Prevalence of Extra-pulmonary Tuberculosis among Patients Diagnosed with Tuberculosis in a Tertiary Hospital in Bauchi, Northeastern Nigeria - A Five-Year Review.

BACKGROUND: Extra- pulmonary tuberculosis ( EPTB) contributes to the burden of Tuberculosis (TB) especially in developing countries. Despite this fact, information on the prevalence of EPTB is scarce. The aim of this study is to determine the five-year prevalence of EPTB among patients diagnosed with tuberculosis (TB) that attended and received treatment for TB at directly observed treatment short course (DOTS) clinic of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, North-eastern Nigeria. METHODOLOGY: This is a retrospective review of all patients' records diagnosed with TB that attended and received treatment at the TB DOTS clinic of ATBUTH, Bauchi from January, 2017 to December, 2021. Extracted data was analyzed using IBM SPSS version 23.0 software. RESULT: There were 676 patients comprising of 389 (57.5%) males and 287 (42.5%) females and out of these, 208 had EPTB. The estimated five-year prevalence of EPTB in the studied cases was 30.8%. Tuberculosis of the spine was the predominant form of EPTB in this study with 117 (56.3%) cases. This was followed by TB Lymph nodes 40 (19.2%), TB Abdomen 36 (17.3%), TB Pleura 6 (2.9%), TB Pericardium 3 (1.4%), 2 (1.0%) each of TB Breast and CNS, and 1 (0.5%) each of TB Testicle and Upper arm. Seventy-eight (11.5%) patients were HIV positive, 549 (81.2%) were HIV-negative and the HIV status of 49 (7.2%) patients was unknown. CONCLUSION: The study showed prevalence of EPTB is still high as reported in some literature. Tuberculosis of spine was the commonest form of EPTB. These findings underscore the need for continued screening of EPTB to reduce the burden of TB in resource-poor countries.

CONTEXTE: La tuberculose extra-pulmonaire (TEP) contribue au fardeau de la tuberculose (TB), en particulier dans les pays en développement. Malgré ce fait, les informations sur la prévalence de la TEP sont rares. Le but de cette étude est de déterminer la prévalence sur cinq ans de la TEP chez les patients diagnostiqués avec la tuberculose (TB) qui ont fréquenté et reçu un traitement pour la TB au centre de traitement de courte durée sous observation directe (DOTS) de l'hôpital universitaire Abubakar Tafawa Balewa (ATBUTH), Bauchi, Nord-Est du Nigéria. MÉTHODOLOGIE: Il s'agit d'une revue rétrospective de tous les dossiers des patients diagnostiqués avec la TB qui ont fréquenté et reçu un traitement au centre de traitement DOTS de l'ATBUTH, Bauchi, de janvier 2017 à décembre 2021. Les données extraites ont été analysées à l'aide du logiciel IBM SPSS version 23.0. RÉSULTAT: Il y avait 676 patients comprenant 389 (57,5%) hommes et 287 (42,5%) femmes, dont 208 avaient une TEP. La prévalence estimée sur cinq ans de la TEP dans les cas étudiés était de 30,8%. La tuberculose de la colonne vertébrale était la forme prédominante de TEP dans cette étude avec 117 (56,3%) cas. Cela a été suivi par la TB des ganglions lymphatiques 40 (19,2%), la TB abdominale 36 (17,3%), la TB pleurale 6 (2,9%), la TB péricardique 3 (1,4%), 2 (1,0%) cas chacun de TB du sein et du SNC, et 1 (0,5%) cas chacun de TB testiculaire et du bras supérieur. Soixante-dix-huit (11,5%) patients étaient séropositifs, 549 (81,2%) étaient séronégatifs et le statut VIH de 49 (7,2%) patients était inconnu. CONCLUSION: L'étude a montré que la prévalence de la TEP est encore élevée, comme le rapporte certaines littératures. La tuberculose de la colonne vertébrale était la forme la plus courante de TEP. Ces résultats soulignent la nécessité de poursuivre le dépistage de la TEP pour réduire le fardeau de la TB dans les pays à ressources limitées. MOTS CLÉS: Tuberculose Extra-Pulmonaire, Prévalence, Bauchi, Nord-Est du Nigéria.

