Abdullahi Mohammed

Inflammatory bowel disease in Nigerians: Still a rare diagnosis?

Inflammatory bowel disease (IBD) has been thought to have a low incidence among subSaharan Africans mainly because of the sporadic cases reported from the continent in comparison with the larger numbers reported from North America and Western European countries. Is this difference based on real demographic susceptibilities or a reflection of lower level of healthcare delivery? Three cases of ulcerative colitis and one case of Crohns disease diagnosed in a tertiary institution in northern Nigeria in the span of three years are reported. Their presentation coincided with the creation of the Gastrointestinal Surgery Unit of our hospital and with it the availability of endoscopic diagnostic procedures. All four patients were indigenous Nigerians. Our findings suggest that IBD may be more common in this part of the world than previously thought. With an increased awareness of the disease in our population, a greater utilization of modern medicine as against alternative medicine and with wider availability of diagnostic tools in our hospitals, it is our guess that more cases may be found in the future to dispel the belief that Africans are somewhat immune to this affliction.

Angiosarcoma of the small intestine

Primary gastrointestinal angiosarcomas are very rare and those of the small bowel even more rare. We report a case which is the first in the literature from this part of the world. It presented in a 25-year-old woman with multiple dissemination and rapid fatality. Diagnosis was based on histological morphology using Hematoxylin and Eosin (H and E) stains, plus reticulin special stain to outline the vascular nature.

Residency training program: Perceptions of residents

BACKGROUND There is a phobia among doctors for the residency training program, since the establishment of the program over 30 years ago. The reason for establishing the program was mainly to provide the much-needed specialists in medicine. OBJECTIVES To ascertain the perception of the residency training program among residents. MATERIALS AND METHODS Structured questionnaires were administered to residents at 3 training institutions in Nigeria. RESULTS One hundred nineteen (85.5%) questionnaires were returned out of 140. The ages of respondents ranged from 27 to 42 years, the median age being 30 years. There were 110 males and 9 females. One hundred six (89.1%) were junior residents. Ninety (75.6%) were sponsored by the training institutions. Seventy-four (62.25%) felt their consultants were contributing just 50% or less to their training. Sixty-two (52.2%) of the respondents had attended a revision course, conference or seminar within the last 6 months. Majority of the residents would want better remuneration, up-front payment of examination and revision fees, more teaching by the consultants and less emphasis on the provision of services as ways of improving the program. CONCLUSION Majority of the residents are sponsored by the training institutions.

A histopathological study of ovarian neoplasms in children in a tertiary hospital of northern Nigeria

BACKGROUND Information concerning the frequency and pattern of ovarian tumours in children is scant, more so in northern Nigeria. In view of this, we reviewed ovarian biopsies obtained from children in Zaria over a 25-year period. MATERIALS AND METHODS Ovarian tumours occurring in 48 patients of age 15 years and below were reviewed and classified using the current World Health Organization (WHO) histological classification of ovarian tumours. RESULTS Ovarian tumours in children accounted for 8.6% of all cases of tumours seen in all age groups over the period. Among all the malignant tumours seen in this period, 32% occurred in children, and Burkitts lymphoma accounted for 31.2% of these. Germ cell tumours accounted for 58.0% while epithelial tumours had a frequency of 2.1%. CONCLUSION Burkitts lymphoma is the most common childhood ovarian tumour in Zaria, northern Nigeria.

Primary bone tumours and tumour-like lesions in children in Zaria, Nigeria.

BACKGROUND Studies on bone neoplasms are generally scanty globally and more so in children. Primary bone tumours and tumour-like lesions in children have not been reported from Zaria. OBJECTIVE To determine the relative frequencies, sex and age distributions, and anatomical sites of occurrence of primary bone tumours and tumour-like lesions in children in Zaria. MATERIALS AND METHODS A retrospective review of histopathology reports of 40 children with bone tumours and tumour-like lesions in 11 years of age. RESULTS Benign tumours accounted for 12 (30%) of the 40 tumours reviewed (osteoma 2.5%, osterochondroma 22.5%, fibroma 5%); while malignant tumours occurred in 19 (47.5%) (osteosarcoma 5%, Burkitts lymphoma 37.5%, diffuse lympholastic lymphoma 5%). Tumour-like lesions accounted for 9 (22.5%), all fibrous dysplasia. Out of 40 tumours, 23 (57.5%) occurred in males and 17 (422.5%) in females. The majority of tumours, 45% occurred in the age group of 10-15 years, followed by 15 (37.5) occurring in the 5-9 years age range. The most common malignany was Burkitts lymphoma 15 (37.5%). Maxilla was the most common site for malignant (30%) and benign tumours (12.5%). CONCLUSION This study has shown that, primary bone tumours are relatively uncommon in children in our setting.

