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Intermittent Testicular Torsion in an African Adult Patient: Sonographic Doppler findings of an uncommon and challenging diagnosis 间歇性睾丸扭转在非洲成人患者:超声多普勒发现一个罕见的和具有挑战性的诊断
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.914
B. Chinene
Testicular torsion is a well known urological emergency most common in the paediatric population. However, testicular torsion can be complete, partial or intermittent. Intermittent testicular torsion is rare in adults and difficult to diagnose. We present a rare case on intermittent testicular torsion in a 35 year old man that was initially misdiagnosed but was later diagnosed by Spectral Doppler ultrasound.   
睾丸扭转是一种众所周知的泌尿外科急症,在儿科人群中最为常见。然而,睾丸扭转可以是完全的、部分的或间歇性的。间歇性睾丸扭转是罕见的,在成人和难以诊断。我们提出一个罕见的病例间歇性睾丸扭转在一个35岁的男子,最初被误诊,但后来被诊断为频谱多普勒超声。
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引用次数: 0
Cardiopulmonary Resuscitation among Nursing Staff At A Tertiary Health Facility: A Cross-Sectional Study 三级医疗机构护理人员心肺复苏:一项横断面研究
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.880
Monisola Aina, O. Bolarinwa, Peace I Adeniran, D. Oyedepo, A. Adeniran
Background: Cardiopulmonary Resuscitation (CPR) is an emergency life-saving care to restore blood circulation following cardiac arrest. Nurses are often the closest when cardiac arrest occurs, thus their competence and initiation of CPR could be life-saving. Aim: To evaluate the knowledge, attitude and willingness to initiate CPR among nurse practitioners. Methods: A cross-sectional study was conducted; participants were nursing staff at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Nursing students and other healthcare workers were excluded from the study. Multistage sampling method was used and all participants completed a self-administered questionnaire after informed consent. Data analysis was with SPSS version 21.0 and p<0.05 was significant. Results: Among the 220 participants, 35(15.9%) were ≤5years post-qualification, 100(45.5%) had sub-specialty training, awareness about CPR was 100%, 66(30%) showed good knowledge on the practice of CPR, 154(70%) had formal training on CPR, 112 (50.9%) of the training were during schooling while 182(82.7%) showed good attitude towards initiating CPR when indicated. Hindrances to initiation of CPR included lack of training (56.2%), heavy workload (47.3%), inadequate knowledge (42.8%), lack of equipment (41.8%) and difficulty establishing diagnosis of cardiac arrest (13.9%). Competence grading for CPR was 48.4% for participants with surgical, 40.0% for medical subspecialty training and 44.2% for non-subspecialists. There was statistical significant relationship between competence in CPR and knowledge about it (p=0.026).   Conclusion: Knowledge and practice of CPR among nurses was low; health institutions and the mandatory nursing professional development programs should prioritize post-qualification training of nurses in the life-saving skills of CPR.
背景:心肺复苏(CPR)是心脏骤停后恢复血液循环的紧急救生护理。当心脏骤停发生时,护士通常是最接近的,因此他们的能力和CPR的启动可能是挽救生命的。目的:了解护理人员实施心肺复苏术的知识、态度和意愿。方法:采用横断面研究;参与者是尼日利亚伊洛林伊洛林大学教学医院的护理人员。护理专业学生和其他医护人员被排除在研究之外。采用多阶段抽样方法,所有参与者在知情同意后自行填写问卷。数据分析采用SPSS 21.0版本,p<0.05差异有统计学意义。结果:220名参与者中,35名(15.9%)获得资格≤5年,100名(45.5%)接受过专科培训,心肺复苏术知晓率为100%,66名(30%)对心肺复苏术有较好的认识,154名(70%)接受过正式的心肺复苏术培训,112名(50.9%)在学校接受过培训,182名(82.7%)在指征时对启动心肺复苏术持良好态度。启动CPR的障碍包括缺乏培训(56.2%)、工作量大(47.3%)、知识不足(42.8%)、缺乏设备(41.8%)和难以诊断心脏骤停(13.9%)。接受过外科培训的参与者心肺复苏能力评分为48.4%,接受过医学亚专科培训的参与者心肺复苏能力评分为40.0%,非亚专科培训的参与者心肺复苏能力评分为44.2%。心肺复苏术能力与心肺复苏术知识之间有统计学意义(p=0.026)。结论:护士心肺复苏术知识和实践水平较低;卫生机构和强制性护理专业发展计划应优先对护士进行CPR救生技能的资格后培训。
