Schistosomiasis presenting as acute appendicitus

No Abstract.The East African Medical Journal Vol. 83 (10) 2006: pp. 528-53

Morphology of colorectal carcinoma among Nigerians: A 30-year review

Background: The incidence of colorectal carcinoma has been on the increase in the developing countries, including Nigeria, as a result of change in diet and adoption of western lifestyle.Objectives: The aim of this review is to highlight the prevalence, age and sex distribution, anatomical location, and morphological characteristics of colorectal carcinomas in Ilorin, Nigeria.Materials and Methods: This is a retrospective study of all cases of histologically diagnosed colorectal carcinoma in the University of Ilorin Teaching Hospital, Ilorin, Nigeria, over a 30-year period (January 1979–December 2008), using the departmental record and histological slides of the cases.Result: A total of 241 cases of colorectal carcinoma were reported, 144 cases (60%) in males and 96 cases (40%) in females with a male: female ratio of 1.5:1. The peak age of occurrence for males was between 51 and 60 years, while that of the females was between 41 and 50 years. The malignancy was found in the rectum in 60.2% of the cases, while the least affected site is the descending colon (1.2%). The exophytic occluding masses were found in 82.2% of the cases, and the most common histological type is adenocarcinoma (77.2%) with well-, moderately, and poorly differentiated forms constituting 52.3%, 32.8%, and 14.9% respectively. Of the 241 cases that were seen over the last 30 years, 93 cases (38.6%) were seen in the last 5 years.Conclusion: Colorectal carcinoma is no longer a rare disease in Nigeria. The surge in the incidence reported in the last 5 years in this center calls for a pragmatic action in its control, with emphasize on colonoscopic  screening for those with family history, and possibly making digital rectal examination a mandatory aspect of clinical examination, because most colorectal carcinomas are within the reach of examining finger

Blindness Caused by Pterygium – A Case Report

Pterygium leading to bilateral blindness and forcing patient to quit job is uncommon. This is a case report of a 46 year old indigent woman who had blinding pterygia over 10 years. She could not afford pterygium excision offered in a private eye clinic where she initially presented after a period of unsuccessful self medication. She was forced out of sewing job consequent to her inability to thread needle, difficulty reading number on the tape rule and difficulty recognising faces of her clients. Six years later, she presented at eye clinic of the University of Ilorin Teaching Hospital, Nigeria with advanced bilateral pterygia. Having defaulted from clinic over 4 months for lack of fund, the patient, after concession, had successful bilateral pterygia excision using bare sclera technique with Mitomycin C (MMC) dab. There was restoration of the lost vision. Pterygium is a cause of avoidable blindness with consequential impact on quality of life. Eye care providers should identify individual patient challenges to reduce avoidable blindness. Keywords: Avoidable blindness, Patient challenges, Pterygium, Quality of lif

Clinico-pathological pattern of nasopharyngeal carcinoma in Ilorin, Nigeria

Nasopharyngeal carcinoma is an uncommon tumour in Nigeria but the burden of the disease in terms of morbidity and mortality is very high.The aim of the study was to document the clinic-pathological characteristics of nasopharyngeal carcinoma in Ilorin, North central Nigeria.This was a retrospective review of all patients seen in ENT department, University of Ilorin Teaching Hospital with the diagnosis of nasopharyngeal carcinoma between January 1st 1999 and December 31st,2008. The patient's biodata, clinical presentation and histopathological findings are presented. The histopathological diagnosis was in accordance with the 1991WHOclassification. A total of 30 patients with histologically confirmed nasopharyngeal carcinoma seen during the study period accounted for 2% of the total cancers recorded in Ilorin cancer registry. There were 20 males and 10 females with a mean age of 48.7 ± 15.9 years. The commonest presenting complaint was cervical lymphadenopathy in 96.7% of patients followed by epistaxis (66.7%) and hearing loss (66.7%). Identifiable riskfactors included regular intake of ungutted salted smoked fish (76.7%) and tobacco use (23.3%) with some having both risk factors. Histologically, undifferentiated carcinoma was the commonest (70%) followed by welldifferentiated keratinizing squamous cell carcinoma (20%) and differentiated nonkeratinizing squamous cell carcinoma (10%).Undifferentiated carcinoma was the commonest type of nasopharyngeal carcinoma reported from this study especially among males in the 4th and 5th decades of life. Identifiable risk factors included consumption of ungutted salted smoked fish with tobaccon usage. Early diagnosis with effective referral system and easy access to radiotherapy would improve the survival outcome in patients with the disease

Beliefs, Attitudes and Health-seeking behavior towards ocular cancers among adults in Abuja, Nigeria

