Assessment of the sociodemographic characteristics and efficacy of screening for oral, head and neck potential malignant lesions in apparently healthy adults in Jos Nigeria.

BACKGROUND: The efficacy of screening for oral, head and neck cancers (HNCs) in adequately identifying high-risk groups is controversial. OBJECTIVES: This study aims to review our experience with a free oral, HNC-screening program to determine the sociodemographic characteristics of the participants and the effectiveness of this program to improve future programs. MATERIALS AND METHODS: A prospective cross-sectional survey of participants in a free oral, HNC screening exercise was performed in the years 2009, 2012, and 2013. RESULTS: In the years of screening, 135 participants presented aged between 21 and 83 years (mean = 47.0; ±15.6) with a male to female ratio of 1.2:1. 32.6% consumed alcohol, and 17.8% were smokers. Smoking (P = 0.04) and alcohol use (P = 0.05) were associated with higher rates of suspicious malignant symptoms. There was no statistical correlation between symptom prevalence and the number of participants requiring immediate consultation for oral, HNC (r = 0.47), and those referred for routine follow-up (r = 0.34). Premalignant and malignant lesions were diagnosed in 5 males aged 44-72 years. 83.7% found the screening program beneficial in increasing their awareness of the disease. CONCLUSIONS: This hospital-based screening demonstrates improved awareness among people about oral, HNCs, and survival outcomes on a small scale. A community-based screening with health education to target a larger high-risk population is recommended to encourage individuals to modify high-risk factors and improve outcomes.

MATERNAL AND NEONATAL OUTCOMES OF HISTOLOGICAL CHORIOAMNIONITIS.

BACKGROUND: Clinical Chorioamnionitis contributes to maternal and neonatal morbidity and mortality but the effect of histological chorioamnionitis is sparse in our environment. AIM: To determine the maternal and neonatal outcomes of histological chorioamnionitis amongst pregnant women and their babies. DESIGN OF THE STUDY: Cross sectional longitudinal study. SETTING: Jos University Teaching Hospital (JUTH), Jos, Nigeria. METHODOLOGY: Parturients were interviewed and examined as well as had their placenta examined histologically for chorioamnionitis. They and their babies were followed up for 6 weeks after delivery to monitor for any complications that may arise. RESULTS: A total of 148 parturients were enrolled from the labour ward of Jos University Teaching Hospital and of these 90 (60.8%) had histologic chorioamnionitis (HCA). As regards outcome, 9(10%) with histologic chorioamnionitis as well as 5(8.62%) of those without HCA had premature delivery. Low birth weight occurred in 12(13.33%) and 6(10.34 %) of those with HCA and without HCA respectively. In all, 1(1.47%) and 1(2.56%) of women with HCA and without HCA correspondingly had neonatal sepsis. Puerperal sepsis occurred in 2(2.94%) of those with HCA and 2(5.13%) of those without HCA. CONCLUSION: Our study has demonstrated that histological chorioamnionitis had no adverse maternal or neonatal effect. There is the need for more studies investigating the cause and the implication of histological chorioamnionitis.

Role of Fine Needle Aspiration Cytology (FNAC) as a Diagnostic Tool in Paediatric Head and Neck Lymphodenopathy.

A neck mass that is present for longer than a week might be pathological requiring rapid and thorough evaluation. This study aims to evaluate the positive role Fine needle aspiration cytology plays in the diagnosis of pediatric patients with lymphadenopathy in the head and neck region. Fine needle aspiration of lymph nodes was carried out, fixed and stained by cytopathologists for 56 patients at the Jos University Teaching Hospital, 43 (76.8%) were inflammatory and 13 (23.2%) malignant. Reactive hyperplasia (72.1%), acute suppurative (18.6%) and tuberculosis (9.3%) constituted the inflammatory lesions. Non Hodgkins lymphoma was the commonest malignant lesion (76.9%) followed by Hodgkins lymphoma (15.4%), the least being Rhabdomyosarcoma (7.7%). Age range 10-14 years had the highest number of cases (46.4%). Males were 36 (64.3%) while females were 20 (35.7%). All malignant cases diagnosed by FNAC had to undergo confirmation/characterization by histology and had 100% concordance. Thus there were no false positives and specificity was 100%, sensitivity 100%. Of the 43 diagnosed as inflammatory by FNAC, 12 cases which did not resolve after treatment or where patients condition worsened had to undergo surgical biopsy. Out of these only 1 (8.3%) case of fungal infection was misdiagnosed by FNAC. The lymph nodes were generalized 4 (7.1%) and localized in 52 (92.9%). Maximum number of cases 53 (94.6%) had Cervical Lymphadenopathy followed by axillary 2 (3.6%) and inguinal 1 (1.8%). Out of the cervical group of nodes, the upper anterior and upper posterior deep cervical nodes were involved in majority of cases (95%).

