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Yomibo-Sofolahan TA, Ariba AJ, Abiodun O, Egunjobi AO, Ojo OS. Reliability of a clinical method in estimating foetal weight and predicting route of delivery in term parturient monitored at a voluntary agency hospital in Southwest Nigeria. Afr J Prim Health Care Fam Med 2021; 13:e1-e6. [PMID: 34636604 PMCID: PMC8517749 DOI: 10.4102/phcfm.v13i1.3017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The antepartum estimation of foetal weight is a major determinant of the route of delivery and this has become vital in modern day obstetrics. The limitations to the use of obstetric ultrasonography, considered as the gold standard in estimating foetal weight, make clinical estimation methods attractive alternatives, especially in resource- constrained settings where many un-booked women may report for delivery. AIM To determine the reliability of intrapartum clinical foetal weight estimation in predicting the actual birth weight (ABW) and route of delivery among term parturient. SETTING The study was conducted at the Sacred Heart Hospital, Lantoro, a voluntary mission agency hospital in Southwest Nigeria. METHODS This cross-sectional study was conducted among 291 term parturient recruited by systematic random sampling between June and September 2017. The clinical estimation of foetal weight was carried out using Johnson's formula. RESULTS The accuracy of Johnson's formula to predict the ABW was 59.5%; while for the mode of delivery, it was 130 (75.1%) for spontaneous vaginal delivery (SVD) and 43 (24.9%) for caesarean section (CS). The sensitivity of the accuracy of Johnson's formula to predict the mode of delivery was 75.1%, with a specificity of 35.6%, a positive predictive value (PPV) of 63.1%, and a negative predictive value (NPV) of 49.4%. CONCLUSION The intrapartum clinical foetal weight estimation at term determined by Johnson's formula was reliably predictive of ABW and SVD, but it was unreliable in predicting the need for a CS.
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Affiliation(s)
- Temitope A Yomibo-Sofolahan
- Olikoye Ransome Kuti Memorial Hospital, Asero, Abeokuta, Ogun State, Nigeria; and, General Hospital Owode-Egba, Owode, Ogun State, Nigeria; and, Department of Family Medicine, National Postgraduate Medical College of Nigeria, Ijanikin, Lagos, Nigeria; and, Department of Family Medicine, Mercy Groups Clinics, Panseke, Abeokuta, Ogun State.
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Abene EE, Gimba ZM, Edah JO, Akinbuwa BA, Uchendu DG, Onyenuche C, Ojo OS, Tzamaloukas AH, Agaba EI. Blood pressure control and kidney damage in hypertension: Results of a three-center cross-sectional study in North Central Nigeria. Niger J Clin Pract 2020; 23:1590-1597. [PMID: 33221787 DOI: 10.4103/njcp.njcp_271_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Hypertension is one of the commonest cause of chronic kidney disease (CKD) in Nigerians. We describe blood pressure (BP) control and kidney disease markers in patients with hypertension as part of measures to curb the burden of this chronic debilitating disease. Methods Patients with hypertension in the main tertiary hospitals in three states in north central Nigeria were evaluated for indicators of CKD, including proteinuria and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Patients had their early morning first void urine tested for proteinuria using Combi-10 test strips. eGFR was estimated using the MDRD equation. Results A total of 1063 subjects (63.1% females and 36.8% males) with a mean age of 55 ± 11 years were studied. Diabetes mellitus (DM) was present in 214 (20.6%) and 422 (39.7%) had optimal BP control. The median duration of hypertension was 6 years (range 1-44 years). Proteinuria occurred in 130 (12.2%), while 212 (19.9%) had reduced eGFR and 46 (4.3%) had proteinuria and reduced eGFR. The use of calcium channel blockers [adjusted odds ratio (AOR): 0.70, 95% Confidence Interval (CI) 0.50-0.99] and the use of more than two antihypertensive medications (AOR: 0.62, 95% CI 0.40-0.96) were associated with reduced odds of optimal BP control. Male sex (AOR: 1.75, 95% CI 1.14-2.70) and the use of renin-angiotensin-aldosterone system blocking medications (AOR: 2.07, 95% CI 1.18-3.64) were independently associated with proteinuria while DM (AOR: 1.69, 95% CI 1.06-2.55) and treatment with more than two medications (AOR: 1.86, 95% CI 1.09-3.17) were more likely to have reduced eGFR. Conclusion A large proportion of hypertensive patients in north-central Nigeria have poorly controlled BP. Kidney damage is common among these patients.
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Affiliation(s)
- E E Abene
- Department of Internal Medicine, Jos University Teaching Hospital, Jos; Department of Internal Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
| | - Z M Gimba
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - J O Edah
- Department of Internal Medicine, Jos University Teaching Hospital; Department of Medicine, University of Jos, Jos, Nigeria
| | - B A Akinbuwa
- Department of Family Medicine, Federal Medical Centre, Makurdi, Nigeria
| | - D G Uchendu
- Department of Internal Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
| | - C Onyenuche
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - O S Ojo
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - A H Tzamaloukas
- Research Service, Raymond G. Murphy Veterans Affairs Medical Center; Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - E I Agaba
- Department of Internal Medicine, Jos University Teaching Hospital; Department of Medicine, University of Jos, Jos, Nigeria
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Ojo OS, Egunjobi AO, Fatusin AJ, Fatusin BB, Ojo OO, Ololade FA, Eruzegbua PA, Afolabi OA, Adesokan AA. Magnitude of missed opportunities for prediabetes screening among non-diabetic adults attending the family practice clinic in Western Nigeria: Implication for diabetes prevention. S Afr Fam Pract (2004) 2020; 62:e1-e10. [PMID: 32896139 PMCID: PMC8378168 DOI: 10.4102/safp.v62i1.5082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND For many decades, hypertension guidelines recommended dual-arm blood pressure measurement. However, this practice is poor in Nigeria and its significance is largely unidentified. Hence, this study was done to determine the point prevalence of inter-arm blood pressure difference and its relationship with hypertension and diabetes mellitus. METHODS A cross-sectional study was conducted among 214 respondents at the general outpatient clinic of a tertiary hospital in Nigeria. Demographic characteristics and anthropometric indices were obtained. Blood pressure readings were obtained through sequentially repeated measurements in respondents' arms. RESULTS One-hundred and eighty-six respondents had complete data given a completion rate of 86.9%. Systolic blood pressure was higher on the right and left arm in 102 (54.8%) and 56 (30.1%) of the respondents, respectively. Diastolic blood pressure was higher on the right and left arm in 73 (39.2%) and 63 (33.9%) of the respondents, respectively. The overall prevalence of significant systolic inter-arm difference (≥ 10 mmHg) and diastolic inter-arm difference (≥ 10 mmHg) were 24.2% and 18.8%, respectively. Significant systolic inter-arm difference (p = 0.033) and diastolic inter-arm difference (p = 0.01) were significantly more among respondents with hypertension and/or diabetes mellitus. CONCLUSION The blood pressure readings in both arms were different among the majority of the respondents, being higher on the right arm in many of them. The prevalence of significant inter-arm difference was high in the unselected primary care patients studied especially among patients with hypertension and/or diabetes mellitus. Blood pressure measurement in both arms should become a routine practice during initial patients' visits in primary care.
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Affiliation(s)
- Oluwaseun S Ojo
- Department of Family Medicine, Federal Medical Centre, Abeokuta.
