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Olaopa OI, Dada AA, Soneye OY, Iyapo O, Akinniyi TA, Adisa AO, Kanmodi KK, Olaopa AO, Emeka CI, Ehanire ID, Coker MO. A rare case of Gardner syndrome in an African adult male: A case report. Clin Case Rep 2024; 12:e8735. [PMID: 38576527 PMCID: PMC10991715 DOI: 10.1002/ccr3.8735] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/08/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Abstract
Gardner's syndrome with the complete manifestation of colonic and extracolonic features is uncommon. Therefore, every clinician should view extracolonic features with a high index of suspicion. This may be key to early diagnosis, definitive management in these patients and importantly, helps prevent malignant transformation of existing colonic polyps.
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Affiliation(s)
- Olusegun I. Olaopa
- Department of Dental ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Adedamola A. Dada
- Department of SurgeryFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | | | - Oluwadamilare Iyapo
- Department of Pathologic ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Taofeek A. Akinniyi
- Department of Oral and Maxillofacial SurgeryObafemi Awolowo University Teaching Hospitals ComplexIle‐IfeOsun StateNigeria
| | - Akinyele O. Adisa
- Department of Oral PathologyCollege of Medicine, University of IbadanIbadanOyo StateNigeria
| | - Kehinde K. Kanmodi
- School of DentistryUniversity of RwandaKigaliRwanda
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
| | | | - Christian I. Emeka
- Department of Dental ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Imudia D. Ehanire
- Department of SurgeryFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Modupe O. Coker
- Department of Oral BiologyRutgers School of Dental MedicineNewarkNew JerseyUSA
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Akintoye SO, Adisa AO, Okwuosa CU, Mupparapu M. Craniofacial disorders and dysplasias: Molecular, clinical, and management perspectives. Bone Rep 2024; 20:101747. [PMID: 38566929 PMCID: PMC10985038 DOI: 10.1016/j.bonr.2024.101747] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
There is a wide spectrum of craniofacial bone disorders and dysplasias because embryological development of the craniofacial region is complex. Classification of craniofacial bone disorders and dysplasias is also complex because they exhibit complex clinical, pathological, and molecular heterogeneity. Most craniofacial disorders and dysplasias are rare but they present an array of phenotypes that functionally impact the orofacial complex. Management of craniofacial disorders is a multidisciplinary approach that involves the collaborative efforts of multiple professionals. This review provides an overview of the complexity of craniofacial disorders and dysplasias from molecular, clinical, and management perspectives.
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Affiliation(s)
- Sunday O. Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Akinyele O. Adisa
- University of Ibadan and University College Hospital Ibadan, Ibadan, Nigeria
| | - Chukwubuzor U. Okwuosa
- Department of Oral Pathology & Oral Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria
| | - Mel Mupparapu
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
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Akinshipo AWO, Shanti RM, Adisa AO, Effiom OA, Adebiyi KE, Carrasco LR, Kaleem A, Arotiba GT, Akintoye SO. Time to Recurrence of Ameloblastoma and Associated Factors in a Multi-institutional Black Patient Cohort. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01927-z. [PMID: 38324239 DOI: 10.1007/s40615-024-01927-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/31/2023] [Accepted: 01/31/2024] [Indexed: 02/08/2024]
Abstract
Ameloblastoma is a highly recurrent odontogenic neoplasm with variable global distribution. However, impact of race and ethnicity on ameloblastoma recurrence are still unclear. The primary aim of this study was to assess duration of time between primary and recurrent ameloblastomas in a predominantly Black multi-institutional patient cohort and secondarily to determine whether recurrent ameloblastomas are more readily discovered when clinically-symptomatic rather than by radiographic surveillance. A retrospective cross-sectional design was used to evaluate demographic, clinical, and pathological information on recurrent ameloblastomas patients. Outcome variable was time to recurrence, determined as period between the diagnosis of primary and recurrent ameloblastomas. We assessed associations between outcome variable and race, time lapse between primary and recurrent ameloblastomas and clinical symptoms of recurrent ameloblastomas at time of diagnosis. Among 115 recurrent ameloblastomas identified, 90.5% occurred in adults, 91.3% in Blacks, and similarly, 91.3% were conventional ameloblastomas. About 41% affected the posterior mandible. 93.9% were clinically symptomatic at time of presentation while 6.1% non-symptomatic lesions were discovered by routine diagnostic radiology. Median time to presentation of recurrent tumor was significantly longer in females (90 months, p = 0.016) and clinically symptomatic group of ameloblastoma patients (75 months, p = 0.023). Ameloblastoma recurrence was distinctively high in Black patients, occurred faster in males than females and was located mostly in the posterior mandible. Concomitant with delayed access to healthcare of Black individuals, routine post-surgical follow-up is essential because time lag between primary and recurrence tumors was longer in clinically symptomatic ameloblastomas at the time of diagnosis.
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Affiliation(s)
- Abdul-Warith O Akinshipo
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Rabie M Shanti
- Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Akinyele O Adisa
- Department of Oral Pathology, University of Ibadan and University College Hospital Ibadan, Ibadan, Nigeria
| | - Olajumoke A Effiom
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Kehinde E Adebiyi
- Department of Oral Pathology & Oral Medicine, Faculty of Dentistry, Lagos State University College of Medicine Lagos, Lagos, Nigeria
| | - Lee R Carrasco
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Arshad Kaleem
- Head and Neck Oncology and Microvascular Surgery, High Desert Oral and Facial Surgery, El Paso, TX, USA
| | - Godwin T Arotiba
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Sunday O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Adeleke AA, Olasehinde O, Adisa AO. Influence of Adhesive Incise Drape Use on Surgical Site Infection Rates in Contaminated and Dirty Abdominal Operations. West Afr J Med 2024; 41:42-47. [PMID: 38412203] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Surgical Site Infection (SSI) remains the most common cause of Healthcare-Associated Infections (HCAIs). In particular, contaminated and dirty abdominal wounds are attended by a high rate of SSI which in turn is associated with a huge burden on patients, caregivers and the entire health care system. OBJECTIVE To compare SSI rates following the use of iodine-impregnated adhesive incise drapes (Ioban) with routine conventional drapes in contaminated and dirty abdominal surgical wounds in a Nigerian tertiary hospital. METHODOLOGY Consecutive, consenting adult patients who underwent laparotomy for cases classified as contaminated and dirty were prospectively enrolled in the study. Patients in the investigation arm had in addition to conventional drapes, iodine-impregnated adhesive incise drapes (Ioban) applied on the skin of the abdomen through which incisions were made, while patients in the control arm only had routine conventional drapes applied. All patients were followed up to 30 days after the operation. Surgical site infection rates were compared between the two groups. RESULTS Sixty-two consecutive patients were enrolled into this study, of which 55 completed the 30-day follow-up. The mean ages of patients in the two groups were 37.96 ± 19.59 years and 36.74 ± 16.93 years (p=0.81). Males were 36 (65.5%) and females were 19 (34.5%). Overall, 30 (54.5%) patients had surgical site infection (SSI) in this study. Thirteen (46.4%) patients had SSI in iodine iodine-impregnated adhesive incise drape group while 17 (63%) patients had SSI in the conventional drape group, a difference that was not statistically significant (p=0.22). The most commonly isolated organism from infected wounds was Klebsiella species. CONCLUSION The use of iodine-impregnated surgical incise drapes was associated with a lower, though non-statistically significant SSI rates compared to the use of conventional drapes. This marginal benefit will require a larger population study to examine its potential cost-effectiveness in our setting.
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Affiliation(s)
- A A Adeleke
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. + 2348039626056 E-mail:
| | - O Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. + 2348039626056 E-mail:
- Department of Surgery, Obafemi Awolowo University, Ile-Ife. Osun State. Nigeria
| | - A O Adisa
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. + 2348039626056 E-mail:
- Department of Surgery, Obafemi Awolowo University, Ile-Ife. Osun State. Nigeria
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Anbinselvam A, Akinshipo AWO, Adisa AO, Effiom OA, Zhu X, Adebiyi KE, Arotiba GT, Akintoye SO. Comparison of diagnostic methods for detection of BRAFV600E mutation in ameloblastoma. J Oral Pathol Med 2024; 53:79-87. [PMID: 38185471 PMCID: PMC10872315 DOI: 10.1111/jop.13506] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Ameloblastoma is an aggressively growing, highly recurrent odontogenic jaw tumor. Its association with BRAFV600E mutation is an indication for BRAFV00E-inhibitor therapy The study objective was to identify a sensitive low-cost test for BRAFV600E-positive ameloblastoma. We hypothesized that immunohistochemical staining of formalin-fixed paraffin-embedded tissues for BRAFV600E mutation is a low-cost surrogate for BRAFV600E gene sequencing when laboratory resources are inadequate for molecular testing. METHODS Tissues from 40 ameloblastoma samples were retrieved from either formalin-fixed paraffin-embedded blocks, RNAlater™ stabilization solution or samples inadvertently pre-fixed in formalin before transfer to RNAlater™. BRAFV600E mutation was assessed by Direct Sanger sequencing, Amplification Refractory Mutation System-PCR and immunohistochemistry (IHC). RESULTS BRAFV600E mutation was detected by IHC, Amplification Refractory Mutation System-PCR and Direct Sanger sequencing in 93.33%, 52.5% and 30% of samples respectively. Considering Direct Sanger sequencing as standard BRAFV600E detection method, there was significant difference between the three detection methods (𝜒2 (2) = 31.34, p < 0.0001). Sensitivity and specificity of IHC were 0.8 (95% CI: 0.64-0.90) and 0.9 (95% CI: 0.75-0.99) respectively, while positive predictive value and negative predictive value (NPV) were 0.9 and 0.8 (Fischer's test, p < 0.0001) respectively. Sensitivity and specificity of Amplification Refractory Mutation System-PCR detection method were 0.7 (95% CI: 0.53-0.80) and 0.9 (95% CI = 0.67-0.98) respectively, while PPV and NPV were 0.9 and 0.6 respectively (Fischer's test, p < 0.0001). CONCLUSION Low-cost and less vulnerability of IHC to tissue quality make it a viable surrogate test for BRAFV600E detection in ameloblastoma. Sequential dual IHC and molecular testing for BRAFV600E will reduce equivocal results that could exclude some patients from BRAFV600E-inhibitor therapies.
