B. A. Salami

Cell Proliferation (KI-67) Expression Is Associated with Poorer Prognosis in Nigerian Compared to British Breast Cancer Women

Background. Black women with breast cancer (BC) in Nigeria have higher mortality rate compared with British women. This study investigated prognostic features of cell proliferation biomarker (Ki-67) in Nigerian breast cancer women. Materials and Methods. The protein expression of Ki-67 was investigated in series of 308 Nigerian women, prepared as a tissue microarray (TMA), using immunohistochemistry. Clinic-pathological parameters, biomarkers, and patient outcome of tumours expressing Ki-67 in Nigerian women were correlated with UK grade-matched series. Results. A significantly larger proportion of breast tumours from Nigerian women showed high Ki-67 expression. Those tumours were significantly correlated with negative expression of the steroid hormone receptors (ER and PgR), p21, p27, E-cadherin, BRCA-1, and Bcl-2 (all P < 0.001), but positively associated with EGFR (P = 0.003), p53, basal cytokeratins: CK56, CK14, triple negative, and basal phenotype using Nielsens classification (all P < 0.001) compared to UK women. Multivariate analyses showed that race was also associated with BCSS independent of tumour size, lymph node status, and ER status. Conclusion. Ki-67 expression was observed to have contributed to the difference in the BCSS in Nigerian compared with British BC women. Therefore, targeting Ki-67 in the indigenous black women with BC might improve the patient outcome in the black women with BC.

Clinical Features and Pattern of Presentation of Breast Diseases in Surgical Outpatient Clinic of a Suburban Tertiary Hospital in South-West Nigeria

Objective: To characterize the clinical features and pattern of presentation of breast diseases as observed in our practice. Materials and Methods: A prospective study of 121 consecutive patients with breast complaints presenting in our Surgical Outpatient Clinics. The relevant data were collected by two surgeons using the prescribed forms and was analyzed using Epi Info 2003, Mann-Whitney (test of two groups) Chi-squared and Fishers exact test was used to compare parameters of benign and malignant groups. P value <0.05 was considered as significant. Results: One hundred and nineteen patients were females, two were males. The age range was 14-70 years. Forty two (34.7%) patients were in the 21-30 year age group. The commonest symptoms were breast lump in 111 (91.7%) patients, and breast pain in 28 (23.1%) patients. Breast pain was a significant presenting complaint in patients with breast malignancy (P=.026). On clinical examination 103 (85.1%) patients had palpable lumps, and seven patients were normal. Forty four patients (36.3%) had malignant disease, seventy patients (57.8%) had benign breast diseases and seven were normal. Fifty nine of the 70 benign diseases were fibroadenoma. One hundred and three patients (85%) had appropriate therapy, while 18 patients (14.8%), including eight with malignant disease absconded. Conclusion: In the study, a breast lump was the commonest clinical feature of breast disease. Over 60% of these were benign. Breast pain was a statistically significant presentation in patients with malignant breast disease. One in seven of the patients absconded.

Checkpoint Kinase 1 Expression Predicts Poor Prognosis in Nigerian Breast Cancer Patients

BackgroundCheckpoint kinase 1 (CHEK1), a DNA damage sensor and cell death pathway stimulator, is regarded as an oncogene in tumours, where its activities are considered essential for tumourigenesis and the survival of cancer cells treated with chemotherapy and radiotherapy. In breast cancer, CHEK1 expression has been associated with an aggressive tumour phenotype, the triple-negative breast cancer subtype, an aberrant response to tamoxifen, and poor prognosis. However, the relevance of CHEK1 expression has, hitherto, not been investigated in an indigenous African population. We therefore aimed to investigate the clinicopathological, biological, and prognostic significance of CHEK1 expression in a cohort of Nigerian breast cancer cases.Material and MethodsTissue microarrays of 207 Nigerian breast cancer cases were tested for CHEK1 expression using immunohistochemistry. The clinicopathological, molecular, and prognostic characteristics of CHEK1-positive tumours were determined using the Chi-squared test and Kaplan–Meier and Cox regression analyses in SPSS Version 16.ResultsNuclear expression of CHEK1 was present in 61% of breast tumours and was associated with tumour size, triple-negative cancer, basal-like phenotype, the epithelial-mesenchymal transition, p53 over-expression, DNA homologous repair pathway dysfunction, and poor prognosis.ConclusionsThe rate expression of CHEK1 is high in Nigerian breast cancer cases and is associated with an aggressive phenotype and poor prognosis.