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Ojo OS, Egunjobi AO, Fatusin AJ, Fatusin BB, Ojo OO, Taiwo BA, Ghazali IB, Gbadamosi NA. Variation between pragmatic and standardised blood pressure measurements in a Nigerian primary care clinic. S Afr Fam Pract (2004) 2020; 62:e1-e11. [PMID: 32242434 PMCID: PMC8378171 DOI: 10.4102/safp.v62i1.5035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 11/16/2019] [Accepted: 11/18/2019] [Indexed: 11/25/2022] Open
Abstract
Background A significant difference in the blood pressure (BP) value of a patient taken by different health workers has been a subject of discussion among health workers. This study investigated the variations between usual-care and guideline-concordant BP measurement protocols and evaluated the implications of the disparities on diagnosis and treatment decision. Methods A cross-sectional study was conducted among 206 participants. The usual-care and guideline-concordant BP readings taken from each participant by the regular clinic nurses and research-trained nurses, respectively, were obtained. Results Majority of the regular clinic nurses following the usual-care protocol used the left arm for BP measurement (59.7%). The systolic BP (SBP) and diastolic BP (DBP) readings were higher on the right arm in 55.3% and 39.2% of the participants, respectively. The mean guideline-concordant BP was 7.67 mmHg higher than the mean usual-care for SBP (p ≤ 0.05) and 7.14 mmHg higher for DBP (p ≤ 0.05). The proportion of participants classified as having hypertension and uncontrolled BP was 11.8% and 15.0% lower when using usual-care BP compared to guideline-concordant BP, respectively. Fifty-one (24.8%) respondents were advised incorrect treatment based on usual-care BP measurement. The Bland-Altman plot showed that limits of agreement were wider than within the 10 mmHg clinical reference range and unacceptable for clinical purposes. Conclusion The usual-care and guideline-concordant BP measurement protocols were significantly different, and the disparity had significant consequences on the diagnosis and treatment of hypertension. Health workers should strictly adhere to the guidelines on BP measurement to avoid mismanagement of patients.
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Affiliation(s)
- Oluwaseun S Ojo
- Department of Family Medicine, Federal Medical Center, Abeokuta, Ogun State.
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Ojo OS, Egunjobi AO, Fatusin AJ, Fatusin BO, Adeyemo AJ. A systematic review of the literature on the specialty preferences of Nigerian medical graduates: disparity between the literature and reality. S Afr Fam Pract (2004) 2019. [DOI: 10.1080/20786190.2018.1531586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- OS Ojo
- Family Medicine Department, Federal Medical Centre, Abeokuta, Nigeria
| | - AO Egunjobi
- Family Medicine Department, Sacred Heart Hospital, Abeokuta, Nigeria
| | - AJ Fatusin
- Family Medicine Department, Federal Medical Centre, Gusau, Nigeria
| | - BO Fatusin
- Family Medicine Department, Federal Medical Centre, Gusau, Nigeria
| | - AJ Adeyemo
- Family Medicine Department, Federal Medical Centre, Abeokuta, Nigeria
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Ojo OS, Malomo SO, Egunjobi AO, Jimoh AOA, Olowere MO. Quality of primary care physicians’ communication of diabetes self-management during medical encounters with persons with diabetes mellitus in a resource-poor country. S Afr Fam Pract (2004) 2018. [DOI: 10.1080/20786190.2018.1504864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- OS Ojo
- Family Medicine Department, Federal Medical Centre, Abeokuta, Nigeria
| | - SO Malomo
- Family Medicine Department, Federal Medical Centre, Abeokuta, Nigeria
| | - AO Egunjobi
- Family Medicine Department, Sacred Heart Hospital, Abeokuta, Nigeria
| | - AOA Jimoh
- Family Medicine Department, Federal Medical Centre, Abeokuta, Nigeria
| | - MO Olowere
- Family Medicine Department, Federal Medical Centre, Abeokuta, Nigeria
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Ojo OS, Malomo SO, Sogunle PT, Ige AM. An appraisal of blood pressure control and its determinants among patients with primary hypertension seen in a primary care setting in Western Nigeria. S Afr Fam Pract (2004) 2016. [DOI: 10.4102/safp.v58i6.4442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Achieving guideline-recommended blood pressure is imperative in reducing the rising tide of uncontrolled hypertension and its attendant sequelae, which are major causes of morbidity and mortality globally. The aim of the study was to describe the pattern of blood pressure control and identify the factors influencing blood pressure control among patients with primary hypertension seen at family medicine clinics of FMC, Abeokuta.Methods: This was a descriptive cross-sectional hospital-based study. A systematic random sampling technique was used in selecting 360 hypertensive respondents over four months. Data were collected through a pre-tested interviewer-administered questionnaire. The Statistical Package for the Social Sciences (SPSS) version 17.0 was used to analyse data.Results: Blood pressure was controlled in 167 (46.4%) of the respondents. The independent predictors of blood pressure control were female gender (p= 0.001, OR = 2.494, 95% confidence interval (CI) = 1.477–4.214), regular use of medication (p = 0.001, OR = 2.900, 95% CI = 1.508–5.577), regular clinic attendance (p 0.001, OR = 3.512, 95% CI = 1.772–6.960), and absence of diabetes mellitus (p 0.001, OR = 7.357, 95% CI = 3.190–16.966).Conclusions: The rate of blood pressure control among the hypertensive respondents was low. Multiple independent predictors of controlled blood pressure call for a team-based approach as well as multiple approaches including education of patients, expansion of a community-based health insurance programme and intensification of treatment efforts when managing hypertensive patients.
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Ojo OS, Malomo SO, Sogunle PT, Ige AM. An appraisal of blood pressure control and its determinants among patients with primary hypertension seen in a primary care setting in Western Nigeria. S Afr Fam Pract (2004) 2016. [DOI: 10.1080/20786190.2016.1186367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ojo OS, Malomo SO, Sogunle PT. Blood pressure (BP) control and perceived family support in patients with essential hypertension seen at a primary care clinic in Western Nigeria. J Family Med Prim Care 2016; 5:569-575. [PMID: 28217585 PMCID: PMC5290762 DOI: 10.4103/2249-4863.197284] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Context: Nonadherence to therapeutic plans has been reported among hypertensive patients. Researchers have also shown that adherence to therapeutic plans improves if motivation in the form of social support is provided. There is a dearth of local studies that explore the influence of family support on treatment outcomes of hypertensive patients. Aims: The aim of the study was to determine the relationship between BP control and perceived family support in patients with essential hypertension seen at a primary care setting in Western Nigeria. Settings and Design: This was a cross-sectional hospital-based study. Subjects and Methods: Systematic random sampling technique was used in selecting 360 hypertensive respondents between April and July 2013. Data were collected through a pretested interviewer-administered questionnaire and a standardized tool, Perceived Social Support Family Scale, which measured the respondents’ level of perceived family support. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) version 17.0 was used to analyze data. Results: The majority of the respondents were middle-aged (61.1%) and female (59.4%). Blood pressure (BP) was controlled in 46.4% of the respondents. Most of the respondents (79.4%) had “strong” perceived family support. Strong perceived family support (odds ratio [OR] 4.778, 95% confidence interval [CI] =2.569–8.887) and female gender (OR 1.838, 95% CI = 1.177–2.869) were independent predictors of controlled BP. Conclusions: The proportion of hypertensive patients with optimal BP control is low in this practice setting. The positive association between BP control and perceived family support emphasizes the need for physicians to reflect on the available family support when managing hypertensive patients.
