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1.
Oman Med J ; 39(2): e607, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38988797

RESUMO

Objectives: Ameloblastoma, comprising approximately 11% of all odontogenic tumors, is a locally aggressive tumor with a high recurrence rate. This study aimed to assess the immunohistochemical expression of Ki-67 and p53 and their association with clinical and pathological factors among patients with ameloblastoma. Methods: Retrospective follow-up data of patients histologically confirmed with ameloblastoma at Makerere College of Health Sciences in Kampala, Uganda from January 2012 to December 2018 were retrieved. Factors associated with Ki-67 and p53 immunohistochemical expression were determined using one-way one-way analysis of variance. Chi-square and Fisher's exact statistical tests were used to assess factors associated with recurrence. A two-tailed p < 0.05 was considered statistically significant. Results: A total of 40 patients confirmed histologically with ameloblastoma were included in the analysis. The majority (62.5%) of cases were of the conventional type of ameloblastoma. The expressions of Ki-67 and p53 were 52.5% and 85.0%, respectively. Recurrence was found in 47.5% of patients and it was associated with conventional histological type (p=0.042), segmental resection (p < 0.001), tumor size (p < 0.001), and high p53 expression (p=0.041). Conclusions: Almost half the cases in this study had recurrence. The immunohistochemical expression of p53 was significantly higher than that of Ki-67.

2.
Sci Rep ; 14(1): 12291, 2024 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-38811672

RESUMO

Breast cancer (BC) screening plays a major role in the prevention of BC through early detection and timely treatment. This study aims to determine the level of uptake of BC screening and associated factors. A community-based analytical cross-sectional study was conducted in Dodoma City, Tanzania from July to December 2020. The study included women aged 8 years and above without a known history of breast cancer. Multivariable logistic regression was used to determine the socio-demographic factors associated with BC screening. P value < 0.05 was considered significant. A total of 354 study participants were included in the present study. The mean age of participants was 31.0 ± 11.8 years. The majority of study participants (67.5%, n = 239) were aware of BC screening. However, only (35.3%, n = 125) reported to have ever practised BC screening. Breast self-examination was the most (16.4%, n = 58) frequently used method for BC screening among study participants. Lack of knowledge of all methods of BC screening was the barrier that was perceived by the vast majority (60.2%, n = 213) of the study participants. Having low family income was the only predictor of failure to practice BC screening. In this study, most of the women were aware of BC, however, few of them had undergone breast cancer (BC) screening at the time of the interview. The study also found that the main barrier to BC screening was the lack of knowledge about BC among the study participants. Immediate measures are necessary to increase women's awareness of BC. Such as community sensitization on the importance of screening, can help improve the uptake of BC screening and the early detection of BC.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer/psicologia , Detecção Precoce de Câncer/estatística & dados numéricos , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Tanzânia/epidemiologia , Adulto Jovem , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Autoexame de Mama/estatística & dados numéricos , Autoexame de Mama/psicologia , Adolescente , Programas de Rastreamento
3.
BMC Public Health ; 24(1): 1026, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609881

RESUMO

BACKGROUND: Patients with sickle cell disease (SCD) are prone to iron profile derangements. This study aimed to determine the prevalence of iron deficiency anaemia (IDA) and their predictors among children with SCD aged between 6 months and 14 years. Assessment of the prevalence of IDA and its predictors helps to understand ways of alleviating the magnitude of the problem so as to prevent possible complications such as shortness of breath and chest pain. METHODS: This was a cross-sectional analytical hospital-based study which included 174 patients with SCD attending SCD clinics at St. Gema hospital and Dodoma regional referral hospital in Dodoma city from October 2020 to March 2021. The cut-off points for detection of IDA was serum ferritin level < 30 µg/L and low mean corpuscular volume (MCV) for age. Data were analyzed using SPSS software version 25.0. Multivariate logistic regression analysis was used to determine the predictors of IDA. P-value less than 0.05 was considered significant. RESULTS: The prevalence of IDA in this study was (16.1%, n = 28). Family income of less than 70,000/= TZS/month (AOR = 2.2, 95% CI = 1.07-2.49, p = 0.023), being transfused with blood less than 3 times from the time of being diagnosed with SCD (AOR = 5.5, 95% CI = 1.03-8.91, p = 0.046), and eating red meat at least once per month (AOR = 3.60, 95% CI = 1.37-9.46, p = 0.010) remained the independent predictors of IDA in multivariate regression analysis. CONCLUSION: The findings of this study have shown that, support of families with children suffering from SCD in terms of financial support for improving medical services including optimal blood transfusion and affordability of diet which is rich in iron such as red meat is imperative.


