Boerhaave's syndrome after pentazocine-induced vomiting in a 21-year-old male with asthma: a case report.

Boerhaave's syndrome is an uncommon syndrome characterized by spontaneous rupture of the oesophagus with a high mortality rate. While excessive alcohol intake and binge-eating are the classic precipitants of this syndrome, medication-induced vomiting causing Booerhave's is quite uncommon. Traditionally managed operatively, conservative management is being increasingly reported in selected cases. We report the case of 21-year-old male with who developed sudden onset chest pain and dyspnoea after pentazocine induced vomiting. He was referred after lack of response to initial treatment for acute severe asthma. A chest CT scan showed pneumomediastinum, subcutaneous emphysema and oesophageal tear. He was managed conservatively with oxygen therapy, nil per mouth and antibiotics with improvement of symptoms and discharge after 8 days.

Prevalence and correlates of anemia in type 2 diabetes mellitus: A study of a Nigerian outpatient diabetic population

Background: Anemia is reportedly common in type 2 diabetes mellitus (T2DM), and it is often unrecognized oroverlooked, despite its contribution to the morbidity and mortality. With the growing burden of diabetes in sub­Saharan Africa, the occurrence of anemia among T2DM patients needs to be adequately characterized. Objective: We aimed to determine the prevalence and correlates of anemia among Nigerian patients with T2DM attending a tertiary outpatient clinic. Materials and Methods: It was a cross­sectional study involving 155 patients with T2DM and 78 controls without diabetes. Full blood count, serum creatinine, fasting plasma glucose,glycosylated hemoglobin (HbA1c), and spot urinary albumin­creatinine ratio were determined in the patients. The frequency anddeterminants of anemia among the participants were determined. Results: Anemia was found in 45.2% of the T2DM patients, compared the to 28.2% of the controls (P = 0.012). The T2DM patients were twice as likely to have anemia as the controls. Among T2DM patients with anemia, majority (68.6%) had a normocytic anemia, while 25.7% and 5.7% had microcytic and macrocytic anemia, respectively. The independent predictors of anemia were longer duration of diabetes and lower estimated glomerular filtration rate (eGFR) with odds ratio of 2.1 and 4.7, respectively. Conclusion: Anemia is common in T2DM patients including those with normal eGFR. Longer duration of diabetes and declining eGFR were the major factors associated with anemia. Screening for anemia is recommended for patients with T2DM as part of their routine annual evaluation, especially in those with longer disease duration and eGFR <60 ml/min