National Hospital Abuja Research Articles

Vimentin and Cytokeratin Immunostaining: The Role in Basic Diagnosis and Prognosis of Sarcomas

Introduction: Specific diagnosis which provides diagnostic, prognostic, and therapeutic information to guide patient care defines the primary goal of sarcoma management and care. The role of immunohistochemistry, using vimentin (mesenchymal linage marker) and cytokeratin (epithelial linage marker) as basic markers for diagnosis and classification of sarcomas for specific management strategies and prognosis was elucidated in the present study.
 Materials and Methods: Twenty four (24) archived paraffin wax processed tissue block sarcoma samples were randomly selected from the histopathology Laboratories and museums of the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi and National hospital Abuja and necessary data obtained from records. Blocks were re-embedded with fresh paraffin wax and 3µ thick sections cut with the aid of a rotary microtome. Haematoxylin and Eosin staining method was employed to confirm diagnosis before proceeding to immunohistochemistry. Antibodies for vimentin and pancytokeratin were employed for immunohistochemistry while exposed mouse and rabbit specific horseradish peroxides/diaminobenzidine detection IHC kit was employed for immunostaining.
 Results: The mean age of patients was 26 years while the ages range from 11 to 48 years with 14 (58.3%) females and 10 (41.7%) males. Vimentin had strong positive immunoreactivity for all sarcoma samples whereas cytokeratin had positive immunoreactions for synovial sarcoma only, which also showed co-expression of both genes.
 Conclusion: Vimentin and cytokeratin may play vital role as basic biomarkers not only for diagnosis and characterization of sarcomas but for specific management regime and prognostication. However, IHC must be performed at high standard using appropriate antibodies, samples and reagents.
 Keywords: Sarcoma, immunohistochemistry, vimentin, cytokeratin, biomarker.

Understanding Etiologies of Road Traffic Crashes, Injuries, and Death for Patients at National Hospital Abuja: A Qualitative Content Analysis Using Haddon’s Matrix

Road traffic crashes and sequelae are reaching pandemic proportions globally and have currently achieved disproportionately high levels in Nigeria. Quantitative studies are accumulating in the peer-reviewed literature, but there is a paucity of qualitative research in Nigeria. Data for this study of structural and behavioral factors of road traffic crashes and injuries in Federal Capital Territory were collected in semi-structured interviews with crash survivors at National Hospital Abuja. Interviews were analyzed via qualitative content analysis, revealing crash location and participant beliefs about crash etiologies. Units of analysis were developed from participant statements and were structured within four a priori etiologic categories using Haddon’s (1980) matrix: human-, vehicle-, physical environment-, and socioeconomic environment-related. Subcategories were generated. Human-related subcategories included reckless behavior and drivers, limited technical knowledge and skill. Vehicle-related subcategories included vehicular disrepair and lack of safety equipment. Physical environment-related subcategories included road disrepair, infrastructural inadequacy, and weather. Socioeconomic environment-related subcategories included government, prehospital care, money, and prayer. Subcategories were organized temporally by pre-event, event, and post-event phases, with most units of analysis allocated in the pre-event phase. These qualitative results can be utilized to guide future research along community-aligned priorities, and to structure community-engaged preventative and interventional efforts.

Persistence of Non-Vertigo Symptoms in Meniere Disease During Remission - A Preliminary Report.

Though the absence of vertigo in Meniere disease is often interpreted as remission, patient-centered subjective assessment of quality of life remains the best indicator of such remission. To assess the presence and severity of aural pressure/tinnitus, hearing loss, unsteadiness, nausea and vomiting in MD patients during remission. Urban tertiary care referral hospital in a developing country. Consecutive patients with diagnosis of Definite Meniere were selected from the Balance and Dizziness Clinic of National Hospital Abuja for the study. Quality of life assessment was carried out using 3 validated tools - Modified MD-POSI, Vertigo Symptom Scale and Tinnitus Handicap Inventory (THI). Patients were included only when they have been vertigo free for at least 4 weeks. Pure tone audiometry was carried out in those with subjective hearing loss at recruitment and 4 weeks later. A total of 26 patients completed the study. All had cinnarizine for acute vertigo control and Betahistine for maintenance of vertigo control. There was female preponderance (17:9). The age range was 32-56 years. The duration of MD ranges from 4 months to 12 years. The total and subscale MD-POSI scores for "between attacks" significantly correlated with hearing, unsteadiness and tinnitus/pressure when compared to during attack. 69.2 per cent of participants experienced symptoms of unsteadiness during remission. 13/26 of participants reported persistent, though less annoying tinnitus that poorly correlated with THI score during remission. Our study showed that significant non-vertigo symptoms affect the quality of life during remission. Perhaps there is need to properly define, in future studies, what constitutes remission in patients with MD.

The efficacy of intermittent preventive therapy in the eradication of peripheral and placental parasitemia in a malaria-endemic environment, as seen in a tertiary hospital in Abuja, Nigeria.

To determine whether intermittent preventive therapy in pregnancy (IPTp) eradicates peripheral and placental malaria and improves birth weight. A cross-sectional study was conducted of 426 pregnant mothers on IPTp with sulphadoxine-pyrimethamine against malaria who presented in labor, at National Hospital Abuja, Nigeria between January and June 2017. The hospital is within the malaria-endemic zone of West Africa. Consenting pregnant women with uncomplicated singleton term pregnancy who had antenatal care in the hospital and lived in the study area for at least 6months were consecutively recruited. Peripheral and placental blood were collected and examined for malaria parasite by microscopy. Babies were weighed at birth. The prevalence of peripheral malaria parasitemia and placental parasitization were 12.9% (95% confidence interval [CI] 10.0-16.6) and 9.4% (95% CI 7.0-12.7), respectively. Parasite density in both peripheral parasitemia and placental parasitization was low among the women that took IPTp, decreasing with increasing doses, with no parasitemia or parasitization in women that took up to three doses. Birth weight was lower in babies of mothers with plasmodium infestation than in those without infestation (P<0.001, P=0.024). IPTp reduces both peripheral parasitemia and placental parasitization, with the capacity to eliminate or prevent them. IPTp also reduces low birth weight.

Pattern of haemoglobin phenotypes in newborn infants at the national hospital abuja using high performance liquid chromatography

Haemoglobin (Hb) disorders are among the most common blood genetic disorders worldwide, and they constitute an important cause of morbidity and mortality, especially in Nigeria. Despite the clinical significance of early diagnosis, newborn screening for these conditions is not routinely done in Nigeria. This study was undertaken to document the pattern of Hb phenotypes of newborn babies at the National Hospital Abuja and highlight the relevance of neonatal screening for early diagnosis of abnormal Hb phenotypes in Nigeria. A prospective study of eligible newborn babies delivered in the hospital at the study site was undertaken following parental informed consent. Venous blood was collected from the babies into an ethylenediaminetetraacetic acid sample bottles. The samples were analysed using high-performance liquid chromatography (HPLC) techniques, and the Hb phenotypes obtained were documented. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 20 (IBM-SPSS, Armonk, NY, USA). Three hundred and eleven newborns (male = 173, female = 138) aged 0-28 days were recruited. Two hundred and thirty-six (75.9%) babies had Hb AA (FA) phenotype, 63 (20.3%) Hb AS (FAS), 6 (1.9%) Hb SS (FS), 4 (1.3%) Hb AC (FAC) and 2 (0.6%) had abnormal HbA variants. The overall prevalence of abnormal Hb phenotype was 24.1%. The results showed a significant association of sex (P = 0.003) and ethnicity (P = 0.047) with Hb phenotype. There is a wide spectrum of abnormal Hb phenotypes in Nigeria, and these phenotypes can easily be detected at birth using HPLC. We, therefore, recommend routine neonatal screening for sickle cell disease by HPLC in Nigeria.

Clinicopathological analysis of prostatic lesions in a tertiary hospital in Nigeria

Background: Prostatic neoplasms are important source of morbidity and mortality among men globally. A rising trend is noted worldwide especially involving sub-saharan African males where paradoxically data is grossly inadequate. We hereby present prostatic lesions from a tertiary center in sub-saharan Africa.Materials and Method: A retrospective analytic study of all prostatic samples received in the histopathology of National Hospital Abuja (NHA), a tertiary hospital in Nigeria, from 1st January 2005 to 31st December 2015 was carried out.Result: The major affected age group is the 61 – 70 year cohort. Majority of neoplastic lesions encountered are malignant adenocarcinomas of moderate differentiation. The predominant presenting symptoms are dysuria, frequency, and acute urinary retention in that order, while raised prostatic specific antigen (PSA) is a frequent sign. Conclusion: Prostatic adenocarcinoma is significant malignancy in NHA while benign prostatic hyperplasia is the commonest benign lesion. Gleason scores 5 and 7 are the predominant malignant differentiation obtained.

Should children know their HIV status? Prevalence, caregiver's perspectives and barriers to disclosure at the National Hospital Abuja, Nigeria.

Nigeria ranks second globally with a HIV/AIDS prevalence of 3.2%. HIV infected children are surviving to adolescence because of anti-retroviral therapy, but many do not know why they need to take these medicines. Disclosure is critical to long-term disease management, yet, if, how and when caregivers and or health professionals disclose to children is not well known in resource-limited settings. The barriers to disclosure remain largely undocumented. To determine the prevalence and age of HIV disclosure to children in Abuja, Nigeria and identify caregivers perspectives as well as barriers to disclosure. A cross-sectional study was done June-July 2016 using a structured questionnaire, convenience sampling and quantitative methods at the infectious disease clinics of National Hospital Abuja. A sample of 164 caregivers of HIV-positive children aged 5-16 years receiving antiretroviral therapy for at least 1 year were enrolled. Prevalence of full disclosure was 24.5%, partial disclosure 22.7%, with overall prevalence of 47.2%. Mean age at full disclosure was 11.87 years. Bivariate analysis showed significant difference between disclosure and child's level of education (χ2 for trend 26.710, P < 0.001), support for disclosure (χ2 4.399, P = 0.036) and if caregiver held the opinion that children should have disclosure done (Pearson's χ2 30.174, P < 0.001). However, on logistic regression, only the age of the child (P < 0.001, 95% CI 1.176-1.499) and the caregiver's opinion (P = < 0.001, 95% CI 4.914-2.542) remained significant. Various barriers to disclosure were identified. The prevalence of full disclosure is low and several barriers prevent early disclosure. Caregiver's and HCWs need empowerment with culturally appropriate skills and platforms to increase disclosure rates, which may help improve adherence.

Comparison of clinical efficacy of long- versus short-acting gonadotrophin-releasing hormone agonists for pituitary down regulation in In vitro fertilisation cycles.

Gonadotrophin-Releasing Hormone agonist (GnRHa) - long and short acting - is used for pituitary down regulation prior to ovarian stimulation in in vitro fertilisation (IVF) treatment. However, there are controversies in the literature as to their effectiveness, dose of gonadotrophin needed subsequently for ovarian stimulation and the clinical outcome. The objective of the study was to compare the efficacy of single-dose long-acting GnRHa - goserelin - and daily dose short-acting GnRHa - buserelin - for pituitary down regulation and their clinical outcome in IVF treatment. : This prospective comparative study was undertaken at the IVF centre in National Hospital Abuja, a public tertiary hospital in Nigeria. A total of 114 IVF patients were consecutively allocated into either long-acting GnRHa - goserelin - 3.6 mg single dose (Group A) or short-acting GnRHa - buserelin - 0.5 mg daily (Group B) both starting on day 21 of the cycle preceding the IVF treatment. The effects on pituitary down regulation and treatment outcomes were compared. Time taken (days) to achieve down regulation (22.6 ± 4.3 vs. 26.1 ± 8.0; P = 0.084) and the mean number of human menopausal gonadotrophin (HMG) doses used (57.7 ± 13.7 vs. 54.2 ± 16.7; P = 0.222) were similar in the two groups. Although the number of oocytes retrieved (9.9 ± 6.7 vs. 7.2 ± 5.0; P = 0.02) and fertilised (6.2 ± 4.4 vs. 4.6 ± 3.5; P = 0.04) were significantly higher in Group A, there was no statistically significant difference in the number of embryos (4.4 ± 2.6 vs. 4.0 ± 3.0; P = 0.850) and clinical pregnancy rate at 6 weeks (49.2% vs. 43.6%; odds ratio 1.249; confidence interval = 0.579-2.612; P = 0.578) in both the groups. While group B had a significantly higher number of hospital visits (P = 0.0001) as well as a higher number of injections (P = 0.0001), the mean cost of GnRHa and gonadotrophin used was significantly higher in Group A (P = 0.043). Single-dose long-acting GnRHa is as effective as daily dose short-acting GnRHa for pituitary desensitisation prior to controlled ovarian stimulation in IVF cycles.

