Vaginally inserted herbs causing vesico-vaginal fistula and vaginal stenosis

A 32-year-old woman developed a vesico-vaginal fistula and vaginal stenosis following insertion of herbs into her vagina by a traditional doctor to “melt” her uterine myomata. She underwent successful trans-abdominal repair of her fistula and passive dilatation of her vagina was recommended for the vaginal stenosis. The emerging importance of traditional treatments as a cause of vesico-vaginal fistula is highlighted. The role of quality improvement through research and strict regulation to maximise the benefits of traditional treatment and minimise complications is also emphasised.     

2010年世界胃肠病学组织关于炎症性肠病诊断和治疗的实践指南

炎症性肠病(IBD)是一组特发性、慢性、炎症性肠道疾病状态,包括两种主要类型:克罗恩病(CD)和溃疡性结肠炎(UC),两者的临床和病理特征既有重叠又有区别。IBD过去常见于发达国家,近几十年,发展中国家的患病率逐步上升。本指南就IBD诊断和治疗方面提出的独特议题在当前的文献和指南中几乎从未被提及。由于各地区的IBD临床特点差异较大,因此根据患者的主诉诊断IBD或评估疾病活动度需随地区的变化而变化。同样,治疗亦应根据疾病的分类和当地医疗资源进行调整。世界胃肠病学组织根据世界各国医疗资源的差异,采用级联方法制订了IBD的诊疗指南。     

Clinical versus sonographic estimation of foetal weight in southwest Nigeria

A prospective study was conducted at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, between 3 January and 31May 2004, to compare the accuracy of clinical and ultrasonographic estimation of foetal weight at term. One hundred pregnant women who fulfilled the inclusion criteria had their foetal weight estimated independently using clinical and ultrasonographic methods. Accuracy was determined by percentage error, absolute percentage error, and proportion of estimates within 10% of actual birth-weight (birth-weight of +10%). Statistical analysis was done using the paired t-test, the Wilcoxon signed-rank test, and the chi-square test. The study sample had an actual average birth-weight of 3,255+622 (range 2,150-4,950) g. Overall, the clinical method overestimated birth-weight, while ultrasound underestimated it. The mean absolute percentage error of the clinical method was smaller than that of the sonographic method, and the number of estimates within 10% of actual birth-weight for the clinical method (70%) was greater than for the sonographic method (68%); the difference was not statistically significant. In the low birth-weight (<2,500 g) group, the mean errors of sonographic estimates were significantly smaller, and significantly more sonographic estimates (66.7%) were within 10% of actual birth-weight than those of the clinical method (41.7%). No statistically significant difference was observed in all the measures of accuracy for the normal birth-weight range of 2,500-<4,000 g and in the macrosonic group (> or =4,000 g), except that, while the ultrasonographic method underestimated birth-weight, the clinical method overestimated it. Clinical estimation of birth-weight is as accurate as routine ultrasonographic estimation, except in low-birth-weight babies. Therefore, when the clinical method suggests weight smaller than 2,500 g, subsequent sonographic estimation is recommended to yield a better prediction and to further evaluate foetal well-being.     

Phenotypic and molecular characterization of Staphylococcus aureus isolates expressing low- and high-level mupirocin resistance in Nigeria and South Africa

Background  

Mupirocin is a topical antimicrobial agent which is used for the treatment of skin and postoperative wound infections, and the prevention of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). However, the prevalence of mupirocin resistance in S. aureus, particularly in MRSA, has increased with the extensive and widespread use of this agent in hospital settings. This study characterized low- and high-level mupirocin-resistant S. aureus isolates obtained from Nigeria and South Africa.     

Caudal block anesthesia for transrectal prostate biopsy

Objective  

Transrectal prostate biopsy is a potentially painful procedure. Our service has significant experience with caudal anesthesia for perianal procedures. This study is aimed to determine the effectiveness of caudal anesthesia for transrectal prostate biopsy.     

Prostate cancer knowledge gaps among community stakeholders in rural Nigeria: implications for seeking screening

Cancer Causes & Control - In Nigeria, knowledge about prostate cancer (PCa) is poor, so are the availability, accessibility, and utilization of PCa screening services. Poor knowledge increases...     

Chorioamnionitis and neonatal sepsis due to extended‐spectrum beta‐lactamase‐producing Escherichia coli infection: a case report

Chorioamnionitis is an acute inflammation of the membranes and chorion of the placenta typically due to ascending polymicrobial infection in the setting of membrane rupture. It is a common complication of pregnancy associated with significant maternal, perinatal, and long‐term adverse outcomes. We present a case of placental infection leading to preterm delivery, severe neonatal sepsis, maternal wound infection, postnatal readmission, and prolonged hospital stay. This virulent infection was caused by multidrug–resistant extended‐spectrum beta‐lactamase (ESBL)‐producing Escherichia Coli (E. Coli), which represent a major worldwide threat according to the Centre for Disease Control and Prevention (CDC). It was managed with appropriate antibiotic therapy, patient‐centered approach, and multidisciplinary team involvement that led to favourable maternal and neonatal outcome.     

Euglycemic diabetic ketoacidosis in pregnancy with COVID‐19: A case report and literature review

Diabetic ketoacidosis (DKA) is a life‐threatening complication of diabetes and is considered a medical emergency. Euglycemic DKA (EKDA) is a variant of DKA with a normal or minimally elevated glucose level <200 mg/dl. The condition can be difficult to diagnose due to the relatively normal glucose levels. Pregnancy, infection, and a low‐calorie intake are some of the contributing common etiologies of EDKA. Despite a rapid increase in scientific publications on COVID‐19, there are still knowledge gaps regarding the course of COVID‐19 in some patient subset. This is especially the case for pregnant women. In this case report, we discuss the course of COVID‐19 infection in a pregnant woman with gestational diabetes who developed severe euglycemic diabetic ketoacidosis triggered by various precipitating factors, including starvation, caused by COVID‐19 infection and its gastrointestinal effects.