FACULTY OF BASIC MEDICAL SCIENCES

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    Distribution and characteristics of endometriotic lesions in South- Western Nigeria: A single institutional experience
    (Zambia Medical Association, 2019) Ajani, M. A.; Salami, A.; Nwanji, I. D.; Olusanya, A. A.; Fatunla, O. E.
    Background: Endometriosis poses a significant burden mainly to women of child bearing age. Historically, endometriosis was thought to be of low prevalence among African women. However, recent studies have documented an increased prevalence than previously thought. This study aimed to determine the distribution and characteristics of endometriotic lesions among Nigerian women . Methods: A retrospective study of all histologically diagnosed cases of endometriosis from the records of the Department of Pathology, University College Hospital, Ibadan from 1st January, 1997 to 31st October, 2018.The age of the women, location and distribution of the lesions were analysed. Results: A total of 85 cases of endometriosis were diagnosed histologically in the period under review. The mean age was 35 years with an age range of 18 to 52 years. The most commonly affected age groups were those between 30-39 years (47.1%) and 20-29 years (30.6%). The most commonly affected site was the ovary (58.8%) followed by the umbilicus (11.9%) and fallopian tubes (9.4%). Fourteen patients (28%) had bilateral ovarian involvement. Left sided ovarian lesions predominated (61.1% versus 38.9%). Eighteen (21.2%) patients had lesions at more than one site frequently involving both ovaries. Conclusion: Endometriosis affected mainly women of childbearing age with particular predilection for the ovaries. Endometriosis affecting the umbilicus is not uncommon among Nigerian women.
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    Central nervous system tumours in children in Ibadan, Nigeria: a histopathologic study
    (Pan African Medical Journal and African Field Epidemiology Network, 2016) Ogun, G. O.; Adeleye, A. O.; Babatunde, T. O.; Ogun, O. A.; Salami, A. A.; Brown, B. J.; Akang, E
    Introduction: Contrary to some earlier teachings that central nervous system (CNS) tumours are uncommon in black children, these neoplasms are the fourth most common paediatric tumours in Ibadan. Our centre is the major referral centre for CNS tumours in Nigeria. The last major study of paediatric CNS neoplasms from Ibadan was in 1985. An update of the data on paediatric CNS neoplasms at our centre is presented. Methods: A retrospective review of all histologically diagnosed CNS tumours in children (0-14 years) from January 2001 to December 2010 from the database of the Department of Pathology, University College Hospital, Ibadan, Nigeria was done. The cases were classified using the 2007 WHO Classification of Tumours of the Central Nervous System and were also based on their supratentorial and infratentorial locations. Results: Seventy-seven tumours, 44 in males, were included in the study. Astrocytic tumour comprised 20 cases, embryonal tumours 15, ependymal tumours 15, germ cell tumours 6, sellar tumours (all craniopharyngiomas) 9 and other histological types- 12 cases. Thirty-seven were WHO Grade 1, eleven Grade 2, ten Grade 3 and nineteen Grade 4 neoplasms. Thirty-six cases were supratentorial and thirty-eight were infratentorial in location. The most common tumours in this series were pilocytic astrocytomas, medulloblastomas, craniopharyngiomas and ependymomas in that order. Conclusion: Childhood CNS tumours are being increasingly diagnosed in our centre. This is largely explained by the recent expansion of the available neurosurgical services
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    Histopathological pattern of primary ovarian neoplasms in south‑western Nigeria
    (Association of Resident Doctors of Jos University, 2016) Ajani, M. A.; Aramide, K. O.; Salami, A. A.; Okolo, C. A.
