Background:Ovarian cancer (OC) is the seventh most common malignancy among women globally and a major cause of cancer-related mortality, with approximately 239,000 new cases and 152,000 deaths each year. Despite extensive research, there is currently no effective public health screening method for early detection, as commonly used investigations such as CA-125 testing, transvaginal ultrasonography, and bimanual examination lack sufficient diagnostic accuracy. This study evaluated the patterns of oestrogen receptor (ER) and progesterone receptor (PR) expression in ovarian cancer cases in Kano State, Nigeria. Methodology:Relevant demographic data were obtained from laboratory records. Archival formalin-fixed, paraffin-embedded tissue blocks were examined using haematoxylin and eosin staining, followed by immunohistochemical analysis for ER and PR. Tumours were classified according to histological type and grade, and receptor expression was assessed based on immunostaining. Statistical analysis was performed using SPSS, version 26. Result:Sixty ovarian cancer cases were analysed, with patient ages ranging from 10 to 75 years (mean age 52 ± 14 years). High-grade serous carcinoma (HGSC) was the predominant histological subtype, accounting for 63.3% of cases, followed by mucinous carcinoma (15%). Endometrioid carcinoma and malignant Brenner tumour each represented 8.3% of cases, while low-grade serous carcinoma was the least common (5%). Most cases occurred in the sixth decade of life, with HGSC comprising 74% of tumours in this age group. Oestrogen receptor (ER) positivity was observed in 40% of cases, with HGSC showing the highest ER expression. In contrast, progesterone receptor (PR) positivity was low (15%), with most PR-positive cases also being HGSC. Conclusion:OC incidence increased with age, predominantly affecting women aged 50 years and above. The relatively high ER expression and low PR expression highlight the potential role of hormone receptor profiling in guiding personalised treatment strategies for ovarian cancer in this setting.

Background:Disparities in cervical screening result in disproportionate cervical cancer burdens in populations. This study assessed cervical human papillomavirus (HPV) infection prevalence in a rural northeast Nigeria community with low access to cervical screening. Methodology:A community health outreach was conducted at a primary healthcare facility in Azare, Bauchi State, Nigeria. The women who wished to and consented to undergo gynaecological consultations were non-randomly enrolled on the study and provided their sociodemographic data and cervical specimens (Pap smear and cytobrush exfoliates in viral transport media) for the study. These were analysed cytologically and for the presence of HPV deoxyribonucleic acid (DNA). Results:Of 62 women screened (mean age 38.5 ± 9.8 years), 34 (54.8%) tested positive for HPV DNA (95% confidence interval = 43-67%). Among these positive cases, 19 had no intraepithelial lesion or malignancy (NILM), 8 were designated atypical squamous cell of undetermined significance (ASCUS), and 6 showed low-grade squamous intraepithelial lesion (LSIL). In contrast, one case was high-grade SIL (HSIL). Thirty single infections were seen, HPV 16 being the commonest (18 cases), followed by HPV 18 (9 cases), while non-16, non-18 genotypes (genotypes 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 67, 68), collectively termed "Others", accounted for 3 cases. Coinfections among different genotype classes (genotypes 16, 18 and Others) occurred in 4 additional cases. Most of the women had a primary education or higher (43; 69.4%), were married (53; 85.5%), and were multiparous (52; 83.9%). However, the majority had not heard about cervical cancer (35; 56.5%), while 60 (96.8%) women had never been screened previously. Conclusions:The results suggest a high prevalence of cervical HR-HPV and SIL in Azare. Improved public enlightenment and access to cervical cancer screening services may help to decrease transmission of HPV and subsequent cervical cancer in the population.

