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Biomedical subjects

E E Akang

Publications and source records attributed to E E Akang.

At least 37 records · Page 2Linked to original sources
PubMed1993

Childhood infections in Nigeria: an autopsy study.

Infections are the leading cause of childhood morbidity and mortality in developing countries. Bronchopneumonia, meningitis and gastroenteritis are the commonest fatal infections encountered in Ibadan. Tuberculous lymphadenitis, bronchopneumonia and meningitis are other frequent causes of death. The predominant sequela of measles is respiratory tract infection. Another important cause of childhood mortality is cerebral malaria. In half of the cases of tetanus no obvious portal of entry can be found. It is advocated that the implementation of immunization schedules should be vigorously pursued to curtail childhood mortality resulting from infection.

Adolescent↗
PubMed1993

Ascarid granuloma presenting as pseudotumour.

Three patients with histologically confirmed ascarid granuloma who presented clinically with abdominal masses simulating abdominal tuberculosis or lymphoma are described. The clinical course of one patient was complicated by the formation of a spontaneous faecal fistula and perforation of the terminal ileum. In two cases there was rupture of the inflammatory pseudotumour through the anterior abdominal wall.

Abdomen↗
PubMed1992

Benign cystic ovarian teratomas with prostatic tissue: a report of two cases.

We report two cases of the rare occurrence of prostatic epithelium in ovarian teratomas with associated transitional epithelium in one of the cases. This association of prostatic tissue with urothelium tends to reinforce the well-established embryogenetic derivation of the prostate from the urogenital sinus. Local hormonal events may influence the formation of prostatic tissue from female urothelium. The histologic and immunohistological differences between adult prostate as seen in our cases and female paraurethral (Skene's) glands are discussed.

Adult↗
PubMed1992

Childhood teratomas in Ibadan, Nigeria.

Childhood teratomas are uncommon neoplasms worldwide. They are nonetheless important because their exact histogenesis has not yet been resolved. The weight of the evidence points to a germ cell origin for these neoplasms. Eighteen percent of 407 teratomas reviewed in the Department of Pathology, University College Hospital, Ibadan, Nigeria, between 1960 and 1985 occurred in children up to 15 years of age. There was a bimodal peak age incidence among these children, the first being due to sacrococcygeal and the second to ovarian teratomas. The female to male ratio was 5:1. The two most common sites of occurrence were the sacrococcygeal region and the ovaries. Eighty-one percent of all childhood teratomas were mature, 15% were immature, and 4% were malignant. Both malignant neoplasms arose in the sacrococcygeal region and occurred in patients relatively older than those with benign sacrococcygeal teratomas. These two malignant teratomas contained yolk sac elements.

Adolescent↗
PubMed1992

Clinicopathological study of nephroblastomas in Ibadan.

The present study reviews 31 patients with histologically confirmed nephroblastoma seen over a 5-year period (1985-1989). There was a predominance of female patients with a male: female ratio of 1:1.7, and the average age of the patients was 47 months. The patients invariably presented with a palpable abdominal mass, but haematuria was exceptional. The neoplasms tended to be larger on average than those reported previously among Caucasian children. Carcinomatous transformation of the epithelial components was observed in 2 renal neoplasms. Poorly differentiated neoplasms were commoner in male than in female patients. Our findings indicate an unfavourable prognosis for nephroblastoma in this environment because of late clinical presentation with advanced disease and inadequate treatment and follow-up.

Adolescent↗
PubMed1992

Tumours of the eye and orbit in Ibadan.

Four hundred and forty ocular and orbital tumours seen in Ibadan over 11-year-period (1980-1990) are reviewed. Three quarters of the 252 patients who had enucleation had malignant neoplasms, of which 55% were retinoblastomas. The mean age of patients with retinoblastomas (3.2 years) was less than that of patients with carcinoma and malignant melanomas (47 years). Malignant melanomas were rare neoplasms in Ibadan. The commonest orbital lymphoma was Burkitt's lymphoma. Only 24% of the enucleated eyes had inflammatory conditions, of which 38% gave a positive history of trauma. Inflammatory lesions were the commonest benign ocular diseases accounting for 33% of these latter cases. Postmeasles keratitis was a significant associated finding in these patients.

Adolescent↗
PubMed1992

Pulmonary embolism in Ibadan, Nigeria: five years autopsy report.

The autopsy findings and clinical features in 60 patients with fatal pulmonary embolism (PE) in University College Hospital, Ibadan, between 1985 and 1989 are analysed in the current study. Pulmonary embolism occurred in 3,8 pc of all autopsied patients during this period. There was a male to female ratio 1,4 to one and average age was 47 years. Malignant neoplasms, infections and cardiac failure were the leading predisposing factors to PE identified. The ante-mortem clinical features consisted largely of non-specific respiratory symptoms of dyspnoea, cough, chest pain and haemoptysis. Of these patients, 15,6 pc were diagnosed ante-mortem as having PE. Pulmonary infarction occurred in 13,3 pc of the cases and was commoner in females and in patients with underlying cardiac diseases. This study emphasises the need for a high clinical index of suspicion to improve the antemortem diagnosis of this potentially fatal condition and to advocate a greater use of prophylactic anti-coagulant therapy in high risk patients.

