Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coinfection with Malaria in Selected States in Nigeria

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.

Occurrence and Clinical Characteristics of Vaginitis among Women of Reproductive Age in Lagos, Nigeria

Background: Vaginitis is an important public health problem globally. It is associated with gynaecological and obstetric complications. Vulvovaginal candidiasis, bacterial vaginosis and trichomoniasis are mainly responsible for vaginitis. The aim of this study is to determine the occurrence, clinical characteristics and associated risk factors of vulvovaginal candidiasis and bacterial vaginosis among women of reproductive age attending Primary Health Care centres in Lagos Nigeria. Methods:This cross-sectional study recruited 258 women with genital complaints after obtaining their informed written consent between May 2017 and March 2018. Structured questionnaires were administered and high vaginal swabs were collected for laboratory examination. The results were analysed with descriptive statistics, chi-square and simple logistic regression. Results: Out of the 210 (81.4%) of the women with one or more vaginal infections, 105 (50.0%), 26 (12.4%) had bacterial vaginosis, and vulvovaginal candidiasis respectively while 78 (37.1%) had both vulvovaginal candidiasis and bacterial vaginosis. Only 1 (0.5%) participant had trichomoniasis and bacterial vaginosis. History of abortion and age below 25 years were associated with vulvovaginal candidiasis while pregnancy, history of miscarriage, age at first sexual activity and discharge were associated with bacterial vaginosis. Itching was associated with both vulvovaginal candidiasis and bacterial vaginosis. Conclusion: This study revealed vulvovaginal candidiasis and bacterial vaginosis as important cause of genital complaints among reproductive age women in Lagos. Health education, robust diagnosis and early treatment are needed in order to reduce the associated risk factors, disease burden and complications.

Characterization and antimicrobial,antioxidant,and anti-proliferative activities of green synthesized magnesium oxide nanoparticles with shoot extracts of Plicosepalus curviflorus

Objective:To synthesize magnesium oxide nanoparticles using ethanol extract of shoots of Plicosepalus curviflorus(PC-MgONPs)and evaluate the antimicrobial,antioxidant,and anti-proliferative activities of PC-MgONPs.Methods:The green synthesized PC-MgONPs were characterized by ultraviolet-visible(UV),Fourier-transform infrared spectroscopy,zeta potential,energy dispersive X-ray,and scanning electron microscopy.Furthermore,we investigated total antioxidant capacity and antimicrobial and anti-proliferative activities using breast cancer cell lines(MDA-231).Results:The UV spectrum of PC-MgONPs showed a sharp absorption peak at 300 nm.The presence of magnesium,oxygen,and sodium was confirmed by energy dispersive X-ray analysis.Scanning electron microscopy revealed PC-MgONPs as roughly spherical granular structures with sizes ranging from 20.0 to 76.4nm.PC-MgONPs showed considerable antimicrobial activities against Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,Pseudomonas aeruginosa and Candida albicans with zones of inhibition of 11-17 mm.In addition,total antioxidant capacity and anti-proliferative activity of PC-MgONPs against MDA-231 cells were dose-dependent.Conclusions:The synthesized PC-MgONPs could be a potent antimicrobial,antioxidant and anti-cancer agent,which needs further investigation.

Programmed cell death-1 inhibitor-related sclerosing cholangitis:A systematic review

BACKGROUND Programmed cell death-1(PD-1)inhibitor has been indicated for many types of malignancies.However,these inhibitors also cause immune-related adverse events.Hepatobiliary disorder is a phenotype of immune-related adverse event affecting 0%–4.5%of patients treated with PD-1 inhibitors.Recent studies have reported PD-1 inhibitor-related sclerosing cholangitis(SC);however,the associated clinical and pathological features are unclear.AIM To evaluate the clinical and pathological features of PD-1 inhibitor-related SC through a systematic review of the literature.METHODS The review,conducted using electronic databases in PubMed,was restricted to the period from January 2014 to September 2019 and focused on case reports/series on PD-1 inhibitor-related SC published in English.We scanned the references of the selected literature to identify any further relevant studies.Six cases previously studied by us,including three that have not yet been published,were included in this review.RESULTS Thirty-one PD-1 inhibitor-related SC cases were evaluated.Median age of patients was 67 years(range,43–89),with a male to female ratio of 21:10.The main disease requiring PD-1 inhibitor treatment was non-small cell lung cancer.Agents that caused PD-1 inhibitor-related SC were nivolumab(19 cases),pembrolizumab(10 cases),avelumab(1 case),and durvalumab(1 case).The median number of cycles until PD-1 inhibitor-related SC onset was 5.5(range,1–27).Abdominal pain or discomfort(35.5%,11/31)was the most frequent symptom.Blood serum tests identified liver dysfunction with a notable increase in biliary tract enzymes relative to hepatic enzymes,and a normal level of serum immunoglobulin G4.Biliary dilation without obstruction(76.9%,20/26),diffuse hypertrophy of the extrahepatic biliary tract(90.5%,19/21),and multiple strictures of the intrahepatic biliary tract(30.4%,7/23)were noted.In 11/23(47.8%)cases,pathological examination indicated that CD8+T cells were the dominant inflammatory cells in the bile duct or peribiliary tract.Although corticosteroids were mainly used for PD inhibitor-related SC treatment,the response rate was 11.5%(3/26).CONCLUSION Some clinical and pathological features of PD-1 inhibitor-related SC were revealed.To establish diagnostic criteria for PD-1 inhibitor-related SC,more cases need to be evaluated.

