CLINICOPATHOLOGICAL AND IMMUNO-HISTOCHEMICAL CHARACTERIZATION OF GASTROINTESTINAL STROMAL TUMOUR AT FOUR TERTIARY HEALTH CENTERS IN NIGERIA USING CD117, DOG1, AND HER-2 BIOMARKERS

Introduction

Gastrointestinal stromal tumours (GISTs) are neoplastic lesions that primarily affect the digestive tract and develop from interstitial cells of Cajal. Due to their malignant potential and personalized treatment, these lesions require histopathologic and immunohistochemical characterization. In this investigation, the sex, age, lesional sites of origin, histopathologic types, the prevalence of HER-2 expression, prognostic indices (based on tumour size and mitotic figures), expression of CD117 and DOG1, and characteristics of patients with GIST were all characterized.

Methodology

This is a retrospective cross-sectional analysis of GIST cases seen at four tertiary healthcare centers in Nigeria over ten years (2008 to 2017) and investigated utilizing histopathological and immunohistochemical (CD117, DOG1, and HER-2) methods.

Result

In this study, there were twenty GIST cases. Notably, the majority (40%) of the cases had tumours with sizes between 7.0 and 8.0, the stomach was the most frequent site (70%) and the spindle cell type of GIST was the most prevalent (80%) histopathological type. Additionally, the stomach was significantly associated with GIST as an origin site (with a P value of 0.001), and 100% and 50% of these tumours were immunoreactive with CD117 and DOG1 respectively. Finally, HER-2 immunoreactivity was negatively stained with GIST tumour.

Conclusion

In our study, GISTs most frequently develop in the stomach, and CD117& DOG1 are essential for correctly diagnosing these tumours. However, HER-2 immunoreactivity is a predictive marker of survival for personalized care.

Presentation and Management of Atypical Orofacial Clefts: A Single-Institution Experience for 13 Year Period

This study reviews the craniofacial clefts that presented at a Nigerian tertiary health facility, highlighting our experience with the pattern of presentation and surgical care of these patients.

A retrospective review of the smile train database and medical records of all individuals who had been diagnosed with any of the Tessier craniofacial clefts and managed between 1st January 2007 and 31st December 2020 was done. The data were presented as numbers and percentages of cases.

The cleft clinic of a tertiary health facility and a major cleft referral center in South-West Nigeria.

Forty-five patients with craniofacial clefts were managed over the study period. 15.6% had associated syndromes, 2.2% had a family history of similar craniofacial cleft and 11% had a history of a possible teratogen. There were 21 (46.7%) middle clefts, 14(31.1%) lateral clefts and 10(22.2%) oblique clefts. The most common type of cleft was Tessier 0 while the Tessier 6 was the least common type. The median age at surgery was 10 months for male and 5months for female subjects, 15.3% complication rate was found in this study. Four patients had revision surgeries to correct residual deformities in this study.

The diverse presentations and occurrence of the rare craniofacial clefts present complex aesthetic and functional problems that require individualized often multidisciplinary care. The execution of a properly planned treatment will reduce complications and the need for revision surgeries.

Knowledge of Environmental and Genetic Risk Factors for Cleft Lip and Palate among Dwellers of a Suburban Community in Nigeria

BACKGROUND

Cleft lip and/or cleft palate (CLP) is a prevalent condition with a multifactorial etiology. An understanding of its etiologic factors discourages harmful habits and promotes societal acceptability.

OBJECTIVES

To assess the knowledge of environmental and genetic risk factors of CLP and determine its effect on predisposing social habits in a suburban community in Nigeria.

METHODS

This was a descriptive cross-sectional study conducted at Ifo Local Government Area (LGA), Ogun state, Nigeria. Participants were adult residents of Ifo L.G.A. Knowledge of CLP categorized into description, environmental risk factors and genetic factors were assessed using a well structured interviewer administered questionnaire.

RESULTS

A total of 300 adults (104 males; 196 females) aged 44.3 + 13.17 years with predominantly secondary level education participated in the study. Majority of participants (89.7%) had low overall knowledge of CLP including low knowledge on description of CLP (81.7%), environmental factors of CLP (81.3%), and genetic factors of CLP (93.7%). High level of education was significantly associated with increased knowledge on description of CLP (P < 0.05). No other significant association was noted between sociodemographic factors and knowledge of CLP. Decreased smoking history was associated with high knowledge on description of CLP (P = 0.043).

