International Journal of Medical Research & Review (IJMRR)
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Lymphocytic colitis: an Important but Underdiagnosed Cause of Chronic Diarrhoea in Adult Nigerians
Full text linkIntroduction: Lymphocytic colitis is an important cause of chronic diarrhoea which is amenable to appropriate treatment which helps to reduce the morbidity and mortality associated with chronic diarrhoea. In Africa unfortunately, there is poor awareness of this treatable cause of chronic diarrhoea on account of a paucity of skilled experts necessary to make a diagnosis and implement effective therapy.
Aim: We present the clinical aspects, endoscopic findings and pathological features of twenty-one Nigerian patients with lymphocytic colitis. A short literature review of the epidemiological, clinical, endoscopic, and pathological features of this important condition is also presented.
Materials and Methods: This was a retrospective analysis of the clinical, endoscopic and pathological findings of twenty-one patients who were diagnosed with lymphocytic colitis following colonoscopy in an open-access endoscopy setting in Akure, Ondo State, Nigeria over eighteen months.
Results: Twenty-one diagnoses of lymphocytic colitis were made from a pool of one hundred and twenty-two colonoscopies done between December 2021 and May 2023. There were slightly more females diagnosed with an M: F ratio of 3:4 with a mean (SD) age of 52.2 (± 14.3) years. All of the patients had a history of passage of watery diarrhoea while normal colonoscopy findings were present in 87.5%. The mean (SD) time to diagnosis in five of these study subjects was 18.4 ± 9.1 months. These patients had standard medical treatment with good outcomes.
Conclusion: In sub-Saharan Africa, lymphocytic diarrhoea is a treatable cause of chronic diarrhoea. It is important to refer patients with chronic diarrhoea to facilities where they can benefit from the expertise of endoscopists and pathologists
Superbugs Unleashed: Is Time Running Out to Stop the Global Infection Crisis? Superbugs Unleashed: The Urgency of Addressing the Global Infection Crisis
Full text linkThe global infection crisis poses a significant threat to public health, with the emergence and spread of antibiotic-resistant bacteria or "superbugs" becoming a major concern. The crisis has been fueled by various factors, including overuse of antibiotics, inadequate infection prevention and control measures, and the lack of investment in research and development of new treatments. Addressing this issue requires a comprehensive approach that involves improving surveillance and monitoring systems, promoting individual responsibility, and investing in research and development. Collaboration between stakeholders, including governments, healthcare providers, researchers, and the public, is crucial in overcoming the challenges posed by the global infection crisis. Despite promising advances in emerging technologies, sustained investment in research and development is necessary to ensure continued progress in addressing the issue. Failure to take action risks a future where superbugs run rampant and existing treatments become ineffective. It is time to act decisively to halt the spread of superbugs and prevent a global health crisis
Kartagener\u27s syndrome with Dextrocardia - A case report
Full text linkOne rare variant of immotile cilia syndrome is known as Kartagener\u27s syndrome. The sinus, eustachian tube, middle ear, and respiratory tract cilia are all impacted by Kartagener syndrome. The inability or improper movement of these cilia causes persistent issues with the ear and sinuses. Some individuals with dextrocardia may not experience any symptoms, while others may have heart-related issues or other associated health problems. Diagnosis typically involves imaging studies such as X-rays, echocardiograms, or CT scans to visualize the position of the heart and other organs. Treatment depends on the presence of any associated heart defects or health issues. In many cases, individuals with dextrocardia can lead normal, healthy lives with proper medical management. Close collaboration between patients and healthcare providers is essential for individuals with dextrocardia to track their heart health and general wellness. Regular check-ups and appropriate medical interventions, if needed, can help manage any potential complications associated with this condition. Individuals with dextrocardia need to work closely with healthcare professionals to monitor their heart health and overall well-being. Regular check-ups and appropriate medical interventions, if needed, can help manage any potential complications associated with this condition.
