Management challenges of pancreatic cancer in a resource scarce setting

Background: Of all forms of gastrointestinal malignancy, adenocarcinoma of the pancreas is associated with the worst survival. Management of pancreatic cancer is associated with some challenges. This study is aimed at determining the hospital incidence, sociodemographic characteristics, managements and management’s outcome of carcinoma of pancreas at our hospital. We also discuss the management challenges encountered with these patients.Patients and Methods: We review 96 pancreatic cancer patients seen at Awolowo University Teaching Hospital Complex, Ile –Ife, Nigeria, from July 1989 to July 2007.Results: There were ninety six patients diagnosed with cancer of the pancreas but only 80 patients had histological proof of pancreatic cancer. This account for 2.1% of all malignancies seen and 238/100000 total admissions during the study period. The median age is 55.0. There were 62 (64.6%) male and 34 (35.4%) female with male to female ratio been 2:1. Duration of symptoms in the patients ranges from 4 weeks to 109 weeks. Only three (3.1%) patients has tumor located in a particular anatomical sub site: two head of pancreas and one tail of the pancreas. Other patients had extensive tumor involving the head and body of the pancreas. Two patients had pancreaticoduodenectomy, one had resection of the tumor at the tail of pancreas and 45 patients had triple bypass. Patients with low serum albumin and serum sodium and elevated transaminases at presentation, had poorer prognosis than other patients.Conclusion: We found that pancreatic cancer is not uncommon in our center with male preponderance. Most patients present with advanced condition only amenable to palliative measures. There are significant challenges in the area of diagnosis, screening, treatment and research.Key words: Pancreatic cancer, Managements, Challenges, Outcom

Current Status of Canine Babesiosis and the Situation in Nigeria: A Review

Nigerian Veterinary Journal, Vol. 32(2): 2011; 69 - 7

Challenges of Pancreatic Cancer Management in a Resource Scarce Setting

Backgrounds: Of all forms of gastrointestinal malignancy, adenocarcinoma of the pancreas is associated with the worst survival. Management of pancreatic cancer is associated with some challenges. This study is aimed at determining the hospital incidence, sociodemographic characteristics, managements and management's outcome of carcinoma of pancreas at our hospital. We also discuss the management challenges encountered with these patients.Material and methods: We reviewed 96 pancreatic cancer patients seen at Awolowo University Teaching Hospital Complex, Ile –Ife, Nigeria, from July 1989 to July 2007.Results: There were ninety six patients diagnosed with cancer of the pancreas but only 80 patients had histological proof of pancreatic cancer. This account for 2.1% of all malignancies seen and 238/100000 total admissions during the study period. The median age is 55.0. There were 62 (64.6%) male and 34 (35.4%) female with male to female ratio been 2:1. Duration of symptoms in the patients ranges from 4 weeks to 109 weeks. Only three (3.1%) patients has tumor located in a particular anatomical sub site: two head of pancreas and one tail of the pancreas. Other patients had extensive tumor involving the head and body of the pancreas. Two patients had pancreaticoduodenectomy, one had resection of the tumor at the tail of pancreas and 45 patients had triple bypass. Patients with low serum albumin and serum sodium and elevated transaminases at presentation, had poorer prognosis than other patients.Conclusion: Pancreatic cancer is not uncommon in our center with male preponderance. Most patients present with advanced condition only amenable to palliative measures. There are significant challenges in the area of diagnosis, screening, treatment and research

Thyroid Diseases In Pregnancy: A Review

Objective: To provide an overview of the pathophysiology of thyroid diseases in pregnancy and the various treatment methods currently available in its management.Data source: Review of literature was affected through index medicus search of major published journals and books.Data selection: Published data on thyroid diseases on women in the reproductive age group over the last four decades were utilised.Data extraction: Abstracts and full text of selected manuscripts were read and analysed to determine their contribution to this article.Data synthesis: All relevant articles were reviewed and contributions extracted. Conclusion: Thyroid diseases are the second most common endocrinopathies in pregnancy. Numerous hormonal changes and metabolic demands occur in pregnancy resulting in complex changes in maternal thyroid function. Thyroid diseases involves a multidisciplinary team approach to achieve good metabolic control and excellent obstetric care in order to ensure normal maternal and perinatal outcome

Quality of Records Keeping by Undergraduate Dental Students in Ibadan, Nigeria

Background: Recording the interaction between a patient and the dentist is of primary importance in dental practice. The completeness of recordings of undergraduate students, often inadequate, has been found to subsequently impact on the quality of dental care offered by professionals. Once identified, correcting the inadequacies has also been shown to improve the quality of dental practice. Objective: We aimed to evaluate the quality of records keeping by dental students in Ibadan, Nigeria.Method: A retrospective review of records of patients seen by dental students, at the clinics of the dental school in Ibadan, Nigeria, over a six months period was conducted. The charts were reviewed for: demographic data, medical and dental history, clinical findings, diagnosis, treatmentplan and note on informed consent. Assessment of the quality of data obtained was done using a modified CRABEL’s scoring system.Results: A total of 318 case files were retrieved for this study. The median modified CRABEL score was 95%, with a range of 65 to 95%. Eighty-two recordings (25.2%) had a score < 90%, while 236 recordings (74.2%) had a score > 90%. The most frequently unrecorded data was written consent in all the charts, followed by procedure done with the documentation absent in 20.4%. All the supervisors signed at the end of the consultation.Conclusion: The quality of records keeping by dental undergraduates is fair but there is a need to emphasize deficient areas and improve upon the quality of record keeping.Keywords: dental record, students, CRABEL scor

Informed Consent In Surgery: An Audit Of Practice In Ile-ife, Nigeria

Objectives: This study was conducted to assess patients\' knowledge of their diagnoses and proposed surgical procedures before giving consent for such procedures in the various surgical units of Obafemi Awolowo University Teaching Hospitals Complex, (OAUTHC), Ile-Ife. Materials and Methods: A structured questionnaire was administered to 80 consecutive patients who had just undergone an elective major surgery in general surgery, gyneacology, orthopaedics and surgical subspecialty units of the hospital. Results: Sixty patients (75%) gave consent themselves, while other consents were obtained from close relations. Thirty-seven (46.25%) respondents were informed of the diagnoses and procedure by the unit consultants but no consultant was involved in the completion of the consent form. Seventy-five (93.75%) respondents had a knowledge of the diagnoses, 68(85%) understood the procedure but only 21(26.25%) knew any alternative to the procedure, 29(36.25%) knew at least one complication of the procedure and 12(15%) knew an option or complication of anaesthesia. Forty-five (56.25%) of the consent forms were properly filled while other forms had one error or another. Conclusion: Well structured and standardized method of obtaining informed consent from surgical patients should be adopted. While educating patients, the various alternatives to the procedure and possible complications should be carefully explained to the patients who should be carried along in decision making. Keywords: Informed consent, Surgical practice. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 206-21

L-Glutamic acid production by Bacillus spp. isolated from vegetable proteins

22 isolates of Bacillus species were obtained from “Dawadawa”, “Ugba” and “Ogiri” (fermented vegetable proteins) in Nigeria. The isolates were identified as Bacillus subtilis (6), (27.3%), Bacillus pumilus (5), (22.7%), Bacillus licheniformis (5), (27.3%) and Bacillus polymyxa (6), (22.7%). Four species of the Bacillus isolates were selected based on their ability to grow and produce L- glutamic acid in a synthetic medium and their comparison with the reference strain Corynebacterium glutamicum ATCC 13032. The four Bacillus species were B. subtilis (UGI). B. pumilus (DD4), B. licheniformis (0G4) and B. polymyxa (OG7) isolated from “Ugba”. “Dawadawa” and “Ogiri”, respectively. All the 22 Bacillus species isolated produced L- glutamic acid with B. subtilis (UGI) from “Ugba” recording the highest (8.5 mg/ml), while B. licheniformis (OG4) from “Ogiri” had the lowest value (5.0 mg/ml). L-Glutamic acid produced by B. subtilis (UGI) from “Ugba” (8.5 mg/ml) compared favourably with that produced by the reference strain C. glutamicum ATCC 13032, (10.2 mg/ml). All the isolates were able to utilize a range of carbon sources with glucose been the best, giving a yield of 8.4 mg/ml, while galactitol was least utilized. Ammonium nitrate was the best nitrogen source (6.5 mg/ml), while asparagine was least utilized (3.40 mg/ml) by the test isolates.Key words: L-Glutamic acid, bacteria strains, fermented vegetable proteins, fermentation

Effect of heat moisture treatment and annealing on physicochemical properties of red sorghum starch

Red sorghum starch was physically modified by annealing and heat moisture treatment. The swelling power and solubility increased with increasing temperature range (60-90°), while annealing and heatmoisturetreatment decreased swelling power and solubility of starch. Solubility and swelling were pH dependent with higher values obtained at pH 12 in both native and modified starches. Water absorption capacities of both annealed and heat-moisture treated starches increased with increasing levels of moisture treatment while highest value was observed in annealed starch. Oil absorption capacity of annealed starch was increased which was contrast to heat-moisture treated starches which decreased from 160 glg in native starch to 140 glg in HMR18 and HMR27. Pasting analysis in the Rapid Visco Analyser (RVA) revealed that both annealing and heat-moisture treatment increased pastingtemperature, while alkaline water retention improved after physical modification

Proximate And Mineral Composition Of Two Soups As Prepared In The South-West And South-South Regions Of Nigeria

The proximate and mineral composition of okro and ogbono soups prepared with two different Nigeria traditional (South/West, i.e. Yoruba, and South/South, i.e. Efik/Ibibio) recipes was assessed in this study. The crude protein, fat, Ca and Na nutrient composition (30.53 + 0.15% dry weight, 32.58 + 1.32% dry weight, 1132.42 + 9.26mg/100DM and 1803.95 + 130.47mg/100DM respectively), of okro soup prepared with South/South (S/S) recipe were significantly higher (

Effect of Moringa oleifera marinade on microbial stability of smoke-dried African Catfish (Clarias gariepinus)

The study examined the antimicrobial effect of Moringa oleifera marinade on smoke-dried catfish stored at ambient temperature (37±20C) for two months. The experimental treatments are the control, 1%, 2% and 3% (w/v) Moringa oleifera Marinade (MOM) and 5% Brine (w/v) solutions. Seventy-five fishes of average weight of 260±8g were gutted, washed and randomly assigned to the treatments. Thereafter, the fishes were soaked in the treatments for 2 hours and later hot smoked for 12hours. After smoking, the fishes were stored in netted boxes and placed on laboratory shelves for two months. Microbial counts were conducted at 7-day interval while biochemical tests were conducted on the 8th week. Seven bacterial species namely; Staphylococcus sp, Bacillus sp, Klebsiella sp, Corynebacterium sp, Pseudomonas sp, Escherichia coli and streptococcus sp and six fungal species namely; Penicillium italicum, Cladosporium sp, Neurospora crassa, Candida sp, Aspergillus niger and Saccharomyces cerevisiae were observed in the study. There was a general increase in microbial load as storage progressed. However, the increment was pronounced in the control and brine treated fish samples. In all levels of MOM and 5% Brine, there was decrease in the bacterial and fungal counts as compared with the control samples. 3% MOM exhibited the highest antibacterial potency while 5% Brine exhibited the highest antifungal potency. Moringa oleifera marinade could be use to protect stored smoke-dried catfish from microbial spoilage thus limiting economic loss and possible heath risk to consumers.Key words: Moringa, marinade, bacteria, fungi, catfish, smoke-drie