Analysis of Gleason grade and scores in 90 Nigerian Africans with prostate cancer during the period 1994 to 2004.

OBJECTIVES: To determine the relative frequency of prostate cancer among surgical specimens, and among prostate specimens received at the pathology department ,University Hospital Calabar. METHODS: Histology records were reviewed for the following: total number of histology specimens received; total number of prostate specimens; total number of prostate cancer; and the total number of cancers in males during the study period. Histology sections 4-5microns thick were cut from paraffin blocks and stained by Haematoxylin and Eosin (H&E). Histopathologic specimens were classified using the grading system of tumour differentiation described by Gleason and associates. RESULTS: One hundred and twenty three cancers of the prostate were received, constituting 2% of the total surgical specimens and 31% of prostate specimens. Thirty three cases (27%) could not be analyzed; therefore the study is based on 90 prostate cancer specimens. Eighty nine (99%) cases were epithelial tumours (adenocarcinoma.) There was a single mesenchymal tumour (rhabdomyosarcoma) (1%). The commonest grade in this study was the high grade (Gleason grade IV). CONCLUSIONS: We observed that prostate cancer is a common among males (all sites) diagnosed at the University Hospital Calabar, with a peak incidence between the ages of 61 - 70 years (seventh decade).

Stevens-Johnson syndrome associated with nevirapine use in an HIV-positive pregnant woman: a case report.

BACKGROUND: Stevens-Johnson syndrome (SJS) is a rare but potentially life threatening condition which has been associated with infections, neoplasm and drug use. OBJECTIVE: To report a case of nevirapine-induced SJS in an HIV-positive pregnant woman on antiretroviral therapy for prevention of mother-to-child transmission (PMTCT) of HIV. METHODS: Clinical and laboratory evaluation of a 31-year old HIV-positive primigravida who presented at 20 weeks gestation with fever and generalized skin rash with bullae. She was admitted and managed conservatively as a case of SJS. RESULTS: There was history of use of nevirapine-containing highly active antiretroviral therapy (HAART) for six weeks prior to presentation. Physical findings included a generalized skin rash with bullae, oral mucosa blisters/ulcerations and purulent conjunctivitis. She was managed as a case of SJS. Antiretroviral drugs were temporarily withdrawn. A skin biopsy confirmed the diagnosis of a drug-induced dermatosis (erythema multiforme). She recovered satisfactorily with significant improvement of her dermatologic, oral mucosal and eye conditions and was discharged after 35 days of hospitalization. She was recommenced on antiretroviral therapy but with substitution of nevirapine in place of saquinavir. She carried the pregnancy to term and was delivered of a live baby through caesarean section. CONCLUSION: Practitioners managing HIV-positive patients on nevirapine-containing antiretroviral therapy should be aware of the potential for SJS. A high index of suspicion is required to be able to promptly diagnose, refer and/or institute appropriate management to avoid severe morbidity and fatality associated with this condition.