PubMed Health⌕ Search

Biomedical subjects

E E Akang

Publications and source records attributed to E E Akang.

At least 19 recordsLinked to original sources
PubMed2006

Factors influencing visual and clinical outcome in Nigerian patients with cranial meningioma.

We retrospectively analysed the impact of selected clinicopathological factors on visual and clinical outcome in patients with histologically verified cranial meningioma. The 60 patients analysed for tumour characteristics consisted of 32 females and 28 males (sex ratio 1.1:1) aged 9-77 years (mean 40 years) seen between 1977 and 1999 at the University College Hospital, Ibadan, Nigeria. The patients for whom sufficient clinical data was available (n=35) presented within 2-60 months (mean 18 months) of symptom onset with large tumours (mean size 52 mm), and perifocal oedema (26/35), poor vision, focal neurological deficits, seizures and clinical evidence of intracranial hypertension. The most common tumour site was the convexity. There was loss of vision in 30/35 (85.7%) patients. Loss of vision was significantly related to tumour site and tumour size as well as perifocal oedema, (P<0.05). The case-mortality rate was 11.4% at 1 month and 20% at 6 months post-operation and was significantly correlated with intracranial hypertension. Neither age nor sex affected the outcome (P>0.05).

Brain Neoplasms↗
PubMed2001

Collagenous colitis in an adult patient with chronic diarrhoea: case report.

Collagenous colitis is an established cause of chronic watery diarrhoea of unknown aetiopathogenesis, characterised by normal colonic endoscopic findings, and a prominent collagen band in the sub-epithelial layer on colonic mucosal histology. We report a case of a 65-year old male who presented with recurrent episodes of watery diarrhoea of 38 years duration. There was a positive family history of similar diarrhoea in the mother and two siblings. Colonoscopy done was macroscopically unremarkable except for a redundant sigmoid colon. Mucosal biopsy of the rectum and colon showed at histology atrophy of the mucosal lining, infiltration of the lamina propria by plasma cells and lymphocytes, and a thick band of collagenous tissue in the sub-epithelial zone of the lining mucosa. A high index of suspicion is necessary to make the diagnosis in patients with chronic diarrhoea, especially when common causes of chronic diarrhoea like intestinal parasitoses, HIV/AIDS, diabetic autonomic neuropathy, thyrotoxicosis have been excluded. It is suggested that colonoscopic examination with adequate biopsy should be performed in patients with chronic diarrhoea with no aetiologic agent identified.

Aged↗
PubMed2001

Mucoepidermoid carcinoma of the oral cavity.

There is presently no uniformly accepted grading system for mucoepidermoid carcinoma, largely due to a lack of consensus as to what criteria should be used to formulate histological grades. The present study was undertaken to determine the relationship between histological grade, clinical stage and survival in these neoplasms. Clinical and histological data from 34 patients with mucoepidermoid carcinoma were reviewed. Mucoepidermoid carcinoma was most common in the parotid gland (44.1%), while 25% of patients had tumors in the minor salivary glands. Low, intermediate, and high-grade neoplasms accounted for 61.7%, 26.5%, and 11.8% of tumors, respectively. There was a general trend towards increasing clinical aggressiveness with increasing histological grade. Similarly, postoperative tumor recurrences were marginally more common in high-grade than in low-grade mucoepidermoid carcinomas. However, both of these findings were statistically insignificant, mainly due to small sample size, late clinical presentation, poor clinical follow-up, incomplete management and incomplete records. These factors explain the relatively low survival figures in the present study, as compared to higher survival figures in white patients with mucoepidermoid carcinoma.

Adolescent↗
PubMed2000

Endometriosis presenting as a groin tumour: case report.

A case of endometriosis presenting to a general surgeon as a groin mass in a 22-year old lady with no abdominal or pelvic symptoms and who had previously been pregnant is reported. Though similar presentations have been reported previously, we believe this is the first case to be reported from Ibadan in this form and we wish to emphasis the importance of consideration of this diagnosis in any groin swelling in a young female as well as the necessity of having a histological examination done on all excised lumps.

Abdominal Neoplasms↗
PubMed1997

Subacute sclerosing panencephalitis manifesting as viral retinitis: clinical and histopathologic findings.

