Medical and Dental Students' Perceptions of the Learning Environment during Anatomic Pathology Placement at Obafemi Awolowo University, Ile-Ife, Nigeria.

BACKGROUND: The educational environment is an important factor in nurturing students' learning. Students' experiences of the climate of their learning environment positively correlate with their academic success, achievements and satisfaction. OBJECTIVES: The study aimed to determine the perceptions of medical and dental students about their learning environment during anatomical pathology clinical placement. METHODOLOGY: A prospective, cross-sectional study using a guided self-administered Dundee Ready Education Environment Measurement (DREEM) questionnaire was conducted among fourth year medical and fifth-year dental students on anatomical pathology placement at the College of Health Sciences, Obafemi Awolowo University Ile-Ife, Nigeria. One hundred and eleven of 118 students participated in the study. RESULTS: The age range was 19-35 years. The majority of the students were males ( n= 80, 72.1%). The overall mean score was 115.19 ± 25.6 (maximum obtainable total score = 200), indicating that the students perceived their learning environment as more positive than negative. The mean score for each subscale of the DREEM instrument was: 29.24/48 (60.9%) for perception of learning; 25.67/44 (58.3%) for perception of teaching; 20.89/32 (65.3%) for academic self-perception; 25.61/48(53.4%) for perception of the atmosphere of learning; and 13.52/28 (48.3%) social self-perception. No statistically significant difference was found by sex, age group, and course of study for each DREEM domain. CONCLUSION: Students' perception regarding the learning environment for anatomical pathology in the focal university shows the need for improvement across various domains. However, academic self-perception and social self-perception are the areas of greatest need.

FOND: L'environnement éducatif est un facteur important pour favoriser l'apprentissage des élèves. Les expériences des étudiants du climat de leur environnement d'apprentissage sont positivement corrélées avec leur réussite scolaire, leurs réalisations et leur satisfaction. OBJECTIFS: Le but de l'étude était de déterminer les perceptions des étudiants en médecine et en médecine dentaire sur leur environnement d'apprentissage lors d'un stage clinique en pathologie anatomique. METHODOLOGIE: Une étude prospective transversale à l'aide d'un questionnaire guidé auto-administré Dundee Ready Education Environment Measurement (DREEM) a été menée auprès d'étudiants en médecine et en médecine dentaire de quatrième année en stage de pathologie anatomique au collège des sciences de la santé, Obafemi Awolowo University Ile -Ife, Nigéria. Cent onze des 118 étudiants ont participé à l'étude. RESULTATS: La tranche d'âge était de 19 à 35 ans. La majorité des étudiants étaient des hommes ( n = 80, 72,1 %). Le score moyen global au questionnaire DREEM était de 115,19 ± 25,6 (score total = 200), indiquant que les étudiants percevaient leur environnement d'apprentissage comme plus positif que négatif. Le score moyen pour chaque sous-échelle de l'instrument DREEM était : 29,24/48 (60,9 %) pour la perception de l'apprentissage ; 25,67 /44 (58,3%) pour la perception de l'enseignement ; 20,89/32 (65,3 %) pour l'autoperception académique ; 25,61/48' (53,4 %) pour la perception de l'atmosphère d'apprentissage ; et 13,52/28 (48,3%) d'auto-perception sociale. Le domaine de l'auto-perception sociale présentait un problème nécessitant une amélioration significative. CONCLUSION: La perception des étudiants concernant l'environnement d'apprentissage de la pathologie anatomique dans l'université focale montre le besoin d'amélioration dans divers domaines. Cependant, l'auto-perception académique et l'autoperception sociale sont des domaines dont les besoins sont les plus grands. Mots clés: Milieu d'apprentissage, pathologie, perception des élèves, DREEM.

Comparative Immunohistochemical Analysis of p53 and Alpha-SMA in Ameloblastoma, AOT and OKC.

