Fine Needle Aspiration Cytology In Tumour Diagnosis

Fine needle aspiration cytology (FNAC), a technique for obtaining cellular material for cytological examination and diagnosis using a 21- gauge or smaller needle, is performed using a 5, 10, or 20ml syringe either freehand or using special syringe holders. It allows a minimally invasive, rapid diagnosis of tissue samples but does not preserve its histological architecture

Histopathological evaluation of H. Pylori associated gastric lesions in Benin city, Nigeria

Background: Endoscopic biopsy of the gastric mucosa allows early diagnosis, grading, staging and classification of gastric diseases. Helicobacter pylori, has been recognized as a major aetiologic factor for chronic gastritis, benign gastric ulcers and gastric adenocarcinoma and lymphoma. The loco-regional variability in the prevalence of Helicobacter pylori and associated diseases in Nigeria, emphasise the need for evaluation of subsets of a heterogeneous population like oursObjective: To determine the frequency of helicobacter pylori in gastric endoscopic biopsies and document the pathology of gastric lesions commonly associated with Helicobacter pylori infection.Design: Retrospective descriptive study.Settings: University of Benin Teaching Hospital (UBTH), and Biogenics Histopathology Laboratory (a private Histopathology Laboratory), both based in Benin City, Niger Delta region of Nigeria.Subjects: Endoscopic gastric biopsies recorded in the surgical pathology register of the department from 2005-2009 were studied and relevant demographic and clinical information extracted from the registers, original request cards and patient case files. The clinical data and slides processed from paraffin embedded tissue blocks of endoscopic biopsies of gastric lesions seen from year 2005 to 2009 were studied, analyzed and statistically presented.Results: Total number of specimens studied was 142. Chronic gastritis was present in 117(82.39%) specimens; 9(6.34%) were benign gastric ulcers; 3(2.11%) were gastric polyps; and 11(7.75%) were gastric malignancies. Helicobacter pylori, was demonstrated in 55.6% of all specimens. The peak age for Chronic Gastritis and Gastric Cancer is the 6th decade. Amongst patients with chronic gastritis, inflammatory activity was present in 65%; atrophy in 53%; and intestinal metaplasia in 16.6%. All gastric malignancies seen were intestinal type adenocarcinomas.Conclusion: The spectrum of lesions diagnosed in gastric endoscopic biopsy specimens in Benin, their frequency and associations are largely comparable to what has been described elsewhere in Nigeria and Africa.Key words: Helicobacter Pylori; Gastric lesions; Endoscopic biopsies

Immunohistochemical detection of Her-2/neu overexpression in breast carcinoma in Nigerians: A 5-year retrospective study

Objective: To determine the pattern of Her-2/neu status among breast carcinoma in the University of Benin Teaching Hospital, Benin City, Nigeria.Materials and Methods: Immunohistochemical staining for Her-2/neu was performed on 10% formalin-fixed, paraffinembedded primary carcinoma of the breast from 83 patients, between 2003 and 2007 using anti-Her-2/neu rabbit polyclonal antibody (DakoCytomation, CA, USA) and reactivity detected by an avidin-biotin immunoperoxidase method. The clinicopathologic parameters analyzed were patients’ age, histological types, and tumor grade. The Her-2/neu Dako scoring system was used.Results: During the 5-year period, 83 histologically confirmed cases of invasive breast carcinoma were assessed for Her-2/neu status. These included 67 (80.7%) cases of invasive ductal carcinoma, nine cases of invasive lobular carcinoma (10.8%), three cases of medullary carcinoma (3.6%), two cases of papillary carcinoma (2.4%), and a case each of mucinous and clear cell carcinoma (1.2%). Mean age of patients was 48.9 ± 13.6 years with an age range of 25 to 83 years. Only nine (10.8%) cases showed immunopositivity for Her-2/neu. Seven of these were cases of invasive ductal carcinoma, while two were invasive lobular carcinoma. Tumors were predominantly high grade with grade III, II, and I accounting for 42, 28, and 13 cases, respectively. There was no significant correlation between patient age, the various histological types, tumor grade, and Her-2/neu positivity.Conclusions: This study indicates that Her-2/neu may not be useful in defining the prognosis of breast cancer in this environment. Nevertheless, it highlights the need for routine immunostaining for Her-2/neu before institution of trastuzumab (Herceptin) therapy

Hepatoblastoma in an adolescent girl: A case report

Hepatoblastoma is the most common primary malignant hepatic tumour in children, occurring between the ages of 6months to 3years. It most often presents with a painless abdominal mass discovered accidentally in youngchildren. Occurrence in adolescents and adults is rare and is usuallyassociated with non-specific symptoms which often result in delayed  diagnosis and commencement of treatment. Abdominal pain preceding a rapidly progressive abdominal mass is a common pattern observed in adolescents and adults. The histologic type commonly seen in adults isassociated with a poor prognosis. We report the case of a sixteen year old girl who presented with abdominal pain and distension and jaundice of a short duration. She was well-nourished with marked hepatomegaly and ascites. Hepatic transaminases were highly elevated with deranged clotting profile. She developed features of hepatic encephalopathy and diedon the seventh day of admission. A Post-mortem histologic diagnosisof hepatoblastoma was made.Key words: Hepatoblastoma, adolescent, poor prognosi