BackgroundHaematological malignancies (HMs) are primary cancers of the blood and blood-forming organs. They are heterogeneous and of diverse clinical features, treatment protocols and prognoses. They constitute a significant source of cancer-related morbidity and mortality. Northeastern Nigeria, being the region in the country with the worst literacy rate and poverty indices, is also battling with the burden of these diseases with the limited health facilities to adequately diagnose and treat these ailments. There is paucity of a comprehensive data on HMs in the region, so this study aims to report on the multi-centre burden of the common HMs in the region and to discuss their patterns of distribution and management challenges.Materials and methodsThis was a 5-year retrospective study where records of cases of HMs diagnosed in the four health facilities [viz., Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi; Federal Teaching Hospital (FTH), Gombe; Modibbo Adama University Teaching Hospital (MAUTH), Yola; and Federal Medical Centre (FMC), Azare] were collected from 1 January 2018 to 31 December 2022. Data on the age, gender, diagnosis and subtypes of some malignancies were also obtained and analysed using the SPSS Version 23.0 statistical software.ResultsA total of 493 cases of HMs, which constituted 8.2% of all cancers, were diagnosed during the period under review. Paediatric HMs constituted 42.0% (207/493) of the HMs. Non-Hodgkin lymphoma (NHL) constituted the majority of the HMs at 115/490 (23.5%), while multiple myeloma (MM) was the least at 38/493 (7.7%). An average cost of 5,000 to 10,000 United States dollars is required to manage an HM in Nigeria. Late presentation of patients, non-availability and inadequate number of personnel, inability to pay for investigations and/or treatments due to financial constraints, and limited facilities for tests such as flow cytometry, immunohistochemistry, cytogenetic and molecular genetic analyses were the challenges identified in the institutions in Northeastern Nigeria that manage cancer patients.ConclusionHaematological malignancies are common in our environment, and there are limited facilities and expertise to accurately diagnose and treat them in the region and Nigeria in general.

Introduction: Cancers are a major cause of childhood mortality worldwide especially in LMICs where underdiagnoses and lack of quality cancer data hampers effective cancer control efforts. This study aimed to document and describe the patterns and characteristics of childhood cancers in the North East geopolitical zone of Nigeria. Methods: This was a retrospective cross-sectional study that collected cancer data from 4 out of the 6 states in the North East of Nigeria. The data included all malignancies diagnosed in children aged 0-19 years between 2019 and 2022. The age-specific incidence rates were also calculated for the individual 5-year age groups (0-4 years, 5-9 years, 10-14 years, and 15-19 years). The crude incidence rates (CIR) were calculated as the weighted averages of the respective ASRs in each age range within 0-14 years and 0-19 years respectively. The cancers were grouped according to the International Incidence of Childhood Cancers, volume 3 (IICC3). Results: Cancers in people <20 years accounted for 7.3% of all cancers diagnosed over the same period. The crude incidence rates (CIR) for cancers in children and adolescents were 20.9 per million children aged 0-19 years and 18.8 per million children aged 0-14 years respectively, while the age-standardized rates (ASR) were 1.80 and 1.63 per million person-years respectively. There was a variation in the most commonly diagnosed cancers across all age groups. However, lymphomas were the most commonly diagnosed cancers overall, while CNS tumors were overwhelmingly rare. Conclusion: Despite data limitations, this study provides useful insights into patterns of cancers in the region and will hopefully provide a basis for the strengthening of pediatric oncology care, childhood cancer control programs and population-based cancer registries.