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Affiliation(s)
- Oluwaseun S Ojo
- Department of Family Medicine, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
| | - Sunday O Malomo
- Department of Family Medicine, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
| | - Peter T Sogunle
- Department of Family Medicine, Federal Medical Centre, Abeokuta, Ogun State, Nigeria
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Durosinmi MA, Salawu L, Lawal OO, Ojo OS, Alatishe OI, Oyekunle AA, Bolarinwa RA, Adisa AO, Badmos K, Anomneze EE, Ayansanwo AO. Imatinib (Glivec) and gastrointestinal stromal tumours in Nigerians. Afr J Med Med Sci 2014; 42:325-32. [PMID: 24839736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
BACKGROUND To assess the response and the impact on the overall survival (OS) on c-KIT-positive (CD117+) gastrointestinal stromal tumours (GISTs) patients treated with imatinib mesylate. METHODS Between July 2003 and December 2012, consenting patients with advanced c-kit-positive GISTs were enrolled to receive imatinib mesylate therapy at a dose of 400mg - 800mg daily, supplied gratis by Novartis Pharma (Basel, Switzerland) under its GIPAP initiative. Disease severity was based on tumour site, size and mitotic index at diagnosis. Clinical features together with drug toxicity, haematological and biochemical parameters were monitored. Overall survival (OS) reviewed at 12 months intervals over 5 years was computed using Kaplan-Meier RESULTS There were 27 patients in all (17 males and 10 females with a median age of 52 years (range 26 - 83). Twenty three patients, 15 males and 8 females that have been followed up for at least 6 months were evaluated, aged 26-83 years (median = 56). There were 17 (73.9%) gastric tumours and 6 extragastric including 3 cases of peritoneum and 1 each of small gut, colon and rectum. At diagnosis, 21 (91.3%) cases were high risk, and 1 each fell into the intermediate and low risks, respectively. Ten patients (43.4%) including 5 with metastases presented with unresectable lesions. Five patients (21.7%) had complete tumour resection, 5 (3 with metastases) had partial resections and 3 others with non-bulky, nonmetastatic diseases underwent no surgery. Imatinib was used as the primary therapy for all patients, except the 5 patients that underwent complete tumour resection. Nine (39.1%) patients were lost to disease progression with a median survival of 16.7 +/- 10.7 (+/- SE) (95% CI = 0-37.6) months. The overall survival at 2 years for all patients was 71.9%, which dropped to 65.9% at 4 years. CONCLUSIONS Although a small number of GISTs, imatinib induced an extended remission in patients with advanced disease, most of whom would have been dead within a few months of diagnosis.
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Ogah OS, Akinyemi RO, Adegbite GD, Udofia OI, Udoh SB, Adesina JO, Ojo OS, Alabi AA, Majekodunmi T, Osinfade JK, Ogundipe RF, Falase AO. Prevalence of asymptomatic left ventricular systolic dysfunction in hypertensive Nigerians: echocardiographic study of 832 subjects. Cardiovasc J Afr 2013; 22:297-302. [PMID: 22159315 PMCID: PMC3721806 DOI: 10.5830/cvja-2010-063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2009] [Accepted: 08/16/2010] [Indexed: 01/19/2023] Open
Abstract
Background We sought to determine the prevalence of echocardiographically determined left ventricular systolic dysfunction in asymptomatic hypertensive subjects seen in Abeokuta, Nigeria. Methods Echocardiography was performed in 832 consecutive hypertensive subjects referred for cardiac evaluation over a three-year period. Results Data were obtained in 832 subjects (50.1% women) aged 56.0 ± 12.7 years (men 56.9 ± 13.3 years, women 55.0 ± 12.0 years, range 15–88). The prevalence of left ventricular systolic dysfunction (LVSD) was 18.1% in the study population (mild LVSD = 9.6%, moderate LVSD = 3.7% and severe LVSD = 4.8%). In a multivariate analysis, male gender, body mass index and LV mass were the predictors of LVSD. Conclusion Significant numbers of hypertensive subjects in this study had varying degrees of left ventricular systolic dysfunction. Early introduction of disease-modifying drugs in these patients, such as angiotensin converting enzyme inhibitors or angiotensin receptor blockers may retard or prevent the progression to overt heart failure.
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Affiliation(s)
- O S Ogah
- Department of Medicine, Federal Medical Centre, Idi-Aba, Abeokuta, Ogun State, Nigeria
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Alatise OI, Arigbabu AO, Agbakwuru EA, Lawal OO, Ndububa DA, Ojo OS. Spectrum of colonoscopy findings in Ile-Ife Nigeria. Niger Postgrad Med J 2012; 19:219-224. [PMID: 23385677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIMS AND OBJECTIVES Lower gastrointestinal (LGI) diseases are the leading causes of morbidity and mortality worldwide. Colonoscopy holds an important place in screening, diagnosing and treatment of these conditions. In Nigeria, as in many other developing countries, the facility for performing colonoscopy is rarely available. This prospective report seeks to evaluate the demographic data of patients presenting for colonoscopy, the pattern and validity of referral diagnosis versus colonoscopy findings in Ile-Ife, Nigeria. SUBJECTS AND METHODS All patients who had colonoscopy procedure done in the Endoscopy Unit of Obafemi Awolowo University Teaching Hospital Complex between January 2007 and December 2011 were included in the study. RESULTS During the study period, colonoscopy was carried out in 320 patients. One hundred and eighty two (56.9%) were males, while 138 (43.1%) were females. The median age was 59.5 years. Their ages ranged from 2-87 years. The most common indications were lower gastrointestinal bleeding and change in bowel habit which together accounted for 79.0%. No abnormality was seen in 93(29.1%) patients. Abnormal endoscopic findings included 66(20.6%) patients who had haemorrhoids, 50(15.6%) cases colorectal cancer, 33 (10.3%) patients had benign polyps and (30 (9.4%) patients had diverticular disease. Other findings were colitis, inflammatory bowel disease, rectovaginal fistula, vascular ectasia and extra luminal compression. Haemorrhoids, diverticulosis and polyps were the most common findings in patients presenting with lower gastrointestinal bleeding. CONCLUSION This present report showed that colonoscopy is a cheap, safe and effective method of investigating lower gastrointestinal disease in Ile-Ife, Nigeria. When the indication is based on symptoms, the diagnostic yield could be as high as 90%. The common causes of lower gastrointestinal bleeding in Ile-Ife, Nigeria include haemorrhoids, diverticulosis and polyps.
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Affiliation(s)
- O I Alatise
- Department of Surgery, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun state, Nigeria.
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Badmos KB, Ojo OS, Olasode BJ, Arigbabu AO. Gastric precancerous lesions among Nigerians with chronic gastritis. Niger Postgrad Med J 2012; 19:92-96. [PMID: 22728974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIMS AND OBJECTIVES To investigate the frequency of precancerous lesions in H. pylori gastritis in Nigerians MATERIALS AND METHODS Previously, the slides of all endoscopic gastroduodenal biopsies seen at the Pathology Department of Obafemi Awolowo University Teaching Hospital, Ile-Ife between 1994 and 2003 were reviewed and published. The current review examined interplay of intestinal metaplasia, glandular atrophy and epithelial dysplasia with H.pylori. The H.pylori, intestinal metaplasia and glandular atrophy were graded based on updated Sydney classification scheme while Vienna classification was used for dysplasia. RESULTS Out of 1036 biopsies seen during the study period, 135 (13%) had associated precancerous lesions. Intestinal metaplasia was the commonest (9.2%), followed by severe atrophic gastritis (4.3%) and low grade dysplasia (0.7%) occurring either alone or in various combinations. Most of these lesions were seen in patients above 40 years of age and over 80% were H.pylori positive. CONCLUSION Frequency of precancerous lesions is low among Nigerians with H.pylori gastritis. Intestinal metaplasia was the commonest lesion and was mostly type I with relatively low risk for gastric cancer development. The relatively high prevalence H.pylori infection among these cases could have resulted from repeated infection and most were localised to the corpus relative to the antral region where the precancerous lesions were seen.
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Affiliation(s)
- K B Badmos
- Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State. Nigeria.
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Alatise OI, Arigbabu AO, Lawal OO, Ndububa DA, Agbakwuru EA, Ojo OS, Adekanle O. Bowel preparation for colonoscopy: enema versus sodium phosphate. Niger Postgrad Med J 2011; 18:134-140. [PMID: 21670782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Colonoscopy is considered to be the gold standard investigation for assessing the colonic mucosa. Good bowel preparation is essential in order to achieve optimal visualisation of the mucosa. Traditionally water enema is used for bowel preparation in most centres in Nigeria. This prospective study was performed at the Gastrointestinal Endoscopy Unit of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria between July 2008 and June 2009. AIMS AND OBJECTIVES This study compared patients' tolerability, adverse effects, efficacy and mean duration of colonoscopy of water enema and sodium phosphate (NaP) for bowel preparation toward colonoscopy. PATIENTS AND METHODS Standard structured questionnaire was completed by 64 patients and the colonoscopist assessing tolerability, adverse effect, efficacy and mean duration of the procedure. RESULTS There were sixty four patients aged between 22 to 86 years. The mean age was 58.16 ± 15.790. Thirty eight (59.4%) patients were in patients and 26 (40.6%) were out patients. Forty one (64.1%) patients had water enema while 23 (35.9%) patients were included in the NaP group. The median age for patients in both groups was 62.0 years. Patients in NaP group rated their bowel preparation as more tolerable and found the dietary restriction much easier than those in water enema group (p < 0.0001). Better colon cleansing score was found in patient in NaP group as compared with those in water enema group in all region of the colon. The procedure took significantly longer time in patients in water enema group as compared with those in NaP group (p < 0.0001). CONCLUSION NaP has a better bowel cleansing score for colonoscopy than water. It has better tolerability, side effect profile, efficacy and gives a shorter mean duration for the procedure.
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Affiliation(s)
- O I Alatise
- Department of Anatomy and Cell Biology/ Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun state, Nigeria.
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Ndububa DA, Ojo OS, Adetiloye VA, Aladegbaiye AO, Adebayo RA, Adekanle O. The contribution of alcohol to chronic liver disease in patients from South-west Nigeria. Niger J Clin Pract 2010; 13:360-364. [PMID: 21220846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This study aimed at determining the level and type of alcohol consumed by patients diagnosed with chronic liver disease (CLD) and, hence, the extent to which alcohol may have contributed to the development of the condition. STUDY DESIGN Patients with diagnosis of CLD were consecutively recruited and a structured questionnaire was administered on each of them. Diagnosis of CLD was made based on liver histology and/or typical clinical and laboratory features. Alcohol consumption was considered significant if a patient took >50 g/day for > 10 years. RESULTS A total of 145 patients were studied consisting of 102 males and 43 females. Their ages ranged from 20- 80 years with a mean of 46.8 ± 15.7 years. Fifty-one (35.2%) patients, all males, drank significant alcohol while consumption was not significant in 43 (29.6%) patients. Alcohol was not consumed at all by 51 (35.2%) patients made up of 18 males (35.3%) and 33 females (64.7%). Beer was the commonest form of alcohol consumed (70.2%) followed by palm wine (50%) and locally-brewed gin (20.2%). The diagnoses made were liver cirrhosis [LC] (60, 41.38%), chronic hepatitis [CH] (54, 37.20%), hepatocellular carcinoma [HCC] (23, 15.86%), alcoholic liver disease [ALD] (6, 4.14%) and non-alcoholic fatty liver disease [NAFLD] (2, 1.38%). The liver disease spectrum did not differ between the patients who drank significant alcohol and those who did not. However, the proportion of LC/HCC cases increased relative to CH with increasing age and consumption of alcohol. CONCLUSIONS The proportion of CLD directly attributable to alcohol (i.e. ALD) is low among the patients studied. However, the burden of LC and HCC is directly related to age and the amount of alcohol consumed and the determinants of alcohol abuse are gender and affluence.
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Affiliation(s)
- D A Ndububa
- Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OA UTHC), Ile-Ife, Nigeria.
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Abstract
BACKGROUND Tumours of the breast are uncommon in childhood and adolescence. Patients in this age group often require a different approach to diagnosis and treatment. The purpose of this study is to highlight the clinicopathologic features of breast tumours in adolescents in a Nigerian city. MATERIALS AND METHODS Eighty-four breast tumour materials from patients aged 10-19 years were analyzed over a 10-year period at the Department of Pathology, University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Benin City, Nigeria. RESULTS A majority of the breast tumours were benign. Fibroadenoma was the most common tumour with 46 cases (54.8%), followed by fibrocystic changes with 15 cases (17%). Malignancy was extremely rare in this group, with only one case (1.2%) of an invasive ductal carcinoma. Histologically, most tumours were indistinguishable from the adult types. CONCLUSION Fibroadenoma is the most common breast tumour in adolescents in Benin City, Nigeria. Breast cancer and male breast tumours are rare in this age group. Routine complete physical examination of children and adolescents should include breast examination.
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Affiliation(s)
- Ivy N Umanah
- Department of Pathology, University of Uyo, Uyo, Nigeria
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17
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Badmos KB, Ojo OS, Olasode OS, Arigbabu AO. Gastroduodenitis and Helicobacter pylori in Nigerians: histopathological assessment of endoscopic biopsies. Niger Postgrad Med J 2009; 16:264-267. [PMID: 20037622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Morphologic changes seen in the endoscopic biopsies are dynamic and could be predictive of more important sequelae of chronic H. pylori gastritis such as gastric carcinoma and lymphoma. The objective of the study was to review the biopsy appearances of endoscopic gastroduodenal biopsies using the updated Sydney System of classification in order to throw some light on the biology of gastroduodenitis. METHODS A retrospective review of all endoscopic gastroduodenal biopsies received in the department of Morbid Anatomy of Obafemi Awolowo University Teaching Hospitals Complex between 1994 and 2003 was undertaken. Grading of the chronicity, activity, atrophy, H. pylori density and metaplasia were done using the updated Sydney System of classification and grading. RESULTS A total of 1047 gastric and 47 duodenal biopsies from 1047 patients were reviewed. There was evidence of significant chronic gastritis in 98.1% of the gastric biopsies and in 78.0% of these, H. pylori was the main identifiable aetiological agent. Marked atrophic changes and intestinal metaplasia that are known to predispose to gastric malignances were seen in 4.9% and 9.3% of our cases respectively. Chronic duodenitis was seen in 83% of the duodenal biopsies and in 29.6%, H. pylori was seen on a background of gastric metaplasia. CONCLUSION The prevalence of H. pylori was high and it was the single most important aetiological factor responsible for the biopsy changes associated with chronic gastroduodenitis.
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Affiliation(s)
- K B Badmos
- Department of Morbid Anatomy and Forensic Medicine,Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State
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18
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Badmos KB, Sabageh D, Ojo OS, Balogun OS. Eosinophilic colitis presenting as a right iliac fossa mass--a case report. West Afr J Med 2008; 27:175-177. [PMID: 19256325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Eosinophilic colitis is an inflammatory condition characterized by infiltration of the colonic wall by eosinophils with submucosal oedema. Involvement of caecum, appendix, ascending colon and the omentum by the inflammatory process could mimic a right iliac fossa neoplasm. OBJECTIVE To highlight the diagnostic challenges posed by eosinophilic colitis and the import of histopathological diagnosis in the treatment of such a patient. METHODS A47-year old perimenopausal woman presented to hospital with a 6-month history of intermittent lower abdominal pain. Besides clinical evaluation, an abdominal ultrasonography and full blood count were carried out. She subsequently had exploratory laparatomy. RESULTS The lower abdominal pain was intermittent but not associated with vomiting or diarrhea. There was a tender right iliac mass extending to the suprapubic region. The ultrasound revealed a right-sided tubo-ovarian mass. At surgery, the mass was found to be a complex of caecum, ascending colon, appendix and the omentum. Histological diagnosis of the resected mass was eosinophilic colitis with peritonitis. She was placed on steroid therapy following a course of antihelminthics with sustained clinical improvement six months after surgery. CONCLUSION Eosinophilic colitis is rare and could mimic a right iliac neoplasm if it is right-sided. Histopathological diagnosis of all specimens removed at surgery particularly in a peripheral district hospital is very important in patient's management.
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Affiliation(s)
- K B Badmos
- Department of Pathology, College of Health Sciences, University of Ilorin, Ilorin, Kwara State.
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19
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Nggada HA, Ojo OS, Adelusola KO. A histopathological analysis of thyroid diseases in Ile-ife, Nigeria. a review of 274 cases. Niger Postgrad Med J 2008; 15:47-51. [PMID: 18408784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To describe the spectrum of histopathological features of thyroid diseases; analyse the occurrence of each of the types and to compare the findings with those from previous studies done in Nigeria and elsewhere. MATERIALS AND METHODS A retrospective study of thyroid lesions seen at the OAUTHC Histopathology Department during a 10-year period between 1988 and 1997. RESULTS The 274 surgical thyroid specimens received during the study period came from 235 (85.8%) females and 39 (14.2%) males giving a female: male ratio of 6:1. Colloid goiter accounted for about 75% of cases with an average age of occurrence of 40.7 years. Only 1.8% showed features of toxic goiter and thyroiditis each. The adenomas constituted about 6% while carcinomas constituted about 11% of cases respectively. Adenomas occurred almost a decade earlier than carcinomas. Follicular carcinoma was the commonest thyroid cancer seen in this study. CONCLUSION This study shows that the commonest thyroid disease in Ile-Ife is colloid goiter, which is a preventable disease. Thus, public health measures such as iodination of salt and health education are called for to reduce the occurrence of this disease.