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Affiliation(s)
- Arularasan Anbinselvam
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia PA
| | - Abdul-Warith O. Akinshipo
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Akinyele O. Adisa
- University of Ibadan and University College Hospital Ibadan, Ibadan, Nigeria
| | - Olajumoke A. Effiom
- Department of Oral and Maxillofacial Pathology/Biology, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Xinhe Zhu
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia PA
| | - Kehinde E. Adebiyi
- Department of Oral Pathology & Oral Medicine, Faculty of Dentistry. Lagos State University College of Medicine Lagos
| | - Godwin T. Arotiba
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Sunday O. Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia PA
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Kanmodi KK, Salami AA, Gbadamosi AA, Nwafor JN, Amoo BA, Adisa AO, Aladelusi TO, Almu B, Amzat J, Braimah RO, Ogbeide ME, Okwuosa CU. Strategies adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in patient education on oral cancer: A Nigerian study. Cancer Rep (Hoboken) 2024; 7:e1929. [PMID: 37884691 PMCID: PMC10809197 DOI: 10.1002/cnr2.1929] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/25/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The burden of oral cancer in Nigeria is increasing. Different studies have shown how public education on oral cancer have increased knowledge of oral cancer across populations, however, it is not known if these practices are adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. AIMS To investigate the patient oral cancer education strategies adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. METHODS This study adopted an analytical cross-sectional study design. This study surveyed practicing oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. An e-questionnaire was used for this study. The data were analyzed using the SPSS Version 20 software, and a p-value of <.05 was used to determine the level of statistical significance. RESULTS The study's response rate was 46.6% (75/161). The 75 participants were from the six geopolitical zones in Nigeria responded to the survey questionnaire. Even though more than half (43/75, 57.3%) of the respondents have never received any training since their post-bachelor's degree qualification on the strategies that can be used in educating patients on oral cancer, majority (54/75, 72.0%) of them knew at least one education strategy; also, the most known (36/54, 66.7%) and utilized (33/54, 61.3%) strategy among those respondents who were aware of patient education strategy was health talk. Only 38.7% (29/75) of the respondents reported that health learning materials (posters, leaflets, fliers, and flipcharts) are available in their clinics, all of which were in insufficient quantities. Also, 93.3% (70/75) of the respondents opined that it is worthwhile that dental clinics/hospitals in Nigeria invest in the provision of oral cancer learning materials for patient use. Inferential statistical analysis did not reveal any significant relationship between the respondents' characteristics and their awareness and practice on patient oral cancer education strategies. CONCLUSION This study identified that many oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria lack the needed capacity to educate their patients on oral cancer. There is a need to strengthen their capacity by giving them training on patient oral cancer education strategies, and by providing them with good quality and enough teaching aids.
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Affiliation(s)
- Kehinde K. Kanmodi
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative IncIbadanNigeria
- School of DentistryUniversity of RwandaKigaliRwanda
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Afeez A. Salami
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative IncIbadanNigeria
- Department of Oral and Maxillofacial SurgeryUniversity College HospitalIbadanNigeria
| | - Adam A. Gbadamosi
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative IncIbadanNigeria
- Department of Dental SurgeryFederal Medical CentreBidaNigeria
| | - Jacob N. Nwafor
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative IncIbadanNigeria
- Division of MedicineNottingham University Hospital NHS TrustNottinghamUK
| | - Babatunde A. Amoo
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative IncIbadanNigeria
- African Field Epidemiology NetworkAbujaNigeria
| | - Akinyele O. Adisa
- Department of Oral Pathology/Oral MedicineUniversity College HospitalIbadanNigeria
- Department of Oral Pathology/Oral MedicineUniversity of IbadanIbadanNigeria
| | - Timothy O. Aladelusi
- Department of Oral and Maxillofacial SurgeryUniversity College HospitalIbadanNigeria
- Department of Oral and Maxillofacial SurgeryUniversity of IbadanIbadanNigeria
| | - Bello Almu
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
| | - Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
- Department of SociologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Ramat O. Braimah
- Faculty of Dental SciencesUsmanu Danfodiyo UniversitySokotoNigeria
- Department of Dental and Maxillofacial SurgeryUsmanu Danfodiyo UniversitySokotoNigeria
| | - Mike E. Ogbeide
- Department of Dental and Maxillofacial SurgeryUsmanu Danfodiyo UniversitySokotoNigeria
| | - Chukwubuzor U. Okwuosa
- Department of Oral Pathology and Oral MedicineUniversity of Nigeria Teaching HospitalItuku‐OzallaNigeria
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Makinde OY, Wuraola FO, Aderounmu AA, Ugalahi TO, Olasehinde O, Adisa AO. Awareness and Knowledge of Breast Cancer and Breast Examination amongst Undergraduate Students. Mixed Method Approach. West Afr J Med 2023; 40:857-862. [PMID: 37639531] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Breast cancer is the most common cause of cancer death amongst women, and the stage at presentation has been found to be an important prognostic index. The study aims to assess breast cancer awareness, including breast cancer education and knowledge of breast self-examination, among undergraduate students with the hope of improving their knowledge of breast cancer. METHODS The study used the mixed method approach, to evaluate during breast cancer awareness month. All consenting participants completed a pre-test questionnaire before a breast health seminar, after which the post-test questionnaire was filled out. Consenting participants also had clinical breast examinations performed on them. The data were analyzed using IBM SPSS version 24. RESULTS One hundred and thirteen participants filled out the pre-test questionnaire while 127 participants filled out the post-test. There was a significant change following the seminar. About 87.9% of respondents knew about breast cancer but had poor knowledge of the predisposing factors (11.3%). Most participants (94.3%) knew about self-breast examination (SBE), however, only 46% examined themselves in the past with only 21% aware of the correct timing for SBE. Clinical breast exams were conducted on 80 participants, six (7.5%) breast lumps were found and two had excision biopsies with histopathology diagnosis of fibroadenoma. CONCLUSION Breast education is important, as knowledge about breast cancer is still low, even among undergraduate students. Continuous breast education should be encouraged.
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Affiliation(s)
- O Y Makinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Osun State, Nigeria
| | - F O Wuraola
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - A A Aderounmu
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Osun State, Nigeria
| | - T O Ugalahi
- Child and Adolescent Mental Health, Leeds Community Healthcare Trust, Leeds, U.K
| | - O Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - A O Adisa
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Adisa AO, Adesunkanmi AO. Laparoscopic Distal Pancreatectomy for a Large Multicystic Pancreatic Tumour in Ile-Ife, Nigeria: A Case Report. West Afr J Med 2022; 39:985-988. [PMID: 36128915] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Distal pancreatectomy is scarcely reported in Nigeria probably because the procedure is rarely performed. The use of laparoscopy for such a procedure is equally rare in our practice. METHODS This is a report of a successful laparoscopic distal pancreatectomy carried out at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. REPORT A 57-year-old male, known hypertensive-diabetic, who had been on antiretroviral therapy for ten years presented in our clinic with recurrent upper back pain. An abdominal CT scan revealed a multi-cystic mass in the distal pancreas with other normal intraabdominal organs. A 3-port laparoscopic distal pancreatectomy with splenectomy was carried out. The postoperative period was uneventful and the patient was discharged in good clinical condition on the second day. Histopathology report confirmed a benign multi-cystic epithelial pancreatic lesion. CONCLUSION Laparoscopic distal pancreatectomy is feasible and was successfully carried out in our setting.
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Affiliation(s)
- A O Adisa
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - A O Adesunkanmi
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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Oboli GO, Abe EO, Adisa AO. CHLAMYDIA TRACHOMATIS EXPRESSES PHYLOGENETICALLY HOMOLOGOUS PROTEINS TO HUMAN PAPILLOMA VIRUS TYPE 16: INFERENCES FOR ORAL AND OROPHARYNGEAL SQUAMOUS CELL CARCINOMA. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.027] [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]
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Erim DO, Oke GA, Adisa AO, Odukoya O, Ayo-Yusuf OA, Erim TN, Tsafa TN, Meremikwu MM, Agaku IT. Associations of Government-Mandated Closures and Restrictions With Aggregate Mobility Trends and SARS-CoV-2 Infections in Nigeria. JAMA Netw Open 2021; 4:e2032101. [PMID: 33471117 PMCID: PMC7818105 DOI: 10.1001/jamanetworkopen.2020.32101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
Importance To prepare for future coronavirus disease 2019 (COVID-19) waves, Nigerian policy makers need insights into community spread of COVID-19 and changes in rates of infection associated with government-mandated closures and restrictions. Objectives To measure the association of closures and restrictions with aggregate mobility and the association of mobility with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and to characterize community spread of COVID-19. Design, Setting, and Participants This cross-sectional study used aggregated anonymized mobility data from smartphone users in Nigeria who opted to provide location history (from a pool of up to 40 million individuals) collected between February 27 and July 21, 2020. The analyzed data included daily counts of confirmed SARS-CoV-2 infections and daily changes in aggregate mobility across 6 categories: retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residential. Closures and restrictions were initiated on March 30, 2020, and partially eased on May 4, 2020. Main Outcomes and Measures Interrupted time series were used to measure associations of closures and restrictions with aggregate mobility. Negative binomial regression was used to evaluate associations between confirmed SARS-CoV-2 infections and mobility categories. Averted infections were estimated by subtracting cumulative confirmed infections from estimated infections assuming no closures and restrictions. Results Closures and restrictions had negative associations with mean change in daily aggregate mobility in retail and recreation (-46.87 [95% CI, -55.98 to -37.76] percentage points; P < .001), grocery and pharmacy (-28.95 [95% CI, -40.12 to -17.77] percentage points; P < .001), parks (-43.59 [95% CI, -49.89 to -37.30] percentage points; P < .001), transit stations (-47.44 [95% CI, -56.70 to -38.19] percentage points; P < .001), and workplaces (-53.07 [95% CI, -67.75 to -38.39] percentage points; P < .001) and a positive association with mobility in residential areas (24.10 [95% CI, 19.14 to 29.05] percentage points; P < .001). Most of these changes reversed after closures and restrictions were partially eased (retail and recreation: 14.63 [95% CI, 10.95 to 18.30] percentage points; P < .001; grocery and pharmacy: 15.29 [95% CI, 10.90 to 19.67] percentage points; P < .001; parks: 6.48 [95% CI, 3.98 to 8.99] percentage points; P < .001; transit stations: 17.93 [95% CI, 14.03 to 21.83] percentage points; P < .001; residential: -5.59 [95% CI, -9.08 to -2.09] percentage points; P = .002). Additionally, every percentage point increase in aggregate mobility was associated with higher incidences of SARS-CoV-2 infection in residential areas (incidence rate ratio [IRR], 1.03 [95% CI, 1.00 to 1.07]; P = .04), transit stations (IRR, 1.02 [95% CI, 1.00 to 1.03]; P = .008), and workplaces (IRR, 1.01 [95% CI, 1.00 to 1.02]; P = .04). Lastly, closures and restrictions may have been associated with averting up to 5.8 million SARS-CoV-2 infections over the study period. Conclusions and Relevance In this cross-sectional study, closures and restrictions had significant associations with aggregate mobility and were associated with decreased SARS-CoV-2 infections. These findings suggest that future anticontagion measures need better infection control and contact tracing in residential areas, transit stations, and workplaces.
