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.

Introduction: Prostate cancer is the commonest cancer in males in Nigeria, a country with the largest concentration of indigenous black patients worldwide. The disease has variable clinical behavior but is noted to have a more aggressive course in blacks. Prognostication is important in detecting which patients have tumours with aggressive invasive potential bringing about proper patient management. This study was carried out to assess the outcomes in patients diagnosed with prostate cancer and the factors determining these outcomes. Material and Methods:This was a retrospective analysis of all histologically proven cases of prostate cancer at the University of Calabar Teaching Hospital, Nigeria over a 10year period. Patients' demographic data, clinical condition and PSA at diagnosis and one year after, histologic diagnoses including Gleason's grade and score, AJCC Stage, as well as treatment regimen were extracted. Data obtained was analyzed using Statistical Package for Social Sciences version 20. Results:One hundred and eleven (111) cases were studied with mean age of 66.7 ± 10.6 years. Most patients (70.2%) were within the 60-79 year age group. Over 64% of patients presented with Gleason grades of 3 or 4 and over 46% of patients had Gleason scores of 6 or 7. Fifty five percent of patients had PSA values greater than 20ng/mL and among these patients mean PSA was 62.3 ng/mL ± 26.6. Over 64% had at least stage 2B disease and above, metastasis was found in over 20% of patients at presentation and the main drug patients were placed on was Antiandrogens. Metastasis at presentation was found to be more common with age less than 60 years, Gleason Grade greater than 3, Gleason Score greater than 6 and AJCC Stage greater than 2B. Better treatment outcomes were recorded in patients older than 60 years of age, without metastasis at presentation and with AJCC Stage 2B or less. No significant difference in outcomes was noted between Gleason Grade less than or above 3 or scores less than or above 6. Significant loss in data was recorded in the study. Conclusion:A significant proportion of patients in our environment still present with advanced disease. Routine screening for prostate cancer is recommended and efforts at improving access to imaging modalities and electronic medical records should be intensified if better results in the management of prostate cancer must be achieved.

Background The current burden of >5 million deaths yearly is the focus of the Sustainable Development Goal (SDG) to end preventable deaths of newborns and children under 5 years old by 2030. To accelerate progression toward this goal, data are needed that accurately quantify the leading causes of death, so that interventions can target the common causes. By adding postmortem pathology and microbiology studies to other available data, the Child Health and Mortality Prevention Surveillance (CHAMPS) network provides comprehensive evaluations of conditions leading to death, in contrast to standard methods that rely on data from medical records and verbal autopsy and report only a single underlying condition. We analyzed CHAMPS data to characterize the value of considering multiple causes of death. Methods and findings We examined deaths identified from December 2016 through November 2020 from 7 CHAMPS sites (in Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa), including 741 neonatal, 278 infant, and 241 child <5 years deaths for which results from Determination of Cause of Death (DeCoDe) panels were complete. DeCoDe panelists included all conditions in the causal chain according to the ICD-10 guidelines and assessed if prevention or effective management of the condition would have prevented the death. We analyzed the distribution of all conditions listed as causal, including underlying, antecedent, and immediate causes of death. Among 1,232 deaths with an underlying condition determined, we found a range of 0 to 6 (mean 1.5, IQR 0 to 2) additional conditions in the causal chain leading to death. While pathology provides very helpful clues, we cannot always be certain that conditions identified led to death or occurred in an agonal stage of death. For neonates, preterm birth complications (most commonly respiratory distress syndrome) were the most common underlying condition (n = 282, 38%); among those with preterm birth complications, 256 (91%) had additional conditions in causal chains, including 184 (65%) with a different preterm birth complication, 128 (45%) with neonatal sepsis, 69 (24%) with lower respiratory infection (LRI), 60 (21%) with meningitis, and 25 (9%) with perinatal asphyxia/hypoxia. Of the 278 infant deaths, 212 (79%) had ≥1 additional cause of death (CoD) beyond the underlying cause. The 2 most common underlying conditions in infants were malnutrition and congenital birth defects; LRI and sepsis were the most common additional conditions in causal chains, each accounting for approximately half of deaths with either underlying condition. Of the 241 child deaths, 178 (75%) had ≥1 additional condition. Among 46 child deaths with malnutrition as the underlying condition, all had ≥1 other condition in the causal chain, most commonly sepsis, followed by LRI, malaria, and diarrheal disease. Including all positions in the causal chain for neonatal deaths resulted in 19-fold and 11-fold increases in attributable roles for meningitis and LRI, respectively. For infant deaths, the proportion caused by meningitis and sepsis increased by 16-fold and 11-fold, respectively; for child deaths, sepsis and LRI are increased 12-fold and 10-fold, respectively. While comprehensive CoD determinations were done for a substantial number of deaths, there is potential for bias regarding which deaths in surveillance areas underwent minimally invasive tissue sampling (MITS), potentially reducing representativeness of findings. Conclusions Including conditions that appear anywhere in the causal chain, rather than considering underlying condition alone, markedly changed the proportion of deaths attributed to various diagnoses, especially LRI, sepsis, and meningitis. While CHAMPS methods cannot determine when 2 conditions cause death independently or may be synergistic, our findings suggest that considering the chain of events leading to death can better guide research and prevention priorities aimed at reducing child deaths.