OBJECTIVES: Ameloblastoma is a benign but highly infiltrative tumour, a behaviour that is lacking in adenomatoid odontogenic tumour but partly shared by the odontogenic keratocyst which possesses a unique intrinsic growth potential with marked ability for destroying bone and a high tendency recurrence. High frequency of stromal myofibroblasts (assessed with alpha smooth muscle actin (α-SMA) correlates with aggressive behaviour while p53-cell cycle regulation system is critical in odontogenic tumours with immunoreactivity signifying prognostic status. This study aims to determine and compare the immunoreactivity of these selected tumours to p53 and α-SMA in order to establish if a relationship exists between the frequency and pattern of distribution of myofibroblasts and the behaviour of these lesions. MATERIALS AND METHODS: 69 blocks of ameloblastoma, and 23 each of adenomatoid odontogenic tumor (AOT), and odontogenic keratocyst (OKC/KCOT) were retrieved. Immunohistochemistry technique was applied for evaluation of these two markers staining with primary antibodies to p53 and -SMA and the frequency and pattern of distribution of myofibroblasts and immunoreactivity to p53 analysed and compared using ANOVA. p was set at <0.05. RESULTS AND CONCLUSION: Immunoreactivity to p53 and α-SMA was highest in ameloblastoma (solid compared to unicystic) with highest mean positive cells to α-SMA (29.7±20.1) and p53 (28.3±24.5) in plexiform ameloblastoma. This suggests that ameloblastoma was the most aggressive of tumours studied. Different pharmacological agents that can regulate stromal MF are useful aids to decrease the need for radical surgery in extensive and aggressive odontogenic tumours.

ABSTRAIT OBJECTIFS: L'améloblastome est bénin mais untumeur mes infiltratif, un comportement qui fait défaut dans la tumeur odontogénique adénomatoïde mais en partie partagé par le kératocyste odontogène qui possède un potentiel de croissance intrinsèque unique avec une capacité marquée de destructionet une récidive à forte tendance. Haute fréquence de stromalmyofibroblastes (évalués avec de l'actine musculaire alpha lisse (α-SMA) est en corrélation avec un comportement agressif lors de la régulation du cycle des cellules p53 est essentiel dans les tumeurs odontogènes immunoréactives signifiant le statut pronostique. Cette étude vise à déterminer et comparer activité l'immunoré de ces tumeurs sélectionnées à p53 et α-SMA afin d'établir s'il existe une relation entre le fréquence et schéma de distribution des myofibroblastes et de la comportement de ces lésions. MATÉRIAUX ET MÉTHODES: 69 blocs d'améloblastome, et 23 chacun de tumeur odontogénique adénomatoïde (AOT) et odontogènedes kératocystes (OKC/KCOT) ont été récupérés. Immunohistochimiela technique a été appliquée pour l'évaluation de ces deux marqueurs de coloration avec des anticorps primaires dirigés contre p53 et α-SMA et la fréquence et schéma de distribution des myofibroblastes et de l'immunoréactivité àp53 analysé et comparé à l'aide de l'ANOVA. p a été fixé à <0,05. RÉSULTATS ET CONCLUSION: Immuno réactivité à p53 et α-SMA était la plus élevée dans l'améloblastome (solide par rapport α-SMA (29,7±20,1) et p53(28,3±24,5) dans l'améloblastome plexiforme. Cela suggère que L'améloblastome était la tumeur la plus agressive étudiée. Les agents pharmacologiques différentes peuvent réguler la MF stromale sont des aides utiles pour diminuer le besoin de chirurgie radicale en cas de chirurgie étendue et agressive tumeurs odontogènes. Mots-clés: Améloblastome, AOT, OKC/KCOT, p53, α-SMA, myofibroblastes, tumeurs odontogènes, immunoréactivité.

Histological Features and Tissue Microarray Taxonomy of Nigerian Breast Cancer Reveal Predominance of the High-Grade Triple-Negative Phenotype.

INTRODUCTION: Little is known about the biology, molecular profile and hence optimal treatment of African Nigerian breast cancer. The aim of this work, therefore, was to characterize the histology and molecular profile of Nigerian breast cancer. METHODS: Breast carcinomas from women at 6 centres of similar tribal origin in Nigeria were reviewed and assembled into tissue microarrays (TMAs), and sections were stained for hormone receptors, i.e. estrogen receptor (ER)α, ERß1, ERß progesterone receptor (PR) and androgen receptor, cyclin D, HER2, Ki67 and cytokeratins (CKs), i.e. CK5/6 and CK14 (basal) and CK18 and 19 (luminal). RESULTS: A total of 835 tumours were analysed. The mean age at diagnosis was 48.62 ± 12.41 years. The most common histological subtype was ductal NST (no-special-type) carcinoma (87.3%). Over 90% of the tumours were grade 2 or 3. The predominant molecular phenotype was the non-basal, triple-negative type (47.65%) followed by the HER2-positive group (19.6%). The percentage of ER-, PR- and HER2-positive tumours was 22.4, 18.9 and 18.8%, respectively. CONCLUSION: Nigerian breast cancer predominantly has a high-grade, triple-negative profile. It occurs at a younger age and bears similarities at the molecular level to pre-menopausal breast cancer in white women, with remarkably lower levels of ERß expression. The early presentation and histological and molecular phenotype may explain the poor prognosis, and tailoring treatment strategies to target this unique profile are required.