Colonoscopy: Early Experience in National Hospital Abuja Nigeria

Colonoscopy has become one of the most important modalities in the assessment of the lower gastrointestinal lesions. This study focused on our early experience with colonoscopy documenting the indications and outcome in the first five years of Colonoscopy in National Hospital, Abuja, Nigeria. This was a retrospective analysis of demographic data, indications for colonoscopy, agents used for bowel preparation, type of anaesthesia used, endoscopic findings, and extent of colon intubation from the endoscopy unit register of National Hospital, Abuja between July 2007 and June 2012. Patients whose data were incomplete or procedure abounded were excluded. Two hundred and eleven patients had colonoscopy during the 5 year period. Only 153 patients fulfilled the inclusion criteria and their data analysed. Males were 107 (69.9%) and 46 (30.1%) were females given a male/female ratio of 2.3:1 Age range was 2years to 90years with a Mean of 48.02. The commonest indications were bleeding per rectum (33.3%), haemorrhoids (24.8%) and suspicion of malignancy of the lower gastrointestinal tracts (24.3%). The most common findings on colonoscopy in our study were haemorrhoids (47.7%) and malignancies (24.2%) of various parts of the large bowel. 12.4% of the patients had normal study. Our Ceacal intubation rate was 75.8%. Majority of the lesions were found in the Anorectal region (69.9%) with only 17.7% in the rest of the Colon 24.2% of our findings were malignancies of lower intestinal tract. 97.3% of the malignancies were Adenocarcinoma. 83.8% of the malignancies were located in the left colon. Assessment of lower gastrointestinal symptom is incomplete without colonoscopy. Colonoscopy gives a good yield in well selected patients, it is safe and has low complication rate.

Determination of Appropriate Deferral Time for Repeat Apharesis Platelets Concentrate Donation in Abuja, Nigeria

Background: Plateletpheresis is the process by which a therapeutic adult dose of platelet concentrate is produced from a single donor using automated cell separator equipment. Recently, the demand for Apheresis Platelets concentrate transfusions has been increasing in our hospitals. This has been attributed to increased cases of malignancy associated bone marrow suppression and various other causes of thrombocytopaenia and thrombopathies. The Increasing use of myeloablative chemotherapy in treatment of haematological and other malignancies also results in transient severe fall in platelet count. The demand generally outstrips the supply necessitating the need to search for additional donor sources to increase the supply of platelets for transfusion. Is it therefore possible to reduce the time interval between plateletpheresis while maintaining donor safety? Aims and Objectives: The aim of the study was to determine the platelets recovery time after platelets concentrate donation with a view to determining the appropriate deferral time for repeat plateletpheresis Methods: The study was conducted at the National Hospital Abuja. Fifty seven healthy plateletpheresis donors were recruited over a period of seven months and their haematological parameters were analyzed on days 0, 2 and 7 post donation. We excluded donors whose pre-donation platelet count were less than 200 x 109/L Results and Analysis: Analysis was done in only forty eight (48) donors as nine (9) participants withdrew before the end of the study. The results show There was a significant decrease in the platelets counts (p &lt;0.001), with subsequent good platelets recovery post donation (Pre: 259.83±44.61 x 109/L; Post - Day 0: 205.29±36.77 x 109/L, day 2: 216.88±32.71 x 109/L and day 7: 240.3±41.83 x 109/L). The apheresis donors recovered 64.29% of the lost platelets by day 2 of donation and subsequently attain 92.49% of pre-donation count within 7 days of donation. There was a statistically significant transient increase in the immediate post donation haemoglobin concentration (14.72±1.32)g/dL but this gradually reduced on day 2 (13.75±1.04)g/dL and 13.83±1.04g/dL on day 7 showing no significant different from the pre-donation Hb of 13.96±1.02g/dL Conclusion: This study has shown statistically significant platelets recovery 7 days after plateletpheresis making a 7 day deferral for repeat plateletpheresis feasible in our environment. The study also shows feasibility of a 2 days deferral as recommended by AABB. Strict monitoring and pre-donation evaluation of donors should be done to prevent any adverse events such as anaemia and thrombocytopenia. Disclosures No relevant conflicts of interest to declare.

