Background: Among the different forms of ectopic pregnancy, cesarean scar pregnancy is one of the most uncommon with an estimated incidence of 1/1800 pregnancies. A major risk of massive hemorrhage, it requires active management as soon as it is diagnosed because it can affect the functional prognosis of the patient (hysterectomy) but can also be life-threatening. Different surgical techniques are generally proposed in first intention to patients who no longer wish to have children, who are hemodynamically unstable and/or in case of failure of medical treatment.Case presentation: We hereby report the case of a young 19-year-old patient with no particular medical history, gravida 2 para 1 with a live child born after a cesarean section for fetal heart rhythm abnormalities during labor 5 months earlier and who presented to the emergency room of our structure for the management of a cesarean pregnancy scar diagnosed at 6 weeks of amenorrhea. She was successfully managed with an intramuscular injection of methotrexate. The follow-up was uneventful.Conclusion: The implantation of a pregnancy on a cesarean section scar is becoming more and more frequent. With consequences that can be dramatic, ranging from hysterectomy to life-threatening hemorrhage, clinicians must be familiar with this pathological entity and be prepared for its management. The latter must be rapid and allow, if necessary, the preservation of the patient's fertility. In this sense, conservative medical treatment with methotrexate injections should be proposed as a first-line treatment in the absence of contraindication.

Lymphomas are common hematological malignancies with an increasing incidence in recent years. The main site of extranodal non-Hodgkin’s lymphoma is the gastrointestinal tract, representing 40% of cases. The most common site of gastrointestinal lymphoma is the stomach, followed by the small intestine, accounting for 25% - 50% and 20% - 30%, respectively [1,2]. Primary colorectal lymphoma is a rare disease, accounting for 0.2% to 1% of all colorectal malignancies [1]. Males are more commonly affected with a peak incidence in the sixth and seventh decades of life [3]. Non-Hodgkin’s lymphoma is the most commonly described subtype of colonic lymphoma [1]. 

Objectives: To examine the effect of dietary supplements on diabetic risk progression, blood glucose level, and lipid profiles.Methods: A randomized, double-blind, placebo-controlled study was conducted at Rajavithi hospital, Thailand. Participants with prediabetes were randomly allocated to three arms of dietary supplements: placebo (PL) or curcumin plus fish oil and vitamin D (CFD), or curcumin plus fish oil (CF) for 24 weeks. Primary outcomes were the progression of glycemic status and the progression to overt diabetes at 24-week and 36-week follow-ups. Secondary outcomes were changes in glycemic profiles (fasting plasma glucose, 75 g OGTT 2-h plasma glucose or HbA1C), body weight, BMI and lipid profiles.Results: A total of forty-seven participants (PL, n = 16; CFD, n = 15; CF, n = 16) were included in the study. At the 24-week follow-up, the participants with worsening glycemic status in the intervention groups were lower, CFD, CF and Placebo, 14.29%, 13.33% and 31.25%, respectively. However, the primary outcome, progression of glycemic status, was statistically different, with p - value = 0.046 (p < 0.05) when excluding previous diabetes in the study. As well as the incidence of type 2 diabetes at 24-week follow-up was not statistically different between the three groups, 14.29%, 13.33%, and 12.5%, p - value = 0.699 (p < 0.05) in CFD, CF, PL group, respectively. The secondary outcomes also failed to demonstrate the effect of dietary supplements on blood glucose, lipid profiles, weight, BMI and blood chemistry.Conclusion: The combined dietary supplements which contained curcumin-fish oil-vitamin D,could lower the glycemic status progression in prediabetes at six months follow-up and were well-tolerated among the participants.