PURPOSE AND METHODS: To describe the clinical and histopathologic features of a patient with viral retinitis secondary to subacute sclerosing panencephalitis. RESULTS: The patient was a human immunodeficiency virus-negative intravenous drug abuser with an acute retinitis that later progressed to encephalitis despite aggressive treatment for possible viral, protozoal, bacterial, and rickettsial infections. The patient had many of the characteristic findings of subacute sclerosing panencephalitis, including a history of measles in early childhood, myoclonus, periodic complexes on electroencephalographic testing, persistently elevated serum and cerebrospinal fluid antimeasles immunoglobulin G (IgG) titers, and a cerebrospinal fluid oligoclonal IgG gammopathy. Ultrastructural examination demonstrated numerous filamentous microtubular intranuclear viral inclusions in the nuclear layers of the retina consistent with the measles virus. This case is unusual in that our patient developed subacute sclerosing panencephalitis later in life and because there was an 8-year period between presumed viral infections in the two eyes. CONCLUSIONS: An acute retinitis in an intravenous drug abuser is not always caused by human immunodeficiency virus-related infections; not all viral retinitis responds to therapy; and mortality as well as the usual morbidity may be associated with viral retinitis. One might consider the diagnosis of subacute sclerosing panencephalitis in a young person with an acute retinitis with little or no vitreal inflammation and lack of response to anticytomegalovirus and antitoxoplasmosis therapy.

Adult↗
PubMed1997

Pharyngeal lipoma with cartilaginous metaplasia (chondrolipoma): a case report and literature review.

The relative rarity of pharyngeal lipomas and paucity of clinical manifestations in the early stages of tumour growth conspire to task the diagnostic acumen of the clinician. A high index of suspicion and meticulous examination are essential in order to arrive at the diagnosis, which may be achieved pre-operatively by computerized axial tomography, revealing a mass lesion with a characteristic low attenuation value. A case of pharyngeal chondrolipoma in a 25-year-old male is reported. It is suggested that this conceptually intriguing and rarely encountered lesion can be explained on the basis of neoplastic transformation of the second to fourth pharyngeal cleft mesenchymal rests displaying both adipose and cartilaginous differentiation. Alternatively, the cartilage could represent vestigial remnants of non-neoplastic pharyngeal cleft tissue entrapped within a primarily lipomatous neoplasm. Slow growth may occur over a period of several years, prior to overt clinical manifestation.

Adult↗
PubMed1997

A prospective study of coroner's autopsies in University College Hospital, Ibadan, Nigeria.

The present study reviews 876 consecutive coroner's autopsies performed in the Department of Pathology, University College Hospital, Ibadan over a two-year period (1 February 1991 to 31 January 1993). The hospital autopsy rate during the study period was 36.2%, and 62.5 per cent of these post-mortems were medico-legal cases. The most common indications for coroner's autopsies were sudden natural deaths (55.6%), followed by accidental deaths (35.3%). The proportions of maternal (4.3%), homicidal (3.1%) and suicidal (0.3%) deaths were much lower. The male to female ratio was 1.7 to 1. Ninety-one (10.4%) of the cases fell within the paediatric age group and the peak age incidence for these cases was in the 5-14 years age group. The remaining 785 (89.6%) cases were adults and the peak age incidence for these cases was in the fourth decade of life. The most common cause of sudden natural death was cardiovascular disease, of which hypertension constituted the majority of cases. Other major causes of sudden death included pneumonia, meningitis, typhoid fever and neoplastic diseases. Road traffic accidents accounted for 78 per cent of accidental deaths followed by falls (13.3%) and burns (4.6%). Abortions, post-partum haemorrhage and eclampsia were the major causes of maternal deaths in the present study. Homicidal deaths were eight times more frequent in male than female victims and the commonest mode of death was gunshot injuries. Suicidal deaths remain extremely uncommon in African patients, as confirmed by our study.

Adolescent↗
PubMed1997

Carcinoma of the oesophagus in Ibadan.

This was a retrospective analysis of 177 histologically confirmed cases of oesophageal carcinoma seen in the University College Hospital, Ibadan, Nigeria over a period of 30 years. Oesophageal carcinoma constituted 0.6 per cent of all malignant neoplasms and 1.4 cases per 1000 surgical biopsies during the study period. Dysphagia and weight loss were the most common clinical manifestations. Ninety three patients presented within one year of onset of clinical symptoms. The peak age incidence occurred in the seventh decade of life. Sex distribution was equal. The middle third of the oesophagus was the most common location of the neoplasm and the vast majority (94.5%) were squamous cell carcinomas. Achalasia of the cardia and Barrett's oesophagus were not associated with oesophageal carcinoma in this study. Regional lymph nodes and lungs were the most common sites of metastasis. Surgical complications included mediastinitis and bronchopneumonia, both occurring within seven days postoperatively. Late clinical presentation and high postoperative mortality are responsible for the persistently poor prognosis of oesophageal carcinoma despite significant advances in the diagnosis and management of these neoplasms.

Adult↗
PubMed1996

A twenty-year review of malignant colorectal neoplasms at University College Hospital, Ibadan, Nigeria.