 
LARGE VESSEL VASCULITIS IN A CASE OF HLAB27 ASSOCIATED AXIAL SPONDYLOARTHRITIS
Full text linkA 24yr old male, with history of inflammatory back pain of 6 years, diagnosed as Radiographic axial spondyloarthritis, using alternate therapies, presented with incidentally found discrepancy of pulses and blood pressure in upper and lower extremities on follow up. Spondyloarthritis disease burden was high with elevated inflammatory markers, high disease activity was observed.
Imaging of blood vessels with CT aortography revealed thrombotic occlusion of upper limb arteries and stenosis of large vessels. Evaluation for underlying procoagulant state was negative. FDG- PET CT scan revealed metabolically active vasculitis involving ascending, arch, and descending aorta, brachiocephalic trunks with occlusive thrombosis of carotid and upper limb vessels. Concomitant occurrence of Takayasu arteritis with Ankylosing Spondylitis was contemplated, considering several reported associations of the two disorders in literature. But owing to the chronic underlying Axial Spondylitis with high disease activity, Spondyloarthritis associated aortitis was considered. High dose glucocorticoids were administered, Anti TNF agents initiated after latent TB prophylaxis.
Presence of high inflammatory markers in Spondyloarthritis should alert one to look for extra musculoskeletal manifestations in Spondyloarthritides in the form of vasculitis
A Study Of The Diaphyseal Nutrient Foramina Of Dried Bangladeshi Fibulae
Full text linkContext: The fibula serves crucial functions in lower limb biomechanics and is frequently used in reconstructive surgery. Understanding its nutrient foraminal patterns is essential for surgical success and forensic applications. However, population-specific data for Bangladeshi fibulae has been lacking.
Objectives: To determine the morphometric characteristics of diaphyseal nutrient foramina in dried Bangladeshi fibulae.
Methods: This cross-sectional analytical study examined 120 dry fully ossified left human fibulae (68 male, 52 female) at Dhaka Medical College. Measurements included total length, diaphyseal dimensions, nutrient foraminal characteristics (number, position, direction), and talar facet parameters. Sexual dimorphism was assessed using unpaired Student\u27s t-test and chi-square test.
Results: Significant sexual dimorphism was observed in total length (male: 35.41 ± 1.67 cm, female: 32.72 ± 1.28 cm, p<0.001), midshaft diameter (male: 14.01 ± 1.07 mm, female: 13.21 ± 0.85 mm, p<0.001), and nutrient foraminal measurements. Single nutrient foramen predominated in both sexes (male: 95.6%, female: 92.3%), with primarily downward direction (male: 95.6%, female: 100%). Type-2 Foraminal Index was most common (male: 98.5%, female: 98.1%). Nutrient foramina were predominantly located on the posterior surface in males (42.6%) and medial crest in females (32.7%).
Conclusion: This study establishes baseline morphometric data for Bangladeshi fibulae, demonstrating significant sexual dimorphism and consistent nutrient foraminal patterns. These findings have immediate applications in surgical planning, particularly for fibular grafting procedures, and provide valuable reference data for forensic sex determination in the Bangladeshi population
Path to a Peaceful Death: Coping with Terminal Illness: Path to a Peaceful Death
Full text link Terminal illness can cause immense suffering, both physical and emotional, for patients and their families. However, with appropriate care and support, patients can experience a peaceful death. This article reviews the literature on peaceful death from terminal illness, including the psychological, emotional, and physical factors that contribute to a peaceful death. The article highlights the importance of early palliative care and psychological interventions in improving the quality of life and reducing suffering for patients with terminal illness. The role of emotional support and legacy-making in enhancing well-being for patients are also discussed. The article concludes by stressing the need for continued efforts to improve end-of-life care for patients with terminal illness
A Case Series Report on Congenital pulmonary airway malformation – antenatal diagnosis and post-natal follow up
Full text linkCongenital pulmonary airway malformation is the most commonly detected congenital lung defect in the ante-natal period. CPAM is a rare developmental, non-hereditary dysplastic lung lesion. No obvious association with maternal age, race or exposure to any given factor could be ascertained. It has an incidence about 1:1500-4000 of all live birth. We present four cases of congenital pulmonary airway malformation: antenatally detected by ultrasound with their follow up in post-natal period. Three of them have normal uneventful post-natal period. One child was normal for six months of age then developed frequent respiratory tract infection.
