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Two-year follow-up of patient showed no recurrence of the lesion. Conclusion Due to the similarity in the clinical symptoms of CA-ex-PA and benign pleomorphic adenoma, it is vital that clinicians maintain a high degree of clinical vigilance, considering the oddity of this malignancy. © 2019 Khanna et al.Introduction Burkitt Lymphoma is the fastest growing tumor in human and the commonest of the childhood malignancies. Generalized lymphadenopathy is a common feature of immunodeficiency associated Burkitt lymphoma but an uncommon presentation of the endemic type in Human Immunodeficiency Virus (HIV) negative children. Case presentation The authors report a 6 year old HIV negative boy who presented with generalized lymphadenopathy, cough, weight loss, fever and drenching night sweat and had received native medication as well as treatment in private hospitals. His examination revealed hepatosplenomegaly, bull neck with generalized significant massive lymphadenopathy. Diagnosis was missed initially until a lymphnode biopsy for histology confirmed Burkitt lymphoma. He was managed on combination chemotherapy with complete resolution and now on follow up. Conclusion To the best of our knowledge, this is the first documented report of its kind of endemic Burkitt lymphoma involving lymphnodes generally as the primary site. High index of suspicion and early biopsy are the key in this uncommon presentation. © 2019 Ezenwosu et al.Introduction Burkitt's lymphoma (BL) is a virus associated childhood B-cell cancer common in Eastern Africa. Continued survival of B-cells in germinal centres depend on expression of high affinity immunoglobulins (Ig) to complementary antigens by somatic hypermutation of Ig genes. Cellular microRNAs, non-coding RNAs have been reported to play role in cell cycle regulation. Both viral antigen dependent mutation and micro-RNA expression maybe involved in BL pathogenesis. Objective To describe immunoglobulin heavy variable (IgHV) rearrangement and micro-RNA expressions in BL tumours. Methods Genomic DNA were extracted and purified from BL tissue blocks at Moi Teaching and Referral Hospital, before amplification using IgHV consensus primers and sequencing. The sequences were then aligned with germline alleles in IMGT/V-QUEST® database. Total RNA extracted from tissue blocks and cell lines were used to determine relative expression of hsamiR-34a and hsa-miR-127. Results In all tumours, allele alignment scores and number of mutations range were 89.2-93.2%, 15-24 respectively. The range of IgHV amino acid changes were higher in EBER-1+ (15-25) than EBER-1- (9-15). selleck chemicals In MYC+ tumours, the relative expression were hsa-miR-127(2.09);hsa-miR-34a (2.8) and MYC- hsa-miR-127 (1.2), hsa-miR-34a (1.0). Conclusion B-cell in BL contained somatic mutated IgHV gene and upregulated cellular microRNAs with possible pathogenetic role(s). © 2019 Ndede et al.Background We investigated the relationship between myometrial invasion and the prognostic factors on overall and progression free survival in endometrial carcinoma. Methods 122 cases operated with endometrial cancer were included into the study. Progression-free survival and overall survival were evaluated according to degree of myometrial invasion. We also investigated the relationship between myometrial invasion and prognostic factors. Results The 5- year progression-free survival rate was 90 % in stage I, 66 % in stage II, 32 % in stage III and 60 % in stage IV. The 5- year overall survival rate was 95 % in stage I, 89 % in stage II, 49 % in stage III and 30 % in stage IV. The progression free survival and overall survival for patients with more than 50 % myometrial invasion were detected 67 % at 58 months and 66 % at 60 months, respectively. The clinicopathological variables that significantly correlated with myometrial invasion of more than 50 % were as follows pelvic lymph node metastasis (p 0,00029-OR 11.2), cervical stromal invasion (p 0008-OR7.9), LVSI (p less then 0.0001-OR 16.5). Conclusion The depth of myometrial invasion is one of the most important prognostic indicators and determinants of therapy in endometrial cancer. © 2019 Dane et al.Background Variceal upper gastrointestinal bleeding (UGIB) is common in sub-Saharan Africa (SSA). However, poor access to endoscopy services precludes the diagnosis of varices. Objectives We determined the diagnostic accuracy of routine clinical findings for detection of esophageal varices among patients with UGIB in rural SSA where schistosomiasis is endemic. Methods We studied patients with a history of UGIB. The index tests included routine clinical findings and the reference test was diagnostic endoscopy. Multivariable regression with post-estimation provided measures of association and diagnostic accuracy. Results We studied 107 participants with UGIB and 21% had active bleeding. One hundred and three (96%) had liver disease and 86(80%) varices. Factors associated with varices (p-value 90% in detection of varices with a number needed to misdiagnose of 13(number of patients who needed to be tested in order for one to be misdiagnosed by the test). Conclusion Where access to endoscopy is limited, routine clinical findings could improve the diagnosis of patients with UGIB in Africa. The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic. © 2019 Opio et al.Introduction Gram-negative bacteria are the major cause of urinary tract infections (UTI) in children. There is limited data on UTI systemic response as measured using C-reactive protein (CRP). Here, we report the association of CRP and UTI among children attending the Bugando Medical Centre, Mwanza, Tanzania. Methods