Gestational gigantomastia with pseudoangiomatous stromal hyperplasia - a case report of rare entities.

Gestational gigantomastia (GG) is a rare and severe clinical complication of pregnancy. It is characterized by dramatic and uncontrolled growth of the breasts, often leading to physical discomfort, psychological distress and significant surgical complications. Its pathophysiology is poorly understood; management options include conservative pharmacological and surgical interventions.

Laptop and tablet use and their influence on total motile sperm count parameters: are laptops linked to infertility in Jamaican men?

Background: This study aims to determine the impact of laptop and tablet use on total motile sperm count (TMSC) in men being investigated for assisted reproduction.

Methods: A cross-sectional study was conducted on 156 men attending a fertility clinic in Jamaica. Routine semen analyses were performed and parameters specific to TMSC assessed.

Consecutive Evaluation of Systematic Community-Based COVID-19 Antigen Rapid Diagnostic Testing in Three Different Populations in Jamaica during the COVID-19 Pandemic.

The rise in COVID-19 cases in late 2021 posed a grave threat to the public health system and the economy of Jamaica. A key pillar of controlling COVID-19 includes rapid diagnosis of SARS-CoV-2 infected individuals and their contacts. Hence, we evaluated the feasibility and acceptability of weekly deployment of antigen rapid diagnostic tests (Ag-RDTs) by conducting three 6-week studies within high-risk populations in Jamaica.

Effects of Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors on Health-Related Quality of Life and Exercise Capacity in Heart Failure Patients With a Preserved Ejection Fraction: A Scoping Review.

This scoping review examines the effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on health-related quality of life (HRQoL) and exercise capacity in heart failure patients with preserved ejection fraction (HFpEF). Five randomized controlled trials were analyzed, revealing consistent improvements in HRQoL metrics, such as the Kansas City Cardiomyopathy Questionnaire (KCCQ) scores and exercise capacity, measured by the six-minute walk distance (6MWD). The findings suggest that SGLT-2 inhibitors significantly enhance physical functioning and overall well-being in HFpEF patients.

Single vs Double-Unit Transfusion in Patients With Hematological Disorders Undergoing Chemotherapy or Stem Cell Transplantation: A Systematic Review And Meta-Analysis.

There is no consensus to support the single unit-transfusion policy (1-RBC) over the double-unit transfusion policy (2-RBC) in patients with hematological disorders undergoing chemotherapy or stem cell transplantation. We searched PubMed, Embase, and Cochrane Library. Risk ratios (RR) and mean differences (MD) were pooled.

Operational Research to Support Rapid Evidence-Based Responses to Outbreaks: Learnings from COVID-19.

During the COVID-19 pandemic, the need for making testing readily available was recognized as an important factor for individuals to help make informed decisions, including to isolate or seek care, and for policymakers to control transmission. Toward this end, FIND and the Access to COVID-19 Tools Accelerator funded 16 rapid operational research studies and one implementation project in Africa, the Caribbean, and Asia evaluating the utility, acceptability, and feasibility of different community-based SARS-CoV-2 testing approaches. Here, we discuss common factors and challenges encountered during study implementation.

Uterine Fibroid-Associated Massive Pulmonary Embolism: A Report of Two Cases.

This report details cases of uterine fibroid-associated deep vein thrombosis leading to massive pulmonary embolism, as well as the likely associated physiology. Two women, aged 33 and 37, presented with fibroid-associated pulmonary embolism. They both had large uterine sizes and no underlying thrombophilia.

Case Report: Obstetric and COVID-19-Related Morbidity and Mortality in Three Patients with Sickle Hemoglobinopathy.

Approximately 3% of pregnant women have sickle cell disease (SCD). COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became a global pandemic in March 2020, resulting in more than 3,500 deaths in Jamaica by April 2023. Sickle cell disease is an immunocompromised state; therefore, contracting COVID-19 may result in adverse maternal/neonatal outcomes.

Current obstetric outcomes in Jamaican women with sickle hemoglobinopathy - a balance of risks for aspirin?

Objectives: Sickle cell disease (SCD) occurs in 2.8 % of our Jamaican antenatal population with homozygous HbSS being most associated with adverse maternal and perinatal outcomes.

Methods: A retrospective comparative analysis of HbSS, HbSC and HbSβThal pregnancy outcomes at the University Hospital of the West Indies (UHWI) between January 2012 and December 2022 was conducted.

Capacity for the management of kidney failure in the International Society of Nephrology North America and the Caribbean region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA).

The International Society of Nephrology Global Kidney Health Atlas charts the availability and capacity of kidney care globally. In the North America and the Caribbean region, the Atlas can identify opportunities for kidney care improvement, particularly in Caribbean countries where structures for systematic data collection are lacking. In this third iteration, respondents from 12 of 18 countries from the region reported a 2-fold higher than global median prevalence of dialysis and transplantation, and a 3-fold higher than global median prevalence of dialysis centers.