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BackgroundThere is a projected increase in lower urinary tract obstruction by 2018, especially in the developing economies of Asia and Africa. However in many of these countries, the problems encountered both by the patients and the clinicians are not well documented. Our aims are, to prospectively analyse the management of urinary retention, the associated difficulties, and complications in our setting, where access to investigative modalities such as Computerize Tomography and Magnetic Resonance Imaging are not available.Patients and MethodsThe study was approved by the University Of Calabar Teaching Hospital ethical committee. A validated Proforma was used to collect data from all patients who were clinically diagnosed with urinary retention based on history, and physical examination, from July 2009 to June 2010. Data collected from the 1st of July 2009 to the 30th of June 2010, include demographics, findings on physical examination, previous medical history and co-morbid conditions. The results of investigations done such as: urinalysis, full blood count, electrolytes, urea and creatinine, intravenous urography, trans- abdominal ultrasonography, chest X-ray and histology of trans-rectal biopsies of the prostate . The total number of new patients seen, including those with urinary retention during the study was documented. The retentions were also classified into acute and chronic. All the patients were followed up throughout the study. The data was analysed using Epi-Info statistical program version 3.4 of 2007 to analyse the data, estimating averages, mean, median and percentages. RESULTS: The total number of new patients seen, including those with urinary retention was Seventy thousand, one hundred and thirty nine (70,139).Of this number, hundred and fifty nine (0.23%), presented with urinary retention; 145 (91.2%) were acute, and14 (8.8%) were chronic. The male: female ratio was 39:1.The patients ages ranged from 4 to 94 years, with a mean of 53.7±11.2. Seventy seven [48.4%] of them were in the 6th and 7th decades of life. The common causes were; prostatic diseases [BPH and cancer of the prostate] 77.0%, infections 75.8%, trauma 12.1%, and congenital 12.1%. Urinary retention was relieved by: indwelling urethral catheterization [IUC] 120 patients (75.5%), supra- pubic cystostomy [SC] 34 (21.4%) and intermittent urethral catheterization [IC] 5 (3.1%). The most frequently encountered complications include pyuria (18.2%), pericatheter sepsis 17.5%, and haemorrhage during change of catheter 16.8% [figure 2].Figure 2Complication after one week bladder drainageConclusionLower urinary retention is common in our environment. The management is appropriate and standard. The man power and facilities are inadequate, and requires urgent improvement.

Background and Aims: Natural dyes and pigments are nontoxic, ecofriendly alternatives to synthetic counterparts and beetroot is one such natural dye. The red color of beetroot derived from betalain pigments confers great advantage to this plant. In this study, the physiochemical and spectrophotometric characteristics of beetroot as well as the histological staining potential of various tissues were carried out to determine its tissue specificity. Methods: The aqueous and ethanol extracts of beetroot were prepared using distilled water and 95% ethanol, respectively. Spectrophotometry, pH, and concentration of both extracts were determined before histological staining with 10% neutral-buffered formalin-fixed, paraffin-wax-embedded tissue sections. Stained sections were viewed with a photomicroscope. Results: The aqueous and ethanol extracts of beetroot were slightly acidic and soluble at concentrations of 381.5 mg/100 g and 253.7 mg/100 g fresh beetroot sample, respectively. Both extracts consist of three betalain pigments with absorbances at different spectrophotometric wavelengths, namely betaxanthins (475 nm), betanin (525 nm), and betanidin (575 nm). The maximum absorbance was 0.925 and 0.615 for the aqueous and ethanol extracts, respectively, at a peak wavelength of 525 nm for each extract. Both extracts stained various tissue structures such as muscles, mucins, red blood cells, keratin, and nerve fibers. Conclusion: Thus, beetroot stain is slightly acidic, contains betalain pigments, stains basic histological tissue structures, and can be used as an ecofriendly alternative to hematoxylin and eosin.

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