Peak Age Incidence Research Articles

Etiological Profile and Management of Epistaxis in Tertiary Care Hospital

Introduction: Epistaxis is a common otolaryngological emergency condition. It occurs due to local and systemic cause. Local cause lies within the nose bleeding either anterior or posterior. Commonest site of bleeding anterior epistaxis is kiesselbach’s plexus. In posterior epistaxis, it is difficult to locate bleeding site. Epistaxis is controlled by simply pinching of nose, decongested nasal drop and abgel packing. Some cases become more challenging required nasal packing and arterial ligation.
 Objectives: To study the epidemiological pattern and management of epistaxis.
 Methods: This was a retrospective study on pattern of epistaxis man­aged at Gandaki Medical College Teaching Hospital over a period from April 2015 to April 2016. Information regarding demographic profile, presentation and management of epistaxis was obtained from the Hospital records, ENT Outpatient clinic, Emergency Department, ENT ward and operation theatre.
 Results: A total of 78 cases were managed during study period. There was a significant male preponderance with male to female ratio 1.78:1. Patients’ age varied from eight to 80 years with mean age 40.7 years. The peak age of incidence was 21 - 30 years group. Idiopathic nasal bleeding 27 (34.6%) was commonest followed by nasal trauma 23 (29.5%) cases and hypertension 16 (20.5%) cases. Seventeen (21.8%) cases managed in day care basis with decongested nasal drop, chemi­cal cautery and abgel packing. Remaining cases required nasal packing and bipolar cautery and other specific form of treatment. Five (6.4%) cases required sphenopalatine artery ligation with no recurrence of bleeding.
 Conclusions: Epistaxis is common ENT emergency. Most common causes are idiopathic followed by nasal trauma and hypertension. Prompt management is instituted according to cases. Most of the cas­es are managed by non-surgical method.

Global incidence and profile of ameloblastoma: A systematic review and meta-analysis.

To evaluate the global incidence of ameloblastoma and to provide a profile of ameloblastoma patients. A systematic review and meta-analysis was conducted. Searches were performed in PubMed, EMBASE, SCOPUS, and Web of Science for articles published from 1969 to 2018 for the global incidence and from 1995 to 2018 for the profile of ameloblastoma patients. Seven studies on the incidence rate of ameloblastoma were included in the meta-analysis. These studies only covered Europe, Africa, and Australia. The pooled incidence rate was 0.92 per million person-years (95% CI: 0.57-1.49), with significant heterogeneity between studies. Forty-two articles provided profile data of 6,446 ameloblastoma patients. Mean age was 34years and the peak age incidence in the third decade of life. In Europe and North America, ameloblastoma mostly occurred at an older age when compared to Africa and South America. A slight male preference (53%) was found, and the mandible appeared to be the preferred site. The most common type of ameloblastoma was multicystic. The histopathologic patterns were mostly follicular and plexiform. This is the first study assessing the global incidence of ameloblastoma. The pooled incidence rate was determined to be 0.92 per million person-years.

Hepatocellular Carcinoma in Benin City, Nigeria: A Twenty-Five (1987-2011) Year Retrospective Histopathological Study

Aim: To evaluate the demographic characteristics and histological variants of hepatocellular carcinoma (HCC) in Benin City. Methodology: The surgical daybooks of the Department of Anatomic Pathology, University of Benin Teaching Hospital were used for data collection. All the liver biopsies received in the period (1987-2011) under review diagnosed with HCC were analysed using SPSS version 16.0. Results: The male to female ratio was 2:1 and the peak age of incidence was in the 50 - 60 years age group. The mean ages were 44.24 ± 18.52 and 48.75 ± 12.92 and the age ranges were 1.5 to 82 years and 20 to 68 years for males and females respectively. The modal age was 60 years. Histological variants of hepatocellular carcinoma were the pseudoglandular/acinar pattern which accounted for 26 cases (44.07%), followed by the trabeculae pattern 17 cases (28.81%), the compact/solid variant 10 cases (16.95%) and the fibrolamellar pattern which was 6 cases (10.17%). Conclusion: Hepatocellular carcinoma has divergent demographic and histological characteristics which have clinical implications on the treatment outcomes; hence pathologists are encouraged to include the subtype in their reports for prognostication.

