Journal of Diagnosis & Case Reports is an open access peer-reviewed journal from the publishers of Scientific Research and Community (SRC) which publishes articles in the form of written, video and power-point presentations from the arena of Diagnosis & Case Reports. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Article acceptance will be in the form of research, review, case reports, analysis, magazines, editorials, opinion, communications, mini-review, short communications, picturized, book review, video type and power point presentations (PPTS). Articles can be submitted through online from https://srcpublishers.com/diagnosis-case-reports/user/register or can send through an e-mail with attachment for editor.jdcr@onlinescientificresearch.info and jdscr@onlinescientificresearch.net 0.5 Impact Factor 84.5% Citations 90% Acceptance
Native Tricuspid Valve Endocarditis in A Non-Intravenous Drug User
We report a case of staphylococcal tricuspid valve endocarditis in a young patient with no history of intravenous drug abuse. Echocardiography revealed two large vegetations, one on each of the lateral and septal cusps of the tricuspid valve complicating an asymptomatic peri-membranous ventricular septal defect with a closing pseudomembrane and a left to right shunt. Treatment with intravenous antibiotics resulted in significant improvement in symptoms and patient was discharged home on I.V antibiotics after two weeks of admission.
Copyright (c) 2026 Journal of Diagnosis & Case Reports
From Burden to Regulation: Why Sub-Saharan Africa Should Lead on Pragmatic Phage Therapy Implementation
Sub-Saharan Africa cannot afford to treat access to phage therapy as a distant objective. Antimicrobial resistance (AMR) is already altering clinical treatment options, prolonging hospital stays, and increasing healthcare costs. Both WHO Africa and the Africa CDC have identified AMR as an urgent continental threat that requires concrete implementation rather than further declarations [1,2]. Zambia and its neighbouring countries should immediately initiate a regulated magistral phage-access pathway, sustained through regional cooperation.
Surgical Management of Multiple Giant Oral Exostoses - Case Report
Intraoral bone overgrowths (IBO), including exostoses and tori, are non-pathological developmental anomalies affecting the maxillary and mandibular alveolar ridges. These lesions are generally asymptomatic and often identified during routine clinical or radiographic examinations. Nevertheless, in rare and extensive presentations, they may result in functional impairment or aesthetic concerns, justifying surgical intervention. This report describes an uncommon case of synchronous and exuberant intraoral bone overgrowths involving multiple anatomical sites in a 40-year-old male, highlighting its clinical features and treatment outcome.
Magnitude of Cardiovascular Disease Admissions and Their Outcomes in Ethiopia: A Systematic Review and Meta-Analysis(2025)
Introduction: CVDs pose a significant burden, particularly in developing countries, affecting individuals, families, healthcare systems, and economies. Cardiovascular diseases are the leading cause of death worldwide, with a disproportionate burden observed in low- and middle-income countries where access to preventive and acute care is limited. So this review is aimed to estimate pooled magnitude of cardiovascular disease admissions and its outcome in Ethiopia. Methods and Materials: A systematic search of published studies from PubMed, Scopus, web of science, google scholar, and reference lists of identified studies were conducted. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of studies was assessed by the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out using a random-effects method using the STATA™ Version 14 software. Result: Ten studies involving 38,440 participants were included in this meta-analysis. The magnitude of cardiovascular admission were ranged from 17.5 - 53.9 %; with pooled magnitude of cardiovascular admission with a random-effects model in Ethiopia was 36.3% (95% CI: 27.6- 45.0). Whereas the magnitude of cardiovascular admission in Addis Ababa region was 40.19 %; 95% CI: (28.3- 51.9) and 45.2%; 95% CI :( 28.1- 62.2) in Tigray region. The magnitude of cardiovascular disease admission outcome ranges from 13.2- 24.3%. Conclusion: According to this study, there is a significant burden of cardiovascular disease admissions in the region. Notably, the Addis Ababa region reports an admission rate of 40.19%, while the Tigray region has an even higher rate of 45.2%. Therefore, urgent targeted interventions and healthcare strategies are needed.
Copyright (c) 2025 Journal of Diagnosis & Case Reports
Magnitude and Determinants of Uncontrolled Blood Pressure among Adult Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis (2025)
Background: According to the World Health Organization, an estimated 1.28 billion adults worldwide have hypertension, with two-thirds residing in low- and middle-income countries. Despite the serious health consequences of this condition, 46% of adults with hypertension are unaware that they have it, only 42% receive treatment, and only 1 in 5 individuals has adequately controlled blood pressure. So this study aimed to estimate the pooled magnitude and determinants of uncontrolled blood pressure among Hypertensive Patients in Ethiopia. Methods: We conducted a systematic search of published studies from PubMed, Scopus, web of Science, and manually on Google Scholar. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, The quality of studies was assessed by the JBI assessment tool. Meta-analysis was carried out using a random-effects method using the STATA™ Version 14 software. Result: The 19 studies included 7013 participants were included in this meta-analysis. The pooled magnitude of uncontrolled blood pressure among hypertensives after correction of Duval and Tweedie’s trim and fill analysis with random effect model was 56.6 % (95% CI: 48.6-62.6) Whereas the highest prevalence 67.8%; (95% CI: 28.2- 107.4) seen in Amhara region and the lowest 44.2 %;( 95% CI: 32.3, 56.1) seen in Tigray region. Conclusion: Despite of it had serious health impact; the magnitude of uncontrolled blood pressure in Ethiopia is a significant public health issue. The observed variation across different regions highlights the need for targeted interventions.
Factors Affecting the Uptake of Human Papillomavirus Vaccine among Children of Rural Women in South Eastern Nigeria: A Cross-Sectional Study
Human papilloma virus (HPV) infection is implicated in the cause of cervical dysplasia and cancer as well as genital warts. Cervical cancer is the second most common cancer in women worldwide and also the third leading cancer worldwide irrespective of gender.
Hepatic Follicular Dendritic Cell Sarcoma with a History of Cervical Cancer: A Rare Case Report of Multiple Primary Malignant Neoplasms
The follicular dendritic cell sarcoma (FDCS) is a rare entity, accounting for only 0.4% of all soft tissue sarcomas. Hepatic FDCS, which represents approximately 30% of extranodal FDCS cases, has been reported in only 30 cases in the English literature. The clinical and imaging features of FDCS are non-specific, and its diagnosis relies heavily on pathological examination. Given that the morphology of FDCS resembles several hepatic tumors, diagnosing it poses significant challenges, requiring the exclusion of multiple differential diagnoses. The final diagnosis is based on immunohistochemical expression results. Multiple primary malignant neoplasms (MPMN) are defined as two or more primary tumors occurring either simultaneously or successively in the same organ (tissue) or different organs (tissues) within the same individual. This is the first reported case of MPMN involving intrahepatic FDCS and cervical cancer.
AI Approach for Predicting Superhyrophobicity of Thermal Sprayed Copper Coated Aluminum Surfaces
Wettability, characterized by the contact angle of a liquid on a surface, is a critical property that influences numerous natural and industrial applications. In this study, I have developed a CNN-based model to predict the hydrophobicity or super-hydrophobicity of copper-coated aluminum surfaces treated with various reagents or etchants. The data set has been created by analyzing copper-coated aluminum samples with a 3D non-contact profilometer, and contact angle measurements were done to correlate surface properties with the resultant contact angle values. After reagent treatments, the approach had been to preprocess 3D profilometer images to extract surface morphology and structure features. These images and associated contact angle measurements were used as inputs to train the CNN model to classify whether the treated surfaces are hydrophobic or super-hydrophobic. Although the model may initially have limited training accuracy, this study demonstrates the potential of deep learning to predict wettability based on surface characteristics. The results also highlight the need for improvements, such as data set expansion, the inclusion of more varied reagent treatments, and the exploration of hybrid modeling approaches to enhance the model.
The Expression and Role of MAN2A1 in Triple-Negative Breast Cancer
Background: This study investigated MAN2A1's role in regulating the proliferation, invasion, and migration of triple-negative breast cancer (TNBC) cells and its clinical significance. Methods: We enrolled 220 TNBC patients treated at our institution from January 2020 to December 2022. MAN2A1 protein expression was detected, and its correlation with TNBC clinicopathological features was analyzed. Western blot and immunohistochemistry measured MAN2A1 protein levels. CCK-8, colony formation, and EdU assays evaluated MAN2A1's impact on TNBC cell proliferation. Wound healing and Transwell assays assessed its effects on migration and invasion. Results: MAN2A1 protein expression positively correlated with TNBC malignancy. Functional assays demonstrated that MAN2A1 overexpression promoted TNBC cell growth, clonogenicity, migration, and invasion, while its knockdown suppressed these processes. Conclusion: As a key glycosylation enzyme, MAN2A1 is highly expressed in TNBC and positively correlates with malignancy. MAN2A1 overexpression acts as an oncogene by promoting TNBC progression, whereas its knockdown suppresses tumor growth, suggesting its potential as a therapeutic target to improve patient prognosis.
Reimagining Sustainable Development: The Role of Creative Industries and Design Education in India
As nations strive for sustainable futures, India emerges as a unique nexus of creativity, heritage, and technological transformation. This paper explores the role of Indian design education in advancing sustainable development within the creative industries. By blending traditional knowledge systems with Industry 4.0 tools like AI, IoT, and data-driven practices, India’s creative sectors hold immense potential to foster resource-efficient, eco-conscious solutions. Through curriculum innovation, interdisciplinary approaches, and strategic collaborations, design education becomes a driver of sustainability and cultural preservation.
