Introduction: Antimicrobial resistance has become a global challenge in health care. Its emergence in previously sensitive bacteria is usually associated with poor antibiotic-prescribing patterns. Methodology: A point prevalence survey was carried out in four tertiary hospitals in Nigeria in 2015 to determine the rate and characteristics of antibiotic prescription. Results: Of 828 patients eligible for the study, 69.7% received antibiotics, with highest rates in the adult Intensive Care Unit. There were therapeutic indications in 51.2% of the prescriptions, of which 89.5% were for community-acquired infections. Third-generation cephalosporins were the most prescribed antibiotics. On the evaluation of surgical prophylaxis, only 4.1% were compliant with institutional guidelines and 39.2% gave a reason for prescribing in patient case notes. Less than 1% of the prescriptions were based on the use of biomarkers. Conclusion: The prevalence of antibiotic prescription in Nigerian hospitals is high with only about 50% of prescriptions based on clear therapeutic indications. We provide evidence that the country needs to institute a cohesive antimicrobial stewardship intervention program.

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Background: Globally, there is a changing trend in the antibiotic susceptibility pattern of Gram-negative uropathogens to the conventional drugs used in the treatment of urinary tract infections due to the production of extended-spectrum beta-lactamases (ESBLs). Aim: This study aimed to determine ESBL production and antimicrobial susceptibility pattern in uropathogens. Materials and Methods: Five hundred urine samples submitted to the Medical Microbiology Department of Ahmadu Bello University Teaching Hospital from January to June 2012 were analyzed by conventional methods. Modified standardized Kirby-Bauer disc diffusion method was used for antimicrobial susceptibility testing. ESBL production by Escherichia coli and Klebsiella pneumoniae isolates was screened for using the Clinical and Laboratory Standards Institute guidelines 2012 and confirmed by the double-disc synergy tests. Results: Five hundred samples were analyzed. Of these, a total of 175 Gram-negative isolates were obtained. Isolation rates were E. coli – 56%, K. pneumoniae – 20%, Proteus mirabilis – 16%, and Pseudomonas aeruginosa – 4%. ESBL production was observed in 34.3% of all the isolates. Fifty percent (50%) of E. coli and 40% of K. pneumoniae were identified as ESBL producers and were found to be resistant to multiple antimicrobial agents. Imipenem and nitrofurantoin had sensitivity of 100% and 70%, respectively, while susceptibility to ciprofloxacin and gentamicin was low at 35% and 30%, respectively, although 96% sensitivity was observed with amikacin. ESBL producers and nonproducers showed a high level of resistance of over 95% to ampicillin, amoxycillin, and trimethoprim-sulfamethoxazole. Conclusion: This study found a high rate of ESBL production (34.4%) among uropathogens with multidrug resistance. Clinical microbiology laboratories should routinely incorporate ESBL detection methods in their laboratory procedures for continuous surveillance of multidrug-resistant isolates and antibiograms to guide empirical therapy.

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Background: Cancer of the breast is globally the most common female cancer including in Nigeria. Newer treatment modalities are based on tumor immunophenotyping, thus the need to characterize these tumors among women with the disease in Northern Nigeria. Aims: This study aims to classify carcinomas of the breast diagnosed in the pathology laboratory of a teaching hospital based on their expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2/neu (HER2/neu) overexpression. Methodology: The histology slides of 478 carcinomas of the breast as well as the ER, PR, and HER2 immunohistochemistry records of 118 stained cases were retrieved and reviewed. Results: Age range of cases was from 20 to 80 years (mean = 46.9 ± 13). The most common histomorphologic entity was invasive carcinoma (NST) which accounted for 73.2% of cases. These were followed in frequency by invasive lobular carcinoma accounting for 6.8% of cases and invasive papillary carcinoma representing 6.5% of cases. Overall, 169 cases (37.6%) were Grade III tumors while Grades II and I tumors accounted for 35.1% and 27.3% of cases, respectively. Triple-negative tumors were the most common molecular subtype and comprised 46.6% of all cases. Luminal B (LUMB) was the least common and accounted for 8% of all cases. HER2 overexpression and LUMA were seen in 17.9% and 28.8% of cases, respectively. Conclusion: Carcinoma of the breast in the population studied occurs at a younger age than among Caucasians. The tumors are characterized by preponderance of invasive carcinoma (NST), high histological grade, and triple-negative phenotype.

