Understanding the RECORDS 3 Trial and its impact on anticiagulation practice in resource poor countries

Venous thromboembolism is a significant cause of mortality and morbidity in patients following major orthopaedic surgeries. The RECORDS 3 trial revolutionised anticoagulation practice especially in patients with total knee arthroplasty and challenging the strong hold of warfarin and heparin in anticoagulation practice. With all these novel agents shifting the paradigm in anticoagulation management, Cost, in accessibility and lack of awareness of the availability of the agents amongst clinicians and surgeons alike are some factors militating against the use of these agents in patients in resource poor countries.Keywords: Anticoagulation practice, new anticoagulation therapy, Regulation of Coagulation in Orthopedic surgery to prevent Deep venous thrombosis and pulmonary embolism 3 trial, rivaroxaba

Correspondence: Doctors do not use the medical microbiology laboratory when infectious diseases are suspected

French Title: Les médecins n'utilisent pas le laboratoire de microbiologie médicale en cas de suspicion de maladies infectieuse

Hereditary multiple exostoses in a 15-year-old boy: A case report and review of literature

Background: Hereditary Multiple Exostoses (HME) is a rare bone disease, usually associated with deformity and pressure symptoms. It is an autosomal dominant disorder characterized by the development of benign tumours growing outward from the metaphyses of long bones and can lead to considerable psychosocial problems. This paper aims at reporting a case of HME with some peculiar features.Methods: A case report of a 15- year-old Nigerian male with Hereditary Multiple Exostoses is presented to highlight the clinical, radiological features and management challenges of the condition.Results: The patient presented with multiple hard, bony and ridge-like growth along the spine, scapula and para-vertebral region which gradually increased in size. These swellings were non-tender, not attached to the overlying skin and immobile, had no differential warmth and appeared to be continuous with the underlying bony structures. A striking feature was exostoses that extended from the lumbar spine towards the left scapula. He also had brachymetatarsia of the first ray of both feet. Skeletal survey confirmed the diagnosis.Conclusion: Though rare, HME do occur in our environment. The treatment is individualized, with small asymptomatic or minimally symptomatic lesions followed up and only supportive care provided. Larger symptomatic lesions may cause major physical handicap and may be resected.Keywords: Hereditary, Multiple, Exostoses, Deformit

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

The past 2 years, during which waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants swept the globe, have starkly highlighted health disparities across nations. Tegally et al. show how the coordinated efforts of talented African scientists have in a short time made great contributions to pandemic surveillance and data gathering. Their efforts and initiatives have provided early warning that has likely benefited wealthier countries more than their own. Genomic surveillance identified the emergence of the highly transmissible Beta and Omicron variants and now the appearance of Omicron sublineages in Africa. However, it is imperative that technology transfer for diagnostics and vaccines, as well the logistic wherewithal to produce and deploy them, match the data-gathering effort