Assessment of Zinc Level and its Relationship with Some Hematological Parameters among Patients with Sickle Cell Anemia in Abakaliki, Nigeria

Background: Sickle cell anemia (SCA) is an inherited hemoglobin (Hb) disorder with susceptibility for oxidative damage due to chronic redox imbalance in red blood cells (RBCs) which often results in hemolysis, endothelial injury, recurrent vaso-occlusive episodes, and derangement in hematological parameters. Zinc is an antioxidant which helps to reduce oxidative damage. This study aimed to assess the serum level of zinc and its relationship with some hematological parameters in patients with SCA (HbSS). Materials and Methods: This was a cross-sectional comparative study which involved HbSS patients in steady state with sex‐ and age‐matched HbAA control. Assay of Hb phenotype, serum zinc level, and some haematological parameters were done. Ethical approval was gotten from the institutional review board, and each participant gave informed written consent before recruitment into the study. Analysis of all data obtained was done using SPSS software, version 20. Results: Thirty adult patients with SCA and thirty sex- and age-matched controls with a mean age of 26.7 ± 7.6 years and 27.7± 5.3, respectively, were studied. There was a significant decrease in serum zinc level among patients with HbSS compared to those with HbAA (P = 0.038). Similarly, patients with HbSS had significantly lower Hb level, packed cell volume, and RBC count compared to HbAA control (P < 0.05). On the contrary, patients with HbSS had significantly higher white cell count and platelet count compared to HbAA individuals (P < 0.05). Correlation between serum zinc level and blood counts showed weak positive relationship between zinc level and Hb level (r = 0.04, P = 0.8) and weak negative relationship between serum zinc level and platelet count (r = −0.3, P = 0.1), as well as zinc and white blood cell (WBC) count (r = −0.2, P = 0.4). Conclusion: There was a significantly low level of zinc among patients with HbSS compared with HbAA controls. Patients with HbSS had zinc levels that weakly correlated with Hb level positively but weakly negatively correlated with platelet and WBC counts. Further studies are required on a wider scale to assess whether zinc supplementation may improve blood counts in patients with SCA

The Role of Fine Needle Aspiration Cytology in Triple Assessment of Patients with Malignant Breast Lumps

Background: Breast cancer is the leading female malignancy in the world and now the most common cancer in Nigeria. The evaluation of patients with breast cancer requires stepwise diagnostic approach to achieve a combined diagnostic information required to make an enhanced decision on how best to approach management. The aim of this study is to evaluate the role of fine needle aspiration cytology (FNAC) in the triple assessment of patients with malignant breast lumps in our center. Patients and Methods: This is a descriptive prospective study of patients with palpable breast lumps over an eighteen-month period. The patients were sequentially subjected to FNAC and open biopsy. Those whose lumps were malignant were further evaluated. Results: There were 88 (44.9%) and 108 (55.1%) biopsy confirmed breast cancers and benign lumps, respectively. From cytology reports, there were 12 (6.1%) unsatisfactory (C1), 96 (49%) benign (C2), 8 (4.1%) atypical (C3), 10 (5.1%) suspicious of malignancy and 70 (35.7%) unequivocally malignant (C5) smears. FNAC performed better than clinical examination in the validity tests for breast malignancy. The diagnostic results for breast malignancies were 97.2% (sensitivity), 98.9% (specificity), 1.4% (false positive rate []), 2.1% (false negative rate), 98.6% (positive predictive value), 97.9% (negative predictive value), and overall diagnostic accuracy of 98.2%.  Conclusion: Considering the high performance of diagnostic cytology noted above, FNAC has proved itself to be useful and significantly accurate in making diagnosis of breast cancers in our center

Fine Needle Aspiration Cytology for Diagnosis of Benign Breast Disease in A Resource-Limited Setting

Background: A majority of breast lesion is benign in nature; benign breast disease is four times more common in Nigerian women. The percentage of unsatisfactory smears in breast cytology appears to be higher in benign conditions compared to malignant ones. The aim of this study is to determine the effectiveness of cytopathology in the diagnosis of benign breast disease in our institution.Methodology: This is a prospective study of 96 patients with benign breast disease seen during the study period. The patients were subjected to clinical assessment, fine needle aspiration cytology (FNAC) and open biopsy histopathology (as standard reference test).Results: One hundred and seventy-four patients with both FNAC and histopathology reports were initially evaluated, 96 (55.2%) had benign while the rest (78, 44.8%) harbored malignant lumps. On further analysis of the benign lumps, FNAC achieved high sensitivity (98.8%), specificity (96.9%) and overall diagnostic accuracy (98.0%) compared to clinical assessment with values of 83.3% (sensitivity), 82.1% (specificity) and 82.2% (overall diagnostic accuracy). The false positive rate (FPR, 2.3%) and false negative rate (FNR, 1.6%) reported for FNAC were equally better than figures of 14.9% (FPR) and 20.0% (FNR) documented for clinical assessment. Cytopathology was utilized in sub-classifying 76 (79.2%) out of the 96 biopsy confirmed benign lumps; 49 slides were correctly typed giving a concordant rate of 64.5%.Conclusion: Fine needle aspiration cytology in our index study showed appreciable concordance with open biopsy histology in the diagnosis and sub-classification of benign breast disease

Histopathological patterns of childhood malignancies seen at Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria: A 10 year retrospective study

Introduction: Childhood malignancies (CM) have been one of the major causes of death in the world. It appears to be increasing in significance due to the ongoing reduction in both infectious and nutritional diseases.Aims: The study was conducted to document the histopathological pattern, age and sex distribution of childhood malignancies in a University Teaching Hospital in Southeast Nigeria.Method: The materials consisted of histology slides, formalin-fixed paraffin-embedded tissue blocks (FPTB), and requisition forms of all cases diagnosed with CM at a University Teaching Hospital between the periods January 2005 and December 2015Results: A total of 2,528 surgical biopsies were received at the Department. Only 60 (2.4%) specimens represented childhood malignancies. Thirty-one cases (51.7%) of the entire CM were lymphomas; 12 (20.0%) were non-Hodgkin lymphoma, 17 (28.3%) others were Burkitt’s type whereas 2(3.3%) were Hodgkin lymphoma. Childhood malignancies were more in males 36 (60.0 %) than females 24 (40.0%), giving a male to female ratio of 3:2. However, Burkitt’s lymphoma was higher in females 12 (70.6%) than males 5 (29.4%) with a male to female ratio of 1.2:3. Twenty-six (43.3%) cases of the CM occurred in children aged 0-5 years but 20 (36.7%) presented in children aged 11 to 15 years. Twelve (20.0%) cases were seen in children 6 to 10 years. Six (23.1%) of the children had Burkitt's lymphoma all of whom were under 5 years.Conclusion: Lymphomas were the commonest CM, Burkitt’s lymphoma being the dominant subtype in this study. There was a female preponderance of Burkitt’s lymphoma