The challenges of managing malignant head and neck tumors in a tropical tertiary health center in Nigeria

s with 38/89 patients having cervical lymphadenopathy at presentation. Four (4.5%) patients were able to afford CT scan. Twenty eight deaths were recorded. Ten patients were lost to follow-up. CONCLUSION: The challenges faced in managing patients with head and neck malignant tumors in our environment are enormous but surmountable. Therefore urgent efforts should be made by health workers and government to ensure a better outcome for these patients

Chronic suppurative otitis media: Socio-economic implications in a tertiary hospital in Northern Nigeria

Background: In developing countries, ear infections and deafness are usually neglected conditions due to insufficient funds, work force, facilities, and knowledge. This paper highlights the socio-economic burden of chronic suppurative otitis media on a northern Nigerian population with suggestions on ways to reduce this burden. Methods: Seventy-four patients presenting to the Otorhinolaryngology unit, Department of surgery, Jos University Teaching Hospital, Plateau state, Nigeria with chronic suppurative otitis media from June 2007 to May 2008 were evaluated for age, gender, occupation, otomicroscopy and audiologic findings, microscopy, culture and sensitivity results, cost of consultation, investigations and treatment, type of complications and the social impact on individuals. Results: Patients were aged 2 to 37 years (Mean age=9.23 years, SD=7.92). Forty-one (55.4%) patients were aged between 1 and 5 years. There were 8 (10.8%) students, 12 (16.2%) unskilled workers, 11 (14.9%) unemployed individuals and 2 (2.7%) professionals. Deafness was the commonest sequele. Minimum monthly wage was 7,500 ($47.5US). Initial cost of treatment per patient per year was 8,100 Naira ($51.3US) increasing to 73,100 Naira ($462.7US) if surgery and hearing aid was required. Eleven (15%) patients required surgery, only 2 (2.7%) patients could afford it. Four patients lost their jobs. Fourteen (18.9%) patients were lost to follow up. Conclusion: The estimated cost of treatment for chronic suppurative otitis media is higher than the monthly minimum wage for individuals in our environment where the cost of health care is the sole responsibility of the patient

The Role of Necropsy in Diagnostic Dilemmas as Seen in a Tertiary Hospital in North Central Nigeria

Background. Necropsy (autopsy) has helped medical science and law. It has given rise to numerous diagnostic surprises as it explains cause of death, pathogenesis of diseases, and circumstances of death. It also explains reasons for most therapeutic failures. In spite of its usefulness, the rate has dropped worldwide and Africa is worse hit. This work aims to highlight the role autopsy (Necropsy) plays in demystifying diagnostic dilemmas and to encourage its patronage by medical practitioners, law enforcement agents and society. Methods. This is a retrospective review of autopsy and clinical reports of cases seen by pathologists and physicians in the Jos University Teaching Hospital (JUTH), Jos, North central Nigeria. Results. A total 166 cases were studied out of which 52 had same diagnosis for both attending physician and pathologist, 106 had different diagnoses and in eight cases diagnoses remained unknown even after autopsy was performed. Conclusions. Autopsy remains an important tool for obtaining definitive diagnosis, determining cause of death to explain pathogenesis of diseases, medical auditing and a vital source of data for health statistics and planning

Signet ring lymphoma: The import of immunohistochemistry in resolving diagnostic dilemnas

Signet ring cell lymphomas are a rare subtype of non Hodgkin lymphoma characterised by malignant lymphoid cells with cytoplasmic inclusions that displace the nucleus and imparts a “signet ring” appearance.This poses a diagnostic challenge as it can be mistaken for an adenocarcinoma or any other epithelial malignancy.A 54yr old male presented with a 6month history of generalised lymphadenopathy. Examination of excision biopsy of the lymph nodes show effacement of architecture by sheets neoplastic cells with abundant cytoplasm distended by eosinophilic amorphous substances. Immunohistochemistry with a panel of three monoclonal antibodies [LCA, CD20, and CD3] confirmed these cells to be of lymphoid origin.Keywords: Non Hodgkin Lymphoma;Signet Ring,Immunohistochemistr

Serological Qualitative Diagnoses of Helicobacter pylori in Patients Accessing Care at the Bingham University Teaching Hospital Jos, Nigeria

The widespread Helicobacter pylori infection is a substantial global health problem affecting approximately 50% of the worldwide population, with 50% infection rates in developed countries and 80% in developing countries, mainly concentrating in resource-limited settings. The mode of transmission is through the faecal-oral route, contamination of food and water, where inadequate sanitation practices, low socioeconomic status and overcrowdedness seem to relate to the high prevalence of H. pylori infections. This study sought to serologically determine the prevalence of H. pylori and the disease-associated burden in patients accessing care in a Tertiary Hospital. This hospital-based cross-sectional study was conducted at the Bingham University Teaching Hospital, North-Central Nigeria, for four months (September to December 2022). There, 551 blood specimens were collected from the patients into plain tubes and spun to obtain serum for the serological qualitative analysis. Out of the 551 screened specimens for H. pylori, 79% (n=437) were 58.4% reactive female and 41.6% male. Ages 15-49 had 62%, 50-70 yrs had 26.5%, and less than 14 yrs had 11.4% respectively. Furthermore, 64.3% of female patients presented with burning pains, nausea/vomiting, and trouble breathing.In comparison, 35.5% of the male counterparts presented symptoms of dyspepsia, and 32.1% had either taken one of the Nonsteroidal-inflammatory drugs. 86.7% of the suspected patients were hand washed after using the toilet, 83.3% had a loss of appetite, 55.4% reported alcohol intake and 35.9% smoked instead. 47.7% ate from mama-put, 30.1% from street-vended foods and 22.2% from classified restaurants, while 94.7% got their drinking water from sachet, bottled, borehole or tap, and well water, respectively.Serum antibody detection of H. pylori infection was higher in female than male patients accessing care at the Bingham University Teaching Hospital, Jos. This revealed that gender could be considered a potential risk factor. Thus, early risk identification factors, such as other transmission routes, are urgently needed in defining clinical and epidemiological characteristics to facilitate appropriate supportive care and prompt treatment

