Adesuwa Noma Olu-Eddo

The rheological profile of chronic liver disease patients in Nigeria.

BACKGROUND In chronic liver diseases, liver function is adversely affected and the consequent alterations in blood constituents are known to affect vascular and rheological parameters. The aim of the study was to analyze the rheological profile in chronic liver disease (CLD) patients in Nigeria. PATIENTS AND METHODS Seventy consecutive CLD patients attending the Gastroenterology Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria were studied prospectively over an 8 month period (May-December, 2007). Fifty apparently healthy age-and-sex matched individuals who were prescreened and found serologically negative to HIV 1 and 2, HBsAg and HCV were used as controls. Diagnosis of CLD was based upon histological findings of chronic parenchymal liver disease in the presence of stigmata of CLD. Plasma fibrinogen level was determined by the clot-weight technique. Plasma viscosity, erythrocyte sedimentation rate, haematocrit and platelet count were analysed. Clinico-demographic features, treatment modalities and the complications were analyzed. RESULTS A total of 120 subjects comprising 70 CLD patients (50 males (71.4%) and 20 females (28.6%)) and 50 controls were studied. Alcoholic cirrhosis (44.3%) was the main risk factor closely followed by viral hepatitis (41.4%). Haematocrit and platelet count of CLD patients were significantly lower than the controls (p<0.001). Plasma fibrinogen concentration and plasma viscosity in CLD patients were significantly lower compared to the controls (p<0.001). CONCLUSION CLD patients had low blood viscosity and low fibrinogen level (hypofibrinogenamia) when compared to controls. This may have contributed to the hypocoagulable state and therefore the bleeding tendency encountered in these patients.

Malignant Skin Tumors in Benin City, South-South, Nigeria

OBJECTIVE Malignant skin tumors rank amongst the most common forms of cancer worldwide and constitute a major challenge in dermatopathology and oncology research. This study aims to determine the frequency and patterns of malignant skin tumors at the University of Benin Teaching Hospital, Benin City, Nigeria. METHODS A 25-year (1982-2007) retrospective study of surgical day books and slides of all patients presenting with skin lesions was conducted at the Surgical and Pathology Departments of University of Benin Teaching Hospital. RESULTS A total of 694 skin biopsies were seen at the department during the study period; of these, 187 cases were malignant constituting 27% of all skin lesions. The majority of the malignant skin tumors (48%) occurred between the third and fifth decades with a male to female ratio of 1.4:1 and a mean age of 47 ± 29 years. Malignant melanoma was the most common skin malignancy, accounting for (n=61; 33%). Kaposi sarcoma constituted the second majority of the cases (n=56; 30%), with a markedly increased incidence between 2000 and 2008. This was consecutively followed by squamous cell carcinoma (n=45; 24%), basal cell carcinoma (n=18; 10%) and dermatofibrosarcoma protuberans (n=7; 4%). The leg and foot were the most common sites for malignant skin tumors. CONCLUSION Malignant melanoma was the most common skin malignancy in this study. However, an increasing incidence of all malignant skin tumors was observed. This was particularly noticeable with Kaposi sarcoma, which may be attributed to the increasing prevalence of HIV/AIDS in Nigeria.

Salivary gland tumors, a twenty-year retrospective study

This is a retrospective study of salivary gland tumor (SGT) specimens seen at the University of Benin Teaching Hospital (UBTH) over a 20-year period. It is aimed at determining the epidemiological pattern of these tumors. The materials for this study that consisted of available slides and paraffin-embedded blocks of all SGT specimens received during the study period were evaluated. Data on age, sex, anatomical sites and histologic diagnosis were obtained from the departmental surgical records. Data analysis was done using SPSS version 16.0. SGTs are very rare, accounting for 0.32% of specimens received in the UBTH. The female to male ratio was 1:1.3, and the ratio of benign to malignant tumors was 1.8:1. The mean ages for benign and malignant tumors were 37.0 and 43.5 years, respectively. The peak age for benign SGTs was in the 3 rd decade, while malignant tumors showed a peak in the 6 th decade. The parotid gland was most commonly affected (57%). Overall, pleomorphic adenoma was the most common SGT seen, accounting for 53.2% of all the cases. Adenoid cystic carcinoma was the most frequently encountered malignant SGT (10.1%). The epidemiological pattern of SGT in the study populace is similar to those of other African-based studies but differ slightly from those of the Caucasians.

Co-existence of TB and adult haematological cancers in Benin City, Nigeria.

Tuberculosis is an ancient human scourge that continues to be an important public health problem worldwide. As impaired immunity is closely associated with the pathogenesis of TB, an increase in the incidence of the disease among patients with cancer is anticipated. A total of 20 cases of haematological cancers co-existing with TB in a tertiary hospital in an African setting between January 2005 and September 2008 were analysed. Clinico-pathologic profiles, types of TB infection and outcome were noted. The incidence of TB in patients with haematological malignancies was 3.4%. Lymphoma and leukaemia were the most common malignancies associated with TB. With the high incidence of such cases we recommend the exclusion of an active disease prior to the initiation of cancer therapy. Chemoprophylaxis might be indicated in TB endemic areas.

