BackgroundMultiple myeloma (MM) is one of the hematological malignancies that require palliative care. This is because of the life-threatening nature and the suffering associated with the illness. The aim of this study is to bring to the fore the complications experienced by people living with MM in the Niger-Delta region of Nigeria and the outcome of various palliative interventions.MethodsThis was a 10-year multi-center retrospective study of 26 patients diagnosed and managed in three major centers in the Niger-Delta region of Nigeria from January 2003 to December 2012. Information on the clinical, laboratory, radiological data, and palliative treatment was obtained at presentation and subsequently at intervals of 3 months until the patient was lost to follow-up.ResultThe mean duration from onset of symptoms to diagnosis was 13.12 months (95% CI, 6.65–19.58). A total of 16 (61.5%), eight (30.8%), and two subjects (7.7%) presented in Durie–Salmon (DS) stages III, II, and I, respectively. The complications presented by patients at diagnoses included bone pain (84.6%), anemia (61.5%), nephropathy (23.1%), and hemiplegia (35%). All the patients received analgesics, while 50.0% received blood transfusion, 56.7% had surgery performed, 19% had hemodialysis, and 3.8% received radiotherapy. A total of 10 (38%) patients benefited from bisphosphonates (BPs). A total of 57.6% of patients were on melphalan–prednisone (MP) double regimen, while 19% and 8% patients were on MP–thalidomide and MP–bortezomib triple regimens, respectively. A total of 3.8% of patients at DS stage IIIB disease had autologous stem-cell transplantation (ASCT). Only 7.6% of the myeloma patients survived up to 5 years post diagnosis. The overall mean survival interval was 39.7 months (95% CI, 32.1–47.2).ConclusionLate diagnosis and inadequate palliative care account for major complications encountered by MM patients in the Niger-Delta region of Nigeria. This could be responsible for the poor prognostic outcome and low survival interval of MM individuals in this region. There is, therefore, a need to improve the quality of palliative care received by myeloma patients in this region. This is achievable via provision of relevant and affordable health care facilities for diagnosis and treatment of the disease.

Head and neck tumours constitute a wide spectrum of heterogeneous tumours affecting different anatomical sites in the head and neck region, with varying histology and biological behaviors.The different sites include sinonasal, nasopharyngeal, parapharyngeal, oral and oropharyngeal, hypopharyngeal, laryngeal, otologic, orbital, thyroid and parathyroid, and salivary gland tumours. The different subtypes include squamous cell carcinomas, paranasal sinus and nasopharyngeal carcinomas, salivary gland cancers, melanomas, sarcomas, lymphomas and lymphatic tumours, orbital tumours, thyroid and parathyroid gland tumours and other neuroendocrine tumours. [1][2][3] Malignancies in the head and neck region though relatively rare, compared to other regions of the body, they contribute significantly to morbidity and mortality in affected patients. Background: Malignancies in the head and neck region though relatively rare, compared to other regions of the body, they contribute significantly to morbidity and mortality in affected patients. In Nigeria, the burden of managing head and Neck malignancies is enormous and there is yet to be a unified record of nation-wide incidence of malignancies involving the head and neck region despite the fact the head and neck malignancies have been diagnosed and documented since the 1960's. The histological pattern and frequency however seems to have some slight variation depending on the region and the identified aetiological risk factors. Aims and Objectives:The aim of this study was to determine the pattern of head and neck tumours seen in the region and the commonest malignancies in the cohort. By comparing the relative prevalence of the lesions with other centers in the country and international published literature we hope to make a case for proper tumour registry and move for nation-wide studies. Materials and Methods:The authors reviewed the histopathological data of the tumor registry at the University of Calabar Teaching Hospital, a major referral Center in South-Eastern Nigeria between 2005 and 2012. All cases of head and Neck tumours with histological diagnosis were included for analysis, their demographic data were obtained and analyzed using SPSSv16. Results: Two hundred and twenty-five specimens from the head and neck region were analyzed during this 6 year period giving an average of 34 cases per year. The Male:Female ratio was 1.2:1. The age range was from 2 years to 76 years with overall mean of 32.7 years. One hundred and forty-five cases (63.3%) were benign while 84 malignant cases (36.7%) were recorded for the study period. The average number of new malignant cases seen was 14 per year. Malignancies were commoner in those less than 50 years of age and were mostly those of epithelial origin. Conclusion: Variations in the regional demographics of head and neck tumors in the country could be accounted for by the differences in data collection methods and certain aetiological factors that may be unique to those regions. A proper tumor registry in each region, harmonized with ...

No abstract

No abstract

BACKGROUND : Hemoglobinopathy is the commonest genetic defect worldwide and sub-Saharan Africa bears the second largest burden of this disorder. The challenges confronting management of hemoglobinopathy in resource-limited settings in Africa are diagnosis, monitoring and prognostication. The old conventional hemoglobin protein electrophoresis test (HbPE) lacks the capacity to make definitive diagnosis of hemoglobin variants (genotype) of an individual, hence, so many diagnosis of hemoglobinopathy have been missed as a result of this defect. This necessitated the need for more reliable technique for screening, diagnosis, monitoring and evaluation of Hemoglobinopathy (High Performance Liquid Chromatography,(HPLC)). AIMS : This study aimed to compare the old conventional HbPE and the new chromatographic methods (HPLC) of determining variant Hemoglobin in a south-eastern tertiary health institution in Nigeria. METHODOLOGY : A one-year prospective study of Eight thousand four hundred and seventy eight (8,478) consecutive patients who presented at the Department of Hematology, Federal Medical Centre, Umuahia for HbPE from January to December 2013 (old era) and seventy (70) patients among them who used HPLC to determine their variant hemoglobin (new era). Biomedical data, electrophoretic and chromatographic patterns of their variant hemoglobin were obtained using the conventional alkaline cellulose acetate HbPE machine and the D-10TM HPLC [Bio-Rad Laboratories] respectively. Statistical analysis was done using SPSS. RESULT: A total of 8,478 patients made up of 1,505(17.8%) males and 5,013(59.1%) females were seen within the study period. The study included both children ( ≥7months) and adult with majority of them (25%) between age of 20-30 years. Three hemoglobin variants were identified viz: [(AA(6447/76%),AS(1876/22.12%),SS(159/1.88%)] using alkaline cellulose acetate HbPE machine in the old era. In the new era, four Hb variants [AA,AS,SS(5.7%) and SD(1.3%)] were obtained using the HPLC. There was a linear increment in quantitative HbF [(AA(31/37),AS(13/20),SS(0/5) had HbF <1%,while AA(0/37),AS(0/20),SS(2/5) had HbF>10%,(Table 1)] and HbA2 [(AA(45/45),AS(8/20),SS(0/5) and AA(0/45),AS(3/20),SS(2/5) had HbA2<3.5% and >10% respectively,(Table 2)] as you move from AA, AS ,to SS Hb variants. The S-window for all HbSS (4/5) was >70% while that of AS and SD ranged between 40-70%. CONCLUSION : A critical comparison of the old and new methods of diagnosis of hemoglobinopathy showed that the later (HPLC) was superior to the former (HbPE) in the early detection, diagnosis, quantification, monitoring and prognostication of Hemoglobinopathy. Therefore, HPLC is strongly recommended in the policy guidelines for Hemoglobinopathy screening in health institutions in developing countries such as Nigeria where the prevalence is high. KEYWORDS : Diagnosis, Hemoglobin variants, HbPE, HPLC, Hemoglobinopathy. Disclosures No relevant conflicts of interest to declare.