Faculty of Basic Medical Sciences

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Browsing Faculty of Basic Medical Sciences by Author "Abdulkareem, FB"

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    Open Access
    Adhesion molecules and rejection of renal allografts
    (Kidney international, 1997) Solez, K; Racusen, LC; Abdulkareem, FB; Kemeny, E; Willebrand, EV; Truong, L D
    Adhesion molecules and rejection of renal allografts. Despite an increasing amount of immunohistochemical and molecular biology data relating to the pathogenesis of kidney transplant rejection, the pathological diagnosis of this condition still rests on routine light microscopy. The detection of changes in expression and distribution of adhesion molecules in renal allograft biopsies may open a new era of increased accuracy of rejection diagnosis. Of the various adhesion molecule reactivities, peritubular capillary VCAM-1 staining appears to be the most specific rinding for chronic rejection. This same staining reaction is seen in acute rejection, but may have less specificity in that setting.
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    Open Access
    Adult Lymphomas in Lagos Nigeria: A Fourteen Year Study
    (Nigerian Quarterly Hospital of Medicine, 2007) Anunobi, C C; Banjo, A A F; Abdulkareem, FB; Daramola, A O; Akinde, R O; Abudu, E K
    Objective: we present a 14 year retrospective histopathological study of 92 cases of adult lymphomas in Lagos. The aim is to document the histologic types, age and sex distribution. Materials and method: The materials consisted of slides and paraffin embedded blocks of all cases of lymphoma in adults above the age of 16 years seen between 1991 and 2004 at the Morbid Anatomy Department of Lagos University Teaching Hospital Idi-Araba Lagos. Results: Of ninety two cases of lymphoma studied, male and female patients accounted for 59(64%) and 33(36%) cases respectively, giving a M: F ratio of 1.8:1. The most frequently biopsied site is the cervical lymph node. Non-Hodgkin's lymphoma (NHL) which accounted for 60 cases occurred most frequently in the 46-55 years age group and gives a male: female ratio of 2:1. Intermediate grade, high grade and low grade variants of NHLs accounted for 39%, 34% and 27% respectively. Hodgkin's lymphoma mostly affected patients of younger age group, 25-35 years with a M:F ratio of 1.7:1. Mixed cellularity 17 (55%) was the commonest subtype of Hodgkin's lymphoma. Conclusion: Non-Hodgkin's lymphoma is commoner than Hodgkin's lymphoma. The age and sex distribution agrees with reports from other parts of Nigeria and Africa with minimal variations.
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    Open Access
    Application of stool-PCR for the Diagnosis of Helicobacter Pylori From Stool in Nigeria- A Pilot Study
    (Springerplus, 2012) Smith, S; Fowora, MA; Lesi, OA; Agbebaku, E; Odeigah, P; Abdulkareem, FB; Onyekwere, CA; Agomo, CA; Contreras, M
    There are various methods for detection of Helicobacter pylori and the gold standard for non-invasive detection is the urea breath test (UBT). The aim of the study is therefore to detect H. pylori from the stool of patients with dyspepsia by PCR and compare results obtained with UBT. A total of 97 stool samples from patients presenting with dyspeptic symptoms in Lagos University Teaching Hospital (LUTH) were screened for urea breath test (UBT) and the presence of H. pylori DNA using stool-PCR. Out of 97 stool samples analysed, 38 (39.2%) were positive for Helicobacter spp. and 20 (20.6%) positive for H. pylori by PCR, through amplification of 16S rRNA and glmMgenes respectively. Of the 20 positive by glmM gene, the cagAgene was detected in 8 (40%) samples, while 47 (48.5%) out of 97 stool samples were positive for H. pylori by UBT. The sensitivity and specificity of the glmM gene compared with UBT as the gold standard is 42.6% and 100% respectively. The positive predictive value (PPV) was 100% while the negative predictive value (NPV) was 60%.The method may be useful for detecting H. pylori from stool amongst children especially where most hospitals lack endoscope for children although the method is expensive.
