Introduction:

Introduction:Bowel perforation needs an urgent clinical intervention and it significantly increase the mortality in the patients. Bowel perforation is rarely seen in post-partum mother. (1) Bowel perforation after a normal vaginal delivery (NVD) is rarer than a Caesarean section (C-section). (1)Appendicitis can be operated during pregnancy but post-partum appendicitis is very rare. (2) In perforated appendicitis, “gas under diaphragm” in plain radiograph is also a very rare incident. (3). Post partum perforated appendicitis is also rarely reported. The most common differential diagnosis are peptic perforation and bowel perforation. Other differential diagnosis are Meckel’s diverticulitis, Ischemic colitis, bowel obstruction, cholecystitis, Fitz Hugh Curtis syndrome, round ligament syndrome, pelvis thrombophlebitis, torsion of adnexal structures etc.From early 1900, surgeon’s are publishing papers related to appendicitis during pregnancy, so currently surgeons are well aware of the diagnosis and management of the appendicitis during pregnancy. Babler had published a paper related to this in 1908. (4) Harris J Timerman had published a paper in 1942, presenting two cases of post-partum appendicitis. (5).So, here we are presenting a very rare case of post-partum perforated appendicitis, a diagnostic dilemma. The abdominal pain and tenderness can be misinterpreted as labour pain and the septic peritonitis can lead to a preterm labour and preterm delivery. (6)Highlights:Post-partum Bowel perforation and Post Partum appendicitis are rare“Gas under diaphragm” due to perforate appendix is also rarePerforated Appendicitis in post-partum period is also rare

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Introduction Tuberculosis (TB) in Nigeria is a serious disease that is fast becoming deadly. In Nigeria, the burden and mortality of the disease are high, making it one of the infectious diseases with a significant public health challenge. Aim This paper is aimed at examining the prevalence of TB in Nigeria, with emphasis on one of its strains, namely XDR-TB, and factors promoting the disease and its strains, among others. Methodology A literature search was done about Tuberculosis in Nigeria using the keywords; ‘Drug Resistance; Factors; Infection Rate; Mortality Rate; Nigeria; XDR-TB’ through databases such as PubMed, ResearchGate, Google Scholar and World Health Organization between a 10-year-period. Result We found that Nigeria is among the 10 countries in the world with very high tuberculosis incidence and mortality. A number of factors aid the prevalence of the disease in Nigeria: poverty, malnutrition, overpopulation and overcrowding, ignorance, stigma and discrimination, etc. When it comes to the diagnosis of tuberculosis, Nigeria encounters a lot of challenges. For instance, the country lacks access to quality diagnostic facilities, the healthcare system is ill-equipped, and a good number of the populace lacks the necessary awareness about the dangerous nature of the disease. Conclusion The Nigerian government, health workers, key stakeholders, and communities, both affected and non-affected, should all come together to fight off Tuberculosis and its spread in Nigeria. In order to be successful, the eradication effort against TB in Nigeria has to permanently eliminate the causative agent and risk factors everywhere in the country as pathogen prevalence is globally reduced to zero, hence removing the risk of re-infection.