Severe chronic hepatic schistosomiasis is a common cause of episodes upper gastrointestinal bleeding (UGIB) in sub-Saharan Africa (SSA). However, there is paucity of data on clinical epidemiology of ...episodes of UGIB from rural Africa despite on going public health interventions to control and eliminate schistosomiasis.
Through a cross sectional study we profiled lifetime episodes of upper gastrointestinal bleeding and associated factors at a rural primary health facility in sub-Saharan Africa were schistosomiasis is endemic. The main outcome was number of lifetime episodes of UGIB analyzed as count data.
From 107 enrolled participants, 323 lifetime episodes of UGIB were reported. Fifty-seven percent experienced ≥ 2 lifetime episodes of UGIB. Ninety-four percent had severe chronic hepatic schistosomiasis and 80% esophageal varices. Alcohol use and viral hepatitis was infrequent. Eighty-eight percent were previously treated with praziquantel and 70% had a history of blood transfusion. No patient had ever had an endoscopy or treatment for prevention of recurrent variceal bleeding. Multivariable analysis identified a cluster of eight clinical factor variables (age ≥ 40, female sex, history of blood transfusion, abdominal collaterals, esophageal varices, pattern x periportal fibrosis, anemia, and thrombocytopenia) significantly associated (P-value < 0.05) with increased probability of experiencing two or more lifetime episodes of UGIB in our study.
Upper gastrointestinal bleeding is a common health problem in this part of rural SSA where schistosomiasis is endemic. The clinical profile described is unique and is important for improved case management, and for future research.
Both Human Immunodeficiency Virus (HIV) and
infections are common in Uganda and can cause liver disease. No study has determined co-infection significance in Uganda. We carried out a study on the ...burden, pattern and factors that contribute to peri-portal fibrosis (PPF) in HIV infected patients attending a Primary healthcare setting at Pakwach.
We conducted a cross-sectional study in the HIV clinic at Pakwach health centre IV. Data on demographics, contact with the Nile, CD4
cell count, ART and alcohol use were collected. Urinary Circulating Cathodic Antigen (CCA), was done for
detection. Liver scan was done for presence and pattern of PPF. HBsAg testing was performed on all participants. Data was analyzed using Stata Version 10.
We enrolled 299 patients, median age 39 years (IQR 16), most were female, 210 (73%). Overall, 206 (68.9%) had PPF, majority 191 (92.7%) had pattern c, either alone (63 participants) or in combination with pattern d (128 participants). Age of 30-50 years was significantly associated with PPF (OR 2.28 p-value-0.003).
We found high prevalence of
and PPF in the HIV infected population and age was a significant factor for PPF. We recommend all HIV infected patients be examined routinely for
infection for early
treatment.
Acoustic neuromata (AN) account for nearly 90 per cent of internal auditory canal (IAC) and cerebello-pontine angle (CPA) tumours. The second most common tumour is meningioma. Rare lesions include ...primary cholesteatoma, facial neuroma, lipoma, angioma and various cysts. Two cases of IAC tumour are presented, one of hamartoma in which smooth muscle was prominent and the other of lymphangioma. Of interest are the specific clinical and radiological features associated with these lesions.
Actinomycosis oto-mastoiditis Ajal, M; Turner, J; Fagan, P ...
Journal of laryngology and otology,
11/1997, Letnik:
111, Številka:
11
Journal Article
Recenzirano
Actinomycosis of the temporal bone is uncommon. There have only been 24 cases previously reported in the English literature. The responsible organism is Actinomyces israelii, an anaerobic filamentous ...Gram positive bacterium. While the cervico-facial region is the most common site of the disease, involvement of the temporal bone is rare. The diagnosis can sometimes be made clinically by identification of sulphur granules in a glue-like substrate but in all cases involving the temporal bone, the diagnosis has been made at histopathology. Effective therapy consists of surgery followed by the long-term administration of penicillin.
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