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    Open Access
    Autopsy Study of the Liver in Adult Nigerians at Lagos University Teaching Hospital
    (West African Journal of Medicine, 2019) Obiajulu, FJ; Badmos, KB; Awolola, NA; Dawodu, OO; Adebayo, LA; Elesha, SO; Abdulkareem, FB
    Background: Liver diseases are one of the major causes of morbidity and mortality in Nigeria. Detection of liver involvement in many disease conditions is often delayed till after death when autopsy is conducted, hence the importance of this study. Study design and method: This was a prospective study to assess the pathologic findings in the liver of one hundred (100) consecutive adults (without pre-mortem diagnosis of liver disease) at autopsy, at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. The organs were examined macroscopically, weighed and representative biopsies taken for histopathological assessment. Special histochemical stains to confirm diagnosis were carried out as appropriate. The biodata and other clinical information were obtained from the case notes. Analysis was carried using descriptive statistics. Results: One hundred cases were studied, comprising of 46 males and 54 females, with overall mean age 47±15.6 years. The mean weight of the liver was 1737±586.02 grams (normal 1200-1400gm). In 19.0% of the cases, the liver showed normal histology. Of the others with pathological findings (81%), the three most common pathologies were chronic venous congestion, steatosis, and metastatic tumours. There was significant correlation of liver pathologies diagnosed with causes of death at autopsy (p=0.001). Conclusion: In view of the fact that major liver diseases may be asymptomatic and may not be diagnosed until death, there is need for a high index of suspicion by clinicians. It is therefore important that clinicians properly assess the functional state of the liver to prevent, detect and promptly treat these disorders.
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    Open Access
    Benign Fibrous Histiocytoma of a Metacarpal Bone
    (BMJ case reports, 2011) Onovo, O D; Eyesan, SU; Abdulkareem, FB
    Benign fibrous histiocytoma (BFH) is a rare skeletal tumour. Its occurrence in the metacarpal bones is even rarer. The management in this location can be challenging, involving tumour resection and metacarpal reconstruction. The authors present a case of BFH involving the second metacarpal bone.
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    Open Access
    Bladder Cancer in Lagos: A 15 Year Histopathologic Review
    (The Nigerian postgraduate medical journal, 2010) Anunobi, C C; Banjo, A A F; Abdulkareem, FB; Daramola, A O; Akinde, O R; Elesha, S O
    Objective: To present a 15 year retrospective pathologic study of bladder cancers. The aim is to document histologic pattern, prevalence, sex and age distribution of urinary bladder cancer. Materials and methods: The materials consisted of slides, paraffin embedded tissue blocks and histology request forms of all urinary bladder biopsies received at the Morbid Anatomy department of Lagos University Teaching Hospital Idi-Araba, Lagos from 1991 to 2005. Each sample represents a different patient. The study did not include information regarding the clinical or pathological stage of the tumours. Results: Bladder malignancies comprised 39 (72.2 %) cases of all bladder biopsies and 0.86% of all diagnosed cancers in LUTH. The malignant lesions of the bladder showed a male preponderance with a M:F ratio of 4.6:1. The age range was 4-75 years with a mean age of 51.37 years and peak at 61-70 years age group. Transitional cell carcinoma was the commonest histological type accounting for 61.5% with a male to female ratio of 5:1 and mean age of 59 years. Squamous cell carcinoma accounted for 20.5% with a M:F ratio of 3:1 and showed a mean age of 47 years. Adenocarcinoma, anaplastic carcinoma and embryonal rhabdomyosarcoma accounted for 5.1%, 5.1% and 7.8% of cases respectively. Conclusion: Bladder cancer is not common in Lagos. The histopathologic pattern, prevalence, sex and age distribution of bladder cancer are similar to previous reports from schistosomiasis non endemic regions of Nigeria, Africa and the rest of the world.
