Background: Evaluating the tumor proliferative index helps predict clinical behavior and provides prognostic insights for cutaneous basal cell carcinoma (cBCC) and squamous cell carcinoma (cSCC). Objective: This study...Background: Evaluating the tumor proliferative index helps predict clinical behavior and provides prognostic insights for cutaneous basal cell carcinoma (cBCC) and squamous cell carcinoma (cSCC). Objective: This study aimed to identify differences in the proliferative indices among variants of cBCC and cSCC diagnosed at a tertiary healthcare center. Method: Skin biopsies histologically diagnosed as cBCC and cSCC between 2012 and 2018 at the Federal Medical Centre (FMC) Umuahia, Abia State, Nigeria, were analyzed. Archival formalin-fixed, paraffin-embedded (FFPE) tissue blocks were retrieved along with clinical data, and were prepared on charged microscope slides and the immunohistochemical staining was carried out. The primary antibody used in this study was clone BioCare CRM325C (RM) and adenotonsillar tissue blocks/slides served as positive controls. Ki-67 immunohistochemistry was performed on fresh 4µm sections of the tumor specimens. Results: The application of Ki-67 immunoperoxidase on both BCC and SCC cohort, yielded an intense observable brownish nuclear stain in areas of dense proliferating tumour cells on both cutaneous tumours. The average Ki-67 index for all cSCC cases was 24.7%, with a range of 2.3% - 80%, while the mean for cBCC was 15.8%, ranging from 1.2% - 45.6%. Variants with high proliferative indices were observed in 11.9% of cBCC cases and 29.1% of cSCC cases. Among the low proliferative index category, cSCC accounted for 5.4%, while cBCC represented 14.3%. For mild proliferative indices, cSCC cases made up 7.3% and cBCC, 11.9%. The majority of cases showed moderate proliferative indices, with 61.9% for cBCC and 58.2% for cSCC. Overall, there was a significant difference in proliferative indices between cSCC, cBCC, and their variants. Conclusion: The study found a significantly higher rate of cell proliferation, measured by Ki-67 immunostaining, in cSCC and its variants compared to cBCC. However, certain variants of cBCC also exhibited high Ki-67 expression, indicating they can be as aggressive as some cSCC variants.展开更多
Objective:To investigate the role of Mirabilis jalapa root extracts in restoration of glucose homeostasis in alloxan-induced hyperglycemic Wistar albino rats.Methods:Experimental hyperglycemic rats were treated daily ...Objective:To investigate the role of Mirabilis jalapa root extracts in restoration of glucose homeostasis in alloxan-induced hyperglycemic Wistar albino rats.Methods:Experimental hyperglycemic rats were treated daily with 200 and 400 mg/kg of Mirabilis jalapa extracts after initial fasting for 6 h.Two-hour postprandial glucose and changes in body weight were monitored during treatment.After 14 d,the rats were sacrificed and blood was collected for biochemical assessment of serum glucose and insulin levels,lipid profile,and oxidative stress markers.Histopathological examinations of harvested pancreas were also carried out.Results:Mirabilis jalapa root extracts at 200 and 400 mg/kg increased the body weight of hyperglycemic rats.Postprandial glucose levels of the extract-treated hyperglycemic groups progressively declined during treatment compared with the untreated hyperglycemic control group(P<0.05).The lipid profile indices of the untreated negative control group were significantly elevated(P<0.05),which were reversed by treatment with Mirabilis jalapa extracts.The remarkable increases in antioxidant enzyme activities and a significant decrease in malondialdehyde levels were observed in the hyperglycemic group treated with Mirabilis jalapa extracts.Mirabilis jalapa extracts also significantly increased serum insulin levels(P<0.05).In addition,histopathological examinations of the pancreas revealed a significant cell population within the islet nests of the extract-treated hyperglycemic groups.Conclusions:Mirabilis jalapa extract can restore glucose homeostasis and show hypoglycemic and hypolipidemic effects in hyperglycemic rats.Further studies are needed to verify the active components of the plant and the underlying mechanism of action in the future.展开更多