Sudden Natural Death in Owerri Imo State, a 10 Years (2003-2012) Retrospective Postmortem Study

Abstract: Sudden unexpected natural death (SUND) was uncommon in our environment; with the adoption of western life style and societal pressures this mode of death is becoming more common. Understanding the causes of sudden natural death is important for prevention and improving treatment outcomes. Aim: The aim of this study was to describe the demographic data, the immediate cause of death and associated risk factors in the sudden unexpected natural death (SUND) cases in Imo state. Methodology: The archived case notes, Post-mortem registers and reports in the data bases of Departments of Pathology and Medical records and Biostastics of Federal Medical Centre (FMC) Owerri were used as the sources of data for this study from January 2003 to December 2012. Full post-mortem examinations were performed by consultant pathologists in the department using laid down protocols. Results: The male to female ratio was 3.3:1 with mean age of 45.2 ± 17.0. The age range was 15 to 80 years. The peak age of incidence was in the 41-50 years age group. The leading causes of SUND were the cardiovascular system (CVS) 55.4%, followed by central nervous system (CNS) which made up 23.1%, gastrointestinal system (GIT) constituted 8.5%, the Respiratory system (4.2%), Vascular disorder (4.2%) and undetermined causes (6.4%). The associated risk factors included dietary factors 14 cases (29.8%), alcohol use 9 cases (19.15%), cigarette smoking (17.02%), Diabetes mellitus 6 cases (12.76%), family history 5 cases (10.64%), those without associated factors 3 cases (6.38%) and congenital anomalies 2 cases (4.25%). Conclusion: In Nigeria, with increased western lifestyle, changes in dietary habits and rise in socioeconomic status, cardiovascular diseases especially complications of hypertension has become the most important cause of sudden unexpected natural death in our society. This calls for immediate and effective management of hypertension through effective clinical and public health policy implementation.

Sildenafil is Safe and Effective for the Treatment of Lower Ureteric Stone with no Major Side Effect

INTRODUCTION: Urolithiasis is one of the most common diseases of the urinary tract. Prevalence of urinary stones in a life time is approximately 1% to 15%.Peak age of incidence is 30 years. Male are more commonly affected than female about 2 to 3 times. At the time of presentation 20 % of the calculi are found in the ureter, among which 70% are located in the distal third of the ureter.
 OBJECTIVE: To study the effect of sildenafil citrate on passage of stone from distal ureter.
 METHODOLOGY: This is the Quasi experimental study performed in College Of Medical Sciences, Chitwan, Nepal, from February 2017 to February 2018 for a period of one year. First 100 patients of urolithiasis were selected and divided into two groups with the help of lotiery method Group A and Group B. In group A we had patient on placebo and in group B we had patient receiving sildenafil 50 mg once daily and for the period of two weeks.
 RESULTS: The mean ± standard deviation of stone size was 7.01±1.70mm for treatment group and 6.85±1.56mm for placebo group (p> 0.64) .The stone expulsion rate was 74.5% for treatment group and 41.7% for placebo group (P<0.001). Mean ± standard deviation of expulsion time was 7.6 ±3.49 days for treatment group and 10.25±3.12 days for placebo group (P<0.008). Mean ± standard deviation of VAS was 3.49±1.300for treatment group and 6.77±1.308 for placebo group (P<0.0001).
 CONCLUSION: Medical Expulsive Therapy (MET) for lower ureterolithiasis with sildenafil during conservative treatment period is safe and effective as demonstrated by the absence of serious side effects and increased stone expulsion rate with early time.