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    Open Access
    Bone Malignancies in Orthopaedic Hospital Igbobi Lagos, Nigeria
    (Nigerian Postgraduate Medical Journal, 2014) Adeniran, JJ; Samuel, UE; Dike, OC; Olayinka, SO; Ayokunle, O; Nnodu, OE; Abdulkareem, FB
    Aims and objectives: To document the pattern of bone malignancies in a highly populated orthopaedic hospital in Lagos Nigeria; Patients and methods: A total of 21 cases of primary malignant bone tumours were studied. This comprised 12 cases of Osteosarcoma, 7 cases of Malignant Fibrous Histiocytoma (MFH) and 2 cases of Chondrosarcoma. Males (13) were affected more than females (8) giving a male to female ratio of 1.6 to 1. The age range was 7 to 45 years with a median age of 24 years. The diameter of the swelling ranged from 6 to 20 cm with a median of 12 cm. All patients had ablative surgery except for those with affectation of the ilium. Data was analysed using the Statistical Package for Social Sciences (SPSS 16). Enneking's classification was used to grade the tumour. The duration of symptoms of all the patients before presentation ranged from 3 weeks to 4 years with a mean of 7 months. The commonest site affected was around the knee (76.2%); distal femur had 42.9% and proximal tibia 33.3%. Results: Osteosarcoma was the most common malignant bone tumour in this series and accounted for 57.1%. The peak incidence was found in the 2nd decade of life. The youngest patient was 7 years old and the oldest 43 years. The tumour was found primarily around the knee. 7 cases were in the distal part of the femur, 4 in the proximal part of the tibia and 1 case was found in the distal radius. Out of the 12 patients with osteosarcoma, 8 had paraosteal type (5 high grade, 3 intermediate grade), the remaining 4 had periosteal (all high grade) Malignant Fibrous Histiocytoma was found in 7 patients and accounted for 33.3%. The peak incidence was found in 3rd and 4th decades. 4 out of the 7 patients were high grade pleomorphic osteosarcoma, 2 were myxoid high grade dedifferentiated and one was low grade giant cell tumour type. Chondrosarcoma was found in 2 patients, accounting for 9.5%. both cases were in the ilium Conclusion: Primary malignant bone tumours occurred in children and young adult in this study. It is commoner among males and most of the patients presented late to the hospital. Osteosarcoma is the commonest followed by Malignant Fibrous Histiocytoma, both occurred commonly around the knee and chondrosarcoma on the ilium.
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    Open Access
    Breast Cancer in a Lagos Facility-Implications for the Institution of a Cancer Screening Programme
    (Pathobiology, 2018) Ikeri, NZ; Oguntunde, OA; Igbokwe, U; Abdulkareem, FB; Banjo, AAF
    Objective: There are significant epidemiological and biological differences between breast cancer in blacks and whites which have wide-reaching implications for the institution of an effective cancer screening programme in Nigeria. The aim of this study was to describe the clinicopathologic features of breast cancer diagnosed in our facility and to discuss their implications for cancer screening. Methods: A retrospective review of the forms, slides, and results of breast cancer cases received in our facility over an 8-year period was carried out, as well as a systematic review of the characteristics of breast cancer in Nigeria, Africa, the US, and the UK. Result: A total of 832 cancers were seen with a mean age of 49 years. Most cases (97%) were invasive ductal carcinomas not otherwise specified, high grade (41.9%), and unassociated with ductal carcinoma in situ (52.3%). Triple-negative tumors were the commonest immunohistochemical type seen (42.1%), and these were less likely to have an intraductal component (p = 0.0048). Luminal-type tumours were more likely to be low grade (p = 0.0005). The majority of cases presented in advanced stages with no statistically significant difference among the different immunohistochemical subtypes (p = 0.7949). Conclusion: The significant epidemiological and biological differences between breast cancer in Lagos and in western populations are important for the establishment of an effective breast cancer screening programme uniquely tailored for the Nigerian population
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    Open Access
    Breast Cancer Reporting in Lagos, Nigeria-Implications for Training and Education in Africa
    (Journal of Global Oncology, 2016) Daramola, AO; Banjo, AAF; Abdulkareem, FB; Shaaban, AM
