Nigerian Medical Journal

An overview of pancreatic cancer diagnosis and treatment in China: Current landscape and future prospects.

Sakarie Mustafe Hidig — 2024-10-15

This comprehensive literature review is to summarize the most recent findings regarding the causes,
diagnosis, and treatments of pancreatic cancer and to encourage additional investigation into this under
researched malignant tumor. Pancreatic cancer is a significant public health issue in China, with annual
mortality rates almost equal to incidence rates. The disease is more prevalent in rural areas and has a poor
prognosis. The data was collected from the following databases: Pub Med, Cross ref, Science Direct,
Scopus, and Google Scholar we reviewed published articles from 2018 to 2023 on the annual incidence
of pancreatic cancer in China is 5.1%, with only 5-7% of patients completely cured. The prognosis is
extremely poor, with a 1-year survival rate of 8% and a 5-year survival rate of 3%. Pancreatic cancer has
no specific clinical manifestations or tumor markers, and its characteristics are not typical of high-risk
factors including smoking, alcohol, chronic pancreatitis, abnormal microorganism metabolism, blood
type, and glucose and lipid levels. For increased detection and survival rates, pancreatic cancer must be
diagnosed as early as possible. However, the low specificity of tumor markers calls for more study.
Future treatment strategies could include immunotherapy and a microbiology-free system, and it's
anticipated that they'll offer intriguing clinical applications for extending patients' lives with pancreatic
cancer. Finally, we suggest measures to improve the health outcomes of pancreatic cancer patients in
China.

The neuropeptide substance p is elevated in sickle cell disease and is a marker of severity of vaso-occlusive crisis

Olutoyin Adenike Olawuyi — 2024-10-15

Background: Acute episode of pain is the most frequent symptom for patients with sickle cell disease
(SCD) seek medical attention. The neuropeptide Substance P (SP) has been suggested as a possible aetiologic
factor. This study compared the serum levels of SP in SCD subjects in painful vaso-occlusive crisis with those in
steady state and normal HbAA subjects.
Methodology: This case-controlled study investigated eighteen SCD patients in vaso-occlusive crisis (VOC) and
eighteen in steady state, while fourteen HbAA subjects were recruited as controls. Blood was collected in plain
bottles and subsequently, the serum was separated for SP assay using the ELISA technique. Each sample was run,
and the results were confirmed in duplicate. Optical density was read at an absorbance of 450nm.
Results: The study showed that SP was significantly higher in SCD patients in steady state (184.79±18.67ng/L
versus 104.17±19.24ng/L) compared to the controls (t=2.97, p=0.006); while the values obtained in those in VOC
(375.78±76.21ng/L) were also significantly higher (t=2.433, p=0.02) than those in steady state
(184.79±18.67ng/L). The SP value in the SCD patients in VOC was almost twice as much as those in steady state
and about three times as much as the value in the controls and the differences were statistically significant (t=7.72,
p=0.001).
Conclusion: The study showed significantly higher SP levels in VOC compared to steady state or HbAA subjects
suggesting that SP may be a marker for pain sensitisation.

Assessment of nutritional status among elderly hospitalized patients in Enugu, Nigeria: A hospital-based study

Ngozi Ijeoma Okoro — 2024-10-15

Background: The ageing population worldwide presents a significant challenge for healthcare systems, with
malnutrition being a common problem among elderly individuals, particularly those hospitalized. Assessing
nutritional status is crucial for identifying and addressing malnutrition in this population. This study aimed to
assess the prevalence of malnutrition among elderly hospitalized patients in a Nigerian tertiary healthcare setting.
Methodology: This was a hospital-based descriptive and cross-sectional study conducted from March to June
2023, involving 122 patients aged 60 years and above. Demographic data and anthropometric measurements were
collected, and the Short-form Mini Nutritional Assessment (MNA-SF) tool was used to assess nutritional status.
The reliability of the MNA-SF was assessed using Cronbach’s α coefficient and item-to-total score correlations.
Results: The mean MNA score was 14.4 ± 5.3, with 71.3% of participants classified as malnourished, 22.1% at
risk of malnutrition, and 6.6% well-nourished. Significant differences were observed in the body mass index (BMI)
of nourished, at-risk, and malnourished individuals respectively (23.3 ± 3.6 kg/m2, 22.5 ± 3.8 kg/m2, and 19.6 ± 2.8
kg/m2, p < 0.001). The MNA-SF tool demonstrated acceptable reliability (Cronbach’s α coefficient = 0.777), with
significant correlations between total MNA scores and most MNA-SF questions.
Conclusion: The high prevalence of malnutrition among elderly hospitalized patients in this Nigerian tertiary
hospital emphasizes the importance of implementing routine nutritional screening protocols and targeted nutritional
interventions for improved health outcomes among the elderly.

