Introduction: The incidence of abdominal aortic aneurysms (AAAs) in high-income countries has been declining in the last three decades. However, in most low-income and middle-income countries especially in Africa, little is known about its burden. The absence of screening services for AAA in African countries makes it difficult to detect and promptly manage AAA before rupture, which has significant implications for mortality. This study sought to systematically assess the prevalence of AAA amongst patients visiting hospitals in Africa and evaluate its epidemiological pattern. Materials and Methods: A systematic review was performed on the EMBASE, GLOBAL HEALTH, MEDLINE, and PUBMED databases. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement standards and protocol registered with PROSPERO (CRD42020162214). A data extraction tool was used to get relevant information from these studies. Quality assessment and risk of bias were performed using the Newcastle Ottawa Scale for cross-sectional studies. Results were summarised in tables, figures, and a forest plot. A narrative synthesis approach of the articles was taken. Results: Two hundred and sixty-one studies were identified and after the exclusion of 246, a final 15 were deemed suitable for analysis. A total of 4012 participants were screened for AAA and of these, 129 cases were identified. The prevalence of AAA in these studies ranged from 0.7 to 6.4%. Male participants accounted for 115 (89.1%) of the cases. There was a wide age range (31–72 years) reflective of both its possible infective and degenerative aetiology. AAA was reported to be associated with hypertension, smoking, advanced age, coronary artery disease, and HIV infection. There was no association between AAA and diabetes. Over 50% of cases were identified incidentally. About one-third (23–54%) of the participants presented aortic rupture with a mortality rate ranging between 65 and 72%. Conclusions: AAA prevalence in Africa is probably higher than the current thinking as there is no baseline data to compare with. Aetiologically, AAA was shown to be associated with hypertension, smoking, coronary artery disease, and possibly infectious pathologies like HIV. Large epidemiological studies would help better characterise AAA in this setting. Lastly, efforts targeting the reduction of the risk factors for AAA would go a long way in reducing the burden of AAA.

Background: Pulmonary tuberculosis remains prevalent in the developing parts of the world. Besides the consequent tuberculous pleurisy, which can be complicated by empyema thoracis, Mycobacterium tuberculosis is associated with significant lung parenchymal disease that poses an additional clinical challenge in achieving a successful outcome of management. This study compared the outcomes of management of tuberculous versus non-tuberculous empyema thoracis managed at the Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria. Materials and Methods: A prospective study of patients being managed for empyema thoracis at the ABUTH, Zaria, within a 22-month study period was conducted. Recruitment into the study included all consecutive patients managed for empyema thoracis in ABUTH, Zaria, after obtaining consent. The required data were collected using a structured proforma. These included data on aetiology, microbial isolates, and initial and total empyema volumes. Sociodemographic data (including age, gender, educational level, and occupation) were also noted. The patients were subsequently managed, and the outcomes of management were noted. These outcomes included the duration of drainage, the duration of hospital stay, complications, lung expansion following drainage, and the need for decortication. Data obtained from the study were analysed using the Statistical Package for the Social Sciences (SPSS) version 20 software (IBM Corp. IBM SPSS Statistics for Windows. Version 20.0. Armonk, NY: IBM Corp.; released 2011) and the statistical differences determined using the chi-square test and the student’s t-test. Results: Eighty-three patients were enrolled in the study, 20 (24.1%) of whom were females. Fourteen (16.9%) patients had tuberculous empyema thoracis, whereas 69 (83.1%) had non-tuberculous empyema thoracis. Patients with tuberculous empyema were significantly older than those with non-tuberculous disease (mean age 37.9 years [standard deviation {SD} = 20.6 years] vs. 26.8 years [SD = 18.2 years], P = 0.045). Compared to non-tuberculous empyema, tuberculous empyema thoracis was associated with lower percentage of mean lung expansion (60.9% [SD = 22.7%] vs. 78.4% [SD = 16.8%], P = 0.001), more than six-fold increased need for decortication (odds ratio = 6.58 [95% confidence interval = 1.84–23.52], P = 0.004), and longer period of hospital stay (36.4 days [SD = 3.8 days] vs. 23.6 days [SD = 16.2 days], P = 0.004). Conclusion: Tuberculous empyema thoracis was associated with worse outcomes (in terms of percentage of lung expansion, need for decortication, and length of hospital stay) compared to non-tuberculous empyema thoracis.

Background: Anatomical variations are subtle structural abnormalities around the osteomeatal complex that might obstruct paranasal sinus drainage and ventilation. The role of these anatomical variants in chronic rhinosinusitis is still controversial and unclear. The aim of this study was to determine the prevalence of anatomical variations and their relationship with the severity of symptoms in patients with chronic rhinosinusitis. Materials and Methods: This was a cross-sectional study conducted among randomly selected patients with chronic rhinosinusitis. Sinonasal Outcome Test-20 (SNOT-20) was used to assess the patient’s severity of symptoms. Computed tomographic scan was used to determine the presence of anatomical variations. The relationship between anatomical variations and symptom severity was determined using the Statistical Products and Service Solution (SPSS) version 20.0. Results: There were 70(58.3%) males and 50(41.7%) females within the age range of 17–60 years. SNOT-20 scoring showed 6(5.0%) of the patients with mild symptoms, 69(57.5%) with moderate, 37(30.8%) with severe, and 8(6.7%) with profound symptoms. The prevalence of sinonasal anatomical variants was 26.7%, which comprised of septal deviation (10.8%), agger nasi (6.7%), concha bullosa (4.2%), Haller cells (3.3%), and Onodi cells (1.7%). There was a statistically significant relationship between the anatomical variations and symptom severity (P = 0.000). Conclusion: This study found a significant relationship between anatomical variations and severity of chronic rhinosinusitis. The prevalence of anatomical variants was found to be 26.7%.

Background: Mucoepidermoid carcinoma (MEC), a tumour previously believed to occur exclusively in the major salivary glands, was atypically recognized in the lacrimal gland. Few ophthalmologists are familiar with this rare neoplasm. Aim: This case is being reported for its rarity and the association with human immunodeficiency virus (HIV). Case Presentation: High-grade MEC of the lacrimal gland of the right eye was diagnosed in an orbital exenteration specimen of a 60-year-old HIV-positive man. He presented to the eye unit of a mission hospital in Jos, Nigeria with significant visual impairment in the right eye and a rapidly growing painful superolateral orbital mass. The tumour invaded and completely obliterated the anterior chamber. The lens, ciliary body, and iris were displaced posteriorly but were free from tumour infiltration. The tumour was exenterated, and the patient was subsequently referred for adjuvant radiotherapy. No evidence of recurrence or metastasis has been noted 15 months post-surgery. Conclusion: Early and decisive surgical intervention in a case of high-grade MEC of the lacrimal gland is crucial in forestalling local invasion as well as distant metastasis. Because of the possibility of local recurrence, adjuvant radiotherapy is required and close follow-up of the patient is warranted.

Cryptococcosis, a global disease problem, seen frequently in the immuno-suppressed, also affects patients without apparent immuno-suppression. Pulmonary cryptococcosis patients often present as cryptococcal pneumonia, whereas intracranial cryptococcosis presents with meningitis. We present a 33-year-old immunocompetent man, diagnosed with invasive pulmonary cryptococcal disease with spread to the brain. This case is unique because the patient was previously treated for tuberculosis and presented with typical bronchopulmonary thoracic, extra-thoracic as well as computed tomography (CT) scan features suggestive of lung cancer. Cryptococcosis was diagnosed by identification of oval thick-walled yeast on histology of lung biopsy specimen. The patient was treated with flucytosine and fluconazole initially and subsequently with Amphotericin B and fluconazole. He made clinical improvement with the resolution of symptoms but had residual radiological features. Invasive cryptococcosis affecting the lung and brain may present with a clinical picture similar to metastatic lung cancer. We recommend routine fungal stains and fungal culture in suspected cases.

Surgical complications of typhoid fever present commonly as gut perforation and very rarely as gall bladder gangrene or gall bladder perforation. Gall bladder complications are rare in children and when they occur they are often the result of an infective condition. Occasionally, typhoid fever causes concomitant gall bladder complications and gut perforation. The coexistence of both conditions accentuates morbidity and mortality.We present two cases of typhoid fever with gall bladder perforation and gall bladder gangrene, respectively. Challenges of diagnosis and treatment are highlighted. The need for surgeons in endemic areas to consider these conditions while evaluating children with peritonitis is emphasized. Ultrasound detection of thickened distended gall bladder with pericholecystic fluid in a child with typhoid fever may be a sign of impending gall bladder perforation. To reduce the high morbidity and mortality from surgical complications of typhoid fever, the implementation of proven preventive measures must be encouraged. In addition, public enlightenment of this scourge must be pursued with vigor.

Epiretinal membrane causing binocular diplopia, also denoted “macular diplopia,” is a well-established entity, which is often difficult to treat. Mini-tenotomy is a surgical procedure to treat diplopia due to small-angle deviations. In this case report, we describe the successful management of a patient with “macular diplopia” secondary to sickle cell retinopathy using a central mini-tenotomy of the left superior rectus muscle and environmental adaptations to diminish peripheral retinal fusion.

Buschke–Löwenstein’s tumor (BLT) is a skin tumor induced by a human papillomavirus (HPV) infection. HPV genotypes 6 and 11, which are of low oncogenic potential, are present in over 90% of condylomas. Genotypes 16 and 18 combine with factors related to immunosuppression and chronic irritation to promote exophytic and endophytic growth and malignant transformation. BLT is most common in men between the ages of 40 and 60, occurring most commonly in the genital area. Perianal localization is less frequent and raises the problem of adequate management to reduce morbidity and the rate of recurrence. We report the cases of two male patients aged 45 and 57 years, who presented with perianal and buttock BLT for which large excisions were performed with satisfactory outcomes. We discuss the epidemiological and therapeutic aspects.