Publications by authors named "Jeremia J Pyuza"

8 Publications

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Non-Hodgkin lymphoma of bone of the femur and humerus: a case report and review of the literature.

Oxf Med Case Reports 2021 Apr 28;2021(4):omab024. Epub 2021 Apr 28.

Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.

Lymphoma of bone is a rare neoplasm composed of malignant lymphoid cells, producing a tumefactive lesion within bone. We report a 13-year-old male who presented with progressively increasing swellings at the right shoulder and right mid-thigh for one month. Radiological images revealed lytic destructive lesions associated with soft tissue masses in both sites and a pathological fracture on the right humerus. The patient had no significant medical history. Histological, immunohistochemical and fluorescent in-situ hybridization assessment of biopsies from the lesions confirmed the diagnosis of primary non-Hodgkin lymphoma of bone. Unfortunately, due to coronavirus disease 2019 outbreak, the patient was unable to follow-up treatment and died shortly after establishment of the diagnosis. Delay in diagnosis and treatment is of serious concern when it comes to improve the prognosis of patients with this disease.
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http://dx.doi.org/10.1093/omcr/omab024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082228PMC
April 2021

Placental pathology and maternal factors associated with stillbirth: An institutional based case-control study in Northern Tanzania.

PLoS One 2020 31;15(12):e0243455. Epub 2020 Dec 31.

Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Objective: To determine the placental pathologies and maternal factors associated with stillbirth at Kilimanjaro Christian Medical Centre, a tertiary referral hospital in Northern Tanzania.

Methods: A 1:2 unmatched case-control study was carried out among deliveries over an 8-month period. Stillbirths were a case group and live births were the control group. Respective placentas of the newborns from both groups were histopathologically analyzed. Maternal information was collected via chart review. Mean and standard deviation were used to summarize the numerical variables while frequency and percentage were used to summarize categorical variables. Crude and adjusted logistic regressions were done to test the association between each variable and the risk of stillbirth.

Results: A total of 2305 women delivered during the study period. Their mean age was 30 ± 5.9 years. Of all deliveries, 2207 (95.8%) were live births while 98 (4.2%) were stillbirths. Of these, 96 stillbirths (cases) and 192 live births (controls) were enrolled. The average gestational age for the enrolled cases was 33.8 ±3.2 weeks while that of the controls was 36.3±3.6 weeks, (p-value 0.244). Of all stillbirths, nearly two thirds 61(63.5%) were males while the females were 35(36.5%). Of the stillbirth, 41were fresh stillbirths while 55 were macerated. The risk of stillbirth was significantly associated with lower maternal education [aOR (95% CI): 5.22(2.01-13.58)], history of stillbirth [aOR (95%CI): 3.17(1.20-8.36)], lower number of antenatal visits [aOR (95%CI): 6.68(2.71-16.48), pre/eclampsia [aOR (95%CI): 4.06(2.03-8.13)], and ante partum haemorrhage [OR (95%CI): 2.39(1.04-5.53)]. Placental pathology associated with stillbirth included utero-placental vascular pathology and acute chorioamnionitis.

Conclusions: Educating the mothers on the importance of regular antenatal clinic attendance, monitoring and managing maternal conditions during antenatal periods should be emphasized. Placentas from stillbirths should be histo-pathologically evaluated to better understand the possible aetiology of stillbirths.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243455PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775101PMC
January 2021

Ovarian malignant mixed Müllerian tumor: a rare case report from Tanzania.

J Surg Case Rep 2020 Oct 20;2020(10):rjaa406. Epub 2020 Oct 20.

Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Malignant mixed Müllerian tumor of the ovary is rare aggressive tumor that is histologically defined by the presence of malignant epithelial and stromal components. We report a 37-year-old woman who consulted our facility complaining of abdominal distention and a painful palpable mass over her lower abdomen. Physical examination including computerized tomography revealed a complex cystic mass lesion on the left ovary with extensive omental involvement. Ovarian cancer was suspected and the patient underwent debulking surgery. The histopathology of the specimen revealed a high-grade tumor composed of both malignant epithelial and sarcomatous elements. Both epithelial and stromal components stained positive for p53 immunostaining. Before the initiation of chemotherapy, on 5th day postoperation, the patient was found unresponsive. The stage of the disease seems to be the most important prognostic factor, thus emphasis should be made to identify it in earlier stages.
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http://dx.doi.org/10.1093/jscr/rjaa406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571862PMC
October 2020

Diagnosis of primary osteosarcoma of the urinary bladder in a resource-limited setting: a case report and review of the literature.

J Surg Case Rep 2020 Jul 23;2020(7):rjaa236. Epub 2020 Jul 23.

Department of Biomedical Science, College of Health Sciences (CHS), The University of Dodoma, Dodoma, Tanzania.

Extraskeletal osteosarcoma is a rare malignant mesenchymal soft tissue tumor without attachment to the bone and is able to produce osteoid or cartilaginous matrix. Rendering a definitive diagnosis may pose a challenge particularly in a resource-limited setting. We report a case of primary osteosarcoma of the urinary bladder presenting with hematuria, dysuria and positive history of schistosomal contact. Computed tomography intravenous urogram revealed a large heterogeneous mass at the right superolateral aspect of the urinary bladder. Morphological evaluation of the biopsy and a minimal panel of immunohistochemical antibodies of vimentin and cytokeratin 20 ruled out potential differentials and thus confirmed the diagnosis of osteosarcoma.
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http://dx.doi.org/10.1093/jscr/rjaa236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378020PMC
July 2020

Schistosomiasis and cancer: Experience from a zonal hospital in Tanzania and opportunities for prevention.

J Surg Case Rep 2020 May 1;2020(5):rjaa144. Epub 2020 Jun 1.

