Pattern of skin diseases at the University teaching hospital, Addis Ababa, Ethiopia

BACKGROUND AND OBJECTIVE: Skin diseases are among the leading causes of hospital visits in Ethiopia. An analysis was performed to describe the pattern of skin diseases at a teaching hospital in Addis Ababa, Ethiopia. PATIENTS AND METHODS: All consecutive new patients seen at the dermatologic referral clinic of Black Lion Teaching Hospital (BLH) from June 1995 to July 1997 were included in this prospective analysis. The clinical examinations were performed by the author, so that uniformity of diagnosis and classification is assured. RESULTS: A total of 1505 patients were assessed; 1093 (72. 6%) were in the age group 21-40 years, and the female to male ratio was 1.2 to 1. The most common skin diseases were allergic skin diseases (25.5%), infections (25.4%), the photodermatoses (22.9%), followed by papulosquamous diseases (11.4%) and pruritis of unknown origin (3.3%). Skin manifestations of collagen diseases were less common findings (0.7%). CONCLUSIONS: The pattern of skin diseases observed in this analysis shows that allergic and infectious causes account for three-quarters of skin problems. Emphasis should be given to this group of common skin diseases at all levels of health care so that proper diagnosis, treatment, and referral can be practiced.     

Quantitative MR characterization of disease activity in the knee in children with juvenile idiopathic arthritis: a longitudinal pilot study

Background The development of a quantifiable and noninvasive method of monitoring disease activity and response to therapy is vital for arthritis management. Objective The purpose of this study was to investigate the utility of quantitative dynamic contrast-enhanced MRI (DCE-MRI) based on pharmacokinetic (PK) modeling to evaluate disease activity in the knee and correlate the results with the clinical assessment in children with juvenile idiopathic arthritis (JIA). Materials and methods A group of 17 children with JIA underwent longitudinal clinical and laboratory assessment and DCE-MRI of the knee at enrollment, 3 months, and 12 months. A PK model was employed using MRI signal enhancement data to give three parameters, K^{trans ′} (min⁻¹), k_ep (min⁻¹), and V_p ^′ and to calculate synovial volume. Results The PK parameters, synovial volumes, and clinical and laboratory assessments in most children were significantly decreased (P < 0.05) at 12 months when compared to the enrollment values. There was excellent correlation between the PK and synovial volume and the clinical and laboratory assessments. Differences in MR and clinical parameter values in individual subjects illustrate persistent synovitis when in clinical remission. Conclusion A decrease in PK parameter values obtained from DCE-MRI in children with JIA likely reflects diminution of disease activity. This technique may be used as an objective follow-up measure of therapeutic efficacy in patients with JIA. MR imaging can detect persistent synovitis in patients considered to be in clinical remission.     

Simulated blood transport of low density lipoproteins in a three-dimensional and permeable T-junction

Previous studies indicate that blood flow and transport of macromolecules in the cardiovascular system and tissues are essential to understand the genesis and progression of arterial diseases and for the effective implementation of arterial grafts, as well as to devise efficient drug delivery mechanisms. In the present study, we use computational fluid dynamics to simulate the blood flow and transport of low-density lipoproteins (LDL) in a three-dimensional and permeable T junction. The Navier-Stokes equation, Darcy's Law, and the advective diffusion equations are the mathematical models used to simulate the flow and transport phenomena of the system. In the numeric model to implement the finite volume method, we used the computational fluid dynamics software Fluent 6.1. The simulation shows higher LDL concentration in the luminal surface at the junction under physiologic flow conditions. At 1 mm depth into the artery from the luminal surface, the LDL concentration is approximately 40% of the lumenal concentration, and at 2 mm depth, it reduces to 20%. Ultimately, the concentration drops further and reaches zero at the outer wall boundary.     

Three faces of costal exostoses: case series and review of literature

The 3 cases presented here involve 3 unusual and different complications of costal exostoses: spontaneous hemothorax, pneumothorax, and pericardial effusion. All of the cases presented with chest pain to the emergency department. Two of the cases have hereditary multiple exostoses. All but one of the patients required surgical intervention. Complications of costal exostoses are rare, but hemothorax, pneumothorax, and pericardial effusions can occur.     

Spontaneously Arrested Bilateral Primary Congenital Glaucoma: A Case Report From Ethiopia

BackgroundPrimary congenital glaucoma is potentially blinding condition characterized by elevated intraocular pressure and optic disc cupping. It is typically bilateral and usually manifest in the first year of life. Spontaneously arrested primary congenital glaucoma can occur, but it is very rare.Case ReportA 32-year-old male patient from North Shewa presented to the department of ophthalmology, Menelik II Hospital with deterioration of vision. On examination he had large corneas with horizontal diameter of 14 mm, increased axial length, faint corneal stromal opacity and Haab''s striae of both eyes. Anterior chamber angles were wide open. His intraocular pressure, optic nerve head appearance and visual field in both eyes were normal. He had subluxated dense cataract of the right eye.ConclusionLate presentation with sequelae of primary congenital glaucoma without optic neuropathy is possible. Regular follow-up of spontaneously arrested congenital glaucoma and scleral fixation of intraocular lens is recommended.