Impact of 10-Day Fulbright Specialist Program and Project Pink Blue Education Sessions on Medical Oncology Knowledge Among Physicians Who Treat Cancer in Nigeria.

Despite an estimated population of over 201 million and over 115,950 yearly diagnosed new cases of cancer, Nigeria does not have dedicated medical oncologists. Most oncology care is delivered through surgical and clinical oncologists, who are trained in both radiation and medical oncology and they number fewer than 50 in the country. With a limited number of oncology professionals, cancer patients in Nigeria experience poor health outcomes, with an estimated cancer mortality rate of 75,000 deaths per year. Participants from 15 Nigerian states were selected to attend the medical oncology training. Through the support of Fulbright Specialist Program and Project PINK BLUE, two of the authors delivered 10 days of lectures based on ASCO, ESMO, and NCCN guidelines. Mean scores of both the pre- and post-course tests as well as a 1-year follow-up test were compared using GraphPad Prism 7.0a by paired t-tests. Forty-four clinical oncologists were selected for participation. Twenty-five (57%) completed the pre- and post-course tests. Of the 25 that completed both tests, percentage of correct answers increased from 45 to 59% (2-sided p-value < 0.0001). Improvements were seen in attending doctors 45 to 59% (p = 0.0046) and resident doctors 45 to 59% (0.0007). Eleven doctors responded to the 1-year follow-up test. Although not statistically significant, a numerical pattern for the benefits was maintained 1 year after the program (45% pre-course versus 52% post-course correct answers, Fisher's exact, p = 0.4185). In the short term, the training improved medical oncology knowledge in Nigeria, regardless of the participant's carrier stage. Long-term benefits were not sustained in a small sample of participants, and continuing education strategies are necessary. Similar models may be employed across Africa.

Comparison of the Ivermectin and Lopinavir/Ritonavir Treatment Outcomes among COVID-19 Mild to Moderate Cases in Kaduna State.

BACKGROUND: Ivermectin has been a popular anti-parasitic drug since the late 1970s. The promising result of in-vitro studies on the antiviral activity of the drug has led clinicians in many countries to use this drug to treat COVID-19 patients. This study determined and compared the mean number of days at clinical recovery for mild to moderate cases of COVID -19 treated with Lopinavir/Ritonavir (Alluvia) and Ivermectin at the Kaduna State Infectious Disease Control Centres. METHODS: This was a comparative cross-sectional study conducted among 300 mild to moderate COVID- 19 cases enrolled for the study. The outcome variables were the time required for the resolution of symptoms from the onset and at commencement of the treatment regimens. Data were collected from patient folders using a questionnaire. Data were analysed with the IBM SPSS Version 25.0 and STATA/SE 13. Statistical significance was set at p<0.05. RESULTS: The mean recovery time (MRT) from symptom onset was significantly lower for Covid-19 patients treated with ivermectin (7.15±4.18 days) compared to lopinavir/ritonavir (9.7±5.3 days), 95%CI=7.37-9.62. Multivariate logistic regression showed that there was no significant relationship between the patients age (AOR=0.36, 95%CI=0.09-1.49), sex (AOR=0.34,95%CI=0.54-5.93), educational status (AOR=1.04, 95%CI=0.3-3.57), marital status (AOR=0.55,95%CI=0.14-2.11) place of treatment (AOR=1.66, 95%CI=0.54-5.11) and MRT. There was also no significant relationship between patients' comorbid chronic illness (AOR=0.83, 95%CI=0.27-2.61) and MRT. CONCLUSION: The mean recovery time for COVID-19 patients managed with ivermectin was slightly lower than for the lopinavir/ ritonavir regimen. RECOMMENDATION: Clinical trials to further prove the efficacy of Ivermectin as a supportive therapy in clinical management of mild to moderate cases of COVID-19 in this setting should be carried out.