CD99and CD 106(VCAM-1)in human testis

Aim: The expression of the cytokines IL-2, IL-6, IL-10, IFN-γ and TNF-α and the adhesion proteins CD99 and CD106 was studied in the human testis at the protein level. Methods: The expression of the cytokines and the adhesion proteins was assessed using immunohistochemistry and immunoblotting. Results: None of the cytokines studied was present in the human testis, but CD99 and CD106 (VCAM-1) strongly were expressed in all the testes investigated. CD99 was present in the interstitial tissue of the human testis as well as in the Sertoli cells. The identity of the CD99+ interstitial cells is unclear. CD106 (VCAM-1) was present in Leydig cells as well as the basal parts of the Sertoli cells in the seminiferous tubules. In immunoblotting, CD99 was demonstrated at molecular ratios of 46-57 (kD). This is a novel isoform of the molecule. Conclusion: The human testis produces both CD99 and CD106 and as CD106 mediates cell binding to lymphocytes, it is possible that the human Leydig cells adhere to lymphocytes like the rodent Leydig cells. (Asian J Androl 2002 Dec; 4: 243-248)

An uncommon cause of corrosive esophageal injury

We present an unusual case of corrosive esophageal injury following liquid glue ingestion. The endoscopic f indings were tissue sloughing and blackened appearance of the esophagogastric junction,due to caustic esophageal injuries following ingestion of glue containing toluene.

Surgical outcome of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass for resolution of type 2 diabetes mellitus:A systematic review and meta-analysis

BACKGROUND Bariatric procedures are considered superior to medical therapies in managing type 2 diabetes mellitus(T2DM).Laparoscopic Roux-en-Y gastric bypass(LRYGB)and laparoscopic sleeve gastrectomy(LSG)are the most commonly used procedures for weight loss and comorbidity resolution worldwide.However,it is not yet known whether the degree of T2DM is influenced by the choice of bariatric procedure.AIM To quantitatively compare T2DM resolution over 1-5 years follow-up by LRYGB and LSG in morbidly obese patients.METHODS We searched the selected databases for full-text English language clinical studies that compared the effectiveness of LRYGB and LSG for T2DM resolution.Review manager 5.3 was used for data analysis,and the overall effect summary was represented in a forest plot.RESULTS From 1,650 titles retrieved by an initial search,we selected nine studies for this research.We found insignificant differences for T2DM resolution by LRYGB and LSG,with an odds ratio of 0.93(95%CI:0.64-1.35,Z statistics=0.38,P=0.71).Additionally,subset analyses for T2DM resolution showed insignificant differences after 24 mo(χ^2=1.24,df=4,P=0.87,overall Z effect=0.23),36 mo(χ^2=0.41,df=2,P=0.81,overall Z effect=0.51),and 60 mo(χ^2=4.75,df=3,P=0.19,overall Z effect=1.20)by LRYGB and LSG.This study reports a T2DM remission rate of 82.3%by LRYGB and 80.7%by LSG.CONCLUSION This study reports similar T2DM resolution rates by both LRYGB and LSG during 1-5 years of follow-up.However,long-term follow-up of 10 years is needed to further substantiate these findings.

