Comparative histopathological analyses of non-scarring alopecia in systemic lupus erythematosus patients in Lagos Nigeria.

Background: Systemic lupus erythematosus (SLE) is known to cause non-scarring alopecia. However, histopathological evaluation is uncommon. Aim: The objective of this study was to document the histopathology of non-scarring alopecia and to compare histopathology of alopecic and normal appearing scalp areas in SLE hair loss patients. Patients and Methods: A cross-sectional comparative evaluation of scalp biopsies from 23 SLE patients; 12 with hair loss and 11 without was conducted over a 7-month period in 2020. A total of 58 scalp biopsies stained with H and E (23 vertical and 35 cross-sectional) were evaluated. Mucin deposit evaluation was done using Alcian blue (pH 2.5). Results: There were no significant differences in the sociodemographic data between the patients. The SLE hair loss patients demonstrated mucin deposition (91.7%), reduced size/number of sebaceous glands (58.3%), epidermal atrophy (50.0%), naked arrector pili muscles (50.0%), lymphocytic infiltration (33.3%), pigment incontinence (16.7%), fibrous stellae (16.7%), increased telogen percentage, and increased terminal versus vellus hair ratios. On comparing the histopathology of those who had hair loss to those without hair loss, the only significant difference was in the number and size of sebaceous gland. There were no significant differences between scalp areas with and without hair loss in the SLE hair loss patients. Conclusion: There are differences in size and number of sebaceous glands on histopathology between SLE patients who have hair loss and those who do not. Also, there are no histopathological differences between alopecic and non-alopecic scalp areas of SLE patient.

FOETUS-IN-FETU, A PAEDIATRIC RARITY IN AN INFANT AT IRRUA SPECIALIST TEACHING HOSPITAL, IRRUA, NIGERIA.

Introduction: Fetus in fetu is a paediatric rarity. It involves the presence of a mass resembling a fetus inside the body of a child or an adult. It is described as a twin growing inside the body of the other. It can be located in different parts of the body but commonly the retroperitoneum. It is usually benign. Case presentation: The patient was a 4 month old male infant who presented to the hospital with complaints of abdominal distention. The distention was noticed two months prior to presenting to our hospital. The distension was generalized and has been progressively increasing until presentation (1). There was no associated abdominal pain and no other abdominal symptoms. Conclusion: Treatment is by complete excision for histological examination.

Isolation and identification of microorganisms associated with automated teller machines on Federal Polytechnic Ede campus.

Automated Teller Machines (ATM) are visited everyday by millions of people. This machine is accessible to the general public irrespective of class, age or race. The contact point of all ATM machines is the hand which on their own are 'vaults' of microorganisms. An elaborate survey was taken for complete assessment of possible microbial contamination in the Federal Polytechnic Ede campus. Selected ATM machines on campus were used as case study to characterize, identify and determine the degree of bacterial contamination of microorganisms and their potential as reservoir of microbes. Swabs were collected from each ATM screen, buttons, floor, user's hand, and exposure of plates. After collection of the samples, they were plated in nutrient agar. The results showed the presence of increased bacterial count subsequently, most pathogens on characterization revealed the genus of the particular organisms E. coli, Pseudomonas, Staphylococcus aureus, Klebsiella, Micrococcus, Salmonella and Serratia. The study showed the potential hazard inherent in ATM machine usage and draws attention to our level of hand hygiene compliance.

Prognostic impact of pretreatment thrombocytosis in epithelial ovarian cancer.

AIMS: This study was aimed at investigating the prognostic impact of pretreatment thrombocytosis in epithelial ovarian cancer (EOC) patients in Lagos, Nigeria. METHODS: This was a retrospective cohort study involving the review of the clinical record of 72 patients with histologically confirmed EOC who were managed at the Lagos University Teaching Hospital, Lagos, Nigeria over a 7-year period from January 2010 to December 2016. Information on the sociodemographic data and platelet counts at diagnosis of EOC were retrieved from the patients' medical records. Descriptive statistics were then computed for all baseline patients' characteristics. Survival analyses were carried out using the Kaplan-Meier estimates. Multivariate analysis of these data was performed with the Cox proportional hazards model. RESULTS: This study revealed that the prevalence of pretreatment thrombocytosis was 41.7% among the women with EOC. Fifty-three (73.6%) of the women had the advanced-stage disease (FIGO stage III-IV) while 52 (72.2%) had high-grade disease (II-III). The majority (66.7%) of the women had a serous histological type of EOC while 76.4% had documented recurrence. Pretreatment thrombocytosis was significantly associated with the women's parity (P = 0.009), serum carbohydrate antigen 125 levels (P = 0.018), median progression-free survival (PFS) (P < 0.001), 3-year median overall survival (OS) (P < 0.001), type of primary treatment (P = 0.002), extent of cytoreduction (P < 0.001), presence of ascites (P = 0.002), International Federation of Gynecology and Obstetrics (FIGO) stage (P = 0.008), and histological type (P = 0.011). Pretreatment thrombocytosis was negatively associated with PFS (hazard ratio [HR] = 0.25; 95% CI 0.83, 0.75; P = 0.014) and 3-year OS (HR = 0.03; 95% CI 0.03, 0.27; P = 0.002). CONCLUSIONS: The study suggests that pretreatment thrombocytosis may be a useful predictor of survivals in EOC patients.