    Purpose: To assess the completeness and accuracy of breast cancer pathologic reporting in Nigeria. Materials and methods: The histologic parameters provided in breast cancer pathology reports at a large teaching hospital in Nigeria were assessed. The corresponding slides were reviewed after the United Kingdom Royal College of Pathologists guidelines, and results were compared. Results: Out of 115 breast cancer cases, histologic type of breast carcinoma was concordant with the review type in 53.1% of cases and discordant in 46.9%. Grading was stated in 89.62% of cases, of which 50.5% were correctly graded, 35.8% were under-graded, and 8.5% were over-graded. Poor fixation and omission of the mitotic count were the main reasons for discordant grades. A comment on lymph node status was included in 40% of cases, and lymphovascular invasion was not commented on in 97.4% of cases. Only 26% of the tumors had hormone receptors and/or HER2 tested. Conclusion: Some essential histologic parameters were absent from the histologic reports, and where present, a proportion were inaccurate. Attention to specimen fixation and method of grading and familiarity with uncommon breast cancer types are required; all can be facilitated by education and training. The use of a template/proforma is recommended to ensure cancer data set parameters are included in the pathology reports.
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    Open Access
    Challenges in the Diagnosis and Management of Musculoskeletal Tumours in Nigeria
    (International Orthopaedics, 2009) Ladejobi, A. O.; Abdulkareem, FB; Nnodu, O. E.; Obalum, D. C.; Eyesan, S. U.
    The management of musculoskeletal tumours is important because of the high mortality rates associated with the available treatment modalities. A 5-year prospective study of bone and soft-tissue tumours is presented, along with the difficulties encountered in diagnosis and treatment. There were 71 patients (male:female ratio of 1.7:1, age range 5-85 years, mean age 32 years) with an average duration of 24.7 weeks (range 1 day to 34 years) before presentation. No patient had computed tomography (CT) scanning or magnetic resonance imaging (MRI) due to financial constraints, 95% had biopsies and X-rays, 15% could afford chemotherapy/ror chemotherapy is a sad consequence. 50% agreed to amputation. In the soft-tissue sarcoma group, only one of three patients could pay for limb-sparing surgery. In the benign group, 65% had limb-sparing surgeries and 15% had amputation. Fifty percent (50%) of patients were lost to follow up within 3 months and 39% of the malignant group died within the same period. Musculoskeletal tumours are a reality in our environment and a significant portion of our population have financial limitations. Ignorance and cultural beliefs promote late presentation to our hospitals, which are poorly equipped to give optimal care, despite the presence of trained personnel.
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    Open Access
    Challenges in the Diagnosis and Management of Musculoskeletal Tumours in Nigeria
    (International Orthopaedics, 2009) Eyesan, S U; Obalum, D C; Nnodu, O E; Abdulkareem, FB; Ladejobi, A O
    The management of musculoskeletal tumours is important because of the high mortality rates associated with the available treatment modalities. A 5-year prospective study of bone and soft-tissue tumours is presented, along with the difficulties encountered in diagnosis and treatment. There were 71 patients (male:female ratio of 1.7:1, age range 5-85 years, mean age 32 years) with an average duration of 24.7 weeks (range 1 day to 34 years) before presentation. No patient had computed tomography (CT) scanning or magnetic resonance imaging (MRI) due to financial constraints, 95% had biopsies and X-rays, 15% could afford chemotherapy/ror chemotherapy is a sad consequence. 50% agreed to amputation. In the soft-tissue sarcoma group, only one of three patients could pay for limb-sparing surgery. In the benign group, 65% had limb-sparing surgeries and 15% had amputation. Fifty percent (50%) of patients were lost to follow up within 3 months and 39% of the malignant group died within the same period. Musculoskeletal tumours are a reality in our environment and a significant portion of our population have financial limitations. Ignorance and cultural beliefs promote late presentation to our hospitals, which are poorly equipped to give optimal care, despite the presence of trained personnel.
