Niger J Clin Pract
-
Cryptococcal meningitis (CM) is underreported in the immunocompetent, the disease being more commonly associated with advanced human immunodeficiency virus (HIV) disease. We report the diagnosis, management, and eventual fatal outcome of CM in a non-HIV-infected man. Late presentation, delayed diagnosis, difficulties in accessing medications, and raised intracranial pressure (ICP) were contributory to his demise. Detailed history, a high index of suspicion, and laboratory workup coupled with prompt antifungal therapy and aggressive ICP management are essential for better outcomes.
-
Gravity impact has been mainly evaluated in mature teeth related to debris extrusion, even though it may affect the amount of apically extruded irrigant. In the literature the influence of gravity on the amount of apically extruded irrigant in immature teeth has been studied by a 45o inclined plate to mimic the position of the maxillary teeth and 90o for the mandibular teeth. However, patients are positioned horizontally in the dental chair while treatment. There is no study in the literature testing the horizontal position to mimic the clinical settings realistically. ⋯ The EndoVac macrocannula is a more reliable and safer irrigation system as it prevents irrigant extrusion independent of the position of the tooth.
-
Peri-implant mucositis and peri-implantitis cases increase in number with the increase of implant applications. Peri-implant mucositis and peri-implantitis are defined as inflammatory diseases with inflammation and loss in soft and hard tissue, similar to the other periodontal diseases. As observed in many diseases, genetic predisposition factors also affect the progress of periodontitis and peri-implantitis. ⋯ Results show that individuals with the G genotype have a higher risk of periodontitis, while individuals with G / C genotype have higher risk of peri-implantitis.
-
Studies evaluating immunization data quality and its determinants in low- and middle-income countries are scarce. ⋯ Routine immunization data are not always accurate in Enugu state. Continuous efforts to improve the data monitoring system, supervision, data audits, funding, and staffing are warranted.
-
Sentinel lymph node biopsy is the current standard of care for axillary staging and further treatment planning in patients with clinical axillary node-negative breast cancer. Sentinel node (SN) biopsy was designed to accurately stage the axilla and minimize the side effects of conventional axillary-lymph-node dissection without sacrificing oncologic outcomes. Sentinel lymph node biopsy is normally performed with nuclear scan and patent blue violet or isosulfan blue. These are expensive and not commonly available in resource-poor regions such as West Africa. Methylene blue dye is a commonly used agent in a wide range of clinical diagnostic procedures and has been used by other investigators to perform this procedure. This study was designed to demonstrate the feasibility and effectiveness of SN biopsy in the management of axillary node-negative breast cancer in resource-limited populations using methylene blue dye. ⋯ Sentinel lymph node biopsy with methylene blue dye can be applied with high accuracy within resource-limited environments. However, there is a definite short learning curve that must be overcome and the procedure validated before clinical application in decision-making.