| 1 |
Author(s):
Agbo P.S., Oboirien M..
Page No : 1-8
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Risk Factors Associated with the Development of Colorectal Cancer in Sokoto, Nigeria
Abstract
Background: Colorectal cancer is a leading cause for patient presentation to surgical clinics worldwide. Risk factors and stage of disease presentation varies widely from different regions of the world. While sporadic cancers account for majority of cases in the general population, hereditary factors have assumed prominence in the etiopathogenesis of the disease in recent times due to advancement in molecular screening and diagnosis. In most developed economies disease presentation is early with better outcome compared to the low income countries of Africa and parts of Asia where it continues to carry poor prognosis as a result of late presentation. Aim: To determine the risk factors associated with development of colorectal cancer among adults presenting to the surgical clinic of a tertiary hospital in North-west Nigeria and highlight the predominant clinical stage of the disease. Method: A seven-year prospective study between 2012 and 2018 where consecutive patients presenting to our clinic with colorectal cancer were recruited and administered questionnaires to obtain information on demographics, clinical stage and risk factors. Results: A total of 109 patients were seen. Of this, 54.1% (59) were males while 45.9% (50) were females giving a male: female ratio of 1.2:1.0. The mean age was 44.7 years while the median age was 45.0 years. Fifty-one percent (56) of patients had no identifiable risk for colorectal cancer, 22.9%(25) admitted to excess intake of roasted beef and cheese, 11.0%(12) had positive family history of colorectal cancer, 5.5%(6) had history of familial adenomatous polyposis (FAP) confirmed by histology, 3.7% (4) were treated for colonic schistosomiasis in the past while ulcerative colitis, angiosarcoma and carcinoid tumor accounted for 1.8%(2) of risks each. Fifty-one percent (56) of patients presented with TNM stage III disease, 35.8% (39) with stage IV and 12.8% (14) with stage II. No patient was seen with stage I disease. Conclusion: Diet rich in animal fat and roasted beef together with family history constitutes important risks for colorectal cancer in this study. Majority of the patients were young and presented with late disease.
| 2 |
Author(s):
S.P. Agbo, U. Mukhtar.
Page No : 9-17
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Evaluation of Auchincloss’ Modified Radical Mastectomy in the Management of Advanced Breast Cancer
Abstract
Background: Mastectomy for breast cancer has progressed from radical approaches in the past to the breast conservative therapies (BCT) of today. Less invasive procedures followed by axillary dissection or radiotherapy achieves better cosmetic and similar prognostic outcome than radical approaches. Auchincloss modified radical mastectomy was originally described for level 1 and 2 axillary node dissection but has since been extended to include level 3 node clearance with variable results. Majority of our patients present late with level 2 and 3 axillary node involvement thereby making BCT impracticable. Aim: To evaluate effectiveness of Auchincloss’ modified radical mastectomy in loco-regional control of stages II and III breast cancer. Method: We recruited consecutive patients presenting to the surgical clinic of our hospital with breast cancer between 2017 and 2018 and administered questionnaires for demographics and clinical stage. They were subsequently counseled and offered mastectomy. Results A total of 51 patients were seen. All were females. Age range was between 30 and 70 years. Mean age was 46.8 years; median age 47 years while modal age was 47 years. One patient (1.96%) presented with stage IIB disease, 27 patients (52.94%) with stage IIIA, 8 patients (15.69%) with stage IIIB and 15 patients (29.41%) with stage IIIC disease. Three patients (5.88%) developed postoperative wound infection, 2 patients (3.85%) arm edema, 1 patient (1.96%) axillary node recurrence, 1 patient (1.96%) local chest wall recurrence and 2 patients (3.85%) developed seroma. Forty-two patients (82.35%) had no reportable post-operative complication. Conclusion: Auchincloss’ modified radical mastectomy is effective in loco-regional control of advanced breast cancer.
| 3 |
Author(s):
Ifunanya R. Akaniro , Augustine O. Odibo.
Page No : 18-28
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Analysis of the Phytochemical Composition of three Selected Fruits: Musa Acuminata, Malus Domestica and Citrus Paradisi
Abstract
Phytochemicals are gaining interests globally in recent times due to their wide range of medicinal importance. The main objective of this study was to evaluate the phytochemical contents of fruits; Musa acuminata, Malus domestica and Citrus paradisi. Preliminary screening involved the use of qualitative methods to detect the presence of alkaloids, saponins, steroidal saponins, phenols, terpenoids, flavonoids, tannins, carbohydrates, proteins, deoxy sugars, reducing sugars. Quantitative estimation of the phytochemicals was done using standard procedures. Qualitative analysis carried out showed that; alkaloids, tannins, phenols, saponins and flavonoids were present in all the three fruits. Highest quantities of alkaloids were obtained in Musa acuminata (70.49 mg/g) and Citrus paradisi (43.19 mg/g). Citrus paradisi (0.45 mg/g) and Musa acuminata (0.42 mg/g) contained more saponins than Malus domestica (0.38 mg/g). Flavonoid was more in Citrus paradisi (10.02 mg/g) and Musa acuminata (6.51 mg/g). Citrus paradisi showed the highest content of phenol (7.11 mg/g) while Musa acuminata and Malus domestica recorded more tannin content of 6.03 mg/g and 2.28 mg/g respectively. Relatively, highest percentage occurrences of phytochemicals were as follows; alkaloids (82.35%), flavonoids (7.61%) and tannins (7.04%) in Musa acuminata, alkaloids (53.44%), phenols (24.52%) and flavonoids (10.85%) in Malus domestica and alkaloids (70.02%), flavonoids (16.25%) and phenols (11.52%) in Citrus paradisi. This study shows that these fruits could be sources for the exploitation of phytochemicals beneficial in food, cosme-ceutical, pharmaceutical and alternative medicine industries.
