Gastrointestinal Basidiobolomycosis Mimicking Colon Cancer in a Sudanese Patient

Basidiobolomycosisis a rare disease caused by the fungus Basidiobolus ranarum. The incidence Rate of Gastrointestinal Basidiobolomycosis is approximately 1 in 45,333,334 or 0.00% in every 5 people in USA), member of the class Zygomycetes found worldwide (1).Basidiobolomycosis is usually a subcutaneous infection but rarely gastrointestinal1. This fungus is found mainly in the soil and on decaying vegetations2. It has been isolated from the banks of tropical rivers in West Africa, and has also been found in association with some insects2. The fungus is known to be present in the gastrointestinal tracts of reptiles, amphibians, and some bat species3. Definitive diagnosis requires culture and serological testing may be helpful. The fungal morphology and the Splendore-Hoeppli phenomenon are characteristic histological features. Basidiobolomycosis is treated with surgical resection and itracanzole 200mg BD for three months or Amphotericin B 5mg /kg iv/24 hrs4.Keywords: Zygomycetes, vegetations, subcutaneous infection.

Trends of gastric malignancies: Case study of Ibn Sina Hospital 2010-2011

Back ground: Gastric malignancies carry poor prognosis, because they commonly present at an advanced stage.Objective: to find out mode of presentation and its impact on the outcome and management of gastric cancer and to find if there are changes in trends of gastric malignancies over the last decade.Patients and methods: A review of 53 patients with gastric malignancies, treated at Ibn Sina Hospital from August 2010 through August 2011. Their demographic data, pattern of clinical presentation, histopathology grading and staging, type of management and hospital mortality were studied.Statistical analysis: Data was fed to Statistical Package for Social Sciences. Means and correlations were computed where appropriate. One sample t-test was performed. Statistical significance was taken at P = 0.05.Results: Out of 53 patients males comprise 30(56.6%) males. The peak frequency was at the age group 55-70 years. Patients from the Northern Region of Sudan constituted 34%. Adenocarcinoma comprised 43(81.3%), GIST 8(15%), lymphoma 1(1.9%) and carcinoid 1(1.9%). Epigastric painwas the commonest symptom in 47(88.7%) patients. Smoking and snuff (Tombak) and high salt diet were found in 7.5% and 5.7% and 3.8% patients respectively. Blood group A and O was found in 22.6% and 60.4% respectively. Family cancer syndrome was found in 11.3% patients.Malignancies of the antrum constitute 27(65.85%), cardia 4(9.8%), body 7(17.1%), and whole stomach 3(7.3%) patients. There were only 6.25% clinically early cases. Potentially curative resection was attempted in 31.7%. The mean hospital stay was 12 days.Conclusion: Patients presented at stage III and IV comprise 30 (93.75%) out of 32 carcinoma patients. The hospital morbidity was 13(24.6%) patients and mortality 4(7.5%) patients. When compared with results from same hospital there is improvement in outcome over a decade.Keywords: Adenocarcinoma, lymphoma, carcinoid, dysphagia