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Introduction: Pancreatic cystic lymphangioma (PCL) is an extremely rare benign tumor of lymphatic origin. Traditionally, it is diagnosed at surgery performed on a patient with a retroperitoneal cyst of unclear etiology. However, recently a few single case reports showed PCL was successfully diagnosed by endoscopic ultrasound with fine-needle aspiration (EUS-FNA). Case Report: We present a new case of PCL in an 11-year-old boy who came to our hospital for swelling of the body. A contrast-enhanced computed tomography scan revealed a 7.7×4.5 cm cystic lesion involving head and neck of the pancreas. EUS-FNA was subsequently performed and diagnosis of PCL was made based on result of cytological examination and measurement of aspirate. Conclusion: In agreement with previous reports, we show that EUS-FNA confirmed the cystic lesion in pancreas and further provided the gross, biochemical and cytological features supporting accurate diagnosis of PCL.

Metronidazole is a commonly used drug and considered relatively safe. But it may present with neurotoxicity, commonly peripheral and rarely central. We report here a case of a young patient with amoebic liver abscess who continued taking metronidazole longer than the prescribed duration of the drug and developed peripheral neuropathy and cerebellar neurotoxicity which was reversible after discontinuation of the drug.

Introduction: Neuroendocrine tumors (NETs) formally known as carcinoids tumors are neoplasms that arise from enterochromaffin cells. The NETs most commonly occur in the gastro-intestinal tract and predominately within the ileum. Symptomatic ileal NETs have most likely metastasized to the liver at the time of diagnosis. Pancreatic metastasis from ileal NETs are exceptionally rare. Case Report: A 76-year-old female with a primary ileal carcinoid underwent right hemi-colectomy secondary to bowel obstruction. One-year post bowel resection, the patient presented with carcinoid syndrome, imaging revealed a singular hepatic metastasis (segment 2) and a pancreatic tail mass. After radiologic workup with an abdominal CT, PET and octreotide scan a presumed diagnosis of recurrent metastatic NET was made. Multi-disciplinary rounds discussed the case. Laparoscopic distal pancreatectomy, splenectomy and radiofrequency ablation of the liver tumor were performed. Surgical pathology of the pancreatic mass was consistent with primary ileal carcinoid tumor. Conclusion: Ileal NET metastasis to the pancreas is a rare phenomenon. Metastatic NET management should be discussed with a multi-disciplinary team. R0 resection of primary and metastatic NETs offers the only chance of cure. Loco-regional, systemic therapies, and surgical debulking can offer a survival benefit in un-resectable disease or in cases where resection incurs a high perioperative risk.

Aims: To determine frequency of incidental gallbladder cancer (IGBC) in Pakistani population, its demographic/histopathological features and type of surgical resections performed. Methods: This observational study was conducted at Combined Military Hospital (CMH)/Armed Forces Institute of Pathology (AFIP) Rawalpindi, Pakistan from July 2009 to July 2015. Clinical as well as pathological records of all patients who underwent laparoscopic cholecystectomy (LC) /open cholecystectomy (OC) were reviewed and data was obtained regarding IGBC and benign gallbladder pathology. Patients diagnosed with cancer underwent staging investigations and were offered definitive surgery. Overall frequency and clinicopathological features of IGBC were studied. Results: One hundred sixty-four patients out of 10,549 had IGBC (1.55%). Mean age of presentation in IGBC and benign gallbladder pathology patients was 59.23±12.17 and 45.73±13.11 years respectively (p-value and#60;0.001). Cancer patients had significantly more comorbid (73.17% versus 39.43%, p-value and#60;0.001) and larger stones (p-value and#60;0.001). Histopathology revealed adenocarcinoma in 148 (90.24%), adenosquamous carcinoma in 08 (4.88%), undifferentiated in 04 (2.44%), squamous cell carcinoma in 02 (1.22%), sarcoma and melanoma in one patient each (0.61%). Most of the tumors were well differentiated (36.59%) and liver was most commonly infiltrated organ (52.44%). Thirty-four patients had stage I, 38 patients had stage II, 49 patients had stage III and 43 patients had stage IV cancer (20.73%, 23.17%, 29.88%, 26.22% respectively). Surgical resection included no further treatment in 31 patients as cholecystectomy proved adequate vis-à-vis stage, extended cholecystectomy in three patients (1.83%), radical cholecystectomy in 17 (10.37%), pancreaticoduodenectomy (Whipple) in 6 (3.66%), palliation/symptomatic management in 42 (25.61%) patients while 65 (39.63%) patients refused surgery. Adequate lymphadenectomy was performed only in 50 (30.49%) patients while 44 (26.83%) showed positive resection margins. Conclusion: IGBC must be kept in mind while performing cholecystectomy and every specimen should undergo routine histopathological examination. Radical surgery should be offered and may improve outcome in carefully selected cases.

