Open Access Case Report

Synchronous Invasive Breast Carcinoma, Endometrial Cancer and Small Lymphocytic Lymphoma in a 49 Year-old Female Libyan Patient: Case Report and Literature Review

Ali Shagan, Essra Obaid, Fatma Emaetig, Youssef Swaisi, Yassen Topov, Ali Alsharksi, Ebrahim H. El Mahjoubi, Khaled S. Ben Salah

International Journal of TROPICAL DISEASE & Health, Page 35-39
DOI: 10.9734/ijtdh/2021/v42i1730531

Although breast cancer and endometrial cancer are two frequent female cancers, finding synchronous primary cancers in the same patient is a comparatively uncommon occurrence. We present the case of a Libyan woman who developed synchronous breast cancer, endometrial cancer, and small lymphocytic lymphoma. For the previous six months, a 49-year-old female patient had a right breast mass. An ultrasound scan revealed an uneven doubtful growth in the right breast as well as swollen of the axillary lymph nodes. After a wide local excision, histopathology revealed that the patient had invasive ductal carcinoma of the breast with a positive resection margin, and he was admitted to the Surgery Department. No distal metastasis was seen on a computed tomography (CT) scan of the chest, abdomen, or pelvis, so the patient had a right mastectomy and axillary clearance. Residual invasive ductal carcinoma was found on histopathology and immunohistochemistry with positivity for the estrogen receptor and the progesterone receptor. Small lymphocytic lymphoma (SLL) affected the axillary lymph nodes, affirmed by immunohistochemical staining positive for CD20, CD5, CD23 and BCL-2 while negative for CD3 and Cyclin D1. Resection margins were free. Second cancers are characterized by being linked to SCL, and some researchers have described that the risk of second cancers is elevated in SCL patients. We represent a combined case of synchronous primary SCL with breast cancer and endometrial cancer in a woman which is a rare occurrence.

Open Access Case Study

Management of the Index COVID -19 Obstetric Patient at the University of Benin Teaching Hospital

Okojie Nkechiyerim Quincy, Ehiarimwian Oisamoje Ruth, Nte Stanley

International Journal of TROPICAL DISEASE & Health, Page 16-21
DOI: 10.9734/ijtdh/2021/v42i1730528

Introduction: The novel coronavirus (COVID-19) was first identified in Wuhan City, Hubei province of China, November 2019. As at September 2020, over 28 million infections have been identified with almost a million deaths worldwide causing an alarming pandemic. Clinical presentations in pregnant patients with COVID-19 could be atypical with normal temperature (56%) and leukocytosis. This is further masked by the features of pregnancy.

We present the management of a COVID-19 parturient in our obstetric unit.

Case Report: A 32 year old unbooked G₃P₁⁺1 lady at 32 weeks who presented via referral from a private facility with a history of elevated blood pressure and ++ of protein in urine. Also, complaints of cough and difficulty with breathing. On examination she was noted to be anxious, afebrile, not pale, anicteric, acyanosed, not dehydrated. Had bilateral pedal oedema. Tachypnic with a respiratory rate of 28 cycles per min with basal crepitations. Pulse rate was 96bpm full and regular. Blood pressure was 180/100 mmHg. Heart sounds S₁S₂only.An impression of Chronic hypertension with superimposed pre-eclampsia at 32 wks GA in a primipara with one previous CS with pulmonary edema. Keep in view COVID-19.

She was managed with oxygen, antihypertensives, steroids, while observing strict infection control protocol. She had an emergency caesarean section under subarachnoid block and was delivered of a live female neonate. A confirmatory positive result for covid-19 was obtained 24hrs later. Neonate was however negative. None of the staff became positive also.

Conclusion: The management of suspected cases of COVID-19 infection should be same as cases already confirmed. As the epidemic persists, numbers will continue to rise andhence our index of suspicion should be heightened. Pregnant women will also present with symptoms masked by the features of a sick parturient. Full complement of PPE must be worn by all staff attending to both confirmed and suspicious cases of COVID-19 infection and strict adherence to stated protocols must be observed.

Open Access Original Research Article

Influence of Open Defecation-Free (ODF) Communication Efforts on Knowledge, Attitude and Practice of Residents of Selected States in South-South, Nigeria

Margaret Offoboche Agada-Mba, Luke Ifeanyi Anorue

International Journal of TROPICAL DISEASE & Health, Page 1-15
DOI: 10.9734/ijtdh/2021/v42i1730526

Aim: To examine the influence of ODF communication intervention on knowledge, attitude and practice as precursor for sustainable ODF adoption.