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引用次数: 0
Histomorphological Spectrum and Trend of Spinal Neoplastic Lesions: A Single Institutional 40-year review 脊髓肿瘤病变的组织形态学谱和趋势:单一机构40年回顾
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.65
A. Salami, Nwadiokwu John Ifeanyi, Iwuagwu Emmanuel Ifeanyi, Ajani Mustapha Akanji, Ayokunle James Balogun, OyemoladeAyofe Toyin, A. Augustine
OBJECTIVES Spinal tumours are known to be much less common compared to brain neoplasms. In our setting, due to poor data gathering, underreporting and probably lack of presentation to medical facilities, studies on spinal tumours are sparse. Previous studies had reported extramedullary tumours to be more common in our environment. This study examines the histomorphological spectrum of spinal tumours in an African setting, comparing it with previous observations to determine changes over the decades. METHODS Data was obtained from the hospital records of patients over a forty-year period. These include the patients’ age, gender and histomorphological data of all the neoplastic spinal lesions. The data was analysed using SPSS 20 statistical software. RESULTS Ninety four cases were seen during the study period. The tumours were more common between the third to the sixth decades of life. There was a slight male preponderance with a male to female ratio of 1.2:1. Meningiomas were the commonest tumours seen during the study period which is in contrast to previous studies that had shown Burkitt lymphoma. The data also showed a steady rise in the number of cases during the study period suggesting an increase in patients’ presenting to the hospital and more surgical cases. CONCLUSION The index study showed a difference in patients demographics and the histological tumour types seen over the study period compared to the data from previous studies. This is probably due to better awareness and better diagnostic facilities.
目的:与脑肿瘤相比,脊柱肿瘤的发病率要低得多。在我们的环境中,由于数据收集不良、少报以及可能缺乏向医疗机构的报告,关于脊柱肿瘤的研究很少。以前的研究报告髓外肿瘤在我们的环境中更为常见。本研究检查了非洲地区脊髓肿瘤的组织形态学谱,并将其与以前的观察结果进行比较,以确定几十年来的变化。方法从40年的医院记录中获取数据。这些包括患者的年龄、性别和所有肿瘤性脊柱病变的组织形态学资料。采用SPSS 20统计软件对数据进行分析。结果研究期间共发现94例。这些肿瘤在30岁到60岁之间更为常见。有轻微的男性优势,男女比例为1.2:1。脑膜瘤是研究期间最常见的肿瘤,这与之前的研究显示的伯基特淋巴瘤形成对比。数据还显示,在研究期间,病例数量稳步上升,这表明患者到医院就诊的人数增加,手术病例增多。结论:指数研究显示,与以往研究的数据相比,研究期间的患者人口统计学和组织学肿瘤类型有所不同。这可能是由于更好的认识和更好的诊断设施。
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引用次数: 0
Characteristics of pregnant women who seroconvert after an initial negative Human Immunodeficiency Virus test result at antenatal booking at selected hospitals in Lusaka, Zambia. 在赞比亚卢萨卡选定医院进行产前预约时,人类免疫缺陷病毒初步检测结果为阴性后进行血清转化的孕妇的特征
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.948
Muyereka Nyirenda, L. Kasonka, B. Vwalika