Background: To assess the beliefs attitudes, and health seeking behaviors towards ocular cancers among adults in Abuja.Methods: A descriptive cross-sectional survey of 1,887 Nigerians between June and September 2009 using interviewer-administered questionnaire.Results: The respondents’ reported refraining from interacting with persons afflicted with ocular cancers along these lines: eating together 261/669 (39%), hugging 149/668 (22%), shaking hands 106/561 (19%), laying on the same bed 328/560 (59%), and contracting marriage 462/558 (83%) with ocular cancer patients. However, 416/486 (85.6%) respondents would support getting appropriate health interventions for ocular cancers.Level of education was associated with positive attitudes towards ocular cancers patients (P<0.05). The respondents’ belief on characteristics of ocular cancers included “dangerous” 814/840 (96.6%), unknown nature 19/840 (2.3%); potential to cause blindness 849/882 (96.3%); potentially fatal 665/870 (76.4%), nonfatal 205/870 (23.6%). Also, the respondents believed treating ocular cancer is necessary 651/679 (95.9%) and unnecessary 28/679 (4.2%). About management of ocular cancers, 560/683 (82%) will consult eye doctors while 123/683 (18%) will seek other methods. Suggestions on how to improve management of ocular cancers were: improve public awareness 28.1%, train personnel 16.3%, provision of facilities 17.8%, establish national ocular cancer reference center 13.2% and free/subsidized treatment 13.2%.Conclusion:  Though significant proportion of respondents had the correct beliefs and attitudes towards ocular cancers, effective health education needs to be mounted to reinforce these positive beliefs and attitudes and also convert those with the wrong notions. This will in the long run improve health seeking behaviors.Keywords: ocular cancers, beliefs, attitudes, healthseeking behavior

Tuberculous epididymo-orchitis mimicking a testicular tumour: a case report

Introduction: Isolated tuberculous epididymo-orchitis may closely mimic testicular tumour particularly in patients with no history of systemic TB thereby presenting a diagnostic and treatment challenges.Case report: A 44-year old man presented with 4 months history of left scrotal mass and had left orchidectomy following a presumptive diagnosis of testicular tumour. Histopathological diagnosis of testicular tuberculosis was subsequently made. Although the patient was thereafter referred for antituberculosis treatment at the local tuberculosis treatment centre, he defaulted after commencing treatment.Conclusion: Adequate evaluation of patients with testicular mass by means of abdominal and scrotal ultrasound coupled with fine needle aspiration cytology is critical to diagnostic accuracy, optimal treatment and possibility of avoiding surgery in those with testicular tuberculosis.Keywords: Tuberculosis, epididymo-orchitis, ultrasound, cytology

Mycetoma in a 29 Year Old Nigerian: A Case Report

Mycetoma is a chronic granulomatous inflammatory disease caused by either aerophllic actinomycetes or true fungi, eumycetoma. The occurrence is worldwide but it is endemic in some African countries. The disease seems not to be common in our environment. We hereby present a case that was successfully managed in our centre. Mycetoma can cause disfigurement and in advanced cases, deformities and disabilities if not properly managed. Keywords: Mycetoma, granulomatous, fungiNigerian Hospital Practice Vol. 2 (1) 2008: pp. 18-2

Haemangioma of the Uterine Cervix in a Postmenopausal Woman – A Case Report

Haemangioma of the cervix is rare and it is often discovered incidentally. A 50-year old postmenopausal woman was being managed for postmenopausal bleeding due to endometrial hyperplasia and was discovered to have a non-friable cervical mass during vaginal examination at one of the follow-up visits. The mass was excised and  histopathological diagnosis of capillary haemangioma was made. The local excision was adequate and the patient had no new complaint at the last follow-up visit which was  about 6 months postexcision. The management approach to cervical haemangioma is conservative treatment except when it provokes life-threatening haemorrhage in which case hysterectomy may be considered. Clinicians should consider haemangioma in the differential diagnosis of cervical mass/lesion in a postmenopausal woman but unlike endometrial haemangioma, conservative approach is often successful in its  management.Keywords: Haemangioma, cervix, postmenopausal, haemorrhage

Squamous Cell Carcinoma arising in a mature cystic ovarian Teratoma with bladder invasion: a Case Report

Background: Malignant transformation in a mature cystic ovarian teratoma is rare. Except in cases with high index of suspicion or overt metastasis, oophorectomy is the mainstay of treatment for ovarian teratoma. Method: A 46-year-old perimenopausal woman who had salpingo-oophorectomy following a clinical diagnosis of benign ovarian tumour that was subsequently reported histologically as mature cystic ovarian teratoma with malignant transformation is presented. Results: She was referred to our facility based on the histopathology report and haematuria two weeks after surgery. Cystoscopic biopsy done was reported as metastatic squamous cell carcinoma most probably from the ovary. Patient was thereafter referred for radiotherapy but was lost to follow-up after the first course. Conclusion: Adequate evaluation prior to surgery in suspected ovarian teratoma with malignant transformation is critical to determine extent of surgery and adjuvant therapy. Prognosis in advanced disease condition such as the case presented is generally poor although radical pelvic surgery with resection of the adjacent involved bladder before radiotherapy would probably have improved her prognosis