Bilateral Retinoblastoma: Management and Impact on the Lives of Survivors
Introduction: Retinoblastoma is a malignant tumor of neuroepithelial origin occurring in infants and young children. Despite its rarity, it is the most common intraocular malignancy in children. It is unilateral in 2/3 of cases and bilateral in 1/3, and may represent a genetic predisposition to cancer. RB survivors are at risk of disease- and treatment-related adverse effects, including loss of vision or one eye, second cancer, genetic predisposition to cancer and reduced quality of life. The aim of our study is to investigate the management Bilateral Retinoblastoma and its impact on the lives of survivors. Method: We report in this retrospective study of 15 cases collected at the Department of Hematology and Pediatric Oncology at CHU Mohammed VI in Marrakech over a 12-year period, from January 2012 to June 2O24. Result: The mean age was 1 year and 5 months with a slight male predominance (60%). No patients had a family history of retinoblastoma. Consanguinity was present in 26%. The most frequent reasons for consultation were: leukocoria (86.6%), strabismus (33.3%) and exophthalmos (13.33%). The majority of patients (80%) were seen within 6 to 14 months, with an average delay of 9 months. Diagnosis was based on ophthalmoscopic examination, ultrasound and CT scan data, while histological examination of the surgical specimen enabled confirmation of the diagnosis and prognostic classification. Optic nerve invasion was found in 3 cases, and choroidal involvement in 3 patients. Therapeutically, enucleation was required in most cases, given the advanced stage of the tumours (86.66%): enucleation of the right eye in 4 patients, enucleation of the left eye in 2 patients, and bilateral enucleation in 8 patients, given the advanced stage of the tumours. Neoadjuvant chemotherapy was indicated in 46.6% of cases, to facilitate enucleation. Eleven 11 patients (73.3%) received post-operative chemotherapy, 3 patients received unilateral conservative treatment (thermotherapy, cryotherapy and intravitreal chemotherapy) and 1 patient received bilateral conservative treatment (radiotherapy). In our series, 11 patients achieved complete remission, two died of severe bone marrow failure after chemotherapy, 1 was lost to follow-up and one girl died of osteosarcoma of the left shoulder. Only one case of tumor recurrence in the optic disc was noted, subsequently put on palliative treatment, 72% benefited from an ocular prosthesis. The parents of the survivors in our study perceived their children's general health and emotional quality of life as inferior (70%), and the participation of children who had undergone unilateral enucleation in school and the community was significantly higher than that of children who had undergone bilateral enucleation. Conclusion: Enucleation and chemotherapy remains the gold standard in the management of bilateral retinoblastoma. Enucleation continues to encounter a range of psychosocial problems. Lifelong follow-up and advice on a healthy lifestyle are necessary for retinoblastoma survivors.
Copyright (c) 2024 Journal of Diagnosis & Case Reports
The Effect and Significance of Mild Hypothermia Adjuvant Therapy on Serum IL-6 and TNF-α in Neonatal Hypoxic-Ischemic Encephalopathy
Objective: To investigate the effect of systemic mild hypothermia therapy on peripheral blood interleukin-6 (IL-6) and tumor necrosis factor (TNF-α) in neonates with hypoxic-ischemic encephalopathy (HIE) within 6 hours after birth. Methods: Forty neonates with HIE within 6 hours after birth, who were admitted to the neonatal intensive care unit of Shangqiu First People's Hospital in Henan Province from October 2021 to October 2023, were selected as the research objects. They were divided into the mild hypothermia group and the conventional treatment group according to the treatment method. The children in the conventional treatment group received conventional supportive treatment, while those in the mild hypothermia group were given head mild hypothermia treatment and conventional supportive treatment. Peripheral blood IL-6 and TNF-α were measured in all children at admission and 72 hours after treatment. Neonatal Behavioral Neurological Assessment (NBNA) scale scores were performed at 14 and 28 days after birth. Results: There was no significant difference in the levels of blood IL-6 and TNF-α in HIE children of the conventional treatment group 72 hours after treatment compared with those at admission (P > 0.05). 2. The levels of blood IL-6 and TNF-α in HIE children of the mild hypothermia group 72 hours after treatment were significantly lower than those at admission (P < 0.05). 3. 72 hours after treatment, the levels of blood IL-6 and TNF-α in moderate HIE children of the mild hypothermia group were significantly lower than those in moderate HIE children of the conventional treatment group (P <0.05). 4. 72 hours after treatment, the levels of blood IL-6 and TNF-α in severe HIE children of the mild hypothermia group were significantly lower than those in severe HIE children of the conventional treatment group (P < 0.05). 5. At 14 and 28 days after birth, the NBNA scores of HIE children in the mild hypothermia group were significantly higher than those in the conventional treatment group (P < 0.05). Conclusion Head mild hypothermia treatment for HIE children within 6 hours after birth has an obvious effect. Head mild hypothermia treatment can reduce the levels of serum IL-6 and TNF-α in HIE children, inhibit the indirect neurotoxic effect caused by the increase of IL-6 and TNF-α levels, play a role in brain protection, improve the NBNA score, and obtain a better prognosis.
