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Context: Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy and its grading is greatly consequential in the management and prognosis of patients with the disease. Aims: To compare histologic grading systems in MEC of minor salivary glands. Settings and Design: Two qualitative (modified Healy and Memorial Sloan‑Kettering Cancer Center [MSKCC] methods) and two quantitative (Armed Forces Institute of Pathology [AFIP] and Brandwein methods) were evaluated. Subjects and Methods: Diagnostics slides of 19 patients including one recurrent case were evaluated using the four grading systems. Statistical Analysis Used: Percentages and proportions were used. Results: Agreement across all grading system was found to be very low (32%) while there was a better agreement between AFIP and MSKCC methods (84%) between modified Healy and Brandwein (58%). The method that gave the poorest agreement with all the others was the Brandwein grading. In general, the AFIP and MSKCC methods tended to grade the tumors lower while the Brandwein and modified Healy methods seemed to grade them higher. Conclusions: Most MEC of minor salivary glands appear to be low‑grade tumors. It is conceivable that some grading methods (Brandwein and modified Healy) may lead to an unnecessary escalation of management methods in these tumors. The MSKCC method may have emphasized some parameters which may not have much importance in minor salivary gland MEC. The AFIP method appears to be the most appropriate to use for the grading of minor salivary gland MEC. Further studies are required to confirm or disprove this finding.
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The role of pharmacist has not only advanced from traditional medication dispensing but also to direct patient care and pharmaceutical interventions aiming at enhancing the populace wellbeing. Objective: The objective of this research was to assess the impact of rural community pharmacist on drug self-medications and disease prevalence among rural settings in the Kwara State Central, Nigeria. . Method: This study was conducted between September, 2011 and February, 2013 in eight rural communities on 730 respondents, following a six-week pilot study on 50 respondents. Respondents aged 30 years and over and regular clients of the community pharmacy were included into the study. Self-medications were assessed using pre-tested and validated questionnaire. Pharmaceutical interventions were carried out on the respondents by the clinical pharmacist at every two months for eighteen months. Descriptive statistics and regression analysis were for the computation of the data. Results: Male respondents were one third of the population studied, while female had the highest percentage of 69.9%. Respondents between the age of 40 and 50 years dominated with 42.3% and majority (88.1%) of the rural residents were illiterates. Farming was the core livelihood of the respondents and survived on less than ten thousand naira Nigeria money ($63) per month. Among the combinations of drugs abused by the respondents, the regimen containing combination of (prednisolone, diclofenac and paracetamol) had the highest users. The least used combination was (Ibuprofen, Diclofenac plus Prednisolone). These combinations were taken two times daily by the majority participants. The most common reasons given for self-medications were osteoarthritis (31.1%), poverty (17.4%), general body pain (14.3%), lack of health facilities (4.6%), ignorance (4.3%) among others. The intervention offered by the pharmacist had reduced the mean systolic blood pressure significantly (p<0.05) from 161mmhg to 129 mmhg and diastolic blood pressure from 104mmhg at baseline to 86 mmhg. Post-intervention evaluation revealed the impact of the pharmacist, as the respondents with dyspepsia at baseline significantly (p<0.05) reduced from 220 to 53 participants. Conclusion: Pharmacist interventions on self-medication of drugs greatly enhanced patient healthcare in the rural communities.
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Background: In Nigeria; as in the rest of equatorial Africa; sickle cell disease (SCD) has its highest incidence and continues to cause high morbidity and early death. The condition is a major public health problem among the black race. The aim of this survey is to determine the level of knowledge about SCD and the factors associated with its prevention among local government workers in Ile- Ife. Methods: This is a cross-sectional descriptive study of the knowledge about SCD; attitude towards premarital sickle cell screening and marital decisions among local government workers in Ile-Ife; Nigeria; using a self-administered questionnaire. Results: 69of study subjects had poor knowledge of SCD; while attitude towards premarital screening was favourable in 95of the study subjects. Knowledge and attitude were significantly better among subjects with tertiary education. There was a strong positive association between attitude towards sickle cell screening and a history of undergoing screening or partner screening. Most (86.7) of the respondents and 74.0of their partners have had sickle cell screening. One-quarter of married and engaged respondents did not know their partner's sickle cell status. One-third to two-thirds of study subjects will continue the relationship with their partner when either or both have haemoglobinopathy. Conclusion and recommendation: This study showed poor knowledge of SCD among the studied subjects. There is a need for more emphasis on health education through programmes promoting sickle cell education. In addition; the development of multifaceted patient and public health education programmes; the intensification of screening for the control of SCD by heterozygote detection; particularly during routine preplacement and premarital medical examinations; and the provision of genetic counselling to all SCD patients and carriers are vital to the identification and care of the couples at risk. These will enhance the capacity of the intending couples to make informed decisions and be aware of the consequences of such decisions. Policies are needed to ensure easily accessible community-wide sickle cell screening and premarital and genetic counselling to achieve the desired decline in new births of children with SCD