A Rare Case of Nonsecretory Multiple Myeloma in Lagos, Nigeria: A Case Report and Literature Review

Multiple myeloma (MM) is a plasma cell disorder associated with clonal proliferation of plasma cells. Nonsecretory multiple myeloma (NSMM) is a rare variant of MM and accounts for approximately 1% to 5% of all cases. It is defined as symptomatic myeloma without detectable monoclonal immunoglobulin on serum or urine electrophoresis. This variant usually poses a diagnostic challenge to the clinician. We present a 60-year-old Nigerian man who was investigated extensively for bone pain, weight loss, and anaemia. He was eventually diagnosed as having nonsecretory multiple myeloma based on histology and immunohistochemistry results of bone marrow trephine biopsy. He is currently being managed with bortezomib, doxorubicin, and thalidomide, as well as zoledronic acid. He is also on anticoagulation. He continues to show remarkable clinical improvement. We describe this case report and literature review for better awareness amongst medical practitioners and pathologists

Knowledge, Attitude and practices of HIV post exposure prophylaxis amongst health workers in Lagos University teaching hospital

Introduction: timely PEP after needle stick exposure to high risk body fluids can reduce the rate of occupational transmission significantly. Ignorance of this may increase the risk of seroconversion to HIV for healthcare workers. This study was conducted with the aim of demonstrating the current level of knowledge and practise of healthcare workers as regards PEP. Methods: this was a cross-sectional study, pretested questionnaire were self administered to 372 health workers from various clinical specialties. The responses were collated and analyzed; results were presented in frequency tables. Results: this study revealed a high level of awareness among the respondents as 83.3% were aware of PEP. Despite the high level of awareness, respondents still have an inadequate knowledge about PEP, only 32% of the respondents could name at least two of the recommended drugs for PEP, only 54.0% of respondents knew when to commence PEP following occupational exposure to HIV. There was a low level of practice of PEP among the respondents as only 6.3% of respondents had PEP despite occurrence of needle stick injury. Conclusion: this study revealed a general low level use of PEP despite the average knowledge of PEP and the favourable attitude towards HIV PEP amongst the respondents

The Kikuchi-Fujimoto Disease in Nigeria: A Case Report and Literature Review

The Kikuchi-Fujimoto is a rare, self-limiting disease, which is characterized by regional lymphadenopathy. It occurs worldwide with a higher prevalence among Asians and women below the age of forty years. We present 41-year-old Nigerian woman who was investigated extensively for unilateral left cervical lymphadenopathy. She was eventually diagnosed as having the Kikuchi-Fujimoto disease and was managed conservatively thereafter. We describe a case report and review of literature for better awareness of the disease amongst medical practitioners and pathologists in Africa

Women’s mass media exposure and maternal health awareness in Ota, Nigeria

Maternal health has been an issue of priority to nations across the globe for years now. This study sought to: identify the sources of maternal health awareness; examine means of obtaining maternal health information; determine the frequency of mass media exposure; and analyse the influence of mass media exposure on maternal health awareness among the female residents. The Agendasetting theory and the descriptive (survey) research design, using the questionnaire as the research instrument, were utilized in this study. For this study, the purposive and haphazard sampling techniques were used. The internet (49%) was the topmost source of maternal health awareness; adverts/campaigns (30.6%) were the most common means of obtaining maternal health information; once in a month [27.6%] was the exposure frequency of most participants to the mass media while the least exposure frequency was once in two weeks [5.1%]. It was discovered that mass media exposure had a significant influence on maternal health awareness

Implementation of Quasi-Newton Method Based on BFGS Algorithm for Identification and Optimization of Signal Propagation Loss Model Parameters

Abstract—Reliable and precise predictive modelling of signal losses along the communications paths and channels of propagated radio frequency waves is fundamental to the proper design, modelling, operation, and management of mobile broadband cellular networks. As such, the identification and tuning-based estimation of the signal propagation loss parameters has advanced into a recurrent task in the field of radio frequency and telecommunication engineering. Amongst the critical challenges known with identification and predictive estimation signal propagation loss parameters, the generic model-empirical data tuning approach is very vital, yet a most often disregarded and tough optimization problem. Here, a robust and fast computation capacity of Broyden-Fletcher-Goldfarb-Shanno (BFGS) algorithm Quasi-Newton (QN) method based on the BFGS algorithm is presented for precise identification and optimization of generic log-distance propagation loss model parameters. The proposed QN based BFGS algorithm has been implemented for prognostic analysis of three sets of real-time signal propagation loss data obtained over a Long Term Evolution (LTE) mobile broadband network. When compared with the most popular Levenberg–Marquardt (LM), QN, and Gradient Descent (GD) methods, the proposed method achieved the 30–46% precision accuracies over other methods using three different statistical indicators, particularly in two study locations. The indicators are root mean square error, correlation coefficient and mean absolute error. The awesome precision performance of the proposed method can be explored to overcome premature convergence and poor predictive fitting issues often experienced in the identification and tuning-based estimation of the signal propagation loss parameters during or after cellular network planning processes

