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Primary naso-sinusal tuberculosis (TB) is a relatively rare or exceptional disorder characterized by polymorphic or non-specific clinical manifestation. Diagnosis is based on anatomo-pathological examination and mycobacteriology test of biopsy specimen. Predictor of good outcome is early conventional anti-tuberculous antibiotic therapy. However, our study reports recurrence at this rare site in an immunocompetent patient despite early suitable TB treatment and good adherence with therapy. Relapse was correlated with underdosing of rifampicin. This study highlights the diagnostic, etiological and therapeutic management of this relapse. Our experience could help clinicians to better manage this uncommon condition.Hydatid disease or hydatidosis is a worldwide zoonosis disease caused by the tapeworm of Echinococcus granulosus and still widely endemic in Tunisia especially in rural areas where the sheep-dog cycle is dominant. It is an important public health problem in the pediatric age group causing significant morbidity and mortality. We report a case of primary hydatid cyst of the small intestine in a child and we want to highlight the difficulty that we meet in the diagnosis despite the contribution of imaging.

nasopharyngeal carcinoma is relatively common in our environment. It is one of the most difficult malignancies to diagnose at an early stage. The aim of the study was to determine the clinical features, clinical disease stage of nasopharyngeal carcinoma at presentation and at diagnosis as well as the histologic types at the University College Hospital, Ibadan, Nigeria.

this was a ten year retrospective study of all histologically confirmed nasopharyngeal carcinoma between January 2007 to December 2016 using clinical and pathology records and files.

there were 73 cases. The male female ratio was 1.7. The age of patients ranged from 12 to 80 years with a mean age of 39 ± 16 years. The median age at diagnosis was 40 years. The peak age group of occurrence was 40-49 years. The most common symptoms were namely epistaxis in 67.1% of patients at presentation, neck mass/swelling (64.4%) and nasal mass/obstruction (63.0%). Majority (54.8%) of the patients presented late with stage 3 or 4 disease. Most (94.5%) of the tumours were of the non-keratinizing squamous cell carcinoma subtype. The keratinizing and basaloid variants accounted for 4.1% and 1.4% of the tumours respectively.

vague, non-specific symptoms make patients present at late stages of the disease, making it almost impossible to attempt cure. selleckchem The dominant histopathological type is non-keratinizing squamous cell carcinoma and resembles that seen in most parts of Nigeria and endemic areas of the world.

vague, non-specific symptoms make patients present at late stages of the disease, making it almost impossible to attempt cure. The dominant histopathological type is non-keratinizing squamous cell carcinoma and resembles that seen in most parts of Nigeria and endemic areas of the world.Sickle cell disease is a major concern of public health significance in Africa. Nearly 2/3rd of the global burden of sickle cell disease (SCD) is found to be in sub-Saharan Africa. There is increased mortality risk in sickle cell disease patients in Africa due to associated complications such as acute chest syndrome, asthma, pulmonary emboli and sepsis. Sickle cell disease management is the major contributor of financial burden on the government. Moreover, there is a shortage of medical specialists in Africa. COVID-19 pandemic has further led to devastating impact on economy and health globally. The chances of SCD patient contracting COVID-19 infections are higher as these patients are immunocompromised and may be at a higher risk of mortality. Practicing preventive measures including isolation and social distancing by these patients will prevent mortality rates as well as economic burden on government in the present unprecedented COVID-19 pandemic.The coronavirus disease (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has become a pandemic. There is currently no vaccine or effective treatment for COVID-19. Early diagnosis and management is key to favourable outcomes. In order to prevent more widespread transmission of the virus, rapid detection and isolation of confirmed cases is of utmost importance. Real time reverse transcriptase polymerase chain reaction (RT-PCR) is currently the “gold standard” for the detection of SARS-COV-2. There are several challenges associated with this test from sample collection to processing and the longer turnaround time for the results to be available. More rapid and faster diagnostic tests that may produce results within minutes to a few hours will be instrumental in controlling the disease. Serological tests that detect specific antibodies to the virus may be such options. In this review, we extensively searched for studies that compared RT-PCR with serological tests for the diagnosis of COVID-19. We extracted the data from the various selected studies that compared the different tests and summarised the available evidence to determine which test is more appropriate especially in Africa. We also reviewed the current evidence and the challenges for the genome sequencing of SARS-COV-2 in Africa. Finally, we discuss the relevance of the different diagnostic tests and the importance of genome sequencing in identifying potential therapeutic options for the control of COVID-19 in Africa.

