African Journal of Medical Case Reports

African Journal of Medical Case Reports Vol. 3 (3), pp. 001-007, March, 2015. © International Scholars Journals

Review

Gastrointestinal stromal tumor: The promise of gene therapy coupled with traditional surgical resection, in a single individual

Ali Mahmood¹*, Martin Luchtefeld², Anthony Senagore³ and Allen Silbergleit⁴

¹Department of Colon and Rectal Surgery, Colorectal Surgical Associates, 7900 Fannin, Suite 3700, Houston, TX 77054, USA.

²Department of Colon and Rectal Surgery, The Ferguson Clinic, Grand Rapids Medical and Educational Center, Michigan State University, 1000 Monroe NW, Grand Rapids, MI 49503, USA.

³Department of Colon and Rectal Surgery, Vice President, Research and Medical Education Spectrum Health, Grand Rapids Medical and Educational Center Michigan State University, Grand Rapids, MI 49503.

⁴Wayne State University School of Medicine St. Joseph Mercy Oakland Hospital 44405 Woodward Avenue Pontiac, MI 48341.

Accepted 15 September, 2014

Abstract

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors arising from the interstitial cells of Cajal. Originally thought to be leiomyosarcomas, these tumors are traditionally resistant to chemotherapy and radiation therapy. Molecular studies have identified the gene mutations that cause these masses to proliferate. The KIT proto-oncogene and PDGFRA mutations have been successfully implicated as the insults leading to disease. We present a 54 year old male, whose tumor was very aggressive yet multi-modality therapy did show an excellent response. Discovered incidentally while he was undergoing a sigmoid colostomy for benign disease, the patient had evidence of metastatic GIST disease. We utilized radiology, pathology and immunohistochemistry to provide a definitive diagnosis. Radiology was extremely useful in identifying disease and possible metastases. Furthermore the use of PET scans, particularly PET/CT allows clinicians to monitor and tailor therapy. Successful management of GISTs involves medical and surgical therapy. Imatinib mesylate is a drug used to inhibit the production of the KIT proto-oncogene. Coupled with surgery, this combination holds promise in successful management and possible eradication of the disease.

Key words: Gastrointestinal stromal tumor, PET scan, Imatinib, gene therapy, small bowel obstruction.

African Journal of Medical Case Reports Vol. 3 (2), pp. 001-005, February, 2015. © International Scholars Journals

Full Length Research Paper

Histological signs of oligodendroglioma in the brain of rats fed with diet containing yaji: The complex Nigerian suya meat sauce

A. O. Nwaopara¹*, C. I. P. Anibeze² and F. C. Akpuaka²

¹Department of Anatomy, Ambrose Alli University Ekpoma, Edo State, Nigeria.

²Department of Anatomy, Abia State University, Uturu, Abia State, Nigeria.

Accepted 05 November, 2014

Abstract 

Yaji is a complex mixture of groundnut cake powder, additives, spices and salt. The production and consumption of Yaji is not regulated despite the excitotoxic, apoptotic and tumourigenic potentials of some of its active principles. This has been the basis for several scientific investigations aimed at determining the effect of Yaji on different body organs. The present study on the brain is intended to determine its tumourigenic potentials. Eighteen weeks old white albino rats of an average weight of 170 g were used for this study. They were divided into eight groups (A - H) of three subgroups each. Subgroup 1, 2 and 3 represents experimental periods of 2, 4 and 6 weeks respectively. Group A rats served as control and were fed with normal feed (growers mash) only, while groups B - H served as the test groups and were fed with normal feed plus graded levels of Yaji (B, 10%; C, 20%; D, 30%; E, 40%; F, 50%; G, 60%; and H, 70%). At the end of the respective experimental periods, test group rats were sacrificed in order to harvest the brain tissues for tissue processing. We observed that the stained brain tissue micrographs from test group F3 (6 weeks; 50%) presented features that were histologically similar to those of oligodendroglioma and the incidence appears to be high dosage/duration dependent. This result implicates the active principles in Yaji and suggests that at high doses, Yaji is capable of inducing brain tissue damage as well as tumour formation.

Key words: Suya, Yaji, additives, spices, oligodendroglioma.

African Journal of Medical Case Reports Vol. 3 (2), pp. 001-003, February, 2015. © International Scholars Journals

Full Length Research Paper

Stress incontinence: Are we tackling the right enemy?

Eric Kinoti Mutema

SPR-Royal Preston hospital, Lancashire. E-mail: [email protected].

