Histological pattern of laryngeal cancers in Komfo Anokye Teaching Hospital

Carcinoma of the larynx is one of the commonest malignant tumours of the upper respiratory system.The main objective of this study was to highlight the histological pattern and evaluate the occurrence of the  malignant tumours of the larynx. This was a retrospective study involving 146 patients aged between 36 to 77 years with an average age of 59.7 years. Patients with symptoms and signs of laryngeal tumour were studied at the Komfo Anokye Teaching Hospital, Kumasi for a 10 year period from 2003 to 2012. Biopsies of suspected cases were taken and sent to the Histopathology Laboratory for histological analysis. The study revealed that there was a high occurrence of squamous cell carcinoma resulting in 92.0% of the patients. This was followed by verrucous carcinoma in 3.4% of the patients, adenocarcinoma and adenoid cystic carcinoma in 1.7% of the patients. Lastly, there was neuroendocrine carcinoma in only one patient (0.9%). This study confirmed histologically that the squamous cell  carcinoma was the most frequently manifested tumour of the larynx.Keywords: Larynx, Cancers, Histology, Carcinoma

Le rhabdomysarcome de l’alvéolaire avancé de l’utérus

Alveolar rhabdomyosarcoma is an uncommon malignant soft tissue tumour rarely found in the female genital tract and carries a very poor prognosis especially in adults. A 44 year old premenopausal woman was evaluated for a lower abdominal mass, intermittent unprovoked vaginal bleeding and weight loss. Examination showed a huge abdomino-pelvic mass, and an irregular cauliflower mass protruding from the cervix, from which a biopsy was taken. Exploratory laparotomy revealed a widespread disseminated uterine tumour with an “omental cake” and involving virtually all the abdominal viscera. Debulking surgery was found to be non-beneficial and uterine and omental biopsies were taken. The cervical, uterine and omental biopsies were all diagnosed alveolar rhabdomyosarcoma. Neither chemotherapy nor radiotherapy could be started before the client died of fulminant neoplastic dissemination 17days postoperatively. While the optimal management of this rare tumour is unknown, early recognition and diagnosis, and a prompt multimodality treatment approach of surgery, chemotherapy and radiotherapy offers the best chance of cure (Afr J Reprod Health 2009; 13[1]:167-173).Le rhabdomysarcome de l’alvéolaire est une tumeur de tissu mois malin rare qui n’est pas souvent trouvée dans la voie génitale féminine et porte un pronostique mauvais surtout chez les adultes. Une femme en préménopause qui est âgée de 44 ans a été évaluée pour la masse abdominale basse, l’hémoragie vaginale non provoquée et intermittente ainsi que pour la perte de poids. L’examen a montré une grande masse abdominal-pelvienne et une masse irrégulière du chou-fleur qui avance du col à partir de laquelle nous avons fait une biopsie. La laparotomie exploratoire a révelé une tumeur de l’utérin disséminée un peu partout avec un « gâteau epiploique « et touchant à peu près tous les viscères abdominal ». La chirurgie par morceaux n’a pas été salutaire et les biopsies de l’utérin et de l’épiploon ont été prises. Les biopsies du col, de l’utérin et de l’épiploon ont été diagnostiquées un rhabdomysarcome de l’alvéolaire. On n’a pas pu commencer la chimiothérapie ni la radiothérapie avant que la patiente soit mort de la dissémination néoplasique fulminante, 17 jours après l’opération chirurgicale. Alors qu’on ne connaît pas la meilleure conduite à tenir devant cette tumeur rare, si elle est reconnue et dignostoiquée tôt et si l’on adopte une approche chirurgicale fondée sur une multimodalité de traitement, la chimiothérapie et la radiothérapie offrent la meilleure chance de guérison (Afr J Reprod Health 2009; 13[1]:167-173)

Advanced Alveolar Rhabdomyosarcoma of the Uterus: A Case Report

Alveolar rhabdomyosarcoma is an uncommon malignant soft tissue tumour rarely found in the female genital tract and carries a very poor prognosis especially in adults. A 44 year old premenopausal womanwas evaluated for a lower abdominal mass, intermittent unprovoked vaginal bleeding and weight loss. Examination showed a huge abdomino-pelvic mass, and an irregular cauliflower mass protruding from the cervix, from which a biopsy was taken. Exploratory laparotomy revealed a widespread disseminated uterine tumour with an “omental cake” and involving virtually all the abdominal viscera. Debulkingsurgery was found to be non-beneficial and uterine and omental biopsies were taken. The cervical, uterine and omental biopsies were all diagnosed alveolar rhabdomyosarcoma. Neither chemotherapy norradiotherapy could be started before the client died of fulminant neoplastic dissemination 17days postoperatively.While the optimal management of this rare tumour is unknown, early recognition and diagnosis, and a prompt multimodality treatment approach of surgery, chemotherapy and radiotherapy offers the best chance of cure (Afr J Reprod Health 2009; 13[1]:167-173)

Cytopathology practice in Kumasi: A 2-year retrospective audit

Aim: Surgical pathology service is generally unavailable in most developing countries and comes with challenges. Cytopathology is a reliable, inexpensive adjunct to surgical histopathology. We present a retrospective review of the various cytopathology cases received at the department. Materials and Methods: A retrospective review of 836 cytopathology cases from January 2010 to December 2011 at the Department of Pathology of our hospital was conducted. All cytopathology reports and records from the department were retrieved and analyzed using the Statistical Package for the Social Sciences version 16 for windows. Results: A total of 836 (mean age 38.18 ± 22.18) cases were reviewed, at an average of approximately 418 cases performed a year (5.7% of the total workload). More than half (58.0%) of the cases received had no clinical diagnosis indicated on request forms. Seventy-seven percent (77%) of the cases were diagnosed as either definite or nondefinite. The breast was the most aspirated specimen site (20.2%). Benign cases formed 45.0% of all the cases and 29.0% were malignant. There were more benign than malignant cases with respect to all sites aspirated except the breast (18.3%), lymph nodes (35.0%), and soft tissues (11.7%) where the reverse occurred. Conclusion: Patronage of cytopathology in Kumasi is increasing and serves as a quick, cheap, and effective alternate means for diagnosis. Improving and expanding on the current practice will ensure that pathologists in practice sustain and improve diagnostic cytopathology and provide material for training young pathologists

Using drones to transport suspected COVID-19 samples; experiences from the second largest testing centre in Ghana, West Africa.

BackgroundThe declaration of COVID-19 as a pandemic on March 11 2020, by the World Health Organisation prompted the need for a sustained and a rapid international response. In a swift response, the Government of Ghana, in partnership with Zipline company, launched the use of Unmanned Automated Vehicles (UAV) to transport suspected samples from selected districts to two foremost testing centres in the country. Here, we present the experiences of employing this technology and its impact on the transport time to the second largest testing centre, the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR) in Kumasi, Ghana.MethodsSwab samples collected from suspected COVID-19 patients were transported to the Zipline office by health workers. Information on the samples were sent to laboratory personnel located at KCCR through a WhatsApp platform to get them ready to receive the suspected COVID-19 samples while Zipline repackaged samples and transported them via drone. Time of take-off was reported as well as time of drop-off.ResultsA total of 2537 COVID-19 suspected samples were received via drone transport from 10 districts between April 2020 to June 2021 in 440 deliveries. Ejura-Sekyedumase District Health Directorate delivered the highest number of samples (765; 30%). The farthest district to use the drone was Pru East, located 270 km away from KCCR in Kumasi and 173 km to the Zipline office in Mampong. Here, significantly, it took on the average 39 minutes for drones to deliver samples compared to 117 minutes spent in transporting samples by road (pConclusionThe use of drones for sample transport during the COVID-19 pandemic significantly reduced the travel time taken for samples to be transported by road to the testing site. This has enhanced innovative measures to fight the pandemic using technology

[In Press] Trends in myopia management attitudes and strategies in clinical practice : survey of eye care practitioners in Africa

Purpose: There remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. Methods: A self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. Results: Responses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. Conclusions: African ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners’ perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa