Surgical Sciences

Assessment of some biomarkers of inflammation in breast cancer patients in Benin City, Nigeria Eboreime Ofunre, Atoe Kenneth, Idemudia Joseph Osagie Nigerian Journal of Surgical Sciences 2017 27(2):33-36 Introduction: Inflammation has been shown to play a major role in the pathogenesis of most malignancies including breast cancer. The inflammatory basis of breast cancer has not been evaluated in our environment. Objective: The purpose of this study is to determine the level of some biomarkers of systemic inflammation in patients with breast cancer compared to those of apparently healthy subjects without the disease in Benin City, Nigeria. Methodology: This is a case control study conducted in Benin City, Edo State, Nigeria. Breast cancer patients from Central hospital, Benin City and controls from the general population had their venous blood sampled and analyzed for Erythrocyte Sedimentation Rate (ESR) and C-Reactive Proteins (CRP) levels using standardized laboratory methods. Data were analyzed using SPSS (version 17). Results: Results showed a statistical significant increase (P < 0.05) in both ESR and CRP levels of patients with breast cancer compared to the control. There is also a significant positive correlation (P < 0.001) between ESR and CRP in the study population. Conclusion: These findings support the fact that inflammation is a risk factor for the development of breast cancer and this association might be of clinical significance as these inflammation markers might be of prognostic value.

Cervical cancer: Risk factors and uptake of screening among expectant mothers in Abakaliki Glory I Urom, Emeka O Omabe, Nkechi J Okoli, Ndubuisi S Eze, Ben N Azuogu, Odidika U J Umeora Nigerian Journal of Surgical Sciences 2017 27(2):37-40 Context: cancer remains the most common reason for death from gynaecological malignancy in Nigeria while screening remains opportunistic. Pregnancy provides a veritable ample opportunity for screening for this malignancy. Aim: to evaluate the risk factors for cervical cancer among antenatal clinic attendees at a tertiary centre and assess their uptake of cervical screening. Methods: This was a cross sectional descriptive study using questionnaires. Result: Three hundred and eighty five out of the 400 questionnaires distributed were analysed. The mean age of respondents was 31.3+6.8 years. Majority 73.2% had tertiary level of education. Only 54% have ever heard of cervical cancer screening. Knowledge was gained mainly via health workers and the media. Of these, only 32 (8.3%) have ever been screened. Many of them (48.3% to 62.5%) knew of some of the risk factors but most of them had no established risk factors. Conclusion: While knowledge of cervical cancer screening is average amongst antenatal clinic attendees at the Federal Teaching Hospital Abakailki is average, the uptake is quite abysmal. Antenatal clinic visits provide an opportunity to increase awareness and uptake of cervical cancer screening among women of reproductive age.

Prostatic adenocarcinoma and prostatic intraepithelial neoplasia: A tale of the autopsy model in a Nigerian tertiary hospital Dele Eradebamwen Imasogie, Akhator Terence Azeke Nigerian Journal of Surgical Sciences 2017 27(2):41-46 Introduction: The frequency of clinical prostatic adenocarcinoma and high-grade prostatic intraepithelial neoplasia (HGPIN) in a certain population could be similar to the prevalent model of latent adenocarcinoma as well as to the frequency and extent of HGPIN. The aim of this prospective postmortem study is to determine the prevalence of occult adenocarcinoma and HGPIN and contrasting same with the existing clinical model in the same environment. Subjects and Methods: Adult individuals who died from ailments unrelated to diseases of the prostate glands were the target population using a calculated minimum sample size of 72 cases. The partial sampling method was employed. Sections were assessed for prostatic adenocarcinoma and HGPIN. The biodata and clinical diagnosis were obtained from stored records. Results: Seven patients had occult adenocarcinoma representing 8.1% of the study population of 86 cases. Their median age was 60 years. It had a peak incidence in the sixth decade, with a prevalence of 42.85% in the subset of the study population who had the disease. Gleason's grade 3 and score 6 were the most frequent grades and scores encountered in this study. Those with occult adenocarcinoma were graded International Society of Urological Pathologist (ISUP) 1 using the ISUP grade group system. There were five cases of HGPIN in this study. Their median age was 54 years. It had a peaked incidence in the eighth decade. Conclusion: There exists a subset of the population with occult prostatic adenocarcinoma and HGPIN. These subclinical prostatic lesions may become clinically apparent if these patients had lived long enough, and hence, the prostate should be considered as a possible primary site of metastatic carcinoma because of this concept “occult adenocarcinoma.”