Autopsy Study of the Liver in Adult Nigerians at Lagos University Teaching Hospital.

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.

An audit of endometrial hyperplasias at the Lagos University Teaching Hospital.

INTRODUCTION: There has been much controversy and confusion surrounding the endometrial hyperplasias stemming from the use of a wide variety of terminologies and also from the pathophysiologic mechanisms underlying the various entities. The current classification by the World Health Organization (WHO) published in 2014 clarifies these issues. OBJECTIVE: The aim of this study, therefore, was to audit and standardize cases of endometrial hyperplasia diagnosed in our institution from 2007 to 2011. MATERIALS AND METHODS: The slides and request forms of cases diagnosed as endometrial hyperplasias at the Department of Anatomic and Molecular Pathology from January 1, 2007, to December 31, 2011 were retrieved, reviewed, and reported according to the WHO 2014 classification scheme. RESULTS: Hyperplasia without atypia accounted for the vast majority of cases (95.5%) and was the most common in the 5th decade. Concordance rates of 74.5% and 100% were found between endometrial hyperplasias without atypia and atypical hyperplasias with their previous diagnoses, respectively. CONCLUSION: The WHO classification scheme standardizes and simplifies the terminology used in the diagnosis of endometrial hyperplasias, while reflecting, at the same time, the current understanding of genetic changes that provide information necessary for prognostication and treatment.

Effectiveness of intra-operative Mitomycin-C in reducing the recurrence of pterygium in Irrua, Nigeria.

AIMS AND OBJECTIVES: To evaluate the effectiveness of intra-operative Mitomycin-C application after pterygium surgery in Irrua, Nigeria. MATERIALS AND METHODS: The medical records of all patients who had pterygium excision with intra-operative application of 0.4mg/ml Mitomycin C between June 2002 and May 2007 and followed up for at least a year were reviewed. RESULTS: Two hundred and forty three eyes (196 patients) had pterygium excision with intra-operative application of 0.4mg/ml Mitomycin C over this period. Male to female ratio was 2:1. The mean age of the patients was 47.1years (SD+ 15.4) Eleven eyes had recurrence after a minimum follow up period of one year. Six (54.5%) out of the eleven eyes that had recurrence had conjunctival granuloma and in such cases recurrence was early (between 2 to 3 months of surgery). Conjunctival granuloma was the main complication occurring in 35 eyes (14.4%). Occurrence of granuloma was significantly associated with recurrence (P =0.0006). Delayed wound healing occurred in 5 eyes (2.1%). There was no case of either scleral or corneal melting. CONCLUSION: Intra-operative application of 0.4mg/ml Mitomycin C is very effective in reduction of recurrence of pterygium after excision. Hence patients should be given the benefit of intra-operative use of Mitomycin C during pterygium surgery.

Prevalence of pterygium and pingueculum among motorcyclists in Nigeria.

OBJECTIVES: To find out the prevalence of pingueculum and pterygium among commercial motorcyclists in Benin City, Nigeria and to note any associated or risk factors. DESIGN: A prospective, cross sectional, case control study. SETTING: A local Government Area (Oredo) and University of Benin Teaching Hospital, Benin City, Nigeria. SUBJECTS: One hundred and forty four commercial male motorcyclists in motorcycle parks in the local Government area and a control group of 114 male indoor workers. MAIN OUTCOME MEASURES: Presence of pterygium or pingueculum. RESULTS: One hundred and forty four male motorcyclists formed the subjects of this study. The age range was 18 to 65 years with a mean age of 34.9 +/- 8.0 years. The total number of motorcyclists with pingueculum was 37 with 26 bilateral cases, 63 eyes were involved. The prevalence rate was 25.7%. Pterygium was present in 18 patients including 12 bilateral cases making a total of 30 eyes. The prevalence rate was 12.5% The total number of indoor workers with pingueculum was 24 and it was present in 46 eyes. The prevalence rate was 21.05%. Pterygium was present in 12 eyes of nine persons in the control group and the prevalence rate was 7.9%. There was no association between the duration of work as a commercial motor cyclist and the presence of a pterygium or a pingueculum. The usage of a hat/cap was found to have a protective effect as motorcyclists who do not wear hats are more likely to develop pingueculum than those who wear them. The use of glasses and hats together was found to be protective against the development of pingueculum and pterygium in this study. CONCLUSION: The prevalence rate of 12.5% of pterygium and 25.7% of pingueculum in commercial motorcyclists in this study is quite high when compared with that of the controls. The wearing of face caps/hats was found to have a protective effect. They should be educated about the importance of wearing protective goggles and caps/brimmed hats.

Pattern of utilisation of eye care services in Benin City, Nigeria.

UNLABELLED: Eye care facilities in Nigeria are still not uniformly distributed. Benin City has more eye care health facilities than most other parts of the country. This is probably due to the privilege of having training schools for both Ophthalmologists Ophthalmic Nurses and Optometrists. OBJECTIVE: This study was carried out with the aim of determining the pattern of utilisation of available eye care services in Benin City by the general public. METHODS: This is a cross sectional descriptive study in which 420 staff of ministries were randomly selected. With the aid of a self-administered questionnaire, we determined the previous use of eye care personnel for those who had had eye complaints in the past. The type of services they sought and the eye care personnel involved was documented RESULTS: Nearly 72% of respondents had received eye care services from professionals, that is ophthalmologists, optometrists and opticians. About 28% received treatment from sources that could be considered as inappropriate consisting of 14.1% that had self medication, 7.2% from patent medicine shops, 4.8% from traditional healers and 1.2% on advice from friends. CONCLUSION: Though a high percentage of respondents have received treatment for their eye ailments from appropriate professionals, an appreciable number still patronise inappropriate sources considering that the sampled population were privileged to have a minimum basic education .

Congenital anomalies of the eye and adnexae in Edo State, Nigeria.

AIMS AND OBJECTIVES: Congenital ocular anomalies are the result of defective development of the ocular tissues during intrauterine life. The aim of this study was to increase awareness amongst Ophthalmologists and other healthcare providers on some cogenital ocular anomalies seen in clinical practice. PATIENTS AND METHODS: The 5 cases presented in this study were cases seen during our routine clinics at the University of Benin Teaching Hospital, Benin City, Edo State and Irrua Specialist Teaching Hospital, Edo State. Informed consent was obtained from the patients regarding the study and the illustrative photographs displayed in the study. Case reports of various congenital anomalies involving the eye and adnexae in Edo State, Nigeria seen over a 1-year period are presented. RESULTS: The first 2 cases were cases of clinical anophthalmos/micophthalmos. The causative factor in one of them was presumably maternal drug (traditional medicine) ingestion for a period of 5 months during pregnancy. The others were cases of dermoid cyst, congenital lid eversion and congenital corneal opacities. CONCLUSION: The literature on congenital anomalies of the eye and adnexae is briefly reviewed.

Prevalence and causes of blindness in Otibhor Okhae Teaching Hospital, Irrua, Edo State, Nigeria.

PURPOSE: This hospital-based retrospective study was aimed at providing baseline information on the causes of blindness in the locality. METHODS: The case notes of all new patients attending the Eye Clinic of Otibhor Okhae Teaching Hospital, Irrua, Edo State, Nigeria, over a six-year period (January 1995-December 2000) were retrieved and analyzed. RESULTS: Over 6% (555) of new patients seen during this period were uniocularly blind while 3.9% (354) were binocularly blind. The leading causes of uniocular blindness were cataract, open-angle glaucoma and corneal ulceration/leucoma. Binocular blindness was mainly due to cataract, open-angle glaucoma and aphakia. CONCLUSIONS: The prevalence of blindness in the study population is high. Cataract, as the main cause of blindness, will require surgical relief, either in the teaching hospital or preferably in the patient's locality. Appropriate interventions need to be evolved (in the form of either mobile clinics or a series of surgical eye camps) to stem the present trend toward high prevalence of avoidable blindness. Prevention of ocular trauma is an essential factor in the reduction of blindness in children. Health education and bringing ophthalmological care to the doorstep of underprivileged rural dwellers will improve their level of awareness.

Solar retinopathy in Benin City, Nigeria.

The case reports of three patients who were seen at the University of Benin Teaching Hospital Benin City with a diagnosis of solar maculopathy are presented. There was good visual recovery in two of the patients. This report shows the effect on the retina of direct sun gazing. The need to use protective filters is emphasized.

Total eversion of the upper eyelids in a newborn.

A case of bilateral congenital eversion of the lids in a newborn is presented. The baby presented at the Eye Clinic of Otibhor Okhae Teaching Hospital about four hours after a spontaneous vaginal delivery. Surgical correction was carried out one eye at a time with absorbable sutures. Recovery was uneventful and normal anatomical configuration was regained 8-10 days post operatively. The aim of this case report is to create awareness among workers in maternity homes, primary health centres and other health institutions about the existence of this congenital anomaly. Prompt referral to the Ophthalmologist is advised, as the condition is very amenable to treatment.