PURPOSE: Colorectal malignancies are less common in developing than developed nations because of lower per capita income and higher dietary fiber consumption. This clinicopathologic study attempts to determine changes in the pattern of these neoplasms in Ibadan, Nigeria, during the last two decades. METHODS: The present study is based on the clinical Cancer Registry records and gross and morphologic surgical pathology findings of 526 patients with histologically verified malignant colorectal neoplasms received in the Department of Pathology, University College Hospital, Ibadan, between 1971 and 1990. RESULTS: Colonic malignancies increased by 81 percent, whereas rectal malignancies decreased 16.1 percent in frequency (P < 0.05). The modal ages were 55 to 60 years and 45 to 50 years for colonic and rectal neoplasms, respectively, in contrast to reported peak occurrence in the seventh decade among Caucasians. Colonic neoplasms were predominantly right-sided (34.3 percent cecal), abdominal mass and pain being major clinical manifestations. This differs from the pattern in American Negroes, among whom colonic carcinomas are predominantly left-sided, dyschezia being an important presentation. As in most other studies, adenocarcinomas were the predominant neoplasms. CONCLUSIONS: Further work is required to determine prognostically significant features of colorectal cancer in our environment.

Adenocarcinoma↗
PubMed1996

Rhinosporodium: case report.

This is the first reported case of rhinosporidiosis in Ibadan, Nigeria. A review of literature shows that the patient came from northern Nigeria where the first case was reported in the country. The organism is difficult to culture and the diagnosis was based on microscopy and histological examination of the polyp. We present the case of recurrent rhinosporidiosis in a 16 year old girl a year after polypectomy in Zaria, northern Nigeria.

Adolescent↗
PubMed1996

Neurological manifestations of chronic myelogenous leukaemia.

Neurological manifestations occur in about one-quarter of patients with chronic myelogenous leukaemia (CML), usually as a result of hyperleukocytosis, predisposing to intravascular thrombus formation. We report the clinical and pathological findings in a 16-year-old female with CML who presented with deafness, blindness and paraplegia, and discuss possible aetiopathogenetic mechanism.

Adolescent↗
PubMed1994

Cryptococcal meningitis with malaria. A case report.

Cryptococcal meningitis is an uncommon infection globally, including Nigeria. This systemic fungal infection often is associated with immunodeficiency. The most common causes of meningitis in Nigeria in the 2-3 year age group are the malaria parasites and bacteria. The concomitant infections of Cryptococcal neoformans and Plasmodium falciparum are uncommon. We present here the report of a case of fatal cryptococcal meningitis with malaria infection in a 2 year old child from Nigeria (one of the malaria endemic regions of the world). This case emphasizes the importance of doing a combination of fungal and bacterial cultures as well as looking for malarial parasites in the determination of etiological agents of meningitis in any hospital in Africa. We suggest that cerebrospinal fluid from meningitis cases must be cultured using Sabouraud dextrose agar and any growth on the agar must be examined using Indian ink.

Autopsy↗
PubMed1994

A review of teratomas in Ibadan.

Teratomas accounted for 3.4 cases per 1,000 surgical biopsies received in the Pathology Department of UCH Ibadan, between 1960 and 1985. The commonest site of teratomas was in the ovaries which accounted for 83.2% of the cases, followed by the sacrococcygeal region which accounted for a further 6.3%. Other sites of occurrence included the neck, testes, mediastinum, abdominal cavity and buccal cavity in descending order of frequency. Rare sites of occurrence were extracranial, intracranial, uterine cervix and intraocular regions. There was a female to male ratio of 18 to 1 and the average age of the patients was 25.8 years. Sixty per cent of ovarian and mediastinal teratomas contained hair and sebaceous material permitting their gross identification. Eighty-eight per cent of the teratomas reviewed histologically were classified as mature, a further 8% were immature, and 4% were malignant.

Adolescent↗
PubMed1994

Simultaneous bilateral malignant breast neoplasms in Nigerian women.

This study reviews the clinicopathological features and survival of 18 Nigerian women with simultaneous bilateral breast cancer. Twelve (67%) of these patients had bilateral Burkitt's lymphoma of the breast. The average age of these patients was 22 years, and all of the women were pregnant or lactating at the time of initial clinical presentation. The remaining six patients (33%) had bilateral malignant epithelial neoplasms, with lobular carcinoma being present in four cases. The average age of patients with bilateral malignant epithelial tumors was 37 years. None of the 18 patients with simultaneous bilateral breast cancer survived for up to 2 years after diagnosis, indicating that bilateral synchronous breast cancer in Nigerian women is a rapidly progressive and aggressive disease.

Adenocarcinoma↗