ABSTRACT
Background: Balanitis is an inflammation of the glans while balanoposthitis involves both the glans and the foreskin and occurs only in uncircumcised males. After Candida infections, aerobic bacteria are the second most common cause of acute infectious balanoposthitis, mainly streptococci groups B and A, and staphylococci, usually Staphylococcus aureus. Its clinical manifestations including diffuse erythema and oedema. Severe balanopreputial oedema with purulent exudate occurs in erosive balanitis. Diabetes is the most common predisposing factor for balanoposthitis and lichen sclerosus has been associated with diabetes. Therefore, it is recommended that patients with severe or recurrent balanoposthitis and patients with lichen sclerosus undergo screening for diabetes. Case Presentation: A 55-year-old man with diabetes underwent circumcision one month ago due to phimosis resulting from lichen sclerosus. The patient presented with a painful, erosive, and exudative plaque on the glans that had been present for 5 days. Abundant growth of Staphylococcus aureus was obtained in the bacterial culture. The fungal culture was negative. The genital lesions healed completely with treatment using oral cloxacillin and topical mupirocin. Conclusions: We present a diabetic male patient with severe, erosive balanitis caused by Staphylococcus aureus following circumcision to treat phimosis secondary to genital lichen sclerosus. We also highlight the association between diabetes and two genital skin conditions, lichen sclerosus and bacterial balanitis.

ABSTRACT
Magnetic resonance imaging (MRI) remains the modality of choice in the investigation of children with seizures especially in age groups that can no longer be examined using transfontanelle ultrasound. High-field MRI equipment, with at least a 1.5 Tesla magnetic field strength, is best used to evaluate these children. This research aimed to audit MRI findings in children (0–17 years) imaged in our department for seizures over a 2-year period (January 2024–January 2026). We retrospectively reviewed the Department of Radiology records at Babcock University Teaching Hospital, Ilishan-Remo, South-West Nigeria, which has a General Electric 1.5 Tesla MRI machine. The MRI findings were recorded in Microsoft Excel and then entered and analysed using SPSS version 25. The Babcock University Research Ethics Committee approved the study. Out of a total of one hundred and six (106) children who had brain MRI within the review period, there were thirty-seven (37) with seizures. Most children with seizures were adolescents (13-17 years, 59.46%), followed by school-aged children (6-12 years, 13.51%) and toddlers (1-3 years, 13.51%). The female-to-male ratio was 1:1.06. MRI abnormalities were found in 21 out of 37 (54.56%) of seizure cases, more in males. The main abnormal brain findings in children presenting with seizures were generalised cerebral atrophy (GCA), focal cortical dysplasia (FCD), mesial temporal sclerosis, infarcts, gliosis, and hypoxic-ischaemic encephalopathy (HIE). Our findings are comparable to those in previous studies. High-field Magnetic Resonance Imaging remains a valuable modality for evaluating seizures in children.

ABSTRACT
Background: Heart failure (HF) is a major public health problem, responsible for numerous hospitalizations and a substantial economic burden. This study aimed to assess the direct cost of inpatient management of HF at the Abidjan Heart Institute. Methods: Prospective cross-sectional descriptive and analytical study conducted from January 1 to May 31, 2025. Adults ≥18 years hospitalized for HF in medical wards and intensive care units were included. Two hundred patients were interviewed; healthcare and associated costs were collected; indirect costs were excluded. The mean total cost incurred during hospitalization was estimated in West African CFA francs (XOF). Results: The mean total cost of inpatient care was 439,560.75 XOF (US$724.15), with values ranging from 303,171 XOF (US$499.45) to 1,340,306 XOF (US$2,200.10). The mean length of hospital stay was 7.1 ± 2 days. Medication costs averaged 169,038.15 XOF (38% of total cost). Diagnostic investigations accounted for 183,832.60 XOF (42% of total cost), and accommodation/hospitalization costs averaged 86,690 XOF (20% of total cost). In multivariable analysis, overall cost was significantly associated with underlying cardiac disease: ischemic heart disease (OR 3.20; 95% CI 1.6–6.5; p = 0.001) and valvular heart disease (OR 4.08; 95% CI 1.1–14.4; p=0.029). Conclusion: The direct cost of inpatient management of HF is substantial in our setting. Strengthening prevention and management of cardiovascular risk factors and improving access to health insurance may help reduce the financial burden associated with HF.