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of both health care- and community- associated infections worldwide and do present therapeutic challenges to beta-lactam antibiotics and other antibiotics due to the development of multidrug resistance. Aim: This study was carried out to determine the prevalence and antibiotic susceptibility profile of MRSA among patients at National Hospital Abuja with a view to providing information that will guide rational choice of antimicrobial agents in the empirical therapy of its infections. Materials and Methods: Between April 2014 and August 2015, clinical samples of patients submitted to Medical Microbiology laboratory of the hospital were processed and all Staphylococcus aureus isolates recovered, using standard laboratory methods. They were subjected to antibiotic susceptibility testing using the modified Kirby Bauer disc diffusion technique with zones of inhibition interpreted according to the Clinical and Laboratory Standard Institute (CLSI) guidelines. Methicillin resistance was determined using cefoxitin disc diffusion. Other clinical data of the patients were gathered along for analysis. Results: Of the 360 S. aureus isolates recovered, 97 (26.9%) were MRSA. All (100%) the MRSA isolates were susceptible to vancomycin, 88 (90.7%) to imipenem and 71 (73.2%) to clindamycin. All (100%) the MRSA isolates were resistant to penicillin, 85(88.0%) to tetracycline, 61 (62.9%) to ciprofloxacin, 58 (60.0%) to erythromycin and 52 (53.6%) to gentamycin. The MRSA strains showed higher resistance rate than MSSA strains to all tested antibiotics. Multidrug resistance was found in 68.0% of the MRSA strains. Conclusion: There was high prevalence of MRSA with high rates of resistance to commonly used anti-staphylococcal antimicrobials, and a significant proportion of these MRSA isolates were multi-drug resistant. Vancomycin is the best choice for empiric treatment of suspected MRSA infections. Routine screening of clinical S. aureus isolates for methicillin resistance, regular surveillance studies as well as institution of infection control measures and antibiotic stewardship programme are recommended.

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Background: The ability of plant extract to improve injury in the liver has gained interest in recent times. This could be due to the side effects and expense of modern medicines that are used to manage hepatic diseases; hence beetroot juice as a potential hepatoprotective agent was evaluated. Materials and Methods: Thirty Sprague–Dawley rats were assigned by weight into six groups average body weight (160.20 ± 2.54 g). Group I: rats plus distilled water (Normal control) 2 ml/kg; Group II: rats received olive oil (2 ml/kg); Group III: rats received carbon tetrachloride (CCl₄) suspended in olive oil (2 ml/kg) and 250 mg/kg of beetroot extract. Group IV: rats received CCl₄suspended in olive oil (2 ml/kg) and 500 mg/kg of beetroot extract. Group V: rats received olive oil (2 ml/kg) and 100 mg/kg of silymarin; Group VI: rats received (2 ml/kg)CCl₄suspended in olive oil. Liver injury was induced by oral administration of CCl₄using gastric gavage at 2 ml/kg every 48 h for 14 days, followed by treatment with beetroot extract and silymarin. Animals were euthanized by decapitation, blood and liver tissue harvested for biochemical and histopathological evaluations. Results: Alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels were significantly (P < 0.05) increased in the groups treated with extract and silymarin when compared to the animals administered only CCl₄, whereas malondialdehyde level was significantly (P < 0.05) increased in the group administered only CCl₄when compared to other groups. Histopathologically, the animals treated with 500 mg/kg of extract showed a normal hepatocyte and mild portal congestion. Conclusion: Beetroot juice has potential hepatoprotective effects on the liver in a dose-dependent manner.

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Background: There is increasing use of antimicrobial agents worldwide and especially in low- and middle-income countries. Point prevalence studies of antimicrobial consumption can be used to determine intervention areas for antimicrobial stewardship programs. This point prevalence study was conducted in preparation for antimicrobial stewardship program in our hospital. Methods: Data on antimicrobial consumption was collected from patients in the hospital during 4 weeks by hospital doctors. Data was entered into the Global Point Prevalence Survey internet-based application, downloaded, analyzed, and presented in frequencies and percentages. Results: Of 197 patients surveyed across 21 wards, 62.4% had one or more antimicrobial agents. Metronidazole was the most frequently prescribed agent, whereas cephalosporins were the most frequent class prescribed. Community-acquired infection was the most common indication for antimicrobial therapy, whereas skin and soft-tissue infections were the most common diagnosis. Reason for prescription was stated in notes of 61.4% of patients, whereas 34.8% had stop or review dates documented. There was no record of the use of biomarkers to guide antimicrobial treatment. Conclusion: There is a high antimicrobial prevalence in our institution with cephalosporins as the most frequently prescribed class of antimicrobials. Community-acquired infections are the most common indication for an antimicrobial prescription but are surpassed by medical and surgical prophylaxis combined. There is a need for clinicians in this institution to use guidelines and microbiology laboratory reports to guide antimicrobial prescribing to reduce the antimicrobial prevalence among patients.

