The hepatic tuberculosis is rare. The interest of this Knowledge consists in the diagnostic problems particularly in its primitive and macronodular forms. It touches all ages with a peak of frequency during 17 - 50 years old, and a female prevalence. The clinical picture is polymorphous but it is still dominated by the prolonged fever and the alteration of the general state.

Automated equipment has many benefits but analytical assessment of instrument is required for laboratory usage. This study evaluates the performance of Sysmex XN-50 slide-maker and stainer compared to manual technique. The primary goal of the study was to evaluate smear’s quality. Additionally, carry-over, repeatability, comparability using Passing Bablok Regression for white blood cells then sensitivity and specificity for red blood cells and platelets. Smear’s quality was acceptable except for one. There was no carry-over on the Sysmex XN50. Repeatability showed acceptable results. There was good agreement on white blood cells differential count including abnormal cells between blood films by the Sysmex XN50 and manually prepared blood films. Red blood cells and platelets were also comparable, the results were excellent, with sensitivity and specificity being very high. The results obtained in this study show the quality of the Sysmex XN50 device in a laboratory, it offers advantages due to its reliability and speed of preparation of blood smears.

Background: Targeted therapy refers to agents that block the growth of malignant cells by interfering with specific targeted molecules needed for carcinogenesis and growth of tumors rather than by simply interfering with all rapidly dividing cells. Haematological malignancies (HM) are clonal haemopoietic disorders that arise as a result of varied genetic damages to several key biochemical pathways in cellular differentiation, proliferation and maturation. These pathways have the focus of a new generation of targeted therapy that have revolutionized the management of haematological malignancies. Methodology: The study was a retrospective study carried out at Delta State University Teaching Hospital, Oghara. Participants were recruited consecutively as diagnosis were made. Data obtained were analysed using Statistical Package for the social sciences (SPSS) version 23. Results: A total of 132 patients with haematological malignancies participated in the study. Males were 71 (53.8%) females were 61 (46.2%). 108 (81.8%) of the patients did not use molecular targeted therapeutic agents while 24 (18.2%) used. and 56.8% of the patients with haematological malignancies were dead at the end of follow-up. Financial constraints accounted for the reason 66 patients, (61.1%) did not use molecular targeted therapies while unavailability of the specific therapy within the country accounted for the reason why 42 patients (38.89%) could not access them. Use of targeted therapy was found to have a significant relationship with treatment outcome (p = 0.035). Patients who used molecular targeted therapy were more likely to be alive at the end of follow-up. Conclusion: Molecular targeted therapies hold tremendous promise in the treatment of haematological malignancies, with associated improvements in patients quality of life and outcomes. However, challenges such as availability, accessibility and cost remain especially in a developing country such as ours.

Background: Hyponatremia is a common endocrine disorder associated with prolonged hospital stays and increased morbidity. Accurate diagnosis and management require systematic clinical and biochemical assessments. This study evaluates the current practices in managing inpatient hyponatremia and compares them with international guidelines. Objectives: This study aims to (1) compare current hyponatremia management practices with international guidelines, (2) identify areas needing improvement in documentation and service provision, and (3) implement changes and reassess outcomes. Methods: A retrospective randomized case note review of 50 inpatients diagnosed with hyponatremia was conducted. Documentation standards were compared with international guidelines. A second audit was performed after implementing a checklist-based documentation system. Results: The first audit revealed suboptimal documentation and testing: volume status was recorded in only 8% of cases, paired osmolality in 8%, medication review in 24%, urinary sodium in 28%, urinary osmolality in 36%, serum cortisol in 56%, and thyroid function tests in 72%. After implementing a standardized documentation sticker, documentation rates improved, with notable reductions in hospital stay duration and time to achieve sodium normalization across all severity groups. Mean hospital stay for severe hyponatremia decreased from 11.4 to 7.5 days. Conclusions: Implementing a standardized documentation checklist improved hyponatremia management, reduced hospital stay duration, and facilitated early specialist input. Further improvements could be achieved by updating hospital guidelines to align with international standards and introducing electronic alerts and referrals.

Background: Chest pain is a prevalent complaint in emergency departments (EDs) and is associated with significant clinical decision-making challenges. The HEART score is a validated tool used for risk stratification of patients with suspected acute coronary syndrome (ACS). Objective: This study evaluates the effectiveness of the HEART score in risk stratification and patient outcomes at Northern Emirates Hospital, UAE. Methods: A retrospective analysis was conducted on 79 patients who presented with chest pain at Northern Emirates Hospital in January 2021. From the available date in patient record, the patients were classified into three risk categories based on the HEART score, and their actual dispositions were compared. Results: Of the 79 patients, 70.8% had a low HEART score (0–3), 25.3% had a moderate score (4–6), and 3.7% had a high score (>7). Discharge rates were 83.9% for low-risk, 70% for moderate-risk, and 33% for high-risk patients while the actual major adverse cardiac event (MACE) rates available from available data were 0%, 15%, and 66.6% for low, moderate, and high-risk patients, respectively. Conclusion: If used, the HEART score can useful in effectively stratifying chest pain patients, aiding in decision-making regarding discharge and admission. Its implementation in EDs could enhance patient care and resource allocation.

