BACKGROUND AND PURPOSE: DWI-detected ischemic lesions are potential complications of endovascular procedures that are performed to treat intracranial aneurysms. We completed a systematic review and meta-analysis to identify the occurrence of DWI-detected ischemic lesions after endovascular treatment for intracranial aneurysms. MATERIALS AND METHODS: A systematic literature search of PubMed, the Web of Science, EMBASE, and Scopus between January 2000 and June 2022 of post-endovascular procedures for intracranial aneurysm studies was conducted using the Nested Knowledge AutoLit software. The main outcome was DWI-detected ischemic lesions within 5 days of the procedures. Information regarding associated risk factors such as the type of procedure, patient demographics, and aneurysm characteristics was also collected. RESULTS: Twenty-nine studies with 2686 patients were included. The overall incidence of DWI ischemic lesions was 47.0% (95% CI, 39.6%–55.8%). The highest rate of lesions was seen with flow diversion at 62.4% (95% CI, 48.4%–80.5%), followed by complex procedures at 49.3% (95% CI, 29.5%–82.1%), stent-assisted coiling at 47.5% (95% CI, 34.6%–65.3%), simple coiling at 47.1% (95% CI, 35.7%–62.3%), and balloon-assisted coiling at 37.0% (95% CI, 28.3%–48.4%). The differences among different techniques were not statistically significant; however, there was significant heterogeneity and a significant risk of publication bias among included studies. CONCLUSIONS: Many patients who undergo endovascular procedures for intracranial aneurysms present with new postprocedural DWI-detected ischemic lesions, regardless of the endovascular procedure used. Future studies and meta-analyses are needed to investigate early and long-term outcomes of such small infarcts.

Fluoroquinolones have been associated with hypoglycemia in patients taking diabetic medications, most commonly due to drug-drug interactions and other associated risk factors. Except for four published case reports, there are no studies that have found positive associations between ciprofloxacin and hypoglycemia. In all but one of the cases, ciprofloxacin was taken with other hypoglycemic drugs. Recently, the Eritrean National Pharmacovigilance Centre received a serious case of hypoglycemia with recurrent episodes in a young and healthy patient without diabetes following use of oral ciprofloxacin. The aim of the present study is therefore to assess the causal relationship between ciprofloxacin and hypoglycemia in patients without diabetes using the World Health Organization-Uppsala Monitoring Centre global adverse drug reaction database (VigiBase®). A search was made on the World Health Organization global adverse drug reaction database (August 15, 2018) using “ciprofloxacin” as the drug substance and “hypoglycemia” as the reaction term. Cases that used hypoglycemic drugs (patients with diabetes) concurrently with ciprofloxacin and those with a completeness score below 50% were excluded to control for confounders and to improve the strength of the data. Hill criteria were used to assess causation. A total of 35 cases of hypoglycemia reported since 1989 from 17 countries in patients without diabetes associated with ciprofloxacin use with a median time to onset of 4 days were retrieved. The cases have a median age of 64 years (interquartile range, 50–85) with a similar male–to-female ratio. Ciprofloxacin was the only suspect and the sole drug administered in 48.5% of the cases. In ten cases, hypoglycemia abated following withdrawal of ciprofloxacin, and reaction recurred in one case on the subsequent rechallenge. Hypoglycemia was marked as “serious” in 20 cases, and the outcome was fatal in two cases. This assessment found a suggestive causal link between use of ciprofloxacin and hypoglycemia in patients without diabetes.

Background: Congenital heart disease (CHD) encompasses morphofunctional anomalies in the heart and circulatory system present at birth, which may not become apparent until later in life. In Ethiopia, there needs to be more understanding of the prevalence, patterns, and associated complications of CHD malformations. This study aimed to investigate the patterns and complications of CHDs among patients receiving follow-up care at a specialized university referral hospital in Ethiopia. Methods: A hospital-based cross-sectional study was conducted on 199 patients with CHDs to assess the patterns and complications of defects. Retrospective data were collected from 16,972 patients who had follow-ups at a cardiac clinic in 2021 using medical records, and a statistical analysis was performed with SPSS version 24. Results: The most prevalent types of CHDs in our study population were atrial septal defects (ASDs) at 41.2% (82 cases), ventricular septal defects (VSDs) at 26.6% (53 cases), and patent ductus arteriosus (PDAs) at 9.5% (19 cases). Complications related to CHDs were observed in 69.3% (138) of patients, with 30.7% (61) experiencing a single complication and 39.2% (87) experiencing multiple complications. Conclusion: This study found a higher prevalence of CHDs in females (77.8%) compared to males, a trend consistent across various atrial and ventricular defect types. Individuals aged 15 to 25 years exhibited the highest incidence of ASD and VSD. Moreover, CHD-related anomalies were present in 69.3% of the patients studied.