Predictors of HIV testing among pregnant women aged 15-49 years in Nigeria

Charles Echezona Nzelu — 2024-10-15

Background: The utilization of HIV testing services in Nigeria has not been optimal due to socioeconomic and
demographic factors such as educational level, place of residence, and religion. For Nigeria to achieve epidemic
control, pregnant women need to know their HIV status through HIV testing, which is the gateway to HIV
prevention, care, support, and treatment services. Therefore, the purpose of this study was to determine the
predictors of HIV testing among Nigerian pregnant women aged 15-49 years HIV testing during antenatal visits or
childbirth.
Methodology: Secondary data analyses of 659 pregnant women randomly selected from the multiple imputation
datasets of the 2013 Nigeria Demographic and Health Survey (NDHS)were done using SPSS version 25. Data on
socio-demographic characteristics, HIV stigmatizing attitudes, and HIV testing were retrieved from the dataset for
the study. Bivariate and multivariate regression analyses were done to determine the predictors of HIV testing.
Results: The prevalence of self-reported HIV testing and receiving results among women of reproductive age was
36.72%. Bivariate model findings showed that educational level, place of residence, and religion were statistically
significant predictors of HIV testing among pregnant women. Only educational level and place of residence
significantly predicted pregnant women's HIV testing in the parsimonious multivariable regression model.
Pregnant women with higher levels of education (Primary Education, AOR, 1.85; 95% CI, 1.07,3.19; Secondary
Education, AOR, 3.75; 95% CI:1.93, 7.28; Higher Education, AOR, 11.23; 95% CI: 4.40, 28.68) and those living
in urban areas (AOR, 1.60: 95% CI:1.03, 2.47) were more likely to test for HIV than those with no education and
those living in the rural areas.
Conclusion: This study identified having a higher level of education and living in urban areas as predictors of HIV
testing, therefore, more efforts are needed to have women with lower levels of education and those living in rural
areas test for HIV as a strategy for the elimination of mother-to-child transmission of HIV.

Vaginal hysterectomy at federal teaching hospital, Katsina: A five-year review

Abdulfattah Mohammed Lawal — 2024-10-15

Background: Even though the vaginal route is said to be the gynaecologist route of surgery, abdominal
hysterectomy remains the predominant method of uterine removal in most parts of the world, despite the
evidence of the safety of vaginal hysterectomy. The study aims to determine the prevalence, socio
demographic variables, indications as well as outcome of vaginal hysterectomy at Federal Teaching
Hospital (FTH) Katsina, during the 5-year study period.
Methodology: A five-year retrospective study on vaginal hysterectomy was conducted in Federal
Teaching Hospital, Katsina from 1st January 2015 to 31st December 2019.
Results: The rate of hysterectomies (Abdominal & Vaginal) was 21.6% of the total major gynaecological
surgeries performed during the study period. Vaginal hysterectomy accounted for 6.7%. The mean age
and parity of the patients were 56.06+/- 9.55 years and 10.17+/- 4.57 respectively. The commonest
indication was Utero-vaginal Prolapse (88.9%) and 80.5% (29) of the patients had no complications.
Most of the patients (94.4%) were discharged within 7 days of surgery and there was no fatality.
Conclusion: The rate of vaginal hysterectomy in our centre is low. Most of the patients were grand
multiparous with the main indication being Uterovaginal prolapse. It is associated with favourable
outcomes and very low complication rates.

Effectiveness of the use of intravenous tranexamic acid and pericervical tourniquet in decreasing peri-operative blood loss following open abdominal myomectomy: A randomized controlled trial.