Epidemiology of open fractures in a nigerian teaching hospital

Background: The management of open fractures has been of great challenge to surgeons over the years, and these fractures are often associated with considerable patient morbidity and high socioeconomic consequences. Epidemiological studies are of great importance in the management of these conditions as the information obtained will be used to define priorities and enhance the understanding of this challenging subgroup of traumas. Objective: The aim of this study was to define the epidemiological profile of patients who were managed for open fractures of the long bones at a teaching hospital in South East Nigeria. Materials and Methods: This was a retrospective and descriptive epidemiological study involving open fractures of the long bones managed at a teaching hospital in the southeastern part of Nigeria over a period of 3 years, from January 2014 to December 2016. Data which were collected from patients' case notes were subjected to descriptive analysis, and the results were presented with simple frequency tables, percentages and charts. Results: Seventy patients with 73 fractures were treated for open fractures within the period of the study. The male to female ratio was 4.3:1, and the peak age incidence was 20–29 years (30%). The most common cause of the injury was motor vehicle accidents (82.9%), of which 64.3% of cases were as a result of motorbike accidents. The leg bones were the most affected site (63%) while the Gustilo type III fractures were the most common injuries (67.1%). The average time interval from injury to presentation was 10 h. Wound infections were the most frequent complications observed, followed by delayed union. Conclusion: Open fractures are challenging conditions which affect mainly the young and active males in our society. The victims often present late which affects the management outcome. The burden of open fractures can be minimised in our society by efforts aimed at reducing the menace of motorbike operators, the latter being the most common cause of the injury.

Cyclooxygenase-2 Expression and Its Correlation with Primary Tumor Size and Lymph Node Involvement in Nasopharyngeal Carcinoma.

AIM:This study aimed to observe the cyclooxygenase-2 expression and its correlation with tumour size and lymph node involvement in nasopharyngeal carcinoma.METHODS:This study was cross-sectional, that enrolled 126 samples diagnosed with nasopharyngeal carcinoma in Haji Adam Malik General Hospital, Medan, Indonesia which fulfilled the inclusion criteria.RESULTS:Based on this study, we found that the age peak incidence of nasopharyngeal carcinoma patients about a 41-60-year-old group (57.1%), dominated by men (71.4%). Through histopathological examination, non-keratinizing squamous cell carcinoma is the most predominant type (79.4%). We also found T3 is the most prevalent primary tumour size (32.5%) with prominent lymph node involvement N3 (45.2%), and stage IV (54.8%). Cyclooxygenase-2 overexpression is prevalent among nonkeratinizing squamous cell carcinoma (81.1%), T3 primary tumour size (41.1%), N3 node involvement (60.0%), and IV clinical stage (71.6%). In addition, we found a significant relationship between cyclooxygenase-2 expressions towards tumor size (p < 0.001) and lymph node involvement (p < 0.001) in nasopharyngeal carcinoma.CONCLUSION:It is proved that the overexpression of cyclooxygenase-2 will increase the susceptibility of nasopharyngeal carcinoma patients having advanced primary tumour size and lymph node involvement.

Vardenafil versus Tamsulosin as a Medical Expulsive Therapy for Distal Ureteral Stones

Background:urolithiasis is one of the most common diseases of the urinary tract. The lifetime prevalence of urinary stones is around 1% to 15% and the peak age of incidence is at 30 years. Men are affected 2 to 3 times more often than women. Ureteral stones account for 20% of the calculi in urolithiasis and about 70% of ureteral stones are present in the distal third of the ureter at the time of presentation. Aim of the work: this study aimed to compare the efficacy and safety of vardenafil (5mg twice daily) vs tamsulosin (0.4mg once daily) as a medical expulsive therapy in the management of distal ureteric stones (DUS) in terms of stone expulsion rate, stone expulsion time, number of pain episodes, analgesic use and side effects related to medical therapy. Patients and Methods: this was a prospective randomized comparative study conducted on 50 patients admitted through the outpatient Urology Clinic in Ain shams University Hospitals and Nasser Institute Hospital between February 2018 and August 2018. The patients were randomized using a closed envelope method. The patients were categorized into 2 main groups 25 patients each. Results: this study showed non significant stone expulsion rates and faster expulsion times in favor of vardenafil when compared to tamsulosin. Conclusion: both of the medications demonstrated a good safety and tolerability profile for medical expulsive therapy in patients with lower ureteric stones.

