FACULTY OF BASIC MEDICAL SCIENCES
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Item Features and outcome of surgical management of spinal tumors in a cohort of nigerian patients(Elsevier Inc, 2014) Adeolu, A. A.; Oyemolade, T. A.; Salami, A. A.; Adigun, T. A.; Malomo, A. O.; Akang, E. A.; Shokunbi, M. T.OBJECTIVE: There is a dearth of information on operated cases of spinal tumors in patients in sub-Saharan Africa. The objective of this study was to evaluate the histologic pattern, anatomic distribution, and extent and outcome of surgery of Nigerian patients with spinal tumors. METHODS: This retrospective study comprised a cohort of Nigerians who underwent surgery for spinal tumors. Data obtained included patient demographics, duration of symptoms, anatomic location, imaging findings, Frankel grading before and after surgery, and type and outcome of surgery. Univariate analysis was performed, and results were compared with results from other parts of the world. RESULTS: There were 59 patients (male-to-female ratio 1:1.1) with a bimodal age distribution. The highest (20.34%) incidence was seen in the 20e29 age group. More than half (58.06%) of the patients presented with a duration of symptoms of at least 6 months (duration of symptoms was >12 months in 35.48%). Motor deficit was present in 97.73% of patients at presentation. Functional grading was Frankel A in 38.10% of patients, Frankel C in 26.19%, Frankel B in 16.67%, Frankel D in 16.67%, and Frankel E in 2.38%. The tumors were mostly in the thoracic region (65.45%), and 58% were extradural in location. Gross total tumor excision was performed in 50.88% of the cases, and subtotal resection was performed in 24.56%. Spinal stabilization was performed in 17.86% with spinous process wiring and vertical strut being the most common method of stabilization (80%) among this group. Metastasis was the most common histologic tumor type (23.21%). Meningioma accounted for 12.50% of tumors, and ependymoma, astrocytoma, and hemangioma each accounted for 7.14%. The most common source of metastasis was the prostate (38.46%). Postoperatively, 45% of patients improved neurologically, 52.5% remained the same, and 2.5% deteriorated. There was no perioperative mortality. CONCLUSIONS: Metastasis was the most common histologic type of spinal tumor in this study, and the most common location was extradural. The outcome was satisfactory in most cases with neurologic function remaining the same or improving after surgery in most patients.Item Correlation of intraoperative cytological and final histological diagnoses(Wiley, 2014) Salami, A.; Adeleye, A.; Ogun, G.; Adeoye, A.; Adeolu, A.; Okolo, C.; Eze, U.; Abdullahi, Y.; Lawan, A.; Ogunbiyi, J.; Akang, E.; Shokunbi, M.; Azeez, A.; Malomo, A.Objective: Intraoperative cytology is a cost-effective, rapid, and easy technique, and studies have shown good correlation between intraoperative cytology and histology. We undertook this study to compare the intraoperative cytology diagnoses of brain lesions made in our unit over a 10-year period with the definitive histological diagnoses. The aim was to determine the degree of accuracy of this procedure. Study design: This is a retrospective study of intraoperative neuropathology consultation cytology smears or imprints and histology of 69 cases obtained over a 10-year period. Cytology smears were stained using both Papanicolaou and Giemsa. Histology sections were prepared from routine formalin-fixed paraffin- embedded tissue and stained using H and E method. Each of the smears and histology samples were assessed by at least two pathologists. Cytological diagnosis was correlated with final histological diagnosis. The sensitivity and specificity of cytological diagnosis was evaluated using final histological diagnosis as gold standard. Results: Correlation was strongest with inflammatory lesions followed by low-grade neoplasms. High-grade neoplasms also showed good concordance, but the degree of correlation was lower than in the other categories. Misdiagnosis was commonest with benign tumors. Conclusion: Intraoperative cytology is a relatively simple, reliable, and accurate diagnostic technique and should be more commonly used, particularly in low-resource settings. Diagn. Cytopathol.Item Enhanced wound contraction in fresh wounds dressed with honey in wistar rats (rattus novergicus)(West African College of Physicians