ABSTRACT
Background: Contrast-induced nephropathy (CIN) remains a significant cause of hospital-acquired acute kidney injury (AKI) globally, with limited data from sub-Saharan Africa. This study aimed to evaluate short-term renal outcomes, including recovery and dialysis dependency, in patients who developed CIN after contrast-enhanced procedures at a tertiary hospital in Nigeria. Methods: A prospective study was conducted at the University of Maiduguri Teaching Hospital involving 150 adult patients undergoing radiologic procedures requiring contrast media. Serum creatinine and cystatin C were measured at baseline, 24, 48, and 72-hours post-contrast to identify CIN, defined as an increase in serum creatinine >0.5 mg/dL or >25% from baseline. Renal function was followed up over 3 months to assess outcomes. Results: CIN was diagnosed in 30% of patients using creatinine and 49.3% using cystatin C. Among the 45 patients diagnosed with CIN, 33 (73.3%) experienced complete renal recovery within two weeks. Eight (17.9%) had persistent renal dysfunction, of which six recovered without dialysis, while two (4.6%) required dialysis. At three months, one patient remained dialysis-dependent, two had not recovered, and four were lost to follow-up. Major predictors of CIN included advanced age, higher contrast volume, elevated baseline serum creatinine, and reduced estimated glomerular filtration rate (eGFR). Conclusion: CIN is a prevalent complication following contrast administration in this Nigerian cohort. While most patients recover within weeks, a subset remains at risk for persistent dysfunction and dialysis dependency. These findings underscore the importance of risk stratification and close follow-up in resource-limited settings.

ABSTRACT
Background: Contrast-induced nephropathy (CIN) remains a significant cause of hospital-acquired acute kidney injury (AKI) globally, with limited data from sub-Saharan Africa. This study aimed to evaluate short-term renal outcomes, including recovery and dialysis dependency, in patients who developed CIN after contrast-enhanced procedures at a tertiary hospital in Nigeria. Methods: A prospective study was conducted at the University of Maiduguri Teaching Hospital involving 150 adult patients undergoing radiologic procedures requiring contrast media. Serum creatinine and cystatin C were measured at baseline, 24, 48, and 72-hours post-contrast to identify CIN, defined as an increase in serum creatinine >0.5 mg/dL or >25% from baseline. Renal function was followed up over 3 months to assess outcomes. Results: CIN was diagnosed in 30% of patients using creatinine and 49.3% using cystatin C. Among the 45 patients diagnosed with CIN, 33 (73.3%) experienced complete renal recovery within two weeks. Eight (17.9%) had persistent renal dysfunction, of which six recovered without dialysis, while two (4.6%) required dialysis. At three months, one patient remained dialysis-dependent, two had not recovered, and four were lost to follow-up. Major predictors of CIN included advanced age, higher contrast volume, elevated baseline serum creatinine, and reduced estimated glomerular filtration rate (eGFR). Conclusion: CIN is a prevalent complication following contrast administration in this Nigerian cohort. While most patients recover within weeks, a subset remains at risk for persistent dysfunction and dialysis dependency. These findings underscore the importance of risk stratification and close follow-up in resource-limited settings.

ABSTRACT
Contrast-induced nephropathy (CIN) remains a significant clinical concern worldwide, recognized as the third leading cause of acute kidney injury (AKI) in developed countries. Defined as an acute increase in serum creatinine greater than 0.5 mg/dL above baseline or a 25% rise within 48 to 72 hours following contrast media (CM) administration, CIN's prevalence and patterns vary across different settings. The advent of novel kidney biomarkers, such as serum cystatin C, has enhanced the detection of contrast-related AKI, yet limited data exist from regions like Northeast Nigeria. This study aimed to evaluate the predictors, clinical patterns, and short-term renal outcomes of CIN using both serum cystatin C and creatinine among patients undergoing contrast procedures at the University of Maiduguri Teaching Hospital (UMTH). Methods: A prospective cohort study was conducted involving 150 consenting adult patients (aged ≥18 years) referred for contrast-enhanced investigations at UMTH. Sociodemographic data were collected, and blood samples analyzed for serum cystatin C and creatinine levels. Estimated glomerular filtration rate (eGFR) was calculated using CKD-EPI equations. CIN was diagnosed based on established criteria, and the prevalence, risk factors, and outcomes were assessed. Statistical significance was set at p<0.05. Results: The prevalence of CIN was 30% (45 patients) when assessed via serum creatinine at 48 hours, and 49.3% (74 patients) using serum cystatin C at 24 hours. Significant predictors of CIN included advancing age (OR=1.346, P=0.009), higher contrast volume (OR=2.037, P=0.001), elevated baseline serum creatinine (OR=1.601, P=0.006), and reduced baseline eGFR (OR=1.767, P=0.003). The diagnostic performance of cystatin C demonstrated sensitivities of 53.3% at 24 hours, increasing to 68% at 48 hours, but it was not more sensitive or specific than serum creatinine. Among patients with CIN, 73.3% experienced complete renal recovery within two weeks, while

ABSTRACT
Background: Several efforts have been made to improve the quality of life of diabetic patients, but obtaining information about the most pressing problems in them may help direct the focus of the interventions. Aim: Was to discover the most worrying disturbances pertaining to diabetes and their relationship with depression in the lives of people living with diabetes mellitus type 2. Method: It was a cross-sectional study of consecutive attendees of diabetes mellitus patients who came for their routine check-up at the out-patient department of Enugu State University Teaching Hospital Enugu, Nigeria. Data were obtained from a clinical and sociodemographic questionnaire; the patient`s folder; General Health Questionnaire-9 (GHQ-9) to assess for depression; and response to an open-ended question: `What worries you most since you have been suffering diabetes mellitus`? Chi-square test was used to assess for association between depression and different disturbances of diabetes mellitus. Result: The rate of occurrence of depression among the participants was 28(16.7%). Most expressed worries about Diabetes were: somatic symptoms 72 (42.9%); treatment related problems (26.2%); poor health status (25.6%); poor finances (19.1%), but only the presence of somatic symptoms (P = 0.021) and poor health status (P = 0.001) have statistically significant association with depression. Conclusion: More attention should be paid to diabetic patients complaining about somatic symptoms and deteriorating poor health status, and it may be necessary to screen them for depression.

ABSTRACT
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.

ABSTRACT
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.

ABSTRACT
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.