Scholarly works in Pathology (Basic Med Sci)
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Item Gender differential in inclination to donate brain for research among Nigerians: the IBADAN Brain Bank Project(Springer Nature, 2019) Akinyemi, R.; Ojagbemi, A.; Akinyemi, J.; Salami, A.; Olopade, F.; Farombi, T.; Nweke, M.; Uvere, E.; Aridegbe, M.; Balogun, J.; Ogbole, G.; Jegede, A.; Kalaria, R.; Ogunniyi, A.; Owolabi, M.; Arulogun, O.Background: Laboratory-based studies of neurological disease patterns and mechanisms are sparse in sub-Saharan Africa. However, availability of human brain tissue resource depends on willingness towards brain donation. This study evaluated the level of willingness among outpatient clinic attendees in a Nigerian teaching hospital. Methods: Under the auspices of the IBADAN Brain Bank Project, a 43—itemsemi-structured interviewer—administered questionnaire was designed to evaluate knowledge, attitude, and beliefs of individuals attending Neurology, Psychiatry and Geriatrics Outpatient clinics regarding willingness to donate brain for research. Association between participants characteristics and willingness towards brain donation was investigated using logistic regression models. Analysis was conducted using Stata SE version 12.0. Results: A total of 412 participants were interviewed. Their mean age was 46.3 (16.1) years. 229 (55.6%) were females and 92.5% had at least 6 years of formal education. Overall, 109 (26.7%) were willing to donate brains for research. In analyses adjusting for educational status, religion, ethnicity, marital status and family setting, male sex showed independent association with willingness towards brain donation OR (95% CI) 1.7 (1.08–2.69), p = 0.023. Participants suggested public engagement and education through mass media (including social media) and involvement of religious and community leaders as important interventions to improve awareness and willingness towards brain donation. Conclusion: The survey revealed low willingness among outpatient clinic attendees to donate brain for research, although men were more inclined to donate. It is imperative to institute public engagement and educational interventions in order to improve consent for brain donation for research.Item Histopathologic pattern of posterior cranial Fossa tumours in a West African tertiary(Zambia Medical Association, 2019) Salami, A.; Adeleye, A.; Oyemolade, T.; Ajani, M.; Usiholo, A.; Nweke, M.; Adeolu, AIntroduction: The posterior cranial fossa contains many vital structures and mortality of patients with tumours occurring in this area is high. Studies done in other geographic locations showed a higher occurrence of posterior cranial fossa tumours in paediatric patients while benign tumours were more commonly seen. Epidemiological data of tumours in this area in our environment is scarce. This study was done to ascertain the histopathologic pattern of tumours in the posterior cranial fossa in a predominantly black population. Method: A ten-year retrospective study of histologically diagnosed posterior cranial fossa tumours seen in our hospital facility was done. A total of 72 cases in which neurosurgical intervention was carried out were identified and this included all age groups. The age, sex, site of tumour and histological diagnosis were extracted from the patients' records. Result: Adult patients predominated with 55.6% while the paediatric patients were 44.4%. The male to female ratio in the paediatric patients was 2.56:1 but the ratio was equal in the adult patients. WHO grade 1 tumours were the commonest tumours seen (45.8%) while grade II tumours were the least (4.2%). Medulloblastomas (20.83%), Pilocytic astrocytomas (18.6%) and Meningiomas (8.33%) were the commonest tumours seen. Commonest locations are in the cerebellar hemispheres (56.9%) and the fourth ventricle (13.89%). Conclusion: Our study showed a higher occurrence of Medulloblastomas in contrast to other studies which have shown more of Schwannomas, a tumour type that was rare in this study. The relatively low number of metastatic tumours in this study may be due to lack of presentation of such patients.Item Pediatric meningiomas in Southwestern Nigeria: A single-institutional experience(Elsevier Inc., 2019) Salami, A. A.; Okunlola, A. I.; Ajani, M. A.; Adekanmbi, A. A.; Balogun, J. A.BACKGROUND: Meningiomas are the second commonest intracranial tumors in many places worldwide. They are rare in the pediatric age group, however, and most studies have been able to document only a few patients. Meningiomas in pediatric patients have also been shown to behave differently from those in the adult population. This study was done to examine histologic types of meningiomas seen in