Von Meyenburg Complex in a Cat and a Dog, and Mini Literature Review
Biopsies of liver from a 10-year-one-month-old male, neutered dog and an adult, male, domestic short haired cat of unknown age were received and microscopically examined. In both cases ectatic bile ducts consistent with von Meyenburg complex also known as bile duct hamartoma (BDH) was diagnosed. The epithelium reacted positive for E-cadherin and CK7 by immunohistochemistry (IHC). Bile duct hamartoma is rare in dogs and cats. BDH is reported to be due to failure of involution of embryological remnant during embryogenesis. The current brief report describes cases of bile duct hamartoma in an adult dog and a cat and would contribute to the literature on BDH in felines and canines.
Effect of Continuous Veno-Venous Hemodiafiltration Combined with Hem Perfusion on NLRP3 Levels and Prognosis in Children with Severe Sepsis
Objectives: To explore the effect of continuous veno-venous hemodiafiltration (CVVHDF) + hemoperfusion (HP) on the level of nucleotide-binding oligomerization receptor protein 3 (NLRP3) and prognosis in children with severe sepsis. Methods: This study is a prospective study. The research subjects are children with severe sepsis who were admitted to the Pediatric Intensive Care Unit (PICU) of the First Affiliated Hospital of Xinxiang Medical College from October 2021 to December 2023. The general information of the children, NLRP3 inflammasome levels in peripheral blood before and after treatment, Pediatric Sequential Organ Failure Assessment (pSOFA) score, incidence of sepsisassociated organ dysfunction (SAOD) during hospitalization, total hospital stays, PICU stay, and 28 Statistical analysis was performed on the prognosis of the day. Results: Fifteen children underwent blood purification treatment (blood purification group) while another fifteen children underwent conventional treatment (conventional treatment group). After 72 hours, both groups showed a significant decrease in serum NLRP3 inflammasome levels (p<0.01), with the blood purification treatment group exhibiting a faster decline rate than the conventional treatment group. The pediatric sequential organ failure score (pSOFA) in the blood purification treatment group (CVVHDF+HP) decreased more than in the conventional treatment group. Additionally, the incidence of sepsis-associated organ dysfunction (SAOD) during hospitalization was lower in the blood purification treatment group compared to the conventional treatment group (p=0.039). Moreover, the hospitalization duration was significantly shorter in the blood purification treatment group than in the conventional treatment group (p<0.05). Conclusion: Blood purification treatment (CVVHDF+HP) can reduce the early levels of NLRP3 in children with severe sepsis, reduce organ damage, and improve prognosis.
Enhancing Paediatric Diagnostic Accuracy: A Case Report on the Clinical Utility of Med Brain in Nigeria
Diagnosing childhood illnesses can often be challenging, particularly with conditions that share overlapping symptoms. This case report examines the role of MedBrain, a Clinical Decision Support System (CDSS), in diagnosing common childhood illnesses. The report discusses two clinical cases involving a 9-year-old child diagnosed with chickenpox and a 4-year-old child diagnosed with measles, both in Nigeria. For each case, MedBrain provided a differential diagnosis with a ranked list of diseases and associated diagnostic scores based on the system's algorithms. The predicted diagnoses were evaluated and validated by paediatricians, demonstrating the diagnostic clinical utility of MedBrain. This case report offered valuable insights into MedBrain's functionality, clinical relevance, and potential in clinical research, with the capability to improve diagnostic accuracy in paediatric care.
Successful Conversion Surgery of Common Hepatic Arterial and Portal Vein Resection Combined with Preoperative Chemotherapy and Coil Embolization for Locally Advanced Pancreatic Cancer: A Case Report
The standard treatment for unresectable locally advanced pancreatic ductal adenocarcinoma (UR-LA PDAC) is chemotherapy or chemoradiotherapy except for surgery. Although conversion surgery (CS) for UR-LA PDAC has been useful strategy, owing to recent advances in the other treatment, the significance and safety of CS remains unclear. We described a case of successful conversion surgery of common hepatic arterial and portal vein resection combined with chemotherapy and preoperative coil embolization for locally advanced pancreatic cancer. A 65-year-old man was diagnosed with UR-LA PDAC which was in contact with common hepatic artery (CHA) -gastroduodenal artery (GDA)-proper hepatic artery (PHA), with invasion extending from the superior mesenteric vein (SMV) to portal vein (PV) without distant metastasis. After gemcitabine plus nab-paclitaxel, the primary tumor had decreased and tumor contacts with the CHA and invasion extending from the SMV to PV were still observed, indicating to the change of borderline resectable PDAC (BR-A). We performed preoperative CHA and GDA embolization to prevent postoperative ischemic complications. Five days after embolization, pancreaticoduodenectomy (PD) with common hepatic arterial resection and portal vein resection were performed, preserving right gastric artery (RGA). Arterial reconstruction was not performed as intraoperative ultrasonography confirmed RGA-PHA blood flow was sufficient to cover the bilateral lobes of the liver. Although liver enzymes levels were moderately increased, the patient was discharged on postoperative day 15 without any ischemic liver event. He had received adjuvant chemotherapy with S-1 for 12 months and alive at 36 months after initial treatment without any tumor recurrence.
