PubMed Health⌕ Search

Biomedical subjects

S O Elesha

Publications and source records attributed to S O Elesha.

At least 19 recordsLinked to original sources

Histopathological study of liver diseases at the Lagos University Teaching Hospital, Nigeria (1989-2000).

OBJECTIVE: We present a retrospective histopathological study of 345 liver biopsies over a 12-year period. The study sought to record the frequencies of the range of histopathological changes observed in liver biopsy specimens. MATERIALS AND METHODS: the materials consisted of slides and paraffin embedded blocks of all liver biopsy specimens received from within and outside the hospital. The clinical data such as the age, sex, and clinical summary were extracted from the request forms. RESULTS: there were 222 males and 123 females; M: F=1.8:1; peak age incidence of 41-50 years. The three common histopathological diagnoses were hepatocellular carcinoma-33%, chronic hepatitis-17.7%, and liver cirrhosis-17.7%. Thirty per cent of hepatocellular carcinoma was post-cirrhotic. The peak age incidence of chronic hepatitis precedes that of liver cirrhosis and hepatocellular carcinoma by one decade. CONCLUSION: the common forms of liver disease diagnosed histologically are hepatocellular carcinoma, chronic hepatitis and liver cirrhosis. The age and sex distribution are similar to those already established in the African literature.

Adolescent↗

Medical audit of maternal deaths in the Lagos University Teaching Hospital, Nigeria.

OBJECTIVES: To determine the rate of autopsy certification of maternal deaths; evaluate concordance and/discordance rates between autopsy and clinical diagnoses of maternal deaths, and to compare these with findings from other parts of the world. DESIGN: Retrospective study. SETTING: The Lagos University Teaching Hospital (LUTH), Nigeria between January 1989 and December 1998. SUBJECTS: Women who died from pregnancy-related complications having been on admission in or having presented as emergencies to LUTH. RESULTS: In the study period, 445 maternal deaths were registered in the LUTH mortuary. Autopsies were performed on 371 of these, giving an autopsy rate of 83.37%. Only 230 cases were found suitable for evaluation of concordance and discordance. Two hundred and six of these (89.57%) had related clinical and autopsy diagnoses (concordance) while 24 (10.43%) had completely unrelated diagnoses (discordance). CONCLUSION: Adequate investigation of cause of death using the autopsy will assist in accurately determining the sequence of events that result in death and hence provide required statistics for the planning of appropriate interventions.

Autopsy↗

Histological Review of Thyroid Lesions: A 13-year Retrospective Study (1989-2001).

OBJECTIVE: We present a 13-years retrospective histological study of 444 thyroidectomies received between 1989 and 2001 at the Morbid Anatomy department of the Lagos University Teaching Hospital, Nigeria. The aim of the study is to update the available literature on the frequencies of the common thyroid lesions as well as compare with previous studies. MATERIALS AND METHODS: The materials for this study consist of slides and paraffin embedded blocks of all thyroidectomies received from within and outside the teaching hospital. The clinical data such as the age, sex, and clinical summary were extracted from the request forms. RESULTS: The male: female ratio is 1: 7. The most common entity was goiter (74%); most of which occurred in the age group 30-39 yrs. Thyroid adenomas (majority; follicular), constituted 10%. There were 29 cases of thyroid carcinoma accounting for 7% of all lesions and occurring more in females than males (17:12). Histologically, follicular carcinoma predominated (48.3%), followed by papillary carcinoma (34.5%) and medullary carcinoma (13.8%). Thyroiditis was uncommon (only 2%). CONCLUSION: Goiter, adenoma and carcinoma remain the commonest pathologic entities of the thyroid gland in Lagos. The age and sex incidences as well as the histological characteristics concur with reports from other parts of Africa and Nigeria. However, unlike many of the Nigerian series except the latest from Ibadan, 4 cases of medullary carcinoma were encountered in this study. The frequencies of toxic hyperplasia and thyroiditis are also lower than those recorded in previous studies. KEYWORDS: thyroidectomy, histopathology, thyroid lesions.

Hospitals, Teaching↗

Maternal deaths in the Lagos University Teaching Hospital: a ten-year review (1989 - 1998).