Paediatric dermatofibrosarcoma protuberan-a case report in an Afro-Caribbean boy.

Dermatofibrosarcoma protuberans is a rare low-grade sarcoma, which rarely metastasizes, but it is locally aggressive with a propensity to recur. It usually affects persons of African descent and is extremely rare in childhood with a favourable prognosis. We present a case of paediatric dermatofibrosarcoma protuberans to the midline of the lower back of a 9-year-old Afro-Caribbean boy who was biopsied with a 2-mm margin.

Pleomorphic hyalinizing angiectatic tumour of the lower back - a rare case and review of the literature.

Pleomorphic hyalinizing angiectatic tumour (PHAT) is a very rare low-grade indeterminate neoplasm of connective and other soft tissue, which is not known to metastasize though local recurrence has been documented. It most commonly presents in the lower extremities, but other anatomical locations have been described. This is the second known case of PHAT from the Caribbean region and adds to the limited reported cases of the condition in the literature.

Prevalence of Overweight and Obesity in Jamaica From 2000 to 2016.

The prevalence of overweight and obesity in Jamaica has been steadily increasing over the past decade and is now a significant health issue. This paper focuses on the trends in the prevalence of overweight and obesity in Jamaica from 2000 to 2016. Overweight and obesity prevalence in adults increased from 43.

Case report: Colonic actinomycosis - A rare cause of a locally advanced colonic tumour.

Introduction And Importance: Colon cancer is a common malignancy and is often encountered initially as locally advanced disease. However, there are many benign clinical entities that may masquerade as complicated colonic malignancy. Abdominal actinomycosis is one such rare mimic.

Dengue, chikungunya and zika arbovirus infections in Caribbean children.

Purpose Of Review: Dengue, chikungunya and zika have caused significant epidemics in the Caribbean in recent years. This review highlights their impact in Caribbean children.

Recent Findings: Dengue has been increasingly intense and severe, seroprevalence is 80-100% in the Caribbean, children have increased attributable morbidity and mortality.

New Delhi Metallo-Beta-Lactamase (NDM)-5 in Uropathogenic Klebsiella pneumoniae in a Tertiary Care Hospital in Jamaica.

We have investigated the prevalence of carbapenemase-producing uropathogens at the University Hospital of the West Indies, Jamaica. From 64 unique urine samples collected between January and March 2020, only 2 closely related Klebsiella pneumoniae (ST11, 14 SNPs of difference; no clear epidemiological links found between patients) were carbapenemase-producers. By whole-genome sequencing (WGS), was found on ~46 kb, IncX3 plasmid.

Cardiovascular Complications of Down Syndrome: Scoping Review and Expert Consensus.

Cardiovascular disease is a leading cause of morbidity and mortality in individuals with Down syndrome. Congenital heart disease is the most common cardiovascular condition in this group, present in up to 50% of people with Down syndrome and contributing to poor outcomes. Additional factors contributing to cardiovascular outcomes include pulmonary hypertension; coexistent pulmonary, endocrine, and metabolic diseases; and risk factors for atherosclerotic disease.

Expanding the prostate cancer cell line repertoire with ACRJ-PC28, an AR-negative neuroendocrine cell line derived from an African-Caribbean patient.

Prostate cell lines from diverse backgrounds are important to addressing disparities in prostate cancer (PCa) incidence and mortality rates among Black men. ACRJ-PC28 was developed from a transrectal needle biopsy and established via inactivation of the locus and simultaneous expression of human telomerase. Characterization assays included growth curve analysis, immunoblots, IHC, 3D cultures, immunofluorescence imaging, confocal microscopy, flow cytometry, WGS, and RNA-Seq.

The successful treatment of Lamellar Ichthyosis-a plastic surgeons perspective.

Congenital Ichthyosis represents a very rare group of congenital skin disorders characterized by some degree of scaling and thickening of the stratum corneum with skin inflammation. Severe forms such as Harlequin and Lamellar forms may present with limb and organ compromise, respectively. Patients with Lamellar subtype presents with severe ectropion which may lead to corneal ulceration, rupture and blindness.

The clinical assessment of foreign body ingestions: Experience in a developing country.

Foreign body (FB) ingestion is an important emergency in low- to middle-income countries. Our study sought to identify which clinical and radiological findings best predict upper gastrointestinal FB impaction. Amongst 149 adolescents and adults presenting to two Jamaican hospitals between 2018 and 2020, FB's were found at 31% of telescopic laryngoscopies and 60% of rigid oesophagoscopies.

Quantifying the impact of equity, diversity, and inclusion in electrophysiology: Training the first female electrophysiologists from Jamaica and Saint Lucia.

Background: Delivery of electrophysiology (EP) care in developing nations and underserviced populations faces many hurdles, including the lack of local expertise and knowledge creation. The West Indies has experienced a paucity of local EP expertise. The University of Toronto has undertaken a unique collaborative educational effort with the University of the West Indies.