Squamous papillomas of the conjunctiva: A retrospective clinicopathological study

Background: There is very limited literature on squamous papillomas of the conjunctiva from Nigeria and sub-Saharan Africa. In an attempt to contribute to the literature on the subject, we studied the clinicopathological characteristics of patients histologically diagnosed with squamous papilloma of the conjunctiva in Ibadan, Nigeria. Materials and Methods: Clinical and pathological records of patients with histological diagnosis of squamous papilloma of the conjunctiva made in the Department of Pathology, University College Hospital, Ibadan, between January 1985 and December 2004, were reviewed. Results: There were totally 26 cases. Patients’ ages ranged from 2 to 58 years with a mean age of 32 years. Male to female ratio was 1.4:1. Size of tumors ranged from 2 to 10 mm. Duration of presenting complaints was from 2 months to 10 years. The lesions in 10 cases were located in the medial canthus, at or close to the limbus in another 10 cases, and in the tarsal conjunctiva in a single case. Five cases had no documentation of location. Sixteen cases (61.5%) had multiple papillomas. Four cases had a history of chemical injury (alkaline based – hair relaxer in a single case, acid based – wet cell car battery fluid in two cases, and unknown chemical in a single case) preceding the lesion by at least 6 weeks. Fourteen cases had koilocytosis on histology suggestive of Human Papilloma Virus (HPV) etiology. HIV screening test was negative in the three patients who had the screening done. Preoperative clinical diagnosis was squamous papilloma in 16 cases, pterygium in 6 cases and squamous cell carcinoma in 2 cases. Conclusion: In the environment where we practice, conjunctival squamous papilloma occurs most commonly in the fourth decade of life. Only very few cases are submitted for histological diagnosis. HPV infection and chemical injury are the main etiology. We strongly advocate that all excisions of the conjunctiva, irrespective of the clinical impression, should be submitted routinely for histological assessment.Keywords: Squamous, papillomas, conjunctivaNigerian Journal of Clinical Practice • Jan-Mar 2012 • Vol 15 • Issue

The effect of vitamin supplementation on the toxic effects of dichlorvos on the microanatomy of rat hippocampal formation

Dichlorvos (DDVP) is a widely used pesticide that is toxic to animals and humans but study of its effect on the microanatomy of the brain is scanty. This study was designed to investigate the ameliorating effect of vitamin supplementation on DDVP-induced neurotoxicity in the hippocampus of Wistar rats. 25 male Wistar rats were separated into unexposed group and those exposed to DDVP (1000 mg/L) through inhalation either without, or with vitamin E, vitamin C or red palm oil supplementation. Treatment lasted for 14 days after which rats were sacrificed by ketamine anaesthesia. Hippocampal biopsies were processed into paraffin blocks and H&E stained sections were evaluated by light microscopy. DDVP administration elicited toxicity in the dentate gyrus, cornuammonis1 (CA1) and cornuammonis 3 (CA3) regions. There was pyknosis and alteration of the microanatomy of dentate granule cells and pyramidal cells of CA1 and CA3. DDVP-induced toxicity was mitigated by vitamins E, C and red palm oil in the dentate gyrus, but partially in CA1 and CA3. Inhalational DDVP induces toxicity in the hippocampus of rats and this could affect memory. Toxicity of DDVP is partially ameliorated by vitamins E, C and red palm oil.Keywords: Dichlorvos, dentate gyrus, cornuammonis, hippocampus, red palm oil

Serum antioxidant vitamins and the risk of oral cancer in patients seen at a tertiary institution in Nigeria

Objectives: Tobacco and alcohol are major risk factors of oral cancer, but nutritional deficiency may also contribute to development of oral cancer. This study compared serum antioxidant vitamin levels in oral cancer patients and controls in order to validate the role of vitamin deficiencies in the etiology of oral cancer. Materials and Methods: Serum vitamin A, C, and E levels of 33 oral cancer patients and 30 controls at University College Hospital, Ibadan, Nigeria, were determined using standard methods. The data obtained were analyzed using the Student t‑test, odds ratio, and logistic regression. Results: Mean vitamin A, C, and E levels were significantly lower in oral cancer patients (P=0.022, P=0.000, and P=0.013 respectively). Risk of oral cancer was 10.89, 11.35, and 5.6 times more in patients with low serum vitamins A, C, and E, respectively. However, on logistic regression analysis, only low serum vitamin E independently predicted occurrence of oral cancer. Conclusions: The lower serum vitamin A, C, and E levels in oral cancer patients could be either a cause or an effect of the oral cancer. Further studies using a larger sample size and cohort studies with long‑term follow‑up of subjects are desirable.Keywords: Antioxidant vitamins, Nigeria, oral cancer riskNigerian Journal of Clinical Practice •Jan-Mar 2012 • Vol 15 • Issue

Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa

<p>Abstract</p> <p>Background</p> <p>African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade.</p> <p>Results</p> <p>Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks.</p> <p>Conclusion</p> <p>The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.</p

Impact of health system challenges on prostate cancer control: health care experiences in Nigeria

Prostate cancer is the second most frequently diagnosed cancer of men (913 000 new cases, 13.8% of the total) and the fifth most common cancer overall. Prostate cancer is the sixth leading cause of death from cancer in men (6.1% of the total)

Cancer mortality patterns in Ghana: a 10-year review of autopsies and hospital mortality

BACKGROUND: Cancer mortality pattern in Ghana has not been reviewed since 1953, and there are no population-based data available for cancer morbidity and mortality patterns in Ghana due to the absence of a population-based cancer registry anywhere in the country. METHODS: A retrospective review of autopsy records of Department of Pathology, and medical certificate of cause of death books from all the wards of the Korle-Bu Teaching Hospital (KBTH), Accra, Ghana during the 10-year period 1991–2000 was done. RESULTS: The present study reviews 3659 cancer deaths at the KBTH over the 10-year period. The male-to-female ratio was 1.2:1. The mean age for females was 46.5 [Standard Deviation (SD), 20.8] years, whilst that of males was 47.8 (SD, 22.2) years. The median age was 48 years for females and 50 years for males.Both sexes showed a first peak in childhood, a drop in adolescence and young adulthood, and a second peak in the middle ages followed by a fall in the elderly, with the second peak occurring a decade earlier in females than in males. The commonest cause of cancer death in females was malignancies of the breast [Age-Standardized Cancer Ratio (ASCAR), 17.24%], followed closely by haematopoietic organs (14.69%), liver (10.97%) and cervix (8.47%). Whilst in males, the highest mortality was from the liver (21.15%), followed by prostate (17.35%), haematopoietic organs (15.57%), and stomach (7.26%). CONCLUSION: Considering the little information available on cancer patterns in Ghana, this combined autopsy and death certification data from the largest tertiary hospital is of considerable value in providing reliable information on the cancer patterns in Ghana

Review of prostate cancer research in Nigeria

Prostate cancer (CaP) disparities in the black man calls for concerted research efforts. This review explores the trend and focus of CaP research activities in Nigeria, one of the ancestral nations for black men. It seeks to locate the place of the Nigerian research environment in the global progress on CaP disparities. Literature was reviewed mainly through a Pubmed search with the terms “prostate cancer”and “Nigeria”, as well as from internet and hard copies of journal pages

Histopathological Diagnosis of Fungal Infections: Problems and Prospects

Fungal infections (mycoses) are world wide in distribution and the incidence is expected to rise especially as HIV/AIDS and other chronic debilitating medical conditions and immunosuppressive therapies are prevalent in recent times, therefore prompt and accurate diagnosis of mycosis will reduce the morbidity and mortality associated with fungal infections. Histopathology is a major diagnostic tool in mycology and has the advantage of rapid diagnosis, cost effectiveness, ability to provide initial identification of the infecting fungus and demonstrates tissue reactions and currently the means of diagnosing the infections caused by the fungi: Lodoa loboi and Rhinosporidium seeberi. The problem of diagnosing fungal infections using histopathology include: late request for histopathological diagnosis due to late presentation of the patients, low index of suspicion by the clinicians and delay in getting surgical biopsy; limitations of Haematoxylin and Eosin (H&amp;E) in morphological identificationof fungal organisms especially when few organisms are present or distorted and masked by tissue reactions; problems of specificity and sensitivity of histochemistry and immuhistochemistry in fungal diagnosis. The prospects of maximizing the benefits and potentials of histopathology in the diagnosis of mycoses lies in the prompt requests in all suspected cases, use of H&amp;E, histochemical stains like Gomori&rsquo; methenamine silver stain (GMS), Periodic Acid Schiff (PAS), and highly specific and sensitive monoclonal based immunohistochemistry. It is concluded that the problems not with standing the prospects are encouraging with improved technological innovations.Key words: Histopathological Diagnosis Fungal Infection

Keratoameloblastoma of the mandible

Keratoameloblastoma is a very rare ameloblastoma variant defined by extensive squamous metaplasia and keratinization. There are 13 previously reported cases in the literature, with a male predilection of 3:1. A 38-year-old male presented with a painless mandibular swelling which had been progressively increasing in size for 18 months. The incisional biopsy was misdiagnosed as basaloid squamous carcinoma. Owing to financial constraints, the patient had mandibular resection a decade after first noticing the growth, during which the clinical course was essentially benign, thus casting doubt on the initial diagnosis. The final histological diagnosis for both the incisional and resection biopsy specimens was keratoameloblastoma