ABSTRACT Objectives:  To examine the role of demographic, socio-economic, health and reproductive characteristics of pregnant women and study the impact of their utilization of health services in relation to seroconversion after an initial negative HIV test result in women attending ANC at selected hospitals in Lusaka. Methods: This was a case control study conducted at the Women and Newborn Hospital and selected level 1 hospitals in Lusaka district between July 2018 and June 2019. Convenience sampling was used. Interviews were conducted using a structured interviewer administered questionnaire involving 47 women who seroconverted (as cases) and 140 women who did not seroconvert (as controls). Results: The study found that monthly income, age at sexual debut, number of sexual partners in a lifetime, children with the same father, partners who did not test for HIV before ANC booking, partner perceived to be faithful, frequent travel in partner and less than four ANC visits were associated with HIV seroconversion. However, when these factors where adjusted in multivariate logistic regression for confounders, women who had sexual debut before the age of 16 years were seven times more likely to seroconvert (AOR=6.67, 95%CI=1.103-39.805, P=0.039), those whose partners tested for HIV before ANC booking were 72 percent less likely to seroconvert  (AOR=0.278, 95%CI=0.089-0.865, P=0.027), those who partners travelled out of town frequently were three times more likely to seroconvert (AOR=3.250, 95%CI=1.063-9.935, P=0.039) and those who attended less than four ANC visits were three times more likely to seroconvert (AOR=3.378, 95%CI=1.018-11.210, P=0.047).   Conclusion: Pregnant women are at risk of seroconverting during pregnancy leading to MTCT of HIV. It is therefore imperative that HCT be strengthened during ANC and labour. Targeting adolescents with sexual and reproductive health education before they start engaging in sexual activities is key to keeping them HIV negative. Pre-exposure prophylaxis should be provided to pregnant women whose partners decline HCT or are HIV positive. Frequent travellers should be educated to practice safer sex. Lastly, there is need to implement the WHO 2016 ANC recommendation of at least 8 contacts during pregnancy. Key words: HIV seroconversion, elimination of mother-to-child transmission, window period.                                       
摘要:目的:探讨人口统计学、社会经济、健康和生殖特征在孕妇中的作用,并研究在卢萨卡选定医院接受ANC治疗的妇女初次艾滋病毒检测结果为阴性后,她们利用卫生服务对血清转化的影响。方法:这是一项病例对照研究,于2018年7月至2019年6月在卢萨卡区妇女和新生儿医院和选定的一级医院进行。采用方便抽样。访谈采用结构化采访者管理的问卷进行,涉及47名转换服务的妇女(作为病例)和140名未转换服务的妇女(作为对照)。结果:研究发现,月收入、初次性行为的年龄、一生中性伴侣的数量、同父异母的子女、预约ANC前未进行HIV检测的伴侣、被认为是忠诚的伴侣、频繁的伴侣旅行以及少于4次ANC访问与HIV血清转化有关。然而,当这些因素在混杂因素的多变量logistic回归中进行调整时,16岁之前有过性行为的女性转化的可能性是其他女性的7倍(AOR=6.67, 95%CI=1.103-39.805, P=0.039),伴侣在ANC预约前检测过艾滋病病毒的女性转化的可能性要低72% (AOR=0.278, 95%CI=0.089-0.865, P=0.027),伴侣经常出市的女性转化的可能性是其他女性的3倍(AOR=3.250, P=0.027)。95%CI=1.063 ~ 9.935, P=0.039),就诊少于4次ANC的患者血清转化的可能性是对照组的3倍(AOR=3.378, 95%CI=1.018 ~ 11.210, P=0.047)。结论:孕妇在妊娠期存在血清转化导致HIV母婴传播的风险。因此,必须在非国大和劳动期间加强HCT。在青少年开始进行性活动之前对他们进行性健康和生殖健康教育,是使他们保持艾滋病毒阴性的关键。应向其伴侣感染艾滋病毒或艾滋病毒呈阳性的孕妇提供接触前预防。应教育经常旅行的人采取安全性行为。最后,需要实施世卫组织2016年ANC关于怀孕期间至少8次接触的建议。关键词:HIV血清转化,消除母婴传播,窗口期
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引用次数: 0
Addressing access to sexual and reproductive healthcare for women during the COVID-19 pandemic in low-resourced settings 解决COVID-19大流行期间资源匮乏地区妇女获得性保健和生殖保健的问题
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.919
M. A. Chipare
The delivery and utilization of reproductive health care services has suffered a major setback due to the COVID-19 pandemic and low and middle income countries have been disproportionately affected. This commentary discusses how the provision of reproductive health services has been impacted on by the COVID-19 pandemic and proffers possible recommendations on how to address this growing burden.