and the West African College of Surgeons, 2004) Osuagwu, F. C.; Oladejo, O. W.; Imosemi, I. O.; Aiku, A.; Ekpo, O. E.; Salami, A. A.; Oyedele, O. O; Akang E. U.Background: Due to reports that honey accelerates wound healing, an investigation on its role in wound con- traction in fresh wounds inflicted on wistar rats was car- ried out. Method: Twenty adult male wistar rats had 2cm by 2cm square wound inflicted on their right dorsolateral trunk. They were divided into two groups. The experimental group had their wounds dressed with honey while the control group had normal saline dressing. Wound dress- ing was done every five days and measurements taken at each dressing. Wound morphology was also assessed. Results: Dressing with honey significantly enhanced percentage wound contraction on day 10 with value of 79.20±2.94 compared to control value of 53.50 ±4.32. p=0.0. The mean wound measurement on day 10 reduced significantly in honey group, 1.15±0.18 compared to con- trol group 2.38±0.28. p=0.002. However, there was no significant difference in fibroblast count per high power field in honey group 68.0 ±2.59 compared to control 90.2 17.40, p=0.242. Honey dressing increased mean blood vessel count per high power field, 18.8±3.77 albeit non significantly when compared to control value of 13.4±2.44, p=0.264. Also honey dressing caused increased granulation tissue for- mation in wounds dressed with honey compared to con- trol group. Conclusion: Our study suggests that honey dressing enhances wound contraction in fresh wounds which is one of the key features of wound healing.Item Comparative analysis of Cervical Human Papillomavirus DNA testing and cytological findings among women presenting for “Pap” smear in a Tertiary Health Centre in Northern Nigeria(SCIENCE DOMAIN International, 2016) Manga, M. M.; Fowotade, A.; Abdullahi, Y. M.; El-Nafaty, A. U.; Adamu, S.; Bojude, A. D.; Pindiga, H. U.; Bakare, R. A.; Osoba, A. O.Aim: This study was conducted to compare different cytological findings with cervical HPV infection among women presenting for cervical cancer screening in Gombe north-eastern Nigeria. Study Design: It is a hospital based cross-sectional study. Place and Duration of Study: Departments of Obstetrics/Gynaecology and Histopathology Federal Teaching Hospital Gombe (FTHG) Nigeria, between August 2013 and May 2014. Methodology: Two hundred and nine (209) women were subjected to liquid-based cervical cytology and HPV DNA testing. Results: Of the 209 participants, cytological findings were normal in 126 (61.6%) women while 80 (39.0%) had abnormal features. Three (1.4%) respondents had unsatisfactory smears. The observed abnormal cytological features include HPV changes 30 (14.4%), HPV changes with inflammation 2 (1.0%), inflammatory changes alone 36 (17.3%), Low Squamous Intraepithelial Lesion; LSIL 3 (1.4%), High Squamous Intraepithelial Lesion; HSIL 5 (2.4%) and malignant changes 3 (1.4%). Positive HPV DNA testing was detected among 100 (48.1%) of the participants. Almost half 60 (47.6%) of the women with normal cytology were positive for HPV. Among women with cytologically detected HPV changes, only 16 (50%) were also HPV DNA positive. The sensitivity and specificity of cervical cytology in detecting HPV infection was 16.2% and 85.0% respectively. Conclusion: This study reports a very low sensitivity but relatively high specificity of cytology in detecting cervical HPV infection. It further justifies the need for introduction of HPV DNA testing to improve efficiency and maximise the sensitivity of cytology based cervical cancer screening for women above 30 years.Item Blueprint for health security in Nigeria by 2050: infectious diseases perspective(University College Hospital, University of Ibadan, 2019) Adekanmbi, O.; Fowotade, A.; Ogunbosi, B.; Oladokun, R.Background: Infectious Diseases remain a leading cause of morbidity and mortality in Nigeria. Notably, natural and socio-cultural differences across Nigeria account for significant differences in types of infectious diseases that occur in different parts of the country. The communicable nature of infectious diseases either from person to person or via vectors has made it difficult to eradicate or even stem the tide of these diseases. HIV/AIDS, tuberculosis and malaria in particular are well established and enduring contributors to the infectious disease burden in Nigeria and this is very