Electrical stimulation and denervated muscles after spinal cord injury

Spinal cord injury(SCI)population with injury below T10 or injury to the cauda equina region is characterized by denervated muscles,extensive muscle atrophy,infiltration of intramuscular fat and formation of fibrous tissue.These morphological changes may put individuals with SCI at higher risk for developing other diseases such as various cardiovascular diseases,diabetes,obesity and osteoporosis.Currently,there is no available rehabilitation intervention to rescue the muscles or restore muscle size in SCI individuals with lower motor neuron denervation.We,hereby,performed a review of the available evidence that supports the use of electrical stimulation in restoration of denervated muscle following SCI.Long pulse width stimulation(LPWS)technique is an upcoming method of stimulating denervated muscles.Our primary objective is to explore the best stimulation paradigms(stimulation parameters,stimulation technique and stimulation wave)to achieve restoration of the denervated muscle.Stimulation parameters,such as the pulse duration,need to be 100–1000 times longer than in innervated muscles to achieve desirable excitability and contraction.The use of electrical stimulation in animal and human models induces muscle hypertrophy.Findings in animal models indicate that electrical stimulation,with a combination of exercise and pharmacological interventions,have proven to be effective in improving various aspects like relative muscle weight,muscle cross sectional area,number of myelinated regenerated fibers,and restoring some level of muscle function.Human studies have shown similar outcomes,identifying the use of LPWS as an effective strategy in increasing muscle cross sectional area,the size of muscle fibers,and improving muscle function.Therefore,displaying promise is an effective future stimulation intervention.In summary,LPWS is a novel stimulation technique for denervated muscles in humans with SCI.Successful studies on LPWS of denervated muscles will help in translating this stimulation technique to the clinical level as a rehabilitation intervention after SCI.

Prevalence and Risk of Anemia in Type-2 Diabetic Patients

Aim: To determine the prevalence and risk of anemia in type-2 diabetes mellitus. In addition, the incidence and risk of anemia in these patients were assessed according to gender and glycemic control status. Methods: The study group comprised 200 patients with type-2 diabetes. Patients were divided into groups according to glycemic control and gender. Glycated hemoglobin (HbA1c), blood glucose level, hemoglobin concentration, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) of subjects were evaluated. The presence of anemia was defined by a hemoglobin level 6.5%, fasting blood glucose >126 mg/dl and random blood glucose >200 mg/dl. Result: 63% of diabetic patients had anemia. There was higher incidence and risk of anemia in females (36%) as compared to males (27%) (p 7.5% (49.5%) compared to those with controlled diabetes HbA1C < 7.5% (13.5%) (p < 0.05). Conclusion: This study indicated that poor glycemic control and gender difference are associated with the incidence of anemia in type II diabetes. Our findings suggest the need of screening for anemia in diabetes out-patient clinics. Routine hematological tests along with blood glucose level should be mandatory in order to make therapeutic decisions for the treatment of anemia in type II diabetes mellitus.

The Effectiveness of Infection Control Practices among Health Care Workers Responding to the COVID-19 Pandemic in Nigeria

Background: The world is currently experiencing a healthcare crisis caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) are at the forefront of controlling the spread of the disease;this response has resulted in a huge number of infections amongst HCWs and unfortunately some casualties. Infection prevention and control practices (IPC) are practical, proven methods that prevent avoidable harm to patients and protect health workers from contagious infection. This study was done to evaluate the effectiveness of IPC practices utilized in COVID-19 testing drive through facility in Lagos Nigeria. Method: The facility recruited 42 HCWs who were trained on IPC and use of Personal Protective Equipment (PPEs). Training on donning and doffing of PPEs, preparation of decontaminants and sample handling were done for relevant personnel. A daily log for monitoring COVID-19 symptoms was deployed to all HCWs;to help early detection of COVID-19 infection and prevent transmission amongst staff. Results: Of 42 personnel, 92.8% had a tertiary level of education while 71.4% had at least 5 years work experience. A total of 5 (11.9%) out of 42 HCWs were positive by week six of the study. All infected persons worked at the drive through centre. Most common symptom filled in the daily log tool was headache and fatigue. Conclusion: Despite all the measures introduced, 11.9% of HCWs became positive within 6 weeks, showing the highly infectious nature of the virus and the need to research into more effective measures in preventing the transmission of highly infectious pathogens to HCWs during outbreaks.

