Medicine and Health Sciences Commons^™

A Rare Case Report Of Tuberculosis Endometritis In A Private Hospital Dar Es Salaam, Tanzania, Willbroad Kyejo, Brenda Moshi, Daudi Gidion, Muzdalfat Abeid, Samina Somji, Munawar Kaguta, Miriam Mgonja

Faculty of Health Sciences, East Africa

Tuberculosis endometritis is a pathological diagnosis and has been always over shadowed by pelvic tuberculosis. It is usually asymptomatic, but patients could complain of menstrual irregularity and per vaginal discharge. We report a case of a 37-year-old female who presented with per vaginal discharge for 2 years. Histopathology showed numerous caseating and non-caseating granulomas with plasma cells, Ziehl–Neelsen stain for acid fast bacillus is positive, and she was initiated on anti-tuberculosis treatment. On subsequent follow-up visits, patient was doing well with complete resolution of symptoms. Genital tuberculosis is usually caused by reactivation of organism from systemic distribution during primary infection. …

Low Use Of Vacuum Extraction: Health Care Professionals’ Perspective In A University Hospital, Dar Es Salaam, Henrik Makokha-Sandell, Andrew Mgaya, Johanna Belachew, Helena Litorp, Hussein Kidanto, Birgitta Essén

Faculty of Health Sciences, East Africa

Background Use of vacuum extraction (VE) has been declining in low and middle income countries. At the highest referral hospital Tanzania, 54% of deliveries are performed by caesarean section (CS) and only 0.8% by VE. Use of VE has the potential to reduce CS rates and improve maternal and neonatal outcomes but causes for its low use is not fully explored.

Method During November and December of 2017 participatory observations, semi-structured in-depth interviews (n = 29) and focus group discussions (n = 2) were held with midwives, residents and specialists working at the highest referral hospital in Tanzania. Thematic analysis …

Pick’S Disease And Subdural Haematoma: A Diagnostic Red Herring, Philip Adebayo, Funmilola Taiwo, Fatma Bakshi, Sunham Nur

Faculty of Health Sciences, East Africa

Frontotemporal dementia (FTD), otherwise known as Pick’s disease, is a clinically heterogeneous group of sporadic and familial neurodegenerative diseases. These conditions are characterized by dementia, behavioural and language dysfunction and loss of executive skills resulting from the degeneration of the frontal and temporal lobes. Although reversible causes of dementia are always sought during the evaluation of patients with progressive cognitive decline, the occurrence of a reversible aetiology may distract from evaluating for neurodegenerative causes of dementia. This report is about a 66-year old man with features of FTD and superimposed chronic subdural haematoma.

Effect Of Early Tranexamic Acid Administration On Mortality, Hysterectomy, And Other Morbidities In Women With Post-Partum Haemorrhage (Woman): An International, Randomised, Double-Blind, Placebo-Controlled Trial, Haleema Shakur-Still, Ian Roberts, Rizwana Chaudhri, Bukola Fawole, Mohamed El-Sheikh, Adesina L. Akintan, Zahida Qureshi, Hussein Kidanto, Bellington Vwalika, Abdulfetah Abdulkadir

Faculty of Health Sciences, East Africa

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage.

Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition …

Effect Of Time Duration Of Digestion/Decontamination Technique On Yield Of Mycobacteria And Contamination Rates From Sterile Body Fluids (Pleural And Ascitic Fluid) And Pus Specimens, Samreen Shafiq, Faryal Saleem, Kauser Jabeen, Joveria Farooqi, Warda Alam, Sadia Hanif, Shazia Ali, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background:
Duration of digestion/decontamination has a considerable impact on yield of mycobacteria especially from sterile body fluids and pus specimens. Additionally, duration of digestion/decontamination affects the contamination rates. This study evaluates the effect of digestion/decontamination protocol for 15 and 20min versus inoculation of media directly from the sample on contamination rates as well as the yield of mycobacteria from pus and sterile fluids other than cerebrospinal fluids.
Methods:
Pleural fluid (n=60), pus (n=48) and ascitic fluid (n=12) specimens were cultured for mycobacteria and evaluated for contamination and mycobacterial yield using three different processing methodologies: without digestion/decontamination with 5% NaOH-NALC (D/D), …

Association Of Plasma Cytokines With Radiological Recovery In Pulmonary Tuberculosis Patients, Najeeha Talat Iqbal, Rabia Hussain, Firdaus Shahid, Ghaffar Dawood