ABSTRACT
Megaloblastic anemia is a type of anemia characterized by the presence of large, immature red blood cells called megaloblasts. The classic clinical symptoms include fatigue, weakness, pallor, palpitations, and dizziness, reflecting the underlying anemia. Neurological signs, such as paresthesias, ataxia, and cognitive impairment, may also be present in cases of vitamin B12 deficiency. Physical examination may reveal signs of digestive involvement, like glossitis and intestinal motility disorders. The key laboratory findings in the diagnosis of megaloblastic anemia include macrocytic, normochromic anemia, the presence of megaloblasts and macrocytes on the blood smear, and decreased levels of vitamin B12 and/or folate. Elevated homocysteine and methylmalonic acid levels can also be observed in vitamin B12 deficiency. In cases of suspected malabsorption, further testing, such as the Schilling test, endoscopy, and intestinal biopsy, may be necessary to identify the underlying cause. A comprehensive clinical assessment and the interpretation of laboratory results are essential for the accurate diagnosis and appropriate management of megaloblastic anemia. Understanding the various clinical and laboratory aspects of this condition is crucial for healthcare professionals to ensure timely and effective diagnosis and treatment.

ABSTRACT
One among the commonest type 1 surgical offloading procedure is gastrocnemius-soleus recession which is performed to correct equinus in neuropathic foot ulcer as well as other foot and ankle pathologies. There are numerous techniques be it open, percutaneous or endoscopic, being performed in different parts of the world, depending upon availability and surgeons choice. This paper aims to review the open and percutaneous gastrocnemius-soleus recession/lengthening techniques.

ABSTRACT
Recurrent urinary tract infection (rUTI) affects a large proportion of women after an initial episode and consumes a substantial share of community antibiotic prescribing, yet prevention remains unsatisfactory and recurrence incompletely explained. Approximately half of recurrences are caused by the strain responsible for the index infection, implying a host reservoir that antimicrobial treatment does not eradicate. That reservoir is the intestine. This review applies to that reservoir an established mechanism that governs its size. Depletion of butyrate-producing Clostridia reduces peroxisome proliferator-activated receptor gamma signalling in colonocytes, shifts epithelial metabolism away from beta-oxidation, raises luminal oxygen and nitrate availability and permits an aerobic expansion of Enterobacteriaceae, including Escherichia coli. Butyrate sustains the physiological hypoxia that restrains this expansion by stabilising hypoxia-inducible factor, and the pathway is pharmacologically reversible in animal models. Women with rUTI show depletion of richness and of butyrate-producing bacteria without a corresponding difference in E. coli abundance, an apparent paradox that the proposed mechanism resolves, because what is lost is the epithelial capacity to restrain expansion rather than the organism itself. At population scale, butyrate-producer abundance is inversely associated with hospitalisation for infection. Antibiotics deplete these taxa profoundly and for prolonged periods, which closes a plausible self-perpetuating loop. Restoration of the intestinal community by faecal microbiota transplantation reduces recurrence. Butyrate nevertheless does not appear among interventions evaluated in current syntheses of non-antibiotic prophylaxis. We set out the evidence, state the falsifiable predictions of the model, and outline the trial required to test it. We locate butyrate-directed intervention within the wider class of postbiotic and microbial-metabolite strategi

ABSTRACT
Tonsillectomy is a common otorhinolaryngological procedure, and although postoperative taste disturbance is uncommon, it can persist and adversely affect quality of life. We report a case of persistent taste disturbance following cold-steel tonsillectomy in a previously healthy 31-year-old woman. The patient presented to the ENT department in July 2025 with a six-month history of loss of taste that had started immediately after tonsillectomy performed for chronic tonsillitis associated with persistent halitosis and throat discomfort. She reported inability to perceive sweet, salty, and sour tastes, while her sense of smell remained intact. Clinical examination showed well-healed tonsillar fossae and no other relevant abnormality. Laboratory and radiological investigations were not performed because of limited diagnostic facilities. She was managed conservatively with vitamins B1, B6, B12 and folic acid together with zinc sulphate. Complete recovery of taste was reported after four months of treatment and follow-up. Post-tonsillectomy taste disturbance is a rare but clinically significant complication. Patients should be counselled about this possible complication, and persistent symptoms should prompt appropriate clinical assessment and follow-up.