Safety and Efficacy of Low-Dose Regorafenib Combined with Nivolumab in Patients with Advanced HCC in Progression Beyond Two or More Lines of Tyrosine Kinase Inhibitors: Case Reportsand Short Review of the Literature
Background and Aims: A few clinical studies have suggested that low doses of anti-angiogenic molecules might enhance the therapeutic effects of anti-PD1 in HCC and may improve their tolerance. Here, we present case reports of patients treated with low-dose regorafenib combined with nivolumab after the failure of at least two lines of oral chemotherapy. Design: We report 12 observations of patients with advanced HCC in progression after at least two lines of tyrosine kinase inhibitor (TKI) therapy who received regorafenib (starting with 80 mg/day) combined with nivolumab (3 mg/kg/14 days/IV) until progression or unacceptable toxicity.The safety based on NCI-CTCAE 4 and the clinical efficacy (progression free survival, overall response rate, disease control rate, time to treatment response and median duration of response) were retropectively assessed. Results: Median age was 68 years (IQR [64; 71.5]), and 75% had BCLC-C. The median follow-up was 18.8 months (IQR [11.5; 23.4]) and the median duration of treatment was 10 months (IQR [3.8 ;17]). Because of the frequent early adverse events associated with regorafenib, this treatment remained at an initial dose of 80 mg/day in all patients. Of note, most grade III adverse events (AEs) occurred later after a median duration of combined treatment of 10.5 months (IQR ), were also mainly due to regorafenib, but allowed the pursuit of nivolumab alone [5,11,5]. The therapeutic combination led to a partial response in three patients (30 %) and a stable disease in two patients (20 %), corresponding to a disease control rate of 50% at 12 months in the 10 patients who were trated more than 2 months. The median TTR was 2 months (IQR) [1-9]. The median duration of disease control and response was 22 (IQR [21; 24] ) and 24 months (IQR), respectively [23-25]. Conclusion: Combination of low-dose regorafenib and nivolumab might be associated with an interesting disease control rate and manageable safety profile in patients with progressive advanced HCC beyond the second-line treatment with tyrosine kinase inhibitors.
Effect of COVID-19 Period on Tuberculosis Treatment Success; A Mixed Methods Study among Tuberculosis Patients at Jinja Regional Referral Hospital
Introduction: Before the COVID-19 pandemic, over 4000 people were dying from TB every day. TB is still a major public health threat globally, but the TB epidemic may be exacerbated by the COVID-19 pandemic. The lockdown in response to the pandemic and the events related to it can have an adverse epidemiologic impact on TB treatment outcome through its effect on poverty, and dietary intakes. Objectives: Therefore, this study during COVID-19 would determine the effect of COVID-19 period on Tuberculosis Treatment success among TB patients. Methods: Sequential explanatory mixed methods were used. A retrospective cohort study was employed for the quantitative component to determine the association between COVID-19 period and Tuberculosis treatment success among Tuberculosis Patients at Jinja Regional Referral Hospital. A data abstraction sheet was used to extract the required data from the TB treatment registers. Treatment outcomes was dichotomized as successful treatment outcome and poor treatment outcome. Modified possion regression was used to explore associations between treatment outcome and other independent variables. A qualitative study with a phenomenology approach was adopted to get an in-depth understanding to the barriers and facilitators to treatment success during the COVID era among Tuberculosis Patients at Jinja Regional Referral Hospital. The lived experience of the TB patients who had participated in the quantitative component was captured. Data from audio recordings was transcribed and analyzed using a deductive thematic analysis to explore barriers and facilitators. Results: There was no significant effect of COVID-19 Period on TB treatment Success (aRR=1.04: 95% CI 0.78-1.38). In addition, sex, HIV status, age, distance from the health facility, disease classification and treatment mode were not significantly associated with treatment success. The barrier to treatment success were lack of adequate health care information, fearing the COVID thing in the hospital. Some health workers pointed out that donors failed to support most of the TB activities as government redirected most of its funding to COVID-19 activities and neglected TB services. The major facilitators were good relationship with health care workers, TB awareness programs, updating of TB guidelines and availability of free drugs and services. Conclusion: This study did not find a significant effect of COVID-19 period on treatment outcomes. Measures towards alleviating fear and stigma and ensuring financial securities of the patients during the time of health crisis are important for preparedness against future epidemics such as COVID-19.