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    Open Access
    Childhood Renal Neoplasms in Lagos Nigera- A 28 Year Review
    (Nigerian Quarterly Journal of Hospital Medicine, 1999) Elesha, SO; Abdulkareem, FB
    Out of 131 nephretomies received at the Morbid Anatomy Department of the Lagos University Teaching Hospital, there were 63 cases of childhood renal cancer representing 48% of total renal neoplasm seen over a period of 1970-1997. The ages range from 21/2 months - 11 years; over 75% of the cases were found under 5 years with only 3.2% occurring above 10 years. The male female ratio is 1:1. Of the cancers, there were 42 cases of classical nephroblastoma and 10 cases of the blastema type of nephroblastoma. We had 7 cases of purely sarcomatous nephroblastoma one of which is a rhabdomyosarcoma and the remaining 6 were undifferentiated sarcoma. There was one case of anaplastic carcinoma. Also seen was a case of mesoblastic nephroma in a 21/2 months male infant. In this study, neither benign neoplasm nor congenital tumour (angiomyolipoma) was encountered, in all cases, there was no age nor sex disparity. Most of the patients presented with abdominal mass with a unilaterally enlarged kidney, abdominal pain, haematuria and weight loss. All of them had nephrectomy as initial treatment followed by radiotherapy and chemotherapy.
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    Open Access
    Clinical and Autopsy Parameters of Acute Medical Deaths in an Emergency Facility in South-West Nigeria
    (Journal of clinical sciences, 2013) Ajuluchukwu, JNA; Abdulkareem, FB; Achusi, IB; Mbakwem, AC
    Background: Acute medical deaths are usually consequences of acute critical diseases, or acute exacerbations of chronic diseases. Thus, autopsy – confirmed characteristics would provide support for future management strategies. Objectives: To examine clinical and autopsy parameters including causes of death (COD) and mechanisms of death (MOD) among acute medical deaths. Methods: A 5-year (2005–2009) retrospective analysis was undertaken of Emergency Department (ED) related medical deaths occurring <24 hours after presentation. Case-notes provided clinical details while autopsy records supplied the COD and MOD respectively. Results: Decedents were 250 males (58.5%) and 177 females (41.5%), (male: female ratio=1.4: 1), predominantly (78%) young; with mean age of 43.7±16.6 years. In 22.8%, symptom duration was <1 day but >4 days in 42.8%. Coma –36%, and dyspnoea –10% prompted early presentation; but late presentation (>4days) characterised cough (4%), fever (10%), and body swelling (19%). Of the total, 23% presented after 10 pm, 16% were “dead on arrival” (DOA), and 40% died within six hours of arrival. Three commonest CODs were circulatory-cardiovascular disease [CVD](36%), infections/ septicaemia (18%), and malignancies (8.4%). CVD subset was older (52 years), with significant male preponderance (62.5% vs 37.5%; p<0.05); but comparable mean age in both sexes. Common MODs were cerebral dysfunction (29%) – including sub-types of intra-cerebral haemorrhage (51.8%) and tonsillar herniation (33.3%), heart failure (19%), and septicaemia (15%). Conclusion: The highlights were late presentation, early demise from communicable and noncommunicable diseases; and common “exit” mechanisms of septicaemia, heart failure and cerebral dysfunction. These data will guide management and preventive strategies.