High-risk human papilloma virus and cervical abnormalities in HIV-infected women with normal cervical cytology

Background: The prevalence of High-Risk Human papilloma virus (HR-HPV), a necessary cause of invasive cervical cancer (ICC) is relatively high in HIV infected women. Gaps exist in our knowledge of the optimal approaches for managing women who have HR-HPV with normal cervical cytology (NCC) particularly in settings of HIV infection. Methods: Between May 2012 and June 2013 we conducted a colposcopic assessment of HIV-infected women with prior (NCC) and known HR-HPV status to compare cervical abnormalities in women with and without HR-HPV. Colposcopic examinations were done at the Operation Stop Cervical Cancer (OSCC) unit of the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Abnormal colposcopic finding (ACF) was defined as areas of aceto-white epithelium involving the squamo-coulumnar junction, areas of punctation, mosaic pattern or atypical vessels. We compared proportions of ACF as well as histologic grades of cervical intra-epithelial neoplasia (CIN) in women with or without HR-HPV. Statistical analysis was done on STATA. Results: We conducted colposcopic examinations in 78 out of 89 (86.5%) eligible women. The mean age of the cohort was 32.4 years (SD ±4.6) with a median 32 years (IQR 29–36). After a mean follow up time of 20.1 months from the initial cervical pap cytology and HR-HPV testing, we found 12 of 78 (15.4%) women with ACF. The odds for an ACF was statistically higher [OR = 4.0 (95% CI: 1.1-14.7)] in women with HR-HPV compared to those without. Of the twelve women with ACF, subsequent histologic examination of colposcopically directed cervical biopsies confirmed CIN 1 in 4 cases (33.3%), CIN 2 in 1 case (8.3%), CIN 3 in 2 cases (16.7%), carcinoma-in-situ (CIS) in 2 cases (16.7%), and normal cervix in 3 (25.0%). Overall, the proportion of women detected with any grade of CIN was 11.5% (9/78) and 6.4% (5/78) were CIN 2 or greater lesion (CIN2+). Conclusion: HIV-infected women with NCC and HR-HPV had a four-fold higher likelihood for an ACF. The practice of early colposcopic examination of HIV-infected women with prior NCC and HR-HPV may increase early detection of higher grade CIN and CIS cancer stages in our setting

Persistent alveolar soft-part sarcoma with liver metastasis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Alveolar soft-part sarcomas are rare, slow-growing tumors that metastasize commonly via vascular routes to the lungs, bones, lymph nodes and brain, causing morbidity and mortality. To the best of our knowledge, this is the first case describing metastasis to the liver reported from Nigeria.</p> <p>Case presentation</p> <p>A 57-year-old man of the Urhobo ethnic group of Nigeria presented with a persistent mass in his left calf. It was initially diagnosed as soft-tissue sarcoma, and its associated systemic effects lead to his death before a histological diagnosis could be obtained.</p> <p>Conclusions</p> <p>Alveolar soft-part sarcoma with metastasis to the liver can occur in our region (northeast Africa), and a high index of suspicion is required to make an early diagnosis, followed by prompt surgical excision with clear margins in order to prevent mortality.</p

Pattern of gynaecological malignancies in Jos

Context: Female cancer is a public health problem the world over. The malignancies of the female genital organs are major causes of morbidity and mortality which necessitates data for policy formulation and health planning.Objective: To document the relative frequency, age distribution and histological patterns of gynaecological malignancies seen at the Jos University Teaching Hospital (JUTH).Methodology: A retrospective 5 year review of all gynaecological malignancies seen at the JUTH. Main outcome measures: frequency, age distribution and histological patterns of gynaecological malignanciesResult: Female genital tract cancers account for 5.4% of gynaecological disorders in JUTH. The complete records of 203 out of 250 patients with gynaecological malignancies were retrieved giving a retrieval rate of 81.2%. Of these 203 case records, 152(74.9%) cases were from the uterine cervix while 31(15.3%) and 13(6.5%) cases were from the ovary and uterine corpus respectively. The vagina and vulva accounted for 3(1.4%) and 4(1.9%) cases respectively. Squamous cell carcinoma accounted for 93.4% of cervical cancers and 100% of vaginal and vulval cancers. Epithelial tumours accounted for 61% of ovarian tumours while choriocarcinoma accounted for 53.8% of cancers of the corpus uteri.Conclusion: Squamous cell cervical cancer is still the most common gynaecological malignancy in Jos. The challenges of HIV/AIDS and cervical screening need to be addressed to reduce its incidence.Keywords: Gynaecological cancers, pattern, frequency, histology, JosTrop J Obstet Gynaecol, 30 (1), April 201