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Background: Post-transplant malignancies are a recognized complication of long-term immunosuppression in renal transplant recipients, with incidences significantly higher than in the general population [1,2]. Ovarian carcinosarcoma remains a particularly rare and aggressive post-transplant tumour [3]. Case Presentation: A 54-year-old female renal transplant recipient presented with progressive abdominal distension and weight loss 3 years post-transplant. Imaging revealed massive ascites and a large complex ovarian mass. Histopathology confirmed carcinosarcoma of the ovary. Despite initiation of chemotherapy, the patient died three weeks later. Conclusion: This case highlights the importance of heightened surveillance for rare malignancies in immunosuppressed transplant recipients. Ovarian carcinosarcoma is a rare but fatal diagnosis, necessitating prompt intervention and potential immunosuppression adjustment.

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Aims: We aimed to compare the diagnostic efficacy of serum cystatin C (sCyC) for contrast induced nephropathy (CIN) in north-eastern Nigerians undergoing investigations requiring the administration of iodinated contrast media. Methods: In this prospective study of 150 patients undergoing investigations requiring the administration of iodinated contrast. The demographic, levels of sCr and cystatin c at baseline, 24, 48, 72hours and 3 months after the procedure were noted. Increase of 0.5 mg/dl or 25% from baseline sCr was used to define CIN and optimum cut off of sCyC for CIN diagnosis was obtained using Receiver Operating Characteristic (ROC) curve analysis. Sensitivity and specificity of sCyC for diagnosis of CIN was obtained using Receiver Operating Characteristic (ROC) curve analysis. Results: At 24 hours of contrast media (CM) exposure, Cystatin C at 24 hours had maximum sensitivity and specificity of 86.2% and 81.0% respectively indicating a good diagnostic efficacy for CIN, however, a rise in serum creatinine was not significant. The optimum cut off of sCyC for diagnosing CIN was found to be a rise of 10% from baseline (AUC – 0.867; sensitivity – 86.2%, specificity – 81.0%). Conclusion: We may conclude that a rise of 10% in sCyC at 24 h has a good sensitivity and specificity and is reliable in the early diagnosis of CIN.

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Introduction: Appendicovesical fistula is a rare condition that often presents diagnostic challenges. We report the first case managed in our department. Case Report: The patient was a 62-year-old woman who presented with pelvic pain associated with urinary frequency and fever evolving over the past two weeks. Three months earlier, she had experienced pain in the right iliac fossa radiating to the pelvis. No medical investigations were conducted at that time. She had self-medicated, which alleviated the pain. Physical examination was unremarkable except for pelvic tenderness on palpation and pyuria on urination. Laboratory tests revealed leukocytosis with a white blood cell count of 14,000/mm³. A contrast-enhanced abdominal CT scan was performed, revealing a communication between the cecum and the bladder dome. A diagnosis of a cecovesical fistula was made. An exploratory laparotomy was indicated. Intraoperatively, the abdominal cavity was clean. A phlegmonous appendix in the pelvic position adherent to the bladder was discovered. Upon dissection, an orifice communicating the appendiceal lumen with the bladder lumen was identified. An appendectomy was performed along with debridement of the bladder perforation edges and bladder repair (cystorrhaphy) over a transurethral Foley catheter. Conclusion: Appendicovesical fistula is a rare entity. Diagnosis is most often established intraoperatively.

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Background: Cervical cancer is the leading gynecological malignancy in Tanzania accounting 59.1 new cases per 100,000 women (age-standardized to the world population) and mortality of 42.7 deaths per 100,000 (age-standardized to the world population) in 2018. Despite this burden, the cervical cancer screening uptake is not effective. Currently, the proportion of cervical cancer screening is 11% in Tanzania among women but there is limited data of cervical cancer screening uptake among female health care workers especially doctors and nurses whom screening tendency among them might influence more screening uptake to the community since they are good messengers for disseminating health information to the community. The aim of this study was to assess the knowledge of cervical cancer, utilization, challenges, and factors associated with cervical cancer screening among female doctors and nurses. Methods: This was a hospital-based analytical cross-sectional study, conducted at Muhimbili National Hospital (MNH) from 1st August to 31st November 2021. The semi-structured self-administered questionnaires were used to collect data on knowledge of cervical cancer, screening uptake and challenges toward cervical cancer screening. These data were self-report. The factors associated with cervical cancer screening uptake were assessed using a multivariate robust poison regression model. A P< 0.05 was considered statistically significant. Results: A total number of 221 participants were involved in the study, 81.4% had good knowledge of cervical cancer and the proportion of self-reported utilization of cervical cancer screening was 29.9% (95% CI:23.9% – 36.4%). Lack of self-motivation toward screening (58.8%), tight work schedules (50.2%), and lack of perceived risk factors for cervical cancer (29.9%) were some of the challenges mentioned observed. The adjusted prevalence ratio (aPR) in the multivariate robust Poisson regression model revealed a lower level of education was associa