CONCLUSION

Majority of the population had low knowledge of CLP which was to an extent influenced by their lack of high level of education. This low knowledge was significantly associated with increased practices of social habits such as cigarette smoking that predispose unborn children to CLP. The low knowledge of CLP shown in this study highlights the need for increased community education and health promotion to encourage avoidance of risk factors that predispose to the condition and promote societal acceptability and quest for treatment of the condition.

Risk of congenital cardiovascular anomalies in patients with non-syndromic orofacial cleft: A preliminary case-control study

Background

Orofacial clefts (OCs) are one of the most common craniofacial anomalies and are reported to be associated with congenital cardiovascular anomalies (CCAs). However, there is paucity of data in African populations on the risk of CCAs in OC patients compared to the general population.

Aims

This study aims to determine the odds of congenital cardiovascular anomalies in patients with OC compared to the general population.

Subjects and Methods

A case-control study design was used. Case subjects were non-syndromic OC subjects, while controls were non-syndromic subjects without OC. All subjects were thoroughly assessed by a pediatric cardiologist for CCAs; and grouped by OC phenotypic type (cleft lip and/or alveolus, cleft lip and palate, cleft palate only and Tessier cleft). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was placed at P value ≤0.05.

Results

A total of 120 subjects (60 cases and 60 controls) were enrolled in the study. In total, 23.3% of the subjects had CCAs. Among the case group, 40% had CCAs compared to 6.7% in the control group. Patent foramen ovale (18.3%) and atrial septal defects (10.0%) were the most common type of CCAs in cases, respectively. Further, cases had significantly higher odds of CCAs compared to controls (OR: 9.3; CI: 2.8, 39.4).

Conclusions

Our finding reveals that the odds of CCAs are significantly higher in patients with OC than the general population. Future studies could assess the effect of CCAs on surgical outcome.

Phytochemical screening and in vivo antimalarial activity of extracts from three medicinal plants used in malaria treatment in Nigeria

The use of plant to meet health-care needs has greatly increased worldwide in the recent times. The search for new plant-derived bioactive agents that can be explored for the treatment of drug-resistant malaria infection is urgently needed. Thus, we evaluated the antimalarial activity of three medicinal plants used in Nigerian folklore for the treatment of malaria infection. A modified Peter's 4-day suppressive test was used to evaluate the antimalarial activity of the plant extracts in a mouse model of chloroquine-resistant Plasmodium berghei ANKA strain. Animals were treated with 250, 500, or 800 mg/kg of aqueous extract. It was observed that of all the three plants studied, Markhamia tomentosa showed the highest chemosuppression of parasites of 73 % followed by Polyalthia longifolia (53 %) at day 4. All the doses tested were well tolerated. Percentage suppression of parasite growth on day 4 post-infection ranged from 1 to 73 % in mice infected with P. berghei and treated with extracts when compared with chloroquine diphosphate, the standard reference drug which had a chemosuppression of 90 %. The percentage survival of mice that received extract ranged from 0 to 60 % (increased as the dose increases to 800 mg/kg). Phytochemical analysis revealed the presence of tannins, saponins, and phenolic compounds in all the three plants tested.

Antifungal property and phytochemical screening of the crude extracts of Funtumia elastica and Mallotus oppositifolius

The antifungal properties of aqueous and ethanol extracts of Funtumia elastica and Mallotus oppositifolius were carried out using the disc diffusion agar assay. The crude extracts exhibited definite significant antifungal activity on most of the fungi. The zone of inhibition varied for the fungi, which were: Aspergillus flavus, Candida albicans, Microsporium audouinii, Penicillium sp, Trichophyton mentagrophytes, Trichoderma sp and Trichosporon cutaneum with respect to the type of plant extract. The aqueous extracts of Mallotus oppositifolius had the highest zone of inhibition of 24.75 +/- 0.86 mm on Penicillium sp. The fulcin antibiotic had zone of inhibition of 11.94 +/- 0.43 mm on Microsporium audouinii, being its highest inhibition on any of the fungi tested. Preliminary phytochemical studies of F elastica and M oppositifolius extracts revealed that they contain anthocyanins, butacyanin, flavonoids, steroids and tannins. Phytobutanin was absent in the extracts. Heavy metal analysis of plant materials showed absence of cadmium, zinc, lead, chromium and nickel, while the presence of copper iron and manganese was less than 0.95%.