Histochemical Patterns of Collagenic Fibers in the Benign and Malignant Breast Lesions

Cancer is one of the leading causes of death worldwide and breast cancer is the most commonly diagnosed cancer among women. An increased incidence of different types of breast cancer has been reported. This study was designed to evaluate the different types of breast cancer and its possible risk of neoplasmic transformation to an advanced malignant stage from a benign tumor. The histochemical patterns of collagen fibers in the benign and malignant breast lesions were evaluated. From the 50 tissue samples, 25 were malignant breast lesions and 25 were benign breast tumor. Hematoxylin and Eosin (HE), Van Gieson staining were performed to detect a benign and malignant tumor as well as collagen fibers. We found that significant cases after age of 35 were associated with ductal carcinoma while most of the cases within the age of 25 years were associated with fibrocystic changes. The intensity of collagen fiber was higher to Ductal Carcinoma while negative and less intense for Fibroblastic changes. Furthermore, a consistent association of other lesions, such as Lobular Carcinoma, Fibroadenoma, Papilloma and Fat necrosis and noticeable staining for collagen was observed for the different lesion. Our study suggested that women with age of 25 with benign lesion of fibrocystic change and ductal carcinoma are highly susceptible to develop advanced malignant tumor with age. Therefore, quantitative measurement of collagen fiber and regular follow-up are recommended to avoid the possible risk of developing advanced malignant lesions.

Cryptoccocal Neuromeningitis in Immunocompetent Infant in Bonassama District Hospital, Douala: A Case Report

Cryptococcosis is rare in children. We report a case of cryptococcal meningitis in an infant whose mother works as a poultry farmer (chicken farm). The infant was received in the context of fever with convulsions. We performed a lumbar puncture and started antibiotic treatment. Cerebrospinal fluid (CSF) analysis was performed including Indian ink staining. CSF results showed the presence of yeast and we replaced antibiotics with fluconazol-based treatment. After the loss of sight and the appearance of a motor deficit, a brain scan was performed showing cerebral edema. Several lumbar punctures were performed for 02 weeks until partial recovery of visual acuity and motor deficit. This case highlights the importance of taking into account the patient’s history when making the diagnosis. In our case, the working conditions and the employment of the mother guided the realization of the Indian ink coloring of the CSF. Treatment with fluconazol continued for 22 weeks with a completely regained visual acuity and gradual improvement in motor deficit despite limited resources.

胎盘早剥的风险及风险评估

Objective:Several variables related to increased risk of placental abruption are also risk factors for venous thromboembolism. Prior second trimester,third trimester,and repeated fetal loss are reported to be associated to thrombophilias. However,it is yet not known if they are also related to placental abruption. Study design:A retrospective case-control study of 161 women with placental abruption and 2371 unselected gravidae without placental abruption. The medical files were scrutinized and the selected variables were investigated in relation to the develop- ment of placental abruption. Results:As compared to controls,previous second trimester-,third trimester-,repeated fetal loss,and prior placental abruption were related to a 3-,13-,3-,and a 25-fold increased risk of placental abruption,respectively. Several other factors were associated with a roughly three-fold increased risk such as:preeclampsia,IUGR,high maternal age ( > 35),family history of venous thromboembolism,smoking,and multiple birth. A risk score was created and as compared with those with no risk factors present,the risk of placental abruption was increasing from 2.5-fold for those with risk score = 1,to almost 100-fold for risk score 4 or above. Conclusion:Easily obtainable information might be used to classify the risk of placental abruption.

Circulating Levels of Hypoxia-regulating MicroRNAs in Systemic Lupus Erythematosus Patients with Hemolytic Anemia

Objective MicroRNAs are fine regulators for gene expression during the post-transcriptional stage in many autoimmune diseases.HypoxamiRs(miR-210 and miR-21)play an important role in hypoxia and in inflammation-associated hypoxia.Systemic lupus erythematosus(SLE)is a chronic systemic autoimmune disease that would potentiate many pathological complications,including hemolytic anemia.This study aimed to investigate the role of hypoxamiRs in SLE/hemolytic anemia patients.Methods This work was designed to analyze the circulating levels of↱the miR-210 and miR-21 expressions and hypoxia-inducible factor-1α(HIF-α)in SLE/hemolytic anemia patients.SLE activity was evaluated for all patients by SLE Disease Activity Index(SLEDAI).Clinical manifestations/complications and serological/hematological investigations were reported.HIF-αconcentration was assayed by ELISA and expression of miR-21 and miR-210 was analyzed by qRT-PCR.Results The results indicated that the fold change of the miR-210/miR-21 expressions in plasma was significantly elevated in SLE/hemolytic anemia patients.A strong positive correlation between the miR-210 and miR-21 expression levels was also recorded.Among the associated-disease complications,hypertension,arthritis,oral ulcers,and serositis were associated with a high circulating miR-210 expression,while the occurrence of renal disorders was associated with the increased miR-21 expression.Furthermore,the HIF-αlevel was remarkably elevated in SLE/hemolytic anemia patients.A high positive correlation was recorded between the HIF-αconcentration and miR-210/miR-21 expression levels.The occurrence of oral ulcers,arthritis,and hypertension was associated with the increased HIF-αconcentration.On the other hand,SLEDAI and white blood cell count were positively correlated with miR-21/miR-210.The erythrocyte sedimentation rate was positively correlated with miR-21.Conclusion The dysregulation of the circulating miR-210/miR-210/HIF-1αlevels in SLE/hemolytic anemia patients advocated that the hypoxia pathway might have an essential role in the pathogenesis and complications of these diseases.

