Dylan Matthew Salazar, Devanshi Narendra Damani, Piya Kositangool, Osvaldo Padilla, Fatma Dihowm

Interstitial lung disease (ILD) is a group of more than 200 conditions with various etiologies that result in a wide range of inflammation and/or fibrosis of the pulmonary interstitium. Cryptogenic Organizing Pneumonia (COP) is a type of idiopathic ILD that requires a high index of suspicion with an appropriate workup to make the diagnosis. The Coronavirus Disease 2019 (COVID-19) pandemic has enabled COVID-19 pneumonia to become a top differential diagnosis, which has consequently introduced bias into medical decision-making. We present a case of COP that was misdiagnosed for COVID-19 pneumonia for months despite several negative COVID-19 test results. This case also raises awareness of the cognitive bias that likely allowed for the misdiagnosis, resulting in delayed appropriate treatment for this patient.

Abdou Razak Moukaila, Lidaw Deassoua Bawe, Komi Edem Mossi, Komi Dzidzonu Nemi, Awereou Kotosso, Tsevi Yawovi Mawufemo, Agbeko Kodjo Djagadou, Malewe Kolou, Majeste Ihou Wateba, Awalou Mohaman Djibril

Purpose: The severity of COVID-19 is associated with comorbidities such as hypertension, diabetes, and obesity, which are also well known cardiovascular factors. Dyslipidemia, although also cardiovascular risk factors, seems to have been less explored in terms of its role in the severity and prognosis of COVID-19, particularly in sub-Saharan Africa and especially in Togo. Method: We conducted a monocentric, cross-sectional, descriptive and analytical study at the Regional Hospital of Lomé-Commune. Dyslipidemia was defined according to NCEP-ATP III criterias. Results: Our study included 160 patients. Dyslipidemia was identified in 80.5% of cases. HDL hypocholesterolemia was the most represented dyslipidemia (45.7%) followed by hypertriglyceridemia (43%). Hypertriglyceridemia (OR = 2.1; CI: 1.1 - 4.1; p = 0.021), TC/HDL ratio≥5 (OR = 5.8; CI: 1.5 - 23.11; p = 0.011) and TG/HDLc ratio≥4 (OR= 10.1; CI: 3.4-30.1; p<0.001) are the factors associated with a greater risk of COVID-19 severity. Conclusion: Dyslipidemia during COVID-19 is very common in Togo and could play a significant role in the severity and mortality associated with COVID-19.

Md Rahimullah Miah, Md Mehedi Hasan, Jorin Tasnim Parisha, Md Sher-E-Alam, Chowdhury Shadman Shahriar, Foujia Akhtar, Motia Begum, Alexander Kiew Sayok, Fuad Abdullah, Mir Abu Saleh Shamsuddin, AAM Shazzadur Rahman, Mohammad Shamsul Alam, Tasnim Tabassum, Shahriar Hussain Chowdhury, Md Amir Sharif, Md Shoaibur Rahman, Mohammad Belal Uddin, Md Anamul Kabir Tamim, Abu Yousuf Md Nazim, Mohammad Abdul Hannan, Mohammad Jasim Uddin, Mohammad Basir Uddin, Mohammad Abdul Ghani, Nahida Sultan Nipa, Md Shahariar Khan, Guljar Ahmed, Md. Sabbir Hossain, Mahbubur Rashid, Mirza Osman Beg, Alamgir Adil Samdany, S. A. M. Imran Hossain, M. Ahmed Selim, Md. Faruque Uddin, Mosammat Suchana Nazrin, Md Kamrul Husain Azad, Syeda Umme Fahmida Malik, Md. Mokbul Hossain, Md. Abul Khaer Chowdhury

Cardiac Arrest is a non-communicable disease related with unusually high levels of blood pressure. Yet Medical specialists are facing the intolerable augmenting causes of cardiac arrest towards human body as a very key global issue for a number of years. The study aims to assess the applications of the radio frequency that affects on individual's heart within body boundary. Key health information tools poised from experimental specimens on cats and dogs and their living status challenges in risks with fundamental principles are highlighted. The study shows that the prevalence of cardiac arrest was in peak in the world gradually within the period of 2010 to 2020. The study represents the blood circulation speed fluctuates with infection due to misuse of prevaricated radio frequency within GPS locations due to active open-eyes and nearby cellular phone. The findings reflect the significance in cardiac arrest through effective prevention and medication that the physicians deliver. The study also found the municipal hospitals are in risks due to expansion of insecure innovative technology. Scientific healthcare knowledge is indispensable for recovery from sensor effect but such knowledge is poorly identified. Health providers and patients extremely use wireless sensor networks, but clinical supports are still below par. Overall, the study contributes to the heart foundation society through development of dynamic healthcare innovative technological framework indicating effective solutions on cardiac arrest. The study suggests future research trajectories of a new sophisticated alternative treatment approach to promote mental health and well-being linking with Sustainable Development Goals 2030.