Background: The clinical manifestations of Corona Virus Disease of 2019 (COVID-19) varied from patient to patient with evidence of multi-organ involvement. Many patients continue to have a wide range of symptoms for variable periods of time. The long-term effects of COVID-19 infection (post-COVID-19 illness or syndrome) are not yet been fully explored.This study aims to highlight the clinical manifestations of the acute COVID-19 infection and the longer-term manifestations of the disease among the attendants to a private GP clinic in the Urban Amman Area, Jordan.Methods: A clinical case-series study was conducted on a sample of 300 COVID-19-positive cases among patients attending my private GP clinic in the Urban Amman Area, Jordan. We used the structured questionnaire based mainly on World Health Organization (WHO) Case Report Form (CRF) verified tool for post-COVID-19. All patients with COVID-19 were included in the study. Data collection was conducted through phone calls and analyzed using the Statistical Package for Social Sciences (SPSS) software. Results: The incidence of COVID-19 among patients attending the clinic during the period of this study was 25%. Females were 135 (45%) of the study population and males were 165 (55%). The mean (SD) of age was 34.2 (5.0) years. Most of the infected staff (90%) were symptomatic and developed acute COVID-19 symptoms. Fever, Cough, Fatigue, joint pain and loss of smell and taste were the most common symptoms. 72% of the study population had fully recovered from the infection, while 28% of them continued to suffer from many long symptoms. Fatigue (28%), shortness of breath on activity (18%), Social withdrawal (18%), anxiety (17%), forgetfulness (16%), trouble concentrating (15) and depressed mood (14%) were the most frequently reported long symptoms.Conclusion: The prevalence of Post COVID-19 illness was 28% with a high public health burden calling for the public health system to address the medical and psychological needs of affected persons. Mental health and psychosocial support are recommended elements for the management of patients.

Influenza B myositis is a self-limited process that is typically accompanied by myalgia and muscle weakness, which can be caused by an acute respiratory infection. It occurs in the convalescence phase of the disease. It can usually affect preschool and school children, who present bilateral pain and tenderness in the muscle groups of the lower limbs without alterations in the neurological examination. Being able to generate an alteration in the brand or bipedestation. Its main complication is rhabdomyolysis. In Guatemala is difficult to test for viral respiratory infection and the incidence of viral myositis is unknown, for which we consider the report important because it presents a benign course and is easy to manage with the use of non-steroidal anti-inflammatory drugs, to avoid unnecessary hospitalizations. We present to case report to an 8-year-old male patient, previously healthy, with diagnostic de Influenza B myositis.

Recent clinical, experimental and epidemiological studies report that ALS is thought possibly due to a multi-stage process, arising from a combination of genetic susceptibility and environmental factors, which alone or superimposed, perhaps on genetic polymorphism yet to be identified, may contribute to the incidence rate of sporadic ALS. In particular, a large amount of evidence suggests that mercury is toxic to motor neurons and may be a risk factor for ALS, playing a part in its pathogenesis. In fact, there have been case reports of ALS or ALS-like symptoms associated with mercury exposure, thus raising the possibility that mercury could be one of the non-genetic factors of the multistep process that is thought to underlie ALS. In order to give recent elucidations on the putative relationship between mercury exposure and ALS, we reviewed all the papers reported in the literature and published on Pubmed from 2006 to 2022. Despite a number of pathogenetic mechanisms that have been linked to mercury, evidence linking exposure to mercury to ALS is not consistent and discordant and, based on the evaluation of the articles, which emerged from our analysis that to date no convincing correlation between mercury and ALS has been established and no conclusive evidence has been enlightened suggesting increased mercury exposure is associated with ALS.