Introduction: Prostaglandin-endoperoxide synthase-2 (ptgs2), otherwise called Cyclooxygenase 2, is overexpressed in colorectal carcinoma (CRC) compared to normal tissues. However, the impact of differential expression among ptgs2-positive tumours on CRC prognosis has not been well investigated. By sub-stratifying positive tumour expression, this study determined its potential influence on patients' outcomes. Methods: The Cancer Genome Atlas database was explored to determine CRC cases with RNA-Sequence (RNA-Seq) transcript data and matched clinicopathological data alongside gene copy number variation and methylation status. Descriptive, chi-square, Fisher exact, Linear-by-Linear associations, logistic and Kaplan-Meier statistics were used to determine proportions, associations, predictors and survival between ptgs2 and tumour parameters using Statistical Package for Social Sciences version 20. Two-tailed p-value <0.05 was accepted as statistically significant. Results: There were 534 CRC classified predominantly as adenocarcinoma not otherwise specified (86.3%) and mucinous carcinoma (12.4) histologically included in this study. Marker (ptgs2) expression ranged from 0.02 FPKM-131.89 FPKM, (Median 1.4 FPKM). The majority of the cases (53.4%) were diagnosed at an early stage and showed high ptgs2 RNA-Sequence (RNA-seq) expression in 51.5% (275/534). Significant associations were seen between ptgs2 expression and histological subtype (p < 0.001), lymphovascular invasion (p = 0.013), pN2 stage (> 6 positive lymph nodes) (p = 0.011) and American Joint Committee on Cancer Staging stage (p = 0.028), and these all had lower ptgs2 expression. On regression analysis, histological differentiation emerged as a predictor of ptgs2 expression (Odds ratio 2.749, 95% confidence interval 1.479-5.108, p < 0.001). Also, gene methylation was associated with reduced ptgs2 expression. Overall survival was significantly inferior among individuals with low ptgs2 tumours (p = 0.018) while that for disease-free survival was nonsignificant (p = 0.327). Conclusion: CRCs with low ptgs2 transcripts are associated with poorersurvival. This finding suggests a need for closerfollow up and tailored adjuvant therapy for these patients.

Background The clinicopathological significance of KRAS alterations in clinical prostate cancer (PCa) has yet to be comprehensively studied, and the classic KRAS somatic mutations are rare in PCa. Methods The clinico-genomic data of two PCa cohorts were retrieved from the cancer genome databases. KRAS expression-based gene enrichment for cell proliferation, apoptosis, and epithelial-mesenchymal transition /invasion programmes, RAS activation, MAPK and PI3K signalling were sought using gene enrichment analyses, and validated with clinicopathologically relevant tumour biology signatures. Results RAS activation and hallmark tumour biology pathways were enriched in KRAS-high PCa subsets. KRAS expression also demonstrated significant associations with Gleason score and ISUP prognostic grade groups, pathological tumour stage, overall TNM stage, and treatment outcomes, but not with age, pathological node and metastasis statuses. The study further demonstrated that wild-type KRAS expression was deregulated in PCa by a combination of copy number changes, epigenetic/altered transcription factor-expression and microRNA mechanisms. Conclusion The relevance of KRAS expression to clinical PCa biology and therapy outcomes deserves further validation.

The methods section reveals that "other studies" were added to the data presented.This needs to be clarified as to what sort of studies those were and what the criteria were for selecting and including them in this present study.3. From the integration of citations in the results section and the style with which the discussion was presented, it may be appropriate to caption the title in such a way as to reflect a review of literature component to the study.Steps can therefore be taken to analyse and present the results of the selected studies.4.Under the discussion section, much of the primary findings of the study were not discussed, although a reasonable effort was made to suggest likely explanations for the ethnic differences in disease presentation and outcome among the population.5.There were places where "(ref)" was placed at the end of sentences.This could be revised.In all, it is a good paper that could drive policy strategies for improved health among the ethnicities studied.

Background: Definitive, affordable, and timely diagnosis of cancer is key to providing data for surveillance and control programmes.Care disparities have been shown to contribute to poorer survival, especially in resource-constrained populations.Here, we describe the profile of histologically diagnosed cancers in our hospital and highlight the possible effects of inadequate diagnostic support on data reporting. Methods:We designed a retrospective cross-sectional descriptive study to review histopathology reports archived at the Department of Pathology of our hospital spanning from January 2011 to December 2022.Cases diagnosed as cancer were retrieved and classified by systems, organs and histology types alongside the patient's age and gender.The trend in the volume of pathology requests and the corresponding malignant diagnosis yield over the period was also documented.Data generated were analyzed statistically using appropriate statistics and presented as proportions and means, with the level of statistical significance set at p < 0.05.Results: There were 488 cancers out of 3,237 histopathology requests received within the study period.Of these 316 (64.7%) were females.Overall mean age was 48.8 ± 18.6 years with a peak age at the sixth decade, females being significantly younger (46.1 versus 53.5 years; p < 0.001).The top five cancers were breast (22.7%), cervical (12.7%), prostate (11.7%), skin (10.7%) and colorectal cancers (8%).Among females, breast, cervical and ovarian cancers predominated, whereas prostate, skin and colorectal cancers, were commonest among males in decreasing order.Paediatric malignancies accounted for 3.7% of all the cases, most being small round blue cell tumours.The volume of pathology requests rose remarkably from 95 cases in 2014 to 625 cases in 2022 with a corresponding increase in cancer case diagnoses. Conclusion:Cancer subtypes and ranking in this study are similar to those from urban populations in Nigeria and Africa, despite the low number of cases recorded.Efforts to reduce the disease burden are warranted.

