Testicular and paratesticular non- neoplastic lesions in university of maiduguri teaching hospital: a 10-year retrospective review

Objectives: The present study is undertaken to describe the spectrum of histopathological features and age distribution of non-neoplastic testicular and paratesticular lesions in the University of Maiduguri Teaching Hospital (UMTH). Materials and methods: A retrospective descriptive study of 70 testicular and paratesticular nonneoplastic lesions was conducted over a period of 10 years; between January-2005 and December2014 in the Department of Histopathology, UMTH. Histopathological examination was done after routine processing and staining with Haematoxylin and Eosin. Special stain (Ziehl-Neelsen stain) was done to confirm the presence of acid fast bacilli in cases of tuberculous epididymoorchitis. Results: There were of which (24.3%) followed by testicular torsion and infarction (14.3%). The youngest patient was 2 years old and the oldest was 80 years of age. The highest incidence occurred in the age range of 30 ­ 59 years with a total of 25 cases representing 35.7%. The lowest incidence was observed in the elderly (= 60 years) with a total of 21 cases (30%). Conclusion: This study shows that inflammatory disorders are the predominant causes of the testicular and paratesticular non-neoplastic lesions capable of interfering with fertility and mimicking malignancy. There is also the need to emphasise the necessity of proper evaluation and treatment of acute orchitis and microabscess to avoid unnecessary orchidectomy.70 cases of non-neoplastic testicular and paratesticular lesions the majority were inflammatory disorders accounting for 53 cases (75.7%). They included acute orchitis (4.3%), tuberculosis (12.9%), schistosomiasis (8.6%), hydrocoele (24.3%), chronic orchitis (10.0%), epididymal cyst (11.4%) and tumoral calcinosis (4.3%). Other categories of the lesions included congenital abnormalities (10.0%) and traumatic disorder (14.3%). Long-standing hydrocoele was the commonest lesion

Renal Cancer in Maiduguri: an 8-Year Review of Clinico-Pathological Pattern

Background: Primary renal cancer accounts for 10 - 20of all genito-urinary tract malignancies. The present study determined its clinico-pathological pattern and outcome of management. Methods: All patients with malignancies of the kidney seen between January 1999 and December 2007 were included in the study. These patients had surgery alone or in combination with preoperative/postoperative chemotherapy or radiotherapy and all specimens were confirmed malignant on histopathological examination. Results: Forty-nine patients with renal malignancies were seen of which 26(55.1) were males and 23(44.9) were females. The adults comprised 30(61.2) and children 19(38.8). The mean age was 27.60 +/- 22.12 years (range 7months-70 years). The male: female ratio was 1.1:1 and the mean duration of symptoms was 12.56 months (range 1-48 months). The most frequent clinical features were loin pain; 17 (44.7); and flank mass; 32(84.2). Others included haematuria; 13(34.2); fever; 19(50.0) and anaemia; 15(39.5). The main diagnostic investigations were ultrasonography and intravenous urography. Forty-seven (95.9) patients underwent radical unilateral nephrectomy and 2(4.1) had debulking or lymph node biopsies because of non-resectable tumours. These two had chemotherapy and subsequent nephrectomy. The most frequent renal malignancy was renal cell carcinoma (44.9) followed by nephroblastoma (38.8) which accounted for all the childhood renal tumours. All the children with nephroblastoma had postoperative 17(89.5) or preoperative 2(10.5) combination chemotherapy. Common postoperative complications included anaemia; fever; and chest and wound infections. There were 3 known deaths (mortality rate of 6.1). The main cause of death was advanced malignancy. Conclusions: Renal cell carcinoma is the most frequent malignant tumour of the kidney in the study population. Late presentation resulted in in-operable tumours with poor survival despite neo-adjuvant chemotherapy

The Use of Cervical Smear in the Diagnosis of Genital Tract Infections at a University Teaching Hospital

Background: Genital tract infections such as Gardnerella vaginalis vaginosis; trichomoniasis and candidiasis have continued to assume immense importance because of the particular unique features of their main causative organisms - Gardnerella vaginalis; Trichomonas vaginalis and Candida albicans; and myriads of clinical and pathological changes in affected persons. Aim: To investigate the prevalence of Gardnerella vaginalis; Candida albicans and Trichomonas vaginalis in randomly selected sexually active women and the influence of some socioeconomic and demographic factors on the prevalence of these genital infections. Methods: The subjects were 450 randomly selected sexually active women attending antenatal; postnatal; gynaecology and family planning clinics in the Department of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital from April 2001 to May 2002. The Pap smear of these patients were examined microscopically for evidence of Candida albicans; Gardnerella vaginalis and Trichomonas vaginalis. A questionnaire assessing sociodemographic characteristics of the patients were administered. Results: Sixty six (66) of the 450 patients studied had specific infections giving a prevalence rate of 14.7. Candida albicans; Gardnerella vaginalis; Trichomonas vaginalis and Candida albicans in conjunction with gardnerella vaginalis contributed 7.1; 5.1; 2.4and 1.8respectively to this overall prevalence. Age range of 15-20 years had the highest prevalence of each of the infections; but this association with age was not statistically significant (P0.05). The prevalence of each of the infections was highest among students and was lowest among housewives and business executives. These differences were statistically significant (P = 0.034). The prevalence of these genital infections increased with increasing educational level; being lowest among those with no formal and primary education and highest in the patients with post-secondary educational qualifications. This difference was statistically significant (P = 0.034; c2 for linear trend = 0.90). About 36.5) of the married women tested had evidence of genital infections compared to 41.6of the women who were not currently married; this difference was not statistically significant (P0.05). Conclusion: This study has shown that cervical cytology is of definite value in the diagnosis of some genital tract infections especially in low resource setting

The Influence of Marital Factors on Genital Human Papilloma Virus Infection

Aim: To study the association between marital factors and human papilloma virus (HPV) infection of the cervix. Method: The subjects were 450 randomly selected sexually active women attending the antenatal; postnatal; gynaecology and family planning clinics in the Department of Obstetrics and Gynaecology of the University of Maiduguri Teaching Hospital; Nigeria between April 2001 to May 2002. The Pap smear of these patients were examined microscopically for evidence of HPV infection. A questionnaire assessing various marital characteristics of the patients were administered. Result: Abnormal smears occurred in 245 (54.5) of the patients screened. Forty eight women (10.7) had HPV associated changes constituting 19.6of all abnormal smears. Their ages ranged between 15 and 64 years; with a mean of 26+3 years. There was a statisti-cally significant association between marital status and genital HPV infection. Conclusion: Single sexually active women are at increased risk of acquiring HPV infection of the cervix and should be the target in a sporadic or an organized cervical cancer screening programme without discriminating other sexually active women