Background: Fungal pathogens are the leading cause of severe healthcare-associated infections in immunocompromised patients, especially from low-income countries like Nigeria. Acquired Immunodeficiency Syndrome (AIDS) arising from HIV infection is reputed to be a key in immune suppression globally. Presently, Anambra state is number 5 in HIV prevalence in Nigeria. This study was aimed at screening patients from the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, for fungal infections. Samples were collected with consideration to gender, age, occupation, education status and clinical presentations. Methods: Sampling was done according to global best practices. Patients’ consent and details were obtained by signing a consent form and filling of questionnaires respectively. Key questionnaire details included sociodemographic and personal details, history of present illness, clinical signs and symptoms. All patients were screened afresh for HIV-1 and HIV-2 using an immuno-chromatographic technique with Determine kit (Alere, Japan) and Stat-pack kit (USA). Specimens screened include Urine, Blood, Oropharyngeal swab, Skin scraping, and Sputum. All samples were labeled, transported and processed within 1-2 hours of collection. Results: A total of 1200 participants (610 males and 590 females) were examined. About 16.5% and 54.41% of the subjects examined were positive for HIV infections and fungal infections respectively. Overall, 233 males (19.41%) and 420 females (35.0%) had fungal infections. Fungal infections were most prevalent in patients between 30-39 years, 17.75%, followed by 40-49 years (15.0%). Infection was least prevalent in patients between 15-29 years at 5.0%. Farmers had the highest prevalence rate of fungal infection, though not significant when compared with those of traders, artisans and public servants (X2 =0.621; df=2; P>0.05). Candida species were the most prevalent fungal pathogen, accounting for 609 (67.1%) followed by Aspergillus spp. 234 (25.8%) and Cryptococcus species 31 (3.4%). Penicillium and Fusarium spp. were the least prevalent pathogens (1.9%). Oropharyngeal candidiasis was the most common fungal infection (49.9%-17.4% HIV negative and 32.46% HIV positive patients); followed by Pneumocystis pneumonia (28.80%-9.50% HIV negative and 19.30% HIV positive patients). Similarly, Cryptococcal meningitis was the least recorded infection at 16.81% (6.43% HIV negative and 10.38% HIV positive patients). Significantly, fungal infections were more prevalent in HIV infected patients (62.14%) compared to HIV negative patients (33.33%). Conclusion: This study has revealed that HIV positive and negative patients are often affected with fungal infections in Anambra State, Nigeria. This may have contributed to impaired immune system in patients and development of AIDS in HIV infected patients. Poor personal hygiene and intimate association with household pets among subjects examined were the suspected sources of infection. Therefore, there is an urgent need for improved surveillance and monitoring of fungal infections in the area and in other Teaching Hospitals in the country as well as treatments of infected subjects.

Primary Oral Mucosal Melanoma represents 0.2 to 8% of all melanomas and 0.5% of all oral malignant neoplasia. The etiology still unknown, however, it has been suggested that head and neck mucosal melanomas change their genetic and metabolic pathways through intracellular cascades, which are associated with its etiopathogenesis mechanisms. The BCL2 protein is an integral part of the cell membrane, and it is also found in the cell nucleus, mitochondria, and endoplasmic reticulum. It is overexpressed in several malignant neoplasms, including cutaneouse ocular melanomas. Among all evaluated cases, we found positive immunostaining of BCL-2 in 26/34 (76.47%) and they had a membrane and cytoplasmic pattern, and the intensity was variable. According to our results and the findings of the literature, it can be suggested that BCL-2 has an important role in melanoma pathogenesis, including Primary Oral Mucosal Melanoma and also melanoma metastases. It seems that BCL-2 could be an adjunct marker for POMM and also a target for treatment development. New researches involving BCL-2 and a larger primary oral mucosal melanoma cohort could corroborate the present study

We report a case of Li Fraumeni Syndrome (LFS), where our patient was affected by two malignancies before the age of 30: chondroblastic osteosarcoma and unilateral breast ductal carcinoma in situ. Her daughter was diagnosed with adrenocortical carcinoma at the age of four, and her mum was diagnosed with cervical cancer when she was in her 20’s. After her daughter’s cancer diagnosis, she and her family members underwent genetic testing. She and her daughter were found to have Tumour Protein 53 gene (TP53) mutation suggestive for Li Fraumeni Syndrome (LFS). Patients with LFS should be managed with a surveillance program with minimal exposure to radiation therapy due to their high risk for second primary cancer. This report will make the clinician aware of this syndrome for early diagnosis and management.

This article analyses the different profiles related to communication risk, such as all errors, adverse events, that occur within the care path. In this respect, an analysis of a variety of factors shows a twofold trend. Innovation is a level that can positively influence communication risk, on the other hand, towards deospedalization towards multiple forms of taking charge at territorial level require a multi-factorial communication based on different channels. Based on this dual perspective, the article analyzes the set of organizational measures planned and implemented in a preventive and proactive key in the different dimensions of communication both and public. This analytical path is to be modulated concerning the different objectives pursued by communication in health both in ordinary times and emergency through the management of information in the different institutional and organizational levels involved.

Introduction: Kushta Nella-Tutia has a wide range of Pharmacological actions in Unani system of medicine. It is used both internally as well as externally. In Unani system of medicine, it is commonly used for Qatil e-deedane-am’a (Anthelmintic), Mundamil qurooh (Healing of wound), Aatishak (syphilis), Juzam (leprosy), Qarha asir al indimal (Indolent ulcers), Nawasir nafidha (Fistula). Methods: Kushta Nella-Tutia has been evaluated by using classical, organoleptic and physicochemical tests. The methodology was followed according to the protocol of ASU drugs. Results: Physiochemical results revealed that Kushta Nella-Tutia is Black in color, odorless, lusterless, tasteless and soluble in organic solvents, but insoluble in water and all the physiochemical standards were set. Conclusion: The present study has provided evidence-based scientifically validated data for the standardization of Kushta Nella-Tutia and will serve as a useful tool to minimize adulteration and substitution of Kushta Nella-Tutia. The standardization of herbal drugs is very important for quality control. it improves the efficacy and safety of the drug. Physiochemical results of Kushta Nella-Tutia will serve as a reference standard for identification in the future and the intern will prevent adulteration and improve the quality, identity, and purity of the drug.