Background: Measurable residual disease (MRD) status before allogeneic hematopoietic stem cell transplantation (AHSCT) is commonly associated with a high risk of relapse. It is still uncertain whether AHSCT could overcome the negative impact of MRD positivity (MRD+), especially in patients with high-risk Philadelphia negative acute lymphoblastic leukemia (Ph-negative ALL). Materials and methods: An observational retrospective study was conducted on patients with high-risk Ph-negative ALL who underwent AHSCT between January 2005 and June 2022. The patients selected were in complete remission (CR): with 80% in CR1 (n = 69) and 20% in CR2 (n = 17). Graft sources were bone marrow (BM) in 71% of patients and peripheral blood stem cells in 29% of patients. The conditioning regimen was TBI or chemotherapy-based (CT). Bone marrow MRD level was quantified using 4-6 color multiparametric flow cytometry (MFC). The threshold for MRD positivity was ≥ 0.1%. Results: The study included 86 patients (45 B-ALL and 41 T-ALL) with a median age of 18 years (range, 4–55 years). The median level of MRD pre-AHSCT (pre-MRD) was 0.4×10-3 (range, 0.01-75.6×10-3). After a median follow-up of 25 months (range 1-205 months), the cumulative incidence of relapse (CIR) was significantly higher in the MRD+ group (39% vs. 20%, p = 0.04). The median time of relapse post-AHSCT was 14 months (range, 1-203 months) in the MRD+ group and 32 months (range, 4-209 months) in the MRD- group (p = 0.28). Non-relapse mortality (NRM) was 15% in both groups (p = 0.97). The 2-year estimated overall survival (OS) and event-free survival (EFS) were 61% vs. 74% (p = 0.07) and 58% vs. 70% (p = 0.10) in the MRD+ and MRD- groups, respectively. A subgroup analysis in MRD+ patients showed that a TBI-based conditioning regimen was distinctly associated with lower CIR (22% vs. 60% respectively, p = 0.04), improved OS (82% vs. 36% respectively, p = 0.007) and better EFS (73% vs. 38%, p = 0.04) compared to CT-based. In a multivariate analysis, pre-AHSCT MRD+ status and non-TBI-based conditioning were significantly associated with inferior OS (OR, 2.30; 95% CI, [1.027-5.168], p = 0.04 and OR, 3.91; 95% CI, [1.624-9.418], p = 0.002, respectively). The only predicting factor of lower EFS was the non-TBI-based regimen (OR, 2.82; 95% CI, [1.308-6.097], p = 0.008). Non-TBI-based and CR2 were significantly associated with higher CIR (OR, 6.25; 95% CI, [1.947-20.055], p = 0.002 and OR, 4.74; 95% CI, [1.197-18.791], p = 0.03, respectively). Peripheral stem cell source was significantly associated with higher NRM (OR, 6.55; 95% CI, [1.488-28.820], p = 0.01). Conclusion: High-risk Ph-negative ALL patients with MRD ≥ 10-3 prior AHSCT had lower OS compared to MRD- patients and may benefit from TBI as a conditioning regimen before AHSCT.

Coronary heart disease (CHD) seriously endangers human health, and there are obvious gender differences in incidence rate and prognosis, which are related to the evident differences in anatomical structure, physiological characteristics, and wall shear stress between males and females. In recent years, cardiac rehabilitation has been proven to be safe and effective in controlling the progression and improving the prognosis of CHD. Thereinto, exercise therapy is the central link of cardiac rehabilitation. Exercise can significantly affect vascular endothelial function by regulating wall shear stress. Based on previous research, this paper will briefly review the influence of exercise on wall shear stress in male and female patients with CHD, in order to provide a reference for formulating personalized cardiac rehabilitation programs and further improve the prognosis of CHD.

Background: It is unknown what effect the menstrual cycle can have on the susceptibility to trauma following sexual assault. Objectives: To compare the incidence of genital injuries following sexual assault in women with relationship to the three phases of the menstrual cycleMethods: The design was a retrospective, cohort analysis set in a community-based nurse examiner program over a five-year study period. Sexual assault victims were between the ages of 13 - 40 years and agreed to a forensic examination. The menstrual cycle was divided into three phases: follicular, luteal and menses phase. The primary outcomes were the frequency and type of genital injuries documented in relation to the different phases of the menstrual cycle.Results: Case files of 1376 cases of sexual assault were reviewed; 682 (49.6%) met the inclusion criteria. A total of 220 victims (32.3%) were in the follicular phase, 361 (52.9%) were in the luteal phase and 101 (14.8%) were in the menses phase. The three groups were comparable in terms of demographics, assault characteristics, and overall frequency of non-genital injuries. Assault victims in the follicular phase of the menstrual cycle had significantly more documented genital injuries (72.3%; 95% CI 66.4 - 78.2) compared to the luteal phase (64.0%; 95% CI 59.0 - 68.9) and the menses phase (58.4%; 95% CI 48.8 - 68.0). Conclusion: Forensic examiners documented more genital injuries in the follicular phase of the menstrual cycle. Sex hormones may have confounding effects through influences on vaginal epithelial and mucosal integrity.