Background: Hypertension frequently coexists with Type 2 diabetes mellitus (T2DM), significantly increasing the risk of cardiovascular and kidney complications. This dual burden escalates morbidity and mortality, emphasizing the need for early detection and effective management. However, there is limited research on hypertension prevalence among T2DM patients in Bangladesh. Objective: This study aimed to assess the prevalence of hypertension among patients with Type 2 diabetes mellitus and to identify associated risk factors in a tertiary care hospital in Dhaka, Bangladesh. Methodology: A prospective observational study was conducted at the Department of Medicine, Community Based Medical College, Bangladesh, from June 2022 to December 2022. A total of 83 T2DM patients were selected through purposive sampling. Data were analyzed using SPSS version 23.0, focusing on demographic characteristics, diabetes duration, body mass index (BMI), glycemic control, and blood pressure readings. Results: The overall prevalence of hypertension in T2DM patients was found to be 70.1%. Among the hypertensive patients, 42.2% had Stage 1 hypertension, while 27.9% had Stage 2 hypertension. Hypertension was significantly associated with the duration of diabetes, poor glycemic control (HbA1c > 7%), and a BMI greater than 25 kg/m². Conclusion: Hypertension is highly prevalent among patients with Type 2 diabetes mellitus, with poor glycemic control and obesity being significant risk factors. Regular monitoring and effective management of hypertension in T2DM patients are essential to reduce the risk of cardiovascular complications.

The study was carried out to detection of H.pylori in (200) patients who attended two teaching hospitals in Baghdad. The diagnosis done by Immunochromatography methods. Stools and blood samples was taken from each patient as well as other (30) healthy control matching in their age. The study included detection the Levels of Interleukin-39 and CRP in sera of patients and control. The result indicated presence of H pylori antigen in 115 cases 59 cases of males and 51 of females, Also, the result indicated increasing levels of IL-39 and CRP in patients sera in comparison with healthy control.

Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening obstetric emergency, often complicated by multiorgan dysfunction syndrome (MODS). We report a case of a 25-year-old primigravida woman at 34 weeks and 7 days of a twin pregnancy presenting with abdominal pain, nausea, and vomiting for three days. Diagnosis was established based on clinical, laboratory, and imaging findings. Prompt multidisciplinary management, including termination of pregnancy and intensive care support, resulted in a favorable maternal outcome. This case underscores the importance of early recognition and aggressive intervention in AFLP complicated by MODS.

Background: Sickle cell disease (SCD) impacts the physical, emotional and psychological aspects of life of the affected persons, often times exposing them to disease-associated stigmatization from family members and/or the community and this in turn affects their health-related quality of life (HRQoL). There is paucity of data from southern Nigeria as regards stigmatization among SCD patients, hence this study was aimed at determining the level of stigmatization amongst them. Methodology: It was a cross-sectional study involving two hundred and twenty-four SCD patients recruited from three well recognized health facilities that offer comprehensive care for individuals with SCD in Benin City, Nigeria. The measure of sickle cell stigma and the sickle cell disease health-related stigma scale psychometric tools were used for this study. Results: One hundred and sixty- four (73.2%) participants were not married despite attaining marriageable age. One hundred and seventy-one (76.1%) were dependents, living with their friends and family members. Sixty-eight (47.7%) had a severe disease course and one hundred and eighty-five (82.6%) had perceived/ experienced stigmatization. Conclusion: The study found a high prevalence of stigmatization among SCD patients.

Digestive haemorrhage (HD) is a frequent reason for consultation at the Emergency Department. Approximately 80% of GI haemorrhages are upper GI, i.e. related to a lesion located above the angle of Treitz. The main causes are ulcer disease, portal hypertension, gastritis and ulcerated lesions of the stomach, and reflux oesophagitis. In approximately 10% of cases, a rarer cause (Mallory-Weiss, acquired vascular malformations, Dieulafoy, primary PAEF or secondary aortodigestive fistulas, biliary or pancreatic tract anomalies, tumours,...) is responsible. We report the case of a patient with high HD in whom aortoduodenal fistula was the cause diagnosed on abdominal CT.