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Cervical cancer is a common and important public health problem in developing countries. Even though many developed countries have achieved significant successes in reducing invasive cervical cancer burden, the burden in developing countries is still worrisome. Currently, cervical examinations and Papanicolaou (Pap) tests remain the screening method of choice for most women in many parts of Africa. Molecular diagnostic tests for human papillomavirus (HPV) can augment screening for cervical cancer when used in conjunction with the Pap smear. Due to the inherent limitations of morphologic interpretation and borderline cases, the atypical squamous cells (Atypical Squamous Cells of Undetermined Significance [ASCUS] and Atypical Squamous Cells cannot rule out High Grade [ASC-H]) were introduced and this led to significant colposcopic follow-up and/or treatment of these women. p16^INK4a is an efficient triage method; the dual staining with Ki-67 was introduced mainly to increase reproducibility and specificity compared with stand-alone p16^INK4a staining. Diffuse p16^INK4a immunostaining is the hallmark of high-grade squamous intraepithelial lesions regardless of HPV status.

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Background: The use of social media in medical education is an emerging field of study in the developed world, but there is little evidence of scholarly inquiry into this field in Nigeria. Acceptability among learners is a crucial factor to consider when adopting technology in education. The aim of this study was to assess how undergraduates use social media and their perceptions about its use in pathology education. Materials and Methods: A paper-based questionnaire was administered to 169 4^th year medical and dental students in the University of Benin. Data were analyzed using descriptive and simple inferential statistics. Results: All respondents were aware of social media and most had devices with which they could access the internet; 80.5% used mobile phones. Facebook (95.3%), Instagram (56.8%), and Twitter (44.4%) were the most common social media platforms used by students. Social media is used for educational purposes by 82.8% of students and 68.6% indicated that they would like their pathology educators to teach using social media. Distraction from noneducational feeds was the major aversion to the use of social media in pathology education (66%). Conclusion: Most undergraduate pathology students actively use social media for varied purposes including education. Many find the idea of educators engaging with them through social media acceptable. Opportunities abound for pathology educators to leverage this veritable educational tool.

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Background: Overweight and obesity seem to be responsible for the occurrence of noncommunicable diseases among the health-care workers. This study was conducted among the health-care workers in the University of Benin Teaching Hospital (UBTH), Benin City, South-South Nigeria, to determine the prevalence of overweight and obesity and assess their lipid profile. Subjects and Methods: Three hundred and twenty-five hospital workers ranging from doctors, nurses, and other health-care workers were recruited for this study. Demographic and socioeconomic data were collected using a structured questionnaire. One hundred and sixty (49%) were male while 165 (51%) were female with average age of 40.9 ± 8.8 years and average body mass index (BMI) of 26.7 ± 5.9 kg/m². BMI and blood pressure measurements were taken using standard techniques. BMI was classified using the National Institutes of Health criteria, 2000. Results: Based on BMI, the prevalence of overweight and generalized obesity among health-care workers in the UBTH, Benin City, were 31.7% and 25.5%, respectively. Overweight and obesity are more common among female health-care workers than their male counterparts. Using the waist circumference, approximately 60% of the health-care workers had central obesity, while 57.2% are either overweight or obese. More than half of the overweight and obese patients have elevated low-density lipoprotein-cholesterol. Conclusion: The high prevalence of overweight and obesity seen among health-care workers calls for the introduction of therapeutic lifestyle modification in this group of workers. Even though there was no significant difference in the lipid levels across the BMI categories, the means of total cholesterol were found to be elevated among health-care workers.