Background:This study aimed to characterise epithelial cell adhesion molecule (EpCAM) expression patterns in colorectal carcinomas (CRC) from Nigerian patients, its association with E-cadherin and tumour characteristics, to forecast patient selection for anti-EpCAM therapy among whom no data existed previously.Methods:Tissue microarray blocks of formalin-fixed and paraffin-embedded CRC tissues, with their non-cancer margins of resection, were sectioned and stained with EpCAM and E-cadherin primary antibodies. Scoring for antibody staining was done semiquantitatively by combining staining proportion and intensity. The outcome was correlated with patient age, gender and tumour histological parameters with p ≤ 0.05 regarded as statistically significant.Results:Sixty-three carcinoma tissues had staining status for the two markers and were included in this study. Of these, 36 (57.1%) showed positive EpCAM expression (immunoscore ≥3) out of which 83% (30/36 positive cases) were overexpressed (combined immunoscore ≥4) while 12 (19%) tissues were positive for E-cadherin. Non-tumour margins of resection tissues showed less EpCAM positivity in 24% (6/25) of histospots. The difference in staining between tumour and non-tumour margin tissues with EpCAM was significant (p < 0.001). Also, EpCAM overexpression was significantly associated with reduced E-cadherin (p < 0.035) expression in tumour cells. Tumour extent within the gut wall was equal (50% each) for early and late pT stages among EpCAM overexpressing tumours but two-thirds (8/12) of cases expressing E-cadherin had later pT stage paradoxically, while distant metastasis was negligible among tumours bearing both markers. Also, tumours overexpressing EpCAM had significant association with tumour-associated lymphocytes (p < 0.02 each).Conclusion:CRC in this study preferentially overexpress EpCAM over E-cadherin whose strong cell-cell contact inhibitory role is weakened even when expressed, resulting in further local tumour spread. This, and the observed immune response, supports targeted therapy among eligible patients.

Background: Different reasons for autopsies include medico-legal causes, medical education and deducing the cause of death. An additional benefit is auditing with regards to patient care in the diagnosis and treatment of diseases. The main objective of this study was to determine the concordance between ante-mortem clinical diagnoses and post-mortem causes of death. Materials and Methods: From January 2009 to December 2015, Autopsy records at the Department of Pathology, University College Hospital, Ibadan were reviewed. Discrepancies between the clinical diagnoses and postmortem findings were categorised using Goldman criteria into major and minor classes. Goldman's criteria can be sub-categorised into five classes: Class I, Class II, Class III, Class IV and Class V. Classification of the cause of death categories was by the International Classification of Diseases, Version 10. The study was carried out with respect to the world medical association's Declaration of Helsinki (2013). Data analysis was carried out with the use of the Statistical Package for the Social Sciences (SPSS version 22). Results: Five hundred and thirty-three cases were involved with a male-female ratio of 1.6. The most common postmortem causes of death were traumatic Injuries (20.6%), Circulatory system-related deaths (19.7%), infections (16.9%) and malignant neoplasms (9.4%). Only 298 (55.9%) of the cases showed a concordance between the post-mortem causes of death and the clinical diagnosis. Conclusion: The post-mortem autopsy is useful in the audit of current medical practice in our environment.