Background: The most common form of extrapulmonary tuberculosis is lymphadenitis. Lymphadenitis is considered mainly a disease of young children and has a peak age of onset at 20 to 40 years. Objectives: The purpose o...Background: The most common form of extrapulmonary tuberculosis is lymphadenitis. Lymphadenitis is considered mainly a disease of young children and has a peak age of onset at 20 to 40 years. Objectives: The purpose of this study was to detect and compare the presence of acid fast bacilli in lymph node biopsies and their touch preparations using Ziehl Neelsen and fluorescence staining. Materials and Methods: The lymph node biopsies and their touch preparations were prepared and stained with Haematoxylin and eosin to determine their morphology. Slides were stained with ZN staining and fluorescent staining technique using Auramine O and Rohdamine B to demonstrate the presence of acid fast bacilli in tissue and their touch preparations. Results: AFB was detected in 56% of biopsies and 54% of touch preparations. In addition in these cases we observed that fluorescent staining technique using Auramine O and Rohdamine B is superior to ZN stain because low magnification used in fluorescent staining technique makes it possible to scan the smear rapidly and detects the AFB as glowing spots even if it is present in small numbers. Conclusion: The results of AFB in tissue biopsies are in equivalent in their touch preparation.展开更多
Background: Breastfeeding is cost effective means towards the realization of some key United Nations Sustainable Development Goals by the year 2030 particularly in resource limited settings. The objectives of the stud...Background: Breastfeeding is cost effective means towards the realization of some key United Nations Sustainable Development Goals by the year 2030 particularly in resource limited settings. The objectives of the study were to evaluate the predictors of exclusive breastfeeding duration among mother and child pairs utilizing a tertiary immunization clinic facility. Methods: This was a cross-sectional descriptive study. Respondents were mother-and-child pairs who were recruited consecutively. Relevant maternal and child characteristics were collected using a semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences version 20.0 (p Results: Four hundred and twenty seven mother-child pairs were studied. Majority of the mothers have at least secondary education, 383 (80.7%). 407 (95.3%) of the mothers fully understood the actual meaning of EBF. 189 (42.7%) reported practicing EBF in their index child for six months. Maternal perception of insufficient milk production, 52/99 (52.5%) was the most common reason for practicing EBF for Maternal education and occupation and gender of the child were significantly associated with completion of EBF for 6 months among respondents. Conclusion: EBF duration in the current study is low and is significantly associated with maternal education, maternal occupation and gender of the child. Improving girl child education, complementing baby friendly hospital initiative with baby friendly community initiative should be adopted to improve EBF duration in our setting.展开更多
Background: Foreign body granuloma is a rare late complication of fascia lata graft donor site with few reported cases in the literature. It can mimic soft tissue sarcoma. Clinical and radiological findings may not be...Background: Foreign body granuloma is a rare late complication of fascia lata graft donor site with few reported cases in the literature. It can mimic soft tissue sarcoma. Clinical and radiological findings may not be enough to solve the puzzle and histology remains the mainstay of diagnosis. Aim: Our aim is to highlight the unusual long interval between initial surgery and presentation of foreign body granuloma. Case Presentation: A 65-year-old man who presented 48 years after initial surgery with progressive painless fascia lata donor site soft tissue swelling. The management and histology findings were highlighted. Conclusion: The occurrence of foreign body granuloma remains an important differential following a history of past surgical procedure regardless of the time interval between the surgical procedure and the clinical presentation.展开更多
Urinary retention in women is rare and is more frequently described as case reports or small case series. The female/male ratio is 1:13 with about 3 cases per 100,000 women every year We report a case of a 12-year old...Urinary retention in women is rare and is more frequently described as case reports or small case series. The female/male ratio is 1:13 with about 3 cases per 100,000 women every year We report a case of a 12-year old female student. She presented with progressive weight loss, worsening lower urinary tract symptoms with distended lower abdomen of 10 weeks duration. Physical examination revealed a mobile tender firm pelvic mass, 18 centimeters (cm) × 16 cm in size. Laboratory and imaging studies showed obstructive nephropathy and uropathy respectively. She was worked up and had uneventful exploratory laparotomy with right salpingo-oophorectomy, urinary bladder diverticulectomy and pelvic lymphadenectomy. Histopathology of the pelvic mass showed ovarian dysgerminoma with lymph node metastasis. She responded very well to chemotherapy and resumed her school activities. Bladder outlet obstruction is relatively rare in females and in the index patient, ovarian dysgerminoma is the cause leading to obstructive nephropathy and uropathy.展开更多