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Background: Cryptococcosis is an important opportunistic infection and major contributor to mortality in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients. There have been increasing reports of varied prevalence for cryptococcosis among HIV patients in Nigeria. Aims: The aim of this study was to determine the prevalence and factors associated with risk of cryptococcosis among HIV/AIDS patients from Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: A descriptive cross-sectional study at HIV clinic of UDUTH, Sokoto, Nigeria, was conducted. The participants were HIV positive enrolled by systematic random sampling. Information on sociodemographics and clinical features of the participants was recorded. Blood was collected to determine the CD4 count/presence of cryptococcosis among the participants. Their CD4 counts were determined, and the presence of cryptococcal antigen was detected in the blood sample using IMMY CrAg LFA (cryptococcal antigen lateral flow assay test kit). Statistical analysis using Epi Info version 7.2/SPSS version 20.0 was done. Univariate, bivariate, and multivariate analyses were done. Results: Of 326 HIV-positive patients recruited, 36 of them were positive to cryptococcal antigen (prevalence of 11%). The highest proportion of patients positive to cryptococcosis (13 [36.1%) had CD4 values <50 cells/μL. Weight loss was the most common presenting symptom (11 [30.6%]) among those who were Cryptococcus positive. Conclusions: This study demonstrates that cryptococcosis is a burden among HIV patient in Sokoto, and its occurrence is associated with decreasing levels of CD4.

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Background: Blood is a scarce commodity and every effort needs to be made to use it judiciously and avoid wastage. This study reviewed the pattern of blood procurement, ordering, and utilization at a hospital-based blood bank. Materials and Methods: This was a retrospective study in which data on blood procurement methods, pattern of requisition of blood, and outcome of issued blood were obtained from blood bank registers over a 2-year period at the Nnamdi Azikiwe University Teaching Hospital blood bank. Results: Approximately, 99% of donors were family replacement donors. In 2014, total blood donated was 4003 which exceeded the request for red blood cell (RBC) transfusion by 921 units. The highest request for blood was from the accident and emergency and 90% of blood issued were used. Overall percentage wasted of RBCs was 19.8% and the major contributors to these were antenatal clinic and labor ward both having 80% and 55.8% issued blood returned to blood bank unused. Conclusion: The proportion of wasted units of RBC is high. Designing and adhering to maximum blood ordering schedule and blood transfusion guidelines with efforts toward converting family replacement donors to voluntary blood donors will help in maintaining a steady supply of safe blood.

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Objective: The objective of this study is to determine the incidence of cytolytic vaginosis among patients undergoing cervicovaginal cytology for vaginal discharge, pruritus, dyspareunia, and other symptoms. Cytolytic vaginosis is also known as Lactobacillus overgrowth syndrome or Doderlein's cytolysis. It is characterized by an abundant growth of Lactobacilli resulting in lysis of vaginal epithelial cells. Methods: A total of 308 women presented to gynecological outpatient department. All of the patients were subjected to Pap test with the help of cytobrush. The cervicovaginal smears were fixed in methanol, stained with papanicolaou stain, and studied under a microscope independently by two pathologists. Results: Of 308 patients, 190 (61.7%) had an inflammatory lesion and were negative for intraepithelial malignancy. Of 190 cases, 31 (16.3%) were diagnosed with cytolytic vaginosis based on the clinical and morphological features. Conclusion: Cytolytic vaginosis is a fairly common entity often misdiagnosed as candidiasis. Morphological features play an important role in identifying cytolytic vaginosis. The results of this study may contribute to reports in the literature indicating the importance of cytolytic vaginosis which is not included in the current Bethesda system for reporting of cervical cytology.

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Background: Intestinal parasites are a cause of morbidity and mortality throughout the world particularly in HIV-infected patients. This study determined the prevalence of intestinal parasites among HIV-infected patients, assessed risk factors predisposing to infection and also assessed association of intestinal parasites with the CD4 counts of the patients. Materials and Methods: It was a cross sectional study and 226 HIV-infected patients attending the Virology Research Clinic of OAUTHC were recruited. Questionnaires were administered to obtain relevant demographic information. Stool samples were collected and examined. Data processing was done using SPSS Inc USA version 17. Statistical analysis was done using frequency, proportion, percentages, tables and Pearson's chi-square was used to determine the association between intestinal parasites and risk factors. Results: The overall prevalence of intestinal parasites in this study is 15.4%. Cryptosporidium sp. and Ascaris lumbricoides had the highest prevalence, both had rates of 4.4% followed by Entamoeba histolytica with a rate of 3.1%. Cyclospora sp. had a rate of 1.8%, Strongyloides stercoralis had a rate of 0.9% while Entamoeba coli and hookworm both had rates of 0.4%. Co-existence of Cryptosporidium with Strongyloides stercoralis occurred in one of the HIV-infected patients. Exposure to goats and dogs was found to be significantly associated with intestinal parasites. The CD4 count was not significantly associated with presence of intestinal parasites. Conclusion: Intestinal parasites are still prevalent among HIV-infected patients and exposure to dogs and goats was a risk factor. There was no association between intestinal parasites and CD4 counts of the patients.