Study Design: Data was gathered using a mixed method.  A total of 384 participants were selected from the South-South region using multistage sampling technique.

Place and Duration: A total of eight communities were selected from four states (Cross River, Rivers, Delta and Bayelsa) in South-South Nigeria. The study was conducted between June and July 2019.

Methodology: A total of eight focus group discussions were held, one in each community while 384 copies of questioners were administered, 48 for each community.

Results: indicates high awareness (89%) of ODF but poor understanding. Significant difference in knowledge between those exposed and those not exposed to ODF communication intervention was revealed. Attitude to ODF was poor and insignificant between those exposed and those not exposed. Practice towards ODF initiative was manifest in the proper handling of child feaces, ownership and use of toilet while a binary logistic regression of demographic factors associated with the likelihood of practice towards ODF initiative revealed gender, education and age as the three strongest. Other factors impacting negatively on sustained ODF adoption are inappropriate and inadequate communication, denial of structural constraints and intervention systemic glitches.

Conclusion: The relevance ODF communication intervention is established yet inappropriate and adequate application as well as other factors combines to obscure the full realization of its potential in improving defecation practices.  A region specific ODF intervention and evidence based participatory communication approaches are recommended.

Open Access Original Research Article

Menstrual Hygiene Management Amidst COVID-19 Pandemic in Nigeria’s Epicentre: The Reality of Girls and Women in a Low-Income Community

David B. Olawade, Yinka J. Adeniji, Ojima Z. Wada, Oluwayomi R. Akosile, Aderonke Odetayo, Grace O. Anuforo, Temitope D. Afolalu

International Journal of TROPICAL DISEASE & Health, Page 22-29
DOI: 10.9734/ijtdh/2021/v42i1730529

Menstrual Hygiene Management (MHM) is typically a constant reality for post menarche and premenopausal females globally. However, unlike other natural routine physiological experiences, a healthy monthly MHM comes with considerable financial implications. Hence, this study examines the financial ability of girls and women in a Nigerian low-income community to access materials needed for MHM monthly. The possible implication of the COVID-19 pandemic was also considered. Semi-structured questionnaires were administered to 130 respondents selected via systematic-random sampling. Data were analyzed using SPSS version 20. The respondents’ age ranged between 14 to 40 years, while 82.3% worked informal jobs. Half of the respondents reported they were unable to purchase sanitary pads and other items required for monthly MHM. Over 65% of the respondents revealed they suffered anxiety thinking about the financial burden associated with monthly MHM, while about one-third of the respondents were more financially capable before the pandemic. Common alternatives to sanitary pads used were tissue paper, cloth napkins, old sanitary towels, and newspapers. Moreover, 64% of the respondents reported had at least a form of vaginal/urinary tract infection in the past 3 months. The results clearly show that period poverty remains a barrier to achieving gender equality. The fact that 1 out of every 2 females in the study area reportedly suffered period poverty shows the dire need for socio-economic interventions. Local and State Governments must consider subsidizing products required for MHM to improve and maintain the health of girls and women in low-income communities.

Open Access Original Research Article

Assessment of Fungal Concentrations Associated with Relative Humidity and Temperature Variations in the Indoor Environment

Chioma Maureen Obi, Ifeoma Bessie Enweani-Nwokelo, Ifeanyi Onyema Oshim, Monique Ugochinyere Okeke

International Journal of TROPICAL DISEASE & Health, Page 30-34
DOI: 10.9734/ijtdh/2021/v42i1730530

Background: Indoor environmental factors and human activities influence the presence and concentration of fungal propagules which may lead to the risk of developing respiratory infections and allergic reactions.

Aim/Objectives: This study aimed to identify the factors that influence indoor fungal composition and determine its association with the development of respiratory and allergic reactions.

Methodology: A total of 549 air samples and 226 nasal swabs of occupants were examined using health base questionnaire, malt extract agar and A6 single stage microbial air sampler. House dampness, mould growth on indoor materials, temperature, relative humidity, type of ventilation, type of human activity, and location of building were found to affect the prevalence and diversity of indoor fungi.

Results: A total of 55, 46 and 50 species of fungi were isolated from homes, offices and hospitals respectively. High fungal count, were recorded in homes with moisture problems, low temperature and high relative humidity and homes located in high density areas. High cases of respiratory health problems were reported by occupants of these homes.

Conclusion: Improvement in housing and establishment of awareness programmes can be used to lower fungal load and health problems associated with dampness in homes.It is necessary to maintain and prevent the housekeeping activities that can predispose fungal concentration in indoor environment.