Pattern of placenta histopathology in low birth weight babies seen in a tertiary health centre in South-Western Nigeria.

BACKGROUND: Pre-term delivery is usually associated with low birth weight and is a known obstectrics problem in our setting. Few Histopathologists are interested in placental pathology, and this is particularly so because consent is often difficult to get from the relatives making few specimens available for study in our environment. OBJECTIVE: Our objective was to evaluate the placental histopathology in low birth weight infants (LBW, birth weight < 2500 g) and to determine if placental histopathological findings are associated with low birth weight and preterm deliveries. METHODS: The placenta of thirty-eight consecutive cases of LBW deliveries at the Obafemi Awolowo University Teaching Hospital, Wesley Guild Hospital, (lesa were histologically examined. RESULTS: A total of thirty-eight LBW placentas were examined. The Male: Female ratio was 1.8:1. The maternal age range 19 - 38 years (mean age = 28.7 yrs +/- 5.37SD). The parity ranged from 0 to 5. The birth weight ranged 0.75 - 2.4kg (mean 1.84kg +/- 0.39SD). The gestational age at delivery range was 25 - 38 weeks (mean 32.85 weeks +/- 3.7SD). Histological examination of the placentae showed that 17 cases (44.7%) had evidence of placenta malaria (PM), 17 cases (44.7%) had chorioamnionitis (CA), 9 cases (23.7%) had villitis, 2 cases (5.3%) had vasculitis and 4 cases (10.5%) had no abnormality. Four sets of twins (8 cases) were among the 38 cases seen. A case of abruptio placenta was delivered by caesarean section, with histological diagnosis of active- chronic malaria. Out of the cases with CA11 (64.7%) had mild CA, 4 (23.6%) moderate while 2 (11.8) had severe infection. Placenta malaria co-infection was also found in 7 (41%) of the CA. Nine (23:7%) had villitis, only 2 cases had umbilical cord vasculitis. Of the cases with PM, 10 (58.8) had active-chronic infection while 7 (41.2%) had evidence of past infection. CONCLUSION: The main placenta findings histologically in LBW babies include chorioamnionitis and placenta malaria infection. These are known contributory factors to preterm labour. Improved maternity care, health education of pregnant women to reduce ascending infection and use of intermittent preventive treatment for malaria in pregnancy will go a long way in improving outcome of pregnancy.

Carcinoma head of the pancreas masquerading as hepatocellular carcinoma: a case report.

BACKGROUND: Cancer of the pancreas is the primary malignant tumour of the pancreas commonly seen in the elderly. Hepatitis B virus infection is not a known marker of the disease, but patient with carcinoma head of the pancreas presenting with epigastric mass with positive hepatitis B infection in the region of the world with high endemicity for hepatitis B virus infection may cause diagnostic pitfall. OBJECTIVE: To present a case of carcinoma head of the pancreas masqueradingas hepatocellular carcinoma METHODS: A review of the case note, autopsy findings including gross and microscopic examinations and literature was done. RESULTS: An elderly woman with history of weight loss and cigarette smoking.There was an epigastric mass and the liver was enlarged. The serum hepatitis B antigen was positive. Autopsy revealed an ill-defined mass in the head of the pancreas with metastasis to the liver. CONCLUSION: Things are not always what they seem.

Perinatal autopsies in a tertiary health facility in Southwestern Nigeria: a retrospective evaluation of 14 consecutive cases.

BACKGROUND: Perinatal autopsy remains a valuable tool in perinatal medicine. It provides an insight into the genetic implications of subsequent pregnancies and also helps reduce parental events such as maternal illness or maternal use of medications. The practice is not popularly acceptable in our environment for socio-cultural reasons. The scarcity of pathologists who are interested in this aspect of pathology is also an issue. No wonder, the literature is scanty on the cases of perinatal autopsy reported in our environment. MATERIAL AND METHODS: This was a retrospective review of patients' medical and autopsy records to measure the perinatal autopsy rate at a tertiary health institution and identify the trends over the last 12 months (January 1, 2010 and December 31, 2010). This study also aim examining any discordance between antemortem diagnoses and postmortem diagnoses. RESULTS: Of 263 perinatal deaths, autopsies were requested and performed in 14 of the cases representing a perinatal autopsy rate of 5.3%. New information was obtained in 64.3% of the cases. The birth weights of the infants ranged from 500g to 3600g with their gestational ages ranged from 22 weeks to 41 weeks. CONCLUSIONS: This study is a preliminary report that serves principally to provide base line data for the ongoing study.

