Annals of Tropical Pathology

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Background: Hypercholesterolaemia is known to be frequently associated with diabetes mellitus. Lipid abnormalities in patients with diabetes are likely to play important role in the development of atherogenesis and so are called atherogenic dyslipidaemia. Improved glycaemic control may prevent the appearance and enhance the regression of macrovascular and microvascular complication. It has been noted that improved glycaemic control can alter the serum lipid level. This study demonstrates the effect of glycaemic control in Nigerians with type II diabetes on serum levels of lipid. Methodology: A total of 160 consenting type II diabetic patients were recruited for the study consisting of 49(30.6%) male and 111(69.4%) female, while 70 non-diabetics subjects matched for age and sex with the patients were recruited as control consisting of 25 (35.7%) males and 45 (64.3%) females. A total of 5mls of blood sample was collected from each patient in sitting position after an overnight fast from the antecubital vein at the dorsum of the hand. Glucose, Total cholesterol, HDL-C and LDL-C were estimated. The absorbance of samples and standards were measured against reagent blank. Statistical analysis was done using Statistical Package for Social Science (SPSS version 15.0) results were expressed as means±SD. Paired sample t-test was used to compare means of results where appropriate, Pearson's correlation analysis was used to examine the relationships between the variables. A p-value less than 0.05 were considered statistically significant. Results: There were statistically significant difference when the mean lipid profiles of diabetic subjects were compared with that of controls (p <0.05). Significant elevations were observed in the values of total cholesterol, triglycerides, and LDL-C, in diabetic subjects when compared with that of controls. Coronary heart disease risk ratio was statistically significantly different when mean value of subjects is compared with that of controls. Significant positive correlation was observed when total cholesterol, triglyceride, LDL-c were compared with glycaemic control with r values of 0.613, 0.631 and 0.607 respectively with p-value <0.05 in all. There was also significant negative correlation when coronary heart disease risk ratio was compared with glycaemic control. (r = -0.595 and p-value <0.05). Conclusion: This study has highlighted the fact that type II diabetic patients have a high frequency of atherogenic dyslipidaemia especially for TC, Tg and LDL-C. The study also shows that the poorer the glycaemic control the higher the incidence of dyslipidaemia. It is therefore suggested that along with glycaemic control, physicians should also focus on lipid profiles.

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Background: National Cancer Institute (NCI) formulated a five-tiered system for reporting cytological smears from the breast. Of these, C1, C2 and C5 are usually unequivocal. The equivocal categories C3 (atypical probably benign) and C4 (suspicious probably malignant) need to be evaluated to determine their cytomorphologic correlation and thus provide useful information on the degree of clinical weight that can be put on them in patient management. Methods: A retrospective study of cytological smears made from palpable breast lesions performed over a 5-year period from 2008 to 2012. The C3 and C4 smears were then compared with final histological diagnoses for these categories and their diagnostic value calculated. Result: There were 1,162 smears taken in the five years, 200 (17.2%) of which had subsequent histology. Of the 200 smears 20 were C3 and 27 were designated as C4. Subsequent histology upgraded 7 (35%) of the C3 cases to malignant and downgraded 4 (14.8%) of the C4 cases to benign. The overall Suspicious Rate was 23.5% with sensitivity of 76.7%, specificity of 76.5%, positive predictive value and negative predictive values of 85.2% and 65.0% respectively. Conclusion: A fair degree of clinical reliance can still be placed on cytologically categorized C3 and C4 breast smears. However, the rate of reporting of these categories can be reduced with availability of ancillary radiological techniques such as mammography and ultrasonography.