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Introduction: Hanging is seen worldwide and is the most common method of suicide globally. Hanging in Western nations has been well documented. However, there appears to be a dearth of published data on hanging in Nigeria, Africa. The essence of this work is to look at the morphological characteristics and the epidemiological profile of victims who died from hanging. Materials and Methods: This was a 9-year retrospective autopsy study on hanging deaths from January 1, 2005, to December 31, 2013. The details of the injuries present were recorded in a predesigned format so as to minimize error. Such findings included age, sex, type of hanging, position of knot, number of turns of the ligature, and fracture of hyoid and thyroid cartilages. The findings noted were carefully compiled, tabulated, and analyzed using the Statistical Package for the Social Sciences version 20. Results: There were 22 cases of hanging during the study period representing 0.2% of the total autopsy cases. The mean age was 38 ± 12 years, ranging from 15 to 60 years. This was predominantly a male phenomenon, with males constituting 94.5%, whereas females accounted for only 4.5%. Hanging was most common in the fifth decade (27.3%). This was closely followed by the third and fourth decades. This study revealed that 95.5% had single loop. The knot was most common on the right representing 54.5% and least common at the occiput accounting for 13.6%. Hyoid bone fracture and thyroid cartilage fracture were seen in 22.7% each. Conclusion: This study has shown that the mean age of hanging was in the fourth decade in this environment, with an overwhelming male preponderance. Fixed single loop on the right side was the most common picture and a quarter had fracture of hyoid bone and thyroid cartilage. All the ligature marks were obliquely placed, and no fracture of cervical vertebrae was identified. A future study will be needed to determine what percentage of suicide is hanging in this part of the world.

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Background: Breast cancer remains the leading cause of cancer morbidity and mortality in women worldwide. The treatment of breast cancer has drifted from radical mastectomy, to conservative treatment owing to the presence of micro metastasis at even earlier stages of the disease. These novel medical treatments are hinged on characterizing breast cancer at the molecular level. Estrogen receptor (ER), Progesterone receptor (PR), and Human epidermal growth factor 2 receptor (HER2) are the commonest molecular-markers used. Failure to stain for these three receptors, earns a breast cancer the triple negative designation, an aggressive type of the disease with the worst prognosis. Materials and Methods: All histologically confirmed cases of breast cancer at Jos University Teaching Hospital, between 2010 and 2012, were retrieved, and their histological type and grade documented. Using the Avidin-biotin method, the status of each case was established for ER, PR, and HER2. Cases with negative staining for these three antibodies were further stained with CK5/6, a basal biomarker for Triple Negative Breast Cancer (TNBC). Statistical softwares were used to analyse the data and present in tables. Results: Sixty-three cases of female breast cancers met the inclusion criteria. The age range was 28-74 years with mean age of 46.7±11.1 years. Invasive carcinoma (no special type) was the majority of histological type of breast cancer, accounting for 54(85.7%) cases. Histological grades 1, 2 and 3, recorded 18(28.6%), 29(46.0%), and 16(25.4%), cases respectively. TNBC accounted for 26 (41.3%) cases. Fifteen (57.7%) cases of TNBC stained positively for CK 5/6. Conclusion: Indicators of worse prognosis which includes lower hormone receptor status and high percentage of TNBC, as well as greater number of basal subtype of TNBC was exhibited by the study population.

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Introduction: Ovarian lesions represent a significant cause of morbidity among females in most countries of the world. The prevalence of ovarian lesions in Abuja the Nigerian capital however, has not been adequately reported. We hereby present its incidence and characteristics in the tertiary hospital of a cosmopolitan capital city of Nigeria. Setting: The National Hospital Abuja is a 400-bed tertiary hospital serving Abuja and surrounding cities. Material and Methods: A retrospective analytical study of ovarian samples received in a decade in Histopathology department of the hospital with review of ward folders from Health records department. Results: Ovarian lesions account for 1.3% of all surgical exercised samples involving predominantly the 30 to 49 year females. The commonest encountered lesions are the non-neoplastic (58%) followed by the neoplastic with 23%. Germ cell tumours are the commonest neoplastic conditions (46%). Abnormal vaginal bleeding, abdominal pain and abdominal mass are the predominant symptom bringing patients with ovarian lesions to the hospital. Conclusion: Ovarian lesions are significant causes of surgical mass diseases in National Hospital Abuja.