Access to care and financial burden for patients with breast cancer in Ghana, Kenya, and Nigeria.

6562 Background: Breast cancer is the most frequently diagnosed malignancy and the most common cause of cancer-related death in women in Ghana, Kenya, and Nigeria. We evaluated healthcare resource use and financial burden for patients treated at tertiary cancer centers in these countries. Methods: Records of breast cancer patients treated at the following government/private tertiary centers were included – Ghana: Korle-Bu Teaching Hospital and Sweden Ghana Medical Centre; Kenya: Kenyatta National Hospital and Aga Khan University Hospital; Nigeria: National Hospital Abuja and Lakeshore Cancer Center. Patients presenting within a prespecified 2-year period were followed until death or loss to follow-up. Results: The study included 299 patient records from Ghana, 314 from Kenya, and 249 from Nigeria. The use of common screening modalities (eg, mammogram, breast ultrasound) was &lt; 45% in all 3 countries. Use of core needle biopsy was 76% in Kenya and Nigeria, but only 50% in Ghana. Across the 3 countries, 91-98% of patients completed blood count/chemistry, whereas only 78-88% completed tests for hormone receptor and human epidermal growth factor receptor 2 (HER2). Most patients underwent surgery: mastectomy (64-67%) or breast-conserving Most patients in Ghana and Nigeria (87-93%) paid for their diagnostic tests entirely out of pocket (OOP) compared with 30-32% in Kenya. Similar to diagnostic testing, the proportion of patients paying OOP only for treatments was high: 72-89% in Nigeria, 45-79% in Ghana, and 8-20% in Kenya. Among those receiving HER2-targeted therapy, average number of cycles was 5 for patients paying OOP only vs 14 for patients with some level of insurance coverage. Conclusions: Patients treated in tertiary facilities in sub-Saharan African countries lack access to common imaging modalities and systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their breast cancer care, suggestive of privileged financial status. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population.

When walking is bad for your back: a cohort study of risk factors for traumatic spinal injury in Abuja.

IntroductionThis study evaluates characteristics and risk factors of traumatic spinal injuries (TSIs) treated at a trauma center in Abuja, Nigeria. TSIs are a global concern. They are frequently disabling, leading to economic, workforce, and quality of life strain. Little is known of the epidemiology of TSIs in Nigeria.MethodsData were collected from National Hospital Abuja's trauma registry on 3025 patients treated at the hospital between 2014 and 2017. Patient characteristics were compared between spinal and nonspinal injury groups. Multiple logistic regression was used to identify risk factors of TSIs.Results15% (452) of all injuries were spinal. Road traffic crashes were a significantly greater cause of spinal (77.4%) than nonspinal (59.4%) injuries (p<0.0001). Pedestrians were involved in 19% (356) of total crashes, occupying a significantly larger proportion of spinal (18.6%) than nonspinal (10.6%) injuries (p<0.0001). Three variables were modeled as risk factors of crash-related TSIs: mode of transportation, age, and gender. Only mode of transportation demonstrated statistical significance, with involvement as a pedestrian showing an adjusted odds ratio of 1.38 (95% confidence interval: 1.03-1.85, p=0.0329).ConclusionDetermining characteristics and risk factors of TSIs is an essential step in addressing this health concern in Nigeria. Crashes are a significant cause of TSIs, and a quarter of TSI patients involved in a crash are pedestrians. Involvement in a crash as a pedestrian is associated with high risk of TSI. These results can help guide both the development of spinal injury prevention policies and the allocation of resources.

