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

SELECTED MARKERS OF OXIDANT CHALLENGE IN ESSENTIAL HYPERTENSIVE SMOKERS

Aim: The study was set to assess the relationship between antioxidant status, smoking and hypertension, the argument being whether there would be a significant difference in antioxidant status and perhaps, a significant difference in blood pressure. Methods: A total of105 samples were collected. 36 samples were collected from type I hypertensive smokers; 47 from hypertensive non smokers, the remaining 22 were collected from normal non smokers, who served as control. The blood pressure of each subject was measured. Determinations of SOD activity and TBARS content were carried out on each of the samples. Determination of systolic and diastolic blood pressure was also carried out using a digital sphygmomanometer. The results of all investigations were thereafter subjected to statistical analysis using SPSS 17, the student’s t test being the tool of choice. Significance was tested at P<0.05. Results: The mean systolic and diastolic blood pressureof hypertensive smokers and non smokinghypertensives was found to be significantly increased. Similarly the mean systolic and diastolic blood pressure of hypertensive smokers was found to be significantly increased. SOD activity was significantly decreased while TBARS levels were significantly higher in both hypertensive groups. Lipid peroxidation was significantly higher while SOD activity was significantly lower in hypertensive smokers when compared with hypertensive non smokers Conclusion: It appears that cigarette smoking as a social lifestyle depletes SOD levels but increases lipid peroxidation. It also seems to favour the progression of essential hypertension from mild to severity

A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa.

The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants