ABSTRACT
Background: Metabolic dysfunction-associated steatotic disease (MASLD) is the most common chronic liver disease that has become a leading health problem globally. Objectives: To determine the prevalence, grades and associated risk factors for MASLD in type 2 diabetes mellitus (T2DM) subjects at NAUTH, Nnewi, Nigeria. Materials and Methods: This was a cross-sectional study that was carried out among stable T2DM out-patients at NAUTH. Anthropometric and blood pressure (BP) measurements were done. Glycated haemoglobin and fasting lipid profile were assayed. Abdominal ultrasonography was performed to diagnose and stage MASLD. Data was analysed using SPSS version 25. Results of categorical variables were presented as frequencies and percentages, in tables. The mean values and standard deviation for the continuous variables were calculated. Chi-square test was used to determine the association between MASLD and MASLD stages with the risk factors. The level of significance was set at p ˂ 0.05. Results: A total of 142 T2DM subjects with complete results were analysed. The prevalence rate of MASLD was 46.5% among the subjects, with 47.9%, 35.2%, 14.1% and 2.8% of them having grades 0, 1, 2 and 3 MASLD, respectively. A statistically significant association was found between MASLD and educational levels (X2 = 20.732; p = 0.000), DM duration (X2 = 5.509; p = 0.019), global obesity (X2 = 6.079; p = 0.014) and anti-hypertensive medications use (X2 = 5.938; p = 0.015). Equally, significant association was found between MASLD grades and marital status (X2 = 9.181; p = 0.027), educational level (X2 = 25.492; p = 0.02), DM duration (X2 = 8.083; p = 0.044), abdominal obesity in the male subjects (X2 = 11.786; p = 0.003), global obesity (X2 = 9.736; p = 0.021) and diastolic hypertension (X2 = 14.509; p = 0.002) in the subjects. Conclusion: The prevalence of MASLD from the study was high and thus showed a high burden of the disease in T2DM subjects. MASLD and it stages showed significan

ABSTRACT
Background: Cervical cancer is the leading gynecological malignancy in Tanzania accounting 59.1 new cases per 100,000 women (age-standardized to the world population) and mortality of 42.7 deaths per 100,000 (age-standardized to the world population) in 2018. Despite this burden, the cervical cancer screening uptake is not effective. Currently, the proportion of cervical cancer screening is 11% in Tanzania among women but there is limited data of cervical cancer screening uptake among female health care workers especially doctors and nurses whom screening tendency among them might influence more screening uptake to the community since they are good messengers for disseminating health information to the community. The aim of this study was to assess the knowledge of cervical cancer, utilization, challenges, and factors associated with cervical cancer screening among female doctors and nurses. Methods: This was a hospital-based analytical cross-sectional study, conducted at Muhimbili National Hospital (MNH) from 1st August to 31st November 2021. The semi-structured self-administered questionnaires were used to collect data on knowledge of cervical cancer, screening uptake and challenges toward cervical cancer screening. These data were self-report. The factors associated with cervical cancer screening uptake were assessed using a multivariate robust poison regression model. A P< 0.05 was considered statistically significant. Results: A total number of 221 participants were involved in the study, 81.4% had good knowledge of cervical cancer and the proportion of self-reported utilization of cervical cancer screening was 29.9% (95% CI:23.9% – 36.4%). Lack of self-motivation toward screening (58.8%), tight work schedules (50.2%), and lack of perceived risk factors for cervical cancer (29.9%) were some of the challenges mentioned observed. The adjusted prevalence ratio (aPR) in the multivariate robust Poisson regression model revealed a lower level of education was associa

ABSTRACT
Arteria lusoria, also known as an aberrant right subclavian artery (ARSA), is a congenital vascular anomaly of the aortic arch in which the right subclavian artery arises directly from the aorta distal to the left subclavian artery, rather than from the brachiocephalic trunk. This variation, occurring in a small percentage of the population, is frequently associated with a Kommerell’s diverticulum, a pouch-like aneurysmal dilation at the origin of the aberrant artery. A recent case at Mohammed VI University Hospital in Oujda involved a 62-year-old patient with exertional dyspnea who underwent thoracic angioscanning for suspected pulmonary embolism, revealing a retro-oesophageal right subclavian artery and a 22 mm Kommerell's diverticulum. In the absence of significant symptoms or complications, a conservative management strategy was chosen, consisting of therapeutic abstention and regular follow-up, with no issues reported to date. Diagnosis is primarily based on thoracic CT imaging, which provides detailed anatomical insights, and treatment varies from observation to surgical or endovascular intervention depending on clinical findings. The management of this anomaly is tailored to each case, considering symptom severity, potential complications, overall health status, and patient preferences.

ABSTRACT
Background: Stress hyperglycemia is common among critically ill patients admitted in the intensive care units (ICU), affecting 17-68%of patients within the first 48 hours of admission. Long-term stress hyperglycemia is linked to poor clinical outcomes and increases mortality. The burden and outcomes of stress hyperglycemia in critically ill patients is unknown in Tanzania. Methodology: Prospective short-term cohort study was conducted at Muhimbili National Hospital for 6 months. Adult critically ill patients in medical and surgical ICU were recruited consecutively. On admission, HbA1c and RBG were checked. FBG/RBG was tested daily until discharge or death. Stress hyperglycemia was defined as FBG≥6.1mmol/l or RBG of 140mg/dl (7.8mmol/L) or more observed during ICU admission. Length of stay and ICU mortality in one month of follow-up were recorded. SH proportion is reported as percentages. Predictors of SH were analyzed using logistic regression. P value <0.05 was considered statistically significant. Kaplan Meier’s mortality curves were used to compare the mortality of patients with SH to those without. Results: A total of 270 patients were enrolled, among them 120/270(44.4%) developed SH. These patients were largely male (58.2%) with a mean age of 48.2±17.8years. predictors of SH were having comorbidities and the use of steroids. Stress hyperglycemia increased the risk of staying in the ICU for ≤ 5 days by 2 folds aOR (95%CI), 2.416 (1.261-4.629) P=0.008. Steroid use reduces the risk of SH by 67% aOR (95%CI), 0.326 (0.167-0.636) P=0.001 and by 78% for patients with other comorbidities aOR (95%CI), 0.2196(0.097-0.497) P<0.001. Conclusion: The incidence of stress hyperglycemia is high in ICU patients as evidenced in this study. Duration of ICU stay, comorbidities, and steroid use was significantly associated with stress hyperglycemia. Stress hyperglycemia contributes to a higher mortality rate among critically ill patients.

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Teenage pregnancy remains a significant public health concern globally, especially in low- and middle-income countries like Tanzania. It contributes to increased maternal and fetal morbidity and mortality, including complications such as anemia, hypertensive disorders, obstetric hemorrhage, low birth weight, and preterm delivery. Despite various interventions, teenage pregnancy rates remain high. This study aimed to assess obstetric outcomes and associated factors of teenage pregnancy in Mwanza region, Tanzania. A hospital-based cross-sectional study was conducted from April to June 2019 in four hospitals: Misungwi District Hospital, Sengerema District Designated Hospital, Bugando Medical Center, and Sekou Toure Regional Referral Hospital. A total of 357 teenage mothers who met inclusion criteria participated. Data were collected using structured questionnaires and checklists, then analyzed using STATA version 13. The mean age of participants was 17±1.3 years, with 72% from rural areas and 85.7% having no education or only primary education. Most were primiparous (90.2%) and had booked antenatal care (98.9%), though attendance and service utilization were inadequate. Vaginal delivery was common (79.2%). Adverse maternal outcomes included perineal tears (28.4%), anemia (59.7%), and hypertensive disorders (11.8%). Fetal outcomes showed 75% healthy live births, with occurrences of low birth weight (12.9%), small for gestational age (37.2%), and prematurity (14.8%). Hypertensive disorders were independently associated with poor fetal outcomes. The study concludes that teenage pregnancy is high-risk, often leading to adverse maternal and neonatal outcomes, highlighting the need for targeted interventions.

ABSTRACT
Diabetes mellitus (DM) is assuming epidemic proportions worldwide, particularly in developing countries. Identifying the current burden of DM in Nigeria is essential for effective healthcare planning and resource allocation for prevention. This review aimed to determine the current prevalence and risk factors of DM across the six geopolitical zones of Nigeria over the last two decades. Using the preferred reporting items for systematic review and meta-analysis (PRISMA) study design, articles pertinent to the study objective were searched from 2000 to 2024. The quality of the studies included in this review was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool for descriptive studies. Forty-four full-text publications met the eligibility criteria, out of which 23 were excluded because only an abstract was published, and 21 articles were included in the review. The overall pooled prevalence of DM in Nigeria was 6.3%. The prevalence of DM in the six geopolitical zones of Nigeria was 6.2% in the north-west, 6.1% in the north-east, 5.6% in the north-central zone, 5.4% in the south-west, 13.1% in the south-east, and 6.0% in the south-south zone. The prevalence of DM in Nigeria has increased over the last two decades compared to previous reports. Physical inactivity, unhealthy diet, and obesity are important perpetuating factors. A national diabetes care and prevention policy is highly recommended.

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Abstract: HER2-positive metastatic breast cancer represents a significant therapeutic challenge. Its prognosis has been altered thanks to significant advances in targeted anti-HER2 therapies. These treatments, such as trastuzumab and pertuzumab, have significantly improved the management of this pathology, enhancing patient survival, but are also responsible for adverse effects. Hypothyroidism, although less frequent than other complications, is an important side effect to recognize and manage. This clinical case presents a 47-year-old patient with HER2-positive metastatic breast cancer treated with chemotherapy combined with a dual anti-HER2 blockade using trastuzumab and pertuzumab, along with letrozole. After 52 cycles of dual blockade, the patient developed overt hypothyroidism. Levothyroxine replacement therapy improved her symptoms. This case illustrates the clinical importance of endocrine monitoring in patients receiving targeted anti-HER2 therapies, highlighting the need for a multidisciplinary approach to optimize the management of adverse effects and the quality of life of patients. A diagnostic delay of hypothyroidism can potentially impact the prognosis of the disease.