Risk Factors and Pattern of Lower Limb Deep Venous Thrombosis in Gombe, North-Eastern Nigeria.

BACKGROUND: Deep venous thrombosis (DVT) is one of most common causes of morbidity and mortality among hospitalized patients. Many risk factors ranging from inherited to acquired are associated with increased risk of DVT. AIMS: The aim of the study was to review the pattern and risk factors of DVTs in Gombe. METHODS: This study was a retrospective review of Doppler ultrasound confirmed lower limb DVT that were managed in the Department of Haematology, Federal Teaching Hospital Gombe, North-eastern Nigeria over a 4-year period (January 2018 to December 2021). Data obtained was analyzed using SPSS version 28. RESULTS: Ninety (90) patients were seen and managed during the study period, most were females, (56.7%; n =51) with an age range of 18 to 92 years and mean of 47.3±17.8 years. Young adults (18-45 years) were in the majority (n=45; 50%), followed by the middle aged (46-60 years) (n=28; 31.1%) and then elderly (>60 years) (n=17; 18.9%). Twenty-five patients (27.8%) had proximal DVT, thirteen (14.4%) distal while 49 (57.8%) had extensive DVT. The most affected side is the left lower limb (64.4%; n=58). Most of the patients had provoked DVT (n=65; 72%) with immobilization, recent surgery, bone fracture and stroke as the leading provoking factors. Among those with provoked DVT, young adults were the majority (n=34; 38%), followed by those in the middle-aged group (n=21; 23%) and then the elderly (n=10; 8%). CONCLUSION: Our study showed the preponderance of left sided DVT and the majority of the cases were provoked affecting young adults.

CONTEXTE: La thrombose veineuse profonde (TVP) est l'une des causes les plus courantes de morbidité et de mortalité chez les patients hospitalisés. De nombreux facteurs de risque, qu'ils soient héréditaires ou acquis, sont associés à un risque accru de thrombose veineuse profonde. OBJECTIFS: L'objectif de l'étude était d'examiner les caractéristiques et les facteurs de risque de la TVP à Gombe. MÉTHODES: Cette étude était un examen rétrospectif des TVP des membres inférieurs confirmées par échographie Doppler qui ont été prises en charge dans le département d'hématologie de l'hôpital universitaire fédéral de Gombe, au nord-est du Nigéria, sur une période de 4 ans (janvier 2018 à décembre 2021). Les données obtenues ont été analysées à l'aide de SPSS version 28. RÉSULTATS: Quatre-vingt-dix (90) patients ont été vus et pris en charge au cours de la période d'étude, dont la plupart étaient des femmes, (56,7% ; n =51) avec une tranche d'âge de 18 à 92 ans et une moyenne de 47,3±17,8 ans. Les jeunes adultes (18­45 ans) étaient majoritaires (n=45 ; 50%), suivis par les personnes d'âge moyen (46­ 60 ans) (n=28 ; 31.1%) et les personnes âgées (>60 ans) (n=17 ; 18.9%). Vingt-cinq patients (27,8 %) présentaient une TVP proximale, treize (14,4 %) une TVP distale et 49 (57,8 %) une TVP étendue. Le côté le plus touché est le membre inférieur gauche (64,4% ; n=58). La plupart des patients présentaient une TVP provoquée (n=65 ; 72%), l'immobilisation, une intervention chirurgicale récente, une fracture osseuse et un accident vasculaire cérébral étant les principaux facteurs de provocation. Parmi les patients présentant une TVP provoquée, les jeunes adultes étaient majoritaires (n=34 ; 38%), suivis du groupe d'âge moyen (n=21 ; 23%) et des personnes âgées (n=10 ; 8%). CONCLUSION: Notre étude a montré la prépondérance de la TVP du côté gauche et la majorité des cas ont été provoqués en affectant les jeunes adultes. Mots-clés: Thrombose veineuse profonde, Schéma, Gombe, Facteurs de risque.

Dyke-davidoff-masson syndrome: A case report of an adolescent boy at a tertiary hospital in Adamawa, North-Eastern Nigeria.

Dyke-Davidoff-Masson Syndrome (DDMS) is a rare clinical condition in which atrophy or hypoplasia of one cerebral hemisphere occurs secondary to brain insult during fetal or early childhood, which results in variable clinical manifestations like hemiparesis, seizures, expressive aphasia, and mental retardation. This rare entity mainly presents in childhood and is unusual in adults. DDMS is a rare cause of epilepsy and should be considered and excluded in cases of refractory seizures. Few cases have been reported from a developing nation like Nigeria but not from the north-eastern part of Nigeria to the best of our knowledge. Though fewer specialists exist in Adamawa State, efforts to train more specialists and education of medical officers to manage this rare case need to be strengthened. Herein is a case of an adolescent boy with recurrent generalized tonic-clonic convulsions complicated by left-sided hemiparesis, expressive aphasia, and mental age equivalent of a six-year-old by the Goodenough draw-a-person test. Found to be obese with Body Mass Index (BMI) of 29 kg/m2 (Z-score >2 Standard deviation SD), microcephaly, Occipito-frontal Circumference (OFC) of 45 cm (Z-score > -3 SD), spastic left-sided hemiplegia and hemiplegic gait. Magnetic resonance imaging (MRI) of the brain showed hyper-intensity in the right cerebral hemisphere, extensive atrophy of the right cerebral hemisphere involving the ipsilateral fronto-temporoparietal lobes, cerebral peduncle, and a contralateral megalencephaly, ipsilateral lateral ventricular dilatation, hypertrophic calvarium, hyperpneumatization of sphenoidal sinuses and midline shift due to loss of volume on the right. A diagnosis of Dyke-Davidoff-Masson syndrome was made; the patient did well on carbamazepine and physiotherapy. Caregivers were counseled, and the patient was discharged home and is currently on a follow-up visit.