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Affiliation(s)
| | - Gbemisola A. Oke
- Department of Periodontology and Community Dentistry, University of Ibadan, Nigeria
| | | | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, University of Lagos, Nigeria
| | | | | | | | - Martin M. Meremikwu
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Israel T. Agaku
- Department of Oral Epidemiology, Harvard Dental School, Boston, Massachusetts
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Adenekan AT, Aderounmu AA, Wuraola FO, Owojuyigbe AM, Adetoye AO, Nepogodiev D, Magill L, Bhangu A, Adisa AO. Feasibility study for a randomized clinical trial of bupivacaine, lidocaine with adrenaline, or placebo wound infiltration to reduce postoperative pain after laparoscopic cholecystectomy. BJS Open 2019; 3:453-460. [PMID: 31388637 PMCID: PMC6677102 DOI: 10.1002/bjs5.50159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/31/2018] [Accepted: 02/15/2019] [Indexed: 11/06/2022] Open
Abstract
Background Short‐term pain relief can be achieved by local anaesthetic infiltration of port sites at the end of laparoscopic surgery. This study aimed to assess feasibility of performing an RCT to evaluate short‐term postoperative analgesia after laparoscopic surgery in Nigeria using two local anaesthetics for port‐site infiltration versus saline placebo. Methods This was a placebo‐controlled, patient‐ and outcome assessor‐blinded, external feasibility RCT. Patients undergoing elective laparoscopic cholecystectomy for symptomatic ultrasound‐proven gallstones were randomized into three groups: lidocaine with adrenaline (epinephrine), bupivacaine or saline control. The feasibility of recruitment, compliance with randomized treatment allocation, and completion of pain and nausea outcome measures were evaluated. Pain was assessed at 2, 6, 12 and 24 h after surgery using a 0–10‐point numerical rating scale (NRS) and a four‐point verbal rating scale. Nausea was assessed using NRS at the same time points. Clinical outcomes were assessed only in patients who received the correct randomized treatment allocation. Results Of 79 patients screened for eligibility, 69 were consented and randomized (23 per group). Overall, compliance with randomized treatment allocation was achieved in 64 patients (93 per cent). All pain and nausea assessments were completed in these 64 patients. On the NRS, most patients had moderate to severe pain at 2 h (39 of 64, 61 per cent), which gradually reduced. Only six patients (9 per cent) had moderate to severe pain at 24 h. Conclusion Recruitment, compliance with the randomized allocation, and completion of pain outcome measures were satisfactory. This study demonstrates the feasibility of conducting a surgical RCT in a resource‐limited setting. Registration number: ISRCTN 17667918 (https://www.isrctn.com).
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Affiliation(s)
- A T Adenekan
- Department of Anaesthesia and Intensive Care Obafemi Awolowo University Ile-Ife Nigeria.,Department of Anaesthesia and Intensive Care Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - A A Aderounmu
- Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - F O Wuraola
- Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - A M Owojuyigbe
- Department of Anaesthesia and Intensive Care Obafemi Awolowo University Ile-Ife Nigeria.,Department of Anaesthesia and Intensive Care Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - A O Adetoye
- Department of Anaesthesia and Intensive Care Obafemi Awolowo University Ile-Ife Nigeria.,Department of Anaesthesia and Intensive Care Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - D Nepogodiev
- National Institute for Health Research Global Health Research Unit on Global Surgery University of Birmingham Birmingham UK
| | - L Magill
- National Institute for Health Research Global Health Research Unit on Global Surgery University of Birmingham Birmingham UK
| | - A Bhangu
- National Institute for Health Research Global Health Research Unit on Global Surgery University of Birmingham Birmingham UK
| | - A O Adisa
- Department of Surgery Obafemi Awolowo University Ile-Ife Nigeria.,Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
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Agbakwuru EA, Olasehinde O, Onyeze CI, Etonyeaku AC, Mosanya AO, Wuraola FO, Akinkuolie AA, Aderounmu AA, Adisa AO. Use of commercial mesh for hernia repair in a low resource setting: experience after 500 cases. Hernia 2019; 24:613-616. [PMID: 31129796 DOI: 10.1007/s10029-019-01987-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/17/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND The use of mesh has revolutionized the management of hernias in many parts of the world. There is, however, limited experience on its use in sub-Saharan Africa. This study describes a single hospital experience after 500 cases of mesh hernia repairs in a sub-Saharan African country. METHODS We reviewed the records of the first 500 cases of abdominal wall hernia operations performed using commercial mesh since year 2007. Socio-demographic characteristics, hernia type, method of repair and outcome data were analyzed and presented as descriptive statistics. RESULTS The first 500 cases of mesh hernia repairs were performed between 2007 and 2017 during which a total of 1,175 hernia operations were carried out, mesh repair accounting for 42.5% of the total. There was a progressive rise in the uptake of mesh repairs over time, with mesh repairs overtaking tissue based repairs in the last few years of the review. Inguinal hernia was by far the commonest indication for mesh use (80.4%), followed by incisional hernia (9%). Polypropylene mesh was the most common type of mesh used in about 96.2% of cases. Overall, there were seven recurrences (1.4%) at a mean follow-up period of 15.3 months (1-108 months) CONCLUSION: In spite of resource limitations, the use of mesh for hernia repairs continues to rise and has overtaken tissue-based repairs in a sub-Saharan African setting. Results show good outcomes justifying continued use.
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Affiliation(s)
- E A Agbakwuru
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
| | - O Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria.
| | - C I Onyeze
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
| | - A C Etonyeaku
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
| | - A O Mosanya
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
| | - F O Wuraola
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
| | - A A Akinkuolie
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
| | - A A Aderounmu
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
| | - A O Adisa
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, PMB 5538, Ile-Ife, Nigeria
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13
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Adisa AO. Exploring ways of Expanding access to minimal access Surgeries in Nigeria - A Review. West Afr J Med 2019; 36:43-47. [PMID: 30924115] [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: 06/09/2023]
Abstract
The practice of laparoscopy and other forms of minimal access surgery is currently limited in Nigeria, with only a few tertiary public and some private hospitals offering the services. There are several benefits of laparoscopy some of which are extremely important for patients in our setting and equally beneficial to our healthcare system. The different barriers to the practice are reviewed in this article and solutions proffered to enhance increased adoption of laparoscopy in surgical practice across the country. DISCLOSURE: An oral presentation of the abstract of this ndreview was made at the 102 Annual Clinical Congress of the American College of Surgeons held in Washington, DC, 16-20 October 2016.
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Affiliation(s)
- A O Adisa
- Department of Surgery, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife
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14
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Akinyamoju AO, Adeyemi BF, Adisa AO, Okoli CN. Audit of Oral Histopathology Service at a Nigerian Tertiary Institution over a 24-Year Period. Ethiop J Health Sci 2018; 27:383-392. [PMID: 29217940 PMCID: PMC5615027 DOI: 10.4314/ejhs.v27i4.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/17/2022] Open
Abstract
Background Biopsies are often essential for definitive diagnosis of oro-facial lesions and are a part of oral diagnostic procedures carried out in histopathology laboratories. At present, there is paucity of literature on the audit of oral histopathology services in Nigeria. The objectives of this study were to determine the prevalence of biopsied oral lesions in a Nigerian tertiary institution. Also to profile the usage of oral pathology service and to identify challenges that may be present in an oral histodiagnostic service. Methods This was a retrospective study performed at the Oral Pathology Department of the University of Ibadan/ University College Hospital, Ibadan, Nigeria. Reports of all biopsies submitted at the Oral Pathology laboratory, for the period 1990-2014, were reviewed and data extracted. Descriptive analysis was done using SPSS software, version 20. Results The total number of reports was 1,998; invalid reports constituting 220(11%) were subsequently excluded leaving 1,778(89%) valid reports. The mean age of patients was 36.70±19.79, while the peak age of presentation was in the 3rd decade. Male to female ratio was 1:1.1, and the mandible was the most common site of lesions 619(34.8%). These services were mainly utilized by oral surgeons (83.9%) and ameloblastoma (11.5%) was the most frequently diagnosed lesion. CD45 (16.7%) was the most frequently requested immuno-diagnostic test. Conclusion Biopsied oral lesions were more prevalent in females, while oral and maxillofacial surgeons utilized these services the most. Inadequate biopsy specimens or unrepresentative specimens and deficient documentation were challenges identified in this study.
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Affiliation(s)
- Akindayo O Akinyamoju
- Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan/University College Hospital Ibadan, Nigeria
| | - Bukola F Adeyemi
- Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan/University College Hospital Ibadan, Nigeria
| | - Akinyele O Adisa
- Department of Oral Pathology, Faculty of Dentistry, College of Medicine, University of Ibadan/University College Hospital Ibadan, Nigeria
| | - Chidinma N Okoli
- Department of Oral Pathology, University College Hospital, Ibadan, Nigeria
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Udeabor SE, Adisa AO, Orlowska A, Sader RA, Ghanaati S. Tumor-associated macrophages, angiogenesis, and tumor cell migration in oral squamous cell carcinoma. Ann Afr Med 2018; 16:181-185. [PMID: 29063902 PMCID: PMC5676408 DOI: 10.4103/aam.aam_8_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective: To investigate the relationship between tumor-associated macrophages (TAMs), neovascularization, and tumor cell migration in oral squamous cell carcinoma (OSCC) of an African subpopulation. Materials and Methods: Twenty OSCC paraffin blocks underwent immunohistochemistry to TAM1 (CCR7), TAM2 (CD206), Twist, E-cadherin, N-cadherin, and CD34. The relative percentage of CCR7 + and CD206 + cells to overall immune cell population was calculated for three high power fields and an average was taken. TAM-related microvessel density (MVD) was determined as the mean of the three recorded values. Cases that had no CD34 + vessels adjacent to the TAMs region were regarded as having an MVD score of 0. Results: Ten cases (50%) expressed greater CCR7 activity than CD206, seven cases (35%) expressed approximately equal activity of CCR7 and CD206, while three cases (15%) expressed greater activity of CD206 than CCR7. Twist expression was strong in some cases with strong N-cadherin and weak E-cadherin, but the expression of Twist was not consistently high in all cases that expressed strong N-cadherin and weak E-cadherin. Conclusions: TAMs distribution suggested antitumor activity and the potential for tumor metastasis was only partly due to Twist-mediated epithelial–mesenchymal transition.
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Affiliation(s)
- Samuel E Udeabor
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia; Frankfurt Orofacial Regenerative Lab, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of Goethe University Frankfurt am Main, Germany
| | - Akinyele O Adisa
- Frankfurt Orofacial Regenerative Lab, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of Goethe University Frankfurt am Main, Germany; Department of Oral Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Anna Orlowska
- Frankfurt Orofacial Regenerative Lab, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of Goethe University Frankfurt am Main, Germany
| | - Robert A Sader
- Frankfurt Orofacial Regenerative Lab, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of Goethe University Frankfurt am Main, Germany
| | - Shahram Ghanaati
- Frankfurt Orofacial Regenerative Lab, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of Goethe University Frankfurt am Main, Germany
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Alatise OI, Komolafe MA, Agbakwuru EA, Adisa AO, Amusa YB. Percutaneous Endoscopic Gastrostomy in Ile-Ife, Nigeria:An Initial Report. West Afr J Med 2018; 35:47-52. [PMID: 29607479] [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: 06/08/2023]
Abstract
BACKGROUND Protein-energy malnutrition is a common problem in critically ill patient and it is a major cause of accelerated morbidity and mortality in this group of patients. Recent dramatic advances in both enteral and parenteral nutritional support have ensured that most of these critically ill patients are adequately nutritionally supported. Unfortunately, most of these advancements in nutritional supports are far from the reach of most patients in developing countries. In this report, we highlighted the indications, success, challenges of the use of percutaneous endoscopic gastrostomy (PEG) in Nigeria patients. PATIENTS AND METHODS All cases of PEG performed at the Endoscopy Unit of Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Osun State from January 2011 and June 2012 were recruited into the study. The data obtained included the sociodemographic parameters, indication and duration of the procedure, complications, and follow up. RESULTS During the 18 months study period 645 upper gastrointestinal endoscopic procedures were performed. Majority [601(93.2%)] of the cases were for diagnostic purposes. Six (0.9%) cases of PEG were performed. Most (5 of 6) of the patients had central nervous system impairment while only one had severe chronic facial infection with naso-oral fistula. The median age of patients was 60.5 years. The entire procedure including endoscopy lasted an average of 25 minutes with a range of 12-35 minutes. Only one case had peristoma infection which resolved with antibiotics and repeated dressing with povidone iodine. There was no episode of aspiration pneumonitis or procedure related mortality. The average follow up was 6 months with variable weight gain during the follow up period. CONCLUSION PEG is a simple, cost effective and safe method to rehabilitate nutritionally all chronically ill patients in less developed countries such as Nigeria. The need to increase awareness and acceptability of PEG among physicians managing such patients and the society cannot be overemphasized.