Background: Sub-Saharan Africa has the highest childhood mortality worldwide. In this study, we reviewed post-mortem records retrospectively noting both the causes of death and autopsy trend in childhood documented at our hospital. Aim: This study was done to ascertain the mortality patterns in childhood as seen in post mortem examinations. Materials and Methods: Autopsy records of deceased who were 16 years or less performed from 2008 to 2017 in our hospital were accessed and reviewed. Written consents were duly obtained before all post-mortem examinations. The causes of death were defined using the International Classification of Diseases-11. Results: There were 89 cases representing 8.2% of 1092 autopsies performed within the review period. Most of the childhood mortalities were in the 1st year of life. The majority of cases in the 1st year of life were cases of early neonatal death (40%), followed by deaths from 29 days to 1 year (34.3%) and late neonatal death constituting 25.7% of cases. Infections resulted in deaths in 34.8% of cases, followed by malignancies at 12.4%, developmental anomalies at 10.1%, accidents at 6.7%, sickle cell disorder at 4.5%, and nephrotic syndrome at 4.5%. Pneumonia represented 48.4% of all infectious death, followed by bacteria sepsis of newborn at a distant 9.7%. Malignancies are the main cause of mortality in children above 10 years of age. It constitutes 36% of the cases in that age group. Mortalities from developmental anomalies were relatively more common in infants (17.1% of deaths). Conclusion: This study has shown varying causes of death in different age demographics among children in the population studied. Infection control and adequate treatment in addition to early diagnosis of malignancies are advocated.

AIM:To describe the pattern of paediatric Rhabdomyosarcomas (RMS) and Non-Rhabdomyosarcomas (NRMS) with emphasis on the indices that affect survival outcomes.METHODS:We reviewed all patients with histologically confirmed RMS and NRMS in the Departments of Pathology and Paediatrics, University College Hospital (UCH), Ibadan, Nigeria; in children aged 0-14 years. The study period was January 1991 to December 2016. Information obtained included age, gender, morphology and site of the tumours. The tumour grade and pathologic/clinical staging of all patients were also obtained and verified by the clinical records. Tumour grading was carried out using the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) Sarcoma group grading system and staging was done using TNM. Follow up, survival information and final outcome were retrieved.RESULTS:The 104 patients included in the study had almost equal male-to-female ratio, age ranged between 5 months and 14 years (median 8.2 years). Rhabdomyosarcoma had mean age of 5.6 (±3.8) years while that of NRMS was 9.2(±4.1) years. Overall, the modal age group was 5-9 years. Rhabdomyosarcoma was the commonest histological type (76%), undifferentiated sarcomas (6.7%), fibrosarcoma (3.8%) and 2.9% each for synovial sarcoma and dermatofibrosarcoma protuberans. The common primary sites were the head and neck (including the orbit) 49 (47.1%), and the abdominopelvic 26 (25%) regions. Majority (89%) had histologic grade 3 at presentation. Seventy per cent and 64% of patients with RMS and NRMS, respectively, had high stage tumour at presentation. Median survival for all patients with Rhabdomyosarcoma was 45 weeks with a 1-year survival of 43% and 2-year survival of 25%. Non-RMS (Dermatofibrosarcoma protuberans and Solitary fibrous tumours) had survival of over 4 year's duration.CONCLUSION:Majority of our patients presented at a late stage with histologic high grade which confers poor prognosis and reduced chances for good overall survival outcome.

