Diagnosis of Thyroid Neoplasm-Associated Dermatomyositis in Ethiopian Woman.

Background: Dermatomyositis is an inflammatory myopathies causing proximal muscle weakness accompanied by muscular inflammation and skin rash. Dermatomyositis patients have a higher incidence of malignancy as compared to the general population. Case Report: A 52-year-old known female patient with a toxic multi-nodular goiter presented with insidious onset of itchy erythematous rash on her neck and bilateral hands and progressive muscle weakness of 4 months' duration. Associated with this, she had photosensitivity, and periorbital edema of 2 months' duration. On physical examination, she had an anterior neck mass, proximal muscle weakness, periorbital edema, and violaceous skin rash on her bilateral arms, shoulders and neck. Thyroid function tests were normal, creatinine kinase was elevated, and muscle biopsy revealed inflammatory myositis. Ultrasound of the anterior neck mass and analysis of fine needle aspiration suggested thyroid cancer. Conclusion: A high index of clinical suspicion is usually required for early diagnosis of dermatomyositis in resource-limited settings in order to prevent adverse outcomes and identify associated malignancies.

Pediatric lymphatic leishmaniasis: a case report.

BACKGROUND: There are three main forms of leishmaniases: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose, and throat). Leishmaniasis is caused by protozoan parasites, which are transmitted by the bite of infected female phlebotomine sandflies. The disease affects some of the world's poorest people and is associated with malnutrition, population displacement, poor housing, a weak immune system, and lack of financial resources. An estimated 700,000 to 1 million new cases occur annually. Only a small fraction of those infected by parasites causing leishmaniasis will eventually develop the disease. We report a case of exclusive lymph node involvement in leishmaniasis, presenting as localized lymphadenopathies. The diagnosis of lymphatic leishmaniasis was confirmed by the presence of Leishmania donovani bodies in fine needle aspiration cytology, and positive anti-rK39 antibodies. The bone marrow aspiration was negative for Leishmania donovani bodies. Abdominal ultrasound was done and there was no organomegaly. Furthermore, localized lymphadenopathies may provide a diagnostic challenge by clinically mimicking a lymphoma or other causes of lymphadenopathy. Due to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report a case of lymphatic leishmaniasis. CASE PRESENTATION: A 12-year-old Amara male patient presented to the University of Gondar comprehensive specialized hospital, Northwestern Ethiopia, with six discrete right lateral cervical lymphadenopathies, the largest measuring 3 × 2 cm2, with no cutaneous lesion. Fine needle aspiration cytology confirmed the diagnosis of leishmaniasis in lymph node, and he was put on sodium stibogluconate (20 mg/kg body weight/day) and paromomycin (15 mg/kg body weight/day) injections, which are given intramuscularly for 17 days. Having completed his medication at the University of Gondar comprehensive specialized hospital, he had a smooth course and was discharged with appointment scheduled for follow-up after 3 months. CONCLUSION: In the clinical evaluation of a patient with isolated lymphadenopathies, leishmaniasis must be considered as a differential diagnosis in immunocompetent subjects in endemic areas for early diagnostic workup and management.

Wound Healing Activities of Hydromethanolic Crude Extract and Solvent Fractions of Bersama abyssinica Leaves in Mice.