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    Open Access
    Clinico-pathologic Patterns of Extremity Liposarcoma
    (The Nigerian Postgraduate Medical Journal, 2010) Eyesan, S U; Obalum, D C; Onovo, D O; Ketiku, K K; Abdulkareem, FB
    Background: Liposarcoma is a tumour derived from primitive cells that undergo adipose differentiation. Objective: To describe the clinico-pathological pattern of extremity liposarcoma in Lagos, Nigeria. Methods: This is a descriptive study of patients with histologically established liposarcoma affecting the extremities seen at the Oncology unit of the National Orthopaedic Hospital, Lagos Nigeria. Demographic and clinical data ( including age, gender, presenting complaints anatomic location of lesions ), histologic type, clinical stage and treatment outcome were collected using a prepared proforma and analysed. Results: Liposarcoma accounted for 6 [27.3%] of 22 cases of soft tissue sarcomas seen within the study period. All 6 were males with a M:F of 6:0. The age range was 36- 59 years. Lesions were mostly located in the thigh 5/6 (83.3%). The most common histologic type was myxoid seen in 3/6 [50%]. All presented at stage T2bNoMo. Five (83.3%) had limb salvage surgery with adjuvant radiotherapy while one had ablative surgery. Survival and recurrent rates could not be determined as all patients were lost to follow-up soon after surgery. Conclusion: Liposarcoma is the commonest extremity soft tissue sarcoma seen in our centre, the myxoid type being the commonest histologic subtype.
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    Open Access
    Clinico-pathological Review of Malignant Gastric Tumours in Lagos, Nigeria
    (Nigerian Quarterly Journal Hospital of Medicine, 2010) Abdulkareem, FB; Onyekwere, CA; Awolola, NA; Ajekigbe, AT
    Background: Gastric cancer is one of the most common cancers and the 2d most common cause of cancer deaths worldwide. Contrary to earlier reports from Africa, prevalence of this cancer has been found to be comparable to that of other parts of the world. Objective: To describe the clinico-pathological features of gastric cancer diagnosed in Lagos and determine the prevalence of H. pylori infection in gastric adenocarcinoma. Methods: This was a retrospective histopathological study of all gastric cancer seen between 1995 and 2007 in the Morbid Anatomy Department of Lagos University Teaching Hospital as well as two other private histopathology laboratories in Lagos (2002-2007). The blocks and slides of gastric cancer tissue were the materials used for the study. The patients' bio data and relevant clinical details were extracted from the demographic records. Results: There were 105 cases of gastric cancer (M:F = 2:1, mean age-55.3 years), 81% of which occurred above 45 yrs. There were 95 cases (90%) of adenocarcinomas, 8 (7.6%) mesenchymal tumours with one case each of small cell non-Hodgkin's lymphoma and carcinoid tumour. H. pylori was detected in 15.5% of 45 cases of adenocarcinoma with 36% showing evidence of chronic gastritis in adjacent non cancerous gastric tissue. All patients with clinical data had one or more alarm features; most recurring being abdominal fullness, recurrent vomiting, anorexia and weight loss. Conclusion: This study suggests that gastric malignancies are not uncommon in Lagos and often manifest with alarm features which should raise a suspicion particularly in our setting with poor diagnostic endoscopic facilities.
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    Open Access
    The Clinicopathologic Pattern of Prostatic Carcinoma in Lagos, Nigeria
    (North American Journal of Medicine and Science, 2013) Odubanjo, MO; Banjo, AAF; Ayoola, S; Abdulkareem, FB; Anunobi, CC; Olayinka, AA
    This is a review of the clinicopathological pattern of prostatic carcinoma in Lagos, Nigeria. The mean age was 68.48 years. 20% of our patients were asymptomatic at presentation, significantly higher than values from most previous Nigerian studies, likely due to an established PSA screening program. This however did not appear to translate to better disease outcomes, likely because radical prostatectomy was not offered as a treatment option for early disease. 68.6% of symptomatic patients presented with lower urinary tract symptoms, and 4.4% had a family history of prostate cancer. The median PSA value at presentation was 58.90ng/ml. Clinical stages II and III disease were most common, 42.5 and 30% respectively. Gleason scores 6 and 8 were the most common (23.3 and 20% respectively). The clinical stage and the age showed the best correlation with disease progression evidenced by increased PSA 2 months after treatment (PSA progression) and metastasis during follow up. The Gleason score also showed good correlation with these parameters while the pre-treatment PSA showed poor correlation, possibly due to the high incidence of urogenital infections and prostatitis in this environment. The incidence of PSA progression and metastasis were 0.35 and 0.54 per patient year of follow up respectively.
