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   2016| January-June  | Volume 1 | Issue 1  
    Online since April 5, 2017

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Acute Myeloid Leukaemia in a Patient with Sickle Cell Disease: A case report and literature review
H Bello-Manga, AA Babadoko, A Hassan, AI Mamman, S Awwalu, A Adebayo, MA Kana
January-June 2016, 1(1):12-16
Introduction: The coexistence of sickle cell disease (SCD) and haematologic malignancies is not a common occurrence. Improvement in management of SCD and a consequent increase in the life expectancy has increased the risk of occurrence of haematologic and other malignancies in them. Aim: To report the coexistence of Acute Myeloid Leukaemia (AML) and SCD in the same patient. Method: The patient's clinical case notes were reviewed and analysed, as well as medline search on relevant literature. Case Report: A 24year old male with SCD (HbSC) presented with a history of bone pains, fever, sore throat, cough and headache. Examination revealed pyrexia, jaundice and crepitation in the left lung. Haemogram showed anaemia, lymphocytosis with atypical forms and asymptomatic hrombocytopenia (100x109/L). He was treated for a vaso-occlusive episode secondary to lobar pneumonia. Three weeks later, he represented with a persistence of symptoms, increasing white blood cell count (from 2.5x109/L to 28x109/L) and thrombocytopenia(51x109/L). Blood and bone marrow films showed a predominance of myeloblasts with irregular nuclei and prominent nucleoli (>25%), consistent with Acute Myeloid Leukaemia(French-American-British (FAB) M0/M1 AML). Further characterization could not be done. Induction of remission was started using intravenous Daunorubicin and Cytosine Arabinoside(DA 3+7 regimen) at 25mg/m2 for three days and 50mg/m2 12-hourly for seven days, respectively, with the possibility of a stem cell transplantation borne in mind. During therapy, he developed thrombocytopenia (platelet count (12x109/L) and fever (temperature; 39°C). His symptoms worsened with development of sub-conjunctival haemorrhage, epistaxis, bleeding from the gum and altered sensorium. He succumbed to the disease on day 10th of chemotherapy. Conclusion: The co-existence of a haematologic malignancy and SCD is not common and remains a challenge in resource constraint settings. Examination of the peripheral blood film may be the first indicator of such an occurrence. There is a need to develop both diagnostic and treatment protocols for the management of haematologic malignancies in resource-poor settings.
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A Case Report of Neuroleptic Malignant Syndrome Following the Stoppage of Anti Parkinsonian Medication
BA Yakasai, H Sani
January-June 2016, 1(1):9-11
Background: Neuroleptic Malignant Syndrome (NMS) is a rare and potentially fatal complication seen in Parkinson's disease (PD), mostly due a reduction of anti-Parkinson's medication. The mortality rate is up to 4percent. Case: We report a case of 73 years old man who has been receiving treatment for PD since 2001 with Sinemet, bromocriptine and benzhexol ( artane). On subsequent follow up visits at BarauDikko Teaching Hospital (BDTH), Kaduna State University (KASU), the dosage of the Sinemet was increased to 250 mg. However, despite the increase in the dosage of Sinemet, his condition was not improving much, as such we decided to add Bromocriptine 10 mg tid. A week after introduction of bromocriptine, the patient started having an "ON and Off Phenomenon" This prompted the immediate removal of the bromocriptine from his medication. A few days after the removal of bromocriptine he developed acute fever with a generalized body stiffness, excess salivation and confusion. Conclusion: The result of blood tests and physical examination indicated a strong evidence of a NMS.
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Paediatric Head Trauma: A two year review in a newly established Neurosurgical Unit in Kaduna, Nigeria
S Danjuma, SA Kache, N Nduka, L Jonathan Ajah
January-June 2016, 1(1):1-5
Background: Paediatric head injury accounts for a large number of emergency room visits. Understanding the pattern of injuries is very important for appropriate treatment with resultant good outcome. The aim of this study is to outline the pattern and outcome of paediatric head trauma in a newly established neurosurgical unit in North-western Nigeria. Patients and Methods: The personal data, mechanism of injury, treatment and outcome was obtained using a proforma from all patients less than 18 years who presented at our accident and emergency unit. The data obtained was analysed using SPSS version 15.0 for Windows. Result: A total of 37 children were included in the study; 25 were male and 12 were female. The most common mechanism of injury was road traffic accident. Twelve patients required operative neurosurgery for evacuation of haematoma, elevation of depressed skull fracture and burr hole. Majority of the patients had a Glasgow outcome score of 5. Three mortalities were recorded. Conclusion: Road traffic accident is the most common cause of head injury in children and most of our patients recover with good outcome.
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Late Abdominal Pregnancy in a Patient with Bicornis Unicollis Uterine Anomaly: A Case Report
CM Taingson, TS Akande, I Aniko, DOK B Iyalar, AG Adesiyun
January-June 2016, 1(1):6-8
Background: Abdominal pregnancy constitutes about 1% of all ectopic pregnancies. Maternal mortality could be as high as 20%, mainly from massive haemorrhage. Case: A 17 year old woman (G2P0+1) with 20 weeks amenorrhea. She presented with lower abdominal pain and absence of fetal movement for two days. Abdominal pregnancy was diagnosed by transabdominal ultrasonography. At laparotomy, 600mls of haemoperitoneum and a macerated female fetus that weighed 600gms were found. She had a bicornuate uterus with the right horn greater than the left; each horn had a fallopian tube and ovary attached. The placenta was loosely attached to the anterior abdominal wall, omentum and the bicornuate uterus. She had a laparotomy and surgical removal of the pregnancy. Following an uneventful recovery, was discharged home on the 7th day. Conclusion: The concomitant finding of a bicornis unicolis congenital uterine anomaly and abdominal pregnancy, with its proximity to the rudimentary horn makes it likely 'secondary abdominal pregnancy
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Victoria Pam
January-June 2016, 1(1):0-0
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