Introduction: Members of the Human Epidermal Receptor [HER] family of receptor tyrosine kinases, such as HER2 and EGFR proteins are overexpressed in several epithelial malignancies and serve as effective therapeutic t...Introduction: Members of the Human Epidermal Receptor [HER] family of receptor tyrosine kinases, such as HER2 and EGFR proteins are overexpressed in several epithelial malignancies and serve as effective therapeutic targets in cancer management. However, their role in prostate cancer development has been sparingly explored and with contrasting findings. Notably their relationship with prostate cancers cases seen in Sub-Saharan Africa is yet to be explored. Design: A retrospective study involving histologically diagnosed cases of adenocarcinomas of the prostate. Cases were classed according to the WHO/ISUP Gleason Prognostic groups [G1 - G5]. Immunohistochemical analysis was performed using monoclonal antibodies for HER2 and EGFR, while in situ hybridization employed DNA probes for the corresponding genes. Scores of +2 and +3 were regarded as positive for both antibodies, while a target gene: centromere ratio of >2 was set as the threshold for amplification. Results: A total of 44 cases were included in the study. The acinar type was the commonest morphologically, with Gleason group 5 [Gleason scores 8 - 10] accounting for close to half of the cases [47.7%]. The HER2 antibody stained negatively in the majority of cases [93.2%], being positive in only 3 [6.8%] of cases seen. High level expression of EGFR [+2/+3] was observed in 25% of cases, low level expression was identified in 6 [13.6%] cases. All HER2 positive malignancies displayed overexpression of EGFR. In situ-hybridization revealed the absence of high level amplification for both HER2 and EGFR, while polysomy was not detected in any of the cases. Conclusion: The overexpression of EGFR in prostate cancers has been demonstrated in a native African population, affirming its suitability for targeted therapy. Overexpression of HER2 in prostate cancer is inconstant, and amplification of the HER2 gene is less frequent than as compared to malignancies of the Breast and Ovary. There’s a need for a standardized protocol for assessing HER2 in prostate cancer.展开更多
In tropical countries, malaria and preeclampsia/eclampsia are common diseases of pregnancy;and placenta have been implicated in the pathophysiology of both disease processes. The two diseases have pathophysiologic sim...In tropical countries, malaria and preeclampsia/eclampsia are common diseases of pregnancy;and placenta have been implicated in the pathophysiology of both disease processes. The two diseases have pathophysiologic similarities in the placenta such as placenta ischaemia, endothelial dysfunction and production of pro-inflammatory cytokine. Yet, there is paucity of studies on the association of these two disease processes. Determining the association between the two disease processes may help to unravel the pathogenesis of preeclampsia and also help in its prevention and patient management. Objective: Determined the association between placenta malaria parasitemia and preeclampsia/eclampsia among parturients at Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods: This was a case control study that was conducted in the Labour wards of department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and Mile 4 Missionary Hospital Abakaliki, a comprehensive health care centre in Abakaliki, Ebonyi state. It was conducted over a period of 6 months between 1<sup>st</sup> October 2021 and 31<sup>st</sup> March, 2022. The cases in this study were parturients that developed preeclampsia/eclampsia in the course of pregnancy, while the controls were parturient without preeclampsia/eclampsia. Interviewer-administered questionnaires were used to collect data on socio-demographic characteristics, obstetrics and medical histories. Histological examinations were conducted to isolate plasmodium falciparum parasites from placenta samples obtained from the maternal surface of the placenta. The data was processed using Epi Info software. Categorical variables were analyzed using Mc Nemar X<sup>2</sup> test, with a p-value of 0.05 considered statistically significant. Logistic regression models were used to estimate the odds ratios (OR) and 95% CI of the association between placenta malaria parasites and preeclampsia/eclampsia was conducted. Relative risk with 95% CI was used to determine both fetal and maternal outcomes. Results: The prevalence of preeclampsia during the study period was 2.9%. Placenta malaria was positive in twenty one (21) of the 67 cases of preeclampsia/eclampsia analyzed, giving a prevalence of 31.3% and in eleven (11) out of 68 controls (normotensive) patients analyzed, giving a prevalence of 16.2%. The presence of placenta malaria significantly increased the odds of developing preeclampsia/eclampsia among parturients (OR = 2.4, 95% CI = 1.0 - 5.4, P value = 0.04). Presence of placenta malaria in mothers with