pediatric patients from a predominantly African population using the 2016 World Health Organization (WHO) grading system for intracranial tumors. METHODS: Data from the operating logs of patients and histology reports of the samples sent to the pathology department during the study period were extracted. The data obtained were the age, sex, location of the intracranial tumor, histologic diagnosis, WHO grade, and tumor recurrence. RESULTS: Nine pediatric age patients were found among the 166 surgically excised meningiomas received at the pathology department in our institution over a 19-year period. The age range was from 8 months to 17 years. There was a male-to-female ratio of 1:2 with a female predominance. Six tumors were basally located. All tumors were WHO grade I, with transitional meningiomas being the commonest, followed by meningothelial. There was no history of recurrence in any of the tumors after complete surgical excisions. CONCLUSIONS: Our study showed the rarity of meningiomas in the study population, and there was a predominance of basally located tumors.Item Paediatric bilateral thalamic glioma: Case report and literature review(Elsevier B.V., 2019) Badejo, O. A.; Osobu, B. E.; Salami, A. A.; Adeyinka, A. O.; Shokunbi, M. T.1. Introduction Primary thalamic tumours are rare [1]. They account for 1–1.5% of all brain tumours and approximately a quarter of them occur in children younger than 15 years [2,3]. Bilateral thalamic gliomas (BTGs) are extremely rare sub-types of thalamic tumours, which are known to have a poor outcome regardless of the treatment modality [4]. About 70 cases have been reported so far in the literature [5]. We present the outcome of treatment of BTG in a three-year-old Nigerian child and a brief review of the literature on these uncommon types of central nervous system tumours. 2. Case Presentation A three-year-old right-handed boy presented with headache, abnormal gait, and inability to sit unsupported of one week duration. There was an associated history of drowsiness, excessive sleeping, and multiple episodes of projectile vomiting. Examination revealed a young boy who was fully conscious but drowsy. His pupils were of normal size but reacted sluggishly to light. He had bilateral abducens nerve palsies, bilateral papilloedema, global hypertonia/hyperreflexia, and bilateral extensor plantar responses. He also had truncal ataxia and dysmetria but no sensorimotor deficit. Examination of other systems revealed normal findings. A clinical diagnosis of acute onset raised intracranial pressure from an infratentorial space-occupying lesion was made. Cranial computed tomography scan showed bilateral symmetrical enlarged thalamic nuclei which were hypodense to isodense and non-contrast enhancing (Fig. 1a and b). There was associated obstructive hydrocephalus. Brain magnetic resonance imaging showed bilateral symmetrical non-enhancing masses involving both thalami (with estimated volumes of 40.17 cm³ on the right and 44.84 cm³ on the left). These were hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. There was associated dilatation of the lateral ventricles and effacement of the quadrigeminal/ambient cisterns bilaterally (Fig. 2a–d). A radiological diagnosis of a bilateral thalamic tumour was made. The patient's management was multidisciplinary, involving the neurological surgery, radiology, pathology, paediatric oncology, and radiation oncology teams. A biopsy specimen obtained via an endoscopic transventricular route showed features of a WHO grade II diffuse astrocytoma (Fig. 3a–c). He subsequently received sixteen courses of Vincristine/Carboplatin chemotherapy, which was later changed to Etoposide/Cisplatin on account of clinico-radiological evidence of tumour progression. He had cerebrospinal fluid diversion (via a ventriculoperitoneal shunt) five months after the initial procedure due to worsening hydrocephalus (Fig. 4a–c). The second-line chemotherapeutic agents were discontinued after the third cycle on request by the patient's mother because of their side effects (bone marrow suppression, widespread dermatitis, recurrent chest infection). Radiotherapy was considered unsafe in this patient given his age and the potential for radiation-induced neurocognitive decline (on the advice of the radiation oncology team). Repeat neuroimaging at six months following the initial surgery showed further tumour progression with involvement of the caudate nuclei and brainstem, and extension into the lateral ventricles (Fig. 5a–c). Attempts at switching his chemotherapeutic agents were futile due to non-availability of the drugs. At nine months post tumour biopsy, he had recurrent headache and vomiting, expressive aphasia, worsening gait