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Background: Thyroid disorders are common among women of childbearing age with associated adverse pregnancy outcomes. A normal pregnancy results in a number of important physiological changes that alter thyroid function with considerable variations per trimester. American Thyroid Association recommended each laboratory to establish its thyroid function tests reference interval for each trimester. Lack of these reference intervals makes management of thyroid disorders during pregnancy difficult. Objective: To establish trimester-specific thyroid function reference values in pregnancy. Method: Three-hundred apparently healthy pregnant women were recruited into the study. Thyroid function tests (TSH, free T₄, free T₃, Thyroxin Binding Globulin (TBG) were assayed using ELISA kits. Trimester-specific reference intervals (2.5^th and 97.5^th centiles) were calculated for 75, 125 and 100 pregnant women in first, second and third trimesters' respectively using Microsoft Excel software 2007. Results: Mean ages ± Standard deviation was 25.4 ± 5.98 years respectively (p>0.05). First trimester TSH, Free T₄, Free T₃ and TBG reference intervals were (0.03 – 2.41) μIU/L, (0. 84 – 2.06) ng/mL, (1.92–3.51) pg/mL, and (11.32 – 43.17) μg/mL respectively. Second trimester reference intervals for TSH, Free T₄, Free T₃ and TBG were (0.14 – 3.55) μIU/L, (0.76 – 2.08) ng/mL, (1.65 – 3.96) pg/mL, and (14.51–72.86) μg/mL respectively. Third trimester reference intervals for TSH, Free T₄, Free T₃ and TBG were (0.21– 3.12) μIU/L, (0.70–1.70) ng/mL, (1.74 - 3.65) pg/mL, and (20.33–72.55) μg/mL respectively. Conclusion: Thyroid function Reference intervals established in keeping with international recommendations.

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Syringocystadenoma papilliferum is an exceedingly rare skin adnexal neoplasm of apocrine gland origin, commonly located primarily on the scalp and appearing as a hairless nodular plaque lesion. We report the case of a 35-year old man with history of an ulcer on the right leg which started three years earlier as a small excoriation after trauma to the leg over a lesion present from birth. Histological examination confirmed the diagnosis of syringocystadenoma papilliferum, which is a very rare lesion on the leg. We report this case due of its rarity and unusual clinical presenation.

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Objectives: This study was undertaken to validate human immunodeficiency virus( HIV) 1&2 testing in urine samples as a screening process. Method and Materials: 160 samples of urine were collected from people living with HIV who attended the adult antiretroviral clinic and 38 urine samples of pregnant women attending the antenatal clinic of the university of Port Harcourt Teaching Hospital who had tested negative previously and two others who came for routine test in the laboratory were screened for HIV using a urine kit. Results: One hundred and sixty (160) of these samples from the adult clinic which were known to be positive previously from serum tests still were positive giving a sensitivity of 100% while the rest 40 which were negative with serum, one was found to be positive and another discrepant result making the specificity to be in the range of 95-97.5% Conclusions: The sensitivity and specificity of the urine test kit is adequate for screening purposes but all positive samples must be confirmed with an alternative test or Western blot.

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Introduction: Despite the overwhelming evidence in favour of thromboprophylaxis and availability of effective methods and clinical guidelines, the awareness and practice still vary significantly globally. This study sought to highlight the current level of knowledge, attitude and practice of thromboprophylaxis among doctors in Edo state, as a microcosm of the national health system. Method: This is a cross-sectional descriptive study carried out in major health centers in Edo state, Nigeria to survey the knowledge, attitude and practice of thromboprophylaxis among doctors in Edo state. Relevant data were collected using a pretested self- administered questionnaire and analyzed using IBM SPSS 20. Result: A total of 90 practitioners returned the completed questionnaire. All the respondents demonstrated good basic knowledge of the concept of thromboprophylaxis. However, only 2% knew that placement of inferior vena cava (IVC) filter and chest exercise are thromboprophylactic methods. Over 90% of the respondents thought that venous thromboembolism was a significant problem among hospitalized patients while 45% of them also thought that the practice of thromboprophylaxis was sub-optimal in their various hospitals. Majority of the practitioners (90%) preferred pharmacologic prophylaxis with LMWH (70%) being their most favorite for thromboprophylaxis. Less than 50% of the respondents had managed >5 cases of thrombosis and less than 20% consistently administer thomboprophylaxis to at-risk patients. Conclusion: While this survey showed a considerably high level of knowledge of thromboprophylaxis among practitioners, there was still significant deficiency with regards to attitude and practice of the same among doctors in this region.

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Online since 21^st November 2017.