Trend in relative survival in squamous cervical cancer by decade from 1983 to 2012: a period analysis.

ObjectiveSquamous cervical cancer (SCC), the predominant histological type, represents approximately 75–80% of all cervical cancers. Although the overall incidence of cervical cancer has declined worldwide, the data describing the changes in the incidence and long-term survival in SCC remain limited.MethodsThe data were extracted from Surveillance, Epidemiology, and End Results (SEER) registries for an evaluation of the changes in the incidence and survival associated with SCC during 1983–2012. In addition, the patients with SCC were stratified by age, race, and socioeconomic status (SES). Stata 12.0 software was used to perform the Cox regression and Spearman’s rank correlation analyses.ResultsThe overall incidence of SCC constantly declined from 7.3 to 5.6 to 4.3 per 100,000 people; the peak age of incidence was 55–69 years in the first decade, while the 40–54 age group served as another incidence peak in the last 2 decades. Median survival increased from 189 months to 231 months in the first 2 decades and was not reached in the third decade. The 10-year relative survival rates (RSRs) changed from 63.2% to 66.5% to 62.1% across the 3 decades. Additionally, the survival gaps narrowed from 13% to 8% between Whites and Blacks and from 5.4% to 3.5% between low- and medium-poverty groups in the 3 decades.ConclusionThis study demonstrated a declining incidence over the 3 decades with an improvement in median survival. However, the relative survival associated with SCC did not improve in the last decade. Furthermore, the survival gaps between races and various SESs significantly narrowed over the 3 decades.

Continuing barriers to care of Wilms tumor in a low-income country.

This study evaluates the outcome of Wilms tumor (WT) following introduction of multidisciplinary team management and patient treatment stratification by tumor histology in two referral centers in southeastern Nigeria. We analyzed histologically confirmed WT cases managed from January 2008 to June 2017. There were 45 patients, peak age incidence of 2 to 5years who presented after mean symptom duration of 4.9 months (range, 1-12 months), with mean tumor weight of 1040g (range, 350-4200g). Overall, 14 (31.1%) had unfavorable histology of WT. A total of 22 (48.9%) patients received preoperative chemotherapy, 43 (95.6%) received postoperative chemotherapy based on stage of disease and histopathology, but none received adequate radiotherapy. Of these, 19 (44.2%) patients complied with chemotherapy regimen, 15 (33.3%) were lost to follow-up and 12 (26.7%) cases relapsed. With 30 cases available for evaluation and mean follow-up duration of 23months (range, 6-80 months), the overall 5-year survival is 53.3% (16 cases). Survival in children who complied with postoperative chemotherapy was 73.7%, and abandonment-sensitive survival was 35.6%. Persisting challenges were late presentation, poor compliance to treatment, and lack of radiotherapy treatment. Multidisciplinary team management and chemotherapy based on tumor histology might have resulted in slight improvement of outcome since our last report. However, to ensure survival that may approach global benchmarks, there is need for public health measures to improve time to diagnosis, and improvement of facilities and healthcare funding to ensure compliance to all phases of standard therapy.