由于2019冠状病毒病大流行,生殖保健服务的提供和利用遭受了重大挫折,低收入和中等收入国家受到的影响尤为严重。本评论讨论了COVID-19大流行如何影响生殖健康服务的提供,并就如何应对这一日益加重的负担提出了可能的建议。
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引用次数: 0
Comparison of the Rowland University Dementia Assessment Scale and Mini-Mental State Examination cognitive screening tools among older people in Nigeria 尼日利亚老年人罗兰大学痴呆评估量表和迷你精神状态检查认知筛查工具的比较
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.915
L. Adebusoye, G. Arinola, George Amaefula, S. Hunter, H. Merl, V. Pitt
Introduction and objectives: Dementia is progressive neuro-degeneration characterized by ongoing deterioration in cognition and capacity for independent living. Empirical evidence is lacking on the best screening tool because of the cultural and linguistic diversities of Nigerians. This study screened for dementia and described the differences between the Rowland University Dementia Assessment Scale (RUDAS) and Mini-Mental State Examination (MMSE) tools among older people at the University College Hospital (UCH), Ibadan, Nigeria. Materials and Methods: Cross-sectional hospital-based descriptive study of 96 older people ≥60years at UCH, Ibadan. Dementia was assessed with the RUDAS and MMSE tools. Socio-demographic characteristics and memory issues were also assessed. Descriptive and inferential statistics were done and the level of significance was set at 5%. Results: The mean age was 70.5±7.4 years and 57(59.4%) were female respondents. The overall mean score on RUDAS was 22.8±4.0 points and MMSE was 24.2±4.8 points. Point prevalence of dementia on RUDAS and MMSE were 6.2% and 4.2% respectively. Using MMSE as the standard, the AUROC for the RUDAS was 85.9% (95% CI:60.4-99.8), and its sensitivity and specificity were75.0% and 96.7% respectively. Both RUDAS and MMSE were associated with age and residence. MMSE, but not the RUDAS, scores were influenced by total years of education (p<0.001). Conclusion: RUDAS was as accurate as MMSE for the screening of dementia in our setting. Contrary to the MMSE, RUDAS was not influenced by the years of education for dementia. Our finding supports the use of RUDAS as an effective alternative test to MMSE for dementia screening in older Nigerians.
前言和目的:痴呆症是一种进行性神经退行性疾病,其特征是认知能力和独立生活能力的持续恶化。由于尼日利亚人的文化和语言多样性,缺乏关于最佳筛选工具的经验证据。本研究对尼日利亚伊巴丹大学学院医院(UCH)的老年人进行痴呆筛查,并描述罗兰大学痴呆评估量表(RUDAS)和简易精神状态检查(MMSE)工具之间的差异。材料和方法:对伊巴丹联合医院96名≥60岁的老年人进行横断面描述性研究。痴呆用RUDAS和MMSE工具进行评估。社会人口特征和记忆问题也被评估。进行描述性和推断性统计,显著性水平设为5%。结果:平均年龄70.5±7.4岁,女性57例(59.4%)。RUDAS总分为22.8±4.0分,MMSE总分为24.2±4.8分。RUDAS和MMSE的痴呆点患病率分别为6.2%和4.2%。以MMSE为标准,RUDAS的AUROC为85.9% (95% CI:60.4 ~ 99.8),敏感性为75.0%,特异性为96.7%。RUDAS和MMSE均与年龄和居住地有关。MMSE分数受总受教育年限的影响,但RUDAS分数不受影响(p<0.001)。结论:在我们的环境中,RUDAS与MMSE一样准确地筛查痴呆。与MMSE相反,RUDAS不受痴呆症教育年限的影响。我们的发现支持使用RUDAS作为MMSE筛查老年尼日利亚人痴呆的有效替代测试。
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引用次数: 0
An Audit of Computed Tomography Services in Zambia 赞比亚计算机断层扫描服务审计
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.69
Stefan Kafwimbi, O. Bwanga, J. Sichone
Background: In Zambia, Computed Tomography (CT) has been available since 1994 as part of the healthcare delivery pathway. Radiographers undertake CT examinations of the body to diagnose diseases, injuries and to plan for radiotherapy.  Objective: The aim of this study was to audit CT services in Zambia.  Methodology: The study used a convergent parallel design in which quantitative and qualitative data were collected concurrently using an online questionnaire. Quantitative data were analysed using descriptive statistics, whilst qualitative data were analysed by themes.  Results: Out of the 23 facilities, a total of 22 responded. Results indicated that Western and Central provinces did not have CT scanners. Most CT facilities are in the Lusaka province. 59% (N=13) and 41% (N=9) were from the public and private sectors, respectively. In public hospitals, 46% (N=6) of CT scanners were functional with service contracts and 89% (N=8) were functional in the private hospitals with service contracts. 61.5 % (N=8) of public hospitals had maintenance schedules while 89% (N=8) of private hospitals had maintenance schedules. A total of 7 facilities reported having radiographers with a qualification in CT. 12 out of 22 facilities indicated having a radiologist with average patient waiting times for CT reports being 76 hours and 24 hours in public and private facilities, respectively.  Conclusion: This audit revealed an unequal distribution of CT scanners characterised by poor maintenance and lack of service contracts, especially in public hospitals. The audit also revealed longer waiting times for CT reports in public than in private hospitals.