preeclampsia/eclampsia was associated with adverse pregnancy outcomes such as cerebrovascular accident (RR = 19.2, 95% CI = 1.1 - 341.7, P value = 0.04), DIC (RR = 10.9, 95% CI = 1.4 - 88.0, P value = 0.02), abruptio placenta (RR = 2.4, 95% CI = 1.2 - 4.8, P value = 0.01), pulmonary edema (RR = 2.7, 95% CI = 1.1 - 25.9, P value = 0.03), IUGR (RR = 2.1, 95% CI = 1.1 - 4.5, P value = 0.03) and IUFD (RR = 3.8, 95% CI = 1.3 - 11.7, P value = 0.02). Presence of placenta malaria also increased the risk of NICU admission (RR = 2.6, 95% CI = 1.1 - 6.0, P value = 0.03), Low 1<sup>st</sup> minute APGAR score (RR = 2.7, 95% CI = 1.2 - 6.1, P value = 0.02) and Low 5<sup>th</sup> minute APGAR score (RR = 3.0, 95% CI = 1.0 - 8.6, P value = 0.04) among neonates delivered by mothers with preeclampsia/eclampsia. However, presence of placenta malaria did not significantly increase maternal and perinatal mortalities. Conclusion: There is a higher prevalence of placenta malaria among mothers with preeclampsia/eclampsia when compared with normotensive controls and this was associated with increased risk of certain maternal and perinatal morbidities. Placental malaria was not associated with increased risk of either maternal or perinatal mortality.展开更多
AIM： To study the frequency, gender and age distribution as well as pathological characteristics of colorectal carcinoma （CRC） in Lagos and Sagamu in SW Nigeria. METHODS： This is a retrospective pathological revie...AIM： To study the frequency, gender and age distribution as well as pathological characteristics of colorectal carcinoma （CRC） in Lagos and Sagamu in SW Nigeria. METHODS： This is a retrospective pathological review of histologically diagnosed CRC from 5 laboratories inLagos ＆ Sagamu. The clinical data, such as age, sex and clinical summary were extracted from demographic information. Cases of anal cancer were excluded from this study. RESULTS： There were 420 cases （237 males and 183 females） of CRC. It peaked in the 60-69 year age group （mean： 50.7; SD： 16.2）, M：F ratio 1.3：1 and 23% occurred below 40 years. The majority was well to moderately differentiated adenocarcinoma 321 （76.4%）, rnucinous carcinoma 45 （10.7%） and signet ring carcinoma 5 （1.2%）, and more common in patients under 40 years compared to well differentiated tumors. The recto-sigmoid colon was the most common site （58.6%）. About 51% and 34% of cases presented at TNM stages Ⅱand Ⅲ, respectively. CONCLUSION： CRC is the commonest malignant gastrointestinal （GIT） tumor most commonly located in the recto-sigmoid region. The age and sex prevalence and histopathological features concur with reports from other parts of the world.展开更多
Background: Breast cancer remains an important medical challenge, despite sustained global efforts at its prevention and control. Various immunological factors are expressed in the serum during breast tumourigenesis, ...Background: Breast cancer remains an important medical challenge, despite sustained global efforts at its prevention and control. Various immunological factors are expressed in the serum during breast tumourigenesis, and can be of value in the surveillance of the disease. These serum bio-markers include pro-inflammatory cytokines since breast cancer is associated with chronic inflammation. In our locality with different racial/ethnic variations from Caucasian as well as environmental factors, there is scanty information on the value of these serum factors in screening and surveillance of breast cancer—hence the need for this study. Methodology: A total of 68 females (mean age = 48.7 ± 8.7 yrs) with clinically and pathologically confirmed breast cancer were recruited by self selection;representing breast cancer patients group. Due to small sample size they were further grouped into advanced stage breast cancer cases (N = 40) and early stage breast cancer cases (N = 28). Controls consisted of two groups: A—Patient control group (N = 21) comprised females with benign breast tumour (15 cases with fibroadenoma and 6 cases with fibrocystic disease) and group B—apparently healthy age/sex matched control group (N = 21). Pre-treatment samples were collected after which all patients underwent standard treatment modalities (neoadjuvant or adjuvant chemotherapy, radiotherapy, chemoradiation, and/or surgery;depending on the stage of presentation and thereafter post treatment samples were collected after 3 and 6 months respectively. Serum from the patients and controls were assayed immunoenzymatically for TNF-α and IL-1. Results: The results showed that at 6 months post-treatment stage, the mean values of IL-1 differed significantly (P > 0.05) when advanced stage breast cancer were compared with early stage and apparently healthy control groups respectively. Likewise at 6 months post-treatment stage, the TNF-α mean values differed significantly (P > 0.05) between advanced stage breast cancer and apparently healthy control. No significant differences in mean