Appendicitis revisited: a comparative study of Malawian and English appendices.

The incidence of appendicitis shows a marked variation between populations which has been attributed to dietary differences. Neural mechanisms and serotonin discharge from subepithelial neurosecretory cells have been previously implicated in pain referable to the appendix and appendicitis. Forty consecutive appendicectomy specimens from Malawi were studied by staining with haematoxylin and eosin, an alcian blue - PAS diastase sequence coupled with lead haematoxylin (PbH) and immunohistology for serotonin and NSE. The findings were compared with those in appendices removed at the Middlesex Hospital, London, to see if there were any differences between a population with a low risk of appendicitis (Malawi) and a high risk population (England). Acute transmural appendicitis was seen in fewer appendices from Malawi (27.5 per cent) than in English appendices (58 per cent). Subepithelial neurosecretory cells identified with PbH were present in 20 per cent of appendices from Malawi and 69 per cent of English appendices. These cells in both series showed immunohistochemical staining for serotonin. Nerve hyperplasia identified by staining for NSE in the appendix was present in 17.5 per cent and 81 per cent of non-inflamed appendices from Malawi and England respectively. Appearance of subepithelial neurosecretory cells and hyperplasia appear to be concomitants of an increased risk of appendicitis. Neural mechanisms may participate in adapting to a low residue diet and in some cases may generate appendicitis.

Appendicitis revisited: a comparative study of Malawian and eng appendices

The incidence of appendicitis shows a marked variation between populations which has been attributed to dietary differences. Neural mechanisms and serotonin discharge from subepithelial neurosecretory cells have been previously implicated in pain referable to the appendix and appendicitis. Forty consecutive appendicectomy specimens from Malawi were studied by staining with haematoxylin and eosin; an alcian blue - PAS diastase sequence coupled with lead haematoxylin (PbH) and immunohistology for serotonin and NSE. The findings were compared with those in appendices removed at the Middlesex Hospital; London; to see if there were any differences between a population with a low risk of appendicitis (Malawi) and a high risk population (England). Acute transmural appendicitis was seen in fewer appendices from Malawi (27.5 per cent) than in eng appendices (58 per cent). Subepithelial neurosecretory cells identified with PbH were present in 20 per cent of appendices from Malawi and 69 per cent of eng appendices. These cells in both series showed immunohistochemical staining for serotonin. Nerve hyperplasia identified by staining for NSE in the appendix was present in 17.5 per cent and 81 per cent of non-inflamed appendices from Malawi and England respectively. Appearance of subepithelial neurosecretory cells and hyperplasia appear to be concomitants of an increased risk of appendicitis. Neural mechanisms may participate in adapting to a low residue diet and in some cases may generate appendicitis

Subcutaneous phaeohyphomycosis: a histopathological study of nine cases from Malawi.

The clinical and histopathological features of subcutaneous phaeohyphomycosis in nine patients from Malawi are presented. The patients had varied clinical presentations and microscopically, in each case, there was a subcutaneous abscess or cystic granuloma. In seven cases (78%) the causative fungal elements were easily identified in sections stained with haematoxylin and eosin. The fungal elements were easily identified in the other two cases with special fungus stains. The misleading terminology, which was used previously to cover this infection, is discussed. Even though this paper reports on this disease in a tropical country, subcutaneous phaeohyphomycosis occurs world wide, and these fungi should be looked for in otherwise unexplained subcutaneous abscesses or cystic granulomata.

Studies on nasopharyngeal carcinoma in the Sudan--I. Epidemiology and Aetiology.

Three hundred and seventy-four cases of nasopharyngeal carcinoma (NPC) recorded in the Sudan Cancer Registry (SCR) and 512 cases seen at the Radiation and Isotope Centre, Khartoum (RICK) were analysed. NPC formed 5.8% of all cancer cases in the SCR and 7.2% at the RICK; this is the highest frequency so far reported outside the Chinese. The male/female ratio was 3:1; NPC was the commonest tumour in males at the RICK (12.1%) and second commonest in the SCR (9.2%). It tended to occur in younger patients (youngest, 3 yr), with 14 and 12.1% of cases in children 14 yr or under in the SCR and RICK respectively; it is the commonest childhood malignancy in the Sudan. The ethnic and geographical distribution of the cases showed that racial susceptibility played a significant role in the aetiology of NPC in the Sudan whereas environmental factors could be excluded; however, Epstein-Barr virus might be an exciting factor.

Epidemiology aspects of endomyocardial fibrosis.

Endomyocardial fibrosis (EMF) is a specific clinicopathological entity. It occurs sporadically throughout the world but is endemic in parts of Africa, India and South America. In sporadic cases, blood eosinophilia is a common feature; this is a variable finding in endemic cases. The curious geographical distribution of EMF in the tropics remains unexplained.

Schistosomiasis of the female genital tract. A histopathological study of 176 cases from Malawi.

The histopathology of 176 cases of gynaecological schistosomiasis reported from Malawi during the period 1976-80 was reviewed. Schistosomal infection was found throughout the genital tract, with 60% of cases involving the cervix. The dominant tissue reactions to ova were categorized into five histopathological groups A-E and for each site the relationship between histopathological and clinical features was explored. No evidence was found linking schistosomiasis with cancer of the genital tract. Schistosomiasis was a significant cause of gynaecological morbidity, particularly when infection involved the lower genital tract; however in a proportion of cases ova were found coincidentally in other lesions or normal tissues, and were not apparently causally linked with symptoms. The findings are discussed in relation to previous studies of gynaecological schistosomiasis.

Cardiovascular diseases in the tropics. A geographical pathologist's overview.

Somente em decadas mais recentes tem sido possivel reunir informacoes que permitem ajuizar a importancia das doencas cardiovasculares. E destacada a limitacao de informacoes derivadas das areas tropicais, praticamente exclusivas de regioes restritas de alguns paises. A doenca reumatica e considerada a causa mais comum de cardiopatia em pessoas de ate 40 anos e e atribuida a elevada incidencia nas regioes tropicais e subtropicais. E aparente o aumento de incidencia da doencas isquemica do coracao, particularmente nas sociedades que sofrem rapidas mudancas de estrutura.Apesar da distribuicao universal da endomiocardiofibrose, ela e endemica em regioes tropicais, e tambem elevada a incidencia de insuficiencia cardiaca de etiologia obscura (cardiomiopatia congestiva). O autor discute a associacao de infeccoes parasiticas e cardiopatia