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Background: Chlamydia trachomatis infections are the most prevalent bacterial sexually transmitted infections recognized globally. There is a paucity of data on the prevalence of C. trachomatis infection in Northern Nigeria. This research was conducted with the objective of determining the prevalence of genital C. trachomatis infection among females in the reproductive age group. Materials and Methods: Three hundred and sixty-five patients were enrolled in this study. Patients were administered questionnaires requesting information on biomedical, sociodemographic data. Endocervical specimens were collected, subjected to DNA extraction and polymerase chain reaction (PCR) using primers from Inqaba Biotechnical industries, South Africa. Data management was done using SPSS software version 20.0 statistical package. Results: Of the 365 patients studied, 95 of them had positive results by the PCR assay, giving 26% prevalence for genital C. trachomatis infection among women of reproductive age group. Associated risk factors for genital chlamydia infection identified include low educational status, early age at sexual debut, early age at marriage, and lack of use of condoms during sexual intercourse. The frequency of positive results was found to be higher among the age group 25-29 years, those living in suburban areas and the unmarried [Table 1] and [Table 2]. Conclusion: A prevalence of 26% was found, in this study, for genital C. trachomatis infection among women of reproductive age group. Risk factors include as follows: low educational status, early age at sexual debut, early age at marriage, and lack of use of protection during sexual intercourse.

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Background: The choice of high-performance liquid chromatography (HPLC) to measure HbF and HbA₂in sickle cell disease patients is regarded as a method of choice by many researchers. This study was aimed at using HPLC in determining the mean and gender-specific reference values of HbF and HbA₂in sickle cell anemia (SCA) population and bringing to fore all associated implications. Materials and Methods: This was a cross-sectional, retrospective, descriptive study involving SCA patients. All case notes containing HPLC hemoglobin quantification reports were reviewed to extract the percentages of HbA₂, HbF, and HbS of patients. The demographic data of individual patients were also obtained from the records. Data were analyzed with IBM SPSS Statistics for Windows, Version 20.0 Armonk, New York, USA. Results: A total of 100 participants' records were reviewed consisting of 40 (40%) males and 60 (60%) females. The overall mean age (±standard deviation [SD]) of participants was 25.89 years ±9.34. The overall mean HbF and HbA₂were 6.94% ±5.05 and 3.75% ±0.74, respectively. Thirty percent had HbF <3%, whereas 34% of them had elevated HbA₂level >4%. The mean (±SD) HbF and HbA₂for both males and females were 6.97% ±5.45 and 3.68% ±0.58, 6.92% ±4.87, and 3.80% ±0.83, respectively. Conclusions: Thirty percent of the study participants had HbF <3%, whereas 34% of them had elevated HbA₂level >4% and could indeed be carrying beta thalassemia trait with the sickle cell gene.

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Background: Evaluation of error occurrence is a vital component of laboratory-quality assurance. One method of the measuring errors is by an assessment of discrepancies in clinical and pathology diagnosis. This study was carried out to determine the occurrence of such differences in our institution and to find out if any association exists between clinical diagnostic reasoning and the nature of the lesion. Materials and Methods: A 3-year retrospective analysis of surgical pathology specimen records was performed for report contents, clinical diagnosis, clinical suspicion, or diagnostic questions. Discrepancy index (Di) was calculated as the number of incompatible cases/total number of cases ×100. Results: An analysis of 1703 cases showed complete agreement between the clinical and pathology diagnosis in majority of the cases (1514, 89.9%) while discordance occurred in 189 (11.1%). There was more discrepancy in benign cases (12.3%, n = 1144) than malignant conditions (8.6%, n = 559). Using Chi-square test of independence, there was association between the nature of the lesion (benign or malignant) and diagnostic concordance (χ² = 5.24, P = 0.02207) at 0.01 level of significance. There was more discordance in diagnosis of soft tissue lesions (Di = 23.8, n = 1587). Conclusion: This study suggests that greater discrepancies are likely to occur in the diagnoses of benign conditions than malignant diseases.

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Malignant proliferating trichilemmal tumor, though uncommon, predominantly occurs in the scalp, trunk, head, and neck, and females are more commonly affected. It is rarely seen in the extremities, and malignant transformation is a rarity. Due to the rarity of malignant transformation, only a hand full of cases has been documented in the literature. We present an unusual case of gluteal malignant proliferating pilar tumor in an elderly male.

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Context: Despite the high incidence of cervical cancer in Nigeria, there are only a few large scale population based studies on HPV prevalence and genotype distribution. Aims: This study was carried out to determine the prevalence and distribution of human papillomavirus (HPV) types in invasive cervical cancer (ICC) in Nigeria. Settings and Design: Cross sectional period prevalence study. Methods and Material: Paraffin embedded tissue blocks of two hundred and thirty five archival cervical cancers diagnosed in three participating laboratories from South West Nigeria were analyzed for the presence of HPV DNA. Statistical Analysis: Data analysis was performed with the Statistical Package STATA 10. Results: Of the one hundred and eighty seven samples that were considered appropriate for HPV detection after histological evaluation 160 (85.6%) were positive for HPV DNA. The five most common types identified as single types among HPV positive cases were HPV16 (46.9%), HPV18 (19.4%), HPV45 (11.9%), HPV35 (5.0%), and HPV31 (3.1%). Others were HPV33, 39, 51, 52, 56, 58, 59, 66, and 68. HPV16 and 18 in single/multiple infections accounted for 69.4% of the samples. Multiple infections were detected in 4.4%. All the adenosquamous and neuroendocrine carcinomas tested positive for HPV, while 86.1% and 66.7% of the squamous cell and the adenocarcinomas were positive, respectively. Conclusion: These results are in consonance with reports from all other parts of the world that HPV16 and 18 accounts for almost 70% of cervical cancers, supporting data that effective vaccination against these two types will reduce the cervical burden in South West Nigeria.

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Background and Objective: Nigeria has the second largest number of individuals living with human immunodeficiency virus/AIDS (HIV/AIDS) in the world after South Africa and contributes about 9% of the global HIV burden. It has also been estimated that there are 336,379 annual new HIV infections and about 192,000 of these individuals die of HIV/AIDS annually in Nigeria. Yet, there is a paucity of autopsy data among HIV/AIDS deaths in Nigeria. The objective of this study was to describe autopsy findings in HIV/AIDS cases in Lagos University Teaching Hospital (LUTH), a tertiary health center in Southwest Nigeria, which has one of the highest autopsy rates in the country. Materials and Methods: This 1-year prospective descriptive study included all HIV-1- and HIV-2-positive cases referred for autopsy examination at the Anatomic and Molecular Pathology Department of LUTH, Lagos, Nigeria. The study population included HIV-positive cases of all ages and sex. Results: Seven hundred and fifty-four autopsies were performed over the study period giving an autopsy rate of 33.1%. Forty-four patients (21 males and 23 females) were found to be HIV positive representing a prevalence of 5.8%. Of these, 23 (53.3%) cases were diagnosed antemortem, while 21 (47.7%) were diagnosed in the autopsy room. The patients' age ranged from 6 h to 69 years with a median age of 34 years. Infections were seen in 27 (61.4%) cases, out of which 13 (48.1%) were AIDS defining infections: 8 (18.2%) of them had tuberculosis, 2 (4.5%) cases of nontuberculous bacterial pneumonia, 1 (2.3%) case each of cryptococcosis, Pneumocystis jiroveci pneumonia, and progressive multifocal leukoencephalopathy (2.3%). Two (4.5%) patients had neoplasms (one case each of non-Hodgkin lymphoma and pleomorphic sarcoma). Miscellaneous causes of death included hypertensive heart disease, perforated strangulated right inguinal hernia, perforated ileoileal intussusceptions, and penetrating perineal injury. Conclusion: This study showed a demographic pattern of HIV infection comparable with previous national surveillance data, but a higher HIV seroprevalence than the most recent national surveillance data. Opportunistic infections were the most common cause of mortality in HIV infection and about half of HIV infected persons presented to the autopsy room undiagnosed.