Background Emerging data suggest a negative role of cyclooxygenase-2 (COX-2) in colorectal carcinomas (CRC). Investigating this in developing communities such as ours helps to contribute to existing understanding of these lesions. Methods and findings Formalin-fixed paraffin-embedded CRC colectomy tissues and their corresponding non-tumour margins of resected tissues were sectioned and stained with COX-2 antibody. Adenomatous polyp tissues from non-cancer bearing individuals were similarly processed for comparison. COX-2 expression was scored for percentage (< 5% = 0; 6%-25% = 1; 26%-50% = 2; 51%-75% = 3; 76%-100% = 4) and intensity (no staining = 0; yellow = 2; yellowish-brown = 3, brown = 4). Total immunoscore (percentage + intensity score) ≥ 2 was regarded as positive COX-2 expression. Outcome was statistically evaluated with clinicopathological data to determine COX-2 expression-associated and predictor variables. Ninety-five CRC cases and 27 matched non-tumour tissues as well as 31 adenomatous polyps met the inclusion criteria. Individuals with CRC had a mean age of 56.1 ± 12.6 years while those with adenomatous polyps had a median age of 65 years (range 43–88). COX-2 was differentially overexpressed in CRCs (69/95; 72.6%) and in adenomatous polyps (17/31; 54.8%) than in non-tumour tissues 5/27 (18.5%); p < 0.001). The difference in COX-2 expression between CRC and polyps was non-significant ( p > 0.065). Tumour grade, advanced pT-stage, tumour-infiltrating lymphocytes, and dirty necrosis were also significantly associated with COX-2 expression ( p < 0.035; 0.043, 0.035 and 0.004, respectively). Only dirty necrosis and Crohns-like lymphocytic aggregates predicted COX-2 expression ( p < 0.05). Conclusion This study showed a progressive increase in COX-2 expression from normal to adenomatous polyp and CRC tissues, this being associated with poorer prognostic indicators. Although COX-2 appears early in CRC, it may play a secondary role in promoting tumour growth and invasiveness.

Aims: To review lymph node yield in colorectal carcinoma (CRC) resections and its associated factors in a Nigerian Teaching Hospital practice. Study design: This was a retrospective cross-sectional study. Place and duration of study: Department of Pathology, University College Hospital Ibadan Nigeria and colectomies from January 2014 to December 2018 were reviewed. Methodology: Surgical Pathology reports of CRC resections at the University College Hospital Ibadan over 5 years (2014-2018) were reviewed. Colectomy lengths, tumour location (colon/rectum), tumour size, comment on presence of lymph node (yes/no), lymph node count, presence of attached mesentery (yes/no), histological subtype, tumour grade, presence of tumour-positive node and count, and pT stage were documented. Fisher’s Exact test was employed to test the effects of these variables on presence of lymph node and tumour-positive node at histology using SPSS 20. Significance level was set at P < .05. Results: Of 66 histology reports retrieved, 62 (93.9%) had comments on search for lymph nodes and attached mesentery was documented in 25 (37.9%). The median colectomy length and tumour size were 25cm (6cm-152cm) and 6.75cm (3-30cm) respectively. Lymph nodes were present in 52 (78.8%) specimens; 28 (53.8%) of these had tumour-positive lymph nodes. Adenocarcinoma NOS was the commonest histological subtype 53 (80.3%), mucinous carcinoma 12 (18.2%) and signet ring carcinoma 1 (1.5%). Eighteen, 9 and 1of adenocarcinoma NOS, mucinous carcinoma, and signet ring carcinoma respectively had tumour-positive lymph nodes. Finding of lymph node was significantly associated with comment on search for lymph node (p < .01) while finding tumour-positive nodes was associated with histological subtype, presence of mesentery, late tumour stage and lymph node count ≥ 12 (p < .05). Conclusion: If lymph nodes were present, more than likely there will be metastatic involvement. To increase Lymph node yield in CRC resections, submission of mesentery and search for lymph nodes is indicated. When nodes are absent, a mention is required for practice audit. It is imperative to include both clinical and grossing notes for lymph nodes to certify and guide precise staging of the cancer.

