Correlation of Level of Serum 25-Hydroxy Vitamin D and Gleason Score as a Measure of Aggressiveness of Prostate Cancer in Black Africans

Background Cancer of the prostate (CaP) is the second most commonly diagnosed cancer worldwide and the sixth leading cause of death from cancer in males. . Black men of African descent have higher risk for developing prostate cancer and are most likely to present at a younger age with more advanced disease and a poorer disease prognosis. Objective To determine if there is a relationship between the level of serum 25 hydroxy vitamin D and aggressiveness of prostate cancer using the Gleason score in black Africans in Jos. Methods A cross sectional study conducted among fifty patients presenting at the urological surgical out-patient clinics of the Jos University Teaching Hospital who were evaluated to have a clinical diagnosis of prostate cancer and scheduled for prostate biopsy. Blood samples for serum 25-hydroxy vitamin D were assayed using the ELISA technique, prostate biopsy was done and only those histologically confirmed to be prostate cancer were analysed. Data was collected using a proforma with statistical analysis done using SPSS(R) version 23 and Spearman’s rank correlation test used with a p-value < 0.05 considered significant. Results Fifty patients with histologically proven prostate cancer was studied whose age ranged from 50-89 years with a predominant age group 70-79 years (70.0±7.9).The mean level of serum 25-hydroxy vitamin D was 37.90ng/ml±17.92. All patients in the study had adenocarcinoma as the histologic type with a mean Gleason score of 9.36±13.14. A Spearman’s rank order correlation was statistically significant (rs (50) = -0.423, p = 0.002). Conclusion A Spearman’s rank order correlation shows a moderate negative correlation between the serum 25- hydroxy vitamin D and Gleason score (rs (50) = -0.423, p = 0.002.Thus, serum 25-hydroxy vitamin D assay can be used to prognosticate in patients with cancer of the prostate

Value of the visual prostate symptom score in evaluation of symptomatic benign prostatic enlargement: prospective study in a Nigerian population

Background: To evaluate the correlation of Visual Prostate Symptom Score (VPSS) with International Prostate Symptom Score (IPSS) and Maximum Urinary Flow (Qmax). To investigate the effect of educational level on the ability to independently complete the VPSS versus the IPSS and time taken to do so.Methods: Bio data was taken from men with lower urinary tract symptoms (LUTS) due to Benign Prostatic Enlargement (BPE) who presented at the Urology clinic of Jos University Teaching Hospital. They were administered the IPSS questionnaire and VPSS pictogram, which they completed with or without physician assistance and the time taken to do so was noted. They subsequently had uroflowmetry done on same visit and the data was recorded in a structured proforma. Statistical analysis was done using SPSS(R) version 20. Correlation test was done for VPSS, IPSS and Qmax while the paired t-test was used for the average time spent in completing both questionnaires. A p-value <0.05 was considered as significant.Results: Eighty-five men (aged 42 to 94 years) were enrolled in the study. The VPSS correlated significantly with the IPSS in terms of total score (r = +0.684, p<0.001) and QoL (r = +0.570, p<0.001), as well as with the Qmax (r = -0.222, p = 0.041). A greater proportion (21.2%) of men with limited education could complete the VPSS without physician assistance as compared to the IPSS (6.0%) and the average time taken to complete the VPSS (170.51 seconds) was significantly shorter than the time taken to complete the IPSS (406.42 seconds).Conclusions: The VPSS correlates significantly with the IPSS and Qmax. It can be completed without physician assistance by a greater proportion of men with limited education within a shorter time period

Swallowed Metalic Spoon In A 7 Year Old Child (Case Report)

We present a 7 year old female child who swallowed a broken metallic spoon. The patient presented at the casualty unit of the hospital with history of swallowing a metallic spoon while feeding. Plain abdominal x-ray film showed the spoon in the region of the stomach. The patient was admitted and managed conservatively. Conservative management is emphasized. Contraindications to this form of treatment as well as complications of foreign bodies in the gastrointestinal tract are highlighted.. Key words:Foreign bodies, Conservative management, Swallowed, Stomach. Highland Medical Research Journal Vol.1(3) 2003: 41-4

The Mass Casualty from the Jos Crisis of 2008: The Pains and Gains of Lessons from the Past

Background: Following the mass casualty of September 2001, we experienced challenges due to the prolonged nature of the crisis and disaster response. We subsequently made changes to our response protocol which were soon tested in the mass casualty resulting from the violence ofNovember 2008 in our city. We present here the management of the mass casualty situation that resulted from that crisis.Patients and methods: A retrospective analysis of the management of the patients who presented following thecrisis. Data was collected from the Emergency Room, theoperating room records and the crisis register. Informationgathered included patient demographics, cause of injury, mechanism, body part affected, treatment, morbidity and mortality. Data was analyzed using Epi Info statisticalsoftware using simple percentages.Results: One hundred and three patients presented over 2 days. There were 101 males (98.1%) and 2 females (1.9%) patients. The ages ranged from 11-65 (+ SD 10.23) years. Injury was caused by gunshots in 71 (68.9%) patients and machetes in 23 (22.3%) patients. The most frequently affected body parts were the lower limbs in 36 (35.0%) patients, upper limbs in 29 (28.2%) patients, chest in 18 (17.5%) patients and abdomen in 14 (13.6%) patients.Nineteen (18.4%) patients required formal surgicalprocedures, mainly exploratory laparotomy, 10 (9.7%).Complications were seen in 14 (13.6%) patients, 11 (10.7%) of these were infection related. There were 3 (2.9%) hospital mortalities. All had severe head injuries.Conclusion: Majority of the injuries were due to gunshots and only one fifth required urgent life saving interventions. From previous experience, effective and continuous IncidentCommand and Mass Casualty Commander positions , andactivation of unit specific protocols within the hospitalensured a hitch free hospital response and enabled the hospital to return to routine activities within 24hours

Progress towards the elimination of trachoma in Nigeria.

Trachoma is targeted for elimination as a public health problem worldwide by 2030. In Nigeria, elimination activities are implemented at the local government area (LGA) level. They started in 2002 by conducting baseline population-based prevalence surveys (PBPSs), which continued in a systematic manner with engagement from the Global Trachoma Mapping Project in 2013, and subsequently Tropical Data. The results led to the development of Nigeria's first trachoma action plan and its subsequent revision with additional information. Following 449 baseline PBPSs, 122 LGAs had an active trachoma prevalence above the elimination threshold, requiring interventions, while 231 LGAs required community-based interventions for trichiasis management. By 2021, >34 million antibiotic treatments had been provided in 104 LGAs, with 89 LGAs eliminating active trachoma. Nationally, water and sanitation coverages increased by 3% and 18%, respectively, in 7 y. Systematic trichiasis case finding and management were carried out in 231 LGAs, resulting in the management of 102 527 people. Fifty-four LGAs decreased trichiasis prevalence unknown to the health system to <0.2% in persons ≥15 y of age. Where this elimination prevalence threshold was reached, trichiasis services were transitioned to routine eye/healthcare systems. Such progress relied on strong leadership and coordination from the national trachoma program and tremendous support provided by partners. Attaining elimination of trachoma as a public health problem in Nigeria by 2030 is feasible if funding support is sustained