Lubabatu Abdulrasheed — 2024-10-15

Background: Uterine fibroid is the most common gynaecological tumour, with a prevalence of 20% to 50% of women over
30years.Abnormal uterine bleeding is one of the most common modes of presentation with menorrhagia. Open abdominal
myomectomy is the most common treatment option in our environment. It is associated with a significant degree of blood loss,
with consequent blood transfusion. Thus, the need for interventions to reduce blood loss during the procedure. This study
assessed the effectiveness of intravenous tranexamic acid in reducing blood loss when used as an adjunct to peri-cervical
tourniquet during open abdominal myomectomy.
Methodology: This study was conducted at Barau Dikko Teaching Hospital, Kaduna. It comprised thirty-six consenting
patients scheduled for elective open abdominal myomectomy, randomly assigned to receive either intravenous tranexamic acid
or placebo immediately after securing intravenous access in the theatre. All the patients had a peri-cervical tourniquet applied
intraoperatively. The volume of intraoperative blood loss, blood transfusion rate and the total number of units transfused,
haemodynamic changes associated with blood loss, and the complications associated with the use of tranexamic acid were
evaluated during the first 72hours following the surgery.
Results: A total of thirty-six women who met the eligibility criteria were studied between June 2023 and December 2023. The
mean age of the participants in the tranexamic acid group was 37.82 ± 5.89 years and 39.74 ± 5.17 years in the placebo group
(p = 0.307). Most of the women 35 (97.2%) presented with symptoms of menorrhagia. Major blood loss > 1000 ml was
recorded more among women in the placebo group than those who received tranexamic acid. There was a statistically
significant reduction in the mean blood loss in the tranexamic acid group 947.65 ± 451.88 compared to 1320.53 ± 563.28. (p
0.037).
There was an increase in the number of women who received a blood transfusion in the placebo group 7 (36.8%) compared to
the tranexamic acid group 4 (23.5%) (p=0.387). Tranexamic acid resulted in a decrease in the risk of perioperative blood loss
by 30%, RR 0.7 95% CI (2.19-2.59) and packed cell volume was significantly lower in the control group postoperatively
(P value = .001). There was no significant side effect noticed in both groups.
Conclusion: Tranexamic acid reduces blood loss during and after myomectomy for patients with uterine fibroids and the need
for blood transfusion is reduced in patients who had intravenous tranexamic acid as an adjunct to the application of a
tourniquet.

Knowledge, attitude, and practice of patient referral among patent and proprietary medicine vendors in Obio-Akpor, Rivers state

Igboamalu Chukwunonso — 2024-10-15

Background: With the limited number of trained healthcare providers in Nigeria, PPMVs are inevitable, especially in
rural areas for the supply of drugs, and integration through appropriate referral practices is quintessential. This study
assessed the knowledge, attitude, and practice of patient referral among PPMVs in a setting with limited hospital
infrastructure.
Methodology: This cross-sectional descriptive survey was conducted in Obio-Akpor, Rivers State using a structured
questionnaire that measured the participants’ socio-demographic characteristics as well as knowledge, attitude, and
practice of patient referral. Descriptive and inferential analyses were conducted with SPSS version 25 and a p-value
≤0.05 was considered significant.
Results: Most of the respondents reported moderate knowledge, attitude, and practice (62.4%, 73.4%, and 58%
respectively) of patient referral. Multivariate analysis showed statistically significant inverse relationships between years
of experience and odds of their knowledge, attitude, and practice of referral. PPMVs with 3 years of experience reported
significantly higher odds of adequate knowledge (AOR = 178.96; 95%CI: 60.15 – 532.49; p-value <0.005), attitude
(AOR = 7.38;95%CI: (3.78 – 14.40; P-value <0.005) and practice (AOR = 131.56; 95%CI: 53.50 – 323.51; p-value
<0.005) than those with above 10 years of experience after controlling for the effects of other variables. The most
frequently reported barrier to referral was fear of losing clients while most referrals were for laboratory investigations.
Conclusion: Most PPMVs reported moderate knowledge, attitude, and practice of patient referral. PPMVs were aware
of the benefits of referrals but concerned about losing their clients to formal healthcare facilities.