Department of General Surgery, Kilimanjaro Christian Medical Center, Moshi, Tanzania.

Schistosomiasis infection is endemic in many parts of Tanzania. The morbidity due to Schistosomiasis and its association with cancer remains to be of great concern and poses greater challenge that needs to be assessed. Cancer is an increasing public health problem in most sub-Saharan African countries, and yet, cancer control programs and the provision of early detection and treatment services are limited despite this increasing burden. This article aims to discuss case series of patients diagnosed with urinary bladder, prostate and colorectal cancer together with Schistosoma infection. We further highlight the opportunities for combating new Schistosomiasis infection, a potential to reduce its oncological complications particularly in low-resource setting.
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http://dx.doi.org/10.1093/jscr/rjaa144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263752PMC
May 2020

Missed opportunity of deworming a Maasai boy from nomadic family leading to life threatening intestinal obstruction.

J Surg Case Rep 2020 May 26;2020(5):rjaa096. Epub 2020 May 26.

Department of pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Mass deworming against soil-transmitted helminthiasis, including (AL), is one of the largest public health interventions in low- and middle-income countries. The prevalence of in Tanzania is 6.8%. We present a 3-year-old male of a known Tanzanian nomadic tribe (Masaai tribe) with history of missed deworming, who was brought to the emergency department with a 3-day history of constipation, nonprojectile, bilious vomiting, generalized abdominal distension and pain.

He was diagnosed with intestinal obstruction by the use of a plain abdominal X-ray, which revealed marked gaseous distension of the stomach and bowels without significant air-fluid levels. He was initially treated with intravenous ceftriaxone 50 mg/kg, metronidazole 15 mg/kg and acetaminophen 15 mg/kg. An explorative laparotomy was then performed. Intraoperative findings demonstrated a dense collection of worms in the gangrenous proximal jejunum and duodenum. Thorough abdominal lavage was carried out and abdomen was closed.
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http://dx.doi.org/10.1093/jscr/rjaa096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251234PMC
May 2020

Seroprevalence of hepatitis B virus infection and associated factors among healthcare workers in northern Tanzania.

BMC Infect Dis 2018 Sep 21;18(1):474. Epub 2018 Sep 21.

Institute of Public Health, Community Health Department, Kilimanjaro Christian Medical University College, P.O.Box2240, Moshi, Tanzania.

Background: Hepatitis B virus infection is a global health problem with the highest prevalence in East Asia and Sub-Saharan Africa. The majority of infected people, including healthcare workers are unaware of their status. This study is aimed to determining seroprevalence of hepatitis B virus infection and associated factors among healthcare workers in northern Tanzania.

Methods: This cross-sectional study included 442 healthcare workers (HCWs) from a tertiary and teaching hospital in Tanzania before the nationwide hepatitis B vaccination campaign in 2004. Questionnaire- based interviews were used to obtain detailed histories of the following: demographic characteristics; occupation risks such splash and needle stick injuries or other invasive procedure such as intravenous, intramuscular or subcutaneous injections; history of blood transfusion and surgeries, as well as HCWs'knowledge of HBV. Serological markers of HBV were done using Laborex HBsAg rapid test. Serology was done at zero months and repeated after six months ( bioscienceinternational.co.ke/rapid-test-laborex.html HBsAg Piazzale-milano-2, Italy [Accessed on November 2017]). Chi-square (χ) tests were used to compare proportion of HBV infection by different HCWs characteristics. Multivariable logistic regression was used to determine factors associated with HBV infection.

Results: A total of 450 surveys were sent out, with a 98.2% response rate. Among the 442 HCWs who answered the questionnaire, the prevalence of chronic hepatitis B virus infection was 5.7% (25/442). Only 50 (11.3%) of HCWs were aware of the HBV status. During the second HBsAg testing which was done after six months one participant sero-converted hence was excluded. Adjusted for other factors, history of blood transfusion significantly increased the odds of HBV infection (OR = 21.44, 95%CI 6.05, 76.01, p < 0.001) while HBV vaccine uptake was protective against HBV infection (OR = 0.06, 95%CI 0.02, 0.26, p < 0.001). The majority of HCWs with chronic HBV infection had poor to fare knowledge about HBV infection but this was not statistically significant when controlled for confounding.

Conclusions: Prevalence of HBV among health care workers was 5.7% which is similar to national prevalence. Although the response rate to take part in the study was good but knowledge on HBV infection among HCWs was unsatisfactory. History of blood transfusion increased risks while vaccine uptake decreased the risk of HBV infection. This study recommends continues vaccinating HCWs together with continues medical education all over the country. We also recommend documentation of vaccination evidence should be asked before employment of HCWs in order to sensitize more uptakes of vaccinations. Although we didn't assess the use of personal protective equipment but we encourage HCWs to abide strictly on universal protections against nosocomial infections.
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http://dx.doi.org/10.1186/s12879-018-3376-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6151054PMC
September 2018

ABO and Rhesus blood group distribution and frequency among blood donors at Kilimanjaro Christian Medical Center, Moshi, Tanzania.

BMC Res Notes 2017 Dec 16;10(1):738. Epub 2017 Dec 16.

School of Public Health, Kilimanjaro Christian Medical University College, P.O. Box, 2240, Moshi, Kilimanjaro, Tanzania.

Objective: This study aims to determine the distribution of blood groups and the demographic background of blood donors in a referral hospital in Northern Tanzania.

Results: The most common blood group was O (52.3%) and the least common was AB (3.18%). 97.7% of the blood donors were Rh positive and the rest were Rh negative. Most donors were young adults, representing the age group of 19-29. The majority of donors were male (88.1%) and the majority (90.8%) were replacement while the remainder was voluntary donors.
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http://dx.doi.org/10.1186/s13104-017-3037-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732446PMC
December 2017