CONTEXTE: L'ivermectine a été un médicament antiparasitaire populaire depuis la fin des années 1970. Le résultat prometteur d'études in vitro sur l'activité antivirale du médicament a conduit les cliniciens de nombreux pays à utiliser ce médicament pour traiter les patients atteints de COVID-19. Cette étude a déterminé et comparé le nombre moyen de jours de récupération clinique pour les jours légers à cas modérés de COVID-19 traités par Lopinavir/Ritonavir (Alluvions) et ivermectine à la maladie infectieuse de l'État de Kaduna Centres de contrôle. MÉTHODES: Il s'agissait d'une étude comparative transversale menée auprès de 300 cas légers à modérés de COVID-19 inscrits pour l'étude. Les variables de résultat étaient le temps requis pour la résolution des symptômes dès le début et au début de la schémas thérapeutiques. Les données ont été recueillies à partir des dossiers des patients à l'aide d'un questionnaire. Les données ont été analysées avec version 25.0 du IBM SPSS et STATA/SE 13. La signification statistique a été fixée à p<0.05. RÉSULTATS: Le temps moyen de récupération (TRM) à partir de l'apparition des symptômes était significativement plus faible chez les patients Covid-19 traités par l'ivermectine(7.15±4.18 jours) par rapport au lopinavir/ritonavir (9.7±5.3 jours), IC à 95 % = 7.37 à 9.62. La régression logistique multivariée a montré qu'iln'avait pas de relation significative entre l'âge des patients (AOR = 0.36, IC à 95 % = 0.09 à 1.49), sexe (AOR = 0.34, 95 % IC = 0.54 à 5.93), education statut (AOR =1.04, IC à 95 % = 0.3­3.57), état matrimonial(AOR = 0.55, 95% IC = 0.14­2.11) lieu de traitement (AOR = 1.66, IC à 95 % = 0.54 à 5.11) et TRM. Il n'y avait pas non plus de relation entre la maladie chronique comorbide des patients (AOR = 0.83, IC à 95 % = 0.27 à 2.61) et TRM. CONCLUSION: Le temps de récupération moyen pour les patients atteints de COVID-19 gérés avec de l'ivermectine était légèrement inférieur à celui du lopinavir/régime de ritonavir. RECOMMANDATION: Essais cliniques pour prouver l'efficacité de l'ivermectine comme traitement de soutien dans la prise en charge clinique des cas lègers à modérés de COVID-19 dans ce contexte devraient être effectués. Mot-clés: Ivermectine, Alluvie, Traitement, MRT, Essai clinique, COVID-19.

A short course postoperative radiotherapy regime for keloid scars in Nigeria.

The unsatisfactory high rate of recurrence following the traditional approach for the radiotherapy of keloid scars in Nigeria, led to the design of this study which employed a short course post operative radiotherapy regime. Two hundred and forty four patients with four hundred and fifty four (454) keloidal scars treated with superficial X-ray therapy within 72 hours following surgical excision at the Lagos University Teaching Hospital Lagos, Nigeria, between January, 1984 and December, 1988 were analyzed. The commonest site treated was the ear lobe (36.8%). Radiation dose ranged between 5-6Gy in single sessions and 12-15Gy in 3 fractions over 5 days. A complete response rate of 93% at 24 months was achieved. The treatment was well tolerated with no serious complications reported to date.

Influence of size of primary breast tumour on local control.

Four hundred and five (405) patients with histologically proven primary breast carcinoma were analysed in this study. There was complete response of 64.2% after surgery and radiotherapy. This is a better result in comparison with developing countries, for example, Nigeria where over 90% of cancer patients report at a late stage before treatment and inadequate radiotherapy facilities lead to long waiting list. A tumour regression rate (complete and partial) of 98.3% was obtained. This work has shown that most women with breast cancer could be cured when the lesions are detected very early and sizes smaller.

"Over and under exposures of radiotherapy patients at the A. B. U. Teaching Hospital, Zaria, Nigeria: case reports".

BACKGROUND: The Radiotherapy and Oncology Centre at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, commenced services with technical cooperation support from the International Atomic Energy Agency, Vienna, Austria in 1995. Brachytherapy services used to be offered at the ABUTH, Tudun-Wada, Zaria since 1995. Teletherapy and other Oncological services commenced at its Permanent Site, Shika- Zariaon Monday July, 2000. OBJECTIVE/METHODS: This is an incidental report of radiation over and under dose of 331 patients treated with Cobalt-60 machine (CIRUS) from July, 2000-December, 2002. RESULTS: 105 (31.7%) of the patients received 10-20% higher doses than prescribed, 161 (48.6%) received about the prescribed dose while 65 (19.7%) of the patients received under dose. CONCLUSION: The purpose of the report is to highlight that incidents and accidents can occur with the radiotherapy equipment at any centre despite trained staff operating the equipment. Any incident or accident should be reported to the appropriate national and international atomic energy agencies.