Introduction: Severe cases of COVID-19 presented a high incidence of multi-organ dysfunction syndrome (MODS) during their evolution. This was attributed to a theoretical cytokine storm, where microcirculatory disorders would play a fundamental role, causing these patients to present a sepsis-like pattern as observed in sublingual microcirculation studies. The evidence in this regard is controversial. The Peripheral Perfusion Index is a reliable method to continuously and non-invasively assess the microcirculatory bed, which assesses the pulsatile (PPI) component of the plethysmographic pulse curve.Methods: We conducted a prospective observational study to evaluate the behavior of the PPI in patients with severe respiratory failure due to SARS-CoV-2 and its association with SDOM.Results: We evaluated 60 patients with APACHE II 14.6 ± 4.4 and SOFA 4.7 ± 2.1. 55% of the patients presented SDOM. Perfusion monitoring showed IP values of 5.32 ± 1.87 that were associated with normal lactate levels of 1.49 mmol/L (min 0.89/ max 2.20 mmol/L). The PPI values between the living and the dead did not show a significant difference (p = 0.854) or the presence of SDOM.The PPI values between the patients who presented renal failure, hemodynamics, or perfusion disorders were determined by the presence of hyperlactatemia, and for those who did not present these characteristics, no statistical difference was found; neither when stratified by PaFiO2 ratio. Mortality was 55%.Conclusion: In our series of patients with severe pneumonia due to COVID-19, we found high PPI values, which would correspond to a pattern of capillary recruitment, and the associated organ injury could not be substantiated by this phenomenon.

Non-Hodgkin Lymphoma is rarely diagnosed as spinal cord compression syndrome. Caused by an epidural mass, this complication is often encountered in the late stage of the disease. We report two cases presenting symptoms of low thoracic spinal cord compression due to an epidural tumor on the MRI. Possible complications that may occur and how to prevent adverse events during surgery are essential. This case is of special interest for being a low-incidence pathology in a rare location. The case is of high interest because of the importance of resecting the lesion to prevent sequels and the complexity of its management and highlights the importance of considering the diagnosis of this event.

The treatment of severe aortic stenosis by transcatheter aortic valve implantation (TAVI) is challenging in patients with high-risk coronary anatomy that is predisposed to iatrogenic or delayed coronary obstruction. Hence, the evidence on performing TAVI with adequate coronary protection with or without deploying a stent needs to be accumulated. We report two cases of TAVI performed in patients with low coronary heights, wherein a “wire only” strategy was used to provide coronary protection along with the implantation of a novel balloon-expandable Myval THV. The first patient underwent a valve-in-valve TAVI, while the second patient underwent the replacement of a native bicuspid Type 1A valve. This case series presents two high-risk TAVI cases wherein a guide extension catheter and a supportive coronary guidewire provided sufficient coronary protection. None of the cases required any rescue revascularization and no incidences of a new pacemaker implantation were reported.