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Affiliation(s)
- H A Nggada
- Histopathology Department University of Maiduguri Teaching Hospital, P.M.B.1414. Maiduguri. Borno State.
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20
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Salako AA, Adisa AO, Ojo OS, Arigbabu AO. Severe gastrointestinal haemorrhage due to primary intestinal Kaposi's sarcoma - a case report. Niger Postgrad Med J 2007; 14:352-354. [PMID: 18163148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Kaposi's sarcoma (KS) was previously a relatively rare disease. With the advent of HIV/AIDS pandemic however, AIDS-related KS has been on the increase and so has interest in the disease. Ninety per cent of patients with KS present with skin lesions. While the gastrointestinal tract is a fairly common site of metastatic KS, primary gastrointestinal KS is uncommon. The presentation of gastrointestinal KS with severe gastrointestinal bleeding is rarer still. In this report, we present a 56yr old HIV-negative patient who presented with severe gastrointestinal bleeding without any skin lesions. Multiple haemorrhagic polypoidal lesions were found on the walls of the jejunum and ileum as well as the liver at exploratory laparotomy and these were found to be KS on histopathologic examination. We also discuss the diagnostic and therapeutic challenges we had with this rare cause of severe GI bleeding.
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Affiliation(s)
- A A Salako
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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21
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Alebiowu G, Femi-Oyewo MN, Elujoba AA, Ojo OS. Toxicity studies on Datura metel L. with reference to official stramonium. J Herb Pharmacother 2007; 7:1-12. [PMID: 17594983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Suspensions of the powdered leaf of Datura metel L. and Datura stramonium L. (Solanaceae) were administered by intubation at different doses: 0.125 mg/kg, 0.250 mg/kg, 0.500 mg/kg, 1.000 mg/kg, 1.224 mg/kg and 1.400 mg/kg to virgin female albino mice and were observed daily. After two weeks, the mice were sacrificed and the liver, kidney and intestine were removed, preserved in 10% formalin solution and embedded in paraffin wax. Tissues from these organs were stained for assessment of tissue morphology. Pathological changes observed at 1.224 mg/kg and 1.400 mg/kg (LD100) were irreversible. At all other dose levels, there were reversible changes in the liver, kidney and intestine. Generally, D. metel-treated mice showed less anatomical abnormalities than D. stramonium-treated mice. Hence, D. metel could serve as a substitute for D. stramonium in drug development.
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Affiliation(s)
- G Alebiowu
- Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria.
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22
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Abstract
Child-Pugh grading is an important determinant of treatment options, surgical interventions and prognosis in chronic liver disease. Sixty-four liver cirrhosis patients (49 men, 15 women) seen at Ile-Ife, Nigeria were graded according to the Child-Pugh parameters. Only one (1.6%) was in Class A, while 21 (32.8%) and 42 (65.6%) were in Classes B and C, respectively. Thirty-four either had coagulopathy or were already in encephalopathy at the time of presentation. Hepatitis B virus-associated disease was present in 64% of the patients. Most Nigerian cirrhosis patients present with very advanced disease; they are thus poor-risk candidates for diagnostic procedures and surgery. Efforts should be intensified at making the diagnosis at a much earlier stage and universal immunization with the hepatitis B vaccine should be commenced to reduce the incidence of HBV-related chronic liver disease in Nigeria.
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Affiliation(s)
- D A Ndububa
- Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), lle-Ife, Nigeria.
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23
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Ndububa DA, Ojo OS, Adetiloye VA, Durosinmi MA, Olasode BJ, Famurewa OC, Aladegbaiye AO, Adekanle O. Chronic hepatitis in Nigerian patients: a study of 70 biopsy-proven cases. West Afr J Med 2005; 24:107-11. [PMID: 16092308 DOI: 10.4314/wajm.v24i2.28177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Liver cirrhosis and hepatocellular carcinoma are known sequelae of chronic hepatitis. Early diagnosis and treatment of chronic hepatitis could delay or even abort progression to terminal liver disease. STUDY DESIGN Prospective study of 70 consecutive patients with features of early liver disease or discovered with HBsAg (or anti-HCV) during pre-employment and/ or pre-donation screening at Ile-Ife, Nigeria. All the patients had liver biopsy and the histology evaluated with the Knodell Histological Activity Index. RESULT Fifty-three patients had symptomatic disease (M: F ratio, 1.5:1) while 17 were asymptomatic (M: F ratio, 3:1). The mean ages were 49.04 (SD+/-16.78) and 29.82 (SD+/-6.13) for the symptomatic and the asymptomatic patients respectively (P< 0.005). Major symptoms were right upper abdominal pain (68%), weight loss (51%) and fatigue (41.5%). Alcohol consumption was significantly related to symptomatic chronic hepatitis (P< 0.01). Over 50 % of patients with asymptomatic chronic hepatitis had abnormal liver scan and liver function tests. All the asymptomatic cases and 77.4 % of the symptomatic group had HBsAg while only 1 patient (symptomatic) was anti-HCV positive. On liver histology, all the patients with asymptomatic chronic hepatitis had a Knodell score of< or = 8 and none had fibrosis. Over half of the symptomatic patients had a Knodell score of > or = 9 (56.6%) and stage 2 or 3 fibrosis (51 %). CONCLUSION Asymptomatic chronic hepatitis patients tend to be younger and of the male sex. Symptomatic chronic hepatitis may signal the onset of significant fibrosis and alcohol abuse may accelerate this process. Serum ALT and liver scan are useful initial screening tests for asymptomatic patients with hepatitis B or C viral markers.
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Affiliation(s)
- D A Ndububa
- Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-lfe, Nigeria.
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Amusa YB, Olabanji JK, Akinpelu VO, Ogundipe OV, Olateju SO, Agbakwuru EA, Ndukwe N, Fatusi OA, Ojo OS. Pattern of head and neck malignant tumours in a Nigerian teaching hospital--a ten year review. West Afr J Med 2005; 23:280-5. [PMID: 15730084 DOI: 10.4314/wajm.v23i4.28141] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Nigeria record of incidence and pattern of Head and Neck malignancies is scanty. In our Hospital, there had been no prior published report on this subject. OBJECTIVE To study the pattern of occurrence of Head and Neck malignancies treated in Obafemi Awolowo university Hospitals Complex, Ile Ife, Nigeria. METHODS medical records of patients with histopathologically confirmed head and neck malignancies over a 10 year period (1989--1998) were analyzed. MAIN RESULTS Three hundred and thirteen (313) cases, made up of 184 (59%) males and 129 (41%) females were found. The most common sites for head and neck malignancies were found to be in the oral cavity (36.8%), the neck (26.8 %), the thyroid (13.7 %), and the esophagus (5.1%). The paranasal sinuses and the ear were the least affected anatomical sites with one (0.3 %) of cases each. The histopathological tumour types found in this work were lymphoma (40.26%), squamous cell carcinoma (25.23%), sarcoma (2.6%), while many other minor histopathological variants accounted for 31.9%. Lymphoma was the most common in children, while carcinoma was found in, and forms the most common histopathological variant of head and neck malignancies in the older age group. PRINCIPAL CONCLUSIONS There is a high incidence of childhood head and neck malignancies found in this study in contrast to the Western literature where the highest incidence is found in the older age group and the elderly. Jaw malignancies constituted the most common malignancies of the oral cavity. Lymphoma and thyroid malignancies are relatively common in our center.