A cross-sectional study was conducted between May and July 2017. Urine and blood were collected and processed within an hour of collection. Data were analyzed using STATA version 13. Results Of 250 enrolled children, 76(30.4%) had significant bacteriuria with 56(22.4%, 95%CI; 11.5-33.3) having gram-negative bacteria infection. There was dual growth of gram-negative bacteria in 3 patients. Escherichia coli (32.2%, 19/59) was the most frequently pathogen detected. A total of 88/250(35.2%) children had positive CRP on qualitative assay. By multinomial logistic regression, positive CRP (RRR=4.02, 95%CI 2.1-7.7, P less then 0.001) and age ≤ 2years (RRR=2.4, 95%CI 1.23-4.73, P less then 0.01) significantly predicted the presence of significant bacteriuria due to gram-negative enteric bacteria. Conclusion C-reactive protein was significantly positive among children with UTI due to gram-negative bacteria and those with fever. In children with age ≤ 2 years, positive CRP indicates UTI due to gram-negative enteric bacteria. © 2019 Mushi et al.Background Helicobacter pylori frequently causes gastritis and peptic ulcers, and affected children are at risk of developing gastric carcinoma later in adulthood. Methods This was a Hospital based cross sectional study. A total of 200 children aged 6 months to 14 years were enrolled. Study subjects were tested for H. pylori using a standard serology rapid test measuring immunoglobulin G for H. pylori. For risk factors, Chi-square tests were used to test for association and then, odds ratios and their corresponding 95% confidence intervals and p-values were computed using logistic regression. Results The overall seroprevalence of H. pylori was 11.5%. The following factors were associated with H. pylori infection Age group above 10 years, keeping a dog and household size. The independent predictors of H. pylori were Fathers' occupation, keeping a dog, indoor tap water, age group, household size and diabetes mellitus type 1.. Conclusion The seroprevalence of H. pylori antibodies was lower compared to most developing countries. Keeping a dog, household size, indoor tap water, fathers' occupation and diabetes mellitus type 1 were found to be independent predictors of presence of H. pylori antibodies. © 2019 Msekandiana et al.Introduction Pneumocystis jirovecii is the causative organism of Pneumocystis pneumonia (PCP) in humans, which is more common among immunocompromised patients. Classically patients present with fever, non-productive cough, and dyspnoea. In the HIV-infected individuals the symptoms may be subtle at first, but gradually progress over several weeks. In the HIV-uninfected patient, however, the duration of symptoms is shorter and more severe, mainly due to the increased inflammatory response of the HIV-uninfected patient. Methods This article focuses on the diagnostic methods and then the management and prophylaxis principles of PCP by reviewing the best current practices and guidelines in Africa. Conclusion This overview is presented by clinicians who have experience with PCP and is directed mainly at first-line healthcare providers. © 2019 Govender et al.Background Kenya is home to an estimated 1.7 million people living with HIV/AIDS. According to the Kenya AIDS Indicator survey KAIS 2012, HIV prevalence in the age group 15-24 stood at 2.2%. Globally, young people aged 15-24 are a highly vulnerable population with respect to HIV/AIDS infection and transmission. HIV testing and counseling services play a critical role as an entry point to care and treatment. However, uptake of HIV testing and counseling services among the youth in Kenya has been reportedly low. Youths at Universities are among the priority populations in HIV/AIDS programs. Objectives This study aimed to determine the barriers to uptake and utilization of institution-based voluntary counseling and testing VCT services among students aged 18-24 in selected public universities in Kenya. The specific objectives were to determine the factors associated with uptake and utilization and the association between various socio-demographic factors and service uptake in institutional VCT facilities. MethodMore research should also focus on the persisting risky sexual behaviors among University students despite the high knowledge they have on HIV/AIDS. © 2019 Cheruiyot et al.Background Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population. Therefore, an assessment of PLHIV's NCD risk factors knowledge is quite critical, to design effective NCD prevention programmes. Objective To assess the level of knowledge of modifiable risk factors for NCDs and its associated factors among adults living with HIV in Rwanda. Methods A cross-sectional quantitative design was used to collect the data. The study targeted PLHIV who visited the out-patients' public health centres in three purposively selected provinces of Rwanda. The knowledge assessment questionnaire relating to risk factors for chronic diseases of lifestyle was used to collect the data. Data were analysed using SPSS version 23. Results Of the 794 respondents, 64.6% were women, and the mean age was 37.9 (±10.8) years. The results revealed that the majority of the respondents (65.0%) had low levels of knowledge about NCD risk factors, while some (35.6%) were of the opinion that they had a low risk of contracting NCDs. Good knowledge was significantly associated with high educational status, a low CD4+ cell count ( less then 350 cells/mm3) and normotension. Conclusion The current study findings highlight the need for comprehensive health education, to raise awareness of non-communicable diseases' risk factors for adults living with HIV in Rwanda. © 2019 Biraguma et al.