Relapsed Bacterial Meningitis in an Adolescent Patient with Aberrant Patent Foramen Caecum
Bacterial meningitis is a serious life-threatening condition. Recurrent meningitis is defined as two independent episodes of meningitis that are separated by a period of convalescence and full recovery. Therefore, true recurrence results from a re-infection with the same or a different bacterial organism. In contrast, recrudescence and relapsed meningitis (RBM) represent persistence of the initial infection resulting from treatment failure. Both are uncommon and could be due to anatomic anomalies of the skull, traumatic head injury with secondary CSF fistula, complement deficiency or spread from a para meningeal infection. We present a case of a 13 years old healthy adolescent boy with no significant past medical history, who presented with flu like symptoms and altered mental status. His work up showed Streptococcus pneumoniae meningitis. While receiving effective IV treatment, on day 7 the patient became symptomatic again with fever, vomiting and prostration. Repeat blood tests showed an increase in total white cell count, neutrophils and inflammatory markers. In order to determine the underlying pathology, a repeat CT-scan of head followed by an MRI was done that showed an aberrant patent foramen caecum, that appeared to be the most likely cause of the relapse. This case report illustrates the importance of a search for an anatomical abnormality to be a cause of RBM, even in an adolescent.
Fortified Pregnancy: A Case Report of Heterotopic Gestation with A Successful Obstetrical Outcome
Heterotopic pregnancy is a rare condition when at least two pregnancies are present simultaneously at different implantation sites. Such cases may lead to devastating outcomes if nor properly handled. The index patient is a 38 year old Gravida 6 Para 4 (4014), who presented with severe hypogastric pain, pallor, amenorrhea with positive pregnancy test and a transvaginal ultrasound showing a strong consideration of heterotopic gestation. Emergency exploratory laparotomy for ruptured tubal pregnancy, Left salpingectomy, and evacuation of hemoperitoneum was done, with a bulbously enlarged left fallopian tube with a 2-cm point of rupture seen intraoperatively. The procedure was well tolerated and postoperative course was generally uneventful. Repeat transvaginal ultrasound on hospital day three prior to discharge revealed a live intrauterine gestation at 10 weeks and 1 day. At 38 weeks and 1 day age of gestation, the patient delivered vaginally to a term, live, baby boy in cephalic presentation, birth weight of 3600 grams, APGAR score of 8, 9 followed by postpartum intrauterine device insertion. The patient was eventually discharged on hospital day 2 without fetomaternal complications. In conclusion, a successful intrauterine pregnancy with a ruptured heterotopic gestation who underwent surgical intervention though rare is a great possibility. Still, high index of suspicion, complete history and physical examination, sonographic findings in the light of a pregnancy test positive are all imperative to its diagnosis and appropriate management.
Microscopic Analysis on Structural Morphologies of Total Protein Isolates from Two Varieties (DAS and BS) of Nigerian CultivatedSolojo Cowpea (Vigna Unguiculata L. Walp)
Structural morphologies of total protein isolate of two varieties of solojo cowpea were studied by scanning electron microscope (SEM). The morphological properties of raw and germinated protein isolates of DAS and BS are presented in Figures. 4.42 – 4.53. Results showed the apparent structural differences between them. The Raw DAS showed plate like structure with relatively smooth surface topography with large cavities while Raw BS showed flaky structure like that of Albumins. This pattern is similar to that of albumin shapes of the Great Northern Bean, field pea protein and that of Crotalaria pallida. The SEM micrographs results of DAS isolates revealed smooth lamella with flake-like structures on it, having large particle sizes and irregular geometry shapes. Large vacuum spaces were also observed. After six hours of modification, a change in morphology of the original isolate was observed with disappearance of the plate-like and flake-like structure and the vacuum space; DAS 24 h protein isolates then exhibited a spongy plate like structure. Rise in the germination period to 36 h led to disappearance of the cloudy mass and formation of smooth non homogeneous mass. Further increase in the germination time to 48 and 72 h led to smoother mass with a few dispersed particles with cracked surface. The observation of the microstructure presentation from 36 h is also comparable to that obtained for bitter vetch (Vicia ervilia) protein films strengthened by microbial transglutaminase, in this case, the images of BVPC films containing mTGase clearly indicate a more compact microstructure, with evident continuous zones. The BS isolates morphology which presented a thin wafer-like structure like that of albumin, possessing wide surface area could in part justify the great solubility of albumins in neutral environment, enabling better access to water molecules. The structure was observed to become more homogeneous and compact, with no cavities as germination proceeded. The DAS protein isolates presents micrograph similar to those of white bambarra (WB) and black bambarra (BB) surfaces which presented cracking. The micrograph of BS 6 h germinated protein isolate, which presents a flaky plate like structure is comparable to that of commercial textured Glycine max protein
Reviewing the Awareness of Mental Health Staff of the Possible Visual Side Effects of Antipsychotic Medications
Objective: A staff awareness project was undertaken in order to assess the awareness of clinical staff working in a UK community psychiatry practice of the visual side effects of antipsychotic medications. Study Design: A staff questionnaire was provided to assess baseline knowledge of the visual side effects of antipsychotic medication (the First Questionnaire). Subsequently, a short information sheet was provided regarding the visual side effects of antipsychotic medications. A Second Questionnaire for clinical staff was provided to assess reflections on knowledge gained. Results: 100% of respondents to the Second Questionnaire found the information sheet informative in refreshing or providing knowledge. 100% of the respondents to the Second Questionnaire also found the information sheet had improved their knowledge of the impact of antipsychotic on vision, and how it can be managed. 100% of respondents stated the information provided would influence their care of patients on antipsychotics and how they might approach care. Conclusion: Antipsychotic medications can cause ocular complications and visual side effects. Staff and patient education regarding these potential side effects can help promote patient safety.
