Snakebite is prevalent in some communities in Nigeria. Unfortunately, some patients still find it difficult to readily assess health care, resulting in late presentation, whereas others will prefer to use traditional remedies, only seeking orthodox care late after experiencing failure of traditional remedies; this accounts for significant increase in cases of complications and mortalities witnessed. Therefore, the case of an 8-year-old boy who had carpet viper bite on the right hand that developed gangrene due to late presentation is highlighted.

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The small-cell carcinoma of hypercalcemic type (SCOCHT) of the ovary is a rare and highly aggressive tumor. Due to the rarity of the disease, there is no consensus on its optimal therapy, and the treatment options are usually combines surgery, chemotherapy, and radiotherapy. Herein, we report the clinical presentation, management, and outcome of three cases of SCCOHT treated at Salah Azaiez Institution in Tunisia. The literature on this rare disease is also reviewed.

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A 75-year-old man, with nasopharyngeal cancer, had multiple metastases on 2-F-18 Fludeoxyglucose positron emission tomography imaging. The left hemitongue had increased activity as compared with the right. This was not the result of the presence of a metastasis to the tongue or underlying gross tumors, as shown by a negative magnetic resonance imaging brain and failure to demonstrate a lesion over a period of weeks. Uptake was likely related to the left hemiglossal muscle activity. This was made more apparent by decreased uptake on the right side of the tongue (up to the midline) as a result of cranial nerve hypoglossal injury.

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We present a rare case of cardiac tamponade as the initial presentation of primary hypothyroidism. A 38-year-old woman presented with shortness of breath and fatigue for 2 months. She had cardiomegaly on chest X-ray, and transthoracic echocardiogram showed evidence of cardiac tamponade. Urgent pericardiocentesis was performed; the pericardial fluid was exudative with negative cultures and cytology. She was also found to have pleural effusions and ascites. Laboratory tests revealed severe hypothyroidism, and thyroxine replacement therapy was started. The case highlights that the diagnosis of hypothyroidism should not be overlooked during the evaluation of patients with pericardial effusions.

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Black hairy tongue is a temporary, harmless oral condition that gives the tongue a dark, furry appearance. The distinct look usually results from a build-up of dead skin cells on the papillae of the surface of the tongue that contains taste buds. The differential diagnosis includes a variety of medical conditions and medication side effect. We present a medical quiz about an occasionally missed cause of black hairy tongue.

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Background: In resource-poor settings, neurocysticercosis (NCC) is a common cause of acute presentation with seizures. There remains an uncertainty regarding its changing epidemiology in resource-rich settings such as Qatar. Patients and Methods: We carried out a retrospective review of case notes and electronic records of 2450 patients presenting to an acute admissions unit with suspected NCC between January 2015 and May 2018. Results: Of the 2450 records reviewed, 26 cases satisfied the Del Brutto criteria for NCC. The mean age at presentation was 31 ± 9.74 years, made up of an entirely male population. There was a higher proportion of patients (n = 20) presenting with seizures 76.9%, of which the most dominant subtype was generalized tonic–clonic seizures 73.7% (n = 14). Advancing age and intracerebral calcifications were associated with an increased risk of having seizures (confidence interval [CI]: 1.18–18.8, P = 0.019, and CI: 0.034–0.9, P = 0.036, respectively). Conclusion: The migrant population in Qatar continues to account for the preponderance of NCC morbidity with seizure, in its various phenotypes, the most common mode of presentation. To our knowledge, this is the most up-to-date account of this disease with interesting and changing demographics in this part of the world.