Twenty-first century technology of combating wildfire

Wildfire causes havoc and serious destruction of forest resources and wildlife. It also causes occasionally serious damages to human lives and properties. Current technology of fighting wildfire employs fire retardant chemicals, which pollute the environment seriously, and damages both wild and aquatic lives. Based on the new novel technology, it is possible that in the near future the industrial emissions that pollute the environments and cause health problems would be completely captured in frozen solid forms of emissions products. One of these is the frozen carbon dioxide, which is known as dry ice, which would be available than in hundreds of millions of tons in any country. Cost analysis shows that the power and cement industries would significantly benefit by selling the dry ice captured using the technology, just at $0.07 per kg. The present paper discusses the new technology of applying dry ice that would thus be abundantly available in fighting a wildfire. The paper discusses how the new technology would be by far superior to current technology that employs fire retardant chemicals in terms of environmental protection and the cost-effectiveness over the current technology

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income. Conclusion At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

An Audit Of Open Breast Biopsies In Two Hospitals In The Niger Delta

Context Biopsies provide histological diagnosis and as such may guide subsequent management of breast lumps. Regular audit of such biopsies are necessary to document epidemiological pattern of the histological diagnosis within a population. Objective To review the histological diagnoses of breast biopsies in two referral centres in the Niger Delta region of Nigeria. Methodology This is a descriptive analysis of retrospective data obtained from the Central Hospital Warri and the University of Benin Teaching Hospital, Benin City, all in the Niger-Delta region of Nigeria between 2005 and 2010. Results Data on 367 biopsies were analysed. Patients with benign diagnoses aged in range between 14 and 48 years and those with malignant conditions between 20 and 85 years. Fibroadenoma was the commonest histological diagnosis (36.0%) with a mean age at diagnosis of 22.9 5.5 years. Just one case of fibroadenoma was recorded beyond 36 years. years. Malignancies were seen in 29.4% of biopsies with Invasive ductal carcinoma being the dominant histological type, 89.8%. The mean age at diagnosis of breast cancer was 46.0 12.1 years. Incidence of malignant findings ranged from less than 1 in 10 biopsies below 30 years, 1 in 2 biopsies at the 31-35 years age range to nearly unit in those 56 years and above. Conclusion Fibroadenoma is the commonest breast biopsy finding in the referral centres in the Niger Delta. Breast cancer occurs commonly among premenopausal women.Key words: Breast, Biopsy, Fibroadenoma, Invasive ductal carcinoma

Impact Of The Introduction Of Fine Needle Aspiration Cytology Services On The Cost Of Care Of Breast Cancer Patients In Benin City, Nigeria

Context The incidence of breast cancer in Nigerian women has been rising since the mid 1970s and it is now the commonest malignancy in Nigerian females. The need for diagnostic approaches that take into cognisance the demographic and socio-economic uniqueness that fuels the high prevalence of this disease in our environment cannot be overemphasised. Objective This is a prospective study to determine the cost effectiveness of the introduction of Fine Needle Aspiration Cytology (FNAC) on the cost of care of women with palpable breast masses in the University of Benin Teaching Hospital (UBTH). Method One hundred and three (103) consecutive FNAC of palpable breast masses were performed on 98 patients referred from the surgical outpatient clinic between January 2005 and March 2006. Comparison was made with subsequent histological diagnoses in order to ascertain the diagnostic accuracy of the procedure and later, determine savings made by the introduction of the procedure compared to hitherto only available option of open surgical biopsy. Results The impact of the introduction of FNAC on the cost of care of patients with breast lumps was assessed and it is established that a reduction of between N7,000 and N15,000 in expenses incurred by these patients was achieved and also a direct impact on patient compliance and reduction in number of surgical cases was noted. Conclussion The introduction of FNAC was found to be useful in the reduction of cost of management of all categories of patients with breast lumps.Key words: Fine needle, breast cancer, cytology, cost

Risk Factors Associated With Cervical Intraepithelial Lesions In A Tertiary Hospital Setting.

Context Cervical cancer despite being largely preventable, is still the leading cause of gynaecological cancer related death among females in developing countries. Identification of risk factors will help to reduce the morbidity and mortality associated with cervical cancer. Methodology This was a prospective study involving four hundred and eighty five women consecutively selected among the women attending gynaecological clinic at the University of Benin Teaching Hospital, Benin- City. Results The prevalence of cervical intraepithelial lesion in this study was 20.6%. A total of 216 (44.9%) of the women were aware of cervical cancer and only 32.4% were aware of cervical cancer screening while only 13.5% ever had at least a Pap smear testing. Premalignant cervical lesion was significantly higher among women 30 years and older and lower socioeconomic class with a significant linear trend in each of these groups. High parity especially vaginal delivery, cigarette smoking and having had a previous Pap testing were each associated with increased risk of abnormal Pap smear. First marriage before 20 years of age and lifetime partners in excess of four were associated with increased risk of abnormal Pap smear. Conclusion the study demonstrated that high parity and women over 30 years of age (especially those who married earlier than 20 years of age) had a higher yield of cervical premalignant lesions.Key Words: Risk Factors, Cervical intraepithelial lesions