Prevalence and predictors of severe pain among patients with orofacial pain in a Nigerian tertiary health facility

Amuh Veronica Obianuju — 2024-10-15

Background: Although several studies on the pattern of oro-facial pain have been reported, none have been
reported on the prevalence and risk factors of severe oro-facial pain. This study aims to determine the prevalence
and predictors of severe oro-facial pain among patients in a Nigerian tertiary hospital.
Methodology: The prospective cross-sectional study was conducted at the Department of Oral Diagnosis of a
Nigerian tertiary hospital from January to December 2023 on all consecutive patients who presented to the centre
with orofacial pains. The data collected were age, gender, occupation, level of education and marital status. Other
data collected were ethnicity, smoking, alcohol intake, location of pain, causes of pain, and pain severity. Both
descriptive and inferential statistics were performed. All data were analysed with SPSS version 26 (IBM Corp,
Armonk, NY, US). A p-value less than 0.05 was considered significant.
Results: The age range was 17-85 years with a mean age of 36.6 ±16.7 years. Almost two-thirds (64.1%) of the
patients were females. Most (46.1%) of the patients were skilled workers. Almost half (48%) of the recruited
patients were single. The prevalence of severe pain among patients with orofacial pain was 45.3%. There was no
relationship between sociodemographic factors and the prevalence of severe orofacial pain except the ethnicity of
the patients (p = 0.012). There was no association between clinical factors and severe orofacial pain (p>0.05).
Conclusion: The prevalence of severe pain among patients with orofacial pain was relatively high and this severity
was only influenced by their ethnicity. It is therefore recommended that a high index of attention is given to
orofacial pain patients and a reduction of waiting time for the same individuals.

Prevalence of prolonged QTc interval among HIV infected patients on highly active antiretroviral therapy (HAART) and its relationship with cd4 cells count and viral load at a tertiary hospital in North Eastern Nigeria.

Musa Mohammed Baba — 2024-10-15

Background: Patients living with HIV infection remain at increased risk of cardiovascular diseases and sudden cardiac death.
Various prevalences of electrocardiographic (ECG) abnormalities among HIV-infected patients were reported: Attamah et al
reported the prevalence of electrocardiographic abnormalities among HIV-infected patients as 34.5%, while Orunta et al
reported a prevalence of 42.9%, and Njoku et al reported a prevalence of 93.0%. Human immunodeficiency virus-infected
patients are at increased risk of developing prolonged QT interval. Sani et al reported the prevalence of prolonged corrected
QT interval among HIV-infected patients was 45.0%. Innocent et al reported a prevalence of 48.0%, while Ajala et al reported a
prevalence of 18%. Prolonged QTc interval increases the risk of premature ventricular contraction which can degenerate into
ventricular tachycardia and or ventricular that can result in sudden cardiac death.
Methodology: The study was a cross-sectional conducted among HIV-infected patients receiving HAART at the Federal
Medical Centre Nguru, Yobe State, North Eastern Nigeria.
Results: One hundred and seven (107) subjects were recruited into the study comprising thirty-three (37.0%) males and
70(65.4%) females. The mean CD4 cell count and viral load of the studied patients were 612.64±34.75 cells/μL
and4646.30±58.68 copies/mL respectively. Twenty (18.7%) patients had prolonged QTc interval, this gave us the prevalence
of prolonged QTc in this study as 18.7%. The commonest cardiac rhythm was sinus rhythm (69.2%), followed by sinus
tachycardia (26.2%) and atrial fibrillation 5(4.7%). Other electrocardiographic findings include First-degree atrioventricular
block was seen in seven (6.5%) patients, Premature ventricular contractions were found in16.8%, RBBB was observed in
2.8%, 3.7% of patients had LBBB and 4.7% had left posterior hemiblock. The distribution of QTc interval according to CD4
cells count and viral revealed a statistically significant difference across the groups. All the patients with prolonged QTc
interval had lower CD4 cells count and higher viral load suggesting that HIV disease severity is associated with prolonged
QTc interval.
Conclusion: In conclusion, the study revealed that the prevalence of prolonged QTc interval among HIV-infected patients on
highly active antiretroviral therapy was found to be 18.7%, and that HIV disease severity increases the risk of developing
prolonged QTc interval.

Patterns and outcomes of cardiovascular disease admissions in the medical wards of the Rivers State university teaching hospital, Port Harcourt, Nigeria: A two-year review.