Morphological patterns of primary skin Sarcoma in Benin-City, Nigeria

Background: The purpose of this study is to determine the frequency and morphological patterns of primary skin sarcoma in University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Materials and Methods: Data of skin surgical received at the Department of Histopathology, over a 25 year period (1982-2007) were reviewed. Information derived from surgical day books includes socio-demographic data on age, sex, hospital numbers, clinical features and diagnosis. Corresponding slides and blocks retrieved were examined histological. Results: During the 25-year period of this study, 187 cases were malignant skin lesions. Of these, 64 constituting 34.2% were primary skin sarcomas. Kaposi sarcoma (KS) accounted for (n = 57; 30.5% and n = 57; 89.1%) of malignant skin tumours and primary skin sarcoma, respectively. Dermatofibrosarcoma protuberans (DFSP) accounted for (n = 7; 3.7% and n = 7; 10.9%) of all skin malignancy and primary skin sarcomas respectively. The peak incidence of KS and DFSP was in the 4 th and 3 rd decades respectively. The mean age for KS and DFSP was 47.5 ± 1.7 and 35.9 ± 5.9 respectively. The age range for KS and DFSP was 17-78 and 25-65 years respectively. KS and DFSP accounted for male to female ratio of 1.3:1. Of the 28 cases with recorded site distribution, 14 cases (50%) occurred in the leg and foot region. Of these 6 cases of DFSP with recorded site distributions, 4 cases (66.7%) occurred in the trunk. Conclusion: The burden of primary skin sarcoma particularly AIDS associated Kaposi sarcoma in developing countries is worrisome. In view of this, it is important that more awareness and effective HIV/AIDS screening be instituted to reduce the morbidity and mortality of this menace. So that at no distance time, there would be a drastic reduction of skin sarcoma in our society.

Patterns of non-melanoma skin cancer in Benin City, Nigeria: A teaching hospital experience

Aim and Objective: The purpose of this study was to determine the frequency and morphological patterns of non-melanoma skin cancers (NMSCs) in University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Materials and Methods: Data of surgical biopsies from the skin received at the Department of Histopathology over a 26-year period (from January 1982 to December 2007) were reviewed. The sources of information were surgical pathology day books, duplicates of histology request form and reports. Corresponding slides were retrieved for histopathology examination. Data were analyzed with SPSS version 17. Results: A total of 187 skin malignancies were encountered. Of these, 63 accounting for 33.7% were NMSCs. Squamous cell carcinoma (SCC) accounted for 45 cases, constituting 24.1% of all malignant skin tumors and 71.4% of NMSCs. Basal cell carcinoma (BCC) accounted for 18 cases (9.6%) of all malignant skin tumors and 28.6% of NMSCs. The peak incidence of SCC and BCC was in the 5 th decade of life. The mean age for SCC and BCC was 51.4 ± 1.3 and 46.3 ± 5.2 years, respectively. The male to female ratios for SCC and BCC were 2.4:1 and 1.6:1, respectively. Conclusion: In conclusion, SCC was the most common NMSC. This is similar to reports of other studies in Africans and Black Americans. In contrast, in Caucasian series, BCC was the most common NMSC. The head and neck region was the most common site of these skin cancers.

Screening of Gynaecological Surgical Patients for HIV-1 Infection in Nigeria

Background : HIV infection in gynaecological surgical diseases (GSDs) is associated with higher complications but epidemiological data in Nigeria is scarce. Objective : To determine the proportion, pattern and factors associated with HIV-1 infections among GSDs patients and early linkage to HIV care and treatment. Materials and Method : This one-year prospective study enrolled consecutive volunteers admitted January 1 through December 31, 2007 for gynaecological surgeries in a tertiary Nigerian hospital. The women were pre- and post-test counselled and screened for HIV-1 antibodies using Abbott Determine for HIV- 1 and 2 (Abbott Laboratories, Illinois, USA) and Uni-Gold Recombigen HIV (Trinity Biotech, Wicklow, Ireland) in a serial test algorithm. Repeatedly reactive samples were considered positive. Discordant results were confirmed using HIV-1/2 Stat-Pak (Chembio, Medford, NY) as tie-breaker. The patients’ socio-demographic characteristics and associated factors were obtained using structured questionnaire. Seropositive women were linked to care. The outcome measures were proportion of women with HIV positive results, associated factors and mortality rate over a one year follow up period. Results : The overall proportion of HIV positive result was 6.3% (26/413) with women aged ≥ 45 years having the highest proportion (8.45%). Only 9.4 % (39/413) were aware of their HIV status prior to testing. Of the HIV positive patients, 7.7% (2/26) knew their status and were on antiretroviral drugs. They had not been sexually active in the last six months. Multiple sexual partners (p<0.000), STIs (p<0.000), traditional medications (p<0.003), pelvic abscess (p=0.008), cervical cancer (p<0.003), induced abortions (p<0.001) were HIV-associated factors. Previous blood transfusion, surgeries, benign tumors, non-cervical gynaecological malignancies were not. There were no mortalities over a one year follow up period. Conclusion : The proportion of HIV infection among women admitted for GSDs was high but prior knowledge of HIV status was low. The study has provided a window of opportunity for screening, diagnosis and early treatment. Integration of HIV counselling and testing into gynecological services would be desirable.