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Affiliation(s)
- Y B Amusa
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Abstract
BACKGROUND Haemangiopericytoma is a very rare slow-growing vascular tumour with a variable malignant potential, constituting less than 1% of all neoplasms. It may arise from any blood vessel and in any organ of the body. Primary haemangiopericytoma of bone is even rarer, constituting about 0.1% of bone tumours. The tumour is extremely rare in Africans and particularly in the head and neck region. STUDY DESIGN We describe the case of a 66-year old Nigerian with haemangiopericytoma of the maxilla, who presented with a recurrent but painless jaw mass. RESULTS Surgical resection of this tumour is potentially bedevilled with the risk of torrential haemorrhage and high rate of recurrence. This risk may be substantially reduced by wide surgical resection with a careful microscopical examination of the resection margins and the institution of adjuvant radiotherapy in incompletely resected tumours. Chemotherapy has no known role in the management of haemangiopericytoma. Postoperative radiation therapy appears to be effective against tumour recurrence. CONCLUSION Even then, long-term follow-up is essential in all cases. To our knowledge, this is the first report of this entity in an African.
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Affiliation(s)
- O A Fatusi
- Departments of Oral & Maxillofacial Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Esimai OA, Ojo OS, Fasubaa OB. Utilization of approved health facilities for delivery in Ile-Ife, Osun State, Nigeria. Niger J Med 2002; 11:177-9. [PMID: 12955995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
This was a cross-sectional population survey carried out to determine utilization of approved health facilities for delivery by mothers in Ile-Ife and factors influencing the observed utilization. A total number of 117 mothers who had delivered once or many times were selected using the systematic sampling method. Information was collected using pretested structured interview administered questionnaire. Data collected was analyzed using frequency tables and statistical test of significance. Of the 117 mothers interviewed, 70 (59.8%) booked in approved health facilities while 51 eventually delivered in the approve health facilities. The prominent reasons given for non utilization of health facilities were time of occurrence of labor, difficulty with transportation, fear of surgical operation, husband/family influence and delivery assistance by TBA's and relatives. Educational status of the mother, religious beliefs, distance from approved health facilities more than 5 km and attitude of health workers were amongst factors significantly influencing choice of place of delivery by the mothers.
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Affiliation(s)
- O A Esimai
- Department of Community Health, Obafemi Awolowo University, Ile-Ife
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Affiliation(s)
- D A Ndububa
- Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ndububa DA, Ojo OS, Adeodu OO, Adetiloye VA, Olasode BJ, Famurewa OC, Durosinmi MA, Agbakwuru AE. Primary hepatocellular carcinoma in Ile-Ife, Nigeria: a prospective study of 154 cases. Niger J Med 2001; 10:59-63. [PMID: 11705059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Primary hepatocellular carcinoma is a tumour with a dismal prognosis. In recent times, however, great advances have been made in its management. This 13-year prospective study done at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, was an attempt to appraise the outlook of the disease in Nigeria at the turn of the 21st century. Primary hepatocellular carcinoma affected mainly middle-aged Nigerians (peak age-group = 40-59 years), predominantly males (M:F = 2:1) and, in a sizeable proportion (78%), it co-existed with cirrhosis. Significant risk factors found were scarification marks (87%), anicteric hepatitis (71.3%), abuse of medicinal herbs and analgesics (68.6%) and injection from quack doctors (51%). Blood test for HBsAg was positive in 61% of patients. The mean duration of symptoms. before diagnosis was 12.64 weeks (SD 13.77) while, on the average, patients died within 14.0 weeks (SD 13.0) of illness, usually of liver failure (67.7%). Only symptomatic treatment could be offered in 148 patients (96.1%) while chemotherapy was merely attempted in 5 (3.25%). Majority of the patients (59.8%) were either discharged against medical advice or lost to follow-up. This study shows that Nigerian patients presenting with primary hepatocellular carcinoma already have advanced disease and this makes treatment and survival hopeless. Universal immunisation with HB vaccine should be implemented in Nigeria without further delay and health education should be directed against socio-cultural practices which are aetiological risk factors for primary hepatocellular carcinoma.
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Affiliation(s)
- D A Ndububa
- Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ndububa DA, Yakicier CM, Ojo OS, Adeodu OO, Rotimi O, Ogunbiyi O, Ozturk M. P53 codon 249 mutation in hepatocellular carcinomas from Nigeria. Afr J Med Med Sci 2001; 30:125-7. [PMID: 14510167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Mutations of p53 tumour suppressor gene often occur in hepatocellular carcinoma and, in particular, codon 249 hot-spot mutation is displayed by hepatocellular carcinomas occurring in hepatitis B virus-endemic areas with high dietary aflatoxin intake. This study was done to determine the frequency of p53 codon 249 mutation in hepato-cellular carcinoma in Nigerian patients with this tumour. Tumour samples were obtained from 18 Nigerian patients (all from the Southwest of the country) with histologically confirmed hepatocellular carcinoma by autopsy (n = 14), surgical resection (n = 3) and ante-mortem liver biopsy (n = 1). Fourteen of them had co-existing cirrhosis. Amplification of exon 7 of p53 gene from DNA samples of hepatocellular carcinoma tissue was undertaken by nested polymerase chain reaction followed by restriction enzyme analysis. One out of the 18 tumour samples tested (5.5%) demonstrated codon 249 mutation. This study suggests that, in Nigeria, especially the south-western region, aflatoxins appear to play a limited role in hepatocarcinogenesis.
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Affiliation(s)
- D A Ndububa
- Laboratoire d'Oncologie Moléculaire, Centre Léon Bérard, 28, rue Laënnec, 69373 Lyon Cedex 08, France.
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Abstract
OBJECTIVES To determine the pattern of vaccine uptake by hospital personnel in a specifically designed pioneer hepatitis B vaccination programme and to highlight major lessons for ensuring success in future programmes. DESIGN A review of vaccination and employment records for a forty four-month period and comparative analysis on the basis of professional grouping and work units. SETTING Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. SUBJECTS A total of 2,548 employees of the teaching hospital that have worked for a minimum of one year on a continuous basis between April 1992 and December 1995. INTERVENTIONS Procurement of recombinant hepatitis B vaccine (Engerix, SmithKline Beecham) by the hospital management and provision of the same to all interested employees of the teaching hospital at no cost under a vaccination programme which was conducted on an on-site basis. MAIN OUTCOME MEASURES 'Participation' in the vaccination programme was defined as the uptake of at least one dose of hepatitis B vaccine, and 'compliance' defined as the receipt of the three prescribed doses of the hepatitis B vaccine. RESULTS The level of participation in the vaccination programme was high with 91.9% of the target population of hospital workers receiving at least a dose of the vaccine, while only about half (53.8%) of the group complied with receiving the required three doses of the vaccine. In terms of participation, by professional grouping, laboratory workers and nurses recorded the lowest rates (82.5% and 84% respectively), while 100% participation was recorded in respect of the staff of engineering, medical records, pharmacy and physiotherapy departments. The highest rate of compliance (receipt of three doses) was also found among non-clinical workers (medical record personnel--76.3% and engineering staff--69.5%) while the lowest rate was found among nurses (39.7%) and doctors (40.3%). CONCLUSION Workers with the highest possibility of knowledge of, and exposure to hepatitis B infection within the hospital setting--doctors, nurses, and laboratory workers--showed the greatest apathy to the vaccination programme. Reasons for this trend demand close examination, and subsequently, identification of specific action that needs to be taken to improve the uptake of the vaccine by the target population, particularly the high-risk groups, in future programmes. Among others, targeting all groups of workers with appropriate education on the infection; active involvement of professional groups in the planning and execution of the vaccination programme; and review of the implementation logistics are some of the key points to note for future programmes.
