Morphological spectrum of non‑neoplastic lesions of the uterine cervix in Warri, South‑South, Nigeria

Background: The uterine cervix is a gateway to several non‑neoplastic and neoplastic gynecological lesions. Most of these non‑neoplastic lesions are commonly found in women of reproductive age. These lesions constitute a source of morbidity and mortality in women worldwide hence the need to analyze them to provide a baseline data of the pattern of these lesions in ur local environment. Objective: The purpose of this study is to determine the frequency and morphological patterns of non‑neoplastic cervical lesions at the central hospital, Warri, Nigeria.Materials and Methods: All uterine cervical biopsies received at the Department of Pathology, Central Hospital, Warri over a 7 year period (January 2005‑December 2011) were the specimens for this study. Slides were retrieved from the archives of the Department of Pathology. Where necessary, new sections were made from formalin fixed, paraffin embedded blocks.Results: A total of 176 cervical specimens were received in the Pathology Department during this period. Of these, 56.3% were benign lesions while 43.7% were malignant. Among the benign cases, non‑neoplastic lesions accounted for 92.9% of benign cervical lesions. The age range of non‑neoplastic cervical lesions was 20 to 89 years with a mean age of 54.9 ± 4.6 years. The peak age incidence of non‑neoplastic cervical lesion was 40‑49 years which accounted for 33.7%. Inflammatory lesions and tumor‑like lesions accounted for 59.8% and 40.2% of non‑neoplastic cervical lesions respectively. Among the inflammatory lesions, chronic non‑specific cervicitis was the most commonly encountered lesion constituting 72.2% of all inflammation. Human papilloma virus (HPV) cervicitis with koilocytic changes accounted for 14.5% of all inflammatory lesions.Conclusion: Inflammatory lesions were the most frequent non‑neoplastic cervical lesions. These lesions therefore account for significant amount of gynecological problems in our environment. Adequate cervical screening with follow up histological biopsies is a relevant tool in diagnosing them to enhance early detection of premalignant and malignant cervical lesions.Keywords: Benign, cervical lesions, non‑neoplastic, diagnosis, histopathologyNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issu

Histopathological Patterns of Endometrial Lesions in Patients with Abnormal Uterine Bleeding in a Cosmopolitan Population

Background: Endometrial diseases ranked among the most common gynecological disorders that aff ect women globally. These diseases cut across all age groups and contribute signifi cantly to increased maternal morbidity and mortality. Due to the wide range of histopathological patterns, the need for urgent diagnosis and treatment cannot be overemphasized.Aim: The aim of this study is to highlight the frequency and histological types and patterns of the endometrial lesions in patients with abnormal uterine bleeding (AUB) in private practice in Benin-City, Nigeria.Materials and Methods: H and E stained-slides of endometrial biopsies diagnosed at the Ashamas foundation histopathology diagnostic center in Benin-City for 10 years were archived and studied. Request forms were analyzed for clinical bio-data, diagnosis and type of biopsies carried out. Data were entered using Micro-soft Excel package and transferred to statistics software (statistical package for the social sciences Version 17, SPSS Incorperated, Chicago Illinois, USA) for descriptive analysis.Results: In all, 231endometrial lesions were received. Of these, 207/231 (89.6%) cases were seen in reproductive and perimenopausal age groups while 24/231 (10.4%) was encountered in postmenopausal age group. The age range and peak age incidence was 17-86 years and fourth decade respectively. The mean age was 38.8 (6.8) years In all 231 endometrial lesions, product of conception was the most common fi nding observed (n=64/231; 27.7%) in reproductive and pre-menopausal women. While the most frequently encountered lesion in postmenopausal women was complex endometrial hyperplasia (n=6/231; 2.6%).Conclusion: Histopathological patterns of endometrial biopsy and curettage of women presenting with AUB is variable. Product of conception was the most commonly encountered among reproductive women. Nevertheless, endometrial hyperplasia was most frequent in perimenopausal age group. Keywords: Cancer, endometrium, histopathology, lesions, private practic

Cytological diagnosis of ascitic fluid in Benin City, Nigeria

No Abstrac

Increased incidence of gang rape in Benin-City, Nigeria: Is this a forensic epidemic?

