Abstract : Tumours of myoepithelial differentiation have only in the last two decades been recognised to occasionally arise from soft tissue. Malignant mixed myoepithelial tumour of soft tissue is an exceptionally rare diagnosis, with less than 10 reported cases to date. Diagnosis is often challenging due to histological polymorphism, variability of immunophenotype and the absence of a cellular counterpart. A 22-year-old man presented with a seven-month history of an enlarging subcutaneous mass on the occipital scalp, measuring 10x14cm. Following excision under general anaesthetic, histopathological and immunohistochemical analysis demonstrated features most in keeping with a malignant mixed tumour of soft tissue. A further 2cm wide local excision was performed, followed by post-operative radiotherapy; to date there has been no recurrence. Soft tissue myoepithelial tumours can be up to 20cm in size, with larger size often associated with malignancy. The size of the tumour in this case enabled primary closure for both excision and wide local excision..
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Abstract : Thalassemia major is a serious chronic hemolytic anemia that leads to excessive iron accumulation in vital organs like the liver & the heart. This high level of iron can lead to serious cardiac complications and is the cause of high morbidity & mortality in these patients. Early evaluation of cardiac function is very important to detect those with asymptomatic functional cardiac abnormalities. To assess the effect of thalassemia on the left ventricular systolic function using conventional echocardiography. This is a cross sectional case control study conducted at the Thalassemia Center in Al-Zahraa teaching hospital/Najaf from the period of January 2022 to January 2023. Eighty five patients with β-thalassemia major who were asymptomatic for cardiac diseases & 43 healthy controls of similar demographic factors included in the study & all were examined with echocardiography to assess the left ventricular function and both groups were subdivided into 2 age groups. Twenty two cases were diagnosed with left ventricular systolic dysfunction using the Simpson method (ejection fraction ˂ 55) & 13 cases by the M-mode (fractional shortening ˂ 27). Significant negative correlation was found between the ejection fraction & serum ferritin. Increase left ventricular internal dimension in diastole is the first parameter that indicates early systolic dysfunction followed by left ventricular internal dimension in systole & reduction in left ventricular posterior wall thickness in systole, ejection fraction & fractional shortening in the following years..
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Abstract : Dyspepsia consists of heterogeneous group of symptoms that are localized in the epigastric region and can be broadly defined as pain or discomfort that is centred in the upper abdomen (particularly the epigastrium). The multienzyme preparation “Unienzyme” is a fixed dose combination (FDC) which contains Fungal Diastase (alpha amylase) and Papain as the major constituents apart from simethicone, activated charcoal and nicotinamide. The combination acts as supplemental enzymes to those secreted by the body. Since majority of patients require long term symptomatic treatment for functional dyspepsia, we undertook a survey to evaluate the efficacy, tolerability as well as other parameters such as duration of treatment, time to get relief from symptoms etc. The survey was conducted between July 2023 to October 2023 in Africa specifically in Tanzania and Zambia. The questionnaire was developed for doctors who were prescribing Unienzyme with MPS to their patients for gastrointestinal disorders and who consented to participate in the survey. A total of 105 doctors participated in this survey. Findings about efficacy and tolerability also coincides with the study conducted by Banka et al (8), while the 95.6% patients in their study and 86.66% doctors in our study rated the efficacy from good to excellent. 94.5% patients in previous study and 84% doctors in this study rated the tolerability of Unienzyme as very good to excellent. The difference could be attributed to clinician’s judgement in our study as compared to patients’s judgement in previous study. The present survey confirmed that Unienzyme is highly efficacious with good tolerability in relieving the symptoms of troublesome functional dyspepsia in African population especially Tanzania, Zambia and neigbouring countries..
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Abstract : Sleep can be defined as a reversible behavioral state of perceptual disengagement from and unresponsiveness to the environment. It is a complex mix of physiological and behavioral process which is generally seen with postural recumbence and closed eyes but not always. Sleep quality can be defined as “an individual’s self-satisfaction with all aspects of the sleep experience.” It has the following attributes which are sleep efficiency, sleep disturbances, sleep latency, sleep duration, wake after sleep onset. Sleep quality have been linked to various non-communicable diseases like diabetes, hypertension and heart diseases. The level of quality of sleep differs from region to region around the world. There are various factors which can affect the level of quality of sleep like sociodemographic factors which include age, location, gender, occupational type and income. Lifestyle habits including screen time, caffeine, nicotine, alcohol, exercise and stress can also affect sleep quality. Environmental factors such as noise pollution, temperature, exposure to light can also affect sleep. Poor sleep quality can also cause high economic burden for countries, increased healthcare costs and reduced workplace efficiency. Health of public and development of the country needs to improve the sleep quality of the population. This paper will look into the latest research on sleep, sleep quality, factors affecting it and sleep hygiene..
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Abstract : Lacerations are pattern of injury in which skin and underlying tissues are cut or torn. Facial paralysis can be a devastating complication post penetrating trauma of head and neck. A 25-year-old gentleman was alleged assault with a knife and sustained left neck laceration wound on the night of Deepavali with delayed left facial nerve palsy of House Brackman Grade VI. Upon examination, left neck laceration wound was 13 x 5 cm with haemostatic suture seen over platysma muscle with no signs of active bleeding and haematoma. Contrast Enhanced Computed Tomography of the neck revealed superficial left neck laceration wound with left platysma muscle transection and left salivary gland involvement. Neck exploration was done. Intra-operatively found laceration at superficial left parotid gland, bleeding from left facial vein injury and the left facial nerve was transected with stimulatable distal part, but not on the proximal part. Then, proceeded with facial nerve re-anastomosis and haemostasis. Post operatively, facial nerve palsy improved to Grade V on follow up. This case report enlighten on the inevitable inauspicious recovery outcome despite early interventions taken..
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