European Journal of Medical and Health Sciences

A Four-Year Trend of Acute Hepatitis B Virus Infection at a Tertiary Health Facility in Lagos, Nigeria

Mabel Ogazi Uwandu — 2023-11-15

Hepatitis B virus (HBV) infection is an important public health challenge. More than 350,000,000 people worldwide have chronic hepatitis B (CHB). Hepatitis B core ImmunoglobinM(HBc IgM) is an important marker used to classify whether an existing HBV is a new infection or an existing one, differentiating acute from chronic HBV infection. When an individual is HBc IgM positive, it shows a new infection, while negative IgM indicates a previous infection. The study aimed to determine the trend of acute HBV infections among hepatitis B-positive patients in a tertiary health facility in Lagos, Nigeria, over a four-year period. Patients accessing HBc IgM tests at a tertiary health facility in Lagos, Nigeria. Five (5) ml of blood samples were collected in K+EDTA vacutainers and centrifuged at 3500 rpm for 5 minutes. Plasma (2 ml) was collected in plain tubes, and HBc IgM assay was performed using DIA-Pro (BIORAD) kits according to the manufacturer’s instructions. The study period was from January 2014 to December 2017. The total number of patients who accessed this assay within the study period was 1,422. The male population was 896 (61.1%). Total HBc IgM positive and HBc IgM negative results were 197 (13.8%) and 1,225 (86.1%) respectively, and there was 1 (0.07%) equivocal. Rates of HBc IgM positivity, indicating acute infection, were 12.9%, 13.0%, 11.9%, and 15.1% in the years 2014, 2015, 2016, and 2017 respectively. The rate of acute HBV infection increased from 12.9% in 2014 to 15.1% in 2017, indicating likely new infection transmission ongoing in communities. These high and increasing rates require the sustenance of public health interventions.

The Role of Calorie Restriction in Cancer Prevention, Cancer Treatment, Longevity, and in Reducing Cellular Stress

Hassan S. Naji — 2023-11-01

Cancer is one of the top main illnesses worldwide. The aging of the population and the widespread presence of risk factors including obesity, smoking, and/or bad eating habits are expected to contribute to its further rise. Chemotherapy, radiation therapy, and surgery continue to be the cornerstones of cancer treatment, despite the gradual replacement or supplementation of these methods by innovative treatments. The American Cancer Society suggests a high-calorie, high-protein diet for cancer patients undergoing chemotherapy. Furthermore, there are no established recommendations for the kind of diet that would significantly reduce cancer rates. However, calorie restriction (CR) and fasting, two common methods of reducing caloric consumption, show a broad variety of positive benefits that may prevent malignancies and boost the effectiveness of cancer treatments. Periodic fasting (PF), fasting-mimicking diets, and restricted food intake without first a decrease in calories have become popular as interventions with the potential to be widely used to prevent and treat cancer, while chronic CR provides both beneficial and detrimental effects and major compliance challenges. In this article, we discuss the impact that calorie restriction has in preventing cancer, aiding in cancer treatment, producing cellular protection and chemotherapy resistance in animal models and early human investigations.

Surgery of Patent Ductus Arteriosus in Soavinandriana Hospital: Our Experience

Zakarimanana Lucas Randimbinirina — 2023-11-09

Introduction: The missionaries of Doctors of the World began performing the surgical closures of patent ductus arteriosus in Madagascar in 2004. The Malagasy team has been completely autonomous in surgical closures of an isolated patent ductus arteriosus since 2018. The aim of this study was to report on the Malagasy team's experience in the first 5 years of surgical closure of an isolated patent ductus arteriosus at Soavinandriana Hospital.

Methods: This was a retrospective and descriptive study, during the five-year period, from January 2018 to December 2022, performed at the Cardiac surgery unit of Soavinandriana Teaching Hospital, including all children underwent surgical closures of an isolated PDA. Demographic data, birth weight, clinical signs, diagnostic imaging, diameter of the ductus, the surgical waiting time after diagnosis, and hospital left stays were analyzed.