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Background: Metabolic dysfunction-associated steatotic disease (MASLD) is the most common chronic liver disease that has become a leading health problem globally. Objectives: To determine the prevalence, grades and associated risk factors for MASLD in type 2 diabetes mellitus (T2DM) subjects at NAUTH, Nnewi, Nigeria. Materials and Methods: This was a cross-sectional study that was carried out among stable T2DM out-patients at NAUTH. Anthropometric and blood pressure (BP) measurements were done. Glycated haemoglobin and fasting lipid profile were assayed. Abdominal ultrasonography was performed to diagnose and stage MASLD. Data was analysed using SPSS version 25. Results of categorical variables were presented as frequencies and percentages, in tables. The mean values and standard deviation for the continuous variables were calculated. Chi-square test was used to determine the association between MASLD and MASLD stages with the risk factors. The level of significance was set at p ˂ 0.05. Results: A total of 142 T2DM subjects with complete results were analysed. The prevalence rate of MASLD was 46.5% among the subjects, with 47.9%, 35.2%, 14.1% and 2.8% of them having grades 0, 1, 2 and 3 MASLD, respectively. A statistically significant association was found between MASLD and educational levels (X2 = 20.732; p = 0.000), DM duration (X2 = 5.509; p = 0.019), global obesity (X2 = 6.079; p = 0.014) and anti-hypertensive medications use (X2 = 5.938; p = 0.015). Equally, significant association was found between MASLD grades and marital status (X2 = 9.181; p = 0.027), educational level (X2 = 25.492; p = 0.02), DM duration (X2 = 8.083; p = 0.044), abdominal obesity in the male subjects (X2 = 11.786; p = 0.003), global obesity (X2 = 9.736; p = 0.021) and diastolic hypertension (X2 = 14.509; p = 0.002) in the subjects. Conclusion: The prevalence of MASLD from the study was high and thus showed a high burden of the disease in T2DM subjects. MASLD and it stages showed significan

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Arteria lusoria, also known as an aberrant right subclavian artery (ARSA), is a congenital vascular anomaly of the aortic arch in which the right subclavian artery arises directly from the aorta distal to the left subclavian artery, rather than from the brachiocephalic trunk. This variation, occurring in a small percentage of the population, is frequently associated with a Kommerell’s diverticulum, a pouch-like aneurysmal dilation at the origin of the aberrant artery. A recent case at Mohammed VI University Hospital in Oujda involved a 62-year-old patient with exertional dyspnea who underwent thoracic angioscanning for suspected pulmonary embolism, revealing a retro-oesophageal right subclavian artery and a 22 mm Kommerell's diverticulum. In the absence of significant symptoms or complications, a conservative management strategy was chosen, consisting of therapeutic abstention and regular follow-up, with no issues reported to date. Diagnosis is primarily based on thoracic CT imaging, which provides detailed anatomical insights, and treatment varies from observation to surgical or endovascular intervention depending on clinical findings. The management of this anomaly is tailored to each case, considering symptom severity, potential complications, overall health status, and patient preferences.

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Background: Stress hyperglycemia is common among critically ill patients admitted in the intensive care units (ICU), affecting 17-68%of patients within the first 48 hours of admission. Long-term stress hyperglycemia is linked to poor clinical outcomes and increases mortality. The burden and outcomes of stress hyperglycemia in critically ill patients is unknown in Tanzania. Methodology: Prospective short-term cohort study was conducted at Muhimbili National Hospital for 6 months. Adult critically ill patients in medical and surgical ICU were recruited consecutively. On admission, HbA1c and RBG were checked. FBG/RBG was tested daily until discharge or death. Stress hyperglycemia was defined as FBG≥6.1mmol/l or RBG of 140mg/dl (7.8mmol/L) or more observed during ICU admission. Length of stay and ICU mortality in one month of follow-up were recorded. SH proportion is reported as percentages. Predictors of SH were analyzed using logistic regression. P value <0.05 was considered statistically significant. Kaplan Meier’s mortality curves were used to compare the mortality of patients with SH to those without. Results: A total of 270 patients were enrolled, among them 120/270(44.4%) developed SH. These patients were largely male (58.2%) with a mean age of 48.2±17.8years. predictors of SH were having comorbidities and the use of steroids. Stress hyperglycemia increased the risk of staying in the ICU for ≤ 5 days by 2 folds aOR (95%CI), 2.416 (1.261-4.629) P=0.008. Steroid use reduces the risk of SH by 67% aOR (95%CI), 0.326 (0.167-0.636) P=0.001 and by 78% for patients with other comorbidities aOR (95%CI), 0.2196(0.097-0.497) P<0.001. Conclusion: The incidence of stress hyperglycemia is high in ICU patients as evidenced in this study. Duration of ICU stay, comorbidities, and steroid use was significantly associated with stress hyperglycemia. Stress hyperglycemia contributes to a higher mortality rate among critically ill patients.