Patient Navigation: Breaking the Barriers of Care While Empowering Patients to Fight Cancer

Purpose Through the Union for International Cancer Control and Pfizer Oncology SPARC MBC grant, Project PINK BLUE–Health &amp; Psychological Trust Centre implemented the Breast Cancer Navigation and Palliative Program with strategic activities focused on metastatic breast cancer with the goal of “empower[ing] women at risk of, or living with advanced breast cancer and to reduce [the] incidence of stage III or IV breast cancer.” The project established Nigeria's first patient navigation program, which trained 138 health workers and social workers across the six area councils of Abuja and connected 116 breast health facilities, 58 in Abuja and another 58 across Nigeria—diagnostic centers and hospitals—in a Web-based navigation map application. The program was designed to train only 18 patient navigators for Abuja only; however, we trained 44 patient navigators from National Hospital Abuja, Enugu, and Kebbi states who are currently working on establishing Breast Cancer Navigation and Palliative Programs in their respective states. Trained oncology nurse navigators are providing optimum palliative care and navigation to patients across the mapped health facilities in Abuja. Whereas 72 institutions have been engaged through diverse partnerships, 27 resources were produced, including videos, documents, and a palliative/navigation book for health care workers. Ten ECHO palliative care trainings were organized for nurses and pain doctors, with an additional eight in-person workshops on palliative care and patient navigation and five patient support group meetings. Seventy-two news articles were published, including for TV, radio, and in interviews. Methods The program used training of nurses, cancer survivors and nurses to become patient navigators at National Hospital Abuja and across the six area councils of Abuja. Currently, navigators in Niger State and Enugu state have also received training on patient navigation, and more patients with cancer have been tracked and observed during their cancer journeys in Nigeria. Results The program has transited to lead national advocacy at Nigeria’s parliament for the establishment of the National Institute on Cancer Research and Treatment and has also establish such initiatives as Abuja’s first cancer support group and patient-led advocacy and campaign. Several patients with metastatic breast cancer were navigated through their journey with cancer. Conclusion Patients with metastatic breast cancer need more support to live a quality life; more than just pain medication. They need someone to listen to them and caregivers who show their care and love. Patient navigation is an emerging area of oncology and there is a need to support the patient navigators so that they may devote more time to its effects. AUTHOR’S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Runcie C.W. Chidebe Travel, Accommodations, Expenses: Jansen and Jansen Consulting or Advisory Role: Novartis Pharmaceuticals

Patient Navigation: Breaking the Barriers of Care While Empowering Patients to Fight Cancer in Nigeria

Background and context: Through the UICC and Pfizer Oncology SPARC MBC grant, Project PINK BLUE - Health and Psychological Trust Centre implemented Breast Cancer Navigation and Palliative Program (BCNPP) with strategic activities focused on metastatic breast cancer with the goal “to empower women at risk of, or living with advanced breast cancer and to reduce incidence of stage III or IV breast cancer”. The project established Nigeria´s first patient navigation program which trained 138 health workers and social workers across the 6 area councils of Abuja and connected 116 breast health facilities, 58 in Abuja and another 58 across Nigeria (diagnostic centers and hospitals) in a Web-based navigation map application. The program was designed to train only 18 patient navigators for Abuja only, however, we trained 44 patient navigators from National Hospital Abuja, Enugu and Kebbi states whom are currently working on establishing BCNPP programs in their respective states. The trained oncology nurse navigators are providing optimum palliative care and navigation to patients across the mapped health facilities in Abuja. While 72 institutions have been engaged through diverse partnerships, 27 resources were produced including videos, documents, and palliative/navigation book for healthcare workers; 10 ECHO palliative care training were organized for nurses and pain doctors, with additional 8 face-to-face workshops on palliative care and patient navigation and 5 patient support group meetings. Seventy-two news articles were published including TV, radio, and interviews. Aim: To empower women at risk for, or living with advanced breast cancer and to reduce incidence of stage III or IV breast cancer. Strategy/Tactics: The program used training of nurses, cancer survivors and nurses to become patient navigators at National Hospital Abuja and across the 6 area councils of Abuja. Currently, Niger state and Enugu state have also been trained on patient navigation and more cancer patients have been tracked and followed up through their journey with cancer in Nigeria. Outcomes: The program has transited to lead national advocacy at Nigeria's Parliament for the establishment of National Institute on Cancer Research and Treatment and has also establish some initiatives, such as Abuja's first cancer support group and patient-led advocacy and campaign. Several metastatic breast cancer patients were navigated through their journey with cancer. What was learned: Metastatic breast cancer patient needed more support to live a quality life, they needed more than just pain drugs. They need listening ear and caregiver who would show their care and love. Patient navigation is an emerging area of oncology, hence, there is a need to support the patient navigators to devote more time for the impact.

