Association between Pre-Operative Total Prostate-Specific Antigen and Survivorship of Prostate Cancer following Radical Prostatectomy: A Systematic Review.

OBJECTIVE: This review aimed to systematically quantify the association between pre-operative total prostate-specific antigen (tPSA) and survivorship of prostate cancer (PCa). METHODS: Data sources for the review included MEDLINE, PubMed, Cochrane Library, CINAHL, Academic Search Complete, PsycINFO, and relevant reference lists. Databases were searched from inception to June 2022. The study took place between May 2022 and March 2023. We included studies that applied a quantitative approach to examine the interaction between pre-operative PSA and survivorship of PCa. Pre-operative PSA constituted the independent variable, whereas survivorship of PCa as measured by biochemical recurrence and mortality constitute the outcome variable. A risk of bias assessment was conducted with the aid of a mixed-method appraisal tool. We employed meta-analysis to quantify the association of pre-operative PSA with biochemical recurrence and mortality and computed I2 to assess the degree of heterogeneity. RESULTS: We found a positive weak association between pre-operative PSA and biochemical recurrence (hazard ratio [HR] = 1.074; 95% CI = 1.042-1.106). With a median rise in PSA (≥2 ng/mL), the likelihood for biochemical recurrence increase by approximately 7.4%. There was statistically a significant association between PSA and mortality (HR = 1.222, CI = 0.917-1.630). CONCLUSIONS: Biochemical recurrence associates with pre-operative PSA in an inconsistent manner. The sole use of pre-operative PSA in estimating post-prostatectomy biochemical recurrence should be discouraged. There is need for a multifactorial model which employs a prudent combination of the most important and cost-effective biomarkers in predicting post-prostatectomy biochemical recurrence.

Assessment of thyroid function of newly diagnosed SARS-CoV-2 infected patients in Nigeria.

INTRODUCTION: the outbreak and rapid spread of the novel SARS-CoV-2, the causative agent of the coronavirus disease 2019 (COVID-19), has evolved into an unprecedented global pandemic. The infection impairs several human organs and systems, however, it is not clear how it affects thyroid function. The study therefore aimed at measuring plasma levels of thyroid hormones and Hs-CRP in COVID-19 patients and apparently healthy uninfected controls to assess the possible effect of SAR-CoV-2 infection on thyroid function. METHODS: in this cross-sectional study carried out between May-August 2020, 90 consenting participants comprising 45 COVID-19 patients and 45 apparently healthy uninfected controls were recruited. Plasma FT3, FT4, TSH and Hs-CRP were measured using Enzyme Linked Immunosorbent Assay (ELISA) method. Data was analysed using SPSS version 20 and statistical significance set at p < 0.05. RESULTS: the mean plasma FT3 and TSH concentrations were significantly higher in COVID-19 patients compared to controls (p < 0.001, p < 0.001 respectively). Euthyroidism was observed in all uninfected controls, whereas 35 (77.8%) COVID-19 patients were euthyroid. Sick euthyroid and subclinical hypothyroidism was observed in 7 (15.6%) and 3 (6.7%) COVID-19 patients, respectively. CONCLUSION: though there was a preponderance of euthyroidism among COVID-19 patients, significantly higher mean plasma levels of TSH and FT3, sick euthyroid syndrome and subclinical hypothyroidism observed among some COVID-19 patients may be indicative of disease-related thyroid function changes. Hence, there is need to pay attention to thyroid function during and after treatment of COVID-19.

Unexpected delivery: a case report of cryptic pregnancy in Nigeria.

The etiology of cryptic pregnancy has not been fully elucidated and there exist misconceptions about this phenomenon in our contemporary Nigerian society. This case presents the first case report of cryptic pregnancy in sub-Saharan Africa. A case of a 19 year old overweight female student who presented to the sick bay at 01: 30 hours with a 3-day history of lower back pain, abdominal discomfort and constipation. At the sick bay the general practitioner on call asked if she was pregnant and she vehemently said no, recounting that she sees her menstruation regularly. Abdominal examination however, revealed a gravid uterus of about 36 weeks and vaginal examination showed a fully dilated cervix. She was surprised, terrified and confused and only remembered having unprotected sexual intercourse many months earlier. Barely two hours later, she gave birth via spontaneous vaginal delivery, to a live female infant at 03: 14 hours. This case emphasizes the need for general practitioners and specialists in sub-Saharan Africa to be aware of the phenomenon of cryptic pregnancy, which involves women not being conscious of their gravid state until final weeks of gestation or at delivery, to reduce neonatal and maternal complications.