Aim: This study aims to describe the characteristics of the red cell concentrates (RCCs) produced by whole blood settling in Burkina Faso. Methods: We conducted a cross-sectional study in the blood centers of Ouagadougou and Koudougou between 12th February and 15th March 2015. 427 blood units selected at Koudougou and divided into three groups were processed by settling method over three durations (methods I = 36–48 h, II = 48–72 h and III = 72–96 h). Other 139 units selected at Ouagadougou were processed by centrifugation (method IV). The RCCs units' characteristics were described by the mean of their hematocrit, volume, hemoglobin level and content. The residual plasma level, the hematocrit yield and the hematocrit concentration ability (ability of method to raise hematocrit in comparison with whole blood) have been used to assess methods efficacy. Results: The volume and hemoglobin content of overall units met standard requirements. 2.1%, 14.2% and 27.7% of units respectively issued from methods I, II, III had hematocrit over 50%. The average volume (mL) was 372.88, 357.91, 350.30 and 332.26 respectively for method I to IV (p

Aim: This study was carried out to determine the prevalence of human T cell lymphotropic virus I/II (HTLV I/II) among blood donors at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. Methods: A total of 355 blood donors were recruited at the hematology department of FTHG for a hospital based cross-sectional study and were screened/confirmed for HTLV I/II by ELISA and western blot methods. Results: Seroprevalence of HTLV I/II among the 355 participants with mean age of 30.77 years (±8.27) was 6.5% on screening with ELISA but confirmed to be 0% by western blot. Majority were males, 352 (99.2%) and mostly (45.9%) between 21–30 years of age. Donors for family replacements predominated (85.1%) with more than half (58.6%) being first time blood donors. Conclusion: This study reveals the absence of HTLV I/II among blood donors in Gombe North-eastern Nigeria. It also highlights the possibility of false positivity in some of the reported prevalence of HTLV I and II from some parts of Nigeria that were based on screening tests only. The importance of confirmatory testing in all research works on HTLV (including HTLV 3 and HTLV 4) is further strengthened with this study. There is however the need for a larger study and the use of molecular diagnostics to reconfirm this assertion.

Aims: Regular donors are often given some sort of non-monetary recognition. In Nigeria, about 92.9% of individuals donate blood because of the benefits they get from hospital. The aim was to study iron status of regular blood donors who had donated at least one or two units of blood in their life. Methods: The study was prospectively conducted on 290 regular blood donors. The blood donors were divided into four groups, according to the number of units of blood they had given. Results: The difference in serum ferritin concentration of first group (208.35±60.62 ng/mL) was statistically significant (p < 0.05) compared with donors in third group (34.20±21.89 ng/mL) and fourth group (2.05±0.22 ng/mL). None of the first group donors suffered from iron deficiency, whereas 11% of the donors who had donated between 11–15 units of blood within a 4-year period had iron deficiency. Conclusion: The results of this study reveal the presence of iron deficiency in second group, third group and fourth group.

Aims: Dengue infection is a global health problem affecting an estimated population of 50–100 millions every year. Thrombocytopenia is an essential diagnostic criteria. Platelet transfusion is given in those patients who have haemorrhagic manifestations along with thrombocytopenia. The aim of the study was to know the effectiveness of platelet transfusion in dengue patients. Methods: The study was conducted during the epidemic of dengue fever from July 2011 to October 2011. Serologically confirmed dengue cases were included in the study. Results: Two hundred thirty two patients were positive for dengue serological tests of which 195 (84.2%), 35 (15%), 2 (0.8%) were DF, DHF DSS respectively. One hundred eighty two (78.4%) patients received platelet transfusion. One hundred eighteen (51%) cases received single unit of platelet transfusion though platelet count was between 0.2–1.0x10x105/mm3. Sixty four (27.5%) patients who had platelet count 0.5x105/mm3 and they were discharged after 5–6 days of hospitalization. Conclusions: This study suggests that 51% platelet transfusions are inappropriate and it is more effective when it is given to patients with platelet count