Assuntos
Anemia Ferropriva , Anemia Falciforme , Criança , Humanos , Lactente , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/epidemiologia , Prevalência , Tanzânia/epidemiologia , Estudos Transversais , Ferro , Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia
4.
Sci Rep ; 14(1): 5035, 2024 02 29.
Artigo em Inglês | MEDLINE | ID: mdl-38424145

RESUMO

Microvascular complications encompass a group of diseases which result from long-standing chronic effect of diabetes mellitus (DM). We aimed to determine the prevalence of microvascular complications and associated risk factors among patients with type 2 diabetes mellitus (T2DM). A cross-sectional analytical hospital-based study was conducted at Singida and Dodoma regional referral hospitals in Tanzania from December 2021 to September 2022. A total of 422 patients with T2DM were included in the analysis by determining the prevalence of microvascular complications and their predictors using multivariable logistic regression analysis. A two-tailed p value less than 0.05 was considered statistically significant. The prevalence of microvascular complications was 57.6% (n = 243) and diabetic retinopathy was the most common microvascular complication which accounted for 21.1% (n = 89). Having irregular physical activity (AOR = 7.27, 95% CI = 2.98-17.71, p < 0.001), never having physical activity (AOR = 2.38, 95% CI = 1.4-4.01, p = 0.013), being hypertensive (AOR = 5.0, 95% CI = 2.14-11.68, p = 0.030), having T2DM for more than 5 years (AOR = 2.74, 95% CI = 1.42-5.26, p = 0.025), being obese (AOR = 2.63, 95% CI = 1.22-5.68, p = 0.010), and taking anti-diabetic drugs irregularly (AOR = 1.94, 95% CI = 0.15-0.77, p < 0.001) were the predictors of microvascular complications. This study has revealed a significant proportion of microvascular complications in a cohort of patients with T2DM. Lack of regular physical activity, being obese, taking anti-diabetic drugs irregularly, presence of hypertension, and long-standing duration of the disease, were significantly associated with microvascular complications.


Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Tanzânia/epidemiologia , Obesidade/complicações , Hipertensão/complicações , Hipertensão/epidemiologia , Hospitais , Encaminhamento e Consulta
5.
J Taibah Univ Med Sci ; 19(2): 287-295, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38283378

RESUMO

Objectives: Adequate haemodialysis helps maintain normal renal function by removing toxins and other waste products in patients with end-stage kidney disease. This study was aimed at determining the prevalence and predictors of adequacy of haemodialysis and outcomes in patients with end-stage kidney disease. Methods: This longitudinal analytical hospital-based study was conducted at two dialysis centres in Dodoma city, Tanzania, between February and July of 2020. Adequacy of haemodialysis was measured with single-pool (sp) Kt/V and urea reduction rate (URR) formulae. Binary logistic regression and multivariable analysis were used to assess the independent predictors of adequacy of haemodialysis. Results: The analysis included 100 patients with a mean age of 50.6 ± 15.0 years. The prevalence of adequacy of haemodialysis according to URR and sp-Kt/V was 72 % and 75 %, respectively. Having <12 months since dialysis initiation (AOR = 7.3, 95 % CI = 0.11-0.90, p = 0.032), fewer than three dialysis sessions per week (AOR = 6.9, 95 % CI = 1.52-31.49, p = 0.013) and severe anaemia (AOR = 2.2, 95 % CI = 0.26-0.93, p = 0.033) were predictors of inadequate haemodialysis, according to the URR formula. Having fewer than three dialysis sessions per week was significantly associated with inadequate haemodialysis (AOR = 5.6, 95 % CI = 1.47-19.66, p = 0.011), according to the sp-Kt/V formula. The mortality rate was 11.2 %, and cardiovascular disease and uremic syndrome were responsible for most deaths. Conclusion: This study indicated a high percentage of adequacy of haemodialysis among patients with end-stage kidney disease. Having fewer than three dialysis sessions per week, late initiation of dialysis after diagnosis of end-stage kidney disease and severe anaemia were predictors of inadequate haemodialysis among patients.

