Neurocysticercosis among patients with first time seizure in Northern Namibia

Introduction: Neurocysticercosis is a common cause of seizures in low resource countries. There is a paucity of data regarding the extent of this infection in Namibia. There are multiple causes of First-time seizure including electrolyte abnormalities, infections, trauma, drugs, alcohol and many times no apparent cause can be found. We sought to describe the burden of Neurocysticercosis among individuals with a first-time seizure in Namibia. Methods: We recruited 221 patients with a First-time seizure who presented to the Intermediate Hospital Oshakati between August 2012 and March 2014. Patients with seizures due to identifiable causes like trauma, electrolytes, intoxications and meningitis were excluded. Brain CT scans were done, blood serological testing of Neurocysticercosis antibodies, Physical examination and demographic variables were collected. Data was entered into Epidata version 3.1 and transferred to stata version for analysis. Results: Ninety-six (96) of the participants had evidence of Neurocysticercosis on Brain CT scan representing a prevalence of 51.41%. Consumption of pork and rearing of pigs in the homestead were significant factors associated with Neurocysticercosis in our study population with odds of 3.48(1.45-8.33) and 2.07(1.11-3.86) respectively.Serological testing for Cyticercosis IgG had a sensitivity of 65.93% and Specificity of 96.51%. The positive and negative predictive values were 95.2% and 72.81% respectively. Conclusion: Neurocysticercosis is a common cause of Index seizures in Northern Namibia, living in a rural area, rearing pigs in homesteads, eating pork and poor sanitary practices are the major risk factors for this illness.Pan African Medical Journal 2016; 2

Cancer of the prostate presenting with diffuse osteolytic metastatic bone lesions: a case report

Abstract Introduction Prostate cancer is the second most common cancer in men and the fifth most common cancer worldwide. In the USA it is more common in African-American men than in Caucasian men. Prostate cancer frequently metastasizes to bone and the lesions appear osteoblastic on radiographs. Presentation with diffuse osteolytic bone lesions is rare. We describe an unusual presentation of metastatic prostate cancer with diffuse osteolytic bone lesions. Case presentation A 65-year-old Namibian man presented with anemia, thrombocytopenia and worsening back pains. In addition he had complaints of effort intolerance, palpitations, dysuria and mild symptoms of bladder outlet obstruction. On examination he was found to be anemic, had a swollen tender right shoulder joint and spine tenderness to percussion. On digital rectal examination he had asymmetrical enlargement of the prostate which felt nodular and hard with diffuse firmness in some parts. His prostate-specific antigen was greater than 100ng/mL and he had diffuse osteolytic lesions involving the right humerus, and all vertebral, femur and pelvic bones. His screen for multiple myeloma was negative and the prostate biopsy confirmed prostate cancer. Conclusion Prostate cancer rarely presents with diffuse osteolytic bone lesions and should be considered in the differential diagnosis when evaluating male patients with osteolytic bone lesions.</p