Subcutaneous Emphysema Complicating the Convalescent Stage of Measles in a Malnourished Indigent Child: A Case Report From North-Western Nigeria.

Measles is a highly infectious, vaccine-preventable viral disease that runs a devastating course in developing countries due to its association with malnutrition and poor immunization coverage. Subcutaneous emphysema (SE) is a rare complication of measles that can be challenging to manage and may portend poor outcomes if untreated. We present a case of a two-year-old unimmunized rural dweller who presented with facial, neck, and chest swellings three days after being managed for measles exanthem from a referral hospital. Clinical findings were consistent with massive SE comorbid with malnutrition complicating the convalescent stage of measles. The child failed to improve with conservative management but responded to closed thoracostomy tube drainage (CTTD) through an underwater seal bottle with intermittent negative pressure wound therapy (NPWT). The child spent 47 days in the hospital during which the social welfare unit of the hospital supported the treatment. SE is a rare complication of measles infection that can be challenging to manage, especially when comorbid with malnutrition in an indigent child. The application of a multidisciplinary team approach and the use of CTTD with NPWT may shorten the duration of hospital stay for the patient.

Relationship between anaemia, hypoalbuminaemia, and dietary lifestyle of the older adults attending a primary care clinic in Nigeria.

Objectives: To determine the prevalence and severity of anaemia and assess the relationship between dietary lifestyle, hypoalbuminaemia, and anaemia of older persons. Design: A cross-sectional hospital-based study. Setting: This study was conducted in the General Outpatient Clinic, the primary care unit of Aminu Kano Teaching Hospital in Kano, Nigeria. Participants: A total of 378 patients aged ≥ 60 years who presented to the General Out-patient Clinic. Main outcome measures: Prevalence and severity of anaemia, relationship between anaemia and hypoalbuminaemia, and dietary lifestyle of the participants. Results: A total of 348 respondents completed the study. The mean age of respondents was 67.83 ±7.53 years, with female (60.9%) predominance. The prevalence of anaemia and hypoalbuminaemia were 42.2% and 17.8%, respectively. Hypoalbuminaemia (ß=0.335, 95%CI=0.131-0.229, P<0.001), long duration of comorbidities (ß= -0.179, 95%CI= -0.165-0.047, P<0.001), one full meal/day (ß=0.130, 95%CI=0.224-1.879, P=0.013), and low monthly income (ß=0.122, 95%CI=0.179-1.543, P=0.026) were the predictors of anaemia among the older persons in this study. Conclusion: This study revealed a high prevalence of anaemia among older adults. The identified predictors, such as hypoalbuminaemia, long duration of comorbidities, reduced food intake and low monthly income, will be useful in developing guidelines and strategies for managing the condition in primary care settings and other similar sites. Funding: None declared.

Reaction of Dioxazolones with Boronic Acids: Copper-Mediated Synthesis of N-Aryl Amides via N-Acyl Nitrenes.

Dioxazolones, as direct amide sources, have been used with boronic acids in the presence of copper(I) chloride to access N-aryl amides at room temperature. The versatility of the developed reaction is proven by ample scope having a wide range of functional group tolerance. The reaction optimization conditions revealed that a fluorine additive demonstrated improved reactivity toward the intended transformation. The addition of triphenylphosphine resulted in N-acyl iminophosphorane, suggesting the involvement of an N-acyl nitrene intermediate.

Laser Peening Process and Its Impact on Materials Properties in Comparison with Shot Peening and Ultrasonic Impact Peening.

The laser shock peening (LSP) process using a Q-switched pulsed laser beam for surface modification has been reviewed. The development of the LSP technique and its numerous advantages over the conventional shot peening (SP) such as better surface finish, higher depths of residual stress and uniform distribution of intensity were discussed. Similar comparison with ultrasonic impact peening (UIP)/ultrasonic shot peening (USP) was incorporated, when possible. The generation of shock waves, processing parameters, and characterization of LSP treated specimens were described. Special attention was given to the influence of LSP process parameters on residual stress profiles, material properties and structures. Based on the studies so far, more fundamental understanding is still needed when selecting optimized LSP processing parameters and substrate conditions. A summary of the parametric studies of LSP on different materials has been presented. Furthermore, enhancements in the surface micro and nanohardness, elastic modulus, tensile yield strength and refinement of microstructure which translates to increased fatigue life, fretting fatigue life, stress corrosion cracking (SCC) and corrosion resistance were addressed. However, research gaps related to the inconsistencies in the literature were identified. Current status, developments and challenges of the LSP technique were discussed.

Reconstruction of the chest wall after excision of a giant malignant peripheral nerve sheath tumor.

Primary chest wall tumors are uncommon and constitute 0.2-2% of all tumors. Metastatic tumors and tumors of local extension are more common. Malignant peripheral nerve sheath tumor (MPNST) of the chest wall is even rarer and its incidence on the chest wall not stated in the literature. The incidence in the general population is 0.0001% while the risk is approximately 4600 times higher in patients with type I neurofibromatosis and 3-13% of them will finally develop into MPNST, usually after latent periods of 10-20 years. Clinically, these tumors are aggressive, locally invasive, and highly metastatic. Excision of giant chest wall tumor leaves a defect that is reconstructed using musculocutaneous flaps with or without a mesh. We report the case of a 24-year-old man who presented at the surgical outpatient clinic with 7 months history of persistent left sided chest pain minimally relieved by analgesics, 5 months of cough and worsening dyspnoea, and 3 months history of anterior chest swelling on the left side of the manubrium. Following evaluation and investigations, the tumor was excised and the residual defect closed with methylmetacrylate sandwiched between two prolene meshes and overlaid with both pectoralis major muscles. The histology of the excised mass revealed MPNST He made an uneventful postoperative recovery, but died barely 3 months later from widespread pulmonary metastases. A review of the literature revealed that such tumors hardly ever reach such large-size as in our case.

Angiosarcoma of the small intestine.

Primary gastrointestinal angiosarcomas are very rare and those of the small bowel even more rare. We report a case which is the first in the literature from this part of the world. It presented in a 25-year-old woman with multiple dissemination and rapid fatality. Diagnosis was based on histological morphology using Hematoxylin and Eosin (H and E) stains, plus reticulin special stain to outline the vascular nature.

A histopathological study of ovarian neoplasms in children in a tertiary hospital of northern Nigeria.

BACKGROUND: Information concerning the frequency and pattern of ovarian tumours in children is scant, more so in northern Nigeria. In view of this, we reviewed ovarian biopsies obtained from children in Zaria over a 25-year period. MATERIALS AND METHODS: Ovarian tumours occurring in 48 patients of age 15 years and below were reviewed and classified using the current World Health Organization (WHO) histological classification of ovarian tumours. RESULTS: Ovarian tumours in children accounted for 8.6% of all cases of tumours seen in all age groups over the period. Among all the malignant tumours seen in this period, 32% occurred in children, and Burkitt's lymphoma accounted for 31.2% of these. Germ cell tumours accounted for 58.0% while epithelial tumours had a frequency of 2.1%. CONCLUSION: Burkitt's lymphoma is the most common childhood ovarian tumour in Zaria, northern Nigeria.