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Introduction: Serum prostatic-specific antigen (PSA) concentration determination has established itself as the leading tool in screening for, as well as in estimating the prognosis of, adenocarcinoma of the prostate. This prognostication is usually done in conjunction with the Gleason score and other prognostic indices. The aim of this study was to determine the association between serum PSA concentration and the new (2016 modified) Gleason grade group of tumor among patients with adenocarcinoma of the prostate. Study Design: A retrospective, analytic study. Study Setting: Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria. Study Period: January 2006 to December 2013. Materials and Methods: A total of 211 patients with biopsy-based diagnosis of adenocarcinoma of the prostate were studied. Each of the cases was graded using the (2016 modified) Gleason grading system. Prebiopsy serum PSA concentration in each of the patients was retrieved from either the patient's case records in the Urology Unit of the hospital or from the values filled in by the requesting surgeon. Gleason grade groups of patients were correlated with serum PSA concentration. Results: Gleason grade group 1 was most common in our study with 68 (32.2%) of our patients falling within that category. The study revealed a statistically significant relationship between the serum PSA concentration and the Gleason grade group of cancer (P = 0.00). Conclusion: This study concluded that the serum PSA concentration has a statistically significant association with the Gleason grade group of the tumor in prostatic adenocarcinoma patients. Therefore, patients with high serum PSA concentrations are likely to have high tumor grade group.

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Background: Breast cancer is the most common cancer among Nigerian women. In Nigeria and indeed Africa as a continent, majority of patients present to the hospital with advanced diseases. This event is a major source of morbidity and mortality in our poor-resource setting and can significantly decrease patient's quality of life. Materials and Methods: Patient's case notes with advanced breast cancers referred for palliative radiotherapy were retrieved from the departmental archives. Patient's biodata was extracted, which included age, sex, and year of referral. Other information extracted includes histology types diagnosed at primary sites, presenting symptoms, type of imaging modality used for confirmation of metastasis, and sites of metastasis. Data collected were analyzed using SPSS version 20. Results: A total of 584 patients with advanced breast cancers were seen during the study period (January 2005 to December 2009), representing an annual referral rate of about 84 patients/year from various centers across the country. Four hundred and twenty-one patients were eligible for the study. The mean age of patients was 45.9 years with only two male patients. Bone was the most common site of metastasis (66.7%) followed by lungs (17.1%). Pain due to bone metastasis accounted for 62.7% of presenting symptoms, followed by dyspnea and cough from lung metastasis (17.1%), multiple symptoms (7.4%), and symptoms associated with brain metastasis (6.2%). Conventional X-ray remained the dominant imaging modality for the confirmation of metastasis in both bones and lungs which accounted for 69.8% of used imaging modalities. Conclusion: Breast cancer metastasis to the bone and lungs remain the major source of morbidity and mortality, with majority of patients presenting with pain and dyspnea. Conventional X-rays remain the common imaging modality for confirmation of metastases in our environment despite advanced imaging techniques (positron emission tomography (PET)–computed tomography and ¹⁸F-fluoro-2-deoxyglucose-PET) used for the similar purpose in other parts of the world.

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Background: Virtually no organ of the body is exempted from the effects of sickle cell disease (SCD) following repeated episodes of vaso-occlusion, infarction, and hemolysis leading to organ dysfunction. However, there is a dearth of data on the anatomic and functional changes of the ears, nose, and throat (ENT) in patients with SCD. Therefore, monitoring and evaluation of the effects of this disease on these organs will be defective due to the absence of baseline data necessary for institution of intervention programs and policy formulation. Aim: To review and determine the prevalence of the general anatomic changes and functional effects of SCD on the ENT in the pediatric age group. Materials and Methods: A cross-sectional prospective study of 52 children with SCD was carried out in 2018. Hematological parameters were determined while otolaryngoscopic examination and audiometric tests were conducted. Data were analyzed using SPSS version 19 software, and Pearson's linear correlation statistical method was also employed and level of significance was set at P ≤ 0.05. Results: The mean age of the children was 8.81 ± 4.58 years. Excessive snoring was present in 28.8% (15) of the participants, of which 60% (9) had >75% occlusion of the nasopharynx. Recurrent ear discharge was seen in 21.2% of the participants. Conductive hearing loss (HL) was 9.6% and 7.7% for the right and left ears, respectively, while sensorineural HL was 13.5% and 3.8% for the right and left ears, respectively. Recurrent sore throat was recorded in 17.3% of the participants, while 73.1% had Brodsky Grade 1 tonsillar enlargement. Conclusion: Ear infections, HL, and tonsillar enlargement are common among pediatric patients with SCD. This may not be unconnected to inadequate clinical care due to lack of good health education, ignorance, poverty, and prophylaxis from infections.

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