Adolescent↗
PubMed1991

Lymphomas in University College Hospital, Ibadan, Nigeria.

The authors reviewed 508 cases of lymphoma seen during a 16-year period in University College Hospital, Ibadan, Nigeria. Hodgkin's disease was diagnosed in 95 (18.6%) patients, of which 45% had mixed cellularity type; 19%, lymphocyte predominance; 18%, nodular sclerosis; and 18%, lymphocyte depletion. The age distribution showed a single mode in the 11 to 25-year-old group. Male preponderance was more marked in children who made up 32% of the Hodgkin's disease patients. Non-Hodgkin's lymphoma occurred in 413 cases, of which 296 (71.7%) were high-grade malignancies. Burkitt's tumor occurred in 211 (41.5%) patients, 95% of whom were children, and showed a male to female ratio of 1.7:1. Compared with previous findings in this hospital, Hodgkin's disease showed increased proportions of the lymphocyte predominant and nodular sclerosing types. However, the characteristics of Burkitt's lymphoma did not change appreciably in the last three decades.

Adolescent↗
PubMed1991

Schistosomiasis of the appendix.

The clinicopathological features of schistosomiasis of the appendix are discussed, based on the clinical presentation, operative findings and morphological changes in the specimens of patients seen in Ibadan between 1980 and 1989. Schistosoma haematobium was implicated as the causal agent of a granulomatous inflammatory reaction with eosinophilia and fibrosis. Intramuscular oviposition was associated with frank acute appendicitis, and serosal involvement resulted in peritoneal adhesions, with ileoileal intussusception in one patient. The actual role of schistosomal infestation as a contributory factor in appendicitis is still open to debate, but the diagnosis must be entertained in patients in the tropics with features of acute appendicitis or recurrent abdominal pain.

Adult↗
PubMed1991

Problems in the management of mycosis fungoides in Nigeria.

The management of Nigerian patients with cutaneous T-cell lymphoma (CTCL) is beset with various problems which are presented in this study. These problems include dearth of specialists medical personnel, shortage of radiotherapy facilities, high cost of chemotherapy drugs which an average patient cannot afford to buy. Cases of eight patients seen and managed over a 21 years period (1968-1989) were analysed. However, many CTCL cases might have been missed since we have acute shortage of medical specialists to carry out accurate diagnosis of this disease in Nigeria. The patients reviewed, received radiotherapy, and cytotoxic chemotherapy. Radiotherapy was found to be the optimum treatment for patients with stages I and II CTCL, who in this study had recurrence free periods of 30 to 60 months post radiotherapy. The authors recommend systemic cytotoxic chemotherapy and local radiotherapy for patients with late stages of CTCL as mainstay of treatment.

Adult↗
PubMedDate not supplied

Conjunctival impression cytology with transfer in the assessment of vitamin A status in Nigerian children.

OBJECTIVE: To determine vitamin A status by conjunctival impression cytology with transfer (CIC-T) and assess its ability to predict low and deficient serum retinol concentrations. STUDY DESIGN: CIC-T was performed on 128 healthy, well-nourished and 230 malnourished children aged under 6 years by a 3-5-second application of cellulose acetate paper to each bulbar conjunctiva followed by transfer of the adhered cells onto glass slides. The slides were stained with Alcian green 2GX, and smears were classified as normal, borderline normal, borderline abnormal and deficient. Corresponding serum retinol levels were determined in each subject. RESULTS: The results showed that CIC-T is a simple procedure with a failure rate of 7.3% caused by tearing and agitation. The power of CIC-T to predict vitamin A status varied with both the CIC-T smear classification used and serum retinol concentration threshold. CIC-T smear classification as abnormal and normal appears to be the most robust and predictive of serum retinol, < 10 and > 10 < 20 micrograms/dL, respectively. CONCLUSION: The simplicity, sensitivity and specificity of CIC-T suggest that this procedure is a good screening tool for epidemiologic survey of vitamin A status.

Child, Preschool↗
PubMedDate not supplied

Congenital malformations: a review of 672 autopsies in Ibadan, Nigeria.