    Background: Ovarian tumours are common forms of neoplasms in women. This study aims to determine the histopathological pattern of primary ovarian neoplasms in south-western Nigeria. Method: A retrospective study was undertaken to review the histopathology reports of all primary ovarian neoplasm specimens submitted to the Department of Pathology, University College Hospital, Ibadan from January 1991 to June 2013. Patients’ biodata were extracted from request forms and surgical day books. Results: There were 821 cases of primary ovarian neoplasms. Surface epithelial neoplasms accounted for 359 (43.7%) of cases and were found in patients aged 10–89 years. Germ cell tumours numbered 313 (38.0%) in patients aged 0–70 years, while sex cord stromal tumours numbered 146 (17.8%) in patients aged 0–99 years. Among benign ovarian neoplasms, Mature Cystic Teratoma was the most common (54.7%) with the 20–29 year age range having the highest frequency. Among primary malignant ovarian neoplasms, serous cystadenocarcinoma was the most common (33.2%) and most frequent in the 50–59 year age group. Conclusion: Surface epithelial tumours were the most common ovarian neoplasms followed by germ cell tumours. This histopathological pattern is observed in most parts of Nigeria, some African and Asian countries, and in the Western world.
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    Childhood ovarian neoplasms in Ibadan,South‑western Nigeria
    (Wolters Kluwer – Medknow, 2016) Ajani, M. A.; Aramide, K. O.; Ajani, T. A.; Salami, A. A.; Okolo, C. A.
    Background: Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in children <15 years over a 22½ year period. Materials and Methods: This was a retrospective study. Twenty‑four cases of childhood ovarian neoplasms were seen in patients <15 years of age. These cases were classified using the current World Health Organization histological classification of ovarian tumors. Results: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. Conclusion: Mature cystic teratoma remains the single most common childhood ovarian neoplasm, and Burkitt’s lymphoma is the most malignant childhood ovarian tumor in Ibadan, South‑western Nigeria.
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    Hepatitis E Virus infection among Asymptomatic pregnant women at the University College Hospital, Ibadan
    (Wolters Kluwer Medknow Publications, 2020) Fowotade, A.; Anaedobe, G. C.; Adesina, O. A.
    Introduction: The high mortality associated with fulminant Hepatitis E infection in pregnancy justifies the need to assess the epidemiologic proportion of this underestimated virus. Objectives: This study aimed to determine the burden of HEV infection among pregnant women attending antenatal Clinic in Ibadan. Methodology: HEV IgG and IgM serological surveys were carried out among 230 pregnant women attending antenatal clinic in Ibadan, Nigeria. Serum and stool samples from HEV IgM positive women were further analysed using two independent reverse transcriptase polymerase chain reactions (RT‑PCR) assays, targeting ORF1 region of HEV genome. Socio‑demographic variables associated with HEV in these women, were analyzed to estimate statistical significance (p < 0.05). Results: Eleven (4.8%) women had HEV IgM, while 39 (17.0%) women had HEV IgG. Three (27.3%) of the 11 anti‑HEV IgM positive samples were positive for HEV RNA while all stool samples tested negative for HEV RNA. HEV infection among pregnant women was statistically associated with age (p = 0.044), and educational status (p = 0.005). Conclusion: Recent HEV infection among this pregnant population is on the lower part of the scale, compared with other Sub‑Saharan African countries. However, the HEV IgG seroprevalence rate suggests indirect evidence of past contact with HEV.
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    Patterns of serologic markers of hepatitis B virus infection and the risk of transmission among pregnant women in southwestern Nigeria
    (Taylor & Francis, 2017) Ifeorah, I. M.; Bakarey, A. S.; Adewumi, M. O.; Faleye, T. O. C.; Akere, A.; Omoruyi, C. E.; Ogunwale, A. O.; Uttah, C. C.; Oketade, M. A.; Adeniji, J. A.
    Hepatitis B virus (HBV) infection is a major health concern in developing countries that has a high morbidity and mortality rate. Vertical transmission of HBV from mother to child has been identified as a major factor leading to chronicity with attendant liver conditions, especially in poor socioeconomic settings. This study aims to evaluate the prevalence of serological HBV markers among pregnant women in Ibadan southwestern Nigeria and to determine the implications for perinatal HBV transmission. This study revealed the presence of varied HBV serological patterns of infection or immunity among pregnant women in Ibadan, Nigeria, and thus the risk of mother to child transmission.
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    Prevalence, socio-demographic features and risk factors of Hepatitis B virus infection among pregnant women in Southwestern Nigeria
    (African Field Epidemiology Network (AFENET), 2015) Anaedobe, C. G.; Fowotade, A.; Omoruyi, C. E.; Bakare, R. A.
    Introduction: Hepatitis B virus is responsible for 50%-80% of Hepatocellular carcinoma cases worldwide. In Nigeria, vertical transmission remains a major route of Hepatitis B virus infection. Primary (vaccines and post-exposure prophylaxis) and secondary prevention of HBV transmission by appropriate sexual and sanitary practices are not yet optimal in the country yet measures for early detection (serological, molecular) and treatment of infected pregnant women is not a practice. This study aimed at identifying the prevalence and risk factors for Hepatitis B virus infection among pregnant women in Ibadan, Southwestern Nigeria. Methods: A cross-sectional study was done at the Ante-natal clinic of the University College Hospital Ibadan. One hundred and eighty pregnant women were recruited from March to August 2013, and tested for Hepatitis B surface antigen (BIORAD FRANCE) using third generation ELISA, as well as HIV-1 and 2 using Uni-Gold Recombigen and ALERE determine (a rapid immunoassay designed to detect antibodies to HIV 1 and/or 2). Positive HBsAg samples were tested for Hepatitis B envelope antigen, antibody and Hepatitis B core antibody (DIAPRO Italy) while serum HBV DNA was detected using PCR. Data were obtained using questionnaires to establish and analysis was performed using SPSS version 20. Results: The seroprevalence of HBsAg was 8.3% out of which 26.7% were positive for HBeAg, 53.3% had HBeAb, 20% had neither HBeAg nor HBeAb, 100% had total HBcAb and 86.7% had HBV DNA in their serum. The mean age was 32.1years, the highest HBV infection rate occurred in 25-29 year age group. Multiple sexual partners (OR- 3.987, P-value=0.026) and early age at sexual debut (OR 11.996, P- value=0.022) were independent risk factors for HBV infection. Conclusion: Hepatitis B virus infection is of high endemicity in Nigeria thus early detection, treatment of infected pregnant women, immunoprophylaxis for exposed newborns and surveillance for those with chronic infection is essential. Health education programs on prevention and control measures must be instituted.
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    Detection and circulation of hepatitis B virus immune escape mutants among asymptomatic community dwellers in Ibadan, southwestern Nigeria
    (Elsevier, 2015) Faleye, T. O. C.; Adewumi, O. M.; Ifeorah, I. M.; Akere, A.; Bakarey, S. A.; Omoruyi, E.C.; Oketunde, K.; Awonusi, O. B.; Ajayi, M. R.; Adeniji, J. A.
    In 2012, the first Nigerian Hepatitis B Virus (HBV) immune escape mutant (IEM) case was detected in a pregnant woman in southwestern Nigeria. Consequently, this study was designed to investigate the presence and possible circulation of IEMs amongst asymptomatic community dwellers in southwestern Nigeria. Methods: Blood specimens collected from 438 asymptomatic community dwellers were screened for HBsAg using ELISA technique. Subsequently, the S-gene was amplified in HBsAg positive samples by a nested PCR protocol, and amplicons sequenced. Isolates were then subtyped by amino acid residues at positions 122, 127, 134 and 160, and genotyped by phylogenetic analysis. Results of the 31 (7.08%) samples positive for HBsAg, the _408 bp Sgene fragment was successfully amplified and sequenced in 27. Samples obtained from 4 patients could not be amplified due to low titres. Sequence data from only 15 of the isolates could be analysed further as eight of the remaining 12 had multiple peaks while the rest three showed no similarity to any HBV gene when subjected to BLAST analysis. Thirteen of the 15 isolates were identified as genotype E. Eleven of which were subtyped as ayw4 while the remaining two could not be subtyped due to sR122Q/P substitutions. The last two isolates that could not be genotyped and subtyped had other mutations in the ‘‘a’’ determinant associated with IEMs. Conclusions: This study confirmed presence and circulation of HBV IEM in Nigeria, the country’s inclusion in the genotype E crescent, and the value of phylogenetic analysis in HBV identification.