Human cysticercosis of the breast mimicking breast cancer: a report of a case from Ile-Ife, Nigeria. .

BACKGROUND: Human cystericosis is the infection caused by the larvae of pork tapeworm Taeniasolium. The infection commonly affects the muscle, the central nervous system and subcutaneous tissues. The involvement of the breast is unusual. OBJECTIVE: To present a 54 years old postmenopausal woman, a petty trader and a Jehovah witness who presented with a painless lump in the right breast which was increasing in size. The mass was clinically diagnosed by the Surgeon who examined her as a case of right breast cancer and an excisional biopsy was done. METHOD: A review of the case note, autopsy findings including gross and microscopic examinations and literature was done. RESULTS: A histopathological appraisal of biopsy revealed the presence of the typical cysticercus larva and a definitive diagnosis of right breast Cystericosis was made. The diagnosis of cysticercosis in unusual sites such as breast may be clinically difficult and this supports why all biopsies must be sent to the pathologists for definitive diagnosis. CONCLUSION: Human cystericosis of the breast is rare, nevertheless, this should be considered as a differential diagnosis for amass in the breast particularly in the tropics and developing countries. To the best of our knowledge, this is the first case from our centre.

Selenium levels in neoplastic breast lesions.

AIMS AND OBJECTIVES: The aim of this prospective case controlled study was to evaluate the tissue levels of selenium in patients with cases of fibroadenoma, cancer of the breast and in the controls in order to relate them to the occurrence of breast diseases. SUBJECTS AND METHODS: Consecutive consenting patients who had histologically confirmed breast cancer and fibroadenoma attending the General surgical outpatients departments of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, were recruited for the study. One gram of core disease breast tissues was taken for Selenium level estimation. RESULTS: There were 127 female subjects;. 95 (74.8%) cases of fibroadenoma and 32 (25.2%) of breast cancer. While breast cancer was common on the left, fibroadenoma was more common on the right breast (? = 8.994; p=0.011). The median tissue level of selenium in patients with fibroadenoma was 0.0272 mg/g with a range of 0.0124 to 0.0576 mg/g and that of the cancer patients was 0.0178 mg/g with a range 0.0072 to 0.0436 mg/g. These were statistically significantly different ( p=0.001). Factors affecting tissue selenium level include age (p<0.001), overall stage of breast cancer (p<0.001), maximum length of breast mass (p=0.023), previous delivery (p=0.004), age at last confinement (p=0.007), parity (p<0.001), oestrogen receptor (ER) status (p<0.001) and progesterone receptor (PR) status (p=0.021). CONCLUSION: Tissue selenium was lower in breast cancer than in fibroadenoma; Tissue selenium inhibits carcinogenesis; low tissue level of selenium therefore may be a factor in the development of breast cancer.

Pseudoangiosarcomatous squamous cell carcinoma in an old surgical scar of an African woman.

BACKGROUND: Squamous cell carcinoma, a malignant proliferation of keratinocytes, can be found in many regions of the body covered by stratified squamous epithelium and in areas covered by other epithelia but which had undergone squamous metaplasia. Squamous cell carcinoma has many variants. METHODOLOGY: We, retrospectively, reviewed the case file and histological features of a 75 year old trader with a rare variant of squamous cell carcinoma arising from an old surgical scar. CASE REPORT: The 75-year-old African female trader presented to the hospital with three and a-half month history of a swelling in the anterior aspect of the left leg arising from an old surgical scar. Clinical examination showed an irregularly shaped ulcer measuring 14 x 16 cm with an everted edge and a hyperpigmented floor. Histologic sections of the specimen showed the infiltration of the papillary and reticular dermis of the skin by sheets of atypical spindle cells with areas of squamous differentiation. There was a contiguous area of capillary-like structures constituting about 30% of the sections examined. The neoplastic cells were positive for vimentin and cytokeratin but were negative for CD34. The diagnosis was pseudoangiosarcomatous squamous cell carcinoma. CONCLUSION: This tumour can be found in Africans and in an old surgical scar. It can coexist with other variants of squamous cell carcinoma. There may be need in the future to add a new mixed variant to the current classification scheme.

