Open Access Case Study

Adenocarcinoma of the Prostate Presenting as a Soft Tissue Metastasis: A Case Report and Review of Literature

O. I. Ajetunmobi, O. D. Dzuachii, I. Offor, I. Emmanuel

International Journal of TROPICAL DISEASE & Health, Page 1-4
DOI: 10.9734/ijtdh/2019/v35i130115

Metastasis is the most frequent cause of mortality in cancer patients and symptoms related to a secondary deposit are a common form of presentation in malignancies. Cancers of the prostate commonly present with metastasis to the vertebrae, and less commonly to the lungs and liver. Metastasis to soft tissue is extremely rare and a highly unlikely form of presentation. However, with rising cancer rates in the developing world, secondary tumors should be excluded when soft tissue masses are encountered.

Open Access Original Research Article

Prevalence of Anaemia after Initiation of Antiretroviral Therapy among HIV-infected Patients Attending University of Calabar Teaching Hospital Calabar, Nigeria

A. O. Okafor, E. C. Akwiwu, J. O. Akpotuzor

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/ijtdh/2019/v35i130109

Aims: To investigating some demographic variables and red cell parameters of infected persons already accessing antiretroviral therapy with a view to identifying sub- groups with higher proportions of anaemia. 

Study Design:  Cross-sectional study.

Place and Duration of Study: University of Calabar Teaching Hospital Calabar Nigeria, between August 2017 and July 2018.

Methodology: Subjects comprised 60 male and female HIV-infected adults attending University of Calabar Teaching Hospital Calabar, and equal number of age and sex-matched control subjects who were HIV sero-negative as at the time of this study. The infected persons were being treated with either Tenofovir+Lamivudine+Efavirenz (TLE) or Lamivudine+Zidovudine+Nevirapine (LZN). A pre-tested structured questionnaire was administered by two trained interviewers which captured the bio-data, sociodemographic variables and therapy-related information. Venous blood was collected aseptically by standard phlebotomy into appropriate sample containers for CD4 and red cell counts by automation.

Results: The proportion of anaemia occurring between TLE and LZN users was observed to be in the ratio of 2:3. The RBC count, haematocrit and haemoglobin concentration were significantly lower (p=.000), while MCV, MCH and RDW were significantly higher (p=.000) in subjects infected with HIV compared to the control subjects, Duration of treatment beyond 6 years significantly raised both MCV (p=.007) and MCH (p=.006) compared to the first 3 years of treatment commencement, while the MCV, MCH and RDW-SD were significantly higher (p=.003, .014 and .018 respectively) among LZN users compared to those on TLE.

Conclusion: Human immunodeficiency virus infection triggers pathologic mechanisms that culminate into anaemia. While the use of antiretroviral therapy appears to gradually resolve this derangement, the adverse effects of some of the antiretroviral agents contribute to the persistence of anaemia particularly with increasing years of treatment.

Open Access Original Research Article

Complications of Falciparum Malaria Infections among Ghanaian Children; from the Healthcare Personnel’s Perspective

Bernard Bahaah, Bright Oppong Afranie, Sampson Donkor, Diana Makafui Tuekpe

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/ijtdh/2019/v35i130114

Background and Aim:  Malaria is known to be the most widespread tropical disease and a chief cause of morbidity and mortality in Africa. This study was conducted to determine some common complications of falciparum malaria in children, from the perspective of healthcare personnel in Kumasi, Ghana.

Materials and Methods: This questionnaire-based cross-sectional study was carried out at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. The study population included health care professionals working at the children`s unit of the hospital. About 80 healthcare personnel were recruited to partake in the survey for eliciting views on malaria. Questionnaires were used to capture some symptoms and complications of malaria from the health workers’ point of view.

Results: More than half of the healthcare personnel were males (52.5%), and majority of the participants were medical officers. The study participants elaborated on some common malaria symptoms among children. Fever recorded the highest frequency, represented by 98.8%, followed by general malaise (97.4%), nausea and vomiting (93.8%), chills (78.8%) and headaches (72.5%). Prostration (45.0%), hyperpyrexia (38.75%) and hypoglycemia (13.75%) were the most frequently reported complications by the respondents. Majority of the participants reported cerebral malaria (30.0%), severe anemia (23.75%), acute respiratory distress (17.5%) and repeated generalized convulsions (16.25%) to be the most lethal feature of complicated malaria infection in children. The overwhelming majority of the respondents (90.0%) use the WHO 2014 standard (page2) as guide for determining complicated malaria.

