Female genital tract cancers in Sagamu, southwest, Nigeria

Objective: To describe pattern of female genital tract cancers seen at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria.Design: This is a retrospective review of all cases of female genital tract cancers managed at the Gynaecology department of OOUTH, Sagamu, Nigeria.Setting: OOUTH is a tertiary health institution of the State’s university and it takes referrals from within and outside the State.Subjects: Case records of all female genital tract cancers managed between January 2004 and December 2013 were retrieved and analysed using SPSS version 16.0.Results: There were 2059 women treated for various gynaecologic conditions, 179 (8.7%) were cases of female genital tract cancers and 161 records were available for analysis. Cervical cancer constituted the commonest (51.6%), followed by ovarian (35.4%), endometrial (9.9%), and choriocarcinoma (1.9%). There were no cases of vaginal and fallopian tube cancers. The lowest mean age was found in choriocarcinoma (36.60 ±4.50 years) and highest in vulvar cancer (70.00 ±2.82 years). The mean ages for cervical, endometrial and ovarian cancers were (51.98±12.39), (65.38±7.24), and (54.42±10.51) years respectively. Similarly the least mean parity was found in choriocarcinoma (2.33±1.52), and the highest in vulvar cancer (6.00±1.44). The mean parity for cervical, endometrial, and ovarian were (4.10±1.49), (3.06±1.48), and (3.72±1.68) respectively. These differences are statistically significant, age; F= 7.61, p<0.0001, and parity; F= 3.27, p= 0.013.Conclusion: Incidence of cervical, endometrial, and ovarian cancers remain high and presentations are at late stages. There is a need to improve on cervical cancer screening, and for the attending physicians to improve on their indices of suspicions as regards endometrial and ovarian cancers

Effect of pre-operative sub-lingual misoprostol versus intravenous oxytocin on Caesarean operation blood loss

Background: Caesarean operation remains the most common abdominal surgery in women and has immense benefits to both mother and baby when employed. Haemorrhage, however, remains the greatest challenge associated with its outcome.Objective: To compare the effectiveness of pre-operative sub-lingual misoprostol with intravenous oxytocin administered after delivery of the neonate in minimising blood loss at Caesarean operationDesign: A prospective study.Results: The mean blood loss was significantly lower in misoprostol group compared to oxytocin group (517.32mls versus 621.22mls; p = 0.005). The drop in haematocrit was significantly lower in misoprostol group than the oxytocin group, (400μg-misoprostol versus oxytocin: 1.88 versus 3.04; p=0.0001). Side effects of chills, shivering and pyrexia were noted more with the use of misoprostol.Conclusion: Pre-operative sub-lingual misoprostol is more effective than intravenous infusion of oxytocin in reducing blood loss at Caesarean section operation. However, occurrence of transient side effects of chills, shivering and pyrexia were noted more with use of misoprostol

Rheumatoid Arthritis Associated with Pulmonary Fibrosis in Nigerians: Two Case Reports

Rheumatoid arthritis may sometimes present with extra-articular involvement, pulmonary involvement is not common. Rheumatoid arthritis has been reported among Nigerians and extra-articular manifestations are rarely seen. One of the patients was misdiagnosed and mismanaged as a patient with pulmonary tuberculosis. The study is to demonstrate that rheumatoid arthritis is not as rare as previously reported in Nigeria and its pulmonary involvement can mimic tuberculosis or other granulomatous lung disorder. Clinical and serological acumen are necessary to distinguish between the two. Two diagnosed patients with rheumatoid arthritis and pulmonary involvement seen at Olabisi Onabanjo University Teaching Hospital (OOUTH), are hereby presented

Acute Pulmonary Thromboembolism: A Retrospective Study in a Nigerian Private Tertiary Hospital

Background: Pulmonary embolism (PE) is a disease associated with high morbidity and mortality in the more technically advanced western world. However, in Africa and Nigeria in particular, the burden of PE is largely poorly defined as few data are available. Objectives: To characterize the clinical profile, management and outcomes in PE patients confirmed with Computerized Tomography Pulmonary Angiography (CTPA). Methods: A retrospective study was conducted at Babcock University Teaching Hospital, Ilishan-Remo, Nigeria. The medical records of PE patients confirmed by CTPA and admitted to the intensive care unit of the hospital spanning July 2016 to June 2020 were retrieved for analysis. Results: Thirty-one patients with the age range of 26 to 93 years were included and the mean age was 55.5±18.5 years. Breathlessness was the most prevalent presenting symptom. In the majority of patients (48.4%), the risk factors were not known. However, the most common risk factor and co-morbidity was pregnancy (16.1%). The in-hospital mortality rate was 9.7%. Conclusion: The clinical characteristics of PE in this cohort were similar to those described in the literature. The high mortality rate in this study also underscores the need for large population studies in black Africans

Omics-based molecular techniques in oral pathology centred cancer: Prospect and challenges in Africa

: The completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and “big data” processing have contributed immensely to individualized/personalized medicine in the developed world.At the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratifcation of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the profciency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among diferent human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences

Primigravida at Advanced Maternal Age

Evolving socioeconomic development and its challenges, and advances in medical science have led to increasing proportion of women delaying childbearing beyond the age of 35years in the past three to four decades. A woman who is carrying her first pregnancy at age 35years or more is referred to as elderly primigravida. Similar consideration is given to a woman who delivers her first child at age 35years or more. Pregnancy in this group of women is associated with several adverse pregnancy outcomes including hypertensive disorders of pregnancy, diabetes and its complications, uteroplacental bleeding, preterm birth, low birth weight, still birth, chromosomal defects, labour complications, and caesarean section. They, therefore, constitute one of the obstetric high risk categories requiring special attention and vigilant care. Early booking, close supervision in the antenatal and intrapartum periods, appropriately timed obstetric intervention and advocation of active management of labour would engender good fetal and maternal outcomes. A definitive increase in the number of women in this group is expected to occur both in developed and developing countries thus necessitating an in-depth review and updating of knowledge in the management of this category of women.Keywords: Primigravida, Advanced Maternal Age, Obstetric OutcomeNigerian Medical Practitioner Vol. 63, No. 5-6,201

Prevalence of hypertenstion and other cardiovascular risk factors in an Africa Sub-Urban religious community

No Abstract

Deep Pressure Sores Complicating Labour; A Case Report

In the late 1960s and the mid 1970s the reproductive health indices from the developing countries, particularly the sub-Saharan Africa, were alarming and worrisome. The maternal and prenatal mortality rates were unacceptably high. Over 80% of all deliveries in these countries are attended to by untrained birth attendants. The United Nation, through its organ World Health Organization [W.H.O.] then conceived the programme of training Traditional birth attendants to care for delivery services of women at the grassroot. The strategy was to reduce maternal and neonatal mortality in communities with shortages of midwives and where pre-natal care and delivery services were lacking. To date, evidence in support of TBAs remains limited and conflicting. The maternal and prenatal indices continue to worsen and majority of these morbidities and mortalities are traceable to errors of judgments by TBAs during conducts of deliveries. Miss AA is here by presented to demonstrate an example of errors of judgments by TBAs during conducts of labour and deliveries resulting in deep pressure sores in the gluteal and sacral areas and obstetric fistula.Keywords: Deep Pressure Sores, Labour, Traditional Birth Attendants [Tbas

Respiratory Symptoms and Pattern of Lung Functions Among Commercial Motorcyclists in Sagamu, Nigeria

Background: The relationship between occupational exposure to air pollutants and poor respiratory health is known. The motorcyclists commonly seek medical care for respiratory diseases in Nigeria. Objective: To determine the prevalence of respiratory symptoms and the pattern of lung functions among commercial motorcyclists compared to control subjects. Method: The controlled cross-sectional study was conducted in Sagamu, an urban town in south-western, Nigeria. The commercial motorcyclists and the controls with similar age, non-smokers and same male sex were included in the study. The riders and controls recruited were non-smokers. A structured questionnaire approved by the British Medical Research Council/ATS (American Thoracic Society) was used. The pulmonary function tests were performed according to ATS recommendation. Results: A total of 200 subjects were studied: 100 were commercial motorcyclists and 100 were non-motorcyclist controls. Compared with the controls, the prevalence of cough (71% vs 21%) and sputum (67% vs 20%) was higher among the commercial motorcyclists. Twenty-one percent of the commercial motorcyclists had an obstructive ventilatory pattern compared to 13% of the control group. Conclusion: This study provides further evidence that commercial motorcyclists are exposed to occupational hazards which predisposed them to increased frequency of respiratory symptoms and impaired lung functions. Health education strategy may assist this group of workers and reduce the burden of respiratory disorders among them

Cervical Cytology in Sagamu Nigeria

Cervical cancer is the commonest female genital tract cancer and second to breast in cancer deaths worldwide. In sub-Saharan Africa it is the commonest cancer and most common cause of cancer deaths in women. The incidence keeps declining in the advanced and industrialized countries of the world due to effective screening programme. The gold standard tool for effective screening programme is the cytology based Pap smear test. The human and material requirements for Pap smear and cytology make it less practicable for effective coverage in poor resource countries thus resulting in less than 5% of women needing screening being covered. The incidence of CIN has been variously quoted between 2% and 12.5% worldwide. To determine the incidence of CIN in women who attend the well women clinic for cervical cancer screening in our hospital. Case records and cytology results of all women who attended Well Women Clinic of our hospital between January, 2005 and December, 2013 were reviewed and analysed using the SPSS version 16.0 statistical package. Four hundred and sixty-seven women had cervical cancer screening using Pap smear and cytology during the study period. Twenty-nine (6.5%) had smear showing intraepithelial neoplasia and 19 (4.1%) of these were high grade lesions. Finding of 6.5% prevalence rate of cervical intraepithelial neoplasia, and with over half of these being high grade lesions in this study, justifies the need to intensify screening of women, especially those in the reproductive age group.Keywords: Cervical; Cytology; Sagamu; Nigeria