6.
Int Health ; 16(2): 200-207, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-37310004

RESUMO

BACKGROUND: Low medication adherence among patients with type 2 diabetes mellitus (T2DM) is associated with significant morbidity and mortality globally. We investigated the prevalence of low medication adherence and its associated factors among patients with T2DM. METHODS: We used the Bengali version of the 8-item Morisky Medication Adherence Scale (MMAS-8) in measuring medication adherence among patients with T2DM who were attending the diabetes clinic at Amana Regional Referral Hospital in Dar es Salaam, Tanzania, from December 2021 to May 2022. Binary logistic regression analysis under multivariate analysis was used to determine the predictors of low medication adherence after controlling for confounders. A two-tailed p-value <0.05 was considered significant. RESULTS: The prevalence of low medication adherence was 36.7% (91/248) of the subjects included in the study. Lack of formal education (adjusted odds ratio [AOR] 5.3 [95% confidence interval {CI} 1.717 to 16.312], p=0.004), having comorbidities (AOR 2.1 [95% CI 1.134 to 3.949], p=0.019) and drinking alcohol (AOR 3.5 [95% CI 1.603 to 7.650], p=0.031) were the independent predictors of low medication adherence. CONCLUSION: More than one-third of the patients with T2DM in this study had low medication adherence. Our study also showed that a lack of formal education, having comorbidities and drinking alcohol were significantly associated with low medication adherence.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Estudos Transversais , Tanzânia/epidemiologia , Adesão à Medicação , Hospitais
7.
PLOS Glob Public Health ; 3(12): e0001351, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38039284

RESUMO

Improvement of primary care for patients with type 2 diabetes mellitus (T2DM) through the promotion of good knowledge, attitude, and practice is of paramount importance for preventing its related complications. This study aimed to assess the levels of knowledge, attitude, and practice and associated factors among patients with T2DM. This was a cross-sectional multicenter hospital-based study that included 979 patients from 8 health facilities in Tanzania. A standardized semi-structured interviewer-administered questionnaire was used to extract the required data. Factor analysis was used to determine the level of knowledge, attitude, and practice. Multivariable analysis under binary logistic regression analysis was used to determine the predictors of knowledge, attitude, and practice. P<0.05 was considered significant. The levels of adequate knowledge, positive attitude, and appropriate practice were 62.1%, 54%, and 30.9%, respectively. Being self-employed (AOR = 1.74, 95% CI = 0.28-0.91, p = 0.040) predicted adequate knowledge. Being male (AOR = 1.46, 95% CI = 1.06-2.01, p = 0.021 and visiting regional hospitals (AOR = 2.17, 95% CI = 1.33-2.51, p = 0.013) were predictors of positive attitude. Residing in rural areas and not having adequate knowledge of diabetes were less likely associated with appropriate practice. This study has shown a significantly low level of appropriate practice among patients with T2DM towards general issues on diabetes, risk factors, and related complications. Therefore, emphasis should be placed on improving good practices that can help prevent related complications.