Though the incidence of gout in general population is less than 5% (globally), a study conducted in Eritrea among patients with multidrug resistant tuberculosis (MDR-TB) revealed a higher incidence (25%). Other similar studies conducted elsewhere, however, did not report gout as an adverse effect. It is unknown why a higher incidence of gout is being reported in Eritrea compared to similar studies from other countries. The objective of this study is therefore to explore risk factors for the increased risk of incident gout among MDR-TB patients in Eritrea. A case-control study was conducted in Merhano MDR-TB National Referral Hospital in Eritrea. All MDR-TB patients diagnosed with gout between June 2011 and June 2018 were considered as cases. Controls matched by age, sex, and cumulative drug exposure time were selected from the same study population (1:1 ratio). A total of 84 MDR-TB patients, 42 cases and 42 controls, were included in this study. No patient from the control group has comorbidities, while six patients from the case group have diabetes (χ2 = 6.46, df=1, p=0.026). Patients having tachycardia (OR=3.26, 95% CI=1.28, 8.27), alopecia (OR=3.11, 95% CI=1.00, 9.67), and gastrointestinal upset (OR=3.17, 95% CI=1.26, 7.96) as adverse effects and being on prolonged use of propranolol (OR=3.26, 95% CI=1.28, 8.27) were found to be more likely to develop incident gout compared to their controls. In conclusion, MDR-TB patients with diabetes mellitus, tachycardia, alopecia, and gastrointestinal upset and on prolonged use of propranolol tablet had increased risk of incident gout.

Hepatic endotheiloid hemangioendothelioma (EHE) commonly presents with multilobar involvement with locally aggressive behavior. In most cases, it presents with right upper quadrant abdominal pain, hepatomegaly, and weight loss with metastasis commonly to the lung. We present a 33-year-old woman with hepatic EHE with an initial presentation mimicking hepatic abscess and imaging findings misleading for metastatic liver lesions. It was confirmed on pathology with immunohistochemistry, but the patient could not survive due to her late presentation and the presence of metastatic lesions in the lung.

Coronary Heart Disease (CHD) being one of the major manifestations of atherosclerotic cardiovascular disease, it ranks a third for all deaths above the age of 35 in developed countries. It is the principal cause of mortality globally for greater than 4.5 million people in the developing world with a relative lack of preventive measures implemented. Eighty percent of deaths due to Cardiovascular Diseases (CVD) occur in developing countries. CHD rates are expected to increase in developing countries mainly South East Asia, Sub-Saharan Africa, Latin America, and the Middle East; from 9 million in 1990 to 19 million by 2020. This Retrospective study was carried out to assess the Prevalence, Presenting Complaints, Risk factors and Comorbidity of Acute Coronary Syndrome (ACS) at Orotta National Referral Hospital Intensive Care Unit, Asmara, Eritrea. Hospital based Retrospective record review study of ten years was done on clinical cards of patients. The study results revealed an overall prevalence of 8.5 percent. ACS was observed to increase with an increasing age, being higher in 164 patients (55%) who are in the age group greater than sixty. Majority (86.6%) of admissions were reported as from zoba Maekel. It was observed to increase in males than females with 3.66 to 1 ratio of male to female. Chest pain was documented as a chief complaint (85.23%). The average length of hospital stay until discharged or death was found to be 11 days. Comorbidity between Hypertension, Diabetes and ACS was documented as 55.4 percent showing a significant association (P Value= 0.001). The study results also revealed a significant association between sex and, NSTEMI and STEMI at a P- value = 0.003, but no any association was found among NSTEMI and STEMI, and age, smoking, cholesterol level, Diabetes and Hypertension. In conclusion, this study revealed that ACS is increasing in Eritrea as any other developed and developing countries. The association between sex and, NSTEMI and STEMI which may be attributed to modifiable behavioral risk factors that are gender related. Therefore, the study recommends to Clinicians to ask and record, family history of premature CHD death, duration of Diabetes, Hypertension and other chronic cardio-pulmonary diseases, all diagnostic investigations and specific medications that are used for the management of the disease and good outcome.