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Background: Most structural malformations are not detected until birth in less developed countries unlike advanced nations. We decided to assess the role of anomaly scan by specialists in a newly installed, sole specialized unit in a Nigeria town. Methodology: Pregnant women referred to the unit were counseled and recruited for the study after informed consent. GE Voluson 730 professional ultrasound machine with 2D & 4D probes was utilized to scan the patients at 20 weeks with a repeat at 34 weeks gestation. The newborns were then clinically examined, investigated and or autopsied. Result: Five thousand fetuses were examined within eighteen months. Twenty anomalies with prevalence rate of 4 per 1000 were discovered. Head/Neck/spinal anomalies were the highest specifically anencephaly .Renal anomalies were also common. The sensitivity and positive predictive values were 100%. Conclusion: Anomaly Scanning at 20 weeks and 34 weeks reduces perinatal mortality and morbidity, provides opportunity for early treatment and reduces the financial, physical and emotional stress on parents. It is also very reliable and sensitive if (and should be) done by specialists with high resolution 2D & 4D ultrasound machines.

(1) Background: NHS England recommended faecal immunochemical testing (FIT) for symptomatic patients in June 2020 to rationalise limited diagnostic services during COVID-19. (2) Aim: to investigate the diagnostic performance of FIT, analysing the proportion of FIT-negative colorectal cancers (CRC) missed in symptomatic patients and how this risk could be mitigated. (3) Design and Setting: a retrospective study of biochemistry and cancer databases involving patients referred from primary healthcare with suspected CRC to a single secondary care trust in North East London. (4) Methods: a retrospective cohort diagnostic accuracy study was undertaken to determine the performance of FIT for detecting CRC at 10 µgHb/g. (5) Results: between January and December 2020, 7653 patients provided a stool sample for FIT analysis; 1679 (22%) samples were excluded due to inadequate or incorrect specimens; 48% of suspected CRC referrals completed FIT before evaluation; 86 FIT tested patients were diagnosed with histologically proven CRC. At 10 µgHb/g, FIT performance was comparable with the existing literature with a sensitivity of 0.8140 (95% CI 0.7189-0.8821), a specificity of 0.7704 (95% CI 0.7595-0.7809), a positive predictive value (PPV) of 0.04923 (95% CI 0.03915-0.06174), a negative predictive value (NPV) of 0.9965 (95% CI 0.9943-0.9978), and a likelihood ratio (LR) of 3.545; 16 patients with CRC had an FIT of ≤10 µgHb/g (18.6% 95% CI 11.0-28.4%). (6) Conclusions: this study raises concerns about compliance with FIT testing and the incidence of FIT-negative CRC at the NICE recommended threshold and how this risk can be mitigated without colonic imaging. Whilst FIT may have facilitated prioritisation during COVID-19, we must be cautious about using FIT alone to determine which patients are referred to secondary care or receive further investigation.

Background: Mortality associated with delayed diagnosis of brain abscess is high. A high index of suspicion in conjunction with the use of neuroimaging is important for the early diagnosis of brain abscess. Early use of appropriate antimicrobial and neurosurgical care improves outcomes., Methods: We report a fatal case of an 18 year old female with a huge brain abscess who was misdiagnosed as a case of migraine headache over a 4-month period in a referral hospital., Report: An 18-year-old female with a missed history of recent furuncles occurring in the right frontal part of her head and right upper eyelid who presented with a recurrent throbbing headache to a private hospital over 4 months. There was a positive maternal history of episodic headaches, as such, the patient was diagnosed as having a migraine headache disorder at the private hospital. The patient was referred to our facility on account of repeated seizures over 2 days and lapsing into a coma. Clinical examination showed evidence of focal neurologic deficits and a suspicion of brain abscess was confirmed with an urgent cranial MRI. She succumbed to her illness within 3hrs of presentation., Conclusion: Detailed history, a high index of suspicion, use of appropriate neuroimaging and early diagnosis is important in reducing the mortality associated with brain abscess., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2023 by West African Journal of Medicine.)

Healthcare workers, both globally and in Nigeria, have an increased risk for SARS-CoV-2 infection compared with the general population due to higher risk contacts, including occupational exposures. In addition, primary healthcare workers represent an important group for estimating prior infection to SARS-CoV-2 because they work at the first point-of-contact for most patients yet have not been included in prior COVID-19 seroepidemiology research in Nigeria. We sought to evaluate baseline seroprevalence, rates of seroconversion (IgG- to IgG+) and seroreversion (IgG+ to IgG-), change in IgG concentration at 3- and 6-month follow-up, and factors associated with seropositivity. From June 2020 to December 2020, we conducted a longitudinal seroepidemiology study among frontline health care workers in Nigeria using a validated dried blood spot assay. Among 525 participants, mean (SD) age was 39.1 (9.7) years, 61.0% were female, and 45.1% were community health workers. The six-month follow-up rate was 93.5%. Seropositivity rates increased from 31% (95% CI: 27%, 35%) at baseline to 45% (95% CI: 40%, 49%) at 3-month follow-up, and 70% (95% CI: 66%, 74%) at 6-month follow-up. There was a corresponding increase in IgG levels from baseline (median = 0.18 ug/mL) to 3-month (median = 0.35 ug/mL) and 6-month follow-up (median = 0.59 ug/mL, Ptrend < .0001). A minority of participants reported symptoms from February 2020 until baseline (12.2%) or during 3-month (6.6%) or 6-month (7.5%) follow-up. only 1 participant was hospitalized. This study demonstrated high baseline, 3-month and 6-month follow-up prevalence of IgG antibodies to SARS-CoV-2 during the first two waves of the COVID-19 pandemic in Nigeria among a cohort of unvaccinated frontline healthcare workers, including primary healthcare workers despite low symptomatology. These results may have implications in state- and national-level disease pandemic modeling. Trial registration: NCT04158154., Competing Interests: I have read the journal’s policy and one of the authors, MDH has the following competing interests:” has patents pending for combination therapy for the treatment of heart failure (HFpEF Poly diuretic) with application serial number: 63/261,121. The George Institute for Global Health has a patent, license, and has received investment funding with intent to commercialize fixed-dose combination therapy through its social enterprise business, George Medicines. The other authors do not report any disclosures., (Copyright: © 2023 Ojji et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)