Introduction: Pneumothorax is defined as air in the pleural cavity, the iatrogenic cause happens after invasive procedures as thoracic needle aspiration, central line placement, pacemaker placement, etc. Nevertheless, it is possible to be found in non-medical procedures, such as alternative medicine, more specifically acupuncture. There are medications used against aging that FDA has warned to be used only in its first objective, an example is procaine hydrochloride.Case: A 63 y/o female, Mexico City resident, with anxiety, came to a follow-up appointment for an aging cohort, where CT, PFT, and laboratories are made for pulmonary healthy subjects to investigate normal lung aging and how other environmental factors can affect the lungs; at physical examination, we did not find any pleuropulmonary syndrome, but in the CT a left Iatrogenic pneumothorax was found; we re-asked for antecedents and she described that 15 days before the date she had 2 punctures in the middle clavicular line to apply procaine hydrochloride as an anti-aging treatment.Discussion: There is diverse evidence of adverse effects associated with acupuncture, and even if pneumothorax has a small percentage of incidence, in some cases it can be severe and can even cause fatalities.Conclusion: The pneumothorax in this case was iatrogenic due to the thoracic puncture for an anti-aging treatment, with a total resolution with conservative treatment, however we as health professionals have the responsibility to inform our patients that initiatives of administration ways can cause important complications.

To evaluate the safety and efficacy of weight-based mycophenolate mofetil (MMF) dosing in adult kidney transplant recipients (KTR), this single-center retrospective study of adult KTR compared biopsy-proven acute rejection (BPAR), infections, hospitalizations, granulocyte colony-stimulating factor (G-CSF) use, and MMF dose changes within one year of transplant pre-and post-implementation of a weight-based MMF dosing protocol. Adult patients who received a kidney transplant at University Health Transplant Institute were reviewed for inclusion. Patients in the weight-based MMF group received 1000 mg twice daily by the first clinic visit if ≥ 80 kg, 750 mg twice daily if 50-79 kg, and 500 mg twice daily if < 50 kg. Patients in the fixed-dose MMF group received MMF 1000 mg twice daily. A total of 170 KTR (50.0% ≥ 80 kg, 44.1% 50-79 kg, 5.9% < 50 kg) were included. Baseline characteristics were similar between groups. The majority of patients were middle-aged Hispanic males and received lymphocyte-depleting induction therapy. Incidences of BPAR, infection, and hospitalization were similar between both groups at one-year post-transplant. Weight-based MMF dosing is safe and effective in adult KTR.

Background: Goldenhar syndrome is a congenital condition primarily affecting eye, ear, and spine development. In some cases, it can also impact the heart, lungs, kidneys, and central nervous system. The exact cause of Goldenhar syndrome is not fully understood, and its incidence is estimated to range from 1 in 3500 to 1 in 5600 live births. While intellectual disability is associated with the condition, no established link exists between Goldenhar syndrome and psychiatric disorders.Case presentation: In the presented case, a patient with Goldenhar syndrome has been diagnosed with an episode of mania with psychotic features in the context of bipolar disorder. The patient had no history of prior mental disorders and had an independent life.Discussion: There are few case reports of Goldenhar syndrome patients with mental disorders. In all instances, including our own case, patients exhibited psychotic features during psychiatric examinations.Conclusion: Based on the studies cited and our own research, it is recommended to further investigate the potential association between this syndrome and psychiatric disorders.The following sections provide details on the examination, medical history, and treatment of this patient.

Background: This retrospective study examines the importance of preoperative cardiology consultations in optimizing patient care and anesthesia surgical perioperative management.Methods: The study includes 7,756 patients from the Department of Anesthesiology at Mohammed V Military Teaching Hospital. Out of these, 122 patients were referred to cardiology consultations. Demographics, surgical specialties, reasons for referral, diagnostic tests, and interventions were analyzed.Results: Referred patients (average age 61.45 years) were mainly over 65 years old, with 59.01% being male. Common surgical specialties seeking consultations were abdominal surgery (30.327%), orthopedic surgery (26.230%), and urological surgery (19.672%). Hypertension, dyslipidemia, and diabetes were prevalent risk factors. Most patients were classified as ASA II (50%) or ASA III (27.04%), with NYHA I (61.5%) or NYHA II (31.2%) classifications. Referrals were due to ECG abnormalities (41.0%), routine evaluation (19.7%), and history of myocardial infarction or previous coronary angiography (39.3%).Discussion: Preoperative cardiology consultations accounted for 1.57% of all pre-anesthesia clinic patients. They were vital in assessing and managing cardiovascular risks, consistent with previous studies. The impact of these consultations was evident in optimizing patient management through treatment plan adjustments and interventions.Conclusion: Preoperative cardiology consultations play a crucial role in identifying and managing cardiovascular risks, contributing significantly to patient care and improving perioperative management. Further research should evaluate long-term outcomes and cost-effectiveness across different patient populations.