A three year experience in Laparoscopic Appendectomy

Background: Acute appendicitis is one of the most common causes of acute abdomen. It may occur from the time of infancy to old age, but the peak age of incidence is in the second and third decades of life. The lifetime risk of appendicitis is approximately 7-8%. Today in developed countries, about 8% of the population is treated for acute appendicitis in the course of their lifetime. The outcome can be very serious at both extremes of life and there is a life time risk of developing acute appendicitis in about 5-8%. The aim of this study was to evaluate the clinical results of laparoscopic appendectomy (LA) for the treatment of acute appendicitis. Material and Methods: A retrospectiveanalysis fallpatients who underwent laparoscopic appendectomy diagnosed with acute appendicitis overa3-yearperiodwasreviewed. Data were retrieved from our departmental data base and analyzed using descriptive statistics. Most of the patients were diagnosed to have appendicitis by ultrasound or have ruled out other cause of right lower abdominal pain especially in females. Results: Out of the 226 patients who underwent laparoscopic appendectomy, 138(61.1%) were females and the remaining 88(38.9%) were males. Most of them are in the age group of 21-40years. 171 (75.7%) patients were discharged within 48 hours. Conclusion: Laparoscopic appendectomy is as safe and effective as conventional surgery, has a higher diagnostic yield, causes less trauma, and offers a more rapid postoperative recovery. Such features make laparoscopy a challenging alternative to laparotomy in premenopausal women referred for urgent abdominal or pelvic surgery, or both.

The association of urinary tract infection with urothelial carcinoma

Background: In Iraq bladder carcinoma is a major problem according to the results of the Iraqi cancer registry between the years (1991-2006). Cancer of the urinary bladder was the 2nd on the table of the commonest ten cancers in male and it was the 8th commonest cancer in females (1). According to the same registry the main histological types were: Transitional cell carcinoma: 43.82%. Sequamous cell carcinoma: 4.49%. Undifferentiated cell carcinoma: 0.31 %. Adenocarcinoma: 0.92%. Male to female ratio was 3.39:1 the peak age incidence was found in the 70+ years (1). Bilharzial ovals were found in about 7%-29% of bladder cancers, which is lower than that in Egypt; 82-90% (2). On the other hand urinary tract infections are among the most common bacterial infections that lead patients to seek medical care. It had been estimated that more than 6 million outpatient visits and 300,000 hospital stays every year are due to urinary tract infections (3). The aim of this study is to find the association or disassociation between bacterial infection of the urothelium and urothelial carcinoma and if it was associated which type is it: causative or associative. Material and Method: This study was carried out on 105 patients with carcinoma of the bladder (transitional, sequamous), whom were referred to the surgical specialties hospital, medical city for diagnostic transurethral endoscopy during the period between 5th of October 2007 till the 1st of September 2008. History of smoking, previous recurrent urinary tract infection and stone was taken, identification of the causative bacteria for their urinary tract infection was done from three samples collected; two urine samples (on admission and post-operatively) and one tissue sample (tumor biopsy). Results: The results showed that: 85.65% of the patients had infections associated with their tumors, the rest 14.35% were negative. These infections were either Escherichia coli, Klebsiella, Proteus, Staphylococcus, Enterobacter, Citrobacter or Morganella spp. Escherichia coli was the most common 73.3% of all the cases. The results also showed that there was a significant association between positive urine culture on diagnosis for bacterial growth and urothelial carcinoma, also Escherichia coli was collected from the intracellular compartment by a mechanical approach. Conclusion: Associations between urothelial carcinomas and bacterial growths were studied and showed that urothelial carcinomas were highly associated with bacterial growth especially Escherichia coli. Although Klebsiella, Proteus, Staphylococcus, Enterobacter, Citrobacter or Morganella spp., occured in a lower incidence, still had a role in urinary tract infection. Finding Escherichia coli intracellular and its high association with urothelial carcinoma could put these bacteria in the causative section of urothelial carcinoma through producing a recurrent acute infection.

Fractures of the femoral shaft in children: national epidemiology and treatment trends in England following activation of major trauma networks.