The postmortem findings in 672 Nigerian children with lethal congenital malformations are reviewed. Eighty-six percent of the patients were less than 1 year of age and the male-to-female sex ratio was 1.3:1. The alimentary tract was the most common anatomic site involved (30%), intestinal and biliary atresia being the two lesions most frequently identified in this location. Twenty-six percent of the children had cardiovascular malformations, of which ventricular septal defect, patent ductus arteriosus, and tetralogy of Fallot were most important. There was an accentuated male predominance among cases with urogenital malformations due to the high frequency of posterior urethral valve. Hydrocephalus, spina bifida, and anencephaly were the most common lesions observed in the craniospinal axis. One-fifth of the children had complex malformations of multiple organ systems, 20% of which were associated with chromosomal anomalies, rubella, and other malformation syndromes.

Abnormalities, Multiple↗
PubMedDate not supplied

Primary malignant bone tumour in a tropical African University teaching hospital.

Bone tumours are relatively rare tumours as compared with all other tumours. The relative frequency has not been well documented in this environment. The aim of the study was to define the frequency of primary malignant bone tumours in an African University teaching hospital in Ibadan. The medical records of 114 patients with malignant bone tumours recorded in the Cancer Registry of the University College Hospital, Ibadan, Nigeria between January 1977 and December 2000 were reviewed retrospectively. Primary malignant bone tumours represented 0.53% of all the 21390 cancers seen in the teaching hospital in the period studied, with a male female ratio of 1.4:1. About 45% oftumours occurred among patients < 20 years of age. Osteogenic sarcoma was the most common primary malignant bone tumour while the mandible was the most commonly affected bone. In contrast to previous studies, Burkitt's lymphoma affected the mandible more commonly than the maxilla. The relative frequency of primary malignant bone tumours is low in our environment as observed in other developing countries.

Adolescent↗
PubMedDate not supplied

Goldenhar syndrome: a case report and literature review.

The case of a 24-year-old female Nigerian with features of Goldenhar syndrome is presented and the challenges of management especially with reference to reconstructive facial surgery and general anaesthesia are discussed.

Adult↗
PubMedDate not supplied

Invasive and in situ carcinoma of the cervix in young Nigerians: a clinico-pathologic study of 27 cases.

A study of young Nigerians aged 30 years and below with invasive and in-situ cervical carcinoma confirms the notion that cervical cancer occurs in all age group. All patients except one were married while all were parous. Forty four percent of the patients presented with stages III and IV disease and hence, were unsuitable for surgery. The youngest patient was aged 17 years, indicating the need tare cancer screening among adolescents and a vigorous family planning programme that emphasizes barrier contraception.

Adolescent↗
PubMedDate not supplied

The predominance of membranoproliferative glomerulonephritis in childhood nephrotic syndrome in Ibadan, Nigeria.

The histological findings in renal biopsy specimens obtained from 41 children with the nephrotic syndrome in Ibadan, Nigeria, between July, 1989 and June, 1996 are presented. The patients consisted of 26 male and 15 female children and their ages ranged from 2-13 years. The predominant histological type was membranoproliferative glomerulonephritis (MPGN) which occurred in 21 (51.2%). Membranous nephropathy and minimal change nephropathy (MCN) accounted for 4 (9.8%) patients each. The prevalence of MPGN was 33.3% in children less than 5 years of age compared with 56.2% amongst children who were > or = 5 years. All the three patients with MCN who were treated with a course of prednisolone had complete remission of the disease. It is concluded that MPGN is the predominant histological lesion seen in childhood nephrotic syndrome in Ibadan and that MCN remains an uncommon lesion. Therefore, renal biopsy is recommended as a prelude to a trial of steroid therapy in these patients since MCN (which is generally associated with steroid-responsiveness) is an uncommon finding among them.

Adolescent↗
PubMedDate not supplied

Changing clinicopathological profile of intussusception in Nigeria--a 20-year review.

BACKGROUND/AIMS: Intussuception was a common cause of intestinal obstruction at the University College Hospital, Ibadan. A peculiar type characterized by being ceco-colic, and found most commonly in adults, was the commonest variety found, but over the last few years this type of intussusception appears to have reduced in incidence. The aim of the study is to define the relative incidence of intussusception and the contribution of the various types of the overall incidence as seen at the University College Hospital, Ibadan, Nigeria. METHODOLOGY: Review of case notes and the surgical pathology records of all cases of Intussusception seen at the University College Hospital, Ibadan between 1975 and 1994 was done. RESULTS: There was a 48.1% decline in the absolute number of cases seen during the period of the study, and this decline was more among adult cases than infantile intussusception. The mean age of presentation of infantile intussusception was 8 months, while it was 42 years for adults. The classical triad of vomiting, pain and bloody stool was seen in only 15% of cases. Morbidity and mortality rates were high at 18 and 8.5% respectively and this was related to delayed presentation. CONCLUSIONS: The incidence of intussusception has fallen in the community studied and this decline has affected the adult age group and the ceco-colic type of intussusception more. Late presentation is a feature of most cases and is related to the high mortality and morbidity rates seen.

Adolescent↗