values were recorded across disease and treatment groups in both IL-1 and TNF-α at pre-treatment and 3 months post-treatment stages. Majority of the breast cancer patients studied were married (91%) and had children, of low income, never smoke cigarette, diagnosed at age above 46 years and presented at advanced stages of the disease. Results also showed that 78% of the cases did not have any history of cancer in their families. Also, 63% of the cases had body mass index values suggestive of obesity (>30 kg/m2). Conclusion: Results suggest that the use of serum levels of TNF-α and IL-1 in the diagnosis of breast cancer in our racial/ethnic environment is of limited clinical value. However it could be useful in disease surveillance in metastasis and relapse. Based on our findings, it could also be concluded that cigarette smoking and social sophistication are not among the risk factors to cancer in this part of the world, contrary to the situation in the advanced parts of the world.展开更多
文摘Background: Evaluating the tumor proliferative index helps predict clinical behavior and provides prognostic insights for cutaneous basal cell carcinoma (cBCC) and squamous cell carcinoma (cSCC). Objective: This study aimed to identify differences in the proliferative indices among variants of cBCC and cSCC diagnosed at a tertiary healthcare center. Method: Skin biopsies histologically diagnosed as cBCC and cSCC between 2012 and 2018 at the Federal Medical Centre (FMC) Umuahia, Abia State, Nigeria, were analyzed. Archival formalin-fixed, paraffin-embedded (FFPE) tissue blocks were retrieved along with clinical data, and were prepared on charged microscope slides and the immunohistochemical staining was carried out. The primary antibody used in this study was clone BioCare CRM325C (RM) and adenotonsillar tissue blocks/slides served as positive controls. Ki-67 immunohistochemistry was performed on fresh 4µm sections of the tumor specimens. Results: The application of Ki-67 immunoperoxidase on both BCC and SCC cohort, yielded an intense observable brownish nuclear stain in areas of dense proliferating tumour cells on both cutaneous tumours. The average Ki-67 index for all cSCC cases was 24.7%, with a range of 2.3% - 80%, while the mean for cBCC was 15.8%, ranging from 1.2% - 45.6%. Variants with high proliferative indices were observed in 11.9% of cBCC cases and 29.1% of cSCC cases. Among the low proliferative index category, cSCC accounted for 5.4%, while cBCC represented 14.3%. For mild proliferative indices, cSCC cases made up 7.3% and cBCC, 11.9%. The majority of cases showed moderate proliferative indices, with 61.9% for cBCC and 58.2% for cSCC. Overall, there was a significant difference in proliferative indices between cSCC, cBCC, and their variants. Conclusion: The study found a significantly higher rate of cell proliferation, measured by Ki-67 immunostaining, in cSCC and its variants compared to cBCC. However, certain variants of cBCC also exhibited high Ki-67 expression, indicating they can be as aggressive as some cSCC variants.
基金Institutional Based Research,(TeTFund/DR&D/CE/UNIV/SOKOTO/RP/VOL 1)Usmanu Danfodiyo University,Sokoto.
文摘Objective:To investigate the role of Mirabilis jalapa root extracts in restoration of glucose homeostasis in alloxan-induced hyperglycemic Wistar albino rats.Methods:Experimental hyperglycemic rats were treated daily with 200 and 400 mg/kg of Mirabilis jalapa extracts after initial fasting for 6 h.Two-hour postprandial glucose and changes in body weight were monitored during treatment.After 14 d,the rats were sacrificed and blood was collected for biochemical assessment of serum glucose and insulin levels,lipid profile,and oxidative stress markers.Histopathological examinations of harvested pancreas were also carried out.Results:Mirabilis jalapa root extracts at 200 and 400 mg/kg increased the body weight of hyperglycemic rats.Postprandial glucose levels of the extract-treated hyperglycemic groups progressively declined during treatment compared with the untreated hyperglycemic control group(P<0.05).The lipid profile indices of the untreated negative control group were significantly elevated(P<0.05),which were reversed by treatment with Mirabilis jalapa extracts.The remarkable increases in antioxidant enzyme activities and a significant decrease in malondialdehyde levels were observed in the hyperglycemic group treated with Mirabilis jalapa extracts.Mirabilis jalapa extracts also significantly increased serum insulin levels(P<0.05).In addition,histopathological examinations of the pancreas revealed a significant cell population within the islet nests of the extract-treated hyperglycemic groups.Conclusions:Mirabilis jalapa extract can restore glucose homeostasis and show hypoglycemic and hypolipidemic effects in hyperglycemic rats.Further studies are needed to verify the active components of the plant and the underlying mechanism of action in the future.
