Abstract: Objective: Previous studies have associated sexual narcissism with aggressive behaviours prevalent among most Cluster B populations. Recent evidence shows that certain characteristics of sexual narcissism could be beneficial for sexual and marital satisfaction. The present study is an exploration of the role of narcissism in Sexual dysfunctions. Method: A cross-sectional design involving a sample of 62 men aged 22-60 years was used for the study. The sample consisted of 31 men having sexual dysfunctions and a matched control group of 31 men free from sexual dysfunctions. Tools used were the International Index for Erectile Functioning, Modified MINI, Sexual Dysfunctional Beliefs Questionnaire, Sexual Narcissism Scale, and Questionnaire for Cognitive Schema Activation in Sexual Context. Scores were subjected to discriminant analysis, and relevant variables were correlated to assess the strength of the association. Results: Results indicated that beliefs about Female Sexual Power (FSP), Helplessness Schema, and Exploitative behaviours of Sexual Narcissism were the best predictors that differentiated the two groups. The higher the scores on these variables, the lower the erectile functioning. FSP shared a positive correlation with both Exploitation and Helplessness, while the latter two variables were unrelated. Conclusions: A higher need to stick to traditional gender roles and fear of being overpowered could be contributing to sexually exploitative behaviours and relationship distress, which in turn, could affect self-efficacy and contribute to Sexual dysfunction.
Key words: Sexual Narcissism, Dysfunctional Beliefs, Sexual Schemas, Sexual Dysfunction

Abstract: Background: Syphilis continues to be a significant global health concern, particularly among antenatal women due to its potential adverse outcomes for both the fetus and the mother. The Venereal Disease Research Laboratory (VDRL) test is widely used for screening and diagnosis of syphilis. However, there are concerns about its reliability in antenatal settings since it is known to exhibit false-positive reactivity. The aim of this study was to determine the frequency of biological false-positive (BFP) among VDRL-reactive pregnant females. Method: A retrospective analysis of 11,198 VDRL test results from female patients was done over a two-year period, with 3,402 samples obtained from pregnant females and 7,796 samples from non-pregnant females. Result: The results revealed a higher proportion of VDRL reactivity among pregnant females (1.21%) compared to non-pregnant females (0.9%). Statistical analysis did not demonstrate a significant association between VDRL titres and Treponema Pallidum Haemagglutination Assay (TPHA) positivity. Conclusion: Among pregnant females, a substantial proportion of those with lower VDRL titres tested negative for TPHA, indicating the presence of BFP results.These findings underscore the importance of implementing comprehensive testing strategies that combine non-treponemal and treponemal tests to improve the accuracy of syphilis diagnosis, particularly in pregnant populations.
Key words: Syphilis, Seroprevalence, VDRL, Biological false positive reactivity, Antenatal females

Abstract: Background: Placenta praevia (PP) is an obstetric complication secondary to an abnormal placentation near or covering the internal cervical os. Prior caesarean delivery is a common risk factor and is associated with placenta accreta spectrum (PAS) with increased risk of maternal and perinatal morbidity and mortality. Evidence shows an increase in caesarean delivery (CD) rate worldwide, increasing the risk of developing PP in future. Objectives: To determine the maternal clinical profile, maternal and neonatal outcomes, and factors associated with serious maternal or neonate outcomes. Methods: Clinical data of 114 women with PP over a two-year period were collected retrospectively from Queen Nandi Regional Hospital’s maternity records using a data collected tool. Descriptive statistics were used to analyse the data. Results: The most common risk factors were multiparity (50%), prior CD (32.5%), advanced maternal age (28.9%). Majority of women received blood transfusion (72.8%). Most of women who had total abdominal hysterectomy (TAH) had history of prior CD (p<0.001) associated with PAS (p<0.001, 95 CI: 0.000-0.021). Women with PAS were more likely to have post-partum haemorrhage (PPH) (p<0.001, 95 CI: 0.03-0.33). There were no maternal deaths. Most babies were delivered prematurely (55.3%), admission to neonatology were 33.6%, mainly due to respiratory problems (19.8%). The perinatal deaths were 5.2%. Conclusion: Prior history of CD is a common risk factor for PP, when associated with PAS, there is an increased risk of complications such as TAH, post-partum haemorrhage and blood transfusion. Prematurity is a major concern in women with PP. Limiting the number of caesarean section in future will decrease the incidence of PP and its complications.
Key words: Placenta praevia, Caesarean delivery, Placenta accreta spectrum, Total abdominal hysterectomy.

Abstract: This prospective, cross-sectional study was conducted from April 3 to July 20, 2023, at the Paul MOUKAMBI Regional Hospital of Koula-Moutou. Blood samples taken from participants were used to diagnose Loa loa filariasis by direct optical microscopy and leucoconcentration. A questionnaire was used to collect data, which were entered into an Excel 2016 spreadsheet and exported to R software version 3.6.1. Univariate analysis, followed by multivariate analysis using logistic regression, yielded crude and adjusted Odds-Ratios. Within a 95% confidence interval, results were considered statistically significant at p ? 0.05. A total of 300 participants, with a mean age of 26.7 ± 17.45 years, took part in the study. A prevalence of Loa loa filariasis of 14% (95% CI: [0.10. 0.18]) was reported. After univariate analysis, multivariate logistic regression adjustment of this prevalence according to the different variables indicated that being female (adjusted OR = 56.9, 95% CI: [1.71; 1893,] p =0.024*) was the only significant risk factor for Loa loa filariasis in this study. Systematic epidemiological surveillance is needed to protect elderly women from Loa loa filariasis in Gabon.
Key words: Prevalence, filariasis, Loa loa, Koula-Moutou, Gabon.