Department of Paediatrics and Child Health

Background: The characterization of tuberculosis (TB) patients as slow or fast responders post anti-TB treatment has always been a matter of tremendous interest as slow responders are most likely to relapse and/or develop complications. Pulmonary tissue healing as assessed with radiology is the only available tool for tissue recovery but is not predictive at intake. The objective of the current study was to assess biomarkers associated with fast and slow recovery in TB patients at recruitment.Methods: Pulmonary TB patients (N=15) were assessed for radiological recovery serially in parallel with clinical signs and symptoms, hematological parameters, and plasma cytokines at 0months, …

‘What About The Mother?’ Women׳S And Caregivers׳ Perspectives On Caesarean Birth In A Low-Resource Setting With Rising Caesarean Section Rates, Helena Litorp, Andrew Mgaya, Hussein Kidanto, Sara Johnsdotter, Birgitta Essén

Faculty of Health Sciences, East Africa

Objective in light of the rising caesarean section rates in many developing countries, we sought to explore women׳s and caregivers׳ experiences, perceptions, attitudes, and beliefs in relation to caesarean section.

Design qualitative study using semi-structured individual in-depth interviews, focus group discussions, and participant observations. The study relied on a framework of naturalistic inquiry and data were analysed using thematic analysis.

Setting a public university hospital in Dar es Salaam, Tanzania.

Participants we conducted a total of 29 individual interviews, 13 with women and 16 with caregivers, and two focus group discussions comprising five to six caregivers each. Women had undergone …

African Primary Care Research: Current Situation, Priorities And Capacity Building, Robert Mash, Akye Essuman, Riaz Ratansi, Felicity Goodyear-Smith, Klaus Von Pressentin, Zelra Malan, Marianne Van Lancker, Jan De Maeseneer

Faculty of Health Sciences, East Africa

The Sixth PRIMAFAMED (Primary Health Care/Family Medicine Education Network) workshop on ‘Capacity Building and Priorities in Primary Care Research’ was held in Pretoria, South Africa (SA), from 22 to 24 June 2014. Delegates from the following countries attended the workshop: Ghana, Nigeria, Uganda, Kenya, Tanzania, Sudan, Malawi, Zimbabwe, Botswana, Namibia, SA, Zambia, Ethiopia, Rwanda, Mozambique, Swaziland, Belgium, and Denmark (Figure 1). Delegates were from established or emerging departments of family medicine and primary care in these countries. The central theme of the workshop was primary care research – the current situation, the priorities for research and the need for capacity …

Histologic Findings In Biopsies/Resection Specimens From The Small Intestine With Special Emphasis On Celiac Disease: Experience From A Developing Country In South Asia, Huma Arshad, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Biopsies from the small intestine especially the duodenum are now being performed much more frequently than in the past. The most frequent reason for performing duodenal biopsies is to evaluate for malabsorption. In the last few years, increased awareness has resulted in more biopsies sent for evaluation of malabsorption, especially celiac disease (CD). In the duodenum, features of malabsorption (increased intraepithelial lymphocytes, villous shortening, and atrophy) were the most common histologic finding seen in 63.4% of cases. Serum tTG levels were available for correlation in 52.8% of cases. In patients with confirmed CD, 53.4% were MARSH IIIb, and 29.5% were …

Giant Cystic Parathyroid Adenoma With Thrombosis Of Internal Jugular Vein Seen On Ct And Tc-99m Methoxy Isobutyl Isonitrile Parathyroid Scan, Maseeh Uz Zaman, Nosheen Fatima, Zafar Sajjad

Department of Radiology

Primary hyper-parathyroidism is attributed by a solitary parathyroid adenoma in 80-85% cases and mostly are non-palpable and needs imaging for localization. Cystic degeneration of parathyroid adenoma is rarely seen in primary hyperparathyroidism. We are presenting a case of giant cystic functioning parathyroid adenoma with associated localized co-morbids.

Ancient Schwannoma Presenting As A Thoracic Mass, Muhammad Z Tahir, Saulat H. Fatimi, S. Ather Enam

Department of Surgery

Abstract

BACKGROUND:

Ancient schwannoma is a rare variant of schwannoma, histologically showing atypical features that may result in erroneous diagnosis of a malignant tumor. There are only few reported cases in literature.

CASE DESCRIPTION:

We report a case of a 34-year-old man who was found to have giant mediastinal tumor. He underwent thoracotomy to remove the mass, which was proven to be ancient schwannoma on histopathology.

CONCLUSIONS:

Clinical and radiological findings are important aids for further consideration of surgical removal of these potentially respectable tumors with good outcome.