Aims: The aim of this is study was to evaluate the usage of fresh frozen plasma (FFP) according to indications and to reduce inappropriate usage. Methods: A two year retrospective study was conducted in Medical College Hospital blood bank. Based on the guidelines published by College of American Pathologists, National Health and Medical Research Council and Australasian Society for Blood Transfusion FFP usage were categorized into appropriate and inappropriate. Pre and post-transfusion INR/PT were recorded and the effect of FFP were studied in patients who received FFP. Results: During two years 1884 units of FFP were used for 945 patients. Only 454 (48%) requests were appropriate and 491 (52%) were inappropriate requests. Absence of bleeding or surgical intervention was the commonest reasons for inappropriate FFP use. Mean improvement in the pre-transfusion INR per unit of FFP was 0.75 (median 0.56, range 0–3.7) of which 33% showed significant improvement in the pre-transfusion INR. Conclusions: Our results showed a 48% appropriate and 52% inappropriate use of FFP in patients. Inappropriate FFP use could be reduced by educating the staff, by establishing the hospital transfusion guidelines, by regular evaluation of requistions and by conducting awareness programme among clinicians.

Aims: The objectives of this study were to assess the knowledge, attitude and practice of voluntary blood donation among physician, to identify and recruit potential voluntary blood donors amongst them and to determine the association between blood donation and gender, duration of practice and sub-specialty of the physicians. Methods: This was a cross sectional qualitative study carried out at the University of Benin Teaching Hospital, Benin City. Pre-tested questionnaires were administered to 140 physicians in the tertiary health facility. Results: Most of the respondents (95.7%) were aware of the risk of transmission of infection by transfusion. The risk of transmission of HIV, HBV, HCV and syphilis was affirmed by 99.3%, 97.9%, 73.6% and 42.9% respectively. Fifty-eight (41.4%) physicians have donated blood in the past, with 33 (56.9%) donating less than once a year, 18 (31%) between 1–3 times a year and five (8.6%) more than thrice a year. Most (53.4%) donated voluntarily, 39.7% donated for friends and relatives, 3.4% for remuneration and 5.2% donated in order to know their HIV, HBV and HCV status. There was no significant association between gender, duration of medical practice, specialty of the physicians and the practice of blood donation as P values were 0.227, 0.613 and 0.844 respectively. Conclusions: Physicians have good knowledge of voluntary donation and a positive attitude towards donation but there were disparities in their practice of blood donation.

Aims: Blood transfusion is an important mode of transmission of infections to recipients. The aim of the study was to analyse the seroprevalence of HIV, HBsAg, HCV and syphilitic infections in the pretransfusion blood. Methods: A total of 19,135 blood units were tested for HIV, HBsAg, HCV and syphilis. Results: The seroprevalence of HIV, HBsAg, HCV and syphilis was 0.9%, 3.2%, 0.35%, 0.04% respectively in total donors. Conclusions: The seroprevalence of HBsAg was more compared to HIV, HCV and syphilis.

Introduction: An anomalous origin of the coronary artery from the pulmonary artery (AcAPA) is a rare congenital anomaly resulting in sudden death in 90% of infants during their

Introduction: Hemangiopericytoma is a rare neoplasm that was first described by Stout and Murray in 1942 as a vascular tumor derived from the pericytes. They account for 2-3% of all soft tissue sarcomas in humans and they occur mainly in the musculoskeletal system. 15-30% of all hemangiopericytomas occur in the head and neck region. Only 5% are located in the sinonasal region, where they display a more benign behavior than in other parts of the body. Case Report: Herein, we are presenting an extremely rare case report of hemangiopericytoma in a 32 year old male patient with a brief overview regarding its epidemiology, macro- and microscopical characteristics, the clinico-pathological findings and the treatment of this extremely rare vascular neoplasm. Conclusion: Conclusion rests with the inclusion of the possibility of such rare vascular tumors in the possible differential diagnoses of the various peripheral soft tissue lesions. An early diagnosis thus helps in the effective management of such lesions without further bringing changes on the subjacent and adjacent structures and tissues including bone.