Impact of new technologies on diabetes care

Technologies for diabetes management,such as continuous subcutaneous insulin infusion(CSII)and continuous glucose monitoring(CGM)systems,have improved remarkably over the last decades.These developments are impacting the capacity to achieve recommended hemoglobin A1c levels and assisting in preventing the development and progression of microand macro vascular complications.While improvements in metabolic control and decreases in risk of severe and moderate hypoglycemia have been described with use of these technologies,large epidemiological international studies show that many patients are still unable to meet their glycemic goals,even when these technologies are used.This editorial will review the impact of technology on glycemic control,hypoglycemia and quality of life in children and youth with type 1 diabetes.Technologies reviewed include CSII,CGM systems and sensoraugmented insulin pumps.In addition,the usefulness of advanced functions such as bolus profiles,bolus calculators and threshold-suspend features will be also discussed.Moreover,the current editorial will explore the challenges of using these technologies.Indeed,despite the evidence currently available of the potential benefits of using advanced technologies in diabetes management,many patients still report barriers to using them.Finally this article will highlight the importance of future studies tailored toward overcome these barriers to optimizing glycemic control and avoiding severe hypoglycemia.

Antifibrotic effects of ambrisentan,an endothelin-A receptor antagonist,in a non-alcoholic steatohepatitis mouse model

AIM: To examine the effects of the endothelin type A receptor antagonist ambrisentan on hepatic steatosis and fibrosis in a steatohepatitis mouse model.METHODS: Fatty liver shionogi(FLS) FLS-ob/ob mice(male, 12 wk old) received ambrisentan(2.5 mg/kg orally per day; n = 8) or water as a control(n = 5) for 4 wk. Factors were compared between the two groups, including steatosis, fibrosis, inflammation, and endothelin-related gene expression in the liver.RESULTS: In the ambrisentan group, hepatic hydroxyproline content was significantly lower than in the control group(18.0 μg/g ± 6.1 μg/g vs 33.9 μg/g ± 13.5 μg/g liver, respectively, P = 0.014). Hepatic fibrosis estimated by Sirius red staining and areas positive for α-smooth muscle actin, indicative of activated hepatic stellate cells, were also significantly lower in the ambrisentan group(0.46% ± 0.18% vs 1.11% ± 0.28%, respectively, P = 0.0003; and 0.12% ± 0.08% vs 0.25% ± 0.11%, respectively, P = 0.047). Moreover, hepatic RNA expression levels of procollagen-1 and tissue inhibitor of metalloproteinase-1(TIMP-1) were significantly lower by 60% and 45%, respectively, in the ambrisentan group. Inflammation, steatosis, and endothelin-related m RNA expression in the liver were not significantly different between the groups.CONCLUSION: Ambrisentan attenuated the progression of hepatic fibrosis by inhibiting hepatic stellate cell activation and reducing procollagen-1 and TIMP-1 gene expression. Ambrisentan did not affect inflammation or steatosis.

Control of seed born mycobiota associated with Glycine max L.Merr.seeds by a combination of traditional medicinal plants extracts

Seeds from soybean collected from different commercial markets were surveyed for seed-borne fungi.Ninetyeight fungal colonies were isolated all over three monthly isolations constituting twenty-two fungal species.The isolated fungi were belonging to the genera:Alternaria,Aspergillus,Cephalosporium,Chaetomium,Cladosporium,Colletotrichum,Curvularia,Fusarium,Macrophomina,Mucor,Penicillium,Rhizoctonia,Rhizopus,Sclerotium,Stemphylium,and Verticillium.Assay of the antifungal activity of four ethanolic extracts of clove,cinnamon,garlic,and mint was carried out against the most common fungal species(Aspergillus flavus,A.niger,Fusarium solani,F.oxysporium,and F.moniliforme),which significantly reduced the growth of tested fungi.Clove extract recorded the highest antimicrobial potentiality against the seed-borne fungal species,followed by cinnamon,garlic,and mint.Clove and cinnamon achieved minimum inhibitory concentration(MIC)values less than that of the reference antifungal drug fluconazole.Simultaneously,garlic and mint recorded MIC values equal to or higher than that of control.A combination of clove and cinnamon,clove and garlic,cinnamon and garlic,cinnamon,and mint extracts increased the mean relative activity percentage.They decreased MIC values below their values when used individually;this indicated synergistic interaction between the two extracts.A combination of clove with mint and garlic with mint recorded a decrease in the percentage of mean relative activity and an increase in MIC values than their values when used individually,indicating antagonistic interaction between them.