文摘Background: The most common form of extrapulmonary tuberculosis is lymphadenitis. Lymphadenitis is considered mainly a disease of young children and has a peak age of onset at 20 to 40 years. Objectives: The purpose of this study was to detect and compare the presence of acid fast bacilli in lymph node biopsies and their touch preparations using Ziehl Neelsen and fluorescence staining. Materials and Methods: The lymph node biopsies and their touch preparations were prepared and stained with Haematoxylin and eosin to determine their morphology. Slides were stained with ZN staining and fluorescent staining technique using Auramine O and Rohdamine B to demonstrate the presence of acid fast bacilli in tissue and their touch preparations. Results: AFB was detected in 56% of biopsies and 54% of touch preparations. In addition in these cases we observed that fluorescent staining technique using Auramine O and Rohdamine B is superior to ZN stain because low magnification used in fluorescent staining technique makes it possible to scan the smear rapidly and detects the AFB as glowing spots even if it is present in small numbers. Conclusion: The results of AFB in tissue biopsies are in equivalent in their touch preparation.
文摘Background: Breastfeeding is cost effective means towards the realization of some key United Nations Sustainable Development Goals by the year 2030 particularly in resource limited settings. The objectives of the study were to evaluate the predictors of exclusive breastfeeding duration among mother and child pairs utilizing a tertiary immunization clinic facility. Methods: This was a cross-sectional descriptive study. Respondents were mother-and-child pairs who were recruited consecutively. Relevant maternal and child characteristics were collected using a semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences version 20.0 (p Results: Four hundred and twenty seven mother-child pairs were studied. Majority of the mothers have at least secondary education, 383 (80.7%). 407 (95.3%) of the mothers fully understood the actual meaning of EBF. 189 (42.7%) reported practicing EBF in their index child for six months. Maternal perception of insufficient milk production, 52/99 (52.5%) was the most common reason for practicing EBF for Maternal education and occupation and gender of the child were significantly associated with completion of EBF for 6 months among respondents. Conclusion: EBF duration in the current study is low and is significantly associated with maternal education, maternal occupation and gender of the child. Improving girl child education, complementing baby friendly hospital initiative with baby friendly community initiative should be adopted to improve EBF duration in our setting.
文摘Background: Foreign body granuloma is a rare late complication of fascia lata graft donor site with few reported cases in the literature. It can mimic soft tissue sarcoma. Clinical and radiological findings may not be enough to solve the puzzle and histology remains the mainstay of diagnosis. Aim: Our aim is to highlight the unusual long interval between initial surgery and presentation of foreign body granuloma. Case Presentation: A 65-year-old man who presented 48 years after initial surgery with progressive painless fascia lata donor site soft tissue swelling. The management and histology findings were highlighted. Conclusion: The occurrence of foreign body granuloma remains an important differential following a history of past surgical procedure regardless of the time interval between the surgical procedure and the clinical presentation.
文摘Urinary retention in women is rare and is more frequently described as case reports or small case series. The female/male ratio is 1:13 with about 3 cases per 100,000 women every year We report a case of a 12-year old female student. She presented with progressive weight loss, worsening lower urinary tract symptoms with distended lower abdomen of 10 weeks duration. Physical examination revealed a mobile tender firm pelvic mass, 18 centimeters (cm) × 16 cm in size. Laboratory and imaging studies showed obstructive nephropathy and uropathy respectively. She was worked up and had uneventful exploratory laparotomy with right salpingo-oophorectomy, urinary bladder diverticulectomy and pelvic lymphadenectomy. Histopathology of the pelvic mass showed ovarian dysgerminoma with lymph node metastasis. She responded very well to chemotherapy and resumed her school activities. Bladder outlet obstruction is relatively rare in females and in the index patient, ovarian dysgerminoma is the cause leading to obstructive nephropathy and uropathy.