The aim of this study was to describe the epidemiology of closed isolated fractures of the femoral shaft in children, and to compare the treatment and length of stay (LOS) between major trauma centres (MTCs) and trauma units (TUs) in England. National data were obtained from the Trauma and Audit Research Network for all isolated, closed fractures of the femoral shaft in children from birth to 15 years of age, between 2012 and 2015. Age, gender, the season in which the fracture occurred, non-accidental injury, the mechanism of injury, hospital trauma status, LOS and type of treatment were recorded. A total of 1852 fractures were identified. The mean annual incidence was 5.82 per 100 000 children (95% confidence interval (CI) 5.20 to 6.44). The age of peak incidence was two years for both boys and girls; this decreased with increasing age. Children aged four to six years treated in MTCs were more likely to be managed with open reduction and internal fixation compared with those treated in TUs (odds ratio 3.20; 95% CI 1.12 to 9.14; p = 0.03). The median LOS was significantly less in MTCs than in TUs for children aged between 18 months and three years treated in both a spica (p = 0.005) and traction (p = 0.0004). This study highlights the current national trends in the management of closed isolated fractures of the femoral shaft in children following activation of major trauma networks in 2012. Future studies focusing on the reasons for the differences which have been identified may help to achieve more consistency in the management of these injuries across the trauma networks. Cite this article: Bone Joint J 2018;100-B:109-18.

Demographics and outcome of diffuse large B-cell lymphoma patients in Hiwa Hospital - Iraq-Kurdistan-Sulaimani

Background: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous form of hematological malignancy which comprises about 30% of lymphomas with variable outcome. Onset is usually in the sixth decade of life with male predominance. Morphological, clinical, and biological variation of DLBCL confirms the coexistence of several subtypes of the disease with distinct behavior of each type. Objective: The aims of this study were to determine the demographics and outcome of patients with DLBCL and compare these parameters with regional and international data. Patients and Methods: A retrospective study was conducted on 61 patients with confirmed diagnosis of DLBCL. The diagnosis was based on histopathological and immunohistochemistry which was done in the Department of Pathology, Shorsh General Hospital in Sulaimani. The cases were randomly selected according to the availability of data since March 2013–March 2017. Results: Median age at diagnosis was about 51 years with peak age of incidence between 50 and 64 years, with female predominance. The most common site of the primary tumor was nodal in which cervical lymph node is the most common site, and majority of the patients were in Stage III with predominance of B-symptoms. Vast majority of the patients have normal chest X-ray, and majority of the patients were in remission over a period of 19 months of follow-up. Conclusion: We found that there is a significant relationship between age, stage, and performance of the patients, while no significant relation between other parameters and the outcome of the patients is near to their Peers internationally.

Sonographic assessment of urolithiasis in University of Abuja Teaching Hospital, Nigeria.

Background:Urolithiasis may result in many complications including renal failure. There is a paucity of documented scientific study on the prevalence of urolithiasis in the University of Abuja Teaching Hospital within the Federal Capital Territory, Nigeria. The aim of the study was to assess the prevalence of urolithiasis in patients undergoing ultrasound at University of Abuja Teaching Hospital.Materials and Methods:This study which adopted a survey approach was conducted at the Department of Radiology, University of Abuja Teaching Hospital between June 2014 and May 2015. A total of 2310 patients that underwent abdominopelvic ultrasound in the department who aged between 2 and 64 years and met the inclusion criteria participated in the study. They were recruited using a convenience (nonprobability) sampling technique. Data obtained were subjected to descriptive statistics and analyzed using Student's t-test. P < 0.05 was considered statistically significant.Results:A total of 2310 patients were scanned, 31 patients were sonographically identified with urolithiasis. The prevalence of urolithiasis was 13.4/1000. The mean age was 31.12 ± 3.69 years. There were 58.06% males and 41.93% females giving a male-to-female ratio of 1.3:1. The peak age of incidence was 21–50 years. Majority (22 [71%]) were located in the upper urinary tract, whereas 9 (27%) were in the lower urinary tract. The most common presenting symptoms were flank/loin pains (renal colic) noted in 12 (40%) patients, followed by hematuria in 4 (13.3%) patients.Conclusion:The prevalence of urolithiasis was 13.4/1000. This information can be utilized in formulating future health plans for prevention of urolithiasis in the hospitals within this locality.