Unruptured Ovarian Ectopic Pregnancy- A Case Report
Background: Ectopic pregnancy complicates 2% of all pregnancies, and accounts for 6% of pregnancy-related mortality [1]. It ends with rupture before the end of the first trimester [2]. Case Report: We report a case of a 27 yr old primigravida with unruptured left ovarian ectopic pregnancy treated with a wedge resection of ovary laparoscopically. Post-operative period of the patient was uneventful. Conclusion: Ovarian pregnancies are rare, and unruptured ovarian pregnancies are rarer. Early detection and treatment plays an important role in prevention of serious complications.
A Rare Cause of Neck Mass in an Adult Woman- Cervical Thymic Cyst - A Case Report
Background: Cervical thymic cysts (CTCs) develop from the thymo-pharyngeal duct, representing less than 0.5% of all neck masses. Most of the cases are diagnosed in the first decade of life, being rarely described in adults. The majority of CTCs are located on the left side, the rest develop on the right side or in the midline. The patients present usually with a painless mass, rarely with compressive signs. The mechanisms of CTCs occurrence are still debated, failure of involution of thymopharyngeal duct, arrest in migration or retained thymic tissue during descent, being considered. Case Presentation: We report a case of a 49-year-old woman who presented a left laterocervical mass, with rapid growth over several months. The lump was soft, mobile and painless, no other clinical abnormalities were noticed. The ultrasound described an anechoic nodule of 57/38/63 mm at the inferior pole of the left thyroid lobe, raising the suspicion of a parathyroid cyst or branchial cyst. Contrast-enhanced CT scan confirmed the well-defined, homogeneous cystic lesion of 35/25 mm, located between the trachea and common carotid artery, being delimitated inferiorly by the left brachiocephalic vein. The aspiration of the cyst resulted in 40 ml of water-clear fluid, cytology examination confirmed the absence of thyroid or parathyroid cells. Surgery was performed, the pathological diagnosis confirmed the CTC. Conclusion: Although the thymic cyst is a very rare cause of a cervical mass in adult, the diagnosis should be kept in mind, based on clinical presentation, ultrasound and CT features, respectively aspirated fluid characteristics.
Perception and Practice of Cervical Cancer Screening among Female Professionals Attending Gynaecology Clinic at A University Teaching Hospital
Background: By using the right screening tools and preventative measures, cervical cancer can be avoided. However, the underuse of preventative measures is caused by a lack of information and awareness. Professional women with sufficient knowledge can have a significant positive impact on the attitudes and behaviours of the broader public. So, we evaluated how professional women perceived and used cervical cancer screening. Objectives: To evaluate how female professionals who visit gynaecology clinics view and approach cervical cancer screening. Methods: A cohort of 160 consenting female professionals working at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, were used in this facility-based, single-center, descriptive, cross-sectional study. Participants filled up questionnaires about their knowledge assessment, screening for cervical cancer, and personal characteristics that influence them. Simple percentages, charts, and IBM SPSS Statistics 26 for Windows, version 26.0 (IBM Corp., Armonk, NY, USA) were used to portray and analyse the data. Results: The analysis employed a total of 160 questionnaires completed by research participants. All of the selected female professionals knew about cervical cancer screening, with nurses (49.3%) making up the majority. However, just 29.6% of them were aware that cervical cancer is connected to sexually transmitted diseases, and 33.2% were unaware that it is connected to age at first sexual activity. Only 93.2% of respondents had heard of Pap smears, despite the fact that every respondent had heard and read about cervical cancer and its screening. Despite the knowledge, only 44 (27.5%) had performed Pap tests and only 76(47.5%) had ever recommended cervical cancer screening to people. Of the women surveyed, 148 (92.5%) said they would be willing to have a cervical cancer screening, while 18 (11.25%) said they would decline. Conclusion: Despite more knowledge and awareness, the rate of cervical cancer screening among female professionals in Nnewi is still below average and insufficient. Cervical cancer can be avoided. Eliminating the morbidity and mortality frequently linked with cervical cancer would need deliberate efforts to increase screening methods' uptake and utilisation.