Background/Aim: There has been a progressive rise in the incidence and prevalence of End Stage Renal Disease (ESRD). It has also been observed that the most important reasons for a rapid increase in Chronic Kidney Disease (CKD) patients are the rapidly increasing worldwide incidence of diabetes and hypertension. The present study evaluates the effect of diabetes, hypertension, and comorbid state of hypertension and diabetes (hypertensive-diabetic) on renal function using serum creatinine and urea as markers. Method: A total number of 120 persons were recruited for the research; 30 controls, 30 hypertensive, 30 diabetic, and 30 hypertensive-diabetic persons. Of the 30 control persons, 18 were females and 12 were males; of the 30 hypertensive subjects, 17 were females and 13 were males; of the 30 diabetics subjects, 20 were females and 10 were males, whereas of the 30 hypertensive-diabetic subjects, 21 were females and 9 were males. In total, there were seventy-six (76) females and 44 males. The respondents were pulled from Central Hospital (Auchi) Diabetic and General Clinic and Auchi Polytechnic Cottage Hospital. Verbal consent was sort and questionnaires were used to extract information regarding biodata and patients’ history of diabetes and hypertension. Height and weight were measured, and blood pressure was determined taken. Blood samples were collected into fluoride oxalate and lithium heparin bottle for the assessment of FBS and (serum urea and creatinine) respectively. Results: The mean (±SD) serum creatinine was higher in the hypertensive-diabetic group (2.08 ± 1.06) and declined as follows: diabetic group (1.75 ± 1.01), hypertensive group (1.34 ± 0.96) and control group (0.70 ± 0.14). The mean (±SD) serum urea was also found to be higher in the hypertensive-diabetic group (17.5 ± 9.06) and declined as follows: diabetic group (14.5 ± 6.13), hypertensive group (12.7 ± 6.23) and control group (7.18 ± 5.06). There was a positive correlation between serum creatinine and fasting blood sugar The study also established a positive correlation between serum creatinine and blood pressure but not between serum urea and blood pressure with r values of 0.31 and 0.16 respectively. Conclusion: Good control of blood glucose and blood pressure levels reduces the likelihood of the development of renal impairment which is usually associated with both diabetes and hypertension. Co-morbidity of diabetes and hypertension poses a higher risk of developing renal disease than individual problems of diabetes and hypertension. Serum creatinine and serum urea are important biomarkers for renal impairment hence the two should be monitored on a regular basis for diabetic and hypertensive patients and much more frequently for hypertensive-diabetic patients.

Background: Grand multiparty is common obstetrical problem, in Sudan large families is desirable for cultural and religious backgrounds and higher incidence of grandmultipra is expected, the risk factors associated with adverse maternal outcomes have yet to be adequately investigated among grand multiparity need to delivered by primary cesarean section.Objective: The main objective was to determine impact of primary cesarean section on grand multiparous, it is indications and complications.Methodology: It was a descriptive prospective cross-sectional hospital-based study conducted at Omdurman Maternity Hospital during period October 2016 to March 2017.An interview questionnaire was used for data collection. Demographic and clinical data concerning personal history, parity, indications of primary cesarean section, type of Cs, maternal complication and neonatal complications were recorded. Also, multiparous less than five delivery, previous lower segment caesarean section, known medical disorders except anemia and twin pregnancy were excluded.Results: During the study period total of 113 grand multipara included, incidence of primary cesarean section in grand multipara was 10%. Indication in our study 22.1% due to malpresentation, fetl distress 15% and prolonged first stage 13.4%, prolonged second stage 12.4% and antepartum haemorrhage 11.5%.  Postpartum haemorrhage developed in 9.7%, hysterectomy 1.8%, uterine tear 5.4% bladder injury fetal laceration 3.6%, spinal anesthesia headache 7%, post-partum pyrexia 5.3%, sepsis 4.4%, urinary tract infections were 2.7%.Conclusion: The finding in this study showed 10% incidence of primary cesarean section in grandmultipra. The most indications of primary cesarean section in grandmultipra malpresentation, fetal distress, prolonged first and second stage of labour. Most CS were emergency. 

