Early sexual debut and associated factors among secondary school students of central zone of Tigray, Northern Ethiopia, 2018 Alem Girmay et al. Adolescence is a period of human development that everyone passes through and experiences new situations as well as experiments different life events. The result of these experiments might be good or bad depending on the different personal and environmental factors  READ MORE Evaluation of the effect of HIV virus on the digestive flora of infected versus non infected infants Celine Nguefeu Nkenfou et al. Since the first cases of human immunodeficiency virus (HIV) infection were identified in 1981, the number of infants infected with HIV has increased dramatically in developing countries because the number of HIV-infected women of childbearing age has risen. However, great advances have been made in developed countries to control transmission of the virus from mother to infant. READ MORE

IMAGES IN CLINICAL MEDICINE Dermolipoma: intraoperative features Yasmine Chaoui Roqai et al. Dermolipoma is an ectopic skin formation with a greasy component which develops at the level of the fornix of the external canthus. Surgery for dermolipoma is not devoid of dangers. There is essentially a risk of causing damage to the right external muscle and levator muscle of the upper eyelid because there is no cleavage plane between the lesion and the adjacent normal tissues to which it adheres. READ MORE Hoffa's disease Taoufik Africha et al. We report the case of a 40-year female patient, with no previous pathological history, presenting with right unilateral mechanical gonalgias with progressive onset, which increased climbing and going down stairs associated with hydarthrosis on clinical examination. After normal standard X ray, MRI showed a grease of hypertrophied Hoffa's grease with heterogeneous hyposignal on T1, hypersignal on T2 with grease saturation, heterogeneously enhancing after gadolinium injection. READ MORE

CASE REPORTS Abdominal pain caused by a giant liver hydatid cyst and the management of the residual cavity in a tertiary public hospital in Greece Athanasios Syllaios et al. Diagnosis and treatment of liver hydatid cysts may be challenging. Many surgical techniques have been proposed for the treatment of liver hydatid cysts, but the problem of the residual cavity still remains controversial and challenging, especially in giant liver hydatid cysts which are rare entities that have not been widely described in the literature so far. READ MORE A laparoscopic treatment of a suspicious adrenal mass revealing an unsual cause of adrenal incidentaloma Houda Salhi et al. Schwannomas are rare tumors, usually benign, originating from the Schwann sheath of the peripheral or cranial nerves. They are an extremely uncommon cause of adrenal incidentaloma. It is difficult to diagnose adrenal schwannoma preoperatively by imaging alone due of their aspect suspect on it. We report a case of adrenal mass discovered incidentally in a 41 years old patient who presented an atypical abdominal pain. READ MORE

CASE SERIES Myxedema coma: four patients diagnosed at the Internal Medicine Department of the Dr. Negrin University Hospital in Spain Noel Lorenzo Villalba et al. Myxedema coma is a rare complication of hypothyroidism. Clinical examination may reveal hypotension, bradycardia, and hypothermia. Laboratory tests may show hyponatremia, lipid disorders, and elevations of creatine kinase, liver, and cardiac enzymes. We describe four cases diagnosed in our hospital during the period 1999-2017. The patients were related to amiodarone treatment, noncompliance with hormone replacement therapy, or a new diagnosis of hypothyroidism. READ MORE Evaluation of Alvarado score in diagnosing acute appendicitis Mahmoud Musa Al Awayshih et al. Acute appendicitis is the most common abdominal surgical emergency with a lifetime cumulative incidence of 7%. In 1886; Fitz described the traditional signs and symptoms of acute appendicitis . The diagnosis of acute appendicitis is mainly clinical based on history, clinical examination and sometimes aided by laboratory investigations. READ MORE

LATEST SUPPLEMENT WHO Response to Disease Outbreaks in Liberia: Lessons learned from the 2014 - 2015 Ebola Virus Disease Outbreak This special issue of the Pan African Medical Journal documents the successful application of lesson learnt from response to the Ebola virus disease outbreak in Liberia and identifies some best practices that could be applied to other disease prevention, control and elimination programmes with similar success. The papers, written by those who were actively engaged in response to epidemics in Liberia, cover critical topics in from preparedness and response to disease outbreaks, strengthening surveillance systems and integration as well as strengthening health workforce post Ebola virus disease outbreak. READ MORE