Waheed Atilade Adegbiji, Dr. Shuaib Kayode Aremu, Kayode Rasaq Adewoye

Background: Nasal polyps are common sinonasal diseases with scarce literature in developing countries.This study aimed at determining the prevalence, sociodemographic features, clinical characteristics, radiological investigation and management of nasal polyps in our center. Materials and Methods: This was a retrospective study of all the patients with nasal polyps who had surgery in ear, nose and throat department of Ekiti state university teaching hospital. The study was carried out from July 2009 to June 2019. Detailed data on the patients were retrieved from our out patients clinic register, emergency ward register, theatre register and hospital medical record and documented. All the data obtained were collated and analysed by using SPSS version 18.0. Results: Prevalence of nasal polyps was 1.2%. There was 69.5% male with male to female ratio of 2.3:1. Urban dwellers accounted for 62.7%. Nasal polyps were 57.6% bilateral, 25.4% left sided and 13.6% right sided. First episode occurred in 88.1% and recurrent cases in 11.9%. Chronic cases (>3|12) was commoner than acute cases (<3|12) in 89.8% and 10.2% respectively. There were multiple grapelike nasal polyps in 64.4% and single nasal polyps in 35.6%. There were ethmoid (simple) polyps in 81.4% followed by nasal cavity polyps in 15.3% and antrochoanal polyps in 3.4%. Main clinical features were nasal masses 91.5%, nasal blockage 86.4%, nasal discharge 54.2%, hyposmia/anosmia 45.8%, bout of sneezing 30.5% and headache 20.3%. Nasal polyps extension were 81.4% Intranasal/paranasal sinuses, 28.8% orbital extension, 6.8% pharyngeal extension and 5.1% intracranial. Associated comorbid illnesses were allergic rhinitis, infective rhinosinusitis and asthma in 44.1%, 37.3% and 25.4% respectively. All patients were managed by surgically as intranasal polypectomy 76.3%, Caldwell Luc procedures 13.6% and external frontoethmoidectomy 10.2%. Postoperative steroid therapy was offered to 66.1%. Conclusion: Nasal polyps are idiopathic common sinonasal chronic disorder. There is associated late presentation with longstanding progressive nasal obstructions. All patients had surgery and medical treatment.

Komi Dzidzonu Nemi, Lihanimpo Djalogue, Abdou Razak Moukaila, Agbeko Kodjo Djagadou, Komi Edem Mossi, Toyi Tchamdja, Abago Balaka, Bayaki Saka, Awalou Mohaman Djibril

Objectives: The aim of this study was to describe the epidemiological and clinical profile of dermatological emergencies admitted to the medical emergency department of the Sylvanus Olympio University Hospital (SO) in Lomé. Methodology: This is a retrospective study conducted from January 2014 to December 2016 at the medical emergency department of the Sylvanus Olympio University Hospital of Lomé. Results: During the study period, 24225 patients were seen at the medical emergency department of the Sylvanus Olympio University Hospital, of which 116 dermatological emergencies, i.e. a frequency of 0.47%. The mean age of the patients was 38.43 years (extremes: 16 and 85 years) and the sex ratio (M/F) was 0.68. The dermatological emergencies were: Leg Erysipelas (N=53; 45.68%), Chickenpox (N=21; 18.10%), herpes zoster (N=13; 11.2%), Stevens-Johnson and Lyell syndromes SJS/TEN (N=22; 18.95%), and Angioedema or Quincke’s edema (N=7; 6.03%). Conclusion: This study showed that skin pathologies were extremely rare in the medical emergencies of the Sylvanus Olympio University Hospital, and dominated by infectious causes.

Abdou Razak Moukaila, Lidaw Déassoua Bawe, Awereou Kotosso, Yawovi Mawufemo Tsevi, Gnimdou Tchamdja, Archad Bozinabo Nekere, Agbeko Kodjo Djagadou, Komi Séraphin Adjoh, Majesté Ihou Wateba, Awalou Mohaman Djibril

Introduction: The COVID-19 pandemic has resulted in millions of deaths around the world with a heavy impact on social and health systems. The objective of this study was to analyze not only the profile of cases of deaths that have occurred since the advent of the pandemic in Togo, but also the determinants of their time of occurrence. Method: This was a cross-sectional study in which the Lomé-Commune Regional Hospital, a COVID-19 care center, served as the framework for our study. The study population consisted of all patients admitted for COVID-19 confirmed by a positive PCR test for SARS-COV-2, aged 18 years and over and who died during their hospital stay. Results: Sixty-seven patients were included. Males were most represented in 62.7% of cases. Almost six out of 10 patients were over 50 years old. The two main comorbidities found in the patients were hypertension (44.8%) and diabetes (28.4%). The majority of patients had the severe form of COVID-19 in 46.3% of cases. Slightly less than half of the patients (49.3%) died within five days of admission. Degree of glycemia elevation (p<0.01), AST elevation (p = 0.012), and ALT elevation (p<0.01) levels were statistically associated with time of occurrence of deaths. Conclusion: Glycemia and liver enzyme disturbances (AST and ALT) can be used as prognostic predictors in the sorting of patients admitted to hospital for COVID-19 and thus plan the implementation of adequate therapies to safeguard their vital prognosis.

