Changing pattern of cancer distribution: experience from a tertiary health institution in Nigeria and review of literature.

Background: Over the years, epidemiological surveys have established that the five leading cancers in Africa (in descending order of prevalence) are cancers of the breast, cervix, prostate, liver, and colorectum.[1] However, a 10-year retrospective review of cases performed at the University of Ilorin Teaching Hospital (UITH) revealed some changes in the cancer incidence pattern in this region. Aims: The aim of the study was to determine the distribution of cancers managed at the UITH, a tertiary health care center in North Central Nigeria, in the past 10 years and create awareness of changing cancer prevalence patterns in this region. Materials and Method: This was a retrospective review of cancer epidemiology at UITH over a period of 10 years. Confirmed cancer cases within this period were extracted from the data in the Department of Anatomic Pathology and the Cancer registry. Descriptive and inferential statistics were applied to obtain rates and proportions for both sexes. Results: There were 2430 confirmed cases of cancer during the study period from January 2011 to December 2020. Out of these cases, 1310 (54%) were seen in females and 1120 (46%) were seen in males. The most common cancer recorded (in total) was prostate cancer, which accounted for 18% of all cases, constituting approximately one in six of all cancer cases. This was followed closely by breast cancer (16.6%). The most commonly diagnosed cancer in males was prostate cancer (four in ten cancer cases in males), whereas in females, it was breast cancer (approximately three in ten cancer cases in females). Cancers of the lungs and liver were rare in both sexes in this study. In children, the most common malignancies were retinoblastoma (38.3%), non-Hodgkin lymphomas (16.8%), and nephroblastoma (12.8%). Conclusion: There is a changing trend in cancer cases with some cancer cases now predominating compared to previous years. This may be because of increased awareness and/or better medical screening and diagnostic techniques.

["Pediatric inflammatory multisystem syndrome"-Experiences from a Berlin Children's Hospital]. / "Pediatric inflammatory multisystem syndrome" ­ Erfahrungen aus einer Berliner Kinderklinik.

BACKGROUND: Since the beginning of the SARS-CoV­2 pandemic, cases of the hyperinflammatory syndrome pediatric inflammatory multisystem syndrome (PIMS) have been accumulating. The clinical presentation is variable and it occurs 2-6 weeks after infection with SARS-CoV­2. As of today, immunoglobulins and/or steroids as well as ASS are used for medication. METHOD: In our clinic 11 patients presented with PIMS between 06/2020 and 06/2021, whose data were retrospectively collected and analyzed. RESULTS: Of the 11 patients 6 were male, the age distribution ranged from 4-18 years and 7 were overweight or obese. Almost all patients showed gastrointestinal and cardiovascular involvement, 4 had respiratory symptoms, 6 showed signs of nephritis. All showed blood count changes with anemia or leukocytosis and coagulopathy. CRP, ferritin, and soluble IL2 receptor were highly elevated in all patients. Only 2 patients had neither troponin­T nor NT-pro-BNP elevation and 7 patients had impaired left ventricular function. Positive SARS-CoV­2 serology was found in 10, and positive SARS-CoV­2 PCR via nasopharyngeal swabs in 2.All were initially treated with antibiotics, 3 patients required O2 supplementation, 6 required intensive care and 5 required vasoactive agents. All but one patient received immunoglobulins and ASS, 5 received prednisolone. Length of stay ranged from 4-51 days. CONCLUSION: PIMS is a severe acute hyperinflammatory disease, which was secured in 11 patients in our clinic. In some cases, there was a need for intensive care. Under anti-inflammatory therapy there was a good response without exception.

Histomorphology of Helicobacter pylori-associated chronic gastritis in Ilorin.

The presence or absence of Helicobacter pylori in gastric biopsies is of significant therapeutic implication. The aim of the study was to review gastric biopsies taken from dyspeptic patients in the University of Ilorin Teaching Hospital for H. pylori mucosa positivity and other parameters of chronic gastritis. Fifty-seven chronic gastritis cases were evaluated using the updated Sydney classification scheme. There were 27 males and 30 females with a mean age of 48.8 +/- 15.6 years. Chronic mononuclear inflammatory infiltrates ranging from mild, moderate to marked was seen in 15 (26.3%), 29 (50.9%) and 13 (22.8%) cases respectively. H. pylori was positive in 28 cases (49.1%) while the rest were H. pylori negative. Neutrophil activity was observed in 39 cases (68.4%). Non-atrophic gastritis was seen in 39 cases (68.4%) while atrophic gastritis ranging from mild to moderate changes was seen in 18 cases (31.6%). Intestinal metaplasia was found in 5 cases (8.8%) and it comprised of type I (3 cases) and type II (2 cases). H. pylori was the main aetiological agent responsible for chronic gastritis, commonly found in the antral mucosal biopsies and the majority presented with mild-moderate chronic inflammatory changes.