Leiomyosarcoma of the uterus: a clinicopathological report of two cases and review of literature.

Leiomyosarcomas of the uterus are highly malignant tumours that are rare and represent slightly over 1% of all uterine malignancies. The clinical presentation is fairly constant and includes abnormal vaginal bleeding, pains or both. Only two cases (0.6%) out of 337 uterine malignancies seen over a period of 15 years in Ile-Ife had histological diagnosis of leiomyosarcoma. Both patients were postmenopausal, aged 49 years and presented in advanced disease stage. Two months after surgery, one of the patients died from disease progression while the other defaulted while on chemotherapy. Leiomyosarcoma of the uterus though rare in our environment, when it occurs, presents with advanced stage of the disease. Poor compliance coupled with high cost of treatment portends poor prognosis thus making it rapidly fatal.

Age and Pattern of Pap Smear Abnormalities: Implications for Cervical Cancer Control in a Developing Country.

AIM: To characterize the age and pattern of Pap smear abnormalities in a major teaching hospital in Southwestern Nigeria. DESIGN: This is a review of medical records of patients that came for cervical cancer screening. MATERIALS AND METHODS: The Pap smear results of women between May 2013 and April 2015 were retrieved. A total of 2048 Pap smear results were retrieved during the study period and analyzed with Statistical Package for Social Sciences (SPSS) version 20. A total of 252 (12.3%) samples were excluded from the analysis. RESULTS: The mean age of the women was 45.77 ± 9.9 years and the mode was 50 years. Normal Pap smear result was reported in 728 (40.6%) women. Only 20 women has had more than one more than one Pap smear done. The most common abnormality was inflammatory smear result as this was reported in 613 (29.9%) women. Atypical squamous cell of undetermined significance, low-grade squamous intraepithelial lesion (LGSIL), and high-grade squamous intraepithelial lesion (HGSIL) were reported in 117 (5.7%), 209 (10.2%), and 111 (5.4%) women, respectively. Atypical glandular cell and squamous cell carcinoma were reported in 12 (6.0%) and 3 (1.0%), respectively. CONCLUSION: There is a high incidence of abnormal Pap smear in this environment and women start cervical cancer screening late in their reproductive life, past the age at which cervical premalignant lesions peak. This may be a contributing factor to the high burden of cervical cancer in developing countries.

Pulmonary alveolar microlithiasis--a case report.

Pulmonary alveolar microlithiasis (PAM) is a rare disease of unknown aetiology. It is characterized by the presence of calcific concretions (calcospherites) inside the alveoli. We present a case of a 22 year old sickle cell anaemia patient with an incidental finding of PAM. This report is to highlight the fact that though rare, PAM is not entirely unheard of in this environment and should be kept in mind as a cause of diffuse opacities of the lungs.

A huge low-grade fibromyxoid sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome: a case report and review of literature.

INTRODUCTION: Low-grade fibromyxoid sarcoma (LGFMS) is a rare non epithelial tumour. It usually arises from the smooth muscles of the extremities. It is, however, occasionally reported to arise from other regions of the body. CASE REPORT: We report the case of a 32 year old man who complained of a progressive abdominal swelling of 4 months duration. There was associated abdominal discomfort and weight loss. Abdominal examination revealed a non-tender intra abdominal mass filling the abdomen completely. Abdominal ultrasound suggested a massive splenomegaly. Abdomina Computerized Tomography (CT) scan was not done due to financial constraints. At laparotomy, a large, pearl-coloured mass was found within the mesentery of the proximal jejunum, with dilated, tortuous vessels. It was resected along with the overlying 60 cm of jejunum. It weighed 7.5 kg. Histology and immunohistochemistry confirmed the diagnosis of lowgrade fibromyxoid sarcoma. Post-operative period was uneventful and there were no features of recurrent after 2 year of follow up. CONCLUSION: LGFMS may cause a diagnostic dilemma, especially in a third world setting where preoperative diagnosis is hampered by lack of facilities and poverty. A high index of suspicion is needed for preoperative diagnosis, which is necessary for proper planning of the operation.

Audit of management of gallbladder cancer in a Nigerian tertiary health facility.