| 4 |
Author(s):
Mathias Tiedemann Svendsen (PhD), Georg Authried.
Page No : 29-35
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The Many Faces of Lyme Borreliosis: A Retrospective Study Covering an 18-year Period
Abstract
Lyme borreliosis is a bacterial infection caused by Borrelia burgdorferi transferred by the bite of the tick Ixodes. The disease Lyme borreliosis can affect many organs and therefor has many different clinical manifestations. In order to describe the many clinical manifestations and prescribed treatments in a real-life setting, a retrospective chart review of Lyme borreliosis cases covering an 18-year period was conducted at a large Scandinavian dermatological university department. A total of 69 patients were included. Patients’ mean age of time of diagnosis was 45 years, with a mean duration of symptoms of 9 months at time of diagnosis. Most patients presented with erythema migrans (56%), but acrodermatitis chronica atrophicans was also common and found in 41% of cases. All parts of the skin integument were affected, the most common being the lower extremity (57% of cases). On serological testing, most patients were IgG positive (41%), and the majority of patients were treated with penicillin V (82%). Lyme borreliosis and its many appearences should be known by all clinicians, since it has potentially severe multisystems manifestations, which can easily be avoided if a sufficient early curative treatment with antibiotics is prescribed.
| 5 |
Author(s):
Etah E. Nkanu, Kayode Dasofunjo, Kebe Obeten.
Page No : 36-45
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Acetaminophen Intake and Taxifolin Supplementation Alters IL-6, TNF-α and Troponin Levels in Wistar Rats
Abstract
Acetaminophen is an organic compound that is commonly used as an antipyretic and analgesic drug. Acetamenophen may cause liver injury and cardiac dysfunction because of complex cardiohepatic interactions.The aim of this study is to assess the possible effect of acetamenophen intake and taxifolin supplementation on some cardiovascular risk factors like tumour necrosis factor-alpha(TNF-α), interleukin-6(IL-6), troponin, and lipid profile in Wistar rats. Four groups of Wistar rats containing five rats each were used. Group 1(control) received normal feed and water. Group 2 received 500mg/kg body weight of acetaminophen(ACTMP), group 3 received 500mg/kg of ACTMP and 1mg/kg body weight of taxifolin (TXF) orally. Group 4 received 1mg/kg of TXF. Feeding and treatment lasted for 5 weeks. Blood samples were collected through cardiac puncture into blood sample bottles and centrifuged to obtain serum. Interleukin-6, troponin and TNF-α concentrations were determined using ELISA kits and following manufacturers procedures. Results showed that tumor necrosis factor-alpha (TNF-α), IL-6 and troponin in ACTMP were significantly(p<0.05) higher than control while lactate dehydrogenase(LDH) was reduced in ACTMP. Lipid profile was significantly (p<0.05) reduced in ACTMP. Treatment with taxifolin significantly (p<0.01) lowered IL-6, troponin, and LDH. We conclude that Acetamenophen intake may alter serum level of IL-6, TNF-α and troponin which are risk factors of cardiotoxicity while taxifolin has little or no effect on TNF-α and troponin but may suppress IL-6 activity.
| 6 |
Author(s):
Ngozi Uzoekwe M., Jared D. S.
Page No : 46-54
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Effects of Aqueous Leaf Extract of Funtumia elastica on Blood and Organs of an Experimental Rat
Abstract
Funtumia elastica has been used for centuries in traditional medicine in many parts of the world. To validate its use in traditional medicine, the present study was carried out to determine the effect of Funtumia elastica on haematological and biochemical parameters of rat. The animals were divided into 4 groups of 3 rats each. Group A, B and C were orally administered with aqueous extract of Funtumia elastica at doses 250, 500 and 750mg/kg/bw, group D served as control. The extracts were administered for 7 days. Haematological assay was carried out using auto reader PC 210 Erma (Japan) and biochemical parameter assay was carried out using RANDOX kit. The organs were preserved in formalin solution, stained with haematoxylin and eosin and viewed under microscope. The animals showed no symptom of toxicity. The results showed the effects of the extraction haematological and biochemical parameters, but all values were within the normal range. Although statistically there was a significant (P < 0.05) increase in AST level and decrease in ALT and ALP levels compared to control, there was slight decrease in WBC level and an increase in RBC, Hb and Hct level. Therefore, use of the extracts at these doses though not toxic to the organs but could alter haematological and biochemical parameters.
| 7 |
Author(s):
Akinmoladun J.A., Adebayo B.E..