Conclusion: Prostration with hyperpyrexia and hypoglycemia were the most common features of falciparum malaria from the perspective of healthcare personnel in Kumasi, Ghana.

Open Access Original Research Article

Economic Burden of Rabies: An Experience from a Tertiary Care Hospital in Kashmir, India

Mariya Amin Qurieshi, Khalid Bashir, Uruj Qureshi, S. M. Salim Khan

International Journal of TROPICAL DISEASE & Health, Page 1-7
DOI: 10.9734/ijtdh/2019/v35i130116

Background: Post-exposure prophylaxis (PEP) is the mainstay of prevention in suspected exposure to rabies virus. Exposed patients are able to obtain anti-rabies vaccine in the anti-rabies clinic pro bono but they have to pay for passive immunization and cover other associated costs.

Aim: To estimate and analyze the direct and indirect costs of rabies PEP.

Methods: This study was conducted on 429 patients, who were exposed to bites from various animals and reported to Shri Mahraja Hari Singh Hospital (SMHS), an associated tertiary hospital of Government Medical College, Srinagar, Kashmir. Patient socio-demographic profile, details of animal bite exposure, the cost incurred for PEP was collected. The data were analyzed using a descriptive statistic.

Results: The study revealed a total median cost incurred on patients for receiving a PEP as 29.3 USD (United States Dollar), with an Inter-quartile Range (IQR) of 0.2 USD to 43.1USD. The direct median cost was 20.5 USD with an IQR of 6.2 USD to 29.4USD, while the indirect median cost was 20.3USD with an IQR of 13.5USD to 24.4USD.

Conclusion: Post-exposure prophylaxis imposes a significant economic burden to bite victims especially those of low socio-economic strata for whom the cost is substantial.

Open Access Review Article

Knowledge, Attitude and Practice of Eyelid Surgeries among Surgeons in Nigeria

C. S. Ejimadu, B. Fiebai, A. A. Onua

International Journal of TROPICAL DISEASE & Health, Page 1-8
DOI: 10.9734/ijtdh/2019/v35i130108

Aim: To determine the level of knowledge, attitude and practice of eyelid surgeries among surgeons in Nigeria.

Methods: A self-administered questionnaires about their knowledge, attitude and practice of eyelid surgeries were given to 135 medical practitioners attending the 49th Annual General Meeting and Scientific Conference of the International College of Surgeons (Nigeria National Section) held in Port Harcourt from 16th to 20th June 2015.  Questions asked tested the Knowledge, Attitude and Practice of the medical practitioners on matters related to eyelid surgeries. Study participants’ knowledge, attitude and practice were graded as Good for scores of 75% and above, Fair for 50-74% score and Poor for scores less than 50%.  Respondents’ demographic data, responses and corresponding scores were entered into computer software-Scientific Package for Social Sciences (SPSS) version 20 and analysed.

Results: There were 135 responders, out of which 121 (89.62%) were male while 14 (10.38%) were females. They were aged between 21-70 years with a mean value of 51.6 +/- 8.6 years, range = 40 years and mean = 50 years. Specialist surgeons with college fellowship accounted for 84.4% while specialist surgeons in training (college membership) accounted for 15.6%. Most of the responders (73.3%) were in public service while 9% were in the private service and 17.7% were in both public and private service. Sixty seven per cent of responders had good knowledge of eyelid surgeries, 22.2% had fair knowledge while 11.1% had poor knowledge. Majority (73.3%) had poor attitude while only 26.7% had good attitude to eyelid surgeries. Responders with poor practice of lid surgeries accounted for 77.8%, fair practice were 13.4% while only 8.8% had good eyelid surgery practice.

Conclusion: Most of our responders were experienced surgeons as shown by their ages, educational and professional status. Though majority of them had good knowledge of eyelid surgeries their attitude and practice of it were poor in spite of their experience in the field of surgery. This could be due to the paucity of oculoplastic surgeons in Nigeria. Measures should therefore be taking to improve on subspecialty training especially in oculoplastic surgery and collaborations should be encouraged amongst surgeons involved in facial surgeries.