Ectopic breast tissue mimicking Bartholin’s Abscess: a case report

Background: Ectopic breast tissue (EBT) is an uncommon occurrence in which the breast tissue can be found at any point along the milk line. Although it is most commonly found on the axilla, it can also present on the thighs, perineum, vulva, inframammary region, and groin. EBT mimicking a Bartholin’s abscess is extremely rare. Case presentation: Here, we report the case of a 31-year-old nulliparous woman who presented to our gynecology clinic with a complaint of right-sided vulvar swelling. An initial diagnosis of Bartholin’s abscess was made after clinical examination. This was surgically removed using marsupialization. However, following histopathological & immuno-histochemical evaluation, a confirmatory diagnosis of ectopic breast tissue was made.  Conclusion: Indeed, our case re-emphasizes the absolute need for histopathological examination of every tumor notwithstanding the nature of the presentation, site of occurrence, and/or initial diagnosis. Furthermore, although rare, EBT should be considered an important differential in tumors of the vulva

Respiratory Epithelial Adenomatoid Hamartoma: An Uncommon Differential of Nasopharyngeal Tumor

Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon tumor-like lesion that has been reported within the nose, paranasal sinuses, and less frequently in the nasopharynx. While it is believed to be benign, its clinical presentation, radiological characteristics, and microscopic features may closely mimic more aggressive tumors of the upper respiratory tract, potentially leading to needless life-altering treatment. Prior to now, there had been no reported cases of this lesion in West Africa. We present a 35-year-old male with persistent bilateral nasal obstruction, difficulty with swallowing, and bilateral reduction in hearing, whose CT findings were highly suggestive of a nasopharyngeal tumor, but upon biopsy and histology showed features most consistent with REAH. Surgery completely alleviated his symptoms with no clinical evidence of recurrence after a 1-year follow-up period

A rare case of uterine lipo-leiomyoma in a 63-year-old Nigerian woman; a case report

Background: Lipo-leiomyoma accounts for about 0.03%-0.2% of uterine tumours. The aetiology of lipo-leiomyoma is unclear, with some suggesting fatty metamorphogenesis and others involving growth factors and oestrogens. Radiological evaluation and histology are necessary for definitive diagnosis. If asymptomatic, no treatment is needed, but surgical resection is performed in symptomatic patients. Case Presentation: This was a case of a 63-year-old Nigerian woman who experienced pelvic pain and heaviness for a year, worsening pelvic pain and distension, and post-menopausal bleeding. Abdominal examinations revealed a pelvic mass, vaginal examination showed no vaginal and cervical lesions, while abdominopelvic ultrasonography (USS) unveiled a hyperechoic mass in the posterior uterus. She underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological assessment of the samples showed a confirmatory diagnosis of uterine lipo-leiomyoma. Conclusion: Lipo-leiomyoma is a rare, distinct uterine pathology that should be considered a differential diagnosis in post-menopausal women with vaginal bleeding. Total abdominal hysterectomy and bilateral salpingo-oophorectomy are recommended for menopausal women with symptomatic disease to prevent recurrent anaemia and also remove possible sites of the tumour even as the patient is unlikely to conceive again. Histopathological evaluation is crucial for post-menopausal women with coexisting bleeding per vagina

Endometrial carcinoma with co-existing granulosa cell tumour in a post-menopausal woman: a case report

Background: Granulosa cell tumors (GCT) of the ovary are extremely infrequent tumors accounting for about 3% of the entire ovarian malignancies with a very high rate of recurrence. Due to its ability to secrete estrogen unopposed, it can give rise to endometrial cancer thus leading to the coexistence of the two tumors on rare occasions. Case presentation: We present here, the case of a 58-year-old post-menopausal Nigerian woman with GCT coexisting with endometrial carcinoma. She presented with abdominal pain, weakness, and post-menopausal vaginal bleeding. Examination revealed an irregular 30-week size abdominopelvic mass while an abdominopelvic ultrasonography showed a right ovarian mass and multiple uterine fibroids. However, the diagnosis of GCT coexisting with endometrial carcinoma was histologically confirmed. She has been clinically stable for ten months post-surgical intervention and completion of adjuvant chemotherapy (Cisplatin [75mg/m2] and Docetaxel [75mg/m2]). Conclusion: Although rare, GCT can exist synchronously with endometrial carcinoma. This should form an important differential diagnosis in a post-menopausal woman with bleeding par vaginum as this is its most important clinical presentation. Total abdominal hysterectomy with bilateral adnexectomy should be done in older patients with GCT. Additionally, adjuvant chemotherapy may be of tremendous benefit to diagnosed patients

Knowledge of Chronic Obstructive Pulmonary Diseases among Healthcare Workers: Nigerian COPD Research Project (NICORP)

Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable chronic inflammatory lung disease that often causes obstruction to airflow in the lungs. The main risk factor in Nigeria is long term exposure to indoor pollution from cooking with firewood and fossil fuel in poorly ventilated spaces. Aims/ objectives: The aim was to evaluate the level of COPD knowledge among healthcare workers (HCWs) in the southwestern state of Nigeria.Materials/ methods: Self-administered online BCKQ which is made up of 65 stem questions was used to evaluate the level of knowledge of HCWs. The overall score of individual participants was represented in percentages and frequencies. Tests of statistical significance like the Chi-square test are applied to find out the statistical significance of the difference in percentages. Univariate analysis was done using respondent knowledge about COPD as the dependent variable and the socio-demographic were identified as independent variables. A p-value of <0.05 was taken as statistically significant in the calculations of variables. Results: Four hundred and five healthcare workers were involved in this study, 53.3% of whom were females. The mean age of the study cohort was 48.7±0.55 years, significant majority (75.6%) of whom were <40 years. (p< 0.001).  Majority of cohorts (39.3%) were doctors, while 32.0% were nurses. Only 11.7% had PhD or Fellowship as their highest educational qualification. The overall mean total score of cohorts on the Bristol COPD questionnaire was 51.9±21.9 %, with 40.4% having good scores and only 11.3% had excellent score. Mean knowledge scores were high among doctors (69.9±02.4), HCWs with medical fellowships /PhD (69.9±02.4) and had worked for <10 years. A positive correlation was demonstrated between age, level of education and knowledge score (p<0.05). Conclusion: This study examined knowledge of COPD among healthcare workers in the southwestern part of Nigeria and confirmed that the knowledge of COPD among healthcare workers was essentially good but there were serious gaps in knowledge observed in areas of vaccination, inhalational therapy, and use of inhaled and oral steroid

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways