Aim: To determine the demographic characteristics, clinical presentation, and management outcome of children treated for complicated inguinal hernia at a tertiary hospital in Enugu, Nigeria. Materials and methods: This was a retrospective analysis of children who were managed for complicated inguinal hernia. Results: Forty-eight cases of the complicated inguinal hernias had an emergency surgery during the study period. There were 34 males (70.8%) and 14 females (29.2%). The ages of the patients ranged from 1 month to 48 months, with a median age of 7.5 months. Sixty percent of the inguinal hernias were right sided and 40% were left sided. None was bilateral. The median time interval from the time of first clinic visit to incarceration was 6.5 months (range: 1–48). Twenty-one percent of the patients visited the clinic at least once before the incarceration. Pain over the inguinal swelling was present in all the patients. Surgical site infection (10.4%) was the most common postoperative complication. Mortality was 2.1%. Conclusion: Treatment of complicated inguinal hernia is associated with morbidity and mortality especially in developing countries due to late presentation. Clinical significance: The importance of early treatment of inguinal hernia in children to avoid complications that may arise.

Introduction: The incidence of inflammatory bowel disease (IBD) has become a global disease in newly industrialized countries. Inflammation leads to a structural modification in platelets, and the secretion of cytokines results in a change of mean platelet volume (MPV). Aim: To evaluate the relationship between IBD activity parameters and MPV. Materials and methods: The study group included 26 patients [consisting of 18 ulcerative colitis (UC), 6 Crohn's disease (CD), and 2 indeterminate colitis patients] followed-up at Dr. Behçet Uz Children's Hospital between 2004 and 2016. The data of patients were screened retrospectively and the demographic, clinical and laboratory characteristics were evaluated. The changes in MPV during the activation, remission and relapse periods of the disease and correlation with other disease activity markers were investigated. Results: The study group consisted of 26 IBD patients (female/male: 11/15) and 71 healthy controls. We used the Pediatric Ulcerative Colitis Activity Index and the Pediatric Crohn's Disease Activity Index to determine disease activity. The IBD group had statistically significantly higher leukocyte count and lower hemoglobin values compared with the control group (p = 0.05). The mean platelet count and MPV values were not correlated significantly with both the C-reactive protein level and erythrocyte sedimentation rate (p > 0.05). Conclusion: We suggest that MPV is a simple and inexpensive method that can be useful in the diagnosis of IBD but does not provide significant results to determine the disease activity.

Background: Fever is the most common presentation of vector-borne diseases. Fever of undetermined origin is also most often caused by an unusual manifestation of a common disease and is a huge public health problem affecting most people in the developing world. Primary objective of this study was to study the seasonal variations and trend analysis of patients with fever in a rural health training center of a tertiary care hospital in South Bengaluru, Karnataka. Materials and methods: A retrospective descriptive record-based analysis of patients with fever was conducted in a rural health training center of a tertiary care hospital, Bengaluru, from January 2019 to September 2019. The trends of fever were analyzed in each village respectively by the method of least squares, linear equation after entering into MS Excel sheet. Results: Study included 5,114 patients with fever, out of which 34% were of 18–30 years. In few villages, there was downward trend of patients with fever and in some villages, an upward trend of patients with fever was observed. Majority of patients with fever (2,795) were observed in August 2019 (12.29%) and September 2019 (12.33%). Conclusion: The number of patients with fever showed a downward and upward trend swings during the study period. Implementation of health education regarding the prevention of the vector-borne diseases is warranted. It emphasizes the importance of visiting a healthcare center in case of a fever. The study will give a better insight into the epidemiology of febrile illnesses. This will further help the health planners to allocate the resources in the most appropriate way.

Background: Cancer can have a deleterious impact on the well-being of a patient and can affect the mental health. Cancer treatment is influenced by anxiety and depression and thereby recovery, quality of life, and survival may get hampered. Depression is the most common psychiatric syndrome that has received the most attention in individuals with cancer. It has an intense impact on lives of patients and it continues to be underdiagnosed and inadequately treated. Depression most commonly coexists with other syndromes such as panic disorder, generalized anxiety disorder, and post-traumatic stress disorder. Cancer is threatening and understandably many patients get anxious in response to that threat and anxiety appears to increase as the illness progresses. Depression and anxiety have impact on morbidity and mortality leading to worsening of quality of life. In patients with cancer on treatment, there is a greater degree of association between anxiety and depression with worsening of quality of life. In this study, we assessed prevalence of depression, anxiety, and the quality of life in patients undergoing cancer treatment. We tried to find out the correlation between prevalence of depression and anxiety. We also looked at the quality of life in patients undergoing cancer treatment. Materials and methods: Our study was conducted on 50 patients who were undergoing cancer treatment. We used Hamilton depression rating (HAM-D) and Hamilton anxiety rating (HAM-A) scales, respectively, to assess the symptoms of depression and anxiety. The quality of life was assessed using quality of life-10 (QOL-10) questionnaire. Results: In this study among subjects on chemotherapy, 46.7% had mild depression, 30% had moderate depression, 16.7% had severe depression, and 6.7% had very severe depression. Among subjects on radiotherapy, 53.3% had mild depression, 13.3% had moderate depression, 33.3% had severe depression, and 0% had very severe depression. Among subjects on chemotherapy along with radiotherapy, 20% had mild depression, 40% had moderate depression, 40% had severe depression, and 0% had very severe depression. In this study, 60% had mild anxiety, 38% had mild to moderate anxiety, and 2% had moderate to severe anxiety. Among those on chemotherapy, 66.7% had mild anxiety; among those on radiotherapy, 53.3% had mild anxiety; and among those on chemotherapy + radiotherapy, 60% had mild to moderate anxiety. In this study, there was positive correlation between HAM-A and HAM-D scores, that is, with an increase in HAM-A score, there was an increase in HAM-D score and vice versa. Conclusion: In our study, patients with cancer had higher prevalence of anxiety and depression. Anxiety and depression often lead to poor quality of life.

Introduction: Cystadenofibroma of the ovary is a rare benign epithelial tumor of the ovary that impersonates with malignant features like solid nodule and papillae on imaging as well on gross examination of the specimen. Case description: A 20-year-old unmarried girl visited our outpatient department with a complaint of pain in the lower abdomen for the last 1 year. Transabdominal ultrasonography revealed a well-defined complex cyst of about 9.4 × 7.4 cm size with a small echogenic nodule of 1.74 × 0.8 cm involving the left ovary. On color Doppler, there was an absence of increased internal vascularity. The right ovary was normal. CA 125 was within normal limits. She underwent laparoscopy, multiple solid papillae were seen after removal of a cyst, left salpingo-oophorectomy was done due to suspicion of malignancy. However, the final histopathology report revealed benign cystadenofibroma of the ovary. Conclusion: Although there are no confirmatory imaging diagnostic tests to differentiate benign cystadenofibroma from malignant pathology, however, absent blood flow is significantly associated with the benign nature of ovarian cystadenofibromas despite solid nodule and papillae within it. An intraoperative frozen section may help in diagnosis and prevent extensive surgery in patients.