Comparative Assessment of p16/Ki-67 Dual Staining Technology for cervical cancer screening in women living with HIV (COMPASS-DUST)-Study protocol.

The risk of progression of low-grade (CIN1) to high-grade cervical intraepithelial neoplasia (CIN2/3) is 3-5 times higher for women living with HIV (WLHIV) than for HIV-negative women. Evidence suggests that the current cervical cancer screening methods perform less effectively in WLHIV. An emerging screening method-p16/Ki-67 dual staining technology (DUST) is a safe and rapid assay that could be used to detect CIN2/3 with higher sensitivity and specificity. The study in this protocol will evaluate the performance of DUST in cervical cancer screening among WLHIV. We will conduct an intra-participant comparative study (Phase 1) to enrol n = 1,123 sexually active WLHIV aged 25-65 years at two accredited adult HIV treatment centres in Lagos, Nigeria to compare the performance of DUST to the currently used screening methods (Pap smear, hr-HPV DNA, or VIA testing) in detecting high-grade CIN and cancer (CIN2+). Subsequently, a prospective cohort study (Phase 2) will be conducted by enrolling all the WLHIV who are diagnosed as having low-grade CIN (CIN1) in Phase 1 for a 6-monthly follow-up for 2 years to detect the persistence and progression of CIN1 to CIN2+. The findings of this study may provide evidence of the existence of a better performance screening method for the primary and triage detection of CIN2+ in WLHIV. It may also demonstrate that this high-performance test can improve the long-term predictive accuracy of screening by extending the intervals between evaluations and thus decrease the overall cost and increase screening uptake and follow-up compliance in WLHIV.

Solitary peutz-jeghers type hamartoma in a Nigerian: A case report of a rare finding and review of literature.

Background: We report a case of solitary Peutz-Jeghers (P-J) type hamartomatous polyp in the sigmoid colon of an asymptomatic Nigerian without other diagnostic criteria for full-blown P-J syndrome. Case Report: During colonoscopy for a 58-year-old man, a solitary, pedunculated polyp was seen in the sigmoid colon. Histopathological examination of the endoscopically resected mass revealed the classical features of P-J type hamartoma. A search for lentigines on the skin or mucous buccal membranes was negative. There is no family history of such findings. Conclusion: The case here presented is truly rare as a review of the scientific literature appears, to the best of our knowledge, not to contain such a unique presentation from our locality nor indeed from among Black Africans. We conducted a review of the literature and wished to highlight the evolving concept that solitary P-J polyps be considered a distinct disease entity when it appears in the absence of other features of the syndrome complex.

RésuméContexte: Nous rapportons un cas de polype hamartomateux solitaire de type Peutz ­ Jeghers (P J) dans le côlon sigmoïde d'un Nigérian asymptomatique sans autres critères diagnostiques du syndrome P J complet. Rapport de cas: Au cours de la coloscopie d'un homme de 58 ans, un polype solitaire pédonculé a été observé dans le côlon sigmoïde. L'examen histopathologique de la masse réséquée par voie endoscopique a révélé les caractéristiques classiques de l'hamartome de type PJ. Une recherche de lentigines sur la peau ou les muqueuses buccales a été négative. Il n'y a pas d'antécédents familiaux de telles découvertes. Conclusion: Le cas présenté ici est vraiment rare car une revue de la littérature scientifique semble, à notre connaissance, ne pas contenir une présentation aussi unique de notre localité ni même des Noirs africains. Nous avons effectué une revue de la littérature et avons souhaité mettre en évidence le concept évolutif selon lequel les polypes P J solitaires doivent être considérés comme une entité pathologique distincte lorsqu'ils apparaissent en l'absence d'autres caractéristiques du complexe du syndrome. Mots clés: Coloscopie, pigmentation mucocutanée, Nigéria, syndrome de Peutz ­ Jeghers, hamartome de Peutz ­ Jeghers solitaire.

Case report: Neonatal pancreatitis, chromosomal abnormality and duodenal stenosis in a newborn. A new syndrome?

INTRODUCTION: Pancreatitis is a dire clinical diagnosis with variable presentation in the paediatric population. Moreover, neonatal pancreatitis has been rarely reported in the English literature. PRESENTATION OF CASE: A newborn, product of a poorly supervised, pre-term gestation with pre-natally diagnosed intestinal obstruction, and post-natal clinical features of jaundice, vomiting, abdominal distension, aphonation and suspected chromosomal abnormalities. There was maternal hepatitis which was untreated. Diagnosed as duodenal atresia, the baby was investigated, resuscitated and had surgery. Intra-operative findings were of an omental bubble, duodenal stenosis with annular pancreas, coagulative necrosis of the pancreas and multiple intra peritoneal cheesy deposits. Following an unfortunate demise, autopsy confirmed pancreatitis and multiple congenital abnormalities. DISCUSSION: Paediatric caregivers should be aware of the possibility of neonatal pancreatitis in jaundiced newborns with intestinal obstruction especially with a background of maternal viraemia. CONCLUSION: A constellation of unusual presentations as highlighted could be a pointer to an emerging syndrome. All paediatric caregivers should entertain a high index of suspicion of pancreatitis in such a case, investigate and expedite appropriate interventions to prevent mortality.