8.
Ann Med Surg (Lond) ; 85(10): 5133-5137, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37811038

RESUMO

Introduction and importance: Aneurysmal bone cysts (ABCs) are benign, non-neoplastic cystic lesions composed of multiple blood-filled cavities, which are separated by connective tissue septa and they constitute ~6 and 1.5% of all cases of the skull and jaws lesions, respectively. Case presentation: Herein, the case of an 80-year-old male with a histologically confirmed diagnosis of ABC involving the body of the left mandible was presented. The patient underwent partial mandiblectomy after confirmation of the diagnosis using orthopantomography, a computed tomography scan, and a tissue biopsy. The patient was free from pain after 1-year of follow-up, and the control orthopantomography showed no evidence of recurrence. This was followed by reconstruction of the healed part of the bone with titanium plates and a piece of bone from the lateral two-thirds of the left femur and thereafter he was cosmetically well. Clinical discussion: Patients with ABCs present with expansile and radiolucent bone lesions, which may be associated with displacement and loss of teeth due to alveolar bone erosion. Complete excision of the lesions is mandatory for the prevention of recurrence and increased morbidity. Conclusion: ABCs that involve the jaws are extremely rare and are more likely to pose a diagnostic challenge as they are more likely to be confused clinically with other expansile radiolucent bone lesions such as ameloblastoma, osteoblastoma, and giant cell tumor among many others. Also, those with extensive bone matrix formation may sometimes be confused histologically with other bone forming tumors including osteosarcoma. Recurrence is common but it can be avoided or minimized by complete resection of the lesion.

9.
J Egypt Natl Canc Inst ; 35(1): 23, 2023 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-37518096

RESUMO

OBJECTIVE: Immunohistochemical expression of P53 protein is so closely related to status of mutation of P53 gene which is tightly linked with pathogenesis of nephroblastoma or Wilms tumor. This study aims to determine the immunohistochemical expression of P53 protein and its predictors in formalin-fixed paraffin-embedded tissue blocks of patients with nephroblastoma. MATERIALS AND METHODS: A series of 83 histologically diagnosed cases of nephroblastoma from formalin-fixed paraffin-embedded tissue blocks archived at the Department of Pathology, Makerere University, in Kampala, Uganda, were analyzed. Monoclonal anti-p53 antibody (DO-7, DAKO) was used to assess the expression of P53 protein expression. Multivariable logistic regression analysis was performed to determine the predictors of P53 protein immunohistochemical expression, and statistical significance was considered when p-value was less than 0.05. RESULTS: Most (42.2%, n = 35) of the cases were in advanced tumor stages (III-V), and almost one-quarter (21.7%, n = 18) of the cases were in high-risk group. The immunohistochemical expression of P53 protein was (8.4%, n = 7), and there were more (83.3%, n = 5) positive anaplastic cases for P53 protein compared with (2.6%, n = 2) of P53 expression for non-anaplastic cases. High risk (AOR = 3.42, 95% CI = 7.91-12.55, p = 0.037) and anaplasia (AOR = 1.41, 95% CI = 13.85-4.46, p = 0.001) were potential predictors of immunohistochemical expression of P53 protein. CONCLUSION: Most of patients with nephroblastoma in resources-limited settings are diagnosed with advanced clinical stages. Association of P53 protein with anaplasia found in this study indicates the possibility of having novel target therapy for treatment of patients with anaplastic form of nephroblastoma with a focus of identifying molecules that lead to its suppression in such subpopulations of patients with nephroblastoma.


Assuntos
Neoplasias Renais , Tumor de Wilms , Humanos , Anaplasia , Formaldeído , Imuno-Histoquímica , Neoplasias Renais/diagnóstico , Neoplasias Renais/genética , Prognóstico , Proteína Supressora de Tumor p53/genética , Uganda , Tumor de Wilms/diagnóstico , Tumor de Wilms/genética , Tumor de Wilms/patologia
10.
Sci Rep ; 13(1): 9673, 2023 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-37316565

RESUMO

Glycemic control is of paramount importance in care and management for patients with type 2 diabetes mellitus (T2DM). Poor glycemic control is a major health problem that greatly contributes to the development of diabetes related complications. This study aims to assess the prevalence of poor glycemic control and associated factors among outpatients with T2DM attending diabetes clinic at Amana Regional Referral Hospital in Dar-es-salaam, Tanzania from December 2021 to September 2022. A face to face interviewer semi-structured questionnaire was administered during data collection. Binary logistic regression under multivariable analysis was used to determine the independent predictors of poor glycemic control. A total of 248 patients with T2DM were included in the analysis with mean age of 59.8 ± 12.1 years. The mean fasting blood glucose was 166.9 ± 60.8 mg/dL. The prevalence of poor glycemic control was 66.1% (fasting blood glucose > 130 mg/dL or < 70 mg/dL). Failure to adhere to regular follow-up (AOR = 7.53, 95% CI = 2.34-19.73, p < 0.001) and alcoholism (AOR = 4.71, 95% CI = 1.08-20.59, p = 0.040) were the independent predictors of poor glycemic control. The prevalence of poor glycemic control observed in this study was significantly high. Emphasis should be placed on ensuring that patients have regular follow-up for their diabetes clinics and they should also continue modifying some of lifestyle behaviors including refraining from alcoholism, this can help them to have good glycemic control.


Assuntos
Alcoolismo , Diabetes Mellitus Tipo 2 , Humanos , Pessoa de Meia-Idade , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Glicemia , Controle Glicêmico , Pacientes Ambulatoriais
11.
Ann Med Surg (Lond) ; 85(4): 1011-1014, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37113870

RESUMO

Extrapelvic endometriosis is quite rare, with a reported prevalence ranging between 0.5 and 1%, and the condition is more likely to pose diagnostic challenges. This condition is more likely to pose clinical diagnostic challenges as it may mimic metastasis such as Sister Mary Joseph's nodule. Case presentation: Herein is reported the case of a 36-year-old woman who presented with a hard nodular dark-bluish umbilicus mass that had a tendency to increase in size and was accompanied by severe pain during menstruation for ∼2 years is reported. Laparotomy revealed a normal uterus without involvement of any other pelvic organ by the endometrial tissue except the umbilicus part. Histological evaluation revealed endometriosis of the umbilicus. Clinical discussion: By far, primary endometriosis of the umbilicus is extremely rare, and most of the time, extrapelvic endometriosis involving the umbilicus would be secondary to surgical procedures involving the abdominal cavity as it was for the presented patient. Although endometriosis is rare, it should always be considered among women of reproductive age presenting with cyclic pains. Conclusions: Meticulous investigation of patients suspected to have umbilical endometriosis helps to confirm the diagnosis and hence expedites proper management of the patients; this also prevents chances of malignant transformation of the condition despite such possibilities being extremely rare.

12.
Int J Surg Case Rep ; 105: 108121, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37028182

RESUMO

INTRODUCTION AND IMPORTANCE: Male breast cancers despite being similar to female breast cancers in various aspects; however, they have important distinctive characteristics such as molecular biology, increased tendency for axillary lymph node metastasis and late age at presentation. PRESENTATION OF CASE: We present the case of a 73-year old indigenous African male who had a 3-year history of right breast swelling which was associated with episodes of pain and tenderness. The assigned clinical stage for the patient was T2aNoMo. The mass was histologically confirmed to be invasive ductal carcinoma, not specified type (NST) without axillary lymph node involvement or distant metastasis. Immunohistochemistry also showed positive results for ER and PR hormonal receptors but negative for HER2. CLINICAL DISCUSSION: Considering the rarity nature of male breast cancers, this contributes to lack of evidence of the specific treatment approaches despite the noticeable difference in clinical presentation and even biological characteristics of male breast cancers, which are more likely to contribute to poor prognosis. CONCLUSION: The prevalence of male breast cancers has been reported to be less than 1 % of all male cancers. This contributes to the lack of analytical large studies that address the comprehensive data regarding the clinical outcomes of breast cancer among men and their predictors. Therefore, having prospective multicenter studies in future would help in providing high level of evidence on prognosis.