文摘Introduction: Members of the Human Epidermal Receptor [HER] family of receptor tyrosine kinases, such as HER2 and EGFR proteins are overexpressed in several epithelial malignancies and serve as effective therapeutic targets in cancer management. However, their role in prostate cancer development has been sparingly explored and with contrasting findings. Notably their relationship with prostate cancers cases seen in Sub-Saharan Africa is yet to be explored. Design: A retrospective study involving histologically diagnosed cases of adenocarcinomas of the prostate. Cases were classed according to the WHO/ISUP Gleason Prognostic groups [G1 - G5]. Immunohistochemical analysis was performed using monoclonal antibodies for HER2 and EGFR, while in situ hybridization employed DNA probes for the corresponding genes. Scores of +2 and +3 were regarded as positive for both antibodies, while a target gene: centromere ratio of >2 was set as the threshold for amplification. Results: A total of 44 cases were included in the study. The acinar type was the commonest morphologically, with Gleason group 5 [Gleason scores 8 - 10] accounting for close to half of the cases [47.7%]. The HER2 antibody stained negatively in the majority of cases [93.2%], being positive in only 3 [6.8%] of cases seen. High level expression of EGFR [+2/+3] was observed in 25% of cases, low level expression was identified in 6 [13.6%] cases. All HER2 positive malignancies displayed overexpression of EGFR. In situ-hybridization revealed the absence of high level amplification for both HER2 and EGFR, while polysomy was not detected in any of the cases. Conclusion: The overexpression of EGFR in prostate cancers has been demonstrated in a native African population, affirming its suitability for targeted therapy. Overexpression of HER2 in prostate cancer is inconstant, and amplification of the HER2 gene is less frequent than as compared to malignancies of the Breast and Ovary. There’s a need for a standardized protocol for assessing HER2 in prostate cancer.
文摘In tropical countries, malaria and preeclampsia/eclampsia are common diseases of pregnancy;and placenta have been implicated in the pathophysiology of both disease processes. The two diseases have pathophysiologic similarities in the placenta such as placenta ischaemia, endothelial dysfunction and production of pro-inflammatory cytokine. Yet, there is paucity of studies on the association of these two disease processes. Determining the association between the two disease processes may help to unravel the pathogenesis of preeclampsia and also help in its prevention and patient management. Objective: Determined the association between placenta malaria parasitemia and preeclampsia/eclampsia among parturients at Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods: This was a case control study that was conducted in the Labour wards of department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and Mile 4 Missionary Hospital Abakaliki, a comprehensive health care centre in Abakaliki, Ebonyi state. It was conducted over a period of 6 months between 1<sup>st</sup> October 2021 and 31<sup>st</sup> March, 2022. The cases in this study were parturients that developed preeclampsia/eclampsia in the course of pregnancy, while the controls were parturient without preeclampsia/eclampsia. Interviewer-administered questionnaires were used to collect data on socio-demographic characteristics, obstetrics and medical histories. Histological examinations were conducted to isolate plasmodium falciparum parasites from placenta samples obtained from the maternal surface of the placenta. The data was processed using Epi Info software. Categorical variables were analyzed using Mc Nemar X<sup>2</sup> test, with a p-value of 0.05 considered statistically significant. Logistic regression models were used to estimate the odds ratios (OR) and 95% CI of the association between placenta malaria parasites and preeclampsia/eclampsia was conducted. Relative risk with 95% CI was used to determine both fetal and maternal outcomes. Results: The prevalence of preeclampsia during the study period was 2.9%. Placenta malaria was positive in twenty one (21) of the 67 cases of preeclampsia/eclampsia analyzed, giving a prevalence of 31.3% and in eleven (11) out of 68 controls (normotensive) patients analyzed, giving a prevalence of 16.2%. The presence of placenta malaria significantly increased the odds of developing preeclampsia/eclampsia among parturients (OR = 2.4, 95% CI = 1.0 - 5.4, P value = 0.04). Presence of placenta malaria in mothers with preeclampsia/eclampsia was associated with adverse pregnancy outcomes such as cerebrovascular accident (RR = 19.2, 95% CI = 1.1 - 341.7, P value = 0.04), DIC (RR = 10.9, 95% CI = 1.4 - 88.0, P value = 0.02), abruptio placenta (RR = 2.4, 95% CI = 1.2 - 4.8, P value = 0.01), pulmonary edema (RR = 2.7, 95% CI = 1.1 - 25.9, P value = 0.03), IUGR (RR = 2.1, 95% CI = 1.1 - 4.5, P value = 0.03) and IUFD (RR = 3.8, 95% CI = 1.3 - 11.7, P value = 0.02). Presence of placenta malaria also increased the risk of NICU admission (RR = 2.6, 95% CI = 1.1 - 6.0, P value = 0.03), Low 1<sup>st</sup> minute APGAR score (RR = 2.7, 95% CI = 1.2 - 6.1, P value = 0.02) and Low 5<sup>th</sup> minute APGAR score (RR = 3.0, 95% CI = 1.0 - 8.6, P value = 0.04) among neonates delivered by mothers with preeclampsia/eclampsia. However, presence of placenta malaria did not significantly increase maternal and perinatal mortalities. Conclusion: There is a higher prevalence of placenta malaria among mothers with preeclampsia/eclampsia when compared with normotensive controls and this was associated with increased risk of certain maternal and perinatal morbidities. Placental malaria was not associated with increased risk of either maternal or perinatal mortality.