likely to continue to be the case in the foreseeable future. Method: Literature from PubMed and Google was extracted using the keywords; Health Security, Year 2050 and Infectious Diseases Results: In more recent times in Nigeria, the problem of emerging and re-emerging infections, often of epidemic importance as well as antimicrobial resistance also add to the infectious disease burden and compete for the already inadequate resources available to battle infectious disease. Many infectious diseases can be prevented by simple, effective and relatively low-cost interventions. Such interventions need to be emphasized to maximize cost-effectiveness of any resources expended. Nigeria’s young, trainable, potential healthcare workforce and existing infrastructure such as the primary healthcare system, disease surveillance systems and widespread mobile phone use need to be strengthened arid leveraged for a good approach to infectious disease control. Conclusion: As Nigeria’s population is set to double by 2050, health security from an infectious disease standpoint will require policy change to support continuous training and re-training all cadres of healthcare workers to respond specifically to the problems that are fed back from the population while being fully aware of predictable (corruption, inadequate financing) and unpredictable (disease outbreaks, climate change, microbial mutation) factors that can serve as a hindrance.Item Isolation and Complete Capsid Sequence of Enterovirus D111 from Faeces of a Child with Acute Flaccid Paralysis in Nigeria(ResearchersLinks Ltd, 2019) Faleye, T. O. C.; Adewumi, M. O.; Olayinka, O. T.; Adeniji, J. A.The WHO recommended cell-culture-based algorithm requires enterovirus (EV) isolates to produce reproducible cytopathic effect (R-CPE) in RD and/or L20b cell lines. Samples with non-reproducible CPE (NR-CPE) are considered negative for EVs. We investigated whether there could be EVs lurking in samples with NR-CPE. Fifty-nine cell culture supernatants (CCS) (collected between 2016 and 2017) from RD and L20b cell-culture-tubes with NR-CPE, were analyzed. The tubes had been previously inoculated with stool suspension from children (<15 years) in Nigeria with acute flaccid paralysis (AFP). All CCS were screened for Enteric Adenoviruses (EAVs) and group A Rotavirus (GARV) using a rapid immunochromatographic test kit. Subsequently, they were passaged in HEp-2 cell line. All isolates were subjected to RNA extraction, cDNA synthesis, three (5l-UTR, VP1 and EV Species C [EV-C]) different PCR assays and sequencing of amplicons. EVs were further subjected to [‘]Illumina sequencing. All CCS were negative for EAVs and GARVs. Four CCS produced R-CPE in HEp-2 cell line, three of which were positive for the 5l-UTR assay. Of the three isolates, two and none were positive for the VP1 and EV-C assays, respectively. One of the two VP1 amplicons was successfully sequenced and identified as Echovirus 1. Illumina sequencing of the three 5l-UTR positive isolates confirmed the E1 isolate and typed the remaining two as EV-Ds (94 and 111). We describe the first EV-D isolates of Nigerian origin and the first complete capsid sequence of the virus globally. We also show that NR-CPE could sometimes be caused by EVs that do not produce R-CPE in specific cell lines.Item Rapid HIV Antigen–Antibody Assays and detection of acute HIV infection in sub-saharan Africa(American Society of Tropical Medicine and Hygiene, 2019) Adetunji, A. A.; Adewumi, M. O.; Michael, O. S.; Fayemiwo, S. A.; Ogunniyi, A.; Taiwo, B. O.Detection of acute HIV infection is a unique problem that fourth-generation HIV assays were expected to alleviate. In this commentary, we draw attention to the limitations and challenges with use of currently available rapid antigen–antibody (Ag/Ab) combination tests for detection of acute HIV infection in sub-Saharan Africa. Laboratory-based HIV-1 Ag/Ab immunoassays are complex, requiring specialized equipment and handling that are currently not affordable in many settings in Africa. The point-of-care Ag/Ab platform on the other hand is easier to deploy and potentially more accessible in resource-limited settings. However, available fourth-generation HIV-1 rapid diagnostic tests have demonstrated poor performance characteristics in field studies where non-B subtypes of HIV-1 dominate. The potential for point-of-care HIV-1 Ag/Ab diagnostics