Boma Oyan — 2024-10-15

Background: Cardiovascular diseases (CVD) are widespread and significantly contribute to global mortality with
a rising prevalence in developing countries. The aim of this study was to identify the pattern and outcome of
admissions related to cardiovascular diseases within the medical wards at the Rivers State University Teaching
Hospital.
Methodology: The study was a retrospective cross-sectional hospital-based study. The records of all patients
admitted into the medical wards from January 2021 to December 2022 were extracted to include information on
biodata, admitting diagnosis, duration of admission, and patients’ outcomes.
Results: Over this 2-year period, a total of 1,540 patients were admitted into the wards and 751 (48.8%) persons
were admitted for CVDs with a mean age of 59.6±15. 1years.The commonest cardiovascular diseases documented
included heart failure (HF) and cerebrovascular accident (CVA) which occurred in 251(33.4%) and 311(41.1%)
patients respectively. Other CVDs recorded were hypertensive crisis in 163(21.7%), acute coronary syndrome
(ACS) in 12(1.6%) and pulmonary embolism (PE) in 6(0.8%) patients. During the study period, 311 deaths were
recorded representing 20.2% of all admissions with 146(46.6%) hospital deaths attributed to CVDs, accounting for
19.4% of the total cardiovascular admissions with 125 of these deaths occurring in patients with CVA and HF.
Conclusion: Heart failure and Cerebrovascular accidents emerged as significant contributors to the morbidity and
mortality of patients on admission in Rivers State. Policies to incorporate appropriate, preventive and management
strategies in the community to reflect this distribution are essential to significantly reduce cardiovascular deaths in
our population.

Obesity defining criteria, and association with cardiovascular disease risk factors among people living with HIV in Jos, Nigeria

Lucius Chidiebere Imoh — 2024-10-15

Background: Obesity is linked to non-communicable conditions. We looked at obesity using four definable
criteria and their relationship to biochemical and inflammatory indicators of cardiovascular diseases (CVDs) in
people living with HIV (PLHIV).
Methodology: This cross-sectional study involved 140 randomly selected HIV-infected patients attending HIV
clinics at the Jos University Teaching Hospital and Faith Alive Foundation in Jos, Nigeria. Anthropometric
measurements such as height, weight, waist circumference, and hip circumference were taken to identify those with
obesity. Fasting plasma glucose, lipid profile, High-sensitivity CRP (hsCRP), and HIV-related markers were
evaluated.
Result: The mean (SD) age of the participants was 42.5 (8.8) years, and the majority (71.4%) were females. The
prevalence of Obesity based on Body-Mass-Index (BMI), International Diabetes Federation (IDF), Adult
Treatment Panel (ATP), and Waist-Hip-Ratio (WHR) criteria were 18.6%, 50.7% 34.3%, and 45.7% respectively.
Obesity concordance among the criteria for obesity was highest between IDF and ATP (Kappa= 0.673, p<0.001);
and least between BMI vs WHR (Kappa= 0.124, p<0.073). Only 9.3% had obesity by all 4 criteria. BMI was
independently associated with hypertension but not glycaemic status nor dyslipidaemia while Obesity by WHR
was significantly associated with hypertension and dyslipidaemia, after adjusting for age and sex. There was no
significant association between Obesity by all the criteria and HIV-related parameters such as duration of HIV
infection, Antiretroviral (ARV) use, and CD4 counts (p>0.05).
Conclusion: Our study urges a unified assessment of obesity and a more prominent use of parameters of central
obesity, for assessing cardiovascular risk in PLHIV

Methicillin resistant staphylococcus aureus infection in neonates- a major concern and a call for action

