Lymphoma and Other Lymph Node Pathologies Among Adult Patients with Lymphadenopathy in Abakaliki, Nigeria.

INTRODUCTION: Lymphadenopathy is usually due to benign or malignant conditions. It can also be local or systemic in distribution and can involve peripheral or deep-seated lymph nodes. This study aimed to determine the prevalence of lymphoma and the distribution pattern of lymph node pathologies among adult patients who presented with lymphadenopathy and its relationship with age and sex. METHODS: A retrospective study was conducted, and a record of all cases of lymphadenopathy with histological diagnosis over 5-year period (January 2017 to December 2021) was extracted from Departments of Anatomical Pathology of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The data generated were analyzed using Statistical Package for Social Sciences (SPSS) software, version 26. RESULTS: One hundred and ninety results were extracted with an age range of 18 to 94 years and a mean age of 41 ± 16 years. They were made up of 75 (39.5%) males and 115 (60.5%) females, with a male-to-female ratio of 1:1.5. The prevalence of lymphoma was 50.0% (95/190). Thirty-five (18.4%) were Hodgkin's lymphoma (HL), while 60 (31.6%) were non-Hodgkin's lymphoma (NHL). Other pathologies manifested by cases of lymphadenopathy include metastatic tumor deposits (38 (20%)), reactive lymphoid hyperplasia (29 (15.3%)), and tuberculous lymphadenitis (18 (9.5%)). Others include sinus histiocytosis (4 (2.1%)), dermatopathic lymphadenitis (5 (2.6%)), and Castleman's disease (1 (0.5%)). CONCLUSION: About half of all patients who presented with lymphadenopathy were lymphoma with a high prevalence of 50%, and the majority were NHL. Other major causes of lymphadenopathy were metastatic tumor deposits, reactive lymphoid hyperplasia, and tuberculous lymphadenitis. Any case of lymphadenopathy should be properly investigated early for effective management.

Chemical analysis of uroliths: A two-center study of doctors' practice and perspective in South-East, Nigeria.

INTRODUCTION: Urolithiasis is a global disease condition secondary to a variety of factors, and sometimes associated with serious complications. Determination of stone composition is important in delineating causative factors. Knowledge of causative and precipitating factors aids patient management and prevention of recurrence. OBJECTIVE: The authors' aim was to evaluate the practice and perspective of doctors regarding chemical analysis of stones in management of urolithiasis. MATERIALS AND METHODS: This comparative cross-sectional study was done between December 2016 and May 2017 in two teaching hospitals in South-East, Nigeria. Data were collected using self-administered questionnaires. RESULTS: In all, 88 doctors with mean (standard deviation) age of 37.3 (9.5) years participated in the study. Urinary bladder stones were the most frequently managed, 51 (58.0%); 45 (51.1%) participants do not routinely send stones for chemical analysis. All respondents (100%) agreed that stone analysis is beneficial to patient management. CONCLUSION: This study showed that in spite of all respondents affirming that chemical analysis of uroliths is beneficial to patient management, more than half of respondents do not routinely send stones for analysis.

Acute perforated peptic ulcer: on clinical experience in an urban tertiary hospital in south east Nigeria.

BACKGROUND: Acute perforated peptic ulcer is a leading cause of generalized peritonitis and its management has continued to be a challenging task in our environment. OBJECTIVE: There is a paucity of published reports on acute perforated peptic ulcers in our environment. This study was conducted to evaluate the different pattern of risk factors clinical presentations, management and clinical outcome of patients with acute perforated peptic ulcer in our setting and to highlight the factors that continue to account for the high mortality and morbidity as seen here. METHOD: A retrospective study where data of seventy-six (76) patients managed for generalized peritonitis due to acute peptic ulcer perforation over a five year period (January 2006-December 2010) were retrieved from medical records of Enugu State University of Science and Technology Hospital (ESUTH). The patients' biodata, clinical and operative findings and treatment outcome were extracted and analysed, after institutional ethical approval was secured. All other cases of generalized peritonitis not traceable to acute peptic ulcer perforation were excluded from the study. RESULTS: There were76 patients; 58 males and 18 females (M:F = 3.2:1) Their ages ranged from 20 to 80years with a mean of 39.5yr and SD ± 13.10years. Majority of the patients 49(64.4%) were 40years of age and below and only 24 (31.6%) had a previous history suggestive of chronic peptic ulcer disease. Twenty five (32.9%) patients presented within 24 h of onset of symptoms of perforation with a mortality of 8.0%. Slightly more than half of our patients 39(51.3%) presented between 24 and 48 h with mortality of 17.9%. Twelve patients (15.8%) presented between 48 and 72 h and the mortality in this group was 58.3%. The latter two groups accounted for most of the mortality in our series. All perforations were anterior perforations within the first 2.5 cm of the duodenum and all had simple closure with pedicled omental patch and peritoneal toilet with copious volumes of warm normal saline. Postoperatively all received Helicobacter pylori eradication therapy and proton pump inhibitors for at least two months. CONCLUSION: Patient groups who presented early had low mortality rates, but patient groups who presented late had higher mortality rates. Overall mortality was 21%.

Post-myomectomy intussusception: report of two cases.

BACKGROUND: Post-myomectomy intussusception is a very rare cause of post-operative intestinal obstruction in adult surgical practice. Preoperative diagnosis is usually missed or delayed because the symptoms are usually subacute and nonspecific. METHOD: The case notes of the patients were retrieved and relevant data extracted and summarized. An extensive literature search was done and results reviewed and compared with the present case. RESULTS: The two patients reported developed features of post operative intestinal obstructions which were thought to be due to adhesive bands and initial conservative managements instituted. Exploratory laparotomies later revealed ileo-ileal and jejuno-ileal intussusceptions which were reduced without resection with good outcome. CONCLUSION: Intussusception is a rare but serious complication of myomectomy. High index of suspicion with prompt intervention and early team management optimize outcomes.