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    Open Access
    A Clinicopathologic Review of Oesophageal Carcinoma in Lagos
    (Nigerian Quarterly Journal of Medicine, 2008) Abdulkareem, FB; Onyekwere, C A; Awolola, N A; Banjo, A A F
    Background: Oesophageal cancer is the 6th most common cause of cancer death world wide. While the incidence is low in some parts of Africa such as Nigeria accounting for 0.4-0.6% of all malignant tumours, it is endemic in Transkei, in South Africa, which is regarded as an epicentre of the disease in Africa. Objective: To document the age and sex distribution, clinical as well as histopathological characteristics of oesophageal carcinoma in Lagos, SW Nigeria, Methods: The paraffin embedded blocks and slides as well as pathology reports of oesophageal carcinoma collected between 1995 and 2007 from Morbid Anatomy Department of the Lagos University Teaching Hospital and between 2002 and 2007 from two private histopathology laboratories in Lagos State were reviewed. The clinical data such as the age, sex, and clinical summary were extracted from demographic information in patients' case file. Results: Twenty cases representing 2.8% of all gastrointestinal tumours were recorded. The mean age was 65.4 years (SD-12.3) with M:F ratio of 1:1. Squamous cell carcinoma predominated; 18 cases (90%); the remaining two cases (one of which showed evidence of Barrett's oesophagus) were adenocarcinoma (10%). All presented at advanced stage with dysphagia and weight loss with or without vomiting, regurgitation, and/or haematamesis. Two third had mid oesophageal fungating masses, the remaining were located in the lower third. Two cases had surgery, the rest were not fit for any intervention. Conclusion: Oesophageal cancer is not common in Lagos, Nigeria, majority are squamous cell carcinoma. Late presentation gives it a dismal outlook. Although the overall survival is poor, efforts at improving quality of life by palliative measures should be encouraged.
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    Open Access
    Colorectal carcinoma in Lagos and Sagamu, Southwest Nigeria: A histopathological review
    (World Journal of Gastroenterology, 2008) Abdulkareem, FB; Abudu, EK; Awolola, NA; Elesha, SO; Rotimi, O; Akinde, OR; Atoyebi, OA; Adesanya, AA; Daramola, AO; Banjo, AAF; Anunobi, CC
    AIM: To study the frequency, gender and age distribution as well as pathological characteristics of colorectal carcinoma (CRC) in Lagos and Sagamu in SW Nigeria. METHODS: This is a retrospective pathological review of histologically diagnosed CRC from 5 laboratories in Lagos & Sagamu. The clinical data, such as age, sex and clinical summary were extracted from demographic information. Cases of anal cancer were excluded from this study. RESULTS: There were 420 cases (237 males and 183 females) of CRC. It peaked in the 60-69 year age group (mean: 50.7; SD: 16.2), M:F ratio 1.3:1 and 23% occurred below 40 years. The majority was well to moderately differentiated adenocarcinoma 321 (76.4%), mucinous carcinoma 45 (10.7%) and signet ring carcinoma 5 (1.2%), and more common in patients under 40 years compared to well differentiated tumors. The recto-sigmoid colon was the most common site (58.6%). About 51% and 34% of cases presented at TNM stages Ⅱ and Ⅲ, respectively. CONCLUSION: CRC is the commonest malignant gastrointestinal (GIT) tumor most commonly located in the recto-sigmoid region. The age and sex prevalence and histopathological features concur with reports from other parts of the world.
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    Open Access
    Colorectal Carcinoma Screening in Lagos, Nigeria, Are We Doing It Right?
