Pheochromocytoma is a rare neuroendocrine tumor that arises from chromaffin cells of the adrenal medulla and secretes excess catecholamines. Clinically, it presents with various symptoms, with a hallmark of treatment-resistant hypertension, often accompanied by paroxysmal episodes of headache, sweating, and palpitations. Although its overall incidence is low, pheochromocytoma should be considered in the differential diagnosis of young patients with refractory hypertension despite the use of multiple antihypertensive agents, particularly when secondary hypertension is suspected. We present the case of a patient who developed a hypertensive crisis and hemodynamic angina, ultimately diagnosed with malignant pheochromocytoma with hepatic and pulmonary metastases.

Background: Liver cirrhosis is a chronic liver disease characterized by fibrosis and inflammation, leading to altered liver function and systemic changes. Several haematological and biochemical abnormalities have been reported in patients with liver cirrhosis. Objective: This study aimed to evaluate the levels of red cell indices and aspartate aminotransferase (AST) in patients diagnosed with liver cirrhosis at Specialist Hospital Umuguma, Owerri. Methods: A total of 60 subjects (30 patients with liver cirrhosis and 30 healthy controls) were recruited. After obtaining informed consent, five millilitres of venous blood samples were collected. Two milliliters were dispensed into EDTA containers for hematological analysis, and three milliliters into plain containers for biochemical assays. AST levels were determined from serum, while red cell indices were evaluated from whole blood. Data were analyzed using SPSS version 27 with t-tests, correlations, and significance set at p<0.05 Results: The mean values of AST (27.10±15.20) IU/L and RDW (17.00±2.61) % were significantly higher in patients with chronic liver cirrhosis when compared to controls (4.63±1.94) IU/L and (12.27±1.23) % (t= 8.03, p= 0.000, t=8.98, p=0.000). That of PCV (24.03±4.72)%, Hb (8.09±1.50)g/dl, RBC (x106/ul)mg/dl, MCV (75.17±4.65)fl, MCH (26.13±3.32) pg and MCHC (33.40±2.37)% were significantly lower in patients with chronic liver cirrhosis when compared to controls (37.03±4.07)%, (12.99±1.36)g/dl, (4.16±0.39)mg/dl, (89.17±7.34)fl, (31.20±1.75)pg and (34.83±1.82)%. (t=11.43, p=0.000; t=13.21, p=0.000; t=6.59, p=0.000; t=8.82, p=0.000; t=7.39, p=0.000; t=2.63, p=0.011). There was no significant difference in the mean values of AST (26.79±15.93)IU/L, MCV (75.32±4.99)fl, MCH (26.05±3.63)pg, MCHC (33.37±2.26)% in male patients with chronic liver cirrhosis when compared to females (27.64±14.58)IU/L, (74.91±4.23)fl, (26.27±2.87)pg and (33.45±2.66)% (t=0.15, p=0.886; t=0.23, p=0.822; t=0.17, p=0.865; t=0.09, p=0.926).The mean values of PCV (25.95±3.94)%, Hb (8.72±1.22)g/dl and RBC (x106/ul) mg/dl were significantly raised in male patients with chronic liver cirrhosis when compared to females (20.73±4.19)%, (7.02±1.36)g/dl and (2.75±0.54)mg/dl (t=3.42, p=0.002; t=3.53, p=0.003; t=3.29, p=0.003).The mean values of RDW (15.89±2.02) % was significantly lower in male patients with chronic liver cirrhosis when compared to females (18.91±2.47)% (t=3.63, p=0.001). There was no significant difference in the mean values of AST (25.94±11.89)IU/L, PCV (23.06±3.99)%, HB (7.84±1.36)g/dl, RBC (x106/ul)mg/dl, MCV (74.50±4.88)fl, MCH (26.33±3.86)pg, MCHC (33.50±2.26)% and (17.28±2.74)% in patients with chronic liver cirrhosis of ages (40-60)yrs when compared to patients with chronic liver cirrhosis of ages (>60)yrs(31.30±20.70) IU/L, (24.80±5.71)%, (8.25±1.73)g/dl, (3.23±0.80)mg/dl, (75.90±4.70)fl, (25.90±2.64)pg, (33.30±2.87)% and (16.60±2.46)% (t=0.87, p=0.390; t=0.95, p=0.351; t=0.69, p=0.493; t=0.33, p=0.743; t=0.74, p=0.468; t=0.32, p=0.755; t=0.20, p=0.841). There was a non-significant negative correlation of AST with PCV (r=-0.11, p=0.554), Hb (r=-0.78, p=0.687), RBC (r=-0.10, p=0.588), MCV (r=-0.08 p=0.672) and MCHC (r=-0.28, p=0.127) in Patients with Chronic Liver Cirrhosis. Correlation of AST with MCH (r=0.25, p=0.174) and RDW (r=0.07, p=0.729) in Patients with Chronic Liver Cirrhosis showed a non – significant association. Conclusion: Elevated AST and RDW are significantly associated with liver cirrhosis. These parameters, alongside red cell indices, may aid in the clinical assessment and diagnosis of patients with suspected liver cirrhosis.