Biodegradation of crude petroleum and petroleum products by fungi isolated from two oil seeds (melon and soybean)

Crude petroleum oil degrading fungi were isolated from two oil seeds, Cucumeropsis mannii (melon) and Glycine max (soybean) seeds in the presence and absence of petroleum fumes. An assessment of the relative ability of each fungus to degrade crude petroleum, diesel and kerosene on minimum salt solution was done using change in optical density read on spectrophotometer. Twenty-one fungal species (14 genera) were isolated altogether during this experiment. These include eight species of Aspergillus; one species each of Botryodiplodia, Bipolaris, Cladosporium, Cunnighamella, Dreschlera, Fusarium, Helminthosporium, Macrophomina, Mucor, Paeciliomyces, Penicillium, Rhizopus and Talariomyces. It was evident that most of the fungi tested were able to biodegrade the crude petroleum oil, though at different rates. Bipolaris had a low rate of biodegradation of the petroleum oil of all the fungal species isolated Botryodiplodia theobromae had the highest degrading ability on the crude oil, while Aspergillus flavus had the least after 40 days of incubation. Aspergillus flavus had the highest ability to biodegrade diesel while A. niger had the least ability. In kerosene, Macrophomina phaseolina had the highest ability while A. niger had the least ability to biodegrade it. There was fluctuation in the growth pattern of the fungi in the petroleum oil medium. The implication of these are discussed.

The possible role of tropical medicinal preparations in human carcinoma in Africa

It is suggested that apart from aflatoxins, plant medicinal preparations containing active compounds imperatorin, dictamine, marmesin and heraclenin may be responsible for some human cancers in Nigeria and perhaps other parts of Africa. Therefore, in this paper, a hypothesis is put forward that these compounds or their reactive (metabolized) types may form epoxides from the 2,3-furan double bonds which may bind tissue macromolecules, DNA, RNA and protein leading to one of the vital steps of environmental carcinogenesis in mammals. This hypothesis has far reaching implications for, besides the examples given, unanalysed plant preparations are widely used in various parts of Africa within traditional methods of healing. Our observation is based on information we now have about AFB1 and is not intended to confirm the roles of double bonds in a vinyl ether system of the active compounds.

Effect of vitamin A deficiency on rat hepatic and colon epoxide hydrase

Rat liver microsomes and homogenized mucosal linings prepared from vitamin A-supplemented and deficient male rats were used in metabolic studies of 7-3H-styrene oxide. The colon tissue in deficient animals exhibits a significantly higher value of Vmax than the same tissue from vitamin-supplemented animals. The implications of this finding in addition to our earlier observation 10 is discussed in relation to colon carcinoma.

Studies of age-related changes in the metabolism of eosin in the rat

Male rats of different age groups maintained normally on laboratory chow were injected with eosin (2,4,5,7-tetrabromo-11-carboxyfluorescein) after which the biliary excretion of the dye was studied. In 3 age groups below 42 weeks, the dye was excreted as 2 compounds which were identified by thin-layer chromatography as unchanged eosin (Rf 0.90--0.91) contributing about 80--90% and one conjugated compound of Rf 0.43--0.47 (14--9%) which was shown to be a glucuronide. Eosin metabolites could not be traced in 30 and 42 week-old rats. This finding is discussed in relation to: (i) age and enzymic activity, and (ii) bio-activated metabolites of this dye which may induce biochemical or toxicological and carcinogenic lesions.

Aflatoxin metabolism and absence of cytochrome P-450 in rat colon tissue during vitamin A malnutrition

Homogenized mucosal linings prepared from vitamin A adequate and deficient male rats were used in metabolic studies of aflatoxin B1 (AFB1). Cytochrome P-420 was identified in both groups which metabolized AFB1 to 4 metabolic products in vitro. The implications of this observation are discussed in relation to colon carcinoma.

Comparative histopathological effects of aflatoxin B1 and palmotoxins B0 and G0 on some organs of different strains of the newly hatched chick (Gallus domesticus)

Aflatoxin B1 and palmotoxin B0 are equitoxic to the developing chick-embryo (Gallus domesticus) whilst palmotoxin G0 is relatively non-toxic. Toxic lesions are present in the heart, liver, skeletal muscle, brain and cartilage in varying severities. The liver and skeletal muscle show fatty change and toxic myositis, respectively. Lesions in the heart, brain and cartilage are relatively mild. The endocardial cushion-like plaques at the base of the atrioventricular valves are lesions peculiar to aflatoxin B1 and palmotoxin B0-induced cardiac damage. It appears that these mycotoxins are not selectively tissue specific in inducing organ damage in the chick-embryo. An ultrastructural study of these lesions in the chick and other species may help to elucidate the molecular mechanism of the toxicity of these mycotoxins which are suspected to be very potent human hepatocarcinogens in certain parts of the tropics. Their acute phase effects in man are, however, unknown.