Pistol-grip Syringe holder (Cameco syringe pistol) in fine needle aspiration Biopsy: any advantages over the use of direct finger grip?

AIMS AND OBJECTIVES: The study seeks to determine the advantages of using the pistol-grip syringe holder in the performance of FNAB over the use of direct finger grip method. PATIENTS AND METHODS: The skin is cleaned with gauze soaked in methylated spirit and the lump is located and firmly held between the thumb and fore finger of the free hand. The syringe is held by the out side of the barrel or by pistol-grip, and the needle tip pushed into the lesion. The plunger is partially retracted, creating a negative pressure. The cutting edge of the needle tip frees the cells inside the lesion which are sucked into the fine bore of the needle. The contents of the needle are then emptied on a microscopic slide and thinly smeared. The slides are then fixed in alcohol and later stained. These were examined under the microscope and a comparison between the aspirations using pistol-grip and direct finger grip was made. RESULTS: A total of 266 cases of FNABs were carried out from 1st January to 31st December, 2008. There were 89 breast cases out of which 42 (47%) had pistol-grip method and 47 (53%) had direct finger grip method; 74 thyroid cases out of which 28 (38%) were pistol-grip and 46 (62%) were direct finger grip cases; 56 cases of lymph node FNABs of which 18(32%) and 38 (68%) had pistol-grip and direct finger grip methods respectively. There were 23 cases of salivary gland FNABs having 8 (35%) and 15 (65%) as pistol-grip and direct finger grip methods respectively. Marked cellularity was observed in the majority of cases using both methods of FNABs. CONCLUSION: This study has shown that the use of pistol-grip syringe holder in the performance of FNABs has no significant advantage compared to the direct finger grip method.

Spectrum of haematologic malignancies and survival outcomes of adult lymphomas in Maiduguri, north eastern Nigeria--a fourteen year review.

BACKGROUND: The incidence of Haematologic malignancies has been shown to vary according to gender, age, geographic region, and histologic subtypes, while cure rates can vary according to region and may be impacted by treatment availability and access to care. METHOD: This was an institution based review of data from the Medical Records Department, Department of Haematology and Cancer Registry of the Histopathology Department of the University of Maiduguri Teaching Hospital between January 1998 and December 2011. The aim was to study the spectrum of Haematologic malignancies and the survival pattern of adult lymphomas in this region and to compare our findings to studies reported elsewhere. RESULTS: The Haematologic malignancies represented 6.05% of all cancer cases seen and 0.31% of hospital admissions. Among the Haematologic malignancies, Non-Hodgkins Lymphoma (NHL) was the most frequent, constituting 51.3% while others include: Hodgkins Lymphoma (HL), 26.7% Chronic Myeloid Leukaemia (CML), 5.5%, Acute Myeloblastic leukaemia (AML), 4.2% Multiple Myeloma (MM), 4.2% Acute Lymphoblastic leukaemia (ALL), 3.8%, Chronic Lymphocytic Leukaemia (CLL), 3.4% Myelodysplastic Syndrome (MDS), 0.4% and Chronic Myelofibrosis 0.4%. Haematologic malignancies are more common in younger age group and also more common in males than females. Lymphomas are particularly common in young adults and the incidence tends to fall after 70 years. Similarly, the characteristic bimodal age incidence for HL found in western world has not been seen in this study. The histological subtypes for both NHL and HL are similar to the pattern reported elsewhere. Default rate was high and we found a strong association between cycles of chemotherapy given and survival in lymphoma patients. CONCLUSION: This study has shown that Haematologic malignancies are not uncommon in our environment. There is need to provide basic facilities and training for immunophenotyping and immunohistochemistry in all cancer treatment centers across the country. Cytotoxic drugs must be subsidized and also be made readily available to all patients with Haematologic malignancies.

Prevalence, risk factors and effects of placental malaria in the UMTH, Maiduguri, North-eastern, Nigeria: a cross-sectional study.

SUMMARY: Most of the adverse effects of malaria in pregnancy on the fetus are usually as a consequence of placental malaria (PM). This study was conducted with the objective of determining the prevalence, risk factors and pregnancy outcome of PM. A cross-sectional study of 437 pregnant women who delivered at the UMTH, Maiduguri was conducted between 24 July 2007 and 12 January 2008. Placental histology was done for the malaria parasite. Maternal packed cell volume was done and thick blood films were studied for the malaria parasite in maternal peripheral blood and the cord blood/heel prick of their babies. The prevalence of PM was 33.9% (148/437). It is associated with non-usage of intermittent preventive treatment of malaria in pregnancy (IPT) and maternal HIV infection. PM in turn predisposes to low birth weight and cord parasitaemia. Only 2.8% of the women were sleeping under insecticide-treated nets (ITNs). The high prevalence of PM calls for renewed efforts for preventive measures, particularly the routine use of IPT and ITN during the antenatal period.