Abstract: Xanthoma in the gastrointestinal tract are rare lesions and are detected incidentally. Xanthoma cells have abundant clear cytoplasm and are seen in sheets in the mucosa or submucosa, and is a mimic various neoplastic and non-neoplastic entities. The present study aims to describe clinicopathological characters of upper gastrointestinal xanthomas. A 10-year retrospective archival search identified 16 cases of upper gastrointestinal xanthomas. The patients were mostly males with an age range of 43-73 years. Most patients presented with abdominal pain (12/16). Gastric antrum (11/16) was the most common site with sessile lesions (5/16) on endoscopy. Associated findings included, H. pylori infection (7/16), intestinal metaplasia (4/16) and chronic gastritis (3/16). Two cases showed adjacent low-grade dysplasia, however follow up did not show any progression. Literature regarding gastrointestinal xanthomas is limited, making the management strategies ambiguous. Most are benign and incidental however owing to reports of associated dysplasia a follow up is imperative in these cases.
Key words: Xanthoma, Foam cells, Endoscopy, Gastric antrum, H. pylori

Abstract: Background: Among rural populations, where frequent visits to the hospital are not possible, Core needle biopsy (CNB) is considered a reliable investigation for confirming diagnosis preoperatively in palpable Breast lumps. Our study aims to assess CNB as the first reliable diagnostic tool for palpable breast lumps among the rural population. Materials and Methods: This is a prospective cross-sectional study, that included 102 patients with palpable breast masses who had undergone Tru-Cut biopsies. Based on the histopathology report, patients with malignant lesions confirmed by CNB were immediately scheduled for surgery according to their staging. On the other hand, those with benign lesions were followed up for up to three years. The rural population was categorised based on demographic characteristics including domicile, age, size of the tumour, type of tumour, the number of core needle biopsies, and the percentage of inadequate samples. Finally, the accuracy, sensitivity, and specificity of the CNB were determined. Benign, malignant, and unspecified samples obtained by core needle biopsy were evaluated with the samples of the surgical and pathological findings. Results: The study population consists of 102 females with a palpable breast lump. Of the 97 (96.87%) cases CNB provided adequate tissue samples, and malignancy was confirmed in seventy-six (68.6%) patients. In 34 (30.4%) patients CNB turned out to be benign lesions of which only one patient turned out to be positive for malignancy at the end of the 3-year follow-up period. As per the gold standard defined as positive surgical biopsy and follow-up, the sensitivity of CNB was as high as 98.7% (95% CI, 94.1-100%) and diagnostic accuracy was 99.1% (95% CI, 97.4-100%). The specificity of the CNB procedure was 100%. Conclusion: Our findings in a single Institute suggest that the cancer detection rate provided by CNB may be on par with that of open biopsy. Hence, we conclude that CNB is the first choice in the diagnostic evaluation of palpable breast mass among rural populations, as they also provide material for Immunohistochemistry which also aids in planning individualistic management.
Key words: Core needle biopsy, Palpable lump, Rural women, Breast cancer

Abstract: Thyroid tissue in an ectopic location (choristoma)seen in the gall bladder is a rare entity.We report a case of thyroid tissue in an ectopic location in gall bladder in a 29 year old woman with recurrent abdominal pain. Abdominal ultrasonography showed multiple gall stones and after cholecystectomy, the histopathology showed thyroid tissue in an ectopic location seen in the wall of the gall bladder.
Key words: choristoma, gall bladder, ectopic thyroid tissue

Abstract: Granular cell tumor (GCT) is a rare schwannian neoplasm, known to mimic carcinomas. GCT typically presents in the tongue but has also been reported at unusual sites with only 2% of cases said to be malignant. We report an unusual case of GCT presenting in the right breast of a 61-year-old female. Ultrasound-guided FNAC revealed scanty cellularity and fibroadipose tissue. Trucut biopsies revealed a combination of atypical cells and fibrocollagenous tissue. Histopathological examination of excision specimen with axillary clearance demonstrated large polygonal cells with abundant eosinophilic granular cytoplasm, peripherally placed nuclei, and pustulo-ovoid bodies of Milian. Importantly, neither mitotic activity nor pleomorphism were seen. All the lymph nodes were free of tumor. Given its rarity and diverse clinical presentation, GCT poses many diagnostic challenges. A holistic approach encompassing clinical, radiological, and histopathological assessments is paramount for accurate diagnosis and management of this neoplasm. Follow up is mandatory to monitor recurrence.
Key words: granular cell tumor, breast, benign, neoplasm, axillary tail

Abstract: Haemoglobinopathies constitute a large proportion of Hemolytic Anemias constituting around 74% of hereditary hemolytic anemias. Till date, about 200 alpha chain variants have been identified, one of which is Hb Fontainebleau. It is a rare alpha chain variant characterized by an Alanine ? Proline substitution at codon 21 with a GCT>CCT change at the molecular level. It is incidentally detected on HPLC as an unknown peak. We present a case of Hb Fontainebleau in a 53 year old male patient who presented with symptoms related to hemolytic anemia and an unknown peak on the HPLC chromatogram.
Key words: Hemoglobinopathy, Hb Fontainebleau, Hemoglobin