BACKGROUND:Systemic hypertension is referred to as a silent killer. Knowledge of disease and religious use of medication could mitigate against complications in hypertensives. This study evaluated outcome among decedent essential hypertensive patients in southwestern Nigeria in relation to their compliance with prescribed antihypertensive medication.MATERIALS AND METHODS:This is a 10-year retrospective review of routine postmortem data. Archival postmortem records from January 1, 2008 to December 31, 2017 in the Department of Pathology, University College Hospital, Ibadan, Nigeria, were reviewed. Data extracted from the records included age, gender, knowledge of hypertension status, systolic and diastolic blood pressure at time of diagnosis, reported adherence to medications, complications of systemic hypertension, duration of survival from diagnosis to demise, cause of death, body length, and heart weight at autopsy. Descriptive, Students t-test, Chi-square test, Pearson correlation and Cox proportional-hazards model statistics was conducted using SPSS version 20 (IBM SPSS Statistics for windows, IBM Corp., Armonk, N.Y., USA).P < 0.05 was considered significant.RESULTS:Eighty-one cases met the inclusion criteria, consisting of 60 males and 21 females with overall mean age of 55.65 ± 12.1 years. Seventy-five (91.7%) cases were known hypertensives prior to admission or demise while 6 (8.3%) were not known hypertensives. The duration of survival from diagnosis to death ranged from 1-month (0.08 years) to 31 years with overall mean duration of 5.2 years. Fifty-two (63.4%) of the 75 known hypertensive cases had documented medication compliance. Medication noncompliant cases had lower mean survival interval (5 vs. 8 years), died younger (53.5 ± 10.8 years vs. 54.8 ± 15.5 years), had higher mean blood pressures (systolic blood pressures: 197 ± 45.8 mmHg vs. 180 ± 55.4 mmHg; diastolic blood pressures: 117 ± 27.2 mmHg vs. 101 ± 32.8 mmHg) and heavier heart weights (476 ± 142 g vs. 390.8 ± 107.6 g). However, only the difference in heart weight was statistically significant (P < 0.036). Age and mean systolic blood pressures were correlated with interval from diagnosis to death (r = 0.5, P < 0.000; r = -0.4,P < 0.017, respectively). Death from complications of hypertension and all-cause mortality occurred with higher frequencies among medication noncompliant cases (40 vs. 12).CONCLUSION:Noncompliance with antihypertensive medication is associated with more cardiovascular and all-cause mortality among Southwestern Nigerians with essential hypertension.

Objectives: Diabetes mellitus (DM) is a global health problem with associated high morbidity and mortality. This study was a retrospective review of post-mortem examination findings of hospitalised patients with DM for causes of death. Materials and Methods: A retrospective, cross-sectional autopsy review of all the patients with DM in our hospital between January 2008 and December 2017 was conducted. The causes of death were classified into cardiovascular, cerebrovascular, acute diabetic emergencies, infection, cancers and unnatural deaths. The demographic data and clinicopathological parameters were extracted, and the data were analysed using the SPSS software version 23. Results: A total of 1092 cases of autopsy were done within the study period, of which 91 cases were on patients with diabetes accounting for 8.3%. Infections with sepsis were the major cause of death, accounting for 51.6% followed by cardiovascular diseases (16.5%), cancers (14.3%), acute diabetic emergencies (6.6%) and cerebrovascular accidents (6.6%), with renal complications and road traffic accidents accounting for 2.2% each. Patients' age ranged from 31 to 84 years, with a modal age of 57 years. There was a male predominance with a male-to-female ratio of 1.5:1. Systemic hypertension co-morbidity was statistically significantly more common in patients aged 60 and above (P = 0.035). The most common lesion observed in the kidneys was benign nephrosclerosis (43.2%). Conclusions: This study suggests that majority of our patients with diabetes mellitus die from infections with attendant sepsis. Older patients appear to have co-morbid systemic hypertension. Patient education on infection prevention and prompt treatment might be life-saving.