BACKGROUND: Bersama abyssinica leaves are traditionally used for management of wounds in several communities of Ethiopia, despite no scientifically approved studies done on wound healing. Our study planned to work out the wound healing effects of B. abyssinica leaves extract in mice. METHODS: B. abyssinica leaves were extracted with 80% hydromethanol and fractioned with chloroform, hexane, and water. The acute dermal toxicity of the crude extract was evaluated in mice. The crude extract formulated at 5% and 10% w/w ointment was investigated in excision, incision, and burn wound models and solvent fractions in the excision model using simple ointment (negative control) and nitrofurazone 0.2% w/v (positive control). We evaluated histopathological analysis, wound contraction rate, complete epithelialization period, and skin durability. One-way ANOVA followed by the post hoc Tukey HSD test with IBM SPSS software version 23.0 was used for data analysis, and p < 0.05 was considered statistically significant. RESULTS: Hydromethanolic crude extract produced 5% (99.5%) and 10% (100%) wound contraction on the 16th day of the treatment and 5% (18.8) and 10% (28.2) percent reduction in the epithelization period on the excision wound healing model. Hydromethanolic crude extract produced 5% (47.5) and 10% (61.17) percent durability on the incision wound healing model. Hydromethanolic crude extract produced 5% (99.82%) and 10% (100%) wound contraction on the 20th day of treatment and 5% (13%) and 10% (21.7%) reduction in the epithelization period on the burn wound healing model. The chloroform fraction produced 5% (90.17%) and 10% (91.01%), hexane fraction produced 5% (85.81%) and 10% (86.78%), and aqueous fraction produced 5% (99.17%) and 10% (99.38%) wound contraction on the 14th day of the treatment and 5% (18.8) and 10% (28.2) percent reduction in the epithelization period on the excision wound healing model. Both hydromethanolic crude extract and solvent fractions at 5% and 10% (w/w) were significant (p < 0.001) compared with negative control. CONCLUSION: The results of this study showed that both 5% w/w and 10% w/w of 80% hydromethanolic crude extract and solvent fractions of B. abyssinica leaves have wound healing effects.

Evaluation of Wound Healing Activity of Methanolic Crude Extract and Solvent Fractions of the Leaves of Vernonia auriculifera Hiern (Asteraceae) in Mice.

BACKGROUND: Medicinal plants play an important role in treating various diseases. Vernonia auriculifera Hiern is one of the medicinal plants used traditionally for the management of wounds. However, there were no scientific reports documented so far on the wound healing activities to substantiate the claim. Thus, the present study provides a scientific evaluation for the wound healing potential of the crude extract as well as solvent fractions of the leaves of Vernonia auriculifera Hiern. METHODS: Extraction was carried out by maceration using 80% methanol and part of the crude extract fractionated with chloroform, ethyl acetate, and aqueous solvents. Simple ointment bases were prepared using hard paraffin, cetostearyl alcohol, white soft paraffin and wool fat according to British Pharmacopoeia. Then, two types of ointment formulations were prepared from the extract, ie, 5% w/w and 10% w/w. Mice and rats were employed for wound healing study and dermal toxicity test, respectively. Wound healing effects were evaluated by percent of wound contraction, period of epithelialization, tensile strength, and histological analysis as parameters in excision, incision, and burn wound models. Finally, the data were expressed as mean ± SEM, and the results were analyzed using one-way ANOVA followed by post hoc Tukey-test. RESULTS: In the excision wound model, the 10% w/w crude extract ointment showed significant wound contraction (P < 0.001) from day 4 to day 18 as compared to the negative control. Both the 5% w/w (P < 0.001) and 10% w/w (P < 0.05) crude extract ointments have showed statistically significant difference in epithelialization period as compared to the negative control. Groups treated with the ethyl acetate and aqueous fractions ointments in incision wound model showed a statistically significant (P < 0.001) increase in tensile. The 10% w/w and 5% w/w ointments of the crude extract showed a significant (P < 0.001) increase in breaking strength compared to simple ointment and the untreated control groups. In burn wound model, significant reduction in epithelialization period was observed in 5% w/w (P < 0.05) and 10% w/w (P < 0.001), and the percentage of wound contraction was significantly increased in most of post wounding days by 10% w/w (P < 0.001) and 5% w/w (P < 0.05) crude extract ointments and compared to the negative control. CONCLUSION: The crude, aqueous, and ethyl acetate fraction of Vernonia auriculifera leaves possess wound healing activities. This finding justifies the use of the leaves of this plant for wound healing as claimed in the traditional medicine literature.