Serum Immunoglobulin E Level and Its Relationship with Eosinophil Count among Patients with Allergic Rhinitis in Tertiary Hospital in Bauchi, Northeastern Nigeria: A Cross-Sectional Study.

BACKGROUND: Allergic rhinitis is an immunoglobulin E-mediated hypersensitivity disease of the mucous membrane of the nasal airway. There is a paucity of information regarding serum immunoglobulin E level and its relationship with eosinophil count among patients with allergic rhinitis in our facility and Northeastern Nigeria. AIM: To determine serum immunoglobulin E level and its relationship with eosinophil count among patients with allergic rhinitis. METHODOLOGY: It was a cross-sectional study of consecutive patients diagnosed with allergic rhinitis that were recruited from the ear, nose, and throat surgery and respiratory medicine clinics of ATBUTH, Bauchi, Bauchi State, Northeastern Nigeria, from January 01, 2022, to May 31, 2023. Five milliliters of blood were analyzed for immunoglobulin E estimation using an immunoglobulin E ELISA kit and determination of eosinophil count using pack five hematologic autoanalyzer. Extracted data were analyzed using IBM SPSS version 23.0 software. RESULT: There were 61 patients studied comprising 22 (36.1%) males and 39 (63.9%) females with a male-to-female ratio of 1:1.7. Their ages range from 18 to 77 years old. The mean age, serum IgE level, and eosinophil counts of all three patients were 38.65 ± 14.34 years, 371.24 ± 82.63 IU/ml, and 3.35 ± 2.87%, respectively. All (100%) participants had raised serum IgE levels, and 88.5% had normal eosinophil count. There was no significant correlation between the serum IgE level and eosinophil counts (r = -0.206; P = 0.112). CONCLUSION: All of the participants had a high serum IgE level. There was no significant association between serum IgE and eosinophil count.

Diagnostic usefulness of serum procalcitonin in patients with bacterial sepsis.

Background: The Sequential Organ Failure Assessment (SOFA) score is used for the diagnosis of sepsis and involves clinical and laboratory parameters that may not be readily and/or timely available in most resource-poor settings. Procalcitonin (PCT) has its level changed in response to bacterial sepsis and its measurement costs only a fraction of the total cost of investigations required to calculate SOFA score. This study aims to determine the diagnostic usefulness of PCT in bacterial sepsis. Materials and Methods: Ninety-nine participants were studied, divided into three groups: apparently healthy volunteers, those with bacterial infection without sepsis (SOFA score <2), and patients with bacterial sepsis (positive culture and SOFA ≥2). PCT level of each participant was measured and median group levels compared. Pearson's correlation was used to determine the correlation between serum PCT levels and SOFA scores in the sepsis group using a significance level of 5 percent (P < 0.05). Diagnostic usefulness of PCT was assessed using receiver operating characteristic (ROC). Result: Positive correlation was found between serum PCT levels and SOFA scores among patients with sepsis r = 0.42, P = 0.016. At a concentration of ≥4.25 ng/ml, serum PCT as a surrogate for SOFA score had a sensitivity and specificity of 57.60% and 84.80%, respectively, for indicating sepsis. The area under the ROC curve (AUC) was 0.74 (95% CI {0.62 to 0.86}, P = 0.001). Conclusion: Serum PCT concentration was significantly higher in bacterial sepsis compared to bacterial infection without sepsis and healthy state. PCT concentration demonstrated positive correlation with SOFA score in bacterial sepsis and can be used as surrogate for sepsis screening/monitoring in resource-poor settings.

Osmotic demyelination syndrome following acute kidney injury with hypernatremia.

Osmotic demyelination syndrome (ODS) is a life-threatening neurological condition often associated with rapid correction of hyponatremia. While ODS is thought to be rare, with prevalence rates of not more than 0.5% in autopsy series, mortality rates are as high as 90% in some studies. Thus, timely diagnosis and life-saving treatment rest on a high index of suspicion among clinicians. In this report, we discuss the case and literature review of a 45-year-old female with sepsis, acute kidney injury, and spontaneous hypernatremia who developed ODS but responded to therapy with high dose steroids, antibiotics, and supportive care.