Histopathological analysis of endometrial biopsies in Jos University Teaching Hospital (JUTH), Nigeria. A 5-year critical review.

AIMS: This study is aimed at giving an insight into the pattern and age distribution of endometrial analysis as seen at Jos University Teaching Hospital. METHODS: This is a retrospective reviewed cases of endometrial biopsies diagnosed between January 1998 to December 2002 in the Histopathological Department ofJos University Teaching Hospital RESULTS: A review of endometrial biopsies slides from 556 patients revealed that pregnancy related diagnosis was the commonest, representing 302 (54.3%) of histopathological diagnosis, followed by endometrial hyperplasia, accounting for 97 cases (17.5%) and majority of which was categorised as mild hyperplasias. Hydatidiform mole, which ranked third, constituted 58 (10.4%) of the cases studied. Choriocarcinoma was the leading malignancy representing 10 cases (45%) of the malignant tumours and 1.8% of all the endometrial biopsies. Endometrial adenocarcinoma, stromal sarcoma and metastatic cancer constituted 6 (1.0%), 3 (0.5%) and 3 (0.5%), respectively. CONCLUSION: The commonest endometrial pattern seen in JUTH over the study period was products of conception which peak in the third decade of life; primary malignancies of the endometrium are uncommon in JUTH and they represented just about 2%.

Embryonal rhabdomyosarcoma of the cervix.

Embryonal rhabdomyosarcoma (sarcoma botyroides) of the cervix, which is rare, is described in a 16-year-old. The combined use of chemotherapy, radiotherapy and surgery has markedly improved survival in those with this condition. However, our patient did not benefit from this treatment modality due to late presentation and loss to follow-up.

Analysis of cases of rape as seen at the Jos University Teaching Hospital, Jos, North Central Nigeria.

OBJECTIVE: Women are at a higher risk of being sexually harassed. There is a need to document the clinical findings of this crime and its outcome in order to improve the quality of care the victims receive. MATERIALS AND METHODS: Case notes of patients who presented with alleged rape at Jos University Teaching Hospital between January 2001 and December 2003 were retrieved and analyzed. RESULTS: During the study period, 2,135 patients were seen in the Gynaecological Emergency Unit. A total of 120 were for alleged rape, representing 5.6% of the total cases seen. However, only 105 case notes were available for analysis. Of these, 63.8% of the alleged rapes were in children, with the infantile age group accounting for 26.7%. 36.2% of the victims had experienced some form of sexual exposure prior to the rape. A previous relationship with the rapist was established in 77.4% of the cases. Most cases delayed in presenting to hospital. Thirty six percent of the cases did not have a human immunodeficiency virus screening test done. Candida albicans (13.3%) accounted for most of the infectious agents. Emergency contraception was administered to the victims when indicated. CONCLUSION: Women under 16 years of age were at an increased risk of being raped, possibly because they are defenseless and vulnerable. Three quarters (3/4) of the assailants had some form of relationship with the victims, which may account for the delays in reporting. Children and young adolescents were more at risk than adults to be raped.

Analysis of Cases of Rape as Seen at the Jos University Teaching Hospital; Jos; North Central Nigeria

Objective: Women are at a higher risk of being sexually harassed. There is a need to document the clinical findings of this crime and its outcome in order to improve the quality of care the victims receive. Materials and Methods: Case notes of patients who presented with alleged rape at Jos University Teaching Hospital between January 2001 and December 2003 were retrieved and analyzed. Results : During the study period; 2;135 patients were seen in the Gynaecological Emergency Unit. A total of 120 were for alleged rape; representing 5.6of the total cases seen. However; only 105 case notes were available for analysis. Of these; 63.8of the alleged rapes were in children; with the infantile age group accounting for 26.7. 36.2of the victims had experienced some form of sexual exposure prior to the rape. A previous relationship with the rapist was established in 77.4of the cases. Most cases delayed in presenting to hospital. Thirty six percent of the cases did not have a human immunodeficiency virus screening test done. Candida albicans (13.3) accounted for most of the infectious agents. Emergency contraception was dministered to the victims when indicated. Conclusion: Women under 16 years of age were at an increased risk of being raped; possibly because they are defenseless and vulnerable. Three quarters (3/4) of the assailants had some form of relationship with the victims; which may account for the delays in reporting. Children and young adolescents were more at risk than adults to be raped

Clinicopathological profile of malignant tumors of the oropharynx: a case series.

