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.

ABSTRACT
Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities associated with cardiovascular disease and diabetes. This study assessed the prevalence, distribution of metabolic syndrome components, and associated factors among adults attending the medical outpatient clinic at Bugando Medical Centre (BMC), Mwanza, Tanzania. Methods: This hospital-based cross-sectional study was conducted from May to June 2022 among adults aged ≥18 years attending the BMC medical outpatient clinic. Participants were selected by systematic sampling. Sociodemographic, lifestyle and clinical information was collected using a structured questionnaire. Blood pressure, body weight, height and waist circumference were measured, and fasting blood samples were analyzed for glucose, triglycerides, high-density lipoprotein cholesterol, C-reactive protein and serum uric acid. MetS was defined using International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Univariable and multivariable logistic regression were used to assess associated factors. Results: Of 219 patients screened, 197 were eligible and 181 consented to participate. The median age was 58 years and 107 (59.1%) were female. MetS was present in 84 (46.6%) participants by IDF criteria and 69 (38.1%) by ATP III criteria. Hypertension was the most common component (159, 87.8%), followed by central obesity by IDF criteria (115, 63.5%). Physical activity of less than 150 minutes/week was associated with higher odds of MetS (odds ratio [OR] 4.17, 95% confidence interval [CI] 1.49–11.11; p=0.008). Obesity (body mass index [BMI] ≥30 kg/m²) was also associated with higher odds of MetS (OR 8.44, 95% CI 2.35–30.25; p=0.001). Conclusion: MetS was common among adults attending the BMC medical outpatient clinic.

ABSTRACT
The aim of this study is to determine the sociodemographic characteristics, as well as the clinical, radiological, histopathological, therapeutic and prognostic aspects of benign non-odontogenic tumours (BNOTs) in the Chadian context. This was a descriptive and analytical cross-sectional study with prospective data collection, conducted between 2023 and 2025 (3 years) in the Department of Dentistry, Oral and Maxillofacial Surgery at the Renaissance University Hospital in N’Djamena for specimen collection and data gathering, and at the Department of Pathological Anatomy and Cytology at Cheikh Anta Diop University in Dakar for the histological analysis of surgical specimens. The study included patients presenting with a benign non-odontogenic tumour confirmed by histopathological examination and who had received treatment. The variables studied were sociodemographic, clinical, radiological, histopathological, therapeutic and prognostic. Benign non-odontogenic tumours accounted for 26% of all benign maxillomandibular tumours. The mean age was 36.32 ± 21.55 years, with a sex ratio of 1.5. The majority of patients resided in the province of N’Djamena (64%). The middle socio-economic class was affected in 64% of cases. Painless swelling was the predominant symptom (100%). The maxilla was affected in 44% of cases. Mixed forms accounted for 40% of the lesions observed based on radiographic characteristics. Surgical excision of the tumour mass was performed in 56% of patients. Ossifying fibroma was the most common histological type (20%). The outcome was favourable in 92% of cases. One case of death and one case of oro-sinus communication were recorded. The mean follow-up period was 8 ± 5 months. The correlation between clinical and radiological characteristics and histological findings was statistically significant (p=0). This study shows that benign non-odontogenic tumours are relatively common. They are diverse and varied. The diagnostic approach requires a correlation be

ABSTRACT
Gastric polyps are mucosal lesions protruding into the lumen of the stomach and are increasingly detected due to the widespread use of upper gastrointestinal endoscopy. Although most gastric polyps are benign and asymptomatic, certain subtypes possess malignant potential and may progress to gastric adenocarcinoma. Accurate pathological diagnosis is therefore essential for appropriate clinical management and surveillance. This review summarizes the current understanding of gastric polyps, including epidemiology, classification, histopathological characteristics, malignant potential, and diagnostic considerations according to recent pathological classifications.