Rheumatoid Arthritis (RA) is a chronic autoimmune disease that primarily affects the joints. In RA, the body’s immune system mistakenly attacks its own tissues, especially the synovial membrane causing inflammation, pain, swelling, and stiffness. This study was aimed at determining changes in some haematological markers and renal profile in rheumatoid arthritis patients attending Imo State Specialist Hospital Umuguma, Owerri, Imo State. A cross-sectional study was carried out from the month of June to September, 2023, and all eligible subjects who gave a written informed consent and completed the questionnaire enrolled in the study. The study population consisted of 50 rheumatoid arthritis and an equivalent number of age-matched healthy subjects (50), who served as the controls. The procedure was carried out at the Specialist Hospital, Umuguma, Owerri. Ten millilitres of venous blood sample was collected at the ante-cubital vein aseptically, 5ml was dispensed into ethylenediaminetetraacetic acid (EDTA) containers for the estimation of haematological parameters, while the remaining 5mls was dispensed into plain containers for the determination of biochemical parameters. The samples in the containers were properly labeled with the subject’s name, sample number and date of collection. The blood dispensed into the EDTA containers was stored in a refrigerator at 40C while the serum was stored in a freezer at -200C prior to use. Haematological parameters and renal profile test were determined using standard laboratory procedure. The results of the tests were analyzed using SPSS version 21. The mean values of haemoglobin (9.84±1.32) g/dl and PCV (30.97±2.43) % were significantly lower in rheumatoid arthritis patients when compared to controls (12.48±1.57) g /dl and (33.20±4.57) %, while platelets (33844.00±102083) cells/ul were significantly higher in rheumatoid arthritis patients when compared to controls (234180.00±132329.01). There was no significant difference in the mean value of creatinine (1.35±1.98) mg/dl, in rheumatoid arthritis patients when compared to controls (1.34±1.86) mg/dl. The mean values of urea (37.56±20.88) mg/dl, sodium (151.02±44.78) mmol/l and potassium (4.94±2.08) mmol/l were significantly raised in rheumatoid arthritis when compared to controls (26.27±15.16) mg/dl, (132.27±5.98) mmol/l and (4.76±1.19) mmol/l (p=0.012, p=0.001, p=0.026, p=0.010. There was a non-significant positive correlation of PCV with urea, creatinine, sodium and potassium in rheumatoid arthritis patients (r=0.04, p=0.767; r=0.10, p=0.474; r=0.01, p=0.975 and r=0.03, p=0.834). Early detection and management of anemia, thrombocytosis, and renal dysfunction are essential for improving patient outcomes and quality of life.

Penile cancer is a rare disease, but its global incidence is on the rise. Human papillomavirus (HPV) is the primary risk factor, making HPV status assessment an essential part of pathological evaluation. The primary goal of treating the tumor is complete eradication while preserving as much of the organ as possible without compromising oncological outcomes. Early detection and treatment of lymph node (LN) metastasis are crucial for survival. In our case, the patient had a high-risk advanced penile cancer (PSCC) which had requirring a multimodal treatment approach, combining chemotherapy, radiotherapy with consolidation surgical treatment.

Hemolytic disease of the fetus & newborn (HDFN) is a disorder where RBCs are destroyed by maternal erythrocyte alloantibodies and there is increased production of unconjugated bilirubin and anemia and in severe cases, hydrops in the fetus. Rh & ABO incompatibility are the most common causes of severe unconjugated hyperbilirubinemia in newborn babies. Though many treatment options are available for this condition, phototherapy stands first and most important of these all. This article signifies the successful management of OB incompatibility with hemolytic jaundice and clinical sepsis in a term neonate who was successfully managed with phototherapy along with serial BIND (Bilirubin Induced Neurological Dysfunction) scoring rather than going for other treatment options such as intravenous immunoglobulin or exchange transfusion.

Rheumatoid arthritis (RA) is a chronic autoimmune disease with profound consequence tos for individuals and society. Characterized by persistent joint inflammation and progressive damage, RA leads to physical disabilities, psychological distress, and reduced quality of life. Beyond its impact on individuals, RA imposes a significant societal burden, including increased healthcare expenditures and loss of productivity, resulting in economic challenges. The disease is further complicated by comorbidities such as anemia, cardiovascular disorders, and infections, necessitating a multidisciplinary approach to care. Hematologists play a pivotal role in managing hematological complications and monitoring biomarkers for disease activity. Meanwhile, nursing managers contribute to patient education, adherence to treatment protocols, and coordination of multidisciplinary care. This article examines the wide-ranging impact of RA and explores the roles of hematologists and nursing managers in addressing its multifaceted challenges, offering insights into strategies for improved outcomes and reduced societal burden.

A rare inflammatory disease of the major duodenal papilla, duodenal papillitis is frequently linked to pancreatitis, infections, stones, or other biliary obstructions. This case study focuses on a 62-year-old male with a history of cholelithiasis and benign prostatic hyperplasia who presented with pain in the epigastrium. Radiological imaging revealed an enlarged and oedematous duodenal papilla, which suggested biliary obstruction and duodenal papillitis. The patient was started on intravenous antibiotics and analgesics, following which endoscopic stenting was performed, and the clinical outcome was promising. Due to its overlap with other illnesses, such as cancer of the papilla of Vater, duodenal papillitis can be difficult to diagnose. However, early discovery and suitable imaging are crucial for successful treatment. To differentiate this illness from other potential diseases, imaging methods such as Computerized Tomography scan (CT scan) and MRCP must be used correctly. This case highlights the potential for non-invasive treatments to improve patient outcomes while reducing the need for surgery. It also underscores the importance of combining multiple imaging techniques in diagnosing rare gastrointestinal disorders, which can lead to more accurate and timely management.