BACKGROUND: Due to recent lifestyle changes, the worldwide incidence of malignant oropharyngeal tumors is on the increase. This study focuses on the clinical and pathological profile of malignant tumors of the oropharynx as seen in a north-central Nigerian teaching hospital. METHODS: This is a descriptive retrospective analysis of the clinical and pathological profile of this disease. RESULTS: Six patients aged between 37 years and 78 years had malignant oropharyngeal tumors. There were 5 (83.3%) males and 1 (16.7%) female. All patients presented with cervical swelling, dysphagia, odynophagia and muffled voice with dental caries and visible masses filling up the oral cavity and oropharynx. Four (66.7%) patients presented with dyspnea and 3 (50%) with otalgia and deafness. Three (50%) patients had histologic diagnosis of non-Hodgkin's lymphoma (centroblastic), 1 had lymphoepithelioma and 2 had squamous cell carcinoma. Two (33.3%) patients died during treatment, 2 (33.30%) defaulted and 1 (16.7%) is being followed up for 5 years and is tumor free. CONCLUSION: Oropharyngeal cancer has a poor prognosis in the tropics due to late presentation. Proper health education aimed at early detection and treatment in our environment is required.

Patterns of malignant salivary gland tumours in Jos University Teaching Hospital (JUTH), Jos: a ten-year retrospective study.

BACKGROUND: Salivary gland tumours are common head and neck tumours and more common in western world than Africans. Most salivary gland tumours are benign but the morbidity and mortality as expected is higher with malignant tumours. This study is aimed at describing the histological pattern, age, sex and site distribution of malignant salivary gland tumours in Jos University Teaching Hospital (JUTH) Jos from January 1998 to December 2007. METHODS: This is a descriptive study of all histologically confirmed malignant salivary gland tumours over a period of ten years. Fresh sections of tissue blocks of these lesions were made using the microtome (3 micrones). They were made into slides and stained with Hematoxylin and Eosin (H and E) and Periodic Acid Schiff (PAS) stains. The slides were reported independently by four pathologists. Diagnosis was made and classification done according to the World Health Organisation (WHO) classification of salivary gland tumours 3. Information such as age, sex and-site of distribution of these tumours was gotten from the patient's case files. The data was analyzed manually. RESULTS: Muco-epidermoid carcinoma accounted for the highest (32 cases) histologic type. Malignant salivary gland tumours occurred more within the age range 40 to 69 years with the age group 50-59 years accounting for the highest frequency (36 cases). Most of these malignant salivary gland tumours occurred more in the parotid gland, the minor salivary being the least site of occurrence. CONCLUSION: Mucoeperdermiod carcinoma is the commonest salivary gland tumour and that malignant salivary gland tumours in this study and it occurred more after the 5th decade of life.

Descriptive pattern of Benign Salivary Gland Tumours in Jos University Teaching Hospital (JUTH); Jos: A ten-year retrospective study

Salivary gland tumours are common head and neck tumours which account for 2.8 to 10of all head and neck tumours in most African studies and 8.0 to 10.5in most western literature. Benign salivary gland tumours are the commonest form of salivary gland neoplasm; with the ratio of benign to malignant tumours ranging from 1.2:1 to 2:1. Objectives: This study is aimed at describing the histological pattern; age; sex and site distribution of benign salivary gland tumours in Jos University Teaching Hospital from January 1997 to December 2006. Methods: This was a descriptive study of all histotogically confirmed benign salivary gland tumours over a period of ten years. The slides were reported independently by four pathologists. Diagnosis was made and classification done according to the World Health Organization (WHO) classification of salivary gland tumours. Data such as age; sex and site of distribution of these tumours were obtained from the patient's case files. Results: Results show that benign salivary gland tumours had a higher distribution than malignant salivary gland tumours with a ratio of 1.7:1. Of these benign salivary gland tumours; male predominance over females was generally observed. Benign salivary gland tumours occurred more within the age range 4 to 49 years (table 1); with pleomorphic Adenoma accounting for the highest frequency (115) and basal cell adenoma for the lowest frequency (1) [table 2]. Parotid gland was also the commonest site of occurrence of most of these lesions except for basal cell adenoma which was found in the sublingual gland