Trend of cancer incidence in an oncology center in Nigeria

Background: Globally, 32.5 million people diagnosed with cancer within the 5 years previously were alive at the end of 2012. 8.2 million deaths and 14.1 million new cases are recorded annually, but 70% will be in developing countries. Lung, breast, and colorectal cancers are commonly diagnosed. Aim and Objectives: The aim and objectives of this study is to review the trend of cancer incidence in Lagos University Teaching Hospital (LUTH) from January 2004 to December 2013.Materials and Methods: This is a retrospective study of histologically confirmed malignancies seen at Radiotherapy Department, LUTH from January 2004 to December 2013. Case files were retrieved through the record department, and the information required was extracted with the aid of a data extraction form. Results: A total of 3,314 new cases of cancer were recorded in LUTH during the study period. The mean age of cancer presentation is 48.52 (±16.44). The median age is 49.00 years with an age range of 1–100 years. The peak age incidence for males was 50–54 years accounting for 10% of all male presentation while females had a peak age incidence of 40–44 years accounting for 14% of female cases. The male-to-female ratio was 1:3. Breast (38.1%), cervical (17.0%), and colorectal cancers (3.3%) are the common ones recorded. In males, the most common cancer was prostate cancer (12.8%) followed by colorectal cancer (4.5%). Conclusion: In general, cancer incidence in Nigeria appears low compared to developed countries which may not truly reflect the burden of the disease. This could be due to poor population-based statistics and poor health patronage of orthodox medical care.

Histopathological pattern of thyroid diseases in Zaria: A 10-year review.

Majority of the previous studies on thyroid diseases in Northern Nigeria focussed mainly on neoplastic lesions. The non-neoplastic lesions are more common and constitute more public health burdens. To determine the histopathological pattern of thyroid diseases in our region and compare our findings with similar studies in Nigeria and elsewhere. This is a retrospective study carried out at the Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, from January 2005 to December 2014 using specified criteria. All cases of thyroid diseases diagnosed histologically within the study period had their histology reports as well as their haematoxylin and eosin-stained slides reviewed and analysed. Statistical package for the social sciences (SPSS) software for windows version 20.0 (IBM SPSS Inc. Chicago, IL) was used. There were 302 thyroid diseases diagnosed during the study period. Only 297 cases fulfilled the study inclusion criteria. There were 255 females and 42 males with a male-to-female ratio 1:6. Ages ranged from 4 months to 80 years, with peak age incidence between 31 and 50 years. Thyroglossal cysts accounted for 17 (5.7%) cases. Non-neoplastic diseases composed of colloid goitre, Graves' disease, Hashimoto thyroiditis and lymphocytic thyroiditis. They accounted for 214 (72.1%), 12 (4.0%), 3 (1.0%) and 1 (0.3%) cases, respectively. The neoplastic diseases comprised 36 (12.1%) adenoma cases and 14 (4.7%) carcinomas, with papillary carcinoma being the most common (71.4%) thyroid cancer. This study showed that thyroid diseases in Zaria had a female predominance with a peak age frequency between 30 and 50 years of age. The most common diseases were colloid goitre, follicular adenoma and papillary carcinoma. These findings are comparable with several studies on thyroid diseases in Nigeria and globally.

Study on the prevalence and incidence of urolithiasis in Korea over the last 10 years: An analysis of National Health Insurance Data.