    (Gastroenterology Research, 2009) Onyekwere, CA; Abdulkareem, FB; Ashindoitiang, J; Ogbera, A O
    Background: Screening for colorectal cancer (CRC) has proven effective in reducing disease mortality and is also cost effective. Recent reports indicate that colorectal cancer is not uncommon and presents with advanced disease in Nigeria. Thus this study was aimed at reviewing the practice of CRC screening among medical practitioners in Nigeria. Methods: A self-administered questionnaire was utilized to obtain data for this study, which was distributed to over 500 practising doctors in Lagos, Nigeria from September to November 2007. The data obtained from the questionnaire include basic demographics, type of practice, duration in years of medical practice described as short (≤ 5 years), medium (5 to 10 years) or long (> 10 years), and knowledge regarding CRC, as well as CRC screening techniques and methodologies. Results: There were 300 respondents with a mean age (SD) of 33 (7.8) years and an age range of 23 - 67 years. In terms of duration of medical practice, 190 (63%) were short, 43 (14%) medium and 67 (23%) long. Majority (65%) of the respondents were in teaching hospitals, 18.5% in private hospitals and 5.7% were in general (community) hospitals. The knowledge of the clinical features as well as the risk factors of CRC was fair in over 75% of the respondents. Most respondents, 265 (87.8%), agreed that CRC was worth screening for; 21 (5%) did not. In all, 246 (82%) gave reasons for their responses. However, just over half of the respondents employed one of the following: faecal occult blood test (FOBT), double contrast barium enema (DCBE), flexible sigmoidoscopy, colonoscopy, or a combination of any of the techniques for screening. Usage of CT colonography was low. Screening rates by respondents for other malignancies in this survey was higher than that of CRC (prostate 95%, breast 97%, cervix 99%), though the most commonly encountered malignancy was breast cancer. On the contrary, for surveillance purposes, barely half of the respondents used FOBT annually or colonoscopy every 10 years, while less than half employed DCBE, sigmoidoscopy and CT colonography. Conclusions: Although awareness of CRC screening in this study is high, its performance is very low and highly variable in form in our region. There is a need to improve the practice of CRC screening through sensitising of medical practitioners to the need for screening, increase knowledge with regard to the relative merits of available methodologies for screening/surveillance of CRC and provide all necessary diagnostic resources and possible formulation of effective local guidelines.
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    Open Access
    Comparison of PCR with other diagnostic techniques for the detection of H. pylori infection in patients presenting with gastroduodenal symptons in Nigeria
    (International Journal of Epidemiology and Genetics, 2011) Smith, I; Fowora, MA; Otegbayo, JA; Abdulkareem, FB; Omonigbeyin, EA; Akere, A; Contreras, M; Haas, R
    The study was aimed at comparing PCR methods of direct detection from biopsy using the boiling method and one other method with two known gold standards (histology and CLO test) for the diagnosis of H. pylori in Nigeria. A total of 168 biopsies (three from antrum and one from corpus each) were taken from 42 patients presenting with various gastroduodenal symptons after informed consent was obtained from them.The biopsies were analysed using the CLO test kit and histology, while the boiling method as described by Holmes and Quigley (1981) was used to obtain DNA and then PCR using the 16S rRNA gene, glmM gene and cagA gene. With CLO test 15/42 (35.71%) were positive, histology 13/42 (30.95%) were positive, 16S rRNA 22/42 (52.38%) were positive, glmM 19/42 (45.24%) were positive, cagA 19/42 (45.24%) were positive. The sensitivity and specificity of the PCR tests with CLO as the gold standard showed that the tests were 100% sensitive and varied between 74.1% to 84.1% in specificity. The PPV and NPV showed that the NPV was almost 100%, while the PPV was between 68.2% and 75%. Using the histology as the gold standard, the sensitivity was almost 100% while the specificity, the PPV were reduced in comparison to the CLO test. The PCR test using the glmM gene appears to be the most reliable test for diagnosis of H. pylori in Nigeria most especially where culture is difficult due to the power outages.