Breast-axillary complex in HIV/AIDS patients.

BACKGROUND: HIV/AIDS have not only increased the health care burden especially in developing countries, it equally complicates the presentation of many diseases. Some well known disease entities now occur in fulminant complexities not previously described or known as such. The objective of this article is to report an unusual presentation of HIV/AIDS patients to the surgeon with Axillary and ipsilateral breast swelling. METHOD: This is a report of three cases seen and managed by the authors. RESULTS: Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known retroviral positive on Highly Active Anti-Retroviral Therapy (HAART). Examination revealed axillary abscess and ipsilateral breast oedema in two cases. The patient on HAART had a hard breast-axillary mass complex. Biopsy (FNAB) revealed inflammatory cells and no malignancy in all three cases. HIV screening was positive in all cases. One of the patients had excision of breast-axillary mass complex, and the histology showed features of chronic inflammation, with no malignant cells. The other two had incision and drainage of their axillary abscess. CONCLUSION: This shows the ubiquitous presentation of HIV/AIDS in our environment and surgeons should be aware of the breast axillary complex in HIV/AIDS. Medical practitioners should be careful to obtain accurate diagnosis before embarking on treatment especially mutilating surgical procedures.

An audit of non-fatal assault injuries treated in Federal Medical Center (FMC), Nguru, north east Nigeria.

BACKGROUND: Violent assault injuries are a frequent occurrence in the native communities of the North Eastern Nigeria. The injuries are mostly unreported, and therefore no policy towards prevention. We hope to highlight the common causes and pattern of such injuries, as well as suggest control measures in order to reduce the incidence. METHODS: A retrospective review of 208 assault injury cases seen at the Accident and Emergency department of the Federal Medical Center, Nguru, between January 2002 and December 2006. RESULTS: All but 12 were males, giving a male to female ratio of 16:1. Most of the patients are illiterate herdsmen and farmers. The age ranged from 12 to 70 years, with a mean of 30.9 +/- 11.2 years. The peak age incidence was 30-40 years. Fighting was the most common cause, accounting for 124 (59.6%), followed by armed robbery assaults, which accounted for 75 (36.1%). Domestic abuse was the cause in 9 cases (4.3%). Arrow shot was the commonest form of assault injury in 55 (26.4%) cases, followed by matchet in 49 (23.6%), gunshot in 37 (17.8%), club/stick in 32 (15.4%) and stab wounds in 26 (12.5 %). Quarrel over farmlands used for grazing by herdsmen was the leading cause of fighting resulting in assault injuries (87), followed by quarrel over women (32)! CONCLUSION: Assault injuries are a common occurrence in the native communities of the North Eastern Nigeria. Addressing the root causes such as mapping out grazing lands in the region, community policing as well as mandatory reporting of all assault injuries to the police for appropriate legal action, will help reduce the incidence of assault injuries.

Recurrent tumoral calcinosis.

Tumoral calcinosis is a rare, benign disease that commonly affects the African blacks. We report on a 20-year-old Nigerian presenting with recurrent multiple subcutaneous masses around the scapular, elbow, hip and gluteal regions. The X-rays, fine needle aspiration cytology and tissue biopsy confirmed the diagnosis and the patient had a successful excision with good healing.