Gastric metastasis by primary lung adenocarcinoma

The diagnosis of gastric metastasis from lung cancer is relatively rare in living patients.We describe a case of Type 4 tumor-like metastasis due to primary lung cancer diagnosed with immunohistochemical staining while the patient was alive.A 68-year-old man was admitted to our hospital because of epigastric pain.Gastrointestinal endoscopy revealed a Type 4 tumor and the histological examination showed poorly differentiated adenocar-cinoma.His chest X-ray showed mass shadow in the right upper lung field.The resected specimens showed moderately differentiated adenocarcinoma.,The diagnosis of gastric metastasis from lung cancer was made by immunohistochemical staining of the lung and gastric tumors which showed positive staining for Thyroid transcriptional factor-1.Diagnosis of gastric metastasis,especially Type 4 metastasis by lung cancer is diff icult.However,immunohistochemical staining is very helpful for diagnosis of primary lung cancer metastasis at sites such as the gastrointestinal tract which are not normally prone to metastatis.

Profile and geographical distribution of reported cutaneous leishmaniasis cases in Northwestern Saudi Arabia,from 2010 to 2013

Objective:To describe the profile and geographical distribution of reported cases of cutaneous leishmaniasis(CL)in the province of Hail,Saudi Arabia from 2010 to 2013.Methods:Human data were collected from the dermatology service of both King Khaled and General Hail hospitals.Results:A total of 483 confirmed CL cases were investigated.Cutaneous leishmaniasis follows a seasonal distribution related to the activity of the phlebotomine sand fly fauna.Both saudi and non saudi patients were almost equally infected.The number of reported cases of CL in men was higher than that in females.The frequency of CL was asoociated with age and increased in teenager and adult group.By analyzing the geographical distribution,the majority of Hail districts were affected with this disease.However it is more prevalent in Hail city.Conclusions:The lack of data concerning the parasite,the sand fly fauna and the existing transmission cycles in Hail province make difficult to interpret the reported results and to follow up the spatio-temporal evolution of the disease.

Prevalence and Pattern of Intestinal Parasitic Infestations among HIV Infected Children in Lagos, Nigeria

Introduction: Intestinal parasitic infections significantly affect paediatric population globally with over 800 million children at risk. The chronic nature of these infestations is associated with chronic disabilities approaching 9 million Disability Adjusted Life Years (DALYs). Co-infection of Human Immunodeficiency Virus (HIV) and intestinal parasitic infections adorned the pre-Highly Active Antiretroviral Therapy (HAART) era resulting in impaired nutritional state and dysfunctional immune system, especially amongst affected children. The success of HAART in conjunction with other life-saving measures has improved the outcome of children living with HIV. This study aimed to evaluate the prevalence and pattern of parasitic infections among children living with HIV in Lagos. Methodology: Consecutive children attending the paediatric anti-retroviral clinic were enrolled. Socio-demographic and clinical characteristics elicited from the clinical examination were recorded. Fresh stool samples of the children were obtained and examined for intestinal parasites. Data were analyzed with the Statistics Package for Social Sciences (SPSS) 20 software. Results: A total of 102 children participated in the study with a majority being males (52.9%), in primary school (73.5%) and living in urban settings (82.4%). Six children were found to harbour intestinal parasites giving a prevalence of 5.9% with Ascaris lumbricoides (50%) and Entamoeba histolytica (33.3%) being the prevalent parasites seen. Children with a Body Mass Index (BMI) Z-score < ?1 had higher estimates of intestinal parasitic infestations [p value < 0.05, OR 10.27, CI 1.72 - 61.20]. Conclusion: The prevalence of intestinal infestation was 5.9% with Ascariasis being the commonest intestinal parasitosis in our study. Malnutrition was found to be significantly associated with its occurrence.