UNLABELLED: To determine the causes and frequencies of maternal deaths in the Lagos University Teaching Hospital (LUTH) as seen at autopsy; to find their age associated frequencies; and to compare these findings with previous studies done in this hospital as well as those from other parts of the world. MATERIALS AND METHODS: Those cases for which autopsies were requested and performed between January 1989 and December 1998 (inclusive) formed the material for this study. Excluded were patients who were dead on arrival, as well as badly autolysed cases. Records including autopsy protocols were retrieved from the Morbid Anatomy Department and relevant information was extracted and analysed from these records. RESULTS: About 81% of autopsy certified were due to direct causes. The three leading causes of maternal death were obstetric haemorrhage (25.61% ), genital sepsis (19.68% ) and pregnancy-induced hypertension (16.71% ). The most common indirect cause of death was anaemia (7.01% ) making it the fifth leading cause of death in this study. Majority of deaths (70% ) occurred in those between 11 and 30 years. Maternal mortality Ratio was 2,920/100,000 live births. CONCLUSION: Though maternal mortality figures from hospital-based studies are usually over-estimates of the true picture in the community they tend to provide a more thorough assessment of the underlying causes of death and their contributing factors, hence providing useful data for planning interventions.

Adolescent↗

Malignant haemangio endothelioma (angiosarcoma) concomitant presentation in the mandible and occiput--a case report.

A case of angiosarcoma presenting simultaneously in the mandible and occiput is presented. The mandibular swelling was preceded by toothache for which the patient had tooth extraction, after which the rate of growth increased tremendously. It was not possible to determine without doubt which lesion presented first. The need to evaluate and investigate all cases of jaw swelling that require tooth extraction is emphasised. Angiosarcoma being a haemorrhagic lesion could be complicated life threatening haemorrhage, if a tooth related to it is extracted, as was experienced on incisional biopsy of this lesion. The procedure was accompanied by torrential bleeding which was only controlled after external carotid artery ligation. This, to our knowledge, is the first reported case of angiosarcoma occurring simultaneously in the mandible and occipital bones.

Adult↗

Prognostic factors in the management outcome of carcinoma of the larynx in Lagos.

This is a retrospective analysis on the prognostic factors in the management outcome of clinically and histologically diagnosed carcinoma of larynx seen in Lagos University Teaching Hospital between 1996-1999. Various prognostic factors have been documented as determinants on the probable outcome of carcinoma of the larynx, such as duration of symptoms, smoking, medical status of the patient, degree of differentiation, size and site of tumour and presence of cervical lymph node. Thirty-six patients between 1996-1999 were reviewed, with a male to female ratio of 11:1, and peak age group of occurrence in 50-59 years, majority (86.12%) of which were non-smokers who presented in varied degrees of airway obstruction necessitating pre-treatment tracheostomy in 70% of the patients with more than 50% presenting within 3-6 months of onset of initial symptom. The tumours were staged clinically and histology revealed well differentiated T3 glottic tumour without any clinically palpable neck node in more than 50% of the patients which should predict a better outcome. But the interplay of many prognostic variables like pre-treatment tracheostomy and its attendant complications, supposed biological aggressive tumour in a non-smoker, coupled with treatment biased by patients, high costs of treatment, logistics and poor follow up compliance, resulted in poor outcome of our management.

Adult↗

Fatal head injuries: the Lagos University Teaching Hospital experience (1993-1997).

Head injuries are a universal problem and they constitute a major public health problem both in terms of morbidity and mortality. The aim of this study is to examine the causes and pattern of fatal head injuries in the Lagos University Teaching Hospital (LUTH). A retrospective autopsy study of fatal head injuries in LUTH between January 1993 and December 1997 was done by retrieving autopsy reports, extracting relevant information and analysing them. Two hundred and fourteen such cases were reviewed (7% of all autopsies during that period). Majority were consequences of road traffic accidents (52%) and assault (12%). Adults between the ages of 21 and 40 years were the most affected (44%), followed by children 10 years and below (17%). Seventy seven percent of all cases were males. Common lesions identified include skull fractures (73%), intracranial haemorrhages (69%), lacerations and contusions (31%).

Accidents, Traffic↗

Effects of anti-protozoal drugs and histopathological studies on trypanosome species.

The trypanosomostatic and trypanosomicidal effects of four anti-protozoal drugs, namely halofantrine hydrochloride, chloroquine phosphate, benzoylmetronidazole and pyrimethamine, on species of trypanosomes, viz. Trypanosoma brucei brucei (MBOS/NG/94/NITR) Bassa strain, T. congolense (MBOS/NG/93/NVRI) Zaria strain and T. brucei gambiense (MHOM/NG/92/NITR) Abraka strain, were investigated. In vitro and in vivo studies on these drugs vis-a-vis the parasites were carried out. The histopathological changes in organs and tissues of experimentally infected rats were also studied. Results from the in vitro studies indicated that halofantrine hydrochloride, chloroquine phosphate, benzoylmetronidazole and pyrimethamine appeared to be effective trypanosomicidal agents against T. brucei brucei (Bassa strain), T. congolense (Zaria strain) and T. brucei gambiense (Abraka strain). The in vivo studies showed that these drugs were sub-curative by prolonging the survival period of the trypanosome-infected rats, but not necessarily curing the infection. Histopathological findings indicated inflammatory reactions characterised by infiltration to variable degrees in the majority of tissues, mostly in the lungs and liver. The most consistent lesions were interstitial pneumonia, multifocal necrosis and oedema. Pathological findings showed the T. brucei brucei and T. brucei gambiense strains studied to be both intravascular and extravascular parasites. These results suggest that halofantrine hydrochloride, chloroquine phosphate, benzoylmetronidazole and pyrimethamine could be used as supportive, suppressive and/or synergistic/additive drugs in the treatment of African trypanosomiasis. Their effects on species of trypanosomes have been studied and are reported for the first time.