Hysterosalpingographic findings in women with infertility in Awka, Anambra State, South-East Nigeria Samuel Iloraah Udobi, Michael Echeta Aronu Nigerian Journal of Surgical Sciences 2017 27(2):47-50 Background: Infertility is a major concern among couples in our environment. Hysterosalpingography (HSG) is a radiological procedure used to investigate women with infertility. It can be used to assess the cervical canal, the uterine cavity, and the fallopian tubes in these women. So far, the pattern of HSG findings in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Amaku, Awka, has not been documented despite a lot of these investigations already carried out here. Objective: The objective of the study was to review the HSG findings among women with infertility in Awka. Materials and Methods: A retrospective study of HSG of women with infertility was carried out simultaneously at COOUTH and Amen Specialist Diagnostic Clinic, both in Awka, Anambra State, South-East Nigeria, from April 2013 to May 2017. The Statistical Package for the Social Sciences (SPSS) version 21 was used for the analysis. Tests for central tendencies and dispersions as well as paired sample correlation tests were carried out.P ≤ 0.05 was considered statistically significant. Results: A total of 446 cases were analyzed. The age ranged from 19 to 53 years. The mean ± standard deviation was 32.33 ± 6.02 years. The most common age group that presented was 26–30 years (33.9%), while the least were those aged ≥51 years (0.2%). Majority (56.1%) of cases presented with primary infertility while 43.9% had secondary infertility. The HSG was normal in 120 (26.9%) cases and abnormal in 326 (73.1%). Intrauterine filling defects were seen in 120 (26.9%) cases. Tubal occlusion occurred in 178 patients (40%): 106 (23.8%) bilateral, 31 (7%) left unilateral, and 41 (9.2%) right unilateral. Hydrosalpinx occurred in 49 (11%) patients: bilateral in 19 (4.26%), left unilateral in 19 (4.26%), and right unilateral in 11 (2.47%). Loculated peritoneal spillage was seen in 58 (13%) cases. Conclusion: HSG plays a vital role in the diagnostic workup of females with infertility in our environment and is therefore encouraged as a frontline investigation in women with infertility.

The pattern and outcome of surgical acute abdomen at a Nigerian tertiary hospital Nnamdi Jude Nwashilli, Nkwo Michael Okobia, Odigie Clement Osime, Orumuah Jude Agbugui Nigerian Journal of Surgical Sciences 2017 27(2):51-56 Background: Surgical acute abdomen is one of the most common causes of admission into the surgical emergency room. It is a sudden onset of abdominal disease condition which requires immediate surgical evaluation and intervention. Aim: This study aims to determine the pattern and outcome in surgical acute abdomen. Patients and Methods: This was a prospective descriptive study carried out at University of Benin Teaching Hospital, Benin City over 1 year between September 2009 and August 2010. Consecutive patients aged 18 years and above with a diagnosis of surgical acute abdomen formed the study sample. Surgical acute abdomen caused by gynecological and urological problems were excluded from the study. A data form was opened for all patients on admission. Patients who met the inclusion criteria were recruited. Data collated from the patients were analyzed using SPSS version 16. Results: One hundred and eighty-six patients who met the inclusion criteria were recruited. There were 99 males and 87 females with male to female ratio of 1.1:1. The mean age of the patients was 36.60 ± 16.74 years with the age range of 18–92 years. Acute appendicitis confirmed on histopathology in 71 patients was the most common cause of surgical acute abdomen in the study. One hundred and seventy-four patients were treated and discharged while 12 patients died. The overall mortality rate was 6.5%. Conclusion: This study has shown that acute appendicitis is the most common cause of surgical acute abdomen at the University of Benin Teaching hospital, Benin City, and the 21–30 years of age group was most commonly affected.

Endobronchial lipoma: A rare indication for a lobectomy Osemobor Kennedy, Gnanamuthu Birla Roy, Mayank Gupta Nigerian Journal of Surgical Sciences 2017 27(2):57-59 Endobronchial lipomas are rare benign tumors of the respiratory tract. We describe a 61-year-old male with a history of recurrent pneumonia and hemoptysis whose computed tomography scan revealed a destroyed left lower lobe of lung caused by an endobronchial tumor. A bronchoscopic biopsy was suggestive of a lipoma. He underwent a left lower lobectomy since there was irreversible damage to the lower lobe beyond the obstruction. With this report, we stress the importance of early diagnosis of such tumors which could have made an endobronchial resection possible without resorting to a lung resection, thus preserving lung function.