Samaha Saleh Mustapha — 2024-10-15

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is both a human commensal and a pathogen
that causes neonatal infection which is associated with significant morbidity and mortality. Its genetic flexibility
and versatility have equipped it with the ability to develop resistance to numerous antibiotics. Outbreaks of
infections in neonatal intensive care units as well as community infections have been reported mostly in developed
countries. However, there is a paucity of data on neonatal MRSA infection in developing countries. The study aims
to highlight cases of MRSA infection, describe the clinical presentation, and outline the antibiotic susceptibility
pattern among term neonates in our facility.
Methodology: It was a prospective cross-sectional hospital-based study carried out from October 2018 to July
2019. A total of 248 term neonates with suspected sepsis were enrolled in the study and had their blood samples
taken for investigations including blood culture. Bacterial identification and antibiotic susceptibility patterns were
carried out using MicrobactTM24E (Oxiod UK) and Staph ID and modified Kirby-Bauer disk diffusion technique
respectively.
Results: Out of the 248 subjects enrolled in the study, 34.2% had proven sepsis, with Staphylococcus species
accounting for 56.4% of these cases. Among those with staphylococcal sepsis, 56.3% were found to have MRSA
infection. Notably, the majority (94.4%) of cases originated from outside the hospital, presenting as neonatal sepsis
with non-specific clinical features. Sensitivity testing revealed that ciprofloxacin and chloramphenicol were the
most effective antibiotics against the identified pathogens.
Conclusion: The presence of MRSA infections in neonates poses a critical public health threat. This trend
underscores the emergence of antimicrobial resistance, potentially compromising treatment efficacy and
jeopardizing neonatal well-being. Urgent and decisive measures are necessary to curb this trajectory.

Knowledge, attitude and practice concerning cervical cancer screening among reproductive age group women in low-resource settings Yenagoa Bayelsa State

Ebikonbowei Okaba — 2024-10-15

Background: Nigeria has one of the highest rates of cervical cancer morbidity and mortality in Sub-Saharan
Africa. Both the human papillomavirus vaccine (HPV) and cervical screening are effective prevention strategies
against both HPV infection and cervical cancer. Lack of awareness, limited knowledge, limited decision-making
agency, lack of spousal support, and stigma are barriers to the uptake of these preventive measures. Cervical cancer is
the second most diagnosed cancer and the third leading cause of cancer death in women worldwide. Eighty three
percent (83%) of the world's new cases and 85% of all cervical cancer-related deaths occur in developing
countries. It is primarily caused by human papillomavirus (HPV); a sexually transmitted pathogen that could be
prevented with safe sexual practice and using vaccines, among others. The aim of the study was to assess the
knowledge and attitude of reproductive age group women in low-resource settings towards cervical cancer and its
prevention in Yenagoa, Bayelsa State Nigeria.
Methodology: This study employed the use of a descriptive study design to examine the knowledge and
assessment of cervical cancer among women of reproductive age (19-54), about cervical cancer, its prevention, and
their utilization of Pap smear screening; using a convenience sample of 406 women in two communities (Okaka
and Agudama) in Yenagoa Local Government Area of Bayelsa State, Nigeria. Women voluntarily completed a
structured questionnaire.
Result: Results showed that women who participated in the study were aware of cervical cancer (78.3%; n=318)
but many (70.4%; n= 286) were unaware of Pap smears as the screening tests for cervical cancer. Although few of
them (45.6%; n =185) knew about a screening center, out of which 17.6% (n= 32) reported that the screening
center was less than 2km away from their residences.
Conclusion: There is a need for healthcare professionals, to intensify efforts to increase awareness about cervical
cancer screening and encourage women through the different clinics to use these services. The benefits of
screening and early diagnosis of cervical cancer should be emphasized to enhance the utilization of cervical cancer
screening services.

Awareness of diagnosis and treatment plan among patients in the accident and emergency department of a Nigerian tertiary hospital

Dabota Yvonne Buowari — 2024-10-15

Background: Patient centred care has a correlation to the effectiveness of patient engagement, patient care, and
perceived quality of care. Even in the emergency room, awareness of diagnosis and treatment plans is a critical
component in every doctor-patient interface as it enhances patient-centred care. This study aims to assess
awareness of diagnosis and treatment plans among patients in the accident and emergency department.
Methodology: This is a cross-sectional study conducted at the accident and emergency department of the
University of Port Harcourt Teaching Hospital.
Result: One hundred and ninety-seven respondents were recruited into this study comprising of 51.3% males and
48.8% females. Most 86.8% of the respondents were aware of their diagnosis, of which 91.8% knew the accurate
diagnosis. Majority 84.8% of the respondents were aware of the treatment, while 68.8% of the respondents were
aware of the names of the medications, most of the respondents 59.4% had no knowledge of the side effects of the
medications. The majority, 61.4% were involved in the management decision. No significant relationship existed
between the socio-demographic characteristics and knowledge of diagnosis and treatment plan.
Conclusion: The chaotic and overcrowded nature of the accident and emergency department should not hamper
the delivery of patient-centred care. Although, findings obtained from this study reveal that the majority of the
respondents are aware of their diagnosis and treatment plan, a portion of respondents do not understand their plan
of care; this indicates the need for further studies to identify interventions that would ensure that gaps in the
physician-patient communication is filled as this optimizes patients’ satisfaction of care received, gives better
sense of control of their total situation and better quality of life.