Animals↗

Gastric acid secretion in Helicobacter pylori positive and negative dyspeptic Nigerians.

The pathological role of Helicobacter pylori is largely unproven in our region of high incidence of infection but very low incidence of serious gastroduodenal lesions. The aim of this study was to investigate the effect of H. pylori infection on gastric acid secretion. One week after gastroduodenoscopy, basal and pentagastrin (8 micrograms/kg) stimulated gastric acid secretion were measured in 39 dyspeptic Nigerians. H. pylori status was determined using urease test, culture, histology and serology, while gastritis was assessed using the Sydney system criteria. The median maximal acid output (MAO) and peak acid output (PAO) in mmol/h were significantly higher in H. pylori positive (29.3, range 7.4-81.6 and 34.4, range 7.6-144.0) than in H. pylori negative (16.6, range 4.2-44.1 and 22.4, range 5.6-48.6) patients, p = 0.019 and p = 0.029, respectively. Stimulated gastric acid secretion was significantly higher in patients with duodenal ulcer (n = 8) than in H. pylori negative (n = 11) patients, but was similar in non-ulcer dyspeptics (n = 20) and H. pylori negative patients. The median basal acid output was not significantly different between the groups of patients. Our patients (median age 32 years) had normal mucosa (12.1%), pangastritis with corpus predominance (12.1%), antrum-only gastritis (24.3%) and pangastritis with antral predominance (51.5%). In the subset of H. pylori positive patients (n = 28, 71.8%), there were no significant correlations between grade of antral chronic inflammation, gastritis index score, anti-H. pylori IgG titre and gastric acid secretion, p > 0.05. H. pylori infection increases MAO and PAO in our relatively young patients with antral predominant chronic gastritis.

Adult↗

Gastric antral juxtamucosal pH in helicobacter pylori positive and negative dyspeptic patients.

Maintenance of gastric juxtamucosal pH at a stable near neutral value may be the cumulative effect of the various components of the mucosal defense system. In order to assess the effect of helicobacter pylori (HP) infection on mucosal defense, we measured the gastric antral juxtamucosal pH in 40 dyspeptic patients by using a flexible glass pH microelectrode which can be passed down the instrument channel of standard gastroscopes. HP status was determined using serology, culture, histology and urease test. We also investigated the relationship between juxtamucosal pH and the severity of antral HP infection. The mean antral juxtamucosal pH in 26 (65%) HP positive patients was 6.49 +/- 0.20 compared to 6.19 +/- 0.21 in 14 (35%) HP negative patients (p < 0.00001). Other factors like age, sex, duodenogastric reflux or presence of chronic duodenal ulcer did not significantly affect juxtamucosal pH (p > 0.05). Subset analysis of data on HP positive patients (n = 26) revealed no significant correlations between antral chronic gastritis anti-HP IgG titre and antral juxtamucosal pH (p > 0.05). This study shows that HP increases gastric antral juxtamucosal pH. This finding supports the suggested role of HP in producing hypergastrinaemia and gastric acid hypersecretion.

Adult↗

Colorectal neoplasms: a retrospective study.

A total of 254 cases of colorectal neoplasms were studied. A male predominance was noted with both benign and malignant neoplasms (M:F of 4.6:1 and 1.1:1 respectively). The peak incidence was in the fifth decade. The rectum was the commonest site for both benign and malignant neoplasms (75% and 63% respectively) followed by the sigmoid colon (11% and 16% respectively). Right-sided cancers presented commonly as fungating masses (74%) while left sided cancers were predominantly of the ulcerating/infiltrating pattern (81%). The commonest benign neoplasm was tubular adenoma (39%) while the commonest malignant neoplasm was adenocarcinoma (90%) followed by squamous cell carcinoma (4%). Advanced stage on presentation was noted with these cancers, especially the mucinous adenocarcinoma variant. This may be explained by the usual late presentation of patients to orthodox doctors in our environment.

Adolescent↗

Primary pulmonary carcinoma in Lagos, Nigeria: a clinicopathological study.

A retrospective clinicopathological study of bronchogenic carcinoma in patients admitted to Lagos University Teaching Hospital (LUTH) during a 17-year period (1975-1991) is presented. Out of the 148 cases, 88 were confirmed histopathologically and in the remaining 66 cases, diagnosis was based on a combination of clinical and radiological features. Epidermoid carcinoma was the commonest histopathological variant and the male/female ratio was 2:1. Sixty five percent of the patients admitted to being heavy smokers. The majority of patients presented with weight loss, chronic cough with chest pain and haemoptysis in that order. With an average of nine cases yearly, this study shows that this disease is still uncommon in Nigerians.

Adolescent↗

Testicular morphometric studies in Nigerian males.

A total of 102 autopsy subjects found to have seemingly normal testicular picture were analysed to determine acceptable normal morphometric values. The mean tubular diameter in the last trimester of intrauterined life is 43.8 mu in contrast to adult value of 173.0 mu. The mean basement membrane thickness increases from 3.2 mu in the last trimester to 6.9 mu in the 10-14 years age range. The adult mean testicular score count is 19.3 in contrast to 5.3 observed in the last trimester. While Sertoli cells predominate in the last trimester of intrauterine life, many spermatozoa are seen during the period 15-19 years.

Adolescent↗

Rising incidence of cerebral malaria in Lagos, Nigeria: a postmoterm study.

One hundred and forty seven cases of acute malaria were diagnosed at autopsy between 1988 and 1991 at the Lagos University Teaching Hospital (LUTH). In 67 (46.5%) cases death was attributed to cerebral malaria (CM). There was a gradual increase in the incidence of CM during the period under review. Both sexes were affected equally but more children than adults succumbed. The highest death rate was recorded in the age group 1-5 years with a peak in the 2nd and 3rd year. There were seven adults out of which one was intenerant white lady. Only one of the six adult Nigerians had travelled outside Africa and stayed away for about four years. The commonest presenting symptoms were: fever only, fever with convulsions and/or coma and fever with gastrointestinal symptoms such as vomiting and diarrhoea. The majority of the adults were comatose (five out of seven) without fever on admission. A review of the English literature on the diagnosis, pathogenesis and management of CM is also presented. The possible reasons of the rising incidence of CM in a holoendemic region such as Nigeria are discussed.

Adolescent↗

Childhood liver diseases in Jos, Nigeria: a retrospective histopathological study.

Forty eight needle biopsies of the liver, from children registered in the histopathological laboratory of Jos University Teaching Hospital (JUTH) were reviewed. Liver disease diagnosis was based on histopathological criteria without recourse to either clinical, biochemical or microbiological data. Hepatic Schistosomiasis (37.5%) and liver cirrhosis (25%) were the most frequently diagnosed lesions. There were only two cases of biliary cirrhosis secondary to biliary atrisia. Parasitic infestation of the liver was the most common cause of childhood hepatic dysfunction. Our results confirm the observations of workers in other tropical and subtropical regions, where infection is the commonest cause of childhood liver disease. This is in sharp contrast to the findings from European countries where neonatal hepatitis or biliary atresia are the most commonly diagnosed disorders. This retrospective study provides a good starting point for a prospective study, to determine the incidence and severity of childhood liver disease in Nigeria. This is a retrospective histopathological study aimed at establishing the pattern of liver disease in the paediatric age group in Jos. The indication for liver biopsy in all the cases was hepatosplenomegaly with or without biochemical abnormality.

Biopsy↗

Cutaneous sarcoidosis in Nigeria.

The study is a retrospective analysis of the cutaneous manifestations of sarcoidosis in patients seen during a 10-year period at the skin and chest clinics of the Lagos University Teaching Hospital. Of the 43 patients with sarcoidosis 30% had skin lesions. The most common was sarcoidal infiltration of scarification marks. Facial macropapular lesions also were frequently present.

Adolescent↗

Sacrococcygeal teratomas in Lagos, Nigeria: relationship of age, sex, clinical type and histopathology to prognosis in 30 cases.

From 1973 to 1986, 30 cases of sacrococcygeal teratomas were seen at the Lagos University Teaching Hospital (LUTH). 67% of the tumours were benign and 33% malignant. There were 25 girls and 5 boys. Majority of the benign cases were operated before the age of 3 months and all had types I & II lesions. All the patients with malignant tumours had significant presacral and endopelvic components; some of these presented clinically with urinary retention, constipation, inability to walk and neurologic deficit. Our surgical experience is compared with the reports from other centres both within and outside Africa.

Child, Preschool↗