Aims: We describe the case of a young man with giant cell fibroma (GCF) of the oral cavity. Cases such as this are rare and we believe that our research adds to the literature concerning this area of study. Presentation of the Case: An asymptomatic, sessile lesion was excised from the tongue of a young man who had no previous history of chronic irritation. The final diagnosis was GCF and no recurrences have been reported to date. Discussion: GCF is a debated lesion, clinically indistinguishable from other benign lesions of the oral cavity. Large, stellate and multinucleated giant cells in a loose, poorly vascularized stroma are characteristic histological features that differentiate it from other fibrous lesions. Our case was negative for CD34 and positive for vimentin and factor XIIIa, which supports origin from a subpopulation of fibroblasts that are normally resident in the oral cavity. Conclusion: Our findings further support the view that GCF should be classified as a distinct entity.
Edwin Kamau, Hoseah M. Akala, Angela O. Achieng, Redemptah Yeda, Luicer A. Ingasia, Agnes C. Cheruiyot, Dennis W. Juma, Charles Okudo, Duke Omariba, Catherine Muriuki, Eunice A. Owiti, Eunice A. Owiti, Patrick Omondi, Amos Otedo, Ben Andagalu, Bernhards Ogutu
We describe a case of attenuated-responsiveness to Artemether-Lumefantrine (AL) in western Kenya. A 4-year old patient with 14% parasitemia was treated with Coartem® but on day 7 still had 5% parasitemia. Parasite genetic profile had similar genetic polymorphism as that selected for when AL is administered. In vitro analysis revealed elevated IC50s for AL components compared to the reference P. falciparum clone 3D7 and samples collected at this site over the last 5 years. There is need for continued global surveillance to effectively manage emergence and spread of artemisinin drug resistance which has now been found in Southeast Asia.
Hereditary hemochromatosis (HH), a common autosomal recessive disease, is characterized by excessive iron overload/toxicity in multiple organs (joints, liver, heart, pancreas, pituitary, adrenals and skin). Symptoms and signs depend upon the location of the excess iron deposition. Dilated cardiomyopathy is a typical complication of HH. Juvenile haemochromatosis is a rare disorder of iron metabolism with clinical manifestations before 30 years of age. Two common mutations of the haemochromatosis associated gene (HFE), cys282tyr (C282Y) and his63asp (H63D), have been implicated in the HH. These genes also appear to be modulators in cardiovascular disease. In fact the HFE gene defects are related to idiopathic dilated cardiomyopathy (IDCM) in some patients, even though the results of genotype analyses were conflicting. In this case report we investigate a 21 year-old male patient affected by juvenile haemochromatosis associated with heterozygosity for the H63D mutation with an idiopathic dilated cardiomyopathy.
Autoimmune Progesterone dermatitis is a rare disorder characterized by recurrent cyclical cutaneous eruptions during the menstrual period, and is due to hypersensitivity to progesterone. It is a dermatosis with myriad modes of presentation including urticaria, eczema, papulovesicles, angioedema, anaphylaxis, pruritus and erythema multiforme. We hereby present the first documented report from Nigeria - the case of a 35 year old woman with recurrent premenstrual eruption of erythematous patches, papulovesicular and urticated lesions with attendant distressing post-inflammatory hyperpigmented spots. Diagnosis was confirmed by the typical premenstrual cyclical presentation and a positive progesterone challenge test.
Although most of the ectopic pregnancies after assisted reproductive technology (ART) are tubal, 10.8% are extra tubal and more difficult to diagnose. A careful ultrasound examination should be made on patients who undergo IVF-ET and the possibility of abdominal pregnancy should be kept in mind. Abdominal pregnancy can be regarded as either primary or secondary. Primary Abdominal pregnancy is when, to start with the blastocyst implants in abdomen while secondary is most commonly associated with early tubal rupture and subsequent implantation of blastocyst on to the peritoneal surface. We here present a case of abdominal pregnancy, following in vitro fertilization in a patient with previous bilateral salpingectomy.