Tuberculosis of the cervix mimicking cervical carcinoma: cCerorrespondence

Daungsupawong Daungsupawong — 2024-10-15

Dear Editor,
We would like to comment on “Tuberculosis of the Cervix Mimicking Cervical Carcinoma: A Case Report [1].”The authors of this case report detail a rare instance of cervix tuberculosis in a 31-year-old nulliparous woman who presented with symptoms similar to those of invasive cervical cancer. The patient continued to experience irregular vaginal discharge and intermenstrual bleeding even after receiving previous treatments for cervical cancer. A biopsy confirmed the diagnosis of tuberculosis after a friable erythematous lesion on the ectocervix was discovered during examination. The illness was effectively managed with anti-tuberculosis drug treatment. The absence of comprehensive details regarding the patient's medical background and prior cervical cancer therapies represents a possible weakness in this case report. Giving a thorough rundown of all the therapies attempted before the tuberculosis diagnosis may aid in the explanation of why the symptoms did not get better. Furthermore, further details regarding the diagnostic procedure, including any imaging studies or lab tests conducted, would improve the case report's overall readability. This case raises the question of whether cervical tuberculosis is as uncommon as thought, or if its clinical resemblance to cervical cancer may be underdiagnosing it. Future studies on the prevalence and diagnostic difficulties of cervical tuberculosis may yield important information for medical professionals handling situations similar to this one. Furthermore, investigating putative risk factors or predisposing circumstances that can raise the chance of acquiring cervix tuberculous lesions could aid in the early detection and treatment of the illness. In terms of future research, larger-scale investigations would be helpful in ascertaining the actual prevalence of cervical TB and its correlation with cervical cancer. Examining alternative diagnostic modalities, including sophisticated imaging methods or molecular testing, may increase the precision and promptness of detecting this uncommon illness. Furthermore, investigating the long-term effects and possible side effects of treating cervical tuberculosis with anti-tuberculosis drugs may help to direct the creation of standardized treatment plans for cases that are comparable to these. Overall, more studies in this field may result in improved comprehension and treatment of cervix tuberculosis.

Ileal perforation and psychosis in a 19-year-old haemoglobin sc patient: A case report

Michael Abiodun Adeyanju — 2024-10-15

Ileal perforation is a fatal surgical complication of typhoid fever. Acute psychosis occurring together
with perforation presents a fatal outlook. This is made worse by these patients presenting late for
appropriate intervention.
A patient with sickle cell disease in addition to ileal perforation and psychosis presents a clinical picture
the outcome of which is unpredictable. It could occasionally cause diagnostic dilemma and a great
clinical challenge.
Typhoid fever, a bacterial disease of low-income countries could be prevented by an improvement in
the socioeconomic conditions of the people. This will prevent or reduce to the barest minimum the
occurrence of these fatal outcomes associated with its complications.
This is the case report of a 19-year-old Haemoglobin SC (HbSC) with ileal perforation and acute
psychosis.

Key Message- Occurrence of Psychosis and ileal perforation increases morbidity and mortality in typhoid
fever. It is worse when they occur in a sickler.

Genital tuberculosis masquerading as hematometra in an adolescent girl with an acute abdomen: A case report

Poojan Dogra Marwaha — 2024-10-15

Childhood and adolescent TB is a silent epidemic. The occurrence of genital tuberculosis (TB) in
adolescent girls is rare. This condition is easily misdiagnosed owing to its non-specific clinical
presentation that mimics different gynecological or non-gynecological pathologies. We present an
unusual case of genital TB in an 11-year-old girl with an acute abdomen, where the clinical and
radiological findings contributed to the diagnostic confusion with hematometra. This case highlights a
rare case of genital TB in a teenage girl, and its clinical and diagnostic complexities, emphasizing the
importance of considering TB as a differential in all cases of pelvic masses in high-burden settings. This
case also exemplifies the need for a multidisciplinary approach to facilitate timely diagnosis and
treatment to prevent the devastating effects of genital TB on the reproductive health of young girls.