背景:在赞比亚,自1994年以来,计算机断层扫描(CT)已成为医疗保健提供途径的一部分。放射技师对身体进行CT检查,以诊断疾病、损伤和计划放射治疗。目的:本研究的目的是审计CT服务在赞比亚。方法:本研究采用趋同平行设计,通过在线问卷同时收集定量和定性数据。定量数据采用描述性统计分析,定性数据采用主题分析。结果:在23家机构中,共有22家机构做出了回应。结果显示,西部和中部省份没有CT扫描仪。大多数CT设施位于卢萨卡省。59% (N=13)和41% (N=9)分别来自公共和私营部门。在公立医院,46% (N=6)的CT扫描仪在服务合同中正常工作,在私立医院,89% (N=8)的CT扫描仪在服务合同中正常工作。61.5% (N=8)的公立医院有维修计划,89% (N=8)的私立医院有维修计划。共有7间医疗机构据报有持有CT资历的放射技师。22家机构中有12家表示有放射科医生,在公立和私立机构中,患者等待CT报告的平均时间分别为76小时和24小时。结论:这次审计发现CT扫描仪分布不均,其特点是维护不善和缺乏服务合同,特别是在公立医院。审计还发现,公立医院等待CT报告的时间比私立医院长。
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引用次数: 0
Chlamydia Trachomatis Infection Amonginfertile Women At The University College Hospital, Ibadan 伊巴丹大学附属医院不孕妇女的沙眼衣原体感染
Pub Date : 2022-03-28 DOI: 10.55320/mjz.48.4.944
O. Lawal, G. Obajimi, O. Bello
Background: Chlamydia trachomatis infection is reported as the commonest cause of tubal and pelvic infection and by proxy, the commonest cause of tubal damage and female infertility. Serotypes D-K are known to cause sexually transmitted genital tract and neonatal infection. Testing for the presence of Chlamydia trachomatis has been revolutionized by the development of monoclonal antibodies. This study sought to determine the prevalence of Chlamydia trachomatis infection among infertile women at the University College Hospital Ibadan and to determine the diagnostic value of Chlamydia antibody testing. Methodology: A cross-sectional study conducted among two hundred and seventy-three women with infertility attending the gynaecology clinic of the University College Hospital Ibadan. Hysterosalpingography (HSG) was performed on all patients as part of their routine evaluation for infertility. Venous blood was obtained to detect Chlamydia Ig G antibodies using the diagnostic bio-probe (DIA.PROBE) enzyme-linked immunoassay (ELIZA) for the quantitative determination of IgG antibodies specific to chlamydia trachomatis.  Results: Positive test results for Chlamydia trachomatis were recorded amongst 136 women, giving a prevalence of 49.8%. 46(33.8%) women with normal tubal appearance and 90(66.2%) with tubal disease tested positive for Chlamydia antibodies. Bilateral tubal blockage was seen in 77(28.2%), while left and right tubal blockages were seen in 35(12.8%) and 21(7.7%) respectively. The accuracy of Chlamydia antibody testing in predicting tubal patency revealed a sensitivity of 67.7% and positive predictive value of 66.1% using HSG as the gold standard. Chlamydia trachomatis infection was found to be associated with age at sexual debut, history of ectopic pregnancy and previous history of abortion (P<0.05).  Conclusion: This study revealed a high prevalence of Chlamydia trachomatis amongst infertile women especially those with tubal disease. Risk factors associated with the infection such as early age of sexual debut, ectopic pregnancy and abortion further support the role of infectious morbidity especially with Chlamydia trachomatis.  