Histopathological analysis of non-squamous cell malignancies of the uterine cervix in Maiduguri, Nigeria.

Carcinoma of the uterine cervix is the most common gynaecological malignancy in the developing world despite being largely preventable. The non-squamous cancers of the cervix have not been properly documented in our setting. This study is aimed at reviewing the histological types ofnon-squamous cell cancers of the uterine cervix in relation to the age of presentation, and to analyze some of the histopathological features of adenocarcinomas. Cases of cancer of the cervix histologically diagnosed between January 1989 and December 2004 were extracted from the cancer register of the University of Maiduguri Teaching Hospital. The request forms, slides, and some tissue blocks were retrieved from the archives of the Histopathology Department. The cases were histologically reviewed and the data analyzed using simple statistical methods. A total of 491 cases of cervical cancers were diagnosed. Of these, 432(88.0%) cases were squamous cell carcinomas while 59(12.0%) were non-squamous cell malignancies. Out of the 59 non-squamous cervical cancers, 42(71.2%) were endocervical-type adenocarcinomas, while serous papillary, clear cell, and adenosquamous carcinomas comprised 2(3.4%) cases each. Seven (11.9%) cases were metastatic choriocarcinomas. Over 60% of these cases occurred within the third and fourth decades of life. Adenocarcinomas are the most common non-squamous malignancies of the cervix and their age of presentation was similar to that of their squamous cell counterpart. Haemorrhage and lymphocytic infiltrates were significantly associated with tumour grade while necrosis was independent of tumour grade.

Correlation between histopathologic and fine needle aspiration cytology diagnosis of palpable breast lesions: a five-year review.

Fine needle aspiration cytology (FNAC) of the breast has been used as an initial investigative procedure of palpable breast lesions. The purpose of this study is to evaluate our experience with Fine Needle Aspiration Cytology (FNAC) and to correlate between histopathologic and FNAC diagnoses of palpable breast lesions. A 5-year retrospective study was performed using records of all patients who had had both FNAC and histopathologic results of breast lumps. This is a retrospective study of 220 diagnosed cases of breast lesion at the University of Maiduguri Teaching Hospital (UMTH), Nigeria between the periods of January 2001 and December 2005. The results of the FNAC were interpreted as inflammatory, benign, suspicious or malignant. A total of 220 patients had both cytopathologic and histopathologic diagnoses and therefore fulfilled the criteria for this study. There were 11 (5%) cases of inflammatory, 140 (63.6%) cases of benign and 69 (31.4%) cases of malignancy. There were two cases that were suspicious of malignancy and for the purpose of this study were considered as malignant. There were five (5) cases of cytologically interpreted errors which were three cases of false negative and two cases of false positive. The diagnostic accuracy was 97.7%, sensitivity was 95.7%: and specificity was 98.7%. The false negative and false positive rates were 2.9% and 1.9% respectively. FNAC of breast lesions is sensitive, specific, and highly accurate as the initial investigation of palpable breast lesions in our tertiary hospital. We therefore implore clinicians to embrace this procedure in the management of patients.

Women and the media in South Asia.

PIP: This article gives a brief overview of women's access to journalism and communication training, status of women in the media, their needs for development of skills, and portrayal of women in the media, in Bangladesh, Nepal, Pakistan, India and Sri Lanka. 5 authors from those countries contributed sections subdivided into each of these subheadings. In India, women have access to training, but their positions in the media are limited. They are often falsely stereotyped, sensationalized or exploited, or totally absent. In Sri Lanka, however, women are closer to being equal to men, in terms of training, hiring and employment, although they tend to work in women's periodicals. Women are shown in most of the advertisements, and are generally portrayed as perpetually in pursuit of glamour, food, clothes and cosmetics. Media in Nepal are comparatively new; for example, television is only 1 year old. Therefore, opportunities for women are few, and men dominate the hierarchy. Women are portrayed in the media negatively or sensationally, and used extensively in commercials. Women's position in Pakistan is limited in the cities by purdah and in rural areas by the feudal heritage, in which women are chattel. A minority of women are enrolled in journalism schools a employed in the media: those are excelling. Women are often either idealized, abused or caricatured as interested only in consumption. Women have recently entered the journalism profession in Bangladesh, now totaling 24 women. Mores do not permit women to work at night or on outside assignments. The media are liberal in Bangladesh, airing news about dowry abuse and female oppression openly. In most of the countries, women tend to work only until marriage, or afterward are limited by domestic duties.^ieng