13.
BMJ Open ; 13(2): e068984, 2023 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-36787973

RESUMO

OBJECTIVES: ABO and Rh blood group systems are the major factors affecting the blood transfusion safety. The frequency and distribution of these blood group systems vary worldwide. We aimed to determine the frequency and distribution of ABO and Rh blood group systems among first-time blood donors at the Northern Zone Blood Transfusion Center in Kilimanjaro, Tanzania. DESIGN: Cross-sectional descriptive population-based study. SETTING: Data on ABO and Rh blood group systems were obtained and analysed from the Northern Zone Blood Transfusion Center among first-time blood donors. PARTICIPANTS: There were 65 535 first-time blood donors aged 15-55 years who donated at the Northern Zone Blood Transfusion Center from January 2017 to December 2019. OUTCOME MEASURES: The percentage of ABO and Rh blood group systems among different categories of blood donors was calculated. RESULTS: Retrospective data from Blood Establishment Computer System of 65 535 first-time blood donors were analysed in the present study. The mean age of the blood donors was 30.6±11.2 years (range: 15-55 years). The vast majority of the blood donors 84.2% (n=55 210) were men. Also, the majority 69.6% (n=45 595) were aged ≥35 years. Blood group O was the most common blood group which was found in over half 52.4% (n=34 333) of the blood donors and majority 95.3% (n=62 461) of the donors were Rh positive. Moreover, the majority 78.3% (n=51 336) were voluntary donors and the remaining 21.7% (n=14 199) were replacement donors. CONCLUSION: Majority of the donors had blood group O and also the vast majority of the donors were Rh positive. Considering the large size of our study population, this has provided a more comprehensive information regarding the frequency and patterns of ABO and Rh blood group systems in Tanzania. The observed association of blood group A with one of the regions from which donors were coming from, is intriguing and further studies may confirm possible related genetic evolution.


Assuntos
Sistema ABO de Grupos Sanguíneos , Doadores de Sangue , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Tanzânia , Estudos Retrospectivos , Sistema ABO de Grupos Sanguíneos/genética , Transfusão de Sangue , Sistema do Grupo Sanguíneo Rh-Hr/genética
14.
BMJ Open Ophthalmol ; 7(1)2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36161862

RESUMO

OBJECTIVES: This study aims to investigate the expression of Ki67 in formalin-fixed paraffin-embedded tissue blocks from patients with a diagnosis of retinoblastoma tumour (RbT) as well as determining its association with histopathological high-risk factors (HHRFs). METHODS AND ANALYSIS: Retrospectively, a total of 194 eyeball specimens from 163 children with RbT were reviewed at Muhimbili National Hospital between 2009 and 2013. Immunohistochemical expression of Ki67 using MIB-1 antibody (Abcam, batch ab93680, Cambridge, UK) was determined and correlated with the conventional HHRFs. The predictors of Ki67 expression were determined using binary logistic regression model in multivariate analysis. A two-tailed p<0.05 was considered statistically significant. RESULTS: Majority (67.5%) of the patients had leukocoria and extraocular disease was found in 20.9% of all the patients. High expression of Ki67 was present in 63.8% of the 80 eyeballs that were tested. Massive choroidal invasion (adjusted OR (AOR)=9.32, 95% CI=2.82 to 10.89), positive retrolaminar optic nerve invasion (AOR=3.01, 95% CI=4.43 to 9.11), positive surgical margin (AOR=7.10, 95% CI=1.63 to 11.40) and pT4 (AOR=7.49, 95% CI=0.12 to 0.89) were the potential HHRFs that were associated with Ki67 overexpression. CONCLUSION: Overexpression of Ki67 may be of prognostic value for patients with RbT as it has been shown in the present study that high expression was common in tumours with massive choroidal invasion, positive retrolaminar optic nerve invasion, positive surgical margin and advanced tumour stage, which are the conventional HHRFs associated with prognosis of RbT.