the outcome of the undergraduate medical training programme in South Africa is to produce competent medical doctors who can integrate knowledge, skills and attitudes relevant to the South African context. Training facilities have a responsibility to ensure that they perform this assessment of competence effectively and defend the results of high-stakes assessments. This study aimed to obtain qualitative data to suggest practical recommendations on best assessment practices to address the gaps between theoretical principles that inform assessment and current assessment practices.

a focus group interview was used to gather this data. link2 The teaching and learning coordinators for five of the six modules that are offered in the clinical phase of the undergraduate medical programme participated in the focus group interview. The focus group interview proceeded as planned and took 95 minutes to complete. The responses were transcribed and recorded on a matrix.

the lack of formal feedback to students was identified as an area of concern; feedback plays an important role to promote student learning and improve patient care. The role of teaching and learning coordinators as drivers of quality assessment were recognized and supported. All participants agreed on the outcome of the programme and the central role of the outcome in all assessments.

the training of assessors and the implementation of workplace-based assessment and assessment portfolios were recommended and can also address feasibility challenges. Participants recommended decreasing summative assessments and only performing these for borderline students.

the training of assessors and the implementation of workplace-based assessment and assessment portfolios were recommended and can also address feasibility challenges. Participants recommended decreasing summative assessments and only performing these for borderline students.Hepatic infarction is a rare and fatal complication associated with hemolysis, elevated liver enzymes and low platelets syndrome. It can develop into fulminant liver failure and lead to death in 16% of cases. A 25-year-old woman, with unremarkable prenatal history, was sent to gynecological emergency unit for management of severe preeclampsia at 30 weeks and 4 days of pregnancy. Initial laboratory studies revealed aspartate aminotransferase at 290 U/L, alanine aminotransferase at 193 U/L and a normal value of hemoglobin, platelets and the prothrombin time. Behind the persistence of high blood pressure despite dual therapy, an emergent cesarean section was performed. However, two days after surgery, the patient accused an epigastric pain and was subsequently noted to have developed HELLP syndrome thrombocytopenia (77000 /ul), anemia (hemoglobin 9.1 g/dL) and worsened liver injury (aspartate aminotransferase 2809 U/L; alanine aminotransferase 2502 U/L). A thoraco-abdominopelvic computed tomography (CT) was perfion and multidisciplinary management is necessary to prevent hepatic failure and death.

it has been close to four years since the authors highlighted the total neglect of the oral health of street children in the Journal of Public Health Policy. Since then, the authorities appear to have simply turned the blind eye making this follow-up imperative. This follow-up report specifically examines the resultant oral health disparity between Nigeria’s street children and Private, fee-paying secondary school students in Northern Nigeria.

we conducted a cross-sectional comparative survey of randomly selected 12-14 years old street children (children of Quranic informal educational institutions) in Northern Nigeria while fee paying, private secondary school children served as controls. A simple close-ended questionnaire translated into Hausa language was used to assess oral health knowledge and the Simplified Oral Hygiene Index used to categorize oral hygiene status of the participants.

the mean age (SD) of the participating street children was 12.7 (0.86) while that of the private secondary school tooth cleaning, none of the secondary school students practiced this (p = 0.0005).

there is disparity in oral health practice between Nigeria’s street children and private secondary school children. This disparity may be attributed to lack of western education and socio-economic status.

there is disparity in oral health practice between Nigeria’s street children and private secondary school children. This disparity may be attributed to lack of western education and socio-economic status.

chronic obstructive pulmonary disease (COPD) has been frequently associated with co-morbidities. link3 The purpose of our study is to analyze the impact of co-morbidities on the progression and prognosis of COPD.

we conducted a retrospective study of patients with COPD hospitalized and/or followed up in the Department of Pneumology at the Fattouma Bourguiba University Hospital in Monastir over the period January 2000-December 2017. The patients were initially divided into two groups, the G0 group (isolated COPD) and the G1 group (with at least one comorbidity). Patients in the G1 group were divided in two subgroups A group (patients with 1-2 co-morbidities) and B group (≥ 3 comorbidities associated). Different parameters of COPD severity were compared between the different groups.

a total of 1152 patients with COPD were enrolled. Seventy-nine percent of patients had at least a chronic disease associated with COPD. The presence of at least one co-morbidity was associated with an increase in the number of severe exacerbations (p = 0.004), in the use of Long-term oxygen therapy (p = 0.006) and with reduced survival (p = 0.001). Similarly, a greater number of co-morbidities (≥ 3 co-morbidities) were associated with more severe systemic inflammation, more frequent use of mechanical ventilation or non-invasive ventilation (p=0.04) and reduced survival (p = 0.05).

the presence of co-morbidities in patients with COPD is associated with higher severity and poorer prognosis.

the presence of co-morbidities in patients with COPD is associated with higher severity and poorer prognosis.