Outcome of primary closure of dirty abdominal wounds in children at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria

Background: The management of dirty abdominal wounds has remained a challenge to surgeons because of the associated complications. Objective: This study was undertaken to determine the outcome of primary closure of dirty abdominal wounds in children. Design: A retrospective study (between 1st January, 2006 and 5th May, 2009) on the outcome of the primary closure of dirty abdominal wounds in children. Setting: Paediatric Surgery Division, Department of Surgery, Olabisi Onabanjo University Teaching Hospital, Sagamu. Materials and Methods: Cases of dirty abdominal wounds managed during the study period were retrieved from the medical records. Information regarding the age, sex, diagnosis, treatment, type of abdominal wound closure, duration of stay in hospital, complications arising from the abdominal wounds, and outcome was obtained and documented. Results: A total of 120 cases of dirty abdominal wound were managed during the study period. However, 90 case notes were retrieved and further evaluated for the proposed study. The age range of the patients studied was 2 months to 14 years. Males were 48 (53.3%), while females were 42 (46.7%). All the cases were acute abdominal emergencies. Differential diagnosis of dirty abdominal wounds managed during the study period are ruptured appendicitis/appendiceal abscess 30 (33.3%), intussusception 19 (21.1%), strangulated inguinoscrotal hernia 16 (17.8%), typhoid ileal perforation 14 (15.6%), and abdominal injuries 11 (12.2%). Healing without complications was seen in 70 (77.8%) patients, while complications occurred in 20 (22.2%) patients. The complications that occurred were wound infections 17 (68%), wound dehiscence 3 (12%), incisional hernia 3 (12%), enterocutaneous fistula 2 (8%), and duration of hospitalization 7-55 days and mortality of 4 (4.4%) was recorded.

Spectrum and prevalence of thyroid diseases seen at a tertiary health facility in Sagamu, South-West Nigeria

Background: The prevalence of goitrous swelling has reduced in Nigeria since the introduction of salt iodisation programme. Thyroid disorders are the second most common endocrine disorder after diabetes mellitus worldwide. They present to general outpatient, medical and surgical clinics accompanied by great anxiety and poor health-related quality of life. Objectives: The study aimed to determine and describe the spectrum of thyroid disorders seen at Olabisi Onabanjo University Teaching Hospital over a 10-year period. Materials and Methods: This was a retrospective analysis of records of patients who presented to the hospital with thyroid swellings over a 10-year period (June 2004 to June 2014). Clinicopathological and demographic data obtained from hospital records in 175 patients diagnosed by clinical examination, thyroid ultrasound, hormone profile and histological confirmation in cases that had surgery were analysed for this study. Results: The records of 175 patients were obtained comprising 151 (86.3%) females and 24 (13.7%) males (female to male ratio of 6.3:1) with age range from 18 to 76 years and mean age of 42.3 years, standard deviation 13.5. With clinical diagnosis, distribution of thyroid diseases was simple goitre 103 (58.9%), toxic goitre 64 (36.6%), hypothyroidism 3 (1.7%), malignant goitre 4 (2.3%) and thyroiditis 1 (0.6%). The age group of 30–49 years had the highest prevalence of the thyroid diseases 100 (57.2%) while the extremes of age, below 20 and over 70 years had the least (5.1 and 2.9%, respectively). Conclusion: The prevalent form of thyroid diseases seen at Olabisi Onabanjo University Teaching Hospital was simple goitre and most common in females. Studies on autoimmunity and other goitrogens are required to further elucidate the cause of this high prevalence.

Asymmetrical tetraphocomelia with radiohumeral synostosis

Ann Saudi Med 2006;26(4):318-320 Amelia is the complete absence of a limb, which may occur in isolation or as part of multiple congenital malformations.1-3 The condition is uncommon and very little is known with certainty about the etiology. Whatever the cause, however, it results from an event which must have occurred between the fourth and eighth week of embryogenesis.1,3 The causal factors that have been proposed include amniotic band disruption,4 maternal diabetes,5 autosomal recessive mutation6 and drugs such as thalidomide,7 alcohol8 and cocaine.9 We report a case of a female baby with a complex combination of two rare limb abnormalities: left-sided humero-radial synostosis and amelia of the other limbs.