背景:据报道,沙眼衣原体感染是输卵管和盆腔感染的最常见原因,同时也是输卵管损伤和女性不孕的最常见原因。已知血清型D-K可引起性传播生殖道感染和新生儿感染。由于单克隆抗体的发展,沙眼衣原体存在的检测已经发生了革命性的变化。本研究旨在确定伊巴丹大学学院医院不孕妇女中沙眼衣原体感染的流行情况,并确定衣原体抗体检测的诊断价值。方法:对在伊巴丹大学学院医院妇科诊所就诊的273名不孕症妇女进行了一项横断面研究。对所有患者进行子宫输卵管造影(HSG),作为其常规评估不孕症的一部分。取静脉血检测沙眼衣原体IgG抗体,采用诊断性生物探针(DIA.PROBE)酶联免疫分析法(ELIZA)定量检测沙眼衣原体特异性IgG抗体。结果:136名妇女沙眼衣原体检测结果呈阳性,患病率为49.8%。46例(33.8%)输卵管外观正常的妇女和90例(66.2%)输卵管疾病的妇女衣原体抗体检测阳性。双侧输卵管阻塞77例(28.2%),左侧输卵管阻塞35例(12.8%),右侧输卵管阻塞21例(7.7%)。以HSG为金标准,衣原体抗体检测预测输卵管通畅的准确率为67.7%,阳性预测值为66.1%。沙眼衣原体感染与初次性行为年龄、异位妊娠史、流产史相关(P<0.05)。结论:本研究揭示了沙眼衣原体在不孕妇女中的高发率,特别是那些有输卵管疾病的妇女。与感染相关的风险因素,如初次性行为年龄过早、异位妊娠和流产,进一步支持了感染性发病率的作用,特别是沙眼衣原体。
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引用次数: 0
MJZ 48 No. 4 Cover mjz48 4号封面
Pub Date : 2022-03-23 DOI: 10.55320/mjz.48.4.997
Medical Journal Zambia
The Medical Journal of Zambia (MJZ) is a peerreviewed quarterly journal intended for the publication of papers from all specialities of medicine (Internal medicine, Surgery, Paediatrics and Obstetrics & Gynaecology) and their subspecialities, basic science, public health, social medicine and medical politics. The journal also welcomes contributions from experienced individuals describing the way they deal with particular problems (i.e. intended to pass on the art of medicine).
《赞比亚医学杂志》(MJZ)是一本同行评议的季刊,旨在发表来自所有医学专业(内科、外科、儿科和妇产科)及其子专业、基础科学、公共卫生、社会医学和医学政治的论文。该杂志也欢迎有经验的个人描述他们处理特定问题的方式(即旨在传递医学艺术)。
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引用次数: 0
Recurrent Giant Cell-Rich Osteosarcoma of the Jaw- a Case Report and Review of the Literature 颌骨复发性巨细胞骨肉瘤1例报告及文献复习
Pub Date : 2022-01-12 DOI: 10.55320/mjz.48.3.193
Fred Maate, Zoran Muhimba, Mutinta Nteeni, Chibamba Mumba, Christopher Kapeshi
Giant cell-rich osteosarcoma of the jaw (JGCRO) is very rare but it is diagnostically important because of its poor prognosis compared to other variants of osteosarcoma. We report a rare case of recurrent JGCRO initially diagnosed as an ossifying fibroma. The clinical presentation, radiologic and histologic features and the intermediate outcome of treatment of the case are highlighted.
颌骨巨细胞富骨肉瘤(JGCRO)非常罕见,但由于其预后较差,因此与其他骨肉瘤相比具有重要的诊断意义。我们报告一例罕见的复发性JGCRO,最初诊断为骨化纤维瘤。临床表现,放射学和组织学特征和中间结果的治疗的情况下强调。
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引用次数: 0
期刊
Medical journal of Zambia
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