Kaposi sarcoma coexisting with new onset diabetes mellitus in a 42-year old KIDNEY TRANSPLANT RECIPIENT: A CASE REPORT

Renal allograft recipients develop several complications such as infections and neoplasms. New onset diabetes mellitus is a common transplant complication but rarely coexist with Kaposi sarcoma. Case report: We report the case of a 42-year-old banker who presented with polyuria, polydipsia, polyphagia, weight loss and dark spots in the lower limbs 8 months after he had received a live-related kidney transplant in India. He is not a known diabetic and had no family history of diabetes mellitus. His post-transplant immunosuppressive drugs included Myfortic® (mycophenolate), tacrolimus and prednisolone. At presentation he was wasted, dehydrated and afebrile, with multiple hyperpigmented nodules and plaques in both his lower limbs. Random blood glucose was 38mmol/l, had 2+ glucosuria and no ketones. Biopsy of skin lesions showed features of Kaposi sarcoma. A diagnosis of post-transplant diabetes mellitus and Kaposi sarcoma was made. His treatment included soluble insulin and antibiotics. Tacrolimus was changed to sirolimus and mycophenolate was reduced to 360mg twice daily. Conclusion: Coexistence of diabetes mellitus and karposi sarcoma occurs rarely among kidney transplant recipients. Evaluation of transplant recipient who developed diabetes for malignancies such as karposi sarcoma will improve patient and graft survival

Sputum smear positivity among patients presenting to the dots clinic with chronic cough

Cough is one of the cardinal features of Pulmonary Tuberculosis (PTB). However, even in communities with high prevalence of TB, lung diseases other than TB appear to account for this symptom. Objective: To estimate the prevalence of sputum smear positivity among patients with TB who presented with complaints of chronic cough to the Directly Observed Therapy Short Course (DOTS) clinic at the University of Maiduguri Teaching Hospital, North Eastern Nigeria. Methodology: A cross sectional study was conducted at the University of Maiduguri Teaching Hospital (UMTH) Borno state, Northeastern Nigeria between September 2014 and January 2017. All patients (new or previously treated) who presented to the DOTS clinic of the UMTH with complaints of chronic cough and had screening for pulmonary TB using sputum smear microscopy were reviewed. The minimum and the maximum ages were 1 year and 85 years, respectively, and the mean age was 36.0 (SD=14.0) years. The mean age did not differ among the male and female patients (i.e.37.3 ± 14.4 vs 34.1 ± 13.2, p=0.78). The overall prevalence of sputum smear positivity for TB was 26.5%. Although majority of patients who were sputum smear positive for TB fell within the age groups 30-39 and 20-29 thus accounting for 42.6% and 28.7% respectively, however, there was no significant association between age of those with chronic cough and sputum smear positivity TB (p=0.80). Among those who were sputum smear positive, 24.3% were new cases and 2.2% were previously treated. Conclusions: Data were entered into a computer database and analyzed with SPSS version 20.0 statistical software. Results: This study showed a high prevalence of sputum smear positivity among suspected TB patients with complaints of chronic cough This could be explained by the fact that the DOTS strategy has improved the case detection of PTB in this community. All patients with chronic cough should be evaluated for PTB

Renal diseases: caregivers' knowledge, attitude and practice in North Eastern Nigeria

Lack of awareness of renal diseases among the parents/ care givers of children can contribute to the development of childhood chronic kidney disease (CKD). Awareness of kidney disease by the care givers of children can improve their health seeking behaviour and reduce the significant economic and public health burden. We conducted a cross-sectional descriptive study to assess the knowledge, attitude and practice of renal diseases among the care givers of children attending University of Maiduguri Teaching Hospital. Management of CKD is very expensive especially in the third world where most care givers are poor and cannot afford the cost of renal replacement therapy like dialysis and renal transplant. This underscores the determination of knowledge, attitude and practice of parents/ care givers on childhood renal diseases. Objective: To assess the knowledge, attitude and practices on renal diseases among the care givers of children attending a tertiary hospital in north eastern Nigeria. Method: This cross-sectional study was conducted among mothers or caregivers of children receiving care in the department of Paediatrics of a Teaching Hospital, Borno state. Mothers/ caregivers were consecutively selected as they come to the hospital and 420 subjects were interviewed through a self-administered questionnaire. Each subject was interviewed on his or her knowledge, attitude and practice of childhood renal diseases and data was entered appropriately into the different sections of the study questionnaires. Data was analysed using Epi-info statistical software (version 7.0). Informed consent was obtained from the parents and confidentiality to any information disclosed by the mother was ensured. Results: The ages of the respondents ranged from 18 – 67 years with amean age of 37.2 (SD±13.6) years. Majority 140 (33.3%) of the respondents were aged 31 – 50 years; p<0.05. Among the respondents, were 255 (60.7%) females and 165 (39.3%) males with male to female ratio of 1: 1.5. The ages of the children ranged from 1 month to 15 years with 239 (56.9%) males and 181 (43.1%) females and male to female ratio of 1.3: 1. There were 267 (63.6%) Muslims and 153 (36.4%) Christians. There were 98 (23.3%) care givers from the upper social class, 120 (28.6%) from the middle social class and 202 (48.1%) from the lower social class. Most mothers (89.2%) had no factor preventing them from seeking medical care. Many (70.7%) of the caregivers took their children to health facilities once sick or developed any symptom of severe childhood disease. Conclusion: Although most of the care givers that participated in this study had knowledge of one form of kidney disease or the other, most had no knowledge of any treatment modality of these kidney diseases

Hepatitis C virus infection in patients with chronic kidney disease – A Review

VIRAL infections contribute greatly to the high global burden of chronic kidney disease (CKD) especially in parts of the world where the prevalence of glomerulonephritis is high. These infections pose special challenges in the management of patients throughout the spectrum of chronic kidney disease. Hepatitis C virus infection in patients with chronic kidney disease could be coincidental or be responsible for the CKD. The observance of universal principle against transmission of blood borne infections in CKD patients. Combination therapy using nucleoside analogue, ribavarin and interferons offers the only real chance of training HCV infected patients

The aethiology of chrinoc kidney disease in Maiduguri, Nigeria.

aetiology of chronic kidney disease among haemodialysis requiring patients in the university of Maiduguri teaching hospital. Nigeria. Method: a cross sectional study of one hundred patients with 5 chronic kidney failure requiring haemodialysis at the university of Maiduguri teaching hospital between January and December 2005. Their demographic data clinical features aetiology of the CKD and laboratory data were recorded using a questionnaire administered by the investigations. Result there were 68 males (68%) and 32 females (32%) with most of the patients (58%) in their 3 and 4 decades of life. Majority (21%) were from Maiduguri metropolitan. The aetiology of CKD was hypertension I 35% chronic demographics in 28% and diabetes in 12% of the study population but in 8% of the cases of CKD could not be ascertained, thus regarded as unclassified. Conclusion: hypertension and Gn were the causes of CDK in this environment gashua   town of yobe state has a very high CKD prevalence rate. The reasons for this need to be investigated

Consumer satisfaction with a federal health care service in Nigeria

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