Assuntos
Neoplasias da Retina , Retinoblastoma , Criança , Estudos Transversais , Formaldeído , Humanos , Antígeno Ki-67/imunologia , Margens de Excisão , Neoplasias da Retina/diagnóstico , Retinoblastoma/diagnóstico , Estudos Retrospectivos , Fatores de Risco
15.
Ann Med Surg (Lond) ; 78: 103932, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35734713

RESUMO

Introduction: and importance: Ruptured esophageal varices are fatal and cause haemorrhagic shock and consequently death if no immediate intervention is instituted to arrest bleeding. The role of forensic pathologists in investigating cases of sudden unexpected deaths is of paramount importance. Upon medico-legal work ups by forensic pathologists, autopsy would shed light to the exact cause of death as to whether it is natural or unnatural. Case presentation: We are reporting an unusual case of an elderly man with alcoholic liver cirrhosis who succumbed to sudden death following ruptured esophageal varices which led to haemorrhagic shock. Clinical discussion: Clinical autopsy was carried out to establish the cause of death. Tissue sections from the healed pathologically fractured bone, liver, prostate and esophagus were taken for histological evaluation. The bone tissue showed relative reparative changes and the prostate tissue showed hyperplasia of both stroma and epithelial components. The tissue from the esophagus showed proliferating distended, engorged vascular structures and some were thrombosed (photograph 3). Liver biopsy showed destruction of the normal liver parenchyma by both micro and macro nodular formation which was marked by the thick broad fibrous bands. A conclusive diagnosis of hemorrhagic shock secondary to ruptured esophageal varices caused by alcoholic liver cirrhosis was established as the cause of death. Conclusion: Esophageal varices can be the likely cause of sudden death upon rupturing. Rupturing of esophageal varices in individuals with a known long-standing history of alcoholism must always be considered in order to prevent haemorrhagic shock from ensuing.

16.
Clin Case Rep ; 10(3): e05541, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35280083

RESUMO

We present the case of a 23-year-old female with multiple diffuse and nodular masses of different sizes involving predominantly the posterior wall of the uterus, omentum, and peritoneum which were histopathologically confirmed to be disseminated peritoneal leiomyomatosis. Meticulous investigation and accurate diagnosis are of utmost importance for the establishment of the correct diagnosis. Additionally, proper management of the patient while considering choice of the patients including close follow-up of the patients is mandatory for the reason of ensuring early detection of recurrence.

17.
Arch Pathol Lab Med ; 146(12): 1523-1529, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-35344993

RESUMO

CONTEXT.­: The incidence of human epidermal growth factor receptor 2 (HER2) positivity in gastric cancers differs widely across various populations and is unknown in many low-resource settings. OBJECTIVE.­: To evaluate the rates of HER2 positivity in gastric and gastroesophageal adenocarcinoma at a national referral hospital in East Africa. We also assessed the association between HER2 overexpression and patient clinicopathologic characteristics. DESIGN.­: A retrospective review of cases diagnosed as either gastric or gastroesophageal adenocarcinoma between 2013 and 2017 was performed at Muhimbili National Hospital in Dar es Salaam, Tanzania. Of 1205 specimens meeting inclusion criteria, stratified random sampling was conducted to select 150 cases for HER2 immunohistochemistry and clinicopathologic analysis. RESULTS.­: The median age of patients was 56.5 years, with 65.3% (98 of 150) of the cohort composed of male patients, and 34.7% (52 of 150) of female patients. HER2 overexpression was identified in 6.0% (9 of 150) of cases. Approximately half of the tumors (51.3%; 77 of 150) were intestinal-type gastric adenocarcinoma, and 36.0% (54 of 150) were moderately differentiated. Intestinal-type (P = .01) and well-differentiated tumors (P = .001) were associated with HER2 overexpression. CONCLUSIONS.­: HER2 overexpression was primarily seen in intestinal-type and well-differentiated tumors. Therefore, prioritizing HER2 testing for patients with intestinal-type, well-differentiated, or moderately differentiated gastric and gastroesophageal adenocarcinomas may be appropriate in Tanzania in efforts to allocate testing for patients who are most likely to benefit from trastuzumab therapy.


Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Neoplasias Gástricas , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia , Junção Esofagogástrica/patologia , Tanzânia , Receptor ErbB-2/metabolismo , Neoplasias Esofágicas/patologia , Adenocarcinoma/patologia
18.
J Taibah Univ Med Sci ; 17(1): 96-104, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35140571

RESUMO

OBJECTIVES: This study aims to determine the histopathological patterns and biological characteristics of ameloblastoma. METHODS: This was a cross-sectional retrospective laboratory-based study using 82 formalin-fixed paraffin-embedded tissue blocks from patients diagnosed histologically with ameloblastoma. Information regarding age, sex, anatomical location of the lesion, histopathologic type, and biological behaviour or characteristics of the types of ameloblastoma was obtained from laboratory request forms. Categorical and continuous variables were summarized in percentage and mean ± standard deviation, respectively. The cohort was conducted on Ugandan patients diagnosed between 2016 and 2019. RESULTS: Most patients (66.3%) were clinically presenting a painless jaw swelling, and a follicular pattern was common (39%) followed by the plexiform pattern (12.2%). All the ameloblastoma cases (100%) were benign, with the majority (76.8%) cases being non-recurrent while the remaining (23.2%) were recurrent, and the plexiform pattern was the commonest recurrent histopathological pattern. CONCLUSION: This study reports a relatively significant rate of recurrence in almost a quarter of the study population. The plexiform histopathologic type was the dominant type in recurrence cases. Therefore, this finding provides insightful information to clinicians to ensure close follow-up for patients diagnosed with such a variant to prevent possible relapse of the disease.

19.
Arab J Gastroenterol ; 23(1): 7-14, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34840096

RESUMO

BACKGROUND AND STUDY AIM: Immunohistochemistry is one of the superior methods and is regarded as the gold standard for the detection of Helicobacter pylori. We aimed to detect the presence of Helicobacter pylori in gastric biopsies among patients at the Muhimbili National Hospital from January 2012 to December 2016. Also, we determined the predictors of Helicobacter pylori infection. PATIENTS AND METHODS: Retrospectively, we retrieved the tissue blocks of gastric biopsies at the Central Pathology Laboratory of the patients with different gastric pathologies at the Muhimbili National Hospital from January 2012 to December 2016. Helicobacter pylori were detected using anti-Helicobacter pylori polyclonal antibodies. Binary logistic regression analysis was done to determine the predictors of Helicobacter pylori infection. A two-tailed p < 0.05 was considered significant. RESULTS: The prevalence of detection of Helicobacter pylori was 37.1% (63/170) using immunohistochemistry compared to 32.4% (55/170) using histology. Peptic ulcer disease, the absence of gastric cancer, and chronic gastritis were the predictors of Helicobacter pylori infection in our study (AOR = 0.2, 95% CI = 0.06-0.70, p = 0.011, AOR = 3.23, 95% CI = 1.02-10.29, p = 0.047, AOR = 0.32, 95% CI = 0.12-0.87, p = 0.025, respectively). CONCLUSION: In this study, Helicobacter pylori infection was associated with the presence of peptic ulcer disease, chronic gastritis, and the absence of gastric cancer. The rate of detection of Helicobacter pylori infection was higher in tissue blocks of elderly patients than in those of young patients. Also, gastric cancer was more prevalent in old female patients.


Assuntos
Gastrite , Infecções por Helicobacter , Helicobacter pylori , Idoso , Estudos Transversais , Feminino , Gastrite/diagnóstico , Gastrite/epidemiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Hospitais , Humanos , Estudos Retrospectivos , Tanzânia/epidemiologia
20.
Clin Case Rep ; 9(9): e04814, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34532052

RESUMO

We present the case of a 64-year-old male with a 3-month history of a mass involving the distal portion of the fifth finger on the left hand which was histologically confirmed as digital papillary adenocarcinoma. Although the tumor is low grade, the chances of recurrence and metastasis are high.

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