Antibiogram of bacterial agents of lower respiratory tract infections in a central Nigerian hospital

BACKGROUND: Lower respiratory tract infections (LRTIs) are one of the major public health concerns in Nigeria. They are associated with significant morbidity and mortality in children and adults.AIM: To identify bacterial causative agents of lower respiratory tract infections and to determine their antibiotic susceptibility profile to locally available antibiotics.METHODS: This was a retrospective study conducted at National Hospital Abuja (NHA). Laboratory data of processed sputum samples of patients with suspected lower respiratory tract infection at National Hospital Abuja were extracted, reviewed and analyzed from 1st January 2016- 1st December 2016. RESULT: Out of the six hundred and thirteen cases, 89 (14.5%) had an established bacterial cause. The prevalence of LRTIs was higher in males (56.1%) than females. Age group 21-40 (25.8%) had the highest cases of LRTIs followed by those aged 41- 60 (20.2%). Klebsiellapneumoniae (52.8%) was the most predominant isolates, followed by Pseudomonas aeruginosa (15.7%), Staphylococcus aureus (13.5%), Escherichia coli (7.9%), Enterococcus spp (5.6%) and Proteus spp (4.5%). The predominant bacterial pathogens were generally highly susceptible to fluoroquinolones, aminoglycosides and carbapenems.CONCLUSION: Klebsiellapneumoniae was the most common bacterial causative agent of LRTIs in Abuja. Fluroquinolones, aminoglycosides and carbapenemsare antibiotics of good choice for empiric management of this infection in this locality. Regular monitoring of trends of this aetiologic agent and its antimicrobial susceptibility profile is important in effective management of these infections.KEY WORDS: Antibiogram, Bacterial Isolates, LRTIs, National Hospital Abuja, Nigeria

A 10-year review of thyroid lesions in a tertiary hospital in Abuja, Nigeria

Introduction: Thyroid lesions are reputed to be the second most common of all endocrine lesions (next to diabetes mellitus) and thyroid cancer is reported to be the 16th commonest cancer globally. This study reviewed the spectrum and scope of thyroid lesions encountered in a tertiary hospital in Nigeria over a decade. Setting: National Hospital Abuja (NHA) is a 450-bed tertiary public hospital located in the cosmopolitan city of Abuja the capital of Nigeria. Materials and Methods: This is a retrospective analytic study involving the entire thyroid specimen received in the department of histopathology from 1st January 2007 to 31st December 2016. Results: Our study demonstrated that thyroid pathologies are commoner in females than males with a ratio of 6:1. Papillary thyroid carcinoma and follicular adenoma are the commonest malignant and benign tumours respectively. Conclusion: Thyroid diseases are common cause of morbidity in our environment. The commonest malignant thyroid disease in NHA is the papillary carcinoma.

Methicillin-Resistant Staphylococcus aureus in a Central Nigeria Tertiary Hospital

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.

Providing molecular diagnosis and monitoring of patients with chronic myeloid leukemia in Abuja, Nigeria

The process of managing chronic myeloid leukemia (CML) at the National Hospital Abuja was frustrating to both the clinicians and patients because the hospital did not have facilities for molecular diagnosis, which is a prerequisite to access imatinib mesylate through the Glivec International Patient

Use of Insecticide-treated Net and Malaria Parasitemia in Under-fives at National Hospital Abuja

Use of Insecticide-treated Net and Malaria Parasitemia in Under-fives at National Hospital Abuja

Histopathological analysis and clinical correlations of ovarian lesions in a tertiary hospital in Nigeria: A 10-year review

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.