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Affiliation(s)
- O I Alatise
- Department of surgery,Obafemi Awolowo University Teaching Hospital Complex, PMB 5538, Ile-Ife, Osun State, Nigeria
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Adisa AO, Udeabor SE, Orlowska A, Sader RA, Ghanaati S. Evaluation of Tumour Associated Macrophages and Angiogenesis in Ameloblastoma. J Clin Diagn Res 2017; 11:ZC33-ZC35. [PMID: 29207829 PMCID: PMC5713851 DOI: 10.7860/jcdr/2017/28067.10568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/17/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Ameloblastoma is a locally invasive odontogenic neoplasm that has a high recurrence rate. The invasion of adjacent tissue is supported by angiogenesis stimulated by Tumour-Associated Macrophages (TAMs). TAMs are macrophages modified in the milieu of the tumour microenvironment and have very weak or no ability to present antigens. Thus, there is collaboration between the tumour and the tumour microenvironment to maintain tumour enlargement. TAMs exist as the classically activated M1 macrophages that possess antitumour activity and the otherwise activated M2 macrophages that support tumour invasion and metastasis. AIM To investigate the relative expression and topography of TAMs and CD34 in ameloblastoma in order to assess their affiliation and effect on tumour growth. MATERIALS AND METHODS Forty-six Formalin Fixed Paraffin Embedded (FFPE) blocks of ameloblastoma were processed for Abcam Mouse monoclonal Anti-CCR7 antibody, Abcam Rabbit polyclonal Anti-CD206 antibody and Dako Mouse monoclonal Anti-CD34 antibody QBEnd-10. Cytoplasmic/membrane brown staining was taken as positive for all antibodies. The relative percentage of TAMs was classified as: <5%, 5-25%, 25-50% and >50%. TAMs related Microvessel Density (MVD) was evaluated as the mean of the three-recorded values. Cases with no CD34+ vessels adjacent to the TAMs region had MVD score of 0. Simple descriptive statistics was applied. RESULTS Macrophages adjacent to peri-tumour islands were marked by CD206 and CCR7 and we noted negligible intra-tumour presence of positive macrophages. The percentage of positive CCR7 immune cells was greater than that for CD206 in 38 (82.6%) cases, approximately equal to CD206 in 6 (13%) cases, and the CD206 expression was more than CCR7 in only 2 (4.3%) cases. In 34 (73.9%) cases, the area of MVD did not overlap with the region of TAMs but in 4 (8.7%) cases (where MVD overlapped TAM1), the average MVD score was 20. CONCLUSION The relative percentage of TAM1 exceeds TAM2 in peri-tumoural areas of ameloblastoma, conferring anti-angiogenic and hence anti-tumour activity on the tumour.
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Affiliation(s)
- Akinyele O Adisa
- Senior Lecturer, Department of Oral Pathology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Samuel E Udeabor
- Assistant Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Anna Orlowska
- Research Fellow, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Medical Center of Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | - Robert A Sader
- Professor, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Medical Center of Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | - Shahram Ghanaati
- Associate Professor, Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Medical Center of Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
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Olasehinde O, Lawal OO, Agbakwuru EA, Adisa AO, Alatise OI, Arowolo OA, Adesunkanmi ARK, Etonyeaku AC. Comparing Lichtenstein with darning for inguinal hernia repair in an African population. Hernia 2016; 20:667-74. [PMID: 27146504 DOI: 10.1007/s10029-016-1498-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 04/22/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Being a relatively new entrant into our practice, mesh repair has not been compared with previously existing tissue-based techniques in our setting. This study is set out to compare darning with Lichtenstein technique of inguinal hernia repair in terms of frequency of post-operative complications, recovery and cost. METHOD Patients with uncomplicated, primary inguinal hernia were randomized to have their hernias repaired either by the Lichtenstein or darning technique. Details of their socio-demographic, hernia characteristics and intra-operative findings were recorded. Postoperatively patients were assessed for pain, wound site complications and recurrence. Both direct and indirect costs were calculated. Mean duration of follow-up was 7.5 months. RESULT Sixty-seven patients were studied. Thirty-three had Lichtenstein repair while 34 had darning repair. Lichtenstein repair was associated with less post-operative pain, less analgesic requirement, and shorter time of return to work activities, these were all statistically significant (p < 0.05). Frequency of post-operative complications was comparable in both groups with wound haematoma and scrotal oedema being the commonest. There was no recurrence in any of the groups. Total cost was comparable between the two groups. CONCLUSION Lichtenstein is superior to darning in terms of post-operative recovery while both techniques are comparable in terms of frequency of early post-operative complications and total cost.
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Affiliation(s)
- O Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria.
| | - O O Lawal
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria
| | - E A Agbakwuru
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria
| | - A O Adisa
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria
| | - O I Alatise
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria
| | - O A Arowolo
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria
| | - A R K Adesunkanmi
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria
| | - A C Etonyeaku
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals, PMB 5538, Ile-Ife, Nigeria
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Agaku IT, Adisa AO. Nativity status and oral cancer survival in the United States: implications for dental clinical practice. Quintessence Int 2016; 45:355-9. [PMID: 24570998 DOI: 10.3290/j.qi.a31344] [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: 11/06/2022]
Abstract
OBJECTIVE Nativity status is a major determinant of health and healthcare access in the United States. This study compared oral squamous cell carcinoma (OSCC) survival between US-born and foreign-born patients. METHOD AND MATERIALS Data were obtained from the 1988-2008 Surveillance, Epidemiology and End Results database. A Cox proportional hazards multivariate model was used to assess the eff ect of birthplace on OSCC survival, adjusting for other sociodemographic and clinical covariates. RESULTS US-born patients had a higher median survival time (19.3 years; 95% confidence interval [CI]: 18.6-19.7) compared to foreign-born patients (10.7 years; 95% CI: 10.1-11.3). After adjusting for other factors, being born in the US conferred a modest protective eff ect from OSCC mortality (hazard ratio [HR] = 0.93, 95% CI: 0.87- 0.99). Other factors that conferred better survival included involvement of paired structures (HR = 0.65; 95% CI: 0.58- 0.74), lip involvement rather than tongue lesions (HR = 0.76; 95% CI: 0.71-0.82), and receipt of either surgery (HR = 0.89; 95% CI: 0.84-0.94) or radiation therapy (HR = 0.92; 95% CI: 0.87-0.97). CONCLUSION US-born patients had significantly better OSCC survival compared to their foreign-born counterparts. This underscores the need for enhanced and sustained efforts to improve access to healthcare among immigrant populations. In addition, oral health professionals such as general dentists, oral pathologists, and oral surgeons providing care to immigrant patients should ensure that reasonable efforts are made to communicate effectively with patients with language barriers, especially in high-stake conditions such as cancer. This may help increase such patients' awareness of treatment provided and the critical issues regarding cancer care, resulting in enhanced treatment outcome.
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Titloye NA, Foster A, Omoniyi-Esan GO, Komolafe AO, Daramola AO, Adeoye OA, Adisa AO, Manoharan A, Pathak D, D'Cruz MN, Alizadeh Y, Lewis PD, Shaaban AM. Histological Features and Tissue Microarray Taxonomy of Nigerian Breast Cancer Reveal Predominance of the High-Grade Triple-Negative Phenotype. Pathobiology 2016; 83:24-32. [PMID: 26730581 DOI: 10.1159/000441949] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 10/26/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Little is known about the biology, molecular profile and hence optimal treatment of African Nigerian breast cancer. The aim of this work, therefore, was to characterize the histology and molecular profile of Nigerian breast cancer. METHODS Breast carcinomas from women at 6 centres of similar tribal origin in Nigeria were reviewed and assembled into tissue microarrays (TMAs), and sections were stained for hormone receptors, i.e. estrogen receptor (ER)α, ERβ1, ERβ progesterone receptor (PR) and androgen receptor, cyclin D, HER2, Ki67 and cytokeratins (CKs), i.e. CK5/6 and CK14 (basal) and CK18 and 19 (luminal). RESULTS A total of 835 tumours were analysed. The mean age at diagnosis was 48.62 ± 12.41 years. The most common histological subtype was ductal NST (no-special-type) carcinoma (87.3%). Over 90% of the tumours were grade 2 or 3. The predominant molecular phenotype was the non-basal, triple-negative type (47.65%) followed by the HER2-positive group (19.6%). The percentage of ER-, PR- and HER2-positive tumours was 22.4, 18.9 and 18.8%, respectively. CONCLUSION Nigerian breast cancer predominantly has a high-grade, triple-negative profile. It occurs at a younger age and bears similarities at the molecular level to pre-menopausal breast cancer in white women, with remarkably lower levels of ERβ expression. The early presentation and histological and molecular phenotype may explain the poor prognosis, and tailoring treatment strategies to target this unique profile are required.
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Affiliation(s)
- N A Titloye
- School of Medical Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Abstract
BACKGROUND It is occasionally difficult to distinguish the stellate reticulum-like region of ameloblastoma from the fibrous connective tissue stroma. This difficulty is further pronounced in the plexiform variant of ameloblastoma that has very sparse fibrous connective tissue. AIM To test the utility of Azan trichrome stain in marking tumour regions and the peri-tumour environment of ameloblastoma. MATERIALS AND METHODS Sections were prepared for 18 formalin fixed paraffin-embedded blocks of ameloblastoma cases and stained with Azan trichrome stain according to the manufacturer's specification. RESULTS AND CONCLUSIONS The tumour areas were stained mostly brown, with the ameloblasts mainly marked as deep brown while the stellate reticulum-like region was light brown. The structures in the peri-tumour region were marked with different shades of blue. Azan trichrome staining was able to distinguish between the fibrous connective tissue and the stellate reticulum-like areas in 100% of the cases.