Myositis Ossificans Circumscripta of the Supra-orbital Region: A Case Report

Myositis ossificans circumscripta is a pathological condition characterized by formation of bony tissue within the skeletal muscles following repeated trauma. A case of myositis ossificans circumscripta of the supra-orbital region in a 25-year-old man is presented and the pertinent literature is reviewed. To the best our knowledge this benign lesion has not been reported previously in the orbital region the world literature. Clinically the patient presented with a swelling and proptosis of the right eye. Radiologically there was a rounded opacity with well defined margin. Lesion was initially misdiagnosed as a fibro-osseous lesion; however microscopic examination indicated matured myositis ossificans. Lesion was excised via a bicoronal flap. Careful clinical, radiological and pathologic evaluation is required to make this uncommon diagnosis in an unusual location such as the supra-orbital region to avoid unnecessary surgical mutilation of the patient.

An analysis of dietary fiber and fecal fiber components including pH in rural Africans with colorectal cancer

Background/Aims Colorectal cancer (CRC) is now a major public health problem with heavy morbidity and mortality in rural Africans despite the lingering dietary fiber-rich foodstuffs consumption. Studies have shown that increased intake of dietary fiber which contribute to low fecal pH and also influences the activity of intestinal microbiota, is associated with a lowered risk for CRC. However, whether or not the apparent high dietary fiber consumption by Africans do not longer protects against CRC risk is unknown. This study evaluated dietary fiber intake, fecal fiber components and pH levels in CRC patients. Methods Thirty-five subjects (CRC=21, control=14), mean age 45 years were recruited for the study. A truncated food frequency questionnaire and modified Goering and Van Soest procedures were used. Results We found that all subjects consumed variety of dietary fiber-rich foodstuffs. There is slight preponderance in consumption of dietary fiber by the control group than the CRC patients. We also found a significant difference in the mean fecal neutral detergent fiber, acid detergent fiber, hemicellulose, cellulose and lignin contents from the CRC patients compared to the controls (P<0.05). The CRC patients had significantly more fecal pH level than the matched apparently healthy controls (P=0.017). Conclusions The identified differences in the fecal fiber components and stool pH levels between the 2 groups may relate to CRC incidence and mortality in rural Africans. There is crucial need for more hypothesis-driven research with adequate funding on the cumulative preventive role of dietary fiber-rich foodstuffs against colorectal cancer in rural Africans “today.”

Abstract 4918: Is Livin a protagonist of mucinous adenocarcinoma histology in colorectal cancer

The mechanism of cancer resistance to chemotherapy regimen remains uncertain. Colorectal mucinous adenocarcinoma is one of the distinct histological subtypes of the disease implicated in chemotherapeutic resistance associated with nodal and peritoneal metastases and worse disease-free survival as an index of poor prognosis. One of the important acquired capabilities used by the cancer cells to resist anticancer therapies is evasion of apoptosis possibly via inhibitor of apoptosis proteins for which Livin is one. This protein contains baculoviral IAP repeat domains in addition to a RING finger, a protein-protein motif important for binding and inhibition of active caspases that interfere with intrinsic and/or extrinsic pathway and the ensuing blockade of apoptosis. Thus, understanding the molecular events on how cancer cells of mucinous histology evade apoptotic death may provide a novel paradigm for a molecular targeted therapy in the management of colorectal mucinous adenocarcinoma. In this study, the expression pattern and prognostic value of IAP family protein, Livin, in colorectal cancer patients with mucinous histology pre and post-chemotherapy regimen was investigated. Tissue sections from advanced stage colorectal cancer patients who were treated or untreated with neo-adjuvant FOLFOX chemotherapy before curative resection were included in this study. The tissue sections were grouped according to colorectal adenocarcinomas showing mucinous histology and non-mucinous component. Histological study including Haematoxylin and Eosin, and immunohistochemistry for Anti-Livin and DNA mismatched repair proteins were carried out. Immunofluorescence study was performed to clarify the expression pattern of the protein using Anti-Livin antibody. Protein expression quantification study was also used. Results show significant cytoplasmic localisation and expression of Livin protein in the colorectal cancer cells. The Livin protein expression was found to be increased by more than a one-fold post-chemotherapy treatment when compared with pre-chemotherapy treated patients with mucinous histology of colorectal cancer. Younger patients were found to have a greater probability of colorectal mucinous adenocarcinoma diagnosis and worse prognosis. Our findings show that Livin-induced inhibition of apoptosis activity can be a target for novel approaches to treatment and prevention of chemotherapy associated drug resistance in mucinous histology colorectal cancer since Livin overexpression has been associated with metastases and worse disease-free survival. More study is needed Citation Format: Mohammed Faruk, Abdulmumini Hassan Rafindadi, Sani Ibrahim, Surajo Mohammed Aminu, Surajo Mohammed Aminu, Ahmed Adamu, Ahmed Adamu, Yawale Iliyasu, Adamu Abdullahi, Mohammed Sani Shehu, Abdullahi Mohammed, John Idoko, Abdullahi Jibril Randawa, Abdullahi Jibril Randawa, Atara Ntekim, Saad Aliyu Ahmed, Aishatu Suleiman Maude, Almustapha Aliyu Liman, Abubakar Sani, Khalid Zahir Shah, Yahaya Ukwenya, Yahaya Ukwenya, Cheh Augustine Awasum, Kasimu Umar Adoke, James Olowu Enemari, James Olowu Enemari, James Olowu Enemari, Andrew Jonathan Nok. Is Livin a protagonist of mucinous adenocarcinoma histology in colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4918. doi:10.1158/1538-7445.AM2017-4918