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    One year of breast cancer in Ibadan, Southwestern Nigeria: a histopathological review
    (African Journal of Open Libraries, 2021) Jimoh, M. A.; Ajani, M. A.; Folorunso, S. A.; Fatunla, E. O.; Aruah, C. S.; Abdus-Salam, A. A.; Ogunbiyi, J. O.
    Background: Breast cancer is a major public health problem in most low- to medium-income countries of the world because of its high morbidity and mortality rate. Histopathological features are vital in risk assessment, selection of treatment and prognostication in breast cancer patients. This study aimed to assess the histopathological features of all breast cancer cases seen in a tertiary hospital in the year 2018. Methods: This is a retrospective review of all breast cancer cases histologically diagnosed and confirmed by three Pathologists at the University College Hospital (UCH), Ibadan over a one-year period from 1st January 2018 to 31st December, 2018. Results: A total of 236 breast cancer cases were seen during this period, 234 (99.2%) were females while only 2 (0.8%) were male. 163 (69.7%) patients were between the fourth and sixth decades of life, 65 (27.8%) patients were above sixth decade while 6 (2.5%) patients were below fourth decade. Invasive ductal carcinoma of No Special Type (NST) was the commonest histological subtype 212 (89.8%). Grade 1 cases were 25 (10.6%), Grade 2 129 (54.7%) and Grade 3 cases were 40 (16.9%) while 42 (17.8%) were not graded. Lymphovascular invasion observed in 98 (41.5%) of the cases. 54 (22.9%) had immunohistochemistry out of which 23 (43.4%) were triple negative while 8 (3.4%) were triple positive. Conclusion: Histopathological features suggesting aggressive disease was predominantly observed. Efforts should be made towards early diagnosis, adequate evaluation and prompt treatment. Cancer care should be fully incorporated in the National Health Insurance Scheme (NHIS).
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    Patterns of inflammatory lesions of the appendix in a Nigerian Tertiary Health Facility
    (African Journal of Open Libraries, 2021) Ajani, M. A.; Awosusi, B. L.; Omenai, S. A.; Adegoke, O. O.; Ajani, T. A.
    Background: Appendicitis is most common between the ages of 10 and 20 years, although all ages can be affected. Acute appendicitis is the most common cause of acute surgical abdomen worldwide and its incidence varies with geographical location. The aim of this study was to review all the inflammatory lesions of the surgically removed appendix in University College Hospital, Ibadan, Nigeria and to describe the histopathological patterns of these lesions. Methods: This study was a retrospective review of all appendectomy specimens submitted to the Department of Pathology, University College Hospital, Ibadan, Nigeria from January 2009 to December 2018. Patients’ biodata, clinical parameters, and histological diagnoses were extracted from departmental surgical day books. The data were analyzed using IBM SPSS Statistics (version 23; IBM Corporation, Armonk, New York) and expressed as frequency distribution. Results: A total of 1071 appendectomy specimens were received in our laboratory during the 10-year study period, accounting for 3% of all specimens received. There were 1062 cases of inflammatory lesions, accounting for 99.2% of the cases. There was a male preponderance with male to female ratio of 1.2:1. The age was from 1 to 83 years. The most common histological diagnosis was acute suppurative appendicitis with peritonitis accounting for 47.6% of all the cases. Conclusion: The findings in our study supports the fact that acute suppurative appendicitis is the most common inflammatory disease of the appendix which is consistent with other similar studies that have been done in our environment and in the developed world.