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Background: Adverse drug reactions (ADRs) can be confined to either skin or be a part of systemic reaction such as drug hypersensitivity syndrome or toxic epidermal necrolysis. Objective: The objective is to evaluate the incidence, causality, severity, preventability, and risk factors of ADRs in the dermatology department of a charitable hospital in India. Patients and Methods: A prospective observational study was carried out over a period of 8 months in the dermatology department. The WHO and Naranjo's scales evaluated the suspected ADRs for causality assessment, severity by Hartwig and Siegel Scale, and preventability by modified Schumock and Thornton Scale. Results: A total number of 200 eligible patients were enrolled in the study. Out of 200, 18 patients developed ADRs. The incidence of dermatological ADRs in the study was 9%. The most commonly manifested ADRs were Stevens–Johnson syndrome (SJS) (22.2%) followed by skin rashes (16.7%) and others. The maximum number of ADRs were observed with antibiotics (33.5%), followed by antiepileptic drugs (16.7%) and nonsteroidal anti-inflammatory drugs (NSAIDs) (16.7%). According to the WHO and Naranjo's scales, most of the reactions were probable with 61.1% and 55.6%, respectively. Most of the ADRs were moderately severe (66.6%) and were not preventable (55.6%). Conclusions: SJS and rashes were the most commonly observed clinical pattern of ADRs. The most common drug class responsible for ADRs was antibiotics, followed by antiepileptic drug and NSAID's. Dermatological ADRs varied in their causality, severity, and preventability.

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Background: Good oral hygiene maintain for pregnant women is the optimal goal of all health-care professionals. The purpose of this study is to assess and compare the prevalence of self-reported gingivitis among pregnant and nonpregnant women in the city of Derna, Libya. Materials and Methods: a cross-sectional survey design was used. A total of 363 women (182 [50.1%] pregnant and 182 [49.9%] nonpregnant women) who attended to public and private clinics of maternity health care in Derna city were randomly invited to have face-to-face interviews to evaluate their gingival and dental status. A questionnaire was used to explore the gingival status of the participants, including oral hygiene practice, gingival bleeding, socioeconomic status, and dental conditions. Collected data were analyzed using the SPSS software and applying appropriate statistical tests at P = 0.05. Results: The overall mean age of the participants is 27.60 ± 6.04 years (28.70 ± 6.09 and 26.50 ± 5.80 years in pregnant and nonpregnant women, respectively, P = 0.001). The prevalence of gingivitis (bleeding on using of tooth brushing) among all participated was 64.7% (68.1% and 61.3% for pregnant and nonpregnant women, respectively, P = 0.175). The pregnant women were more likely to report bleeding from their gum during brushing their teeth as compared to the nonpregnant women (odds ratio = 1.34, 95% confidence interval, 0.87–2.07). Conclusion: The prevalence of self-reported gingivitis in our study did not approach the statistically significant difference between pregnant and nonpregnant women. However, promoting oral health during pregnancy should be a routine practice to raise awareness about this common disease within pregnant women community.

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Background/Aim: Data on birth registration (BR) is needed in planning and monitoring performance of social interventions and health outcomes. An estimated 230 million children worldwide have never had their births registered and are exposed to social and human rights abuses. The objective of this study was to assess community knowledge, attitude, and practices regarding BR among women of childbearing age in Akure metropolis, Nigeria. Methods: A descriptive cross-sectional study was carried out among 456 eligible mothers selected using multistage sampling techniques. Research instrument used was a semi-structured pretested interviewer-administered questionnaire. Data were analyzed using the SPSS software version 17.0. Results: The mean age of studied respondents was 37.2 ± 7.7 years, 454 (99.6%) were aware of BR. One hundred and fifty-eight (34.6%) were aware of the National Population Commission as the concerned relevant agency of government. About 27.0% had inadequate mean composite knowledge, only 32.0% had favorable mean attitude scores, while 109 (23.9%) had their children <11 years registered at birth. Predictors of good practice of BR include having formal education, delivery within a health facility, having adequate knowledge, and favorable attitude scores to BR. Conclusion: Good awareness and knowledge, but the poor practice of BR characterized mothers under the study, and this suggests a need for improved sensitization of mothers by relevant stakeholders and removal of barriers to the practice of BR.

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