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Affiliation(s)
| | | | | | | | - Shahram Ghanaati
- Department of Oral, Cranio Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main; REPAIR Lab, Institute of Pathology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
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Adisa AO, Udeabor SE, Adeyemi BF, Alica K, Booms P, Ghanaati S, Sader RA. Relative expression of α-smooth muscle actin and matrix metalloproteinases-2 in ameloblastoma of a black African sub-population. Ann Afr Med 2015; 14:188-92. [PMID: 26470744 DOI: 10.4103/1596-3519.152075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Ameloblastoma although a benign odontogenic tumor, is locally invasive. The abundant presence of myofibroblasts (marked by α-smooth muscle actin [α-SMA]) in the stroma and expression of matrix metalloproteinase-2 (MMP-2) in the neoplastic or stromal cells have been linked with the tumor's ability for both local and distant spread. We aim to estimate the relative expression of α-SMA and MMP-2 in ameloblastoma from a black African subgroup to gauge their relative potential for enhancing local invasiveness and hence, their prospects as possible chemotherapeutic targets. MATERIALS AND METHODS Twenty-five formalin-fixed paraffin-embedded blocks of ameloblastoma cases from Nigeria were prepared for antibody processing to α-SMA (Dako Monoclonal Mouse Anti-Human α-SMA antibody clone 1A4) and MMP-2 (Abcam Mouse Monoclonal Anti-MMP-2 antibody [CA-4001/CA719E3C] ab3158). The score for percentage positivity of the tumor cells and the score for staining intensities were then multiplied in order to generate an immunoreactive score. RESULTS α-smooth muscle actin was only expressed in the fibrous connective tissues adjacent to the tumor islands while MMP-2 was expressed in the ameloblasts, stellate reticulum, and the connective tissues in varying proportions. All the variants analyzed expressed α-SMA mildly or moderately, except for the follicular variant that either did not express α-SMA or expressed it mildly. The highest number of strong immunoreactivity to MMP-2 in the ameloblast region was found in the plexiform variant. CONCLUSION Chemotherapeutic targeting of both molecules may, therefore, be a vital step in the control of local ameloblastoma invasiveness.
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Affiliation(s)
| | | | | | | | | | - Shahram Ghanaati
- Department for Oral Cranio Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany; REPAIR Laboratory Institute of Pathology, University Medical Center, Johannes Gutenberg University, Mainz, Germany,
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Abstract
Background: Hand-sewn gastrointestinal anastomoses has been the traditional approach to gastrointestinal anastomosis in Nigeria while stapled anastomoses are infrequently performed in few centers. Objectives: To describe the outcome of our initial experience with stapled gastrointestinal anastomoses in a semi-urban patient population. Patients and Methods: Consecutive patients who had stapled gastrointestinal anastomoses between January 2011 and June 2014 in a Nigerian tertiary hospital were prospectively evaluated. Indications for operation, procedures performed and anastomoses constructed and postoperative outcome of each patient were documented. Results: Nineteen patients including seven males and 12 females had stapled anastomoses within the period. Their ages ranged between 41 and 68 (mean 52.5) years. Six (31.6%) Roux-en-Y gastrojejunostomies, 6 (31.6%) ileo-colic, 3 (15.8%) ileo-ileal, 2 (10.5%) colo-colic, and 2 (10.5%) colo-anal anastomoses were performed. Indications include antral gastric cancer in 4 (21.1%), right colon cancer 4 (21.1%), ileal perforations in 3 (15.8%) while 2 (10.5%) each had left colon cancer, common bile duct obstruction, rectal cancer and ruptured appendix. Mean duration of operation was 108 ± 46 min and mean duration of postoperative stay was 5 ± 2.6 days. No intraoperative complications were recorded and no anastomotic leakage occurred. At a median follow-up of 5 months no staple related stricture had occurred. Conclusions: Stapled gastrointestinal anastomoses are associated with a good outcome in our center. We propose a prospective, large-population randomized comparison of the technique with hand-sewn anastomoses.
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Affiliation(s)
- A O Adisa
- Department of Surgery, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, 220005, Nigeria
| | - O Olasehinde
- Department of Surgery, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, 220005, Nigeria
| | - O A Arowolo
- Department of Surgery, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, 220005, Nigeria
| | - O I Alatise
- Department of Surgery, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, 220005, Nigeria
| | - E A Agbakwuru
- Department of Surgery, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, 220005, Nigeria
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Akinyamoju AO, Adisa AO. Non-surgical extraction of a massive sialolith in the Wharton's duct of a Nigerian. Afr J Med Med Sci 2015; 44:177-180. [PMID: 26937532] [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: 06/05/2023]
Abstract
BACKGROUND Sialolithiasis is the most common salivary gland disorder characterized by calculi formation within the gland and/or its duct. The submandibular gland is most frequently affected due to the peculiar anatomy of the duct and the nature of its secretion. Varying sizes have been described for salivary calculi and unusually large sialoliths measuring above 3.5cm have been reported. Similarly, a few giant sialoliths have been reported in Africans. We therefore report the case of a large sialolith in the Wharton's duct of a Nigerian male. CASE PRESENTATION AND MANAGEMENT: A 54 year old Nigerian man presented with a hard, painless, left floor of mouth swelling of one year duration. There were recurrent episodes of moderate pain at meal times. Intraoral examination revealed a hard, mobile, non tender, creamy mass on the left side of the floor of the mouth protruding out of the Wharton's duct orifice. A lower occlusal radiograph revealed a large radio-opacity in the floor of the mouth and a diagnosis of left submandibular sialolithiasis was made. The sialolith was removed non-surgically and measured 4.4 cm by 1.8 cm. The patient was discharged and follow up period was uneventful. CONCLUSION Large sialoliths are rarely reported in Africans, non-surgical extraction can be attempted for accessible and mobile sialoliths after full evaluation. Complex cases should be referred to the oral and maxillofacial surgeon.
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Agaku IT, Olutola BG, Adisa AO, Obadan EM, Vardavas CI. Association between unmet dental needs and school absenteeism because of illness or injury among U.S. school children and adolescents aged 6-17 years, 2011-2012. Prev Med 2015; 72:83-8. [PMID: 25575801 DOI: 10.1016/j.ypmed.2014.12.037] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 11/08/2014] [Accepted: 12/29/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND We assessed the prevalence of dental disease among U.S. children and adolescents aged 6-17 years, as well as the impact of unmet dental needs on school absenteeism because of illness/injury within the past 12 months. METHODS Data were from the 2011/2012 National Survey of Children's Health (n=65,680). Unmet dental need was defined as lack of access to appropriate and timely preventive or therapeutic dental healthcare when needed within the past 12 months. The impact of unmet dental needs on school absenteeism was measured using a multivariate generalized linear model with Poisson probability distribution (p<0.05). RESULTS Within the past 12 months, 21.8% (10.8 million) of all U.S. children and adolescents aged 6-17 years had "a toothache, decayed teeth, or unfilled cavities." Of all U.S. children and adolescents aged 6-17 years, 15.8% (7.8 million) reported any unmet dental need (i.e., preventive and/or therapeutic dental need) within the past 12 months. The mean number of days of school absence because of illness/injury was higher among students with an unmet therapeutic dental need in the presence of a dental condition compared to those reporting no unmet dental need (β=0.25; p<0.001). CONCLUSIONS Enhanced and sustained efforts are needed to increase access to dental services among underserved U.S. children and adolescents.
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Affiliation(s)
- Israel T Agaku
- Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA, USA.
| | - Bukola G Olutola
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Akinyele O Adisa
- Department of Oral Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Enihomo M Obadan
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Constantine I Vardavas
- Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA, USA
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Olasehinde O, Adisa AO, Aderibigbe AS, Alatise OL, Etonyeaku AC, Adesunkanmi AR, Agbakwuru EA. Pattern and outcome of traumatic gastro- intestinal injuries in ile-ife. Niger Postgrad Med J 2015; 22:37-40. [PMID: 25875410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIMS AND OBJECTIVES Trauma continues to assume a prominent role in the cause of disease in the developing world with increased westernization. This study highlights the pattern, management and outcome of gastrointestinal injuries following abdominal trauma in our hospital. PATIENTS AND METHODS A descriptive retrospective study of all patients who had laparotomy following abdominal trauma at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife between January 2008 and April 2013. RESULTS A total of 120 patients had laparotomy following abdominal trauma. Forty- five patients comprising 41 males and 4 females whose ages ranged between 14 and 65 years had gastrointestinal injuries. Majority (68.9%) were in the third and fourth decades with penetrating injury occurring in 55.6% .Causes of injury included gunshots (44.4%), road traffic accidents (37.8%), stabs (8.9%), falls (6.7%) and impalement (2.2%). The small intestine was the commonest site of injury (57.8 %) irrespective of the mechanism. Gut perforations accounted for 71.1% of all injuries. Two-thirds of patients had other associated injuries with retroperitoneal trauma being the commonest associated intra-abdominal injury. Majority (44.4%) had bowel resection and anastomosis with surgical site infection recorded in 35.6%. Overall mortality was 6.7% and this was significantly associated with pre-operative blood transfusion (p<0.05). CONCLUSION Gut perforations from gunshot especially of the small intestine are the commonest gastro-intestinal injury in our setting. Pre-operative blood transfusion, perhaps indicating severity of injury, implies poor prognosis.
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Affiliation(s)
- O Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
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Agaku IT, Adisa AO, Omaduvie UT, Vardavas CI. The relationship between proximity of tobacco retail outlets to schools and tobacco use among school personnel in sub-Saharan Africa. Prev Med 2014; 69:21-7. [PMID: 25152505 DOI: 10.1016/j.ypmed.2014.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 08/08/2014] [Accepted: 08/11/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND We investigated the impact of proximity of tobacco retail outlets to schools on tobacco-related behavior and attitudes of school personnel in sub-Saharan Africa. METHODS A pooled analysis of the 2006-2011 Global School Personnel Surveys from 19 sub-Saharan African countries was performed (n=12,201). Multivariate logistic regression analyses were applied to measure the relationship between proximity of tobacco outlets to school premises and school personnel's tobacco-related behavior and attitudes (p<0.05). RESULTS Among all school personnel, there was a significant association between the presence of tobacco outlets on school premises and current cigarette smoking (adjusted odds ratio [aOR]=3.89; 95% confidence interval [CI]: 2.17-7.20), current smokeless tobacco use (aOR=2.63; 95%CI: 1.04-6.65), and permissiveness towards tobacco industry sponsorship activities in school (aOR=2.27; 95%CI: 1.37-3.78). Complete smoke-free school policies were associated with lower odds of current cigarette smoking (aOR=0.42; 95%CI: 0.23-0.74), but were not significantly associated with current smokeless tobacco use. Among lifetime any tobacco users, there was a significant association between the presence of tobacco outlets on school premises and use of combustible (aOR=2.03; 95%CI: 1.09-3.75) and smokeless (aOR=3.85; 95%CI: 1.51-9.81) tobacco products on campus within the past year. CONCLUSIONS Policies limiting the distance of tobacco outlets from schools, coupled with complete tobacco-free school policies may reduce tobacco use among school personnel.
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Affiliation(s)
- Israel T Agaku
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA.
| | | | | | - Constantine I Vardavas
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA
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Omonisi AE, Adisa AO, Olaofe OO, Omoniyi-Esan GO, Olasode BJ. Carcinoma head of the pancreas masquerading as hepatocellular carcinoma: a case report. Niger J Med 2014; 23:355-357. [PMID: 25470865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Cancer of the pancreas is the primary malignant tumour of the pancreas commonly seen in the elderly. Hepatitis B virus infection is not a known marker of the disease, but patient with carcinoma head of the pancreas presenting with epigastric mass with positive hepatitis B infection in the region of the world with high endemicity for hepatitis B virus infection may cause diagnostic pitfall. OBJECTIVE To present a case of carcinoma head of the pancreas masqueradingas hepatocellular carcinoma METHODS A review of the case note, autopsy findings including gross and microscopic examinations and literature was done. RESULTS An elderly woman with history of weight loss and cigarette smoking.There was an epigastric mass and the liver was enlarged. The serum hepatitis B antigen was positive. Autopsy revealed an ill-defined mass in the head of the pancreas with metastasis to the liver. CONCLUSION Things are not always what they seem.