Background: Dermatofibrosarcoma protuberance (DFSP) is the commonest, yet rare, dermal sarcoma globally. There are few reports in the literature of this neoplasm in Nigerians and indeed in sub-Saharan Africa. This study documents our institutional practice observation and compares it with those from other regions of the world. Methods and materials: This study was a retrospective review of all cases of histologically diagnosed DFSP at the University College Hospital, Ibadan, Nigeria, spanning a period of 27 years (January 1989-December 2016). Data on patient age, gender, tumour location, size, tumour recurrence and metastasis status were obtained from clinical and surgical pathology archival files and records. Results: Sixty-nine cases of DFSP were recorded over the period reviewed with a male-female ratio of 1.6:1. The mean age of the study population was 39.6 years. The youngest patient was 5-year old, while the oldest was 86 years and the modal age group was the 4th decade. The trunk was the commonest anatomic tumour location. Recurrences were seen in seven cases with recurrence interval ranging from 6 to 240 months. The correlation between tumour size and age was non-significant (r = -0.183; p = 0.182). There was fibrosarcoma-like transformation in three cases (4.3%) studied. Conclusion: Dermatofibrosarcoma protuberance is rare in our population and occurs more commonly in males and on the trunk. Recurrence can occur beyond the recommended follow-up period of 10 years.

The original version of this article unfortunately contained a mistake. In Table 2, the number 36 under "N" should be 96 and "Tumour size in cm (range)" should read "Tumour size in cm."

Background and Aim: Colorectal cancer (CRC) is known to be a major cause of morbidity and mortality worldwide. It is believed that CRC develops from adenomas or benign adenomatous polyps. Information concerning this premalignant condition in Nigeria is still relatively scarce. The aim of this study was to describe the clinicopathologic features of colorectal polyps seen in patients who had colonoscopy at the University College Hospital, Ibadan, Nigeria.Patients and Methods: This was a descriptive cross-sectional study carried out at the Endoscopy Unit of the University College Hospital, Ibadan, Nigeria. Colonoscopy was performed on the patients after bowel preparation. Polyps were characterized by their colonic location, size in millimeter, and histopathological diagnosis. The data were analyzed using SPSS version 17.0. Results: The patients comprised 65 (58.0%) males and 47 (42.0%) females. The mean age was 60 ± 12.5 years, with majority being in the age range of 51–60 years. The most common indication for colonoscopy was hematochezia. The location of the polyps was as follows: 41 (36.6%) in the rectum, 30 (26.8%) in the sigmoid colon, and 22 (19.6%) each in the transverse and descending colon. In 51 (45.5%) patients, polyps were <5 mm in size; 5–10 mm in 48 (42.9%) patients; and >10 mm in 13 (11.6%) patients. The most frequent histological diagnosis was adenomatous polyp. Conclusion: Polyps were found more commonly in males and in individuals aged 50 years and above. The most common location is the rectosigmoid colon, and the polyps are majorly adenomatous. Our findings suggest the need for colonoscopy service to be made more widely available across the country so as to contribute to reduction in CRC incidence among Nigerians.

Introduction: Anaemia remains one of the major public health challenges with global impacts, especially in developing countries. Causes of anaemia are multiple and variable among which are social, dietary, physiological and environmental factors with evidences suggestive of contributory roles of metal interactions. Aim: To determine the relationship of anaemia with plasma levels of lead, iron and zinc in adult Nigerians. Materials and Methods: Total 428 subjects (111 males, 184 non-pregnant female and 133 pregnant female), aged ≥18 years (mean=38.4±13.7 years) were enrolled in the study. Sociodemographic data were collected using structured questionnaire while blood samples were collected for the determination of haemoglobin and mineral elements using standard methods and techniques. Anaemia was defined as haemoglobin <12.0g/dl (non-pregnant women), <11.0g/ dl (pregnant women) and <13.0g/dl (men), respectively. Ninety three anaemic subjects were compared with 335 non-anaemic subjects. Results: Although the plasma levels of all the elements were lower in anaemic in comparison to non-anaemic subjects, only lead was significant (0.004±0.002 vs 0.005±0.012 µg/dl; p = 0.027). While none of the elements showed any relationship with haemoglobin, plasma iron was positively correlated with zinc (r = 0.837; p = 0.001). Conclusion: The absence or weak significant relationship between anaemia and any of the elements suggests that relative concentrations of the elements may be important determinant of anaemia in this population. While further studies are desired to substantiate these findings, food diversification and reduction in toxic metals exposure are recommended to improve the nutritional status of residents and reduce anaemia prevalence with its attendant health consequences.