Abstract B71: First ten malignancies by ranking from a population of rural Africans in Zaria, Nigeria: A fourteen years review and report

Every environment is noted for its variability in incidences of various malignancies and subtypes. The objective of this study is to analyze the trend of malignant tumors in a population of rural Africans attending Ahmadu Bello University Teaching Hospital Zaria, Nigeria with particular emphasis on the first ten most frequently diagnosed cancers over a period of 14 consecutive years (2001-2014). Histologically diagnosed cancers in the various cancer registries of the ABUTH Zaria were included in this study. The ten most commonly presenting cancers were extracted and their demographic characteristics and other relevant clinical data documented using a standardized questionnaire. The data obtained were analyzed using SPSS software version 20.0. There were 6,553 histologically diagnosed cancers over 14 years in Ahmadu Bello Unibersity Teaching Hospital Zaria with the following in descending order: Cervical cancer 1042 (15.90%), Breast cancer 788 (12.02%), Prostate cancer 496 (7.56%), Colorectal cancer 360 (5.49%), Lymphoma 306 (4.66%), Eye/orbit cancer 170 (2.59%), Bladder cancer 169 (2.45%), Nasopharyngeal cancer 139 (2.12%), Ovarian cancers 94 (1.43%), and Liver cancer 52 (0.79%). Cervical cancer tops the list as the most frequently diagnosed cancer however, this should be noted that it is a cancer exclusive to females so also breast cancers though rarely males may present with breast cancer. Prostate cancer is a male exclusive disease therefore the percentage would have been higher if the diagnosis would have excluded the females. Of the ten most frequently diagnosed cancers, liver cancer is the tenth despite the fact that complications of viral hepatitidis are known to facilitate liver carcinogenesis and the prevalence of hepatitis C and B in the Nigerian population is 5 and 20 respectively. Citation Format: Abdulmumini Hassan Rafindadi, Surajo Mohammed Aminu, Mohammed Faruk, Yawale Iliyasu, Abdullahi Mohammed, Sani Ibrahim, Ahmed Adamu, Mohammed Sani Shehu, Abdullahi Jubril Randawa, Adamu Abdullahi, Saad Aliyu Ahmed, Maitama Yusuf Hussaini, Danladi Amodu Ameh, Ukwenya Yahaya, John Idoko, Oguntayo Olanrewaju Adekunle, Almustapha Aliyu Liman, Abdulkadir Lawal Rafindadi, Aisha Maude Suleiman, Jigo Dangude Yaro, Ahmad Bello, Bello Kumo. First ten malignancies by ranking from a population of rural Africans in Zaria, Nigeria: A fourteen years review and report. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B71.

Carcinoma in children at Ahmadu Bello University Teaching Hospital Zaria

Introduction: Carcinomas are an important cause of morbidity and mortality among adults but are relatively uncommon in children. However, a significant number of carcinomas do occur in children, with debilitating consequences. Materials and Methods: This is a retrospective study of all the carcinoma diagnoses in children aged 15 years and below during the 17 years′ study period. Laboratory records from the Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria were extracted and reviewed. The findings were compared with similar studies elsewhere. Results: There were 41 children with confirmed cases of carcinoma, with 24 males and 17 females. The male-to-female ratio was 1.4:1. The peak age of incidence was 11-15 years. Patients aged less than 6 years constituted only 9.8% of cases. The commonest sites were the skin (29.3%), colon (22.0%), nasopharynx (14.6%), and major and minor salivary glands (14.6%). Conclusion: Carcinomas in children do occur, but are rare. These tumors are diverse and site-specific in their epidemiology, histogenesis, natural history, biologic behavior, morphology, and prognosis.