ATTITUDE OF GENERAL PUBLIC TO RISKS ASSOCIATED WITH ANAESTHESIA

Objective: To identify specific fears being entertained about general anaesthesia. Methods: People who do work in any medical facility were targeted in this prospective questionnaire-based study. All respondents were literate. The questionnaire was divided into two sections; (a) The baseline information, which included age, sex, marital status, occupation, previous exposure to anaesthesia and patient preference for anaesthesia technique. (b) Fear about risks associated with general anaesthesia; respondents were expected to pick one of four options (very concerned, somewhat concerned, not concerned and not sure), to indicate how they feel about each of the eight risks listed in the questionnaire. The data obtained was analyzed using SSPS version 10 for Windows. Results: In a bivariate analysis, marital status, occupation and previous exposure to anaesthesia are not associated with the expressed fear by the respondents. Respondents had the highest concern for the fear of death (82%), followed by fear of postoperative pain (75.4%). Least concern was for awareness during anaesthesia (37.7%). The mean age of those who expressed concern about being aware during operation is 37.0± 8.6years while those not concerned is 31.8± 8.5years(p=0.034). More of those who are concerned with nakedness preferred general anaesthesia (p=0.023). Also, more females (95.7%) than males (70.6%) expressed fear about pain during general anaesthesia (p= 0.019). Conclusion: Fear of death is a great concern for our patients coming for general anaesthesia and it is followed closely by fear of postoperative pain, the later was of greater concern to females. Finally, more of those who were concerned about nakedness preferred general anaesthesia

Mycosis Fungoides: Case Report and Literature Review

Mycosis fungoides (MF), also known as Alibert-Bazin syndrome or granuloma fungoides, is the most common form of cutaneous T-cell lymphoma. Cutaneous lymphomas are an uncommon, heterogeneous group of non-Hodgkin lymphomas (NHLs) of T- and B-cell origin where the skin is the primary organ of involvement. This is a case of a 60-year-old Nigerian woman, who was diagnosed and managed as a case of chronic dermatitis but further investigations confirmed a diagnosis of MF; she was thereafter managed with topical glucocorticoids/chemotherapy and improved on these treatments. We make a plea for better awareness of the disease among physicians and pathologists in Africa

Seroprevalence of human T-lymphotropic virus antibodies among patients with lymphoid malignancies at a tertiary center in Lagos, Nigeria

Akinsegun Akinbami,1 Idris Durojaiye,2 Adedoyin Dosunmu,1 Sarah John-Olabode,3 Adewumi Adediran,4 Olajumoke Oshinaike,5 Ebele Uche,1 Akinola Dada,5 Mojeed Odesanya,6 Olaitan Okunoye7 1Department of Haematology and Blood Transfusion, College of Medicine, Lagos State University, Lagos, Nigeria; 2Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria; 3Department of Haematology and Immunology, Ben Carson School of Medicine, Babcock University, Ilisan-Remo, Ogun State, Nigeria; 4Department of Haematology and Blood Transfusion, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria; 5Department of Medicine, College of Medicine, Lagos State University, Lagos, Nigeria; 6Oak Hospitals, Ikorodu, Nigeria; 7Department of Medicine, University of Port Harcourt, Rivers, Nigeria Background: There is a significant association of human T-lymphotropic viruses (HTLV) with lymphoid malignancies. HTLV causes a lymphoproliferative malignancy of CD4-activated cells called adult T-cell leukemia/lymphoma (ATL) and a chronic myelopathy called tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). This study aims to determine the prevalence of HTLV among patients with lymphoid malignancies at a tertiary center in Lagos. Methods: A cross-sectional study was carried out at the hematology clinic of the Lagos State University Teaching Hospital. After obtaining consent, approximately 5 mL of venous blood was collected from each subject. The serum was separated and stored at –20°C. Sera were assayed for HTLV by an enzyme-linked immunoassay (ELISA) for the determination of antibodies to HTLV-1 and -2. Western blot confirmatory testing was done on reactive samples. All patients were also screened for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) by rapid kits. Results: A total of 39 patients with lymphoid malignancies were enrolled, consisting of 24 (61.5%) with solid malignancies, while 15 (38.5%) had leukemia. Only two patients (5.1%) with lymphoid malignancies were reactive on the ELISA test. On confirmatory testing with Western blot, two patients (5.1%) with lymphoid malignancies were also positive for HTLV. All patients were HIV negative, but four were positive to HBsAg and HCV. There was no association between history of previous blood transfusion and positivity to HTLV (P=0.544). Conclusion: A prevalence of 5.1% of HTLV among patients with lymphoid malignancies was found in this study, and previous history of blood transfusion was not found to be a significant cause of HTLV infection. Keywords: HTLV, lymphoid malignancies, ATL, ELISA, TSP/HA