BACKGROUND: Gallbladder cancer is a rare malignancy with a variable incidence worldwide. It ranks number eight among all gastrointestinal cancer seen in Nigeria. It is associated with high mortality and morbidity because it is usually diagnosed very late. Adequate surgical resection is the only modality with hope of cure. This requires advanced surgical skills which is quite rare in most developing countries like Nigeria. In this current work, we audit the management and outcome of gallbladder cancer in our hospital, highlighting peculiarity associated with our setting. PATIENTS AND METHOD: Consecutive patients managed as cases of gallbladder cancer at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between January 1990 and December 2010 were studied retrospectively. Patient demographics, disease and treatment-related variables, and outcomes were analyzed by SPSS version 16.0. RESULTS: Thirty-one cases of gallbladder cancer were diagnosed over the 21-year period, and this accounts for about 0.3% of all cancer cases seen in our hospital. The median age of this patient cohort was 58 years (range 28 to 79 years). Seventeen (54.8%) patients were age below 60 while 14 (45.2%) were age 60 and above. Twenty-seven patients (87.1%) were female and four (12.9%) were male, with a male to female ratio approximately 1:7. Over 80% of the patients presented with a triad of upper abdominal pain, weight loss, and jaundice. Majority (67.7%) of the patients were diagnosed intraoperatively. Only four patients underwent complete resection as they had radical cholecystectomy including regional lymph node dissection and wedge resection of the gallbladder fossa of the liver. The stages of the resected patients were T3 in three patients and T2 in one. Overall 1- and 5-year survival rates for our entire patient cohort were 32% and 10%, respectively. CONCLUSION: In conclusion, this study showed that preoperative diagnosis of gallbladder cancer could be challenging in our environment. A triad of upper abdominal pain, jaundice, and weight loss with judicious use of available radiological modality will increase the chances of making the preoperative diagnosis of the cancer. It also showed that good outcome can be obtained when radical surgery is offered to these few patients within the limitation of resources in few patients with resectable tumor.

Testicular and para-testicular tumors in south western Nigeria.

BACKGROUND: Tumors of the testis and paratesticular tissues are rare, especially in men of African descent. In recent reviews however, the incidence is rising among the Caucasians and black Americans. We set out to determine the incidence in South-Western Nigeria and to examine the histopathologic variants. METHODS: A retrospective study of patients who had histopathologically confirmed testicular and para-testicular tumours between 1989 and 2005 (17 years). Their records were documented at the Ife-Ijesha cancer registry which serves 4.7 million men residing in three states of South-Western Nigeria. RESULTS: There were 26 cases of testicular and para-testicular tumors with an average incidence of 1.5 cases per year. The incidence of testicular cancer in our study was 0.55 per 100,000 population (95% CI, 0.52-0.57) and accounted for 1.1% of all male cancers. Rhabdomyosarcomas were the most common variety (70% of the paratesticular tumors and 26.8% of all tumors of the testis). Seminomas comprised 50% of the germ cell tumors and 15.4% of all testicular tumors in this series. CONCLUSION: There still remains a low incidence of testis cancer in the South Western Nigeria. The reduction in the incidence of seminomas makes rhabdomyosarcomas the most predominant tumor in South Western Nigeria.

Wait time and service satisfaction at Antenatal Clinic, Obafemi Awolowo University Ile-Ife.

OBJECTIVE: Antenatal care is an essential aspect of health care delivery for improving pregnancy outcome such that about two-thirds of maternal deaths can be prevented. The study was carried out with the aim to assess patient satisfaction on some aspects of antenatal care services (timeliness, courtesy, communication and competence of personnel in the clinic) and estimated time spent in clinic. METHODOLOGY: The study was a cross sectional survey of pregnant mothers attending antenatal clinic of the Obafemi Awolowo University Teaching Hospital Complex within the period of the study. The patients who were willing to participate in the study were recruited and interviewed with pretested questionnaire. Direct observation of the total time spent clinic was also conducted. RESULTS: Four hundred pregnant mothers were recruited and interviewed. 55% were satisfied with the quality of health talk, 72.6% were of the opinion that the services of the hospital are good and meet their needs and 87% agreed with the quality of health talk. 53.7% agreed with the competency of the hospital staff, 39.1% agreed with timely response of the staff and 20.5% were of the opinion that the staffs were friendly and polite. The socio-demographic factors that significant influenced the respondent's satisfaction of the antenatal services and time spent in clinic were educational and occupational status. The total time spent in the clinic was 2hrs 42 mins of which 1 hr 40 was spent at the nurse's desk, 13 minutes for consultation with the doctor and the rest for laboratory services, record services. The transit time before consultation with nurses and doctors were 51.2 minutes and 2 hr 29 mins respectively. CONCLUSION: Majority of respondents were satisfied with the care received, however long waiting times is the norm of antenatal care services