IntroductionThe burden of HPV-related Head and Neck Cancers (HNC) has been rising in the U.S. and other developed countries but this trend has not been reported in Africa. Objective of study was to evaluate the prevalence of HPV infection in HNC cancer cases seen between 1990 and 2011 at the tertiary health care institutions in Nigeria.MethodsWe retrieved 149 head and neck cancer formalin fixed, paraffin embedded tumor specimens diagnosed between 1990 and 2011 from four teaching hospitals in Nigeria. One hundred and twenty-three blocks (83%) contained appropriate HNC for analysis while DNA extraction was successful in 60% (90/149). PCR amplification was successful in 33% (49/149) and Linear Array genotyping for HPV was successful in 11% (17/149) of these cases. These were in tumors from the larynx (6), cervical lymph nodes (3), nasal cavity (2), parotid (1), palate (1), maxillary sinus (1) and mandible (1). Two cases were non-specific and none were from the oropharynx. Histologically, 41% (7/17) of the successfully genotyped blocks were squamous cell carcinomas (larynx 6, maxillary sinus 1).Results and ConclusionWe were unable to detect HPV in any of the HNC samples in our study. Our result may suggest that there is a low prevalence of HPV-related HNC among the adult population in Nigeria. Our results provide a benchmark to compare future incidence of HPV -related HNC in this community in future. We had significant analytical challenges from possible poor tissue processing and urge that future studies should prospectively collect samples and ensure high quality sample processing.

Abnormal cells were potentially lost on the broom, but were usually represented in the first vial. The likelihood of abnormal cells being discarded was operator dependent in this small study, but this did not affect the quality of the initial preparation. The likelihood of abnormal cells being seen on TP slides was dependent on their cellularity, which provided our laboratory with a criterion for the assessment of sample adequacy.

Necrotizing fasciitis of the head and neck is a rare and potentially fatal disease. It is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue resulting in tissue necrosis and likely death. It is commonly of dental or pharyngeal origin. Factors affecting the success of the treatment are early diagnosis, appropriate antibiotics and surgical debridement. Our study showed eight patients, five males and three females with mean age of 49.25 years (range 20-71 years). Clinical presentations were a rapidly progressing painful neck swelling, fever, dysphagia and trismus. The aetiology varied from idiopathic, pharyngeal/tonsillar infection, trauma and nasal malignancy. There were associated variable comorbidities (diabetes mellitus, HIV infection, hypertension and congestive cardiac failure). All the patients received early and aggressive medical treatment. The earliest time of surgery was 12 h after admission because of the poor financial status of patients. Three cases came in with complications of the disease and were not fit for extensive debridement under general anaesthesia. For them limited and reasonable bed side debridement was done. Mortality was 50 % from multiple organ failure, HIV encephalopathy, aspiration pneumonitis and septicemia. The duration of hospital stay for the patients that died ranged from 1 to 16 days and 4 to 34 days for the survivor. Our study heightens awareness and outlines the management challenges of necrotizing fasciitis of the head and neck in a poor resource setting.

Background: Cutaneous metastasis is valuable though with infrequent occurrence in clinical practice. It is of esteem value in diagnosis as well as treatment of cancer due to the ease of accessibility for clinical examination and biopsy. Case Series: This is a presentation of 5 consecutive patients with histologic diagnosis of cutaneous metastatic malignancies at the University of Calabar Teaching Hospital, (UCTH), Calabar, Nigeria from 2010 to 2013. They were studied in an attempt to evaluate the clinical significance of cutaneous metastatic nodules/disease in a tropical setting. This was compared with total cutaneous malignancies and total malignancies seen over the same period. Conclusion: The spectrum in the reported cases ranged from localised and barely noticeable nodules to generalised nodules. Clinicians are urged to show renewed interest in cutaneous nodules in view of the estimable value by subjecting such for histological evaluation.

This paper studies changes observed in pregnant women at the 3 stages of pregnancy in Calabar. Eighty pregnant women and eighty non-pregnant women were used. Most signs and symptoms occurred more in the first trimester while others occurred more in the third trimester. Vomiting, loss of appetite, excess salivation, Nausea gastroesophageal reflux, fever, headaches otomycosis were predominant in our study.

Noise above a certain acceptable level or sustained noise may cause damage to the ears. The aim of this study is to determine the prevalence and level of awareness of noise induced hearing loss in Calabar. Seventy-five workers from two noise producing companies, in Calabar-Flour mill and Wartsilla were chosen for this study. An author administered questionnaire was used to record sociodermographic data, occupation, access to ear protection, number of working years, etc; Rhine's test, Webers test, otoscopy and pure tone audiometry were done for each of the participants. Workers in the generator house, loading bay and production plant were regarded as noise exposed workers while others were non-noise exposed. Forty-one of the noise exposed workers in flour mill (66.83%) had mild hearing loss and ten (16.66%) had moderate loss. In Wartsilla, twenty six workers (50.98%) of the noise exposed workers had mild hearing loss and six(11.76%) had moderate loss. Three non-noise exposed workers in each of the companies also had mild hearing loss. 40% of the participants never heard about ear protection devices; 60%, knew about them. 50% had seen them and 30% felt better using them.

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Introduction:  The aims of this study were to find out whether cells could be lost on the discarded ThinPrep (TP) broom. A similar study with SurePath (SP), whose methodology recommends leaving the broom in the vial, showed that cells were lost if the broom was discarded and that the amount was operator dependent.1 Methods:  Three experienced colposcopists (C1, C2 and C3) collected TP samples from 306 women. The broom was rinsed thoroughly in a vial (V1) and then rinsed and retained in a second vial (V2). Slides from each case were randomised as A or B to conceal whether they were from V1 or V2, double‐screened and a cytological diagnosis and cell count recorded for each one. Cells were counted in 10 high‐power fields (HPF) and the cellularity classified as follows: high (HC) > 20 per HPF, intermediate (IC) 10–20 per HPF and low (LC) <10 in order to quantitate the cells potentially discarded in V2. Results:  The percentages with high‐grade and low‐grade abnormal cytology decreased with the degree of cellularity of the slide. Abnormal cytology was found in 96/133 (72.2%) of HC, 85/131 (64.9%) of IC and 15/42 (35.7%) of LC in V1 and in 5/8 (62.5%) of HC, 35/54 (64.8%) of IC and 86/244 (35.2%) of LC in V2. The cellularity of V2 was HC or IC in 62/306 (20.3%) and varied between the colposcopists: C1 39/109 (35.8%); C2 20/103 (19.4%); C3 3/94 (3.2%). C1 would have discarded the most cells but had the lowest percentage with LC in V1: 9/109 (8.3%) while the average was 42/306 (13/7%). Abnormal cytology in V2 was also found in V1 in 113/126 (89.1%). Discussion:  Abnormal cells would have been discarded with the TP broom and the amount varied between the colposcopists. This finding could have an affect on adequacy of the sample used for routine diagnosis. Reference:  1. Bigras G, Rieder MA, Lambercy J‐M et al. Keeping collecting device in liquid medium is mandatory to ensure optimized liquid‐based cervical cytology sampling. J Lower Genital Tract Dis 2003;7:168–74.