to significantly improve detection of acute HIV infection remains yet to be realized in sub-Saharan Africa. Assay platforms need to be optimized to identify local circulating subtypes, and optimal algorithms need to be determinedItem Characterization of hepatitis delta virus strains spreading in Abuja, Nigeria(Wiley Periodicals, Inc.,, 2019) Ifeorah, I. M.; Faleye, T. O. C.; Bakarey, A. S.; Adewumi, O. M.; Gerber, A.; Le Gal, F.; Adeniji, J. A; Gordien, E.; Onyemelukwe, N. F.Hepatitis delta virus (HDV) is responsible for the most severe form of liver disease in humans. So far, eight genotypes (HDV‐1 to ‐8) have been individualized worldwide. Little is known about HDV strains that spread in Nigeria. HDV genotyping was performed in 15 anti–HDV positive samples from a cohort of 306 hepatitis B virus (HBV)‐infected patients in Abuja (Nigeria). Phylogenetic analyses revealed 90% were HDV‐1, two among them clustering with European/Asian HDV‐1, the remaining one being HDV‐6. It was also found that two members of a couple superinfected with the same HDV strain, were enveloped by two different HBV strains of genotype E.Item Towards an effective poliovirus laboratory containment strategy in Nigeria(BMC (BioMed Central),, 2018) Ticha, J. M.; Matthew, K. O.; Hamisu, A. W.; Braka, F.; Mkanda, P.; Nsubuga, P.; Tesfaye, E.; Craig, K,; Etsano, A.; Emelife, O.; Shuaib, F.; Akinkugbe, F.; Adeniji, J. A.; Adamu, U.; Dallatu, M.; Oyeyinka, G.; Brown, H.; Nnamah, N.; Okwori, J.; Chinedu, C.; Anibijuwon, I.; Adewumi, O. M.; Donbraye, E.; Bagana, M.; Baba, M.; Gumede, N.; Banda, R.; Tegegne, S. G.; Oyetunji, A.; Diop, O.; Tomori, O.; Vaz, R.G.Background: The Global Commission for the Certification of the Eradication of Poliomyelitis will declare the world free of wild poliovirus transmission when no wild virus has been found in at least 3 consecutive years, and all laboratories possessing wild poliovirus materials have adopted appropriate measures of containment. Nigeria has made progress towards poliomyelitis eradication with the latest reported WPV type 1 on 21 Aug 2016 after 2 years without any case. This milestone achievement was followed by an inventory of biomedical laboratories completed in November 2015 with the destruction of all identified infectious materials. This paper seeks to describe the poliovirus laboratory containment process in Nigeria on which an effective containment system has been built to minimize the risk of virus re-introduction into the population from the laboratories. Methods: A national survey of all biomedical facilities, as well as an inventory of laboratories from various sectors, was conducted from June November 2015. National Task Force (NTF) members and staff working on polio administered an on-site questionnaire in each facility. Laboratory personnel were sensitized with all un-needed materials destroyed by autoclaving and incineration. All stakeholders were also sensitized to continue the destruction of such materials as a requirement for phase one activities. Results: A total of 20,638 biomedical facilities were surveyed with 9575 having laboratories. Thirty laboratories were found to contain poliovirus or potentially infectious materials. The 30 laboratories belonged to the ministries of health, education, defence and private organizations. Conclusions: This article is amongst the first in Africa that relates poliovirus laboratory containment in the context of the tOPV-bOPV switch in alignment with the Global Action Plan III. All identified infectious materials were destroyed and personnel trained to continue to destroy subsequent materials, a process that needs meticulous monitoring to mitigate the risk of poliovirus re-introduction to the population.Item Draft genome sequence of a bovine enterovirus isolate recovered from sewage in Nigeria(American Society for Microbiology (ASM), 2018) Faleye, T. O. C; Adewumi, O. M.; Olayinka, O. A.; Donbraye, E; Oluremi, B.; George, U. E.; Arowolo, O. A.; Omoruyi, E. C.; Ifeorah, M. I.; Oyero, A . O.; Adeniji, J. A.We describe the draft genome of a bovine enterovirus (EV) isolate recovered from sewage in Nigeria. This isolate replicates on both RD and L20B cell lines but is negative for all EV screens in use by the Global Poliovirus Eradication Initiative (GPEI). It contains 7,368 nucleotides (nt) with 50.2% G C content and an open reading frame (ORF) with 6,525 nt (2,174 amino acids).