Accepted 28 September, 2014

Abstract 

A prospective study was done to look at the awareness of patients to the availability of treatment for stress incontinence and whether this would have altered their health seeking pattern. Stress incontinence is when urine leaks because there is a sudden extra pressure ('stress') on the bladder. Questionnaires were distributed to all the patients admitted for continence surgery (n = 26). A second cohort included all patients attending the gynaecological outpatient clinic for any reason during a period of 2 months (n₁ = 65) comprising of 2 groups A and B. After 1 month, a simple poster reminding patients with continence problems to discuss this with the doctor they were about to see. Group A was before and group B was after the implementation of the poster. In the pre-operative group, 26 patients completed the questionnaire. Of these 19 (73%) had been experiencing symptoms of involuntary urine leakage for more than 3 years. Majority of them had been referred for treatment following consultation with their doctor for an unrelated complaint. Only 42% (11) of the patients had seen the GP for the incontinence per se. More than 80% (22 patients) delayed in seeking treatment due to lack of awareness of treatment availability. With the introduction of the poster, there was an increase from 10 - 60% of patients informing the doctor of their incontinence complaints in the out patient clinic. Lack of awareness was found to be the main reason for delayed/failure to seek treatment for incontinence.

Key words: Stress incontinence, medical taboo, lack of awareness, WHO initiative.

African Journal of Medical Case Reports Vol. 3 (1), pp. 001-004, January, 2015. © International Scholars Journals

Case Report

Diagnostic challenges in a case of reccurent hemoptysis

R. K. Gupta* and Huda Bukharie

King Fahd Hospital of University, University of Dammam, Kingdom of Saudi Arabia.

Accepted 25 October, 2014

Abstract 

Actinomycosis is an uncommon disease in children and most cases are of cervicofacial infections. To date there have been only few case reports on children with thoracic actinomycosis which may mimic malignancy, lymphoma or tuberculosis. Here, we report a 14-year old boy, presented with recurrent hemoptysis and diagnosed as thoracic actinomycosis on the basis of CT and typical histopathological findings. The patient was treated successfully with specific antibiotics.

Key words: Actinomycosis, hemoptysis, rigid bronchoscopy.

African Journal of Medical Case Reports Vol. 3 (1), pp. 001-003, January, 2015. © International Scholars Journals

Case Report

Acute fracture of OS trigonum wıth cartilaginous articulation

Bekir Yavuz Uçar¹*, Demet Uçar², Mehtap Bozkurt², Mehmet Bulut¹ and Ibrahim Azboy¹

¹Dicle University Medical School Department of Orthopaedics and Traumatology, 21280 Diyarbakır, Turkey.

²Diyarbakır Education Research Hospital Clinical Of Physical Medicine and Rehabilitation, Turkey.

Accepted 12 November, 2014

Abstract

Os trigonum as one of the most common accessory ossicles of foot, may have a fibrocartilaginous articulation with posterior process of talus. This articulation may be misdiagnosed as a fracture of the posterior process of talus. Despite well known chronic injuries of athletes, acute fracture of the os trigonum is rare. Hyperplantarflexion and invertion of the ankle is the mechanism of injury. We report a case of an acute fracture of the os trigonum with a fibrocartilaginous articulation diagnosed with computerized tomography which highlights the importance of considering such injuries in patients with acute posterior ankle pain and ‘nut cracker’ sign positivity and obtaining advanced imaging modalities in ankle sprains.

Key words: Os trigonum, talus, fracture, ankle sprain, accessory ossicle, foot.

African Journal of Medical Case Reports Vol. 2 (3), pp. 024-027, June, 2014. © International Scholars Journals

Case Report

Moderately severe acute pancreatitis: An unusual manifestation of Hepatitis A

A. Ouyahia

University Ferhat Abbas, Faculty of Medicine, Setif, Algeria.

*Corresponding author. E-mail: [email protected]

Accepted May, 2014

Abstract

Moderately severe acute pancreatitis is a severe form of pancreatitis and is associated with substantial morbidity and mortality. In this case report, a young man had acute viral hepatitis A (HAV) and moderately severe acute pancreatitis together. He was admitted to our hospital with jaundice and abdominal pain. Hepatic and pancreatic enzymes were elevated. Spiral computed imaging revealed imaging features of an acute stage of pancreatitiswith peripancreatic fluid collections. The finding of IgM anti HAV antibodies implicates hepatitis A virus as the cause.He was closely monitored and recovered uneventfully with conservative treatment.In the current literature HAV infections have rarely been reported as a cause of acute pancreatitisand this report serves to alert physicians to the possible developmentof severe pancreatitis during hepatitis A.

Key words: Hepatitis A, moderately severe acute pancreatitis, morbidity, mortality, conservative treatment.