基金Supported by University of Lagos Central Research Grant, No. 2007/08
文摘AIM： To study the frequency, gender and age distribution as well as pathological characteristics of colorectal carcinoma （CRC） in Lagos and Sagamu in SW Nigeria. METHODS： This is a retrospective pathological review of histologically diagnosed CRC from 5 laboratories inLagos ＆ Sagamu. The clinical data, such as age, sex and clinical summary were extracted from demographic information. Cases of anal cancer were excluded from this study. RESULTS： There were 420 cases （237 males and 183 females） of CRC. It peaked in the 60-69 year age group （mean： 50.7; SD： 16.2）, M：F ratio 1.3：1 and 23% occurred below 40 years. The majority was well to moderately differentiated adenocarcinoma 321 （76.4%）, rnucinous carcinoma 45 （10.7%） and signet ring carcinoma 5 （1.2%）, and more common in patients under 40 years compared to well differentiated tumors. The recto-sigmoid colon was the most common site （58.6%）. About 51% and 34% of cases presented at TNM stages Ⅱand Ⅲ, respectively. CONCLUSION： CRC is the commonest malignant gastrointestinal （GIT） tumor most commonly located in the recto-sigmoid region. The age and sex prevalence and histopathological features concur with reports from other parts of the world.
文摘Background: Breast cancer remains an important medical challenge, despite sustained global efforts at its prevention and control. Various immunological factors are expressed in the serum during breast tumourigenesis, and can be of value in the surveillance of the disease. These serum bio-markers include pro-inflammatory cytokines since breast cancer is associated with chronic inflammation. In our locality with different racial/ethnic variations from Caucasian as well as environmental factors, there is scanty information on the value of these serum factors in screening and surveillance of breast cancer—hence the need for this study. Methodology: A total of 68 females (mean age = 48.7 ± 8.7 yrs) with clinically and pathologically confirmed breast cancer were recruited by self selection;representing breast cancer patients group. Due to small sample size they were further grouped into advanced stage breast cancer cases (N = 40) and early stage breast cancer cases (N = 28). Controls consisted of two groups: A—Patient control group (N = 21) comprised females with benign breast tumour (15 cases with fibroadenoma and 6 cases with fibrocystic disease) and group B—apparently healthy age/sex matched control group (N = 21). Pre-treatment samples were collected after which all patients underwent standard treatment modalities (neoadjuvant or adjuvant chemotherapy, radiotherapy, chemoradiation, and/or surgery;depending on the stage of presentation and thereafter post treatment samples were collected after 3 and 6 months respectively. Serum from the patients and controls were assayed immunoenzymatically for TNF-α and IL-1. Results: The results showed that at 6 months post-treatment stage, the mean values of IL-1 differed significantly (P > 0.05) when advanced stage breast cancer were compared with early stage and apparently healthy control groups respectively. Likewise at 6 months post-treatment stage, the TNF-α mean values differed significantly (P > 0.05) between advanced stage breast cancer and apparently healthy control. No significant differences in mean values were recorded across disease and treatment groups in both IL-1 and TNF-α at pre-treatment and 3 months post-treatment stages. Majority of the breast cancer patients studied were married (91%) and had children, of low income, never smoke cigarette, diagnosed at age above 46 years and presented at advanced stages of the disease. Results also showed that 78% of the cases did not have any history of cancer in their families. Also, 63% of the cases had body mass index values suggestive of obesity (>30 kg/m2). Conclusion: Results suggest that the use of serum levels of TNF-α and IL-1 in the diagnosis of breast cancer in our racial/ethnic environment is of limited clinical value. However it could be useful in disease surveillance in metastasis and relapse. Based on our findings, it could also be concluded that cigarette smoking and social sophistication are not among the risk factors to cancer in this part of the world, contrary to the situation in the advanced parts of the world.
