Atypical presentation of mpox in Irrua environs: a case report.

BACKGROUND: Mpox, previously known as monkeypox, -is an orthopoxvirus infection of the skin and previously a public health emergency of international concern. It reemerged in Nigeria over 5 years ago and has since spread to other parts of the world. This is a case report of a confirmed patient who was managed at Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria before the global surge. This report shows peculiar differences from previous patients managed at the same center in terms of the relatively prolonged eruptive phase, possible seasonal occurrence of mpox in the community, and some traditional care for mpox and skin rashes. It also corroborates previous reports of possible sexual transmission of mpox in Nigeria before the report from the global outbreak. CASE PRESENTATION: The patient is a 30-year-old Nigerian male artisan with a 2-month history of raised rashes on the body that started on the genitals then involved other parts of the body. There was history of sore throat and unprotected sex with a female partner with similar rash whose other sexual history could not be ascertained. There was also history of "seasonal" rash in his village for about 7 years prior to his symptoms. Examination showed multiple vesicles and some nodules (ulcerating, healing, and healed) on the face, trunk, limbs, gluteal region, scrotum, palms, and sole, an almost circumferential penile ulcer, and lymphadenopathy. Polymerase chain reaction skin samples sent for mpox returned positive, while retroviral and coronavirus disease 2019 screenings were negative. He was managed in isolation while contact tracing in the affected community was initiated. CONCLUSION: Atypical presentations of mpox, as managed in Irrua before the global surge, emphasize the varied spectrum of presentations (typical and atypical) in Nigeria. Therefore, there is a need for a higher index of suspicion for the uncommon presentations which will strengthen case recognition, case management, and community-based interventions as well as surveillance in the prevention and control of mpox in Irrua, its environs, Nigeria, and the world.

Determination of antioxidant status of pre-eclamptic and normotensive sub-rural Nigerian pregnant women at the Irrua Specialist Teaching Hospital, Irrua, Edo State.

OBJECTIVES: To determine the antioxidant levels of subrural Nigerian population where pre-eclampsia and eclampsia is the leading cause of maternal mortality. METHODS: Prospective case control study done at Department of Obstetrics and Gynaecology, Irrua Specialist Teaching Hospital Irrua, Edo State, Nigeria. Plasma level of vitamin C and E were evaluated in 80 pre-eclamptic patientswhich were compared with normotensive 80 pregnant women matched as controls. RESULTS: Pre-eclampsia was associated with significant reduction in levels of vitamin C and E (p < 0.05). However, the correlation between the blood pressure (severity) and reduction in antioxidants level was not statistically significant. CONCLUSION: Pre-eclampsia at Irrua in Nigeria is associated with significant reduction in plasma antioxidants level similar to some reports from the other parts of the world.

Retained Placenta: Still a Cause of Maternal Morbidity and Mortality in a Nigerian Semi- Urban Population

Background: Retained placenta is associated with morbidity and mortality when left untreated. This study was done to determine the occurrence of retained placenta in our setting as well as to ascertain the possible risk factors; morbidities and mortality. Method of study: This was a retrospective review of all cases of retained placenta over a three year period (March 2005 to March 2007). There were 3542 deliveries; and of which 64 cases were of retained placenta. Results: The incidence of retained placenta was 1.8of all deliveries with a higher incidence in unbooked patients and a case fatality of 3.12.The commonest complication was postpartum haemorrhage in 51(79.68) of cases with blood transfusion rate of 47. onclusion: Complications associated with retained placenta could be reduced by adequate utilisation of health care facilities manned by skilled attendants; availability of blood transfusion services as well as effective and safe anaesthesia