Copyright (c) 2023 Journal of Diagnosis & Case Reports
An Epiduroscopy Complication Mimicking a Subarachnoid Haemorrhage: Case Report
Epiduroscopy is an endoscopic technique which permits to explore lumbosacral epidural interspace. It is a useful technique for pharmacological treatment in failed back surgery syndrome, which represents a chronic waist pain. Even if it is a risky procedure, epiduroscopy should be included in the diagnosis and treatment of patients whit post-surgical lower back pain. Several complications can occur during the procedure as infection, meningeal irritation, epidural bleeding. We report a failed procedure with injection in subdural space causing headache, vomiting, seizures, and hyperthermia, mimicking subarachnoid hemorrage in CT scan. The radiological findings and neurological symptoms underwent rapid and spontaneous complete resolution.
Blood is a connective tissue in fluid form. It carries oxygen from lungs to all parts of the body and CO2 from all parts of body to lungs. Blood contains blood cells (RBC, WBC, PLATELETS) and liquid portion known as plasma.
The Biophysical Modelling of the Criteria in the Living Systems
Generally, the excitation is correlated with a local modification of the membrane potential; but if the depolarization is intense, it „propagates” and the electric features of the membrane of the entire cell change. The adaptation concept can have a narrower sphere, including only the functional, biophysical and anatomical modifications; in a wider meaning, the sphere extends to everything that represents changed functions and structures, which allow the development of life, even in extremely unfavourable environment conditions, until non lethal pathological alterations. Sexuality does not have only a reproductive biological function, but it has others as well: multiplicative, fortifying, selective, diversifying. The adaptation of organism to the life conditions is realized mainly by the adaptation of metabolism. Knowing the biophysical and biochemical regulation leads amongst others – to an even wider conception about the functions of the metabolism in the living organism.
Cardiac Oxidative Status in Diabetic Wistar Rats Exposed To Ethanol Extract of Cucumis Sativus Fruit
The present study investigated cardiac oxidative status in diabetic Wistar rats exposed to ethanol extract of Cucumis sativus fruit. Male Wistar albino rats (n = 25, mean weight = 215 ± 15 g) were randomly assigned to five groups of 5 rats each: normal control, diabetic control, metformin, extract (200 mg/kg body weight, bwt) and extract (300 mg/kg bwt) groups. Diabetes mellitus was induced in the rats via intraperitoneal injection of 50 mg/kg bwt STZ. The diabetic rats were treated for 21 days with either metformin (50 mg/kg bwt) or the extract. Activities of antioxidant enzymes such as catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) as well as molecules like reduced glutathione (GSH), total protein (TP), malondialdehyde (MDA) and nitric oxide (NO) were measured in heart homogenate. The results showed that induction of diabetes mellitus with STZ significantly increased the fasting blood glucose (FBG) concentrations of the rats, while decreasing the activity/concentration of antioxidant enzymes/ molecules (p < 0.05). However, treatment of the diabetic Wistar rats with the extract markedly reduced the FBG concentration and body weights of rats, but enhanced the activity/concentration of antioxidant enzymes/molecules in cardiac tissue (p < 0.05). These results indicate that ethanol extract of the medicinal plant fruit has the potential to promote antioxidant defense in the heart of STZ-induced diabetic rats.
Spontaneous Rupture of the Spleen: A Case Report
This article discusses the complexities of diagnosing and treating splenic rupture, a potentially fatal condition typically associated with trauma, but also linked to a myriad of other pathologies. We detail a case study of a 61-year-old patient, presenting with spontaneous splenic rupture, diagnosed through various clinical examinations, blood tests, and imaging studies. A comprehensive discussion follows, shedding light on the different causes of non-traumatic splenic rupture, diagnostic challenges, and the significance of CT scan in confirming the diagnosis and grading the severity of the injury. This article further highlights the criteria established by Orloff and Peskin, as well as Crate and Payne, for diagnosing spontaneous splenic rupture. We conclude by emphasizing the need for heightened clinical suspicion in diagnosing spontaneous splenic rupture, the critical role of abdominal CT scan in such cases, and the necessity of considering laparotomy for patients with high-grade injuries who do not respond to resuscitation.