PROGRAMMED CELL DEATH LIGAND 1 (PD-L1) EXPRESSION IN TRIPLE NEGATIVE BREAST CANCER CASES IN BENIN CITY.

Background: Triple-negative breast cancers (TNBC) have been particularly challenging to manage due to their lack of intrinsic cellular receptors, with the resultant relatively higher morbidity and mortality. Recently, the programmed cell death 1/programmed cell death ligand 1 (PD-1/PD- L1) immune checkpoint pathway has become the focus of immunotherapy, especially for TNBCs. This study aimed to determine the pattern of expression of PD-L1 in TNBC cases in Benin City. Methods: It was a 3-year retrospective study that involved the PD-L1 immunostaining of the TNBC cases that were diagnosed in the Department of Anatomical Pathology, University of Benin Teaching Hospital, Benin City, from January 1, 2017 to December 31, 2019. Result: Ninety-two cases of TNBC were tested for PD-L1 expression. Thirteen (14.1%) of the TNBC cases were PDL1 positive to varying degrees on tumour and immune cells. Diffuse tumoural PD-L1 staining was seen in 4 (30.8%) of the PD-L1 positive cases. PD-L1 expression was significantly associated with increasing age up to the fifth decade (p =0.030). All the PD-L1 positive TNBC were invasive breast carcinoma of no special type and mostly grade 2 tumours; however, there was no significant association between PD-L1 expression and histological subtype or grade. Conclusion: PD-L1 expression was shown to occur at a relatively low rate among TNBC cases in this environment and was significantly associated with increasing age. This study has shown that 14.1% (1 in 7) of our TNBC patients could benefit from immune checkpoint inhibitor therapy.

Intestinal obstruction secondary to cecal endometriosis.

Endometriosis of the gastrointestinal tract is rare and occurs in <1% of all patients undergoing major gynecological surgeries. Bowel involvement has been reported in 3%-37% of all women of childbearing age with endometriosis. Total obstruction of the gastrointestinal tract occurs in <1% of cases of endometriosis with bowel obstruction. This case report is that of a 42-year-old female who presented with a 6-month history of change in bowel habits in favor of increasing constipation. This was associated with cyclical lower abdominal pains, abdominal swelling, and weight loss. Examination revealed hyperactive bowel sounds with scant fecal matter on rectal examination. An impression of intestinal obstruction was made and she had an emergency laparotomy. Dilated ileum and a hard, constricting cecal mass were found intraoperatively. She had a right hemicolectomy and ileo-transverse anastomosis, with progressive improvement postoperatively. Histology of the resected bowel segment confirmed cecal endometriosis. In conclusion, cecal endometriosis is a rare cause of intestinal obstruction. A high index of suspicion is required for diagnosis, especially if the woman is premenopausal with a history of abdominal pain that worsens with menstrual periods. Outcome is good with appropriate surgical intervention.

Knowledge of malaria and the practices towards its control among urban dwellers in Benin City.

OBJECTIVE: To determine the knowledge of malaria and its control methods among urban dwellers in Benin City, Edo State with a view to making recommendations on its prevention. METHODS: The study was of a cross-sectional descriptive type, using multi-stage sampling technique. Semi-structured questionnaires were researcher-administered and data analysed by means of the Computer Programme for Epidemiologic Research (CPER). RESULTS: The indices of the knowledge of malaria were generally high. 92.5% had correct knowledge about the symptoms, 98.0% its mode of transmission, all the respondents knew at least one method of its preventive measures and 87.0% knew about therapy with chloroquine and other drugs. There was however, poor knowledge of the new artemisinin-based combination therapy (10.6%) and the Roll Back Malaria Initiative (31.5%). In spite of the positive findings on the knowledge, the practice of preventive measures were poor with only 27.8% using door and window nettings, 0.8% using insecticide treated mosquito nets and 25.6% using insecticides. CONCLUSION: Despite the availability of extensive sources of health information, there is the need for appropriate health education to stimulate positive changes in both knowledge and practice of malaria control. In addition, the campaign to " Roll Back Malaria" requires intensification.