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Affiliation(s)
- A O Fatusi
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ola SO, Anomneze EE, Chukwuani CM, Ojo OS, Ndububa DA, Onyenekwe B, Nasidi A. Interferon alfa-2a (Roferon-A) in the management of chronic hepatitis B infection: results of an open prospective study in Nigerian patients. West Afr J Med 2000; 19:259-64. [PMID: 11391836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The efficacy and safety of recombinant interferon alfa-2a (rIFN) was evaluated in 26 adult Nigerian patients with chronic hepatitis B infection. Male and female patients with serological evidence of HBV infection (HBsAg and/or HBeAg positive patients) and abnormal liver histology were monitored for six months to confirm chronicity. At the end of the six months screening period eligible patient were enrolled into the study and treated with rIFN 4.5 MIU given three times a week for 6 months. Efficacy was assessed primarily by loss of HBV-DNA and/or HBeAg from serum and secondarily by loss of HBsAg and normalization of the liver histology. Safety was assessed by monitoring the leukocyte and platelet count over the treatment period whilst tolerability was assessed by recording the occurrence of adverse events (adverse drug reaction and intercurrent illness). At the end of therapy the response rate with respect to loss of HBV-DNA was 67% and 100% for HBeAg (i.e. for the six patients who were HBeAg positive at baseline). There was loss of HBsAg in 22.2% of the patients. A significant reduction in inflammation and necrosis scores was found among the 10 patients who had both baseline and term biopsies. The frequency of occurrence of adverse events was 53.8% and the laboratory safety parameters were not significantly affected by therapy (p > 0.05). 19.2% of the enrolled patients were withdrawn from the study prematurely. These results demonstrate that rIFN is effective in the management of CHB infection even in Nigerians. The high success rate associated with HBcAg clearance is particularly noteworthy.
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Affiliation(s)
- S O Ola
- Department of Medicine, Univ. College Hospital, Ibadan
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Ndububa DA, Ojo OS, Adetiloye VA, Rotimi O, Durosinmi MA, Uchegbu LO. The incidence and characteristics of some paraneoplastic syndromes of hepatocellular carcinoma in Nigerian patients. Eur J Gastroenterol Hepatol 1999; 11:1401-4. [PMID: 10654801 DOI: 10.1097/00042737-199912000-00010] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE To determine whether paraneoplastic syndromes of hepatocellular carcinoma such as erythrocytosis, hypoglycaemia, hypercholesterolaemia and hypercalcaemia are found in Nigerian patients with this tumour, and, if present, to determine their incidence and characteristics. DESIGN Consecutive patients with a diagnosis of hepatocellular carcinoma seen over a 10-year period at Ile-Ife, Nigeria, underwent haematocrit (100 patients), plasma glucose (65), cholesterol (65) and calcium studies (30). Shortage of laboratory reagents did not allow all the 100 patients to be tested for plasma glucose, cholesterol and calcium. METHODS Haematocrit was determined by the microhaematocrit method, and the glucose oxidase-peroxidase, Liebermann-Burchard and O-cresolphthalein complexone methods were employed for the estimation of plasma glucose, cholesterol and calcium respectively. RESULTS The haematocrit values ranged from 19 to 63% with a mean of 34.51% (SD 7.72). Only 1 out of 100 patients (1%) had erythrocytosis (haematocrit 63%). Sixty-five patients had their plasma glucose determined. The range of values for fasting plasma glucose (FPG) was 1-8.4 mmol/l with a mean of 4.3 (SD 1.6). Hypoglycaemia occurred in 18 patients (27.7%)(14 males, 4 females). The mean liver span for patients with FPG > 5.0 mmol/l was 16.87 cm (SD 3.03), while the value for those with FPG < 3.0 mmol/l was 22.0 cm (SD 6.14, P < 0.05). Plasma cholesterol was determined in 65 patients and the range of values was 2.1 -18.1 mmol/l with a mean of 5.65 (SD 2.42). Hypercholesterolaemia occurred in 16 patients (24.6%) (15 males, 1 female). The range of plasma calcium obtained in 30 patients was 1.6-3.15 mmol/l with a mean of 2.36 (SD 0.32). Three patients (10%) (all males) had hypercalcaemia. CONCLUSION While erythrocytosis has a low incidence, hypoglycaemia and hypercholesterolaemia are important paraneoplastic syndromes of hepatocellular carcinoma in Nigerian patients. The study confirms that the larger the liver mass, the greater the tendency towards hypoglycaemia. Also, the paraneoplastic syndromes studied occurred predominantly in hepatocellular carcinomas with cirrhosis.
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Affiliation(s)
- D A Ndububa
- Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, lle-lfe, Nigeria.
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Ojo OS, Akonai AK, Thursz M, Ndububa DA, Durosinmi MA, Adeodu OO, Fatusi OA, Goldin RD. Hepatitis D virus antigen in HBsAg positive chronic liver disease in Nigeria. East Afr Med J 1998; 75:329-31. [PMID: 9803613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Hepatitis B virus (HBV) is strongly associated with an aggressive type of chronic active liver disease (CALD) and hepatocellular carcinoma, which tend to present in the relatively young, in sub-Saharan Africa. It is known that co-existent infection with HDV tends to aggravate the course of HBV-associated liver disease. This study was carried out to determine the sero-prevalence of hepatitis D virus (HDV) among thirty one consecutive southwestern Nigerians with HBsAg-positive, HCV antibody-negative chronic liver disease. Alongside, we tested for HBsAg and the HDV antigen in fifty randomly selected sera each from blood donors and university freshmen undergoing pre-admission medical tests and who had no clinical evidence of liver disease. The HDV antigen (HDVAg) was found in the sera of two of 31 (6.5%) patients. Among the blood donors and university freshmen, HBsAg prevalence was twelve and eight per cent respectively, while HDVAg was present in none. In addition, liver biopsies of 28 other patients were stained for HDVAg. None of these was positive. These findings show that HDV prevalence is low in our community, and suggest that the virus might play only a minor role in the pathogenesis of HBsAg-associated chronic liver disease among our patients. A review of reports on the epidemiology of HDV in sub-Saharan Africa shows a rather complicated pattern that makes its impact on HBsAg-associated CALD difficult to assess. More studies designed to elucidate this pattern of HDV epidemiology are called for.
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Affiliation(s)
- O S Ojo
- Department of Morbid Anatomy and Forensic Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ojo OS, Thursz M, Thomas HC, Ndububa DA, Adeodu OO, Rotimi O, Lawal AA, Durosinmi MA, Akonai AK, Fatusi AO. Hepatitis B virus markers, hepatitis D virus antigen and hepatitis C virus antibodies in Nigerian patients with chronic liver disease. East Afr Med J 1995; 72:719-21. [PMID: 8904063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Although carrier rates for the HBsAg as well as the prevalence of HBV-associated chronic liver disease (CALD) are known to be high in Nigeria, not much is known about the role of the hepatitis C (HCV) and D (HDV) viruses. We undertook a prospective serological study of a cohort of 50 new patients and attending a Nigerian teaching hospital for various forms of histologically characterised chronic liver disease. Forty-five patients (90%) had antibodies to HBcAg (anti-HBcAb). Thirty one patients (62%) were HBsAg-positive, out of whom 15 were HbeAg-positive. Two (4%) of the HbsAg-positive patients, both suffering from liver cancer, were also hepatitis D antigen positive. Similarly, two (4%) patients were positive for anti-HCV antibodies. There were no cases of co-infection by the HBV and HCV. This study suggests that while the HBV is the major aetiological agent of chronic liver disease in Nigeria, the HDV is not an important aggravating factor save in a small number of patients. The HCV is probably not yet an important cause of chronic liver disease but this situation might change when HBV infection is controlled.
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Affiliation(s)
- O S Ojo
- Department of Medicine, University and Teaching Hospital, Ile-IFe, Nigeria
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Ojo OS, Odesanmi WO, Akinola OO. The surgical pathology of colorectal carcinomas in Nigerians. Trop Gastroenterol 1992; 13:64-9. [PMID: 1413101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This paper presents a 10-year experience on the examination of surgical specimens of colorectal carcinomas in Nigerians. Colorectal carcinomas were found to constitute about 80% of all cases of large bowel malignancy. The Male: Female ratio was 2.28:2. Most of the cases (65.9%) were 50 years or younger and the peak incidence was in the 41-50 year age group. The site distribution in order of frequency was recto-sigmoid area (57.3%), descending colon (23.2%), caecum (12.2%) ascending colon and transverse colon 3.7% each. Seventy-three percent of the tumours were well differentiated adenocarcinomas while 15.9% were poorly differentiated. Mucinous carcinoma and signet ring carcinoma were found in 7.3% and 3.7% respectively. There was colonic metastasis in 54.9% of cases and 20.8% had distant metastases at initial surgery. Associated lesions were villous adenoma, 24.4%, Tubular adenoma-17.1%, amoebiasis 6.1% and schistosomiasis, 3.7%. The above observations together with those of previous authors suggests a difference in the biology of colorectal carcinomas in the tropics. The association with chronic granulomatous diseases, in particular, may be indicative of an entirely different oncogenic mechanism in their development in the tropics.
