In vivo Safety Evaluation of a Nigerian Polyherbal Mixture in Female Wistar Rats.

The present study evaluates the oral safety and oral toxicity reversibility of a Nigerian Polyherbal Mixture (NPM) in female Wistar rats. In this study, acute oral toxicity was conducted on 20 female Wistar rats using the limit dose test of Up-And-Down Procedure of the OECD Acute Oral Toxicity Testing 425 guidelines at 5000 mg/kg of NPM. Additionally, 40 female Wistar rats (120-150 g) were divided into 4 groups (n=10) and orally treated with 10ml/kg of distilled water, 82 mg/kg, 410 mg/kg and 2050 mg/kg of NPM, respectively, for 90 days. Five rats from each group were sacrificed while the remaining rats in each group were kept for another 14 days for oral toxicities reversibility test. Blood samples and vital organs were obtained for biochemical, hematological and histological changes. Results showed that acute oral toxicity testing of NPM caused no death in any of the three sequentially treated rats and its estimated LD50 value was greater than 5000 mg/kg. Chronic oral treatment with 82-2050 mg/kg NPM caused significant elevations in the serum urea and creatinine and full blood count parameters (except differential WBC counts). The elevated renal function parameters were corroborated by dose-related histological changes of renal tubular congestions. also caused profound thrombocytosis and histopathological changes of pulmonary interstitial widening and gastritis. In conclusion, NPM may not be considered safe for consumption on prolonged use and at a high dose due to its profound tendencies to cause pulmonary fibrosis, nephrotoxicity, gastritis and thrombo-embolism. However, all the biochemical and hematological but histopathological alterations induced by NPM were reversed 14 days after the treatment cessation.

Completeness and adequacy of clinical and demographic information in non- gynaecologic surgical pathology requisition forms: an analysis of 1046 cases

BACKGROUND: An important cornerstone in health care delivery is the field of surgical pathology and one of its major aims is to provide a complete, precise and comprehensive diagnosis within a short period of time. In achieving this, the clinician needs to properly fill a surgical pathology requisition form.METHOD: All the consecutive requisition forms from January 1, 2018 to April 30, 2018, totaling 1046 were evaluated for completeness of the information. The requesting clinicians were unaware and cytologic smears were excluded. Patient confidentiality was maintained as no names were recorded. All the Information on the forms was recorded as being present or absent. Analysis was done using the Statistical Package for Social Science version 20.RESULTS: Altogether 1046 forms were evaluated and (100%) of the sample population bore the surnames and first names. Ages were recorded in 93.7%. Similarly, 68.2% of the forms did not bear the hospital number. Clinical summary and date of request were absent in 42.9% and 35.4% of the forms respectively. Clinicians name/ signature and investigation required were absent in 25.1% and 21.1% of the forms respectively. Overall, 77.6% of information was provided while 22.4% not provided.CONCLUSION: The names were completely filled in all the requisition forms. Others were incompletely filled. These findings should be communicated to Clinicians and the recurring attitude of allowing House Officers to fill the requisition forms should be discouraged. Efforts should also be made to let Clinicians appreciate the importance of good clinical information since this determines to a large extent the output of laboratory results

A 10 years autopsy-based study of maternal mortality in Lagos State University Teaching Hospital, Lagos, Nigeria.

BACKGROUND: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy. Nigeria is among the six countries that record over 50% of all maternal deaths in the world. There are few papers on autopsy based causes of maternal mortality. This paper is to present the causes of maternal mortality that had postmortem done in our center. MATERIALS AND METHODS: This is a 10-year retrospective study of all maternal deaths seen in our center from January 01, 2005 to December 31, 2014. Lagos State University Teaching Hospital is the only state-owned tertiary center and the main referral center in Lagos State. Autopsy records are taken from the death register and other information were extracted from the postmortem reports. RESULTS: Most maternal deaths 98/328 (29.9%) were seen in the age group 26-30 years which was followed by 31-35 years (24.7%). Postpartum hemorrhage was the most common cause of death followed by eclampsia. Direct causes accounted for 60% of maternal deaths with hemorrhage as the most common while cardiovascular related diseases are the most common indirect cause of death. CONCLUSION: The leading causes of death in this study, hemorrhage, cardiovascular disease and eclampsia are highly avoidable and treatable. We recommend that thorough cardiovascular management should be instituted during antenatal care, and the government should focus more on an emergency response such as availability of adequate blood and blood products in the hospitals.

Emerging Trends in the Epidemiological Pattern of Head and Neck Cancers in Lagos, Nigeria.

BACKGROUND: Unfortunately, despite an increase in medical knowledge, survival rates of head and neck cancers (HNCs) have not been observed to improve greatly. This is true, especially in tumors located in obscure primary sites or late presentation. AIM: The purpose of this study is to assess the epidemiologic pattern of HNCs and to evaluate its emerging trends and patterns in Lagos state. SUBJECTS AND METHODS: A retrospective study was conducted from 2003 to 2013 that analyzed histologically diagnosed cases of HNC at the Pathology Departments of the two tertiary teaching hospitals in Lagos. Data analysis was performed using the Statistical Package for the Social Sciences (version 20) statistical software. RESULTS: One thousand and eighty-three cases of head and neck malignancies were recorded. A female: male ratio of 1.01:1 was reported with mean age of 39.6 (standard deviation 21.1) years. The oral cavity was the most affected anatomic site (21.2%, 230/1083) in the period under review. Malignant epithelial tumors accounted for 72% (779/1083) of cases seen. Carcinomas were the most common histological variant seen (67%, 726/1083) and squamous cell carcinoma accounted for 58% (421/726) of carcinomas recorded. Oral cavity malignancies (21.8%, 118/540) were the most common in males while thyroid malignancies (28.5%, 155/543) were the most seen in females. In children (≤15 years), the most common histologic findings were carcinomas (42.3%; 77/182) and retinoblastomas (23.6%; 43/182). CONCLUSION: Epithelial malignancies were the most common malignancy in the study, and the oral cavity appears to be the increasingly predominant site for HNCs. A changing pattern in gender predominance, age distribution, and frequency with histological variants and anatomical sites was also observed in this study.