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Olasehinde O, Owojuyigbe AM, Adisa AO, Awowole IO. Incidental finding of complete situs inversus in a polytraumatized adult. Afr J Med Med Sci 2014; 43:183-186. [PMID: 25474996] [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: 06/04/2023]
Abstract
BACKGROUND Situs inversus is a rare abnormality typically posing a diagnostic dilemma during routine evaluation of acute abdominal emergencies such as in acute appendicitis and cholecystitis. It is rare to detect such in the setting of trauma. OBJECTIVE To report an incidental finding of complete situs inversus in a poly-traumatized adult. METHODS The clinical records of the patient including preoperative evaluation, intra-operative findings and postoperative care were reviewed. RESULT A 53 year old man presented with difficulty breathing, left sided chest pain, generalized abdominal pain and distension 18 hours after a vehicular road traffic accident. Examination revealed features of left sided haemothorax, absent heart sounds, generalized peritonitis and limb injuries. Plain chest radiograph confirmed left haemothorax with dextrocardia. He had a left closed thoracostomy tube drainage and exploratory laparotomy which revealed complete situs inversus of intra-abdominal organs alongside a jejunal perforation which was repaired. Postoperative recovery was uneventful. CONCLUSION Complete situs inversus is uncommon and may not be anticipated in evaluation of trauma patients. Preoperative clinical and radiological evaluation may however be helpful in making a pre-operative diagnosis and further management.
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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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Olasehinde O, Aderibigbe AS, Akinkuolie AA, Adisa AO, Ajenifuja KO, Aladesuru OA, Oyekunle O. Torsion of wandering spleen, an unusual cause of acute abdomen; a report of two cases. Afr J Med Med Sci 2014; 43:75-78. [PMID: 25335381] [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: 06/04/2023]
Abstract
BACKGROUND Wandering spleen is an uncommon entity that is rarely considered in the evaluation of patients with acute abdominal conditions. OBJECTIVE To report two cases of wandering spleen presenting with acute abdominal pain. METHODS The clinical records of the patients including preoperative evaluation, intra-operative findings and postoperative care were reviewed RESULT A 6 year old boy presented with right lumbar pain which worsened over a 36 hour period with findings of a tender right lumbar mass. Abdominal ultrasound showed a mass with echogenicity consistent with that of the spleen with no blood flow and an empty splenic bed. The pre-operative diagnosis was torsion of a wandering spleen. The second case was that of a 42 year old woman who presented with severe colicky lower abdominal pain which worsened over three days with a background history of progressively increasing lower abdominal mass which was tender and about 26 week gestational size at presentation. The initial diagnosis was torsion of an ovarian cyst. Abdomino-pelvic Ultrasound scan showed a heterogeneously hypo-echoic mass overlying the uterus and the left ovary with no blood flow. The presence of wandering spleen with torsion of the vascular pedicle was confirmed at laparotomy in both instances. Splenectomy was performed in both cases with good recovery. CONCLUSION Torsion of a wandering spleen poses a diagnostic challenge. A high level of suspicion is required to make a diagnosis and institute appropriate treatment.
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Lawal AO, Adisa AO, Kolude B, Adeyemi BF, Olajide MA. A review of 413 salivary gland tumours in the head and neck region. J Clin Exp Dent 2013; 5:e218-22. [PMID: 24455085 PMCID: PMC3892266 DOI: 10.4317/jced.51143] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 05/07/2013] [Accepted: 08/12/2013] [Indexed: 11/05/2022] Open
Abstract
Objectives: Salivary gland tumours (SGTs) are a group of heterogeneous lesions with complex clinico-pathological characteristics and distinct biological behaviours. Previous studies have reported geographic variations in site distribution, incidence and histological types of SGTs. The aim of this study was to describe the demography of SGTs seen at a tertiary health centre and compare findings with previous studies.
Study design: Data on SGTs from archives of the Department of Oral Pathology and the Department of Pathology, University College Hospital Ibadan were retrieved. Information about histological types, age, sex and location were analyzed using SPSS for Window (version 20.0; SPSS Inc. Chicago, IL). Reactive and tumor-like lesions such as sialometaplasia, benign lymphoepithelial lesion, lymphoepithelial cyst, mucocele, mucous extravasation phenomenon, ranula, and sialosis were excluded from the study.
Results: 413 SGTs consisting of 221 (53.5%) malignant and 192 (46.5%) benign lesions were seen. SGTs occurred more in females (50.6%) than males (49.4%) with a mean age of 43.7 (±16.9) years and peak age in the fifth decade of life. The parotid with 171 (41.4%) cases was the commonest site, followed by palate with 89 (21.5%) cases, while only 7(1.7%) cases were seen in sublingual gland. Pleomorphic adenoma with 169 (40.9%) was the most frequent SGT followed by adenoid cystic carcinoma with 93 (22.5%) cases which also was the most frequent malignant SGT while only 3 (0.7%) cases of Warthin’s tumour were seen.
Conclusion: This report is one of few that showed a higher occurrence of malignant SGTs compared to their benign counterparts. The findings were essentially similar to findings in Africa but showed SGTs to be more common in females. The reason(s) for high occurrence of malignant SGTs in minor salivary glands and the rarity of Warthins tumour in this study and other African series compared to those from America needs further investigation.
Key words:Salivary gland tumours, parotid gland, pleomorphic adenoma, adenoid cystic carcinoma, warthin’s tumour.
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Affiliation(s)
- Ahmed O Lawal
- FMCDS, Lecturer/Consultant. Department of Oral Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Akinyele O Adisa
- FMCDS, Lecturer/Consultant. Department of Oral Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Bamidele Kolude
- FWACS, Lecturer/Consultant. Department of Oral Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Bukola F Adeyemi
- FWACS, Lecturer/Consultant. Department of Oral Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Mofoluwaso A Olajide
- BDS, Senior Registrar. Department of Oral Pathology, University College Hospital, Ibadan, Nigeria
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Akinyamoju AO, Adeyemi BF, Kolude B, Adisa AO. Histological grading of oral squamous cell carcinoma patients in Ibadan using Bryne's and Broders' grading systems--a comparative study. Afr J Med Med Sci 2013; 42:333-337. [PMID: 24839737] [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: 06/03/2023]
Abstract
BACKGROUND Several histological grading systems for oral squamous cell carcinoma (OSCC) have been used previously to guide treatment and prognostication, amongst which are the Broders and the Bryne's methods. The Bryne's invasive tumour front (ITF) protocol has been adjudged to have good prognostic significance. We compared the use of Bryne's ITF system and Broders' grading system in grading OSCC at our centre in relation to clinico-demographic profile of patients. METHODS Thirty two formalin fixed paraffin embedded (FFPE) tissue samples of histologically diagnosed OSCC patients at the University College Hospital (UCH) Ibadan were selected, demographic data and site of lesions were retrieved from the medical records of the patients. The haematoxylin and eosin (H&E) slides of the 32 cases were prepared and evaluated using Bryne's ITF system and Broders classification. RESULTS Using Bryne's system, 28% of the cases had a high malignancy score while 72% had a low malignancy score. The high malignancy score lesions were most commonly seen in the palate (15.5%). Also Broders classification showed that 31.3% of cases were well differentiated tumours, 50% were moderately differentiated while 18.7% were poorly differentiated. CONCLUSION Either the Bryne's system or Broders classification can be used to grade OSCC with similar results being obtained.
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Abstract
UNLABELLED This study assessed trends in current frequent smoking among United States middle and high school students. METHODS Data were obtained from the National Youth Tobacco Survey (2000-2011). Current frequent smoking was defined as smoking cigarettes on ≥20 days during the past 30 days. Trends were assessed using linear coefficients in a binary logistic regression (p < 0.05). RESULTS Current frequent cigarette smoking among all students declined between 2000 (6.4%) and 2011 (3.6%) (p < 0.001 for linear trend). Significant declines were observed by age, sex, race/ethnicity, school and grade level. CONCLUSION Sustained efforts are needed to further reduce youth use of all tobacco products.
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Affiliation(s)
- Israel Terungwa Agaku
- 1Harvard School of Public Health, Center for Global Tobacco Control , Boston, Massachusetts , USA
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Arowolo OA, Lawal OO, Adisa AO, Adetiloye VA, Afolabi AI, Sowande OA. Adulthood hirschprung's disease: a report of 4 cases in Ile-Ife. Nigeria. Afr J Med Med Sci 2013; 42:277-282. [PMID: 24579391] [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: 06/03/2023]
Abstract
BACKGROUND Hirschsprung's disease in adulthood is very rare and is often misdiagnosed. We present four cases of adulthood Hirschsprung's disease seen in the last two decades to illustrate challenges accompanying its diagnosis and management. METHOD This descriptive case series included cases of histologically proven Hirschsprung's seen in adulthood at the Obafemi Awolowo University Teaching Hospitals Complex in the last two decades (1991-2011). The clinical data, radiological investigations, details of surgical treatment, histological diagnosis, outcomes and complications were analyzed. RESULT There were 4 adult patients, 3 males and 1 female with age ranging from 17 to 74 years (mean 23 years). Each patient presented with sub acute intestinal obstruction needing two staged procedures of initial colostomy followed by definitive procedure of low anterior resection (State procedure) in 3 patients and Swenson-Bill procedure in one. There was one mortality and good long term outcome in the remaining three. CONCLUSION This review presented the oldest patient presenting with adult Hirschsprung's and the highest mean age of any case series. Four patients with adulthood Hirschsprung's disease managed by two operative procedures enabled comparison of operative outcome with respect to complications and functional outcomes. Mortality seems to correlate with presentation at old age, which is usually due to life long self-management of chronic constipation. Though very rare, a high index of suspicion of adulthood Hirschprung's disease should be maintained in adult patients with recurrent chronic constipation needing lifelong laxative, enema or mechanical wash-out.
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Affiliation(s)
- O A Arowolo
- Department of Surgery, College of Health Sciences, Obafemi Awolowo University.
| | - O O Lawal
- Department of Surgery, College of Health Sciences, Obafemi Awolowo University
| | - A O Adisa
- Department of Surgery, College of Health Sciences, Obafemi Awolowo University
| | - V A Adetiloye
- Department of Radiology, College of Health Sciences, Obafemi Awolowo University
| | - A I Afolabi
- Obafemi Awolowo University Teaching Hospitals Complex, Ille-Ife, Nigeria
| | - O A Sowande
- Department of Surgery, College of Health Sciences, Obafemi Awolowo University
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Agaku IT, Adisa AO, Ayo-Yusuf OA, Connolly GN. Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers. J Am Med Inform Assoc 2013; 21:374-8. [PMID: 23975624 DOI: 10.1136/amiajnl-2013-002079] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [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: 11/03/2022] Open
Abstract
INTRODUCTION This study assessed the perceptions and behaviors of US adults about the security of their protected health information (PHI). METHODS The first cycle of the fourth wave of the Health Information National Trends Survey was analyzed to assess respondents' concerns about PHI breaches. Multivariate logistic regression was used to assess the effect of such concerns on disclosure of sensitive medical information to a healthcare professional (p<0.05). RESULTS Most respondents expressed concerns about data breach when their PHI was being transferred between healthcare professionals by fax (67.0%; 95% CI 64.2% to 69.8%) or electronically (64.5%; 95% CI 61.7% to 67.3%). About 12.3% (95% CI 10.8% to 13.8%) of respondents had ever withheld information from a healthcare provider because of security concerns. The likelihood of information withholding was higher among respondents who perceived they had very little say about how their medical records were used (adjusted OR=1.42; 95% CI 1.03 to 1.96). CONCLUSIONS This study underscores the need for enhanced measures to secure patients' PHI to avoid undermining their trust.
