The practice of hepatocellular cancer surveillance in Nigeria

Background: Hepatocellular cancer is a disease of global and public health importance due to the widespread distribution of risk factors and associated high case fatality. Hepatocellular Cancer (HCC) in Sub-Saharan Africa is commonly seen among the younger age groups (<45 years) who present mostly in the terminal stage, when the disease is not amenable to any curative therapy. Hepatocellular Carcinoma surveillance employs the use of simple, cheap and readily available investigations, to detect early curable cancer in individuals with risk factors for HCC.Objectives:The aim of this study is to assess the practice of hepatocellular cancer screening among physicians.Methodolgy:This is a nationwide online survey carried out among physicians who care for patients with HCC. A questionnaire was sent out via a web link to all consenting doctors in Nigeria. The responses were collated in a cloud-based application and data was analysed using Epi-info version 20.Results:Atotal of 218 respondents, 142 were males (65.1 %) with a mean age of 37.6 ± 5.7 years. The modal age group was 31-40 years 153 (69.5%). The main factors considered as a hindrance to surveillance were; the cost of the tests (57.7%), failure of return of patients (50.5%) and not being aware of a surveillance program (45.2 %). The majority of the respondents were Gastroenterologists and Family Physicians. 54% of the gastroenterologists and 64% of the family physicians have never offered HCC surveillance to their patients.Conclusion:This survey highlights a knowledge gap in HCC surveillance among physicians. There is a need to make HCCsurveillance a daily routine among patients at risk by all physicians. Keywords: Surveillance, Hepatocellular Carcinoma, HBV, HCV, Cancer screening

Massive bleeding from colonic diverticular disease in an elderly Nigerian: A case report

Colonic diverticular disease is one of the most common and costly gastrointestinal disorders among industrialized countries. The disease was thought to be rare in the African population, but is being increasingly diagnosed with the advent of modern imaging techniques and colonoscopy. Diverticular bleeding is a common cause of lower gastrointestinal (GI) haemorrhage and patients typically present with massive and painless rectal haemorrhage. Reports of massive bleeding from colonic diverticular disease are rare in Nigeria. We report a case of massive bleeding from multiple colonic diverticuli in a 70 year old Nigerian male who was admitted due to haematochezia and dizziness and was transfused with 8 units of blood. There was spontaneous resolution of bleeding in spite of the absence of facilities for therapeutic intervention at our institution.Keywords: Colonic diverticular disease, colonoscopy, haematochezia, massive bleeding, gastrointestinal disorder

Prospective Jatropha Curcas based Firms in Nigeria. How Viable?

This study examined the viability of prospective Jatropha based firms vis–a-vis employment opportunities in Nigeria, specifically the study identified the Jatropha bio-diesel and other allied products that were been researched into in Nigeria, estimated the costs and returns structure to Jatropha cultivation and the production of Jatropha based products. For the study, small scale Jatropha based firms were investigated. The results of the study revealed that Jatropha based products manufactured include bio-diesel, Jatropha kernel cake livestock feed, Jatropha ink pigment and dye, glycerine and Jatropha seeds-coat cement sheet and floor tiles. All the various parts of the Jatropha seeds are useful either for one or two of these products. Jatropha cultivation, was shown to be very profitable. Among Jatropha products, only the costs of the biodiesel Jatropha fuel is relative expensive when compared with the common fossil diesel. Based on the study findings, the study calls for the mobilisation of the Nigerian farmers to cultivate Jatropha, Alongside training to intimate the masses of the numerous products and benefits from Jatropha is necessary. They should be trained to manufacture simple Jatropha based necessities like those highlighted in the study. Market accessibility training to farmers and other stakeholders involved should also be embedded in the training. There is also the need to popularize the practicality of using Jatropha to produce these products via workshops and seminars. It is also necessary to step-up steps at introducing these products to the markets so as to enhance the marketability and competitiveness of the Jatropha based firms. Government and also other individuals and stake-holders need ensure the availability of supporting infrastructures for these small holder industries to thrive in the long-run