Background: Ectopic pregnancy (EP) is a common and serious early pregnancy problem with a significant morbidity rate and the potential for maternal death. Women commonly present with minimal vaginal bleeding and abdominal pain.Objective: The main objective of the study was to evaluate the risk factors, clinical presentation, sites, and management outcomes of ectopic pregnancies. Methodology: It was a prospective descriptive, cross-sectional hospital-based study conducted at Bashair Teaching Hospital during the period January 2021–June 2021.An interview questionnaire was used, and eighty-two (82) women were included after informed consent. Demographic and clinical data concerning personal history, symptoms of presentation, risk, site, and type of management were recorded.Results: Ectopic pregnancy incidence was 2% and most risk factors were infection 29.3%, surgery 15.9%, miscarriage 13.4%, infertility 12.2%, tubal surgery 4.9%, previous ectopic pregnancy 4.9%, intrauterine contraceptive device (IUCD) 3.6%, and tubal ligation 2.4%. Women presented with bleeding and abdominal pain at 47.5%, bleeding at 18.3%, abdominal pain at 9.7%, and shock at 8.5%.The sites are ampullary (57.3%), fimbria (9.7%), interstitial (8.5%), isthmus (8.5%), ovarian (7.3%), cervical (4.8%), and abdominal (3.6%).Surgical management was 93.9%, medical and surgical management was 3.6% and medical management was 2.4%. A blood transfusion was received at 37.8%.Conclusion: The study concluded that women of reproductive age are at risk of ectopic pregnancy, so healthcare providers and doctors should have a high index of suspicion, prompt diagnosis, and intervention for ectopic pregnancy. Assessment of women at risk factors and modifications will reduce incidence. 

Purpose: Acute kidney injury (AKI) is a real public health problem due to its severity and gravity. In a 2013 meta-analysis, Susantitaphong, et al. estimated the incidence of AKI worldwide at between 10% and 20%. In the latter study, no African studies were included, given the lack of data in the literature. Our objective was to identify the clinical and paraclinical epidemiological characteristics of patients with AKI.Patients and methods: We conducted a retrospective study including patients who had AKI with recovery of normal renal function hospitalized in a nephrology service between 2002 and 2015.Results: Our population consisted of 107 men and 107 women with a median age of 61 years (IQR 43-73.25) of which 42.1% were multitargeted. Functional AKI represented the predominant mechanism of AKI retained in our study with a rate of 53.2% with dehydration as the main etiology for 108 patients (50.46%). Organic cause was retained in 38.8% of patients, with acute tubular necrosis (ATN) as the most frequent etiology (37.35%). Kidney disease improving global outcomes (KDIGO) stage 3 was the stage retained for 115 patients included in our series, 31 of whom required extra renal purification. During their hospitalization, 78.5% of the patients presented a persistent AKI (duration of the episode > 7 days). A glomerular filtration rate (GFR) lower than 60 ml/min/1.73 m² at discharge was found in 119 patients and 10 patients had a GFR higher than 90 ml/min/1.73 m². After 3 months from discharge, 77.5% of patients had a GFR between 60 and 90 ml/min/1.73 m².Conclusion: Our results give us an idea of the epidemiological and clinical characteristics of patients who have had acute renal failure with recovery of normal renal function and enable us to better recognize patients at risk in order to avoid such complications. AKI remains a major issue and knowing its epidemiological and clinical characteristics will allow its prevention.