Mohamed Wael, Mariam Al-Hammadi, Daher Alarab, Salwa Aly, Hosameldin Mohamad, Walid Assar

Hodgkin lymphoma counts for 15 to 25% of all lymphomas. Cardiac tumors are divided into primary and secondary tumors. Cardiac Lymphomas whether primary or secondary are rare. The most common imaging modality used to diagnose cardiac tumors is Echocardiography. Trans esophageal Echocardiography is superior to Transthoracic Echocardiography with higher sensitivity and specificity. Positron-emission tomography (PET)/ Computed Tomography scan and cardiac Magnetic Resonance Imaging (MRI) are other modalities used for diagnosis. Chemotherapy is currently the main treatment option for Lymphomas. We report a case of a 31-year-old-male who presented with abdominal pain, weight loss and intermittent vomiting and was diagnosed to have Hodgkin’s Lymphoma with cardiac involvement. Patient received chemotherapy and showed complete resolution. In this case report, we compare the different imaging modalities including CT scanning, Transthoracic Echocardiography, Trans-esophageal Echocardiography, and the PET/CT Scan that was done for the patient before and after treatment.

Melissa My Chow, Calvin Yc Chan, Yong Zhi Chen, Yan Zhi Tan, Giat Yeng Khee, Mcvin Hh Cheen, Cheryl Yl Lim, Wan Chee Ong, Yan Qin, Matthew Zw Tan

Background: Increased 25-hydroxyvitamin D (25OHD) testing, driven by studies linking vitamin D (VD) deficiency with many diseases has been challenged due to cost and uncertain health benefits. Insight to current practices in VD testing and replacement can inform development of strategies to ensure judicious testing. Objectives: To assess trends in 25OHD testing and appropriateness, VD status change, VD regimens prescribed, and factors associated with reaching sufficient levels at retest. Design: Single center retrospective large data analysis study in Singapore General Hospital. Subjects: Adults with 25OHD assays performed from 2011 to 2016. Main measures: Data (25OHD tests, patient demographics, co-morbidities and medications) were electronically extracted. Linear regression and chi-square test were used to compare annual change for continuous and categorical variables respectively. McNemar test was used to compare VD status change at retest between adults with low (25OHD <30ng/mL) and sufficient (25OHD >30ng/mL) baseline levels. Multivariate logistic regression was used to identify factors associated with achieving sufficient levels. Key Results: Total of 25,502 25OHD tests were performed in 15,605 adults. Annual tests increased 3.4 fold from 2,125 to 7,236 tests in 2012 and 2016 (p<0.05). Almost 81% of adults had risk conditions, which included chronic kidney disease (57.6%) and fractures (29.6%). Among 4,120 adults with repeated tests, VD status didn’t change significantly between adults with baseline low and sufficient levels (p=0.26). Prescribed VD regimens included VD products at doses <800units/day (42.1%) and cholecalciferol 1,000units/day (32.1%). Factors with higher odds in achieving retest sufficient levels were adults with no risk conditions (OR 1.29, CI 1.03-1.62, p=0.03) and high VD doses (>1,000units/day) (OR 1.23, CI 1.003-1.51, p=0.05). Conclusion: There was an uptrend in 25OHD tests over time. While adults were aptly tested, VD status didn’t improve with repeated testing. High VD doses and no risk conditions were associated with achieving sufficient levels.

Md. Shahariar Khan, Manjur Hossain, Md. Rahimullah Miah, Tania Hussain, Mohammad Basir Uddin, Syed Moosa M. A. Quaium

Background: Airway Tract Infections (ATIs) are one of the most common reasons for physician visits and hospitalization is associated with significant morbidity and mortality. There are many children suffering from frequent lower airway infections (FLAI). A significant number of congenital heart diseases (CHD) remain behind the FLAI but these could not be diagnosed due to lack of practices, investigation facilities, regularly follow-up and proper knowledge. The aim of the study is to identify the impact of birth-defect in heart among patients with FLAI. Methodology: This was a prospective observational study conducted in the Department of Paediatrics in Medical College Hospital over a period of 6 months. Total 50 cases of FLAI were included and data were collected in respect to history, examinations and diagnosis. Results: Out of these 36% of cases were diagnosed as CHD which are related to FLAI and 64% cases were remaining solely FLAI without any CHD. Conclusion: From the study, birth-defect in heart is an important cause of frequent lower respiratory infection. It can be prevented for earlier recognition and effective treatment. The study explores for future research trajectories for improvement of physical condition in children for proper diagnosis and prevention of recurrent attack by proper management.

Mihailo Milikić, Vladimir Jurišić

Gastrointestinal cancer occupies almost half of all tumors which occur in today's time. Etiology tumor formation at the molecular level is now the subject of many studies, it mentioned that the number of factors from hereditary to acquired mutations in the base of which can be factors external to the environment and nutrition. Recently, the author emphasizes the quality and style of life that constantly affect the general health of the individual but of course that their disorder can be both a cause and a consequence of the tumor. In spite of all preventive action of new information to a large extent can prevent the formation of tumors and it is suggested to avoid the corresponding food as well as special attention to the way of preparing food.