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Affiliation(s)
- Israel T Agaku
- Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, Massachusetts, USA
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Alatise OI, Komolafe MA, Agbakwuru EA, Adisa AO, Amusa YB. Percutaneous endoscopic gastrostomy in ile-ife, Nigeria: an initial report. West Afr J Med 2013; 32:190-195. [PMID: 24122684] [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: 06/02/2023]
Abstract
BACKGROUND Protein-energy malnutrition is a common problem in critically ill patient and it is a major cause of accelerated morbidity and mortality in this group of patients. Recent dramatic advances in both enteral and parenteral nutritional support have ensured that most of these critically ill patients are adequately nutritionally supported. Unfortunately, most of these advancements in nutritional supports are far from the reach of most patients in developing countries. In this report, we highlighted the indications, success, challenges of the use of percutaneous endoscopic gastrostomy (PEG) in Nigeria patients. PATIENTS AND METHODS All cases of PEG performed at the Endoscopy Unit of Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Osun State from January 2011 and June 2012 were recruited into the study. The data obtained included the sociodemographic parameters, indication and duration of the procedure, complications, and follow up. RESULTS During the 18 months study period 645 upper gastrointestinal endoscopic procedures were performed. Majority [601(93.2%)] of the cases were for diagnostic purposes. Six (0.9%) cases of PEG were performed. Most (5 of 6) of the patients had central nervous system impairment while only one had severe chronic facial infection with naso-oral fistula. The median age of patients was 60.5 years. The entire procedure including endoscopy lasted an average of 25 minutes with a range of 12-35 minutes. Only one case had peristoma infection which resolved with antibiotics and repeated dressing with povidone iodine. There was no episode of aspiration pneumonitis or procedure related mortality. The average follow up was 6 months with variable weight gain during the follow up period. CONCLUSION PEG is a simple, cost effective and safe method to rehabilitate nutritionally all chronically ill patients in less developed countries such as Nigeria. The need to increase awareness and acceptability of PEG among physicians managing such patients and the society cannot be overemphasized.
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Affiliation(s)
- O I Alatise
- Department of Surgery,Obafemi Awolowo University Teaching Hospital Complex, PMB 5538,Ile-Ife,Osun State,Nigeria
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Akinmoladun VI, Akintububo OB, Adisa AO, Ojo EO, Ayuba D. Evaluation of the histopathology of orofacial lesions in a North-East Nigerian tertiary centre. Ann Afr Med 2013; 12:105-9. [PMID: 23713017 DOI: 10.4103/1596-3519.112401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relative frequencies, types and site distribution of oro-facial lesions in a North-Eastern Nigerian tertiary centre. MATERIALS AND METHODS The records of the Departments of Oral-Dental Surgery and Pathology of a tertiary hospital in Nigeria were reviewed and analyzed for patients with oro-facial lesions during a seven year period (January, 2001 - December, 2007). The main outcome measures were patients' age and sex, histology assessment, tissue type and location. RESULTS A total of 102 (51.3%) benign lesions, 59 (29.6%) malignant lesions and 38 (19.1%) inflammatory/reactive lesions were seen. The common benign neoplasms were ameloblastoma (23.5%), fibrous dysplasia (15.7%) and pleomorphic adenoma (13.7%). The malignant lesions were mainly well differentiated squamous cell carcinomas (28.8%) and terminal duct carcinoma (11.9%). Inflammatory lesions comprised mainly of chronic osteomyelitis (15.8%) and non-specific chronic inflammatory lesions; giant cell granulomas, granulation tissues which constituted 10.5% each. [corrected] There were 104 (52.3%) males and 95 (47.7%) females giving a male: female ratio of 1.1:1. The mean age of the patients was 36.1(SD ± 18.9) years with a range of 1 to 85 years. Most tissue specimens were soft tissues (61.3%), while bone specimen accounted for 15.6% of all specimens analysed. There were 62 (31.2%) mandibular lesions, 24 (12.1%) palatal lesions and 15 (7.5%) parotid lesions, while maxillary antral lesions were the least, constituting only 0.5% of all lesions studied. [corrected]. CONCLUSION The range of diagnosed lesions from our study was diverse, though our results do not represent the actual prevalence of orofacial lesions within the general population, but simply reflect the frequency of histologically diagnosed lesions at a health center in North-East Nigeria. This survey has shown that most oro-facial lesions studied were benign neoplasms and that most of these neoplasms were from the mandible.
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Affiliation(s)
- V I Akinmoladun
- Department of Oral and Maxillofacial Surgery and Oral Pathology, University College Hospital, Ibadan, Nigeria
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Obimakinde OS, Taiwo OJ, Lawal AO, Adisa AO. OP229. Oral Oncol 2013. [DOI: 10.1016/j.oraloncology.2013.03.238] [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: 11/24/2022]
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Lawal AO, Kolude B, Adisa AO, Adeyemi BF. Oro-facial sarcomas: a review of 88 cases in a Tertiary Institution in Nigeria. West Afr J Med 2013; 32:106-109. [PMID: 23913497] [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: 06/02/2023]
Abstract
BACKGROUND A sarcoma is a malignant tumour arising from connective tissue. The word sarcoma is derived from the Greek word, sarkoma meaning fleshy growth and presents either as a soft tissue or bony tumour. Sarcomas are rare in the oro-facial region compared to oral squamous cell carcinoma. The rarity of jaw sarcomas makes diagnosis sometimes challenging and the anatomy makes aggressive treatment difficult without causing unacceptable physiological, functional and cosmetic damage to the patient. The aim of this study was to examine the demographic pattern of patients with jaw sarcomas seen at the University College Hospital, Ibadan, Nigeria over a thirty year period. METHODS All histologically diagnosed cases of sarcomas of the oro-facial region from the Cancer Registry of the University College Hospital Ibadan and the histology records of the department of Oral Pathology, University College Hospital Ibadan from 1980-2010 were reviewed. Data was analyzed using SPSS version 18. RESULTS Eighty eight oro-facial sarcomas were seen consisting of sixteen different histological types. Osteogenic sarcoma was the most common type with 40 cases (45.5%). Osteogenic sarcoma occurred more in females than males with a male: female ratio of 13:27 and a mean age of 32.2 years (SD ± 15.7). Embryonal rhabdomyosarcoma had an equal male: female distribution with mean age of 7.0 years (SD ± 5.2) and peak age incidence in the first decade. CONCLUSION The findings in this study were generally in agreement with reports from Europe, and though, at variance with some African studies, they are mostly in agreement with large African series.
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Affiliation(s)
- A O Lawal
- Department of Oral Pathology, College of Medicine, University of Ibadan
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Abstract
BACKGROUND Giant fibroadenoma of the breast is a rare benign breast tumour which seldom grows to a giant size, it is even rarer for this benign tumour to grow rapidly, ulcerate spontaneously and present like a fungating breast tumour in a way mimicking breast cancer. CASE PRESENTATION This is a presentation of a 14 year old premenarchal girl with a massive ulcerating and fungating left breast mass that was initially thought to be a fungating locally advanced breast carcinoma on clinical examination. Further examination of the morphology of the resected surgical specimen and histological examination confirmed it to be giant fibroadenoma of the breast. It was successfully managed by partial mastectomy and breast reconstruction with an excellent result and a high degree of patient satisfaction was achieved. CONCLUSION Though a rare clinical entity benign breast tumour can present like a fungating breast cancer and this must be bore in mind especially in young adolescent patients presenting with ulcerating breast tumour.
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Affiliation(s)
- O A Arowolo
- Department of Surgery, Obafemi Awolowo University Ile Ife, Osun State, Obafemi Nigeria.
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Olusanya AA, Adisa AO, Lawal AO, Arotiba JT. Gross surgical features and treatment outcome of ameloblastoma at a Nigerian tertiary hospital. Afr J Med Med Sci 2013; 42:59-64. [PMID: 23909095] [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: 06/02/2023]
Abstract
BACKGROUND Ameloblastoma is a benign odontogenic tumour which is locally infiltrative and may cause severe craniofacial deformities. Its epidemiology, clinical and histologic configurations are replete in local and international literature, but data about its gross surgical patterns and treatment outcome in Nigeria is sparse. We therefore describe the clinical, gross surgical configuration, histopathologic features and the outcome of management seen at a Nigerian tertiary hospital. METHODS Records of all histologically diagnosed Ameloblastoma from January 2000 to December 2011 at the University College Hospital, Ibadan, Nigeria, were retrieved from the departments of Oral and Maxillofacial Surgery and Oral Pathology. Patients' biodata, clinical, radiographical, gross surgical and histological features of the tumours, type of treatment, mode of jaw reconstruction and post-surgical follow up period data were documented. RESULTS One hundred and sixty-three ameloblastomas were diagnosed during the study period, only 92 had complete records and were therefore included in the study. The mean age was 34.2 years (+/- 14.25) and the male to female ratio was 1:1.1. Majority of the patients were in the low socioeconomic class (67.4%). Majority of the patients (76.5%) had segmental jaw resection and reconstruction was done mainly with non-vascularised iliac crest grafts. The gross surgical configurations were described as solid, cavitated and cystic. CONCLUSION Despite the locally aggressive nature of ameloblastoma, patients presented late for treatment and majority of them had segmental jaw resection as a mode of treatment. Three gross surgical configurations of the specimens were described.
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Affiliation(s)
- A A Olusanya
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Abstract
Objectives: The aim of this study was to examine the relative frequency of odontogenic tumours at a tertiary hospital in Ibadan, as well as to study the various histologic types based on WHO 2005 classification and to compare results from this study with those of previous studies.
Study design: The records of the Oral Pathology Department of University College Hospital were reviewed. Lesions diagnosed as odontogenic tumours were categorized into four groups based on WHO 2005 classification and were analyzed for age, sex and site using SPSS for Window (version 18.0; SPSS Inc. Chicago, IL) and frequency tables were generated.
Results: Two hundred and sixty six (41.7%) cases of odontogenic tumours were seen. The mean age of occurrence was 32.6 (±15.815) years (range3-82 years) and peak age was in the third decade of life. Eleven (4.1%) malignant odontogenic tumours were seen. Ameloblastoma with 65.4% of cases was the most common odontogenic tumour followed by fibromyxoma (14.7%), no case of odontoma was seen in this series.
Conclusion: The findings were mostly similar to those of African and Asian series and showed variations from reports from the Americas. The reason for the disparity in African and American series needs further investigations.
Key words:Odontogenic tumour, classification, Nigeria.