Results: A total of 104 children underwent surgery of closures of PDA, including 36 boys (34.62%) and 68 girls (65.38%), giving a sex ratio of 52%. The average age was 29.75 months. Fifteen children were born with low birth weight (14.42%). PDA was symptomatic in 84.65% of patients. The commonest symptoms were recurrent pulmonary infections (51.92%) and failure to thrive (25.96%). The mean age at diagnosis was 18 months. Echocardiography showed pulmonary hypertension in 73.25% of cases. The ductus was large in 97.67% of cases, with a mean diameter of 5.17 mm. Chest X-rays showed cardiomegaly (75%) and increased pulmonary vascularization (39.42%). The mean time to surgery after diagnosis was 7.28 months. All patients underwent left posterolateral thoracotomy with sectioning and suturing of the ductus arteriosus. The average hospital stay was 7.33 days.

Conclusion: PDA was the most common symptomatic (83.65%) and large (90.38%). Surgical closures of PDA were satisfied in our practice.

An Audit of Diagnostic Mammography Examination among Women Presenting with Breast Symptoms

Hadijat Oluseyi Kolade-Yunusa — 2023-11-22

Background: Mammography is one of the imaging modalities that has been in existence for a long period of time in investigating the breast for pathologies. Its use in imaging the breast can be for the purpose of screening and diagnosis. Breast screening allows for early detection of breast cancer. Early detection of breast can save lives. Despite its important imaging modality for breast, mammography is not readily available in this part of the world. Our institution just acquired one recently.

Objectives: Therefore, the aim of our study is to document the pattern of mammographic findings and to determine the prevalence of breast pathologies (benign and malignant) among symptomatic patients referred for mammography.

Methodology: This descriptive cross-sectional study comprises 121 symptomatic women who presented for mammographic examination at the Radiology Department of the University of Abuja Teaching Hospital, Gwagwalada from January 2016 to December 2018. Two basic views (craniocaudal and mediolateral views) of the breast were obtained using an EXR-650 mammographic machine. Some of the patients had complimentary ultrasound scans.

Results: The mean age of the study population was 47.23± 8.25 with an age range of 32–77 years. The majority of the patients were in the age group 40–49 years. Most women in the study were premenopausal and the majority had no family history of breast cancer. Breast pain was the most common symptom patients presented with. Heterogenous fibro glandular tissue accounted for the majority of mammographic breast density. Age correlated positively with a pattern of breast density among the study population. Abnormal mammographic findings were seen in 67 (55.4%) patients among which benign mass was the most prevalent. Among patients who presented with breast pain majority had normal mammographic findings while for those with breast lump, benign breast mass accounted for 35.7% representing the majority and malignant mass accounted for 19.1%. The relationship between mammographic outcome and indication was statistically significant P = 0.0001.

Conclusion: Mammography plays a pivotal role in the evaluation of the breast in patients who presented with symptoms as it can differentiate benign and malignant lesions of the breast. In this study, the use of mammography reveals various pathologies in which benign breast mass accounted for the majority of breast pathologies detected.

Frequency of Abdominal Wall Hernias: A Nigerian Hospital Experience

Christopher Nonso Ekwunife — 2023-11-25

Introduction: Hernia is a very common condition in all populations, and its surgical operation constitutes a major workload for physicians worldwide. Although great numbers of these procedures are done in primary and secondary care settings as well as in private hospitals and as part of surgical missions to rural areas, a significant proportion is still present in tertiary centers.

Aim: To review the pattern of external hernias operated upon in Federal Medical Centre, Owerri, over a 10-year period.

Methods: The theatre records were searched for all patients who underwent surgical operations for hernia in the period of 2005–2014. The data on patient demographics, indication for surgery, and procedure performed were retrieved.

Results: A total of 902 patients underwent operations for different types of external hernias. The overall male/female ratio was 2.6:1. Operations for inguinal hernia were the most common, accounting for 72.9% (658) of the total. Ventral hernias constituted 25.1% (n=227) of the cases whereas 1.5% (n = 12) of patients had femoral hernia. One hundred and twelve patients (12.4%) had emergency surgery, of which 78 were for inguinal hernia. Mesh repair was started in 2009 and was utilized in 72 (8%) cases. Laparoscopic method of repair was used in only two patients.

Conclusion: The pattern of operation for hernia in our center mirrors the experience in other local centers. Modern methods of repair are gaining ground.

Disseminated Multisystemic Tuberculosis in an HIV Negative Patient: A Case Report

George Ikpe — 2023-11-12

Disseminated Tuberculosis, quite common in immunocompromised patients is uncommon in the immune-competent and at times mistaken for severe immunosuppression or intra-abdominal malignancy. Therefore, a high index of suspicion is required even in the immune-competent to make a diagnosis. We present a case of disseminated Tuberculosis in an immunocompetent individual.