imbalance, ataxia, paraparesis, bilateral ptosis, upgaze paresis, and choreoform movements. He subsequently defaulted follow-up.Item Protein Quality, Haematological and Histopathological Studies of Rats Fed with Maize-based Complementary Diet Enriched with Fermented and Germinated Moringa Oleifera Seed Flour(Juniper Publishers, 2018) Adeoti, O. A.; Osundahunsi, O. F.; Salami, A. A.This study is about the production of Maize-based complementary diet enriched with fermented and germinated moringa oleifera seed holds great promise in alleviating malnutrition so prominent among Nigerian children less than five years. However, there is scanty scientific information on its protein quality and safety which is necessary prelude to trials on human subjects. This study hence reports a controlled feeding trial involving 30 weanling wister rats housed in individual standard metabolic cages under room temperature condition. Following a subsequent daily feeding of the rats for 28 days, the protein quality of the diet with the haematological and histological studies was conducted. Results showed that the diets had a statistically significant effect on the growth rate on the test rats when compared with the control. The protein quality evaluation of the diets showed that the protein efficiency ratio ranged from 2.10 to 2.38 while the biological value ranged from 62.01 to 89.01 %. The true protein digestibility and protein rating were 55.79 to 79.25 % and 35.42 to 48.61 respectively. The relative weight of organs of the rats fed with the complementary diets showed that the weights of the kidney and liver ranged from 0.57 to 0.76g and 2.87 to 3.60g respectively. The growth performance of the rats fed with the formulated complementary diets showed that the formulated diets contributed to the growth status of the animals indicating that protein quality of the diets could support the growth and development of the infants. The haematological indices showed that the packed cell volume of the sample ranged from 36.67 to 40.67% and the red blood cell counts was 5.00 to 5.93 (×106 mm3). The white blood cell counts ranged from 3.47 to 3.98 (×103mm3) while the mean corpuscular haemoglobin and mean corspucularhaemoglobin concentration ranged from 10.04 to 11.71Pg and 33.10 to 33.45% respectively. Moreover, rat’s biopsy (histopathology) revealed no necrosis in the observed livers of the rats fed with the diets. Evidently, ogi-fermented moringa oleiefera seed complementary diet has no established detrimental effect and may therefore be safe for humansItem Malignant ameloblastoma: a challenging diagnosis(Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil, 2018) Salami, A.; Ezenkwa, U.; Salami, M.; Ajani, M. A.; Okolo, C.Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.Item Cerebellar vermian epidermoid tumor: a report of 2 cases(Elsevier B.V., 2018) Balogun, J. A.; Adeleke, N. A.; Salami, A. O.; Odebode, T. O.BACKGROUND: Epidermoid tumors are rare, benign slow-growing congenital tumors, most frequently located in the cerebellopontine angle of the intracranial cavity. They usually grow to a large size before patients become symptomatic. Although these tumors are amenable to surgery, their adherence to neurovascular structures poses a surgical challenge that results in subtotal resection, thus increasing the risk of recurrence. CASE DESCRIPTION: We report 2 adult patients whose imaging studies revealed epidermoid tumors located in the cerebellar vermis, an uncommon site for such tumors. The patients presented with variable symptomatology. We highlight the imaging features and challenges of surgery. Both patients had good outcomes, with resolution of symptoms and neurologic deficits. CONCLUSIONS: A safe complete excision of epidermoid tumor and its capsule is possible with a good understanding of their clinical and radiologic features and a high index of suspicion. To the best of our knowledge, this is the first report of cerebellar vermian epidermoid tumors from sub-Saharan Africa.Item Malignant ameloblastoma: a challenging diagnosis(Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil, 2018) Salami, A.; Ezenkwa, U.; Salami, M.; Ajani, M. A.; Okolo, C.Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.Item Malignant ameloblastoma: a challenging diagnosis(Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil, 2018) Salami, A.; Ezenkwa, U.; Salami, M.; Ajani, M. A.; Okolo, C.Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.Item Hormone–receptor expression status of epithelial ovarian cancer in Ibadan, South-western Nigeria(Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil, 2018) Salami, A.; Ezenkwa, U.; Salami, M.; Ajani, M. A.; Okolo, C.Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.