Key words-CPAM, USG, cystic lung lesion
 
A SUSPECTED CASE OF ACUTE APPENDICITIS REVELAED TO BE ISOLATED SUBMUCOSAL LIPOMATOSIS OF APPENDIX ON COMPUTED TOMOGRAPHY: A CASE REPORT
Full text linkSymptomatic isolated submucosal intestinal lipomatosis is a rare entity [1,2]. Also, few cases have been reported in literature. Here, we are presenting computed tomography findings of a rare case of isolated submucosal lipomatosis of appendix presumptively diagnosed as acute appendicitis in a 72-year-oldfemale. This case highlights the importance of considering isolated submucosal lipomatosis as a differential diagnosis in instances of suspected acute appendicitis, especially when clinical findings are inconclusive.
 
Refeeding Syndrome: A Multidisciplinary Challenge in Patient Care – A Narrative Review
Full text linkRefeeding syndrome (RFS) is a serious metabolic condition that occurs when nutrition is reintroduced to malnourished individuals after prolonged fasting or starvation. The abrupt shift from catabolism to anabolism triggers rapid insulin release, leading to critical electrolyte imbalances such as hypophosphatemia, hypokalaemia, and hypomagnesemia, which can result in cardiac, respiratory, and neurological complications.
The incidence of RFS varies across populations, with higher prevalence in ICU patients, those receiving total parenteral nutrition, the elderly, individuals with chronic illnesses, pregnant women, and those with anorexia nervosa. Major risk factors include prolonged fasting, malnutrition, gastrointestinal diseases, and alcoholism. Clinical features range from fluid retention, arrhythmias, confusion, and muscle weakness to life-threatening outcomes like heart failure or respiratory collapse.
Prevention involves gradual reintroduction of calories, electrolyte monitoring, and thiamine supplementation to minimize complications. Nurses play a pivotal role by identifying at-risk patients, monitoring electrolyte levels, and ensuring appropriate nutritional support. Their responsibilities extend to educating patients and families, providing emotional support, and coordinating care with dietitians and physicians to prevent adverse outcomes. A multidisciplinary approach is essential for the safe management of RFS, ensuring better patient recovery and survival
Antimicrobial Resistance and its Impact on Public Health
No full textAim of the Study: The current study addresses the increasing threat of AMR and its direct impact on global public health. It aims to contribute to the existing knowledge about the key challenges of AMR, bringing attention to the need for further research and creating a combined effort in the battle with antimicrobial resistance.
Background & Methods: Antimicrobial resistance (AMR) has been considered one of the key problems that humankind has come across, showing a massive impact on public health globally. The continuous emergence of new microbial strains complicates it further by reducing the efficacy of the available antimicrobial drugs. For the current study, various scientific journals were studied from multiple resources. Furthermore, the websites of policymakers and agencies associated with this cause were studied and referred to.
Results & Conclusions: The study has revealed a concerning trend of a steep increase in resistance of pathogens to antimicrobial agents. The major contributing factors which were identified during this study include misuse and overuse in the healthcare sector, inadequate prevention of infections and disease control, overuse in agriculture and the lack of novel antimicrobial agents. Several policies like the “One Health” approach by the Centers for Disease Control and Prevention (CDC) and the United Nations Sustainable Development Goals (SDGs) have been put in place as a means to combat the global public health problem. The study also highlights the need for policymakers, stakeholders and researchers to work in unison to combat the global issue