ABSTRACT
OBJECTIVE: To determine the prevalence and predictors of precancerous cervical lesions among HIV-positive women in Jos, Nigeria. METHODS: A cross-sectional study was conducted from October 2017 to January 2018 among 326 HIV-positive women. Cervical smears were collected for examination at the AIDS Preventive Initiative of Nigeria clinics of Jos University Teaching Hospital (JUTH) and Bingham University Teaching Hospital (BhUTH), Jos, Nigeria. Demographic characteristics of participants were documented using a structured questionnaire. Data were entered and analyzed using SPSS version 21. RESULTS: Of the 326 participants, precancerous cervical lesions were present in 40 (12.2%) women: 4 (1.2%) had atypical squamous cells of undetermined significance, 19 (5.8%) had low-grade squamous intraepithelial lesions, 1 (0.3%) had atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions, 13 (4.0%) had high-grade squamous intraepithelial lesions, and 3 (0.9%) had high-grade squamous intraepithelial lesions, suspected for invasion. The multivariate logistics regression model showed that parity (odds ratio 3.4, 95% confidence interval 1.3-9.5, P=0.043) was a significant predictor of precancerous cervical lesions. CONCLUSION: The prevalence of precancerous cervical lesions among HIV-infected women is relatively low compared to earlier reported prevalence in an HIV population in Jos. Increasing parity was a significant predictor.
Subject(s)
HIV Infections , HIV-1 , Neoplasms, Squamous Cell/epidemiology , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Neoplasms/epidemiology , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Middle Aged , Neoplasms, Squamous Cell/etiology , Neoplasms, Squamous Cell/pathology , Nigeria/epidemiology , Prevalence , Risk Factors , Socioeconomic Factors , Uterine Cervical Neoplasms/etiology , Uterine Cervical Neoplasms/pathology , Vaginal Smears , Young Adult , Uterine Cervical Dysplasia/etiology , Uterine Cervical Dysplasia/pathologyABSTRACT
BACKGROUND: Androgen deprivation therapy (ADT) is accepted as the first-line treatment of advanced prostate cancer. This study sets out to determine the outcomes of ADT in reducing lower urinary tract symptoms (LUTS) in patients with advanced prostate cancer and also to determine the quality of life (QoL) of the patients. PATIENTS AND METHODS: This was a prospective study carried out at Jos University Teaching Hospital. All consecutive patients who had LUTS due to advanced prostate cancer were recruited into the study. All patients completed the international prostate symptom score (IPSS) questionnaire, including QoL assessment. Post-void residual (PVR) urine, maximum flow rate (Qmax), prostate specific antigen and total prostate volume (TPV) were assessed. The parameters before and at 12 months were compared. RESULTS: Data from 65 patients were analysed. The mean age of the patients was 68.5 ± 8.67 years with an age range of 46-85 years. Four (6.2%) had mild LUTS before AD, and their symptoms remained mild at 12 months of ADT. Twenty-two (33.9%) patients had moderate urinary symptoms. Of this, 10 (18.5%) patients had symptomatic improvement at 12 months of ADT. Of 39 (60%) patients who presented with severe LUTS, 21 (32.3%) had improvement at 12 months of ADT. Before ADT and at 12 months of ADT, the mean IPSS score, mean TPV, Qmax, PVR and mean QoL score were 23 ± 8.8 and 15 ± 8.8 (P < 0.0001); 79.7 ± 51.4 and 73.4 ± 34.3 (P = 0.212); 8.0 ± 4.7 and 11.2 ± 4.4 (<0.001); 209.8 ± 127.8 and 163 ± 111.4 (<0.001); 4.23 ± 1.2 and 3.24 ± 1.2 (P < 0.001), respectively. Of the 39 patients (60%) with severe urinary symptoms, 18 (27.7%) of patients had urethral catheterization for either acute or chronic urinary retention before ADT. At 12 months on ADT, eight patients (12.3.7%) were still on catheter due to failed attempts at trial without catheter. CONCLUSION: ADT significantly improves urodynamic parameters, IPSS score and IPSS-related QoL. There remains a subset of patients, in whom LUTS persist with negative effects on QoL.
Subject(s)
Androgen Antagonists , Lower Urinary Tract Symptoms , Prostatic Hyperplasia , Prostatic Neoplasms , Aged , Aged, 80 and over , Androgen Antagonists/therapeutic use , Humans , Lower Urinary Tract Symptoms/etiology , Male , Middle Aged , Nigeria , Prospective Studies , Prostatic Hyperplasia/complications , Prostatic Neoplasms/complications , Prostatic Neoplasms/drug therapy , Quality of LifeABSTRACT
Renal cell carcinoma (RCC) is the most common renal malignant tumour. Owing to its retroperitoneal location, RCC remains asymptomatic and non-palpable until advanced disease develops. Most cases are identified during radiological examination for other reasons. The management of RCC depends substantially on the effective use of imaging. This is true in all the stages of the RCC, from initial diagnosis to follow-up. This article sets to review the current knowledge about multidetector computed tomography (MDCT) scan and how it characterises the RCC. A search of PubMed database was made to locate the original and review articles in English that address the MDCT scan or RCC, without limit to publication date. Relevant articles and textbook chapters were reviewed, analysed and summarised. MDCT reveals the renal tumour, its extent, venous involvement, status of loco-regional lymph nodes as well as adrenal and liver extension. It is available and relatively affordable presently in some centres across the subregion. MDCT is an essential tool that has aided not only the early diagnosis of RCC, but also the staging and characterisation of the RCC