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Affiliation(s)
- O S Ojo
- Department of Morbid Anatomy, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ojo OS, Akinsola AA, Nwosu SO, Odesanmi WO. The pathological basis of chronic renal failure in Nigerians. An autopsy study. Trop Geogr Med 1992; 44:42-6. [PMID: 1496721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
With the aim of determining the relative prevalence of the diseases underlying chronic renal failure (CRF) in a large homogeneous black tropical population, the autopsy records of the Obafemi Awolowo University Teaching Hospital over a four year period were studied. Out of a total of 702 cases coming to autopsy during this period, 66 (9.4%) died as a result of CRF. The highest number of cases of CRF fell within the 31-40 year age group with a male/female ratio of 1.28:1. Chronic glomerulonephritis was responsible for 40.9% of cases, malignant nephrosclerosis 16.6%, benign nephrosclerosis 7.6% while endstage renal disease (ESRD) was responsible for 15.4%. A miscellaneous group of diseases was responsible for 19.7%, about half of which was due to chronic pyelonephritis. Rarer causes of CRF were diabetic nephropathy, multiple myeloma, systemic lupus erythematosus and analgesic nephropathy.
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Affiliation(s)
- O S Ojo
- Department of Morbid Anatomy and Forensic Medicine, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ojo OS, Odesanmi WO, Akinola OO. The surgical pathology of colorectal carcinomas in Nigerians. Trop Gastroenterol 1991; 12:180-4. [PMID: 1667558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This paper presents a 10-year experience on the examination of surgical specimens of colorectal carcinomas in Nigerians. Colorectal carcinomas were found to constitute about 80 per cent of all cases of large bowel malignancy. The male:female ratio was 2.28:1. Most of the cases (65.9%) were below 50 years and the peak incidence was in the 41-50 year age group. The site distribution in order of frequency was recto-sigmoid area (57.3%), descending colon (23.2%), caecum (12.2%), ascending colon and transverse colon 3.7 per cent each. Seventy-three per cent of the tumours were well differentiated adenocarcinoma while 15.9 per cent were poorly differentiated. Mucinous carcinoma and signet ring carcinoma were found in 7.3 per cent and 3.7 per cent respectively. There were colonic metastasis in 54.9 per cent of cases and 20.8 per cent had distant metastasis at initial surgery. Associated lesions were villous adenoma, 24.4 per cent tubular adenoma 17.1 percent, amoebiasis 6.1 per cent and Schistosomiasis 3.7 per cent. The above observations together with those of previous authors suggest a difference in the biology of colorectal carcinomas in the tropics. The association with chronic granulomatous diseases, in particular, may be indicative of entirely different oncogenic mechanisms in their development in the tropics.
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Affiliation(s)
- O S Ojo
- Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ojo OS, Udeh SC, Odesanmi WO. Review of the histopathological findings in appendices removed for acute appendicitis in Nigerians. J R Coll Surg Edinb 1991; 36:245-8. [PMID: 1941741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The vermiform appendix is a frequent surgical specimen in most routine histopathology laboratories. This is because acute appendicitis is one of the commonest reasons for undertaking emergency laparotomy in most hospitals, even in developing countries. Three hundred and sixteen appendices removed for acute appendix in our hospital over a 10-year period were analysed, of which 37 (11.7%) were found to be normal while 221 (69.9%) showed histopathological evidence of acute inflammation. There were 25 cases of chronic appendicitis, four (1.3%) of which were granulomatous. Of these, schistosomal appendicitis was observed in three cases (0.95%) and tuberculous appendicitis was seen in one case. Of the 33 cases classified as miscellaneous, intraluminal ova of parasites with phlegmonous eosinophilic infiltration of the appendix was observed in 17 cases (5.4%) and Toxoplasma appendicitis was observed in five cases. Carcinoid tumour was diagnosed in three cases (0.95%), and in two of these the tumour had spread beyond the appendix.
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Affiliation(s)
- O S Ojo
- Department of Morbid Anatomy and Forensic Medicine, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Affiliation(s)
- O Onayemi
- Department of Dermatology, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Abstract
We report a longitudinal study to detect amyloidosis in 51 patients with chronic osteomyelitis which was carried out between 1986 and 1989 at our University Hospital in Nigeria. Biopsies of the sinus edge and rectal mucosa were carried out and stained specifically for amyloid deposits with Congo Red. Positive microscopic findings at one or other, but not at both sites were present in 5 cases (9.8%). Secondary amyloidosis is not common among patients with long standing suppurating osteomyelitis. When the suppuration is controlled or removed the amyloid deposits are absorbed.
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Affiliation(s)
- Z O Alabi
- Department of Orthopaedic Surgery, Faculty of Health Sciences, Obafemi Awolowo University, Ille-Ife, Nigeria
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Affiliation(s)
- A M Nganwuchu
- Department of Obstetrics & Gynaecology, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ojo OS, Onwudiegwu U, Odesanmi WO. Adenomyosis uteri in Ile-Ife, Nigeria. A prospective clinicopathologic study. Trop Geogr Med 1991; 43:114-6. [PMID: 1750099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A 12-month prospective study of 120 consecutive hysterectomy and 12 myomectomy specimens received at the histopathology laboratory of the Obafemi Awolowo University Teaching Hospitals was undertaken to determine the occurrence of adenomyosis. The observed incidence was 9.8%. Adenomyosis was commonest in multiparous women in the fifth decade of life. The principal presenting complaint was abnormal uterine bleeding. The average dimension of a typical affected uterus was 10 x 7 x 6 cm weighing an average of 175 g. Diagnosis was mostly post-operative. This study shows that adenomyosis uteri is not uncommon in Nigerians.
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Affiliation(s)
- O S Ojo
- Department of Morbid Anatomy and Forensic Medicine, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Abstract
A case of ruptured tubal ectopic pregnancy is presented. On histological examination of the fallopian tube involved, ova of Schistosoma haematobium were found in the submucosal and intramural parts of the tube. The case illustrates a rare preventable cause of ectopic pregnancy in this population.
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Affiliation(s)
- F E Okonofua
- Department of Obstetrics and Gynaecology, Obafemi Awolowo University, Ile-Ife, Nigeria
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Lawal OO, Ojo OS, Durosinmi MA. Burkitt's lymphoma in a 45-year-old Nigerian woman. Trop Geogr Med 1990; 42:294-7. [PMID: 2293442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A clinically advanced stage of Burkitt's lymphoma (BL) occurring unusually in a middle-aged perimenopausal woman in an endemic area is reported. Successful treatment was achieved by tumour debulking and intensive pulsed combination chemotherapy. BL needs to be considered in the differential diagnosis of abdominal swellings in adults in endemic areas.
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Affiliation(s)
- O O Lawal
- Department of Surgery, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Dare FO, Ojo OS, Nwosu SO. An endometriotic cyst of the left ovary in pregnancy. Trop Doct 1990; 20:44. [PMID: 2305488 DOI: 10.1177/004947559002000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F O Dare
- Department of Obstetrics & Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Oyo State, Nigeria
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Dare FO, Ojo OS, Nwosu SO. An endometriotic cyst of the left ovary in pregnancy--a case report. Cent Afr J Med 1989; 35:509-10. [PMID: 2620344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A case of an endometriotic cyst of the left ovary in a pregnant Nigerian woman is presented. Left ovarian cystectomy was performed at the 18th week of gestation. The patient had a spontaneous vaginal delivery of a 3.54kg live male baby.
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