Page No : 55-59
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Soft Markers in the Prenatal Sonographic Diagnosis of Edwards Syndrome: A Case Report
Abstract
Trisomy 18, also known as Edwards syndrome, is the second most common autosomal trisomy after trisomy 21. It is a severe syndrome with a high neonatal and infant mortality and the management of the affected babies is usually challenging. With the advent of prenatal screening for congenital anomalies, some sonographic findings termed soft markers have been linked with the syndrome. If these soft markers are detected during ultrasound scanning, further scanning should be done to rule out other structural anomalies and karyotyping should be offered to the mother for confirmation. Once the diagnosis is made and the mother counselled on the severity of the syndrome, an informed decision could then be made. We present a foetus with ultrasound findings of two soft markers- choroid plexus cysts and echogenic bowel - with associated congenital heart disease during prenatal ultrasound screening. Genetic studies after delivery confirmed trisomy 18.
| 8 |
Author(s):
Friday Emeakpor Ogbetere.
Page No : 60-66
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Large Inguinoscrotal Hernia in an Infant Presenting in Obstruction: A Case Report and Review of Reasons for Delayed Presentation
Abstract
An inguinal hernia is a common pathology requiring surgical treatment in infants and children. However, an inguinoscrotal hernia is less common when compared to an inguinal hernia and much under-reported in the medical literature. The majority of inguinoscrotal hernias in infants present without complications as anxious parents usually bring them early for treatment. In rare cases, however, patients may be brought due to complications. In this case report, a one-year-old boy was brought to the accident and emergency room with a giant swelling involving the left groin and the left hemiscrotum. Clinical examination revealed an irreducible left inguinoscrotal swelling with features suggestive of intestinal obstruction. During surgery, a large closed-loop obstructed bowel was found and successfully reduced. This case report highlights a relatively rare mode of presentation of a common groin pathology and provided a unique opportunity to evaluate the reasons for delayed presentation of patients with inguinoscrotal hernias in the West African subregion.
| 9 |
Author(s):
Agbo P.S., Oboirien M., Etuk B.E..
Page No : 67-77
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Breast Diseases in Sokoto, North-Western Nigeria
Abstract
The Usmanu Danfodiyo university teaching hospital is a regional tertiary center serving the North-western states of Sokoto, Zamfara, and Kebbi. It occasionally receives patients from neighboring Niger state. In recent times the hospital has recorded an increased number of patients presenting with breast diseases due perhaps to the following factors: increased patient awareness, increased number of trained personnel, improvement in diagnostic facilities, and the referral system. Unfortunately, the majority of the patients with malignant breast diseases present late with attendant poor outcomes. And with the rising patient population and dwindling finances, an idea of the spectrum of breast diseases and its burden in a resource-limited country like Nigeria will greatly enhance policy formulations to meet the challenges of providing quality health care for the people. Objectives: (i) To determine the clinical and histo-pathological pattern of breast diseases in Sokoto, Nigeria. (ii) To highlight the most frequently encountered histological subtype of breast lesions in this sub-region. Methodology: A prospective recruitment of consecutive patients with breast diseases presenting to the surgical clinic of the Usmanu Danfodiyo university teaching hospital, Sokoto, between 2014 and 2018 was carried out. Data obtained from administered questionnaires included socio-demographic characteristics and histopathological diagnosis. The results were analyzed using the windows SPSS statistics 20.0. Results: A total of 1822 patients with breast diseases were seen. This was made up of 1006 (55.2%) benign cases and 816 (44.8%) malignant cases. There was a relative annual increase in the number of cases of breast diseases seen over the five-year study period with 280 cases seen in 2014 and 430 cases seen in 2018. The overall male: female ratio for breast diseases was 1:304. Fibroadenoma accounted for 95.4% (960) of all cases of benign breast lesions seen, followed respectively by fibrocystic disease 1.8% (18), breast abscess 0.8% (8), duct papilloma 0.5% (5), duct ectasia 0.2% (2) and breast tuberculosis 0.1% (1). Fifty-one percent (488) of cases of fibroadenoma occurred between the ages of 11-20 years, while 42.8% (411) occurred between ages 21-30 years giving a mean age range of 21-30 years. Sixty-one percent (11) of fibrocystic disease occurred between ages 30-40 years. Invasive ductal carcinoma was the most commonly diagnosed malignant breast lesion accounting for 98% (800) of all malignant diseases. Invasive lobular carcinoma followed at 1.5% (12). Forty-five percent (362) of invasive ductal carcinoma occurred between the 41-50year age group. Conclusion: Fibroadenoma constitutes 95.4% (960) of benign breast diseases in Sokoto with a mean age range of 21-30 years followed by fibrocystic disease at 1.8% (18). Invasive ductal carcinoma constitutes 98% (800) of malignant breast diseases with a peak age range of 41-50 years followed by invasive lobular carcinoma at 1.5% (12).
