Tracheoesophageal fistulas (TOF) are a rare but sometimes a severe complication of tracheotomy. Their clinical presentations, of varying severity, usually involve several symptoms. The diagnostic procedure always combines chest x-rays looking for a pneumothorax, a pneumomediastinum or an aerogastry, and bronchial fibroscopy which determines the location, size and potential severity of the lesion. Therapeutic management is based on surgical repair. Prevention of TOF is important and must represent the real treatment.

A lot of controversy continues regarding the development of human penile urethra.Posterior urethral valves are congenital disorder and can only seen in male infants. It caused by failure of regression of the mesonephric duct. Most of cases PUV’s a sporadic and only occur in males, evidence suggests that they can be found in siblings or twins in a family. If PUV’s are not diagnosed and treated early they can cause damage in the ureters, urethra, bladder and kidney, constraints lung developments cause of low quantity of amniotic fluid. PUV’s are commonly diagnosed prior to birth or at birth when a male infant is evaluated for antennal hydronephrosis.

Pre-ureteric vena cava is a rare congenital disorder, usually presenting clinically with hydronephrosis and an “S or fishhook” deformity of the ureter at the lumbar vertebrae three and four. Unusual presentations do occur and can lead to misdiagnoses. Though it is a congenital disorder, patients do not normally present with symptoms until the 30 years of life with various complains, results due to back pressure changes lead to hydronephrosis (water in the kidney).

Sickle cell disease an inherited common blood disorder due to the presence of the abnormal haemoglobin S. This is a prospective study done at Kenyatta National Hospital that describes a point of care method for diagnosis of HbAS, HbSS, HbSC and HbAA using the Sickle SCAN™ test. It determines the sensitivity, specificity in comparison with haemoglobin electrophoreisis.These results validate the use of sickle Scan as a low cost method for screening and diagnosing children and adults with esickle cell disease.

Cancer is currently the cause of 12% of all deaths worldwide. The number of cancer deaths annually will increase from about 6 million to 10 million. Breast cancer is the most commonly diagnosed cancer in women worldwide, with nearly 1 000 000 new cases diagnosed per year, and the second leading cause of cancer deaths in women worldwide. The causes of breast cancer remain largely unknown, but certain reproductive and hormonal factors are clearly related to risk. It is reported that one in 22 women in India is likely to suffer from breast cancer during her lifetime. The medical records of 300 patients treated at the Mahavir Cancer Institute and research Centre for breast cancer between 2005 and 2008 with perspective age of marriage and menstrual status were reviewed. In present study we can observe that breast cancer cases were more found in pre menopausal women i.e.: 55% than post menopausal women i.e.: 45%. Mean age of marriage is very earlier, which indicate that early marriage may be a causative factor for breast cancer. Thus it is concluded that early age marriage is risk factor for breast cancer as well as pre menopausal women are at higher risk for breast cancer.

The combination of cystitis and emphysematous pyelonephritis is a serious but rare, the prognosis is related to renal damage. CT is the gold standard that allows the diagnosis and establishes a radiological classification with prognostic value. The therapeutic approach is based on The Early antibiotic treatment is systematic. Percutaneous drainage is the first step therapy in most cases,but should not delay a possible rescue nephrectomy. We report a case of emphysematous pyelonephritis associated with emphysematous cystitis in a 26 year old woman. Early diagnosis allowed conservative treatment with appropriate antibiotic therapy and urinary drainage catheter. The outcome was favorable.

Carbon monoxide (CO) poisoning is the leading cause of death by poisoning in western countries. Certainly the neurological symptoms are the most common, yet the cardiovascular signs are considerable too and may be responsible of a significant morbidity and mortality. Therefore health professionals must be aware of its diagnosis, treatments and prognostic implications. We report here a case of a patient with a non ST segment elevation acute coronary syndrome with positive troponin related to carbon monoxide poisoning.

Cardiovascular dysautonomy is a disturbance of the sympathico-vagal balance in the control of the cardiovascular system. The primary objective of this study was to describe the autonomic profile of chronic hemodialysis patients (CHD). This is a cross-sectional observational study, including 22 patients from the hemodialysis (HD) center of the Ibn Sina University Hospital in Rabat. We observed the different cardiac and nephrological characteristics of the patients; Carried out a study of the autonomic nervous system (ANS) by non-invasive methods and established the autonomic profile of the patients. Dysregulation of the cardiovascular autonomic nervous system was found in 72.7% of patients; Vagal disability was the most pronounced autonomic disorder in 63.6%, followed by central (54.6%) and peripheral (50.0%) sympathetic hyperactivity. In multivariate analysis, only the female sex (p = 0.042) was an independent risk factor for vagal disability; On the other hand, the HD quality was a protective factor (r: -0.56, p =0,021). Intradialysis hypotension and hypertension appear to be respectively related to decreased baroreceptor sensitivity and sympathetic alpha hyperactivity. The underlying mechanisms of this involvement require further studies before treatment strategies can be developed.

Cancer is currently the cause of 12% of all deaths worldwide. The number of cancer deaths annually will increase from about 6 million to 10 million. Breast cancer is the most commonly diagnosed cancer in women worldwide, with nearly 1 000 000 new cases diagnosed per year, and the second leading cause of cancer deaths in women worldwide. The causes of breast cancer remain largely unknown, but certain reproductive and hormonal factors are clearly related to risk. It is reported that one in 22 women in India is likely to suffer from breast cancer during her lifetime. The medical records of 200 patients treated at the Mahavir Cancer Institute and research Centre for breast cancer between 2005 and 2008 with perspective age of first pregnancy and menstrual status were reviewed. In present study we can observe that breast cancer cases were more found in pre menopausal women i.e.: 59 % than post menopausal women i.e.: 41%. Most women of the study were belonging to low socieo-economic status from rural area. They have average first pregnancy on 17.95 years of age. Thus it is concluded that early pregnancy having no protective role in breast cancer but they develop breast cancer in early age.