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Affiliation(s)
- Ahmed O Lawal
- FMCDS. Lecturer/Consultant. Department of Oral Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Akinyele O Adisa
- FMCDS. Lecturer/Consultant. Department of Oral Pathology, College of Medicine, University of Ibadan, Nigeria
| | - Adeola A Olusanya
- FMCDS. Lecturer/Consultant. Department of Oral and Maxillo-facial Surgery, College of Medicine, University of Ibadan, Nigeria
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Lasisi TJ, Adisa AO, Olusanya AA. Appraisal of jaw swellings in a Nigerian tertiary healthcare facility. J Clin Exp Dent 2013; 5:e42-7. [PMID: 24455050 PMCID: PMC3892236 DOI: 10.4317/jced.51011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 10/09/2012] [Accepted: 01/06/2013] [Indexed: 01/12/2023] Open
Abstract
Introduction: The mandible and maxilla can be the site of myriads of lesions that may be categorized as neoplastic, cystic, reactive and infective or inflammatory. Literature reviewing jaw swellings in an amalgamated fashion are uncommon, probably because aetiologies for these swellings are varied. However, to appreciate their relative relationship, it is essential to evaluate the clinico-pathologic profile of jaw swellings. The aim of this appraisal is to describe the array of jaw swellings seen at our hospital from 1990 to 2011, to serve as a reference database.
Material and Methods: Biopsy records of all histologically diagnosed cases of jaw swellings seen at the department of Oral Pathology, University College Hospital between January 1990 and December 2011 were retrieved, coded and inputted into SPSS version 20. Data on prevalence, age, sex, site and histological diagnosis were analysed descriptively for each category of jaw swellings. All patients below 16 years were regarded as children.
Results: A total of 638 jaw swellings were recorded in the 22-year study period. The Non Odontogenic Tumours (NOT) were the commonest, accounting for 46.2% of all jaw swellings. Odontogenic Tumours (OT) formed 45% of all adult jaw swelling while it formed 25.2% in children and adolescents. Ameloblastoma was the commonest while the most common NOT was ossifying fibroma (OF). Chronic osteomyelitis of the jaws was about 6 times commoner in adult females than males and mostly involved the mandible. The most common malignant jaw swelling was Burkitts’ lymphoma (BL) that was about 7 times more in children than adults. Osteogenic sarcoma was the most common malignancy in adults.
Conclusion: Jaw swellings are extensively varied in types and pattern of occurrence. This study has categorized jaw swellings in a simple but comprehensive fashion to allow for easy referencing in local and international data acquisition and epidemiological comparison.
Key words:Jaw swellings, odontogenic, Nigeria.
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Affiliation(s)
- Taye J Lasisi
- Lecturer/Consultant. Department of Oral Pathology, University of Ibadan/University College Hospital. Ibadan, Nigeria
| | - Akinyele O Adisa
- Lecturer/Consultant. Department of Oral Pathology, University of Ibadan/University College Hospital. Ibadan, Nigeria
| | - Adeola A Olusanya
- Lecturer/Consultant. Department of Oral and maxillofacial surgery, University of Ibadan/University College Hospital. Ibadan, Nigeria
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Arowolo OA, Akinkuolie AA, Adisa AO, Obonna GC, Olasode BJ. Neglected giant fibroadenoma of the breast presenting like a fungating breast cancer in a premenarchal Nigerian teenager. West Afr J Med 2012; 31:211-213. [PMID: 23310945] [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
BACKGROUND Giant fibroadenoma of the breast is a type of rare benign breast tumour which can grow to a giant size, It is even rarer for this benign tumour to grow rapidly, ulcerate spontaneously and present like a fungating breast tumour in a way mimicking breast cancer. Carcinoma of the breast on the other hand has been on the increase so much that it has assumed an epidemiological dimension. In developing country such as Nigeria late presentation of breast cancer has remained a rule rather than exception and it is very common for patient to present with fungating breast lesion. STUDY DESIGN This is a case presentation of a 14 year old premenarchal girl presenting with a massive ulcerating and fungating left breast mass that was initially thought to be a fungating locally advanced breast carcinoma on clinical examination. Further examination of the morphology of the resected surgical specimen and histological examination confirmed it to be giant fibroadenoma of the breast. RESULTS The giant fungating breast tumour successfully managed by partial mastectomy and breast reconstruction with an excellent result and a high degree of patient satisfaction was achieved. CONCLUSION Though a rare clinical entity benign breast tumour can present like a fungating breast cancer and this must be bore in mind especially in young adolescent patients presenting with ulcerating breast tumour.
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Affiliation(s)
- O A Arowolo
- Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile Ife , 220005 Osun State
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Lawal AO, Adisa AO, Olusanya AA, Adeyemi BF. "Hybrid" ameloblastoma: a report of two cases. Afr J Med Med Sci 2011; 40:413-415. [PMID: 22783694] [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: 06/01/2023]
Abstract
Ameloblastoma is the most common odontogenic tumour. The tumour has been described as a benign but locally invasive polymorphic neoplasm. Hybrid lesions have been described, which combine histological features of desmoplastic and conventional ameloblastoma. The hybrid ameloblastoma is rare and only few cases have been reported worldwide. We present two cases seen from a review of 195 ameloblastoma cases seen over a ten year period. The cases presented with clinical features of the conventional ameloblastoma such as bucco-lingual bone expansion and multilocular radiololucency. Larger clinical series of hybrid ameloblastoma need to be reviewed in order to better characterize the clinical behaviour, aggressiveness and prognosis of this rare variant of ameloblastoma.
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Affiliation(s)
- A O Lawal
- Department of Oral Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Adisa AO, Lawal OO, Arowolo OA, Akinola DO. Laparoscopic cholecystectomy in Ile-Ife, Nigeria. Afr J Med Med Sci 2011; 40:221-224. [PMID: 22428516] [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: 05/31/2023]
Abstract
BACKGROUND Laparoscopic cholecystectomy is not yet routinely performed in most public tertiary hospitals in Nigeria. OBJECTIVES To assess the feasibility and early outcoe of laparoscopic cholecystectoy in Ile-ife, Nigeria. METHOD Consecutive patients who were selected for the procedure from June 2009 through December 2010 at the Ife State Hospital of the ObafemiAwolowo University Teaching Hospitals Complex, Ile-Ife were prospectively studied. RESULTS Eighteen female (75%) and six male patients had laparoscopic cholecystectomy within the study period. They were aged 19-83 years with a mean age of 33.4 years. Six (25%) patients had acute calculous cholecystitis while the rest presented with chronic calculous cholecystitis. Their Body Mass Indices ranged from 21 to 32kg/m2. Operation time ranged from 65 to 105 minutes. One procedure (4%) was converted to open due to bleeding from the gallbladder bed. Another patient who had a minor common bile duct injury presented with generalized dull abdominal pain on the sixth postoperative day. She had open repair of the injury over a T-tube. Three patients (12.5%) were discharged on the first postoperative day while 15 (62.5%) others were discharged on the second postoperative day. No mortality was recorded. CONCLUSION Laparoscopic cholecystectomy is feasible in our setting with outcome comparable to previous pioneering experiences in other African countries centre in spite of resource limitations.
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Affiliation(s)
- A O Adisa
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Adisa AO, Lawal OO, Alatise OI, Adesunkanmi AR. An audit of laparoscopic surgeries in Ile-Ife, Nigeria. West Afr J Med 2011; 30:273-276. [PMID: 22669832] [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
BACKGROUND After several years of lagging behind due to several constraints, many general surgeons across Nigeria are now performing laparoscopic surgery. An audit of the procedure in our setting is required. OBJECTIVE To describe the outcome of consecutive laparoscopic general surgical procedures performed at the Obafemi Awolowo University Teaching Hospital, South-western Nigeria. METHODS All patients with general surgical conditions who had laparoscopic surgery from January 2009 through May 2010 in our hospital were prospectively studied and type of pre, intra and postoperative data including sex, age, indication for surgery, and outcome of the procedure were obtained and analysed. RESULTS Sixty-two patients (ages 18 to 72 years) had laparoscopic surgeries within the study period. Eighteen (29%) patients had laparoscopic cholecystectomy, 13 (21%) had laparoscopic appendicectomy, 10 (16.1%) had laparoscopic adhesiolysis, 7 (11.3%) laparoscopic biopsies of intraabdominal masses while 14(22.6%) others had diagnostic laparoscopies for a range of suspected abdominal conditions. All diagnostic procedures were performed as day cases while the duration of hospital stay was one to two days for the therapeutic procedures. Two(3%) procedures, including a biopsy of hepatic mass and a cholecystectomy were converted to open surgery due to significant haemorrhage. A minor bile duct injury was recorded in one patient who had cholecystectomy and superficial port site wound infections were noticed in two patients who had appendectomy. No mortality was recorded. CONCLUSION Our results show the feasibility of laparoscopic surgery in Nigeria. We advocate local adaptation and improvisations to increase the use of laparoscopic surgery in Nigerian hospitals.
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Affiliation(s)
- A O Adisa
- Department of Surgery, Obafemi Awolowo University, Ile-Ife 220005, Nigeria.
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Abstract
SUMMARY Florid cemento-osseous dysplasia (FCOD) is commonly seen in black women, but few cases have been reported in sub-Saharan Africa. This article presents two cases of FCOD seen at the University College Hospital Ibadan. Two women aged 70 and 60 years were initially diagnosed as chronic osteomyelitis but both were eventually diagnosed as florid cementoosseous dysplasia after radiological examination by orthopanthomogram. Diagnosis of florid cemento-osseous dysplasia is possible by clinical examination and the distinct radiological presentation, especially on orthopanthomogram and a biopsy may not be required.
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Affiliation(s)
- A O Lawal
- Department of Oral Pathology,College of Medicine, University of Ibadan, Nigeria
| | - A O Adisa
- Department of Oral Pathology,College of Medicine, University of Ibadan, Nigeria
| | - T J Lasisi
- Department of Oral Pathology, University College Hospital, Ibadan Nigeria
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Adisa AO, Arowolo OA, Akinkuolie AA, Titiloye NA, Alatise OI, Lawal OO, Adesunkanmi ARK. Metastatic breast cancer in a Nigerian tertiary hospital. Afr Health Sci 2011; 11:279-284. [PMID: 21857862 PMCID: PMC3158525] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome. OBJECTIVE To describe the pattern of clinical presentation and challenges of treating patients presenting with metastatic breast carcinoma in a Nigerian hospital. METHOD Clinical records of all patients who presented with metastatic breast carcinoma between January 1991 and December 2005 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were reviewed. RESULTS More than half of all histologically confirmed breast cancer patients seen within the study period presented with metastatic disease. Their ages ranged between 20-81 years with a mean age of 45.9 years. Only 3% (6 of 202) were males. Two-thirds had more than one secondary site on initial evaluation and the commonest sites were liver (63%), lung parenchyma (51%), pleura (26%) and contralateral breast in 25%. On immunohistochemistry, basal like tumours were found in 46.1%. Mastectomy was done in 37 patients with fungating breast masses while only one third of those referred to a nearby center for radiotherapy had it done. One year survival rate was 27%. CONCLUSION Metastatic disease is common in Nigeria and treatment is limited due to resource limitations. Improved awareness of the disease is advocated to reduce late presentation.
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Affiliation(s)
- A O Adisa
- Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
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