Background: Sexual violence is an inherent and wide-spread violence against women with serious impact on women’s health and well-being. It is a gender-based crime against both individual and the society. It is estimated that 25% and 40% of females in US and Nigeria respectively have been sexually assaulted.Aim: The present study is a hospital-based study that is focused only on gang rape with the aim of understanding the epidemiological pattern as well as the characteristics of the victims and offenders.Materials and Methods: All cases of sexual assault reported to the police in Edo state and its environs are usually referred to either Central Hospital, Benin City or the Police clinic for medical examination and issuing of medical reports. This study is a descriptive retrospective audit of all cases of gang-rape victims, attended to at Central hospital, Benin-City from January 2008 to December 2013. The case notes were retrieved and information relevant for this study, including age, sex of the victim, time and date of the assault, number of violators, and important clinical findings were extracted.Results: A total of 133 female gang-rape victims were seen during this 6 years period. The mode, median and mean age of victims of gang rape was 17 years, 17 years and 17.38±5.67 SD respectively. The age range was 6-32 years and the peak age group was 16-20 years. Seventy percent of gang rape victims were in the 2nd decade. Two perpetrators were encountered in 67 cases, accounting for 57% of gang-rape cases with 63% of perpetrators as known victims.Conclusion: Gang-rape is a common problem in Nigeria with most cases affecting the poor socio-economic class. It is on the increase in this study centre. The late reporting of gang rape cases creates so much negative impact on the legal outcome. There is a need to provide a holistic support to the victims and to review Nigerian laws on sexual offences for the good of all.Keywords: Gang-Rape, Sexual violence, Forensic, E

Diseases mortality patterns in elderly patients: A Nigerian teaching hospital experience in Irrua, Nigeria

Background: Currently, in developing countries, there is a paradigm shift in the mortality patterns from communicable to non‑communicable diseases. Objective: This study is aimed at providing a broad spectrum on the mortality patterns in elderly within a 5‑year‑period in a tertiary healthcare provider in Nigeria. Materials and Methods: This study is a retrospective review of mortality patterns of elderly patients from January 2007 to December 2011 occurring in Irrua specialist teaching hospital, (ISTH), Irrua and its environs. Information derived from the request cards include age, sex, clinical history, diagnosis, duration and cause of death. Results: During this period a total of 3,002 elderly (>65 years) admissions were seen. Of this, 561 patients were confirmed dead. Among this, 317 and 244 cases were elderly male and female patients, respectively. Hence the ratio of male to female was 1.3:1.0. The peak age group was 65‑70 years accounting for 147 patients (26.2%). The age range of patients was 65‑104 years while the modal and mean ages were 69 years and 74 years ± 4.2 standard deviation (SD), respectively. The most commonly encountered cause of mortality was cerebrovascular accident constituting 141 (25.1%) cases. The 2nd and 3rd majority of mortality cases were malignancies and diabetes mellitus (metabolic disorder) accounting for 85 (15.2%) and 45 (8%) cases, respectively. Others include congestive cardiac failure 35 (6.2%), Septicaemia 29 (5.2%), trauma 26 (4.6%) while chronic renal failure and chronic obstructive pulmonary disease consist of 22 cases (3.9%) each. Conclusion: Non‑communicable diseases particularly cerebrovascular diseases and malignancies were the most commonly encountered cause of elderly mortality in our environment. Notwithstanding a large percentage of mortality patterns also results from communicable diseases with sepsis as the leading cause of mortality.Keywords: Cerebrovascular accident, malignancy, mortality, sepsisNigerian Medical Journal | Vol. 54 | Issue 4 | July-August | 201

Morphological Patterns Of Malignant Melanoma In Benin-City, South-South, Nigeria

Context: Malignant melanoma ranked among the top 10 most common malignancies in developed countries. It remains a major skin cancer with considerable geographical, racial and ethnical variation worldwide.Objective: The purpose of this study is to determine the frequency and morphological patterns and variants of malignant melanoma in University of Benin Teaching Hospital (UBTH), Benin City, Nigeria.Materials and Methods: Data of surgical biopsies from the skin received at the department of Histopathology, over a twenty-five year period (January 1982 to December 2007) were reviewed. The sources of information were surgical pathology day books, duplicates of histology cards and reports. Information derived includes socio-demographic data on age, sex, hospital numbers, clinical features and diagnosis. Corresponding slides were retrieved for histopathology examination. Skin cancers were categorized using the W.H.O classificationResults: One hundred and eight seven malignant skin biopsies were seen in the Department during the period. Of these, malignant melanoma was the most common and accounted for (32.6%). The peak age incidence wasth seen in the 5 decade with a male to female ratio of 1:1. The mean age for malignant melanoma was 52.4 ±2.2SD with an age range of 25-79 years. Of the 61 cases, majority accounting for 90.2% occurred in the legand foot region. Nodular melanoma constituted first majority variant accounting for 36.3%. Malignant melanoma in advanced stages IV and V was the most common constituting 81%.Conclusion: The exact incidence of malignant melanoma in most African countries including Nigeria is unknown because most cases of malignant melanoma are unreported.Keywords: Malignant melanoma, Histopathology, Biops

Morphological patterns of malignant cercival lessons in Warri, Niger-Delta zone of Nigeria

Background: Malignant tumours of the uterine cervix constitute a scourge and reproductive ill health to women of different age groups. These tumours are predominantly cancer of the cervix. Studies have shown that more than 80% of cases of cancer of the cervix worldwide live in developing countries. Materials and Methods: All uterine cervical biopsies received at the department of Pathology, Central Hospital, Warri over a seven year period (January 2005-December 2011) were the materials for this study. Request forms were analyzed for clinical bio-data and diagnosis and histological sections and slides were analyzed Results: A total of 994 gynaecological biopsies were received during this 7 years period of study, 102 cases (10.3%) were gynaecological malignancies. Of these 102 cases, cervical malignancies accounted for 77 cases (75.5%). Again, out of the 994 biopsies, cervical biopsies were 178. Of this, 77 cases (43.7%) were malignant and 99 cases (56.3%) were either benign neoplasm, pseudoneoplastic and inflammatory lesions. The patients’ age range for all malignant cervical lesions was 30-87 years. The peak age and mean age incidence for all malignant cervical tumours were 40-49 years and 49.6±8.4 years respectively. Invasive squamous cell carcinoma (SqCC) was the most commonly seen malignancy accounting for (n=60, 77.9%). Conclusion: Cervical cancer constitutes the first majority of gynaecological malignancies with squamous cell carcinoma as the most commonly encountered cervical malignancies. Again, only a small percentage of CIN were seen as compared to cervical carcinomas.Keywords: Cervical cancer; Histopathology; Diagnosi

An adolescent Nigerian girl presenting with juvenile dermatomyositis

Juvenile dermatomyositis (JDM) is a systemic, autoimmune inflammatory muscle disorder and vasculopathy of unknown origin that affects children younger than 18 years. JDM primarily affects the skin and the proximal skeletal muscles. Globally, JDM is rare; in Nigeria only one case has been reported. In general, children with JDM are able to lead normal lives with full recovery when diagnosis and initiation of appropriate therapy is early. A 12 year old girl presented with proximal myopathy, skin rash, elevated muscle enzymes and typical muscle histology. The diagnosis of JDM was delayed despite her having accessed several health facilities. Response to steroids was incomplete as she already had disabilities (muscle wasting with inability to walk) before treatment was commenced. We highlight the challenges of management in a low resource setting which included delay in diagnosis, lack of diagnostic tools, poor referral system and lack of health funding. The need for awareness and a high index of suspicion among health care workers is emphasized to ensure early referrals for early diagnosis/early initiation of appropriate therapy and improved outcome