PurposeWe aimed to analyze the incidence and prevalence of urolithiasis in Korea over the last decade using the National Health Insurance (NHI) sample cohort data.Materials and MethodsFrom January 2002 to December 2013, we enrolled sample cohort data from the NHI. Patients diagnosed with international classification of diseases code N20 or N13.2 were included. The incidence and prevalence rate was counted from the same period and patients previously diagnosed with urolithiasis were excluded. We compared the incidence and prevalence of urolithiasis by region, age, and sex, and identified the changes.ResultsTotal 1,111,828 subjects were included. Of these subjects, 36,857 had urolithiasis. The male-to-female ratio was 1.57:1, and total incidence rate was 3.27 per 1,000 person-years (1,000p-yrs). The annual incidence was lowest in 2013 (3,138 patients) and highest in 2005 (3,751 patients). Incidence rate by diagnostic code was highest in ureter stone only (2.49 per 1,000p-yrs) and was lowest in kidney and ureter stone both (0.17 per 1,000p-yrs). Prevalence gradually increased from 3,172 in 2002 and 5,758 in 2013. Jeollanam-do had the highest incidence rate of 3.70 persons per 1,000p-yrs, and Jeju had the lowest rate of 2.84 persons per 1,000p-yrs. In gender analysis, Daegu had the highest incidence (4.56) in males, Jeollanam-do had the highest incidence (3.20) in females.ConclusionsAnnual incidence remained stable, whereas prevalence gradually increased. The incidence in male was 1.57 times higher than female, and the peak incidence age was 45–49 years, with the highest incidence occurring in Jeollanam-do and the lowest in Jeju.

Nasopharyngeal carcinoma at the Ahmadu Bello University Teaching Hospital, Zaria: A 22-year histopathological review (1992–2013)

Background: Nasopharyngeal carcinoma (NPC) is uncommon cancer with unique geographical variations and strong association with Epstein–Barr Virus. The increasing incidence of NPC in Nigeria in recent years has reinforced the need for more studies to be done. This study aims to determine the frequency, age, and sex distribution as well as the histopathological patterns of NPC seen over a period of 22 years, from 1992 to 2013. Materials and Method: It was a retrospective study of all NPCs diagnosed in the Department of Pathology, Ahmadu Bello University Teaching Hospital from January 1st 1992 to December 31st, 2013. The request forms, histopathology reports, slides, and paraffin-embedded tissue blocks of all histologically diagnosed NPCs within the study period were retrieved and examined. The age, sex and site/nature of the biopsy were extracted. Histopathological diagnosis was in accordance to the 2005 World Health Organization classification. Results: NPC showed a frequency of 0.3% (112 cases) with a significant rise in incidence in the last decade. There was a male preponderance with M: F of 3.5:1. The age range was 6–91 years, mode 40 years, mean age 42.4 years, and peak age of incidence 40–49 years (18.8%). Histologically, nonkeratinizing carcinoma (NKC) was the most common (94.6%) followed by keratinizing squamous cell carcinoma (KSCC, 4.5%) and a single case of basaloid squamous cell carcinomas (bscc, 0.9%). Undifferentiated subtypes made up 79.4% of NKC, 12.7% differentiated and 7.9% mixed. In addition, 44.4% were of Regaud type growth pattern, 34.9% Schmincke type, and 20.6% were mixed. The nasopharynx was the most common site of surgical biopsy (57.1%) followed by the nasal cavity (17.9%) and cervical lymph node (11.6%). Conclusions: NPC showed a recent increase in frequency, a male preponderance and a unimodal age pattern that peaked in the 5th decade with an overall mean age of 42.4 years. NKC over KSCC and a solitary case of BSCC was seen. A significant number of biopsies were from sites outside the nasopharynx, suggestive of advanced disease with poor prognosis.

Mastoidectomy: retrospective analysis of 137 cases in a tertiary care hospital

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Mastoidectomy is a common otologic surgery and at times can be a lifesaving procedure. The aim of the study is to analyze surgical indications, operative parameters and per-operative findings encountered. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;This is a retrospective study done in patients who had undergone mastoid surgeries between 1&lt;sup&gt;st&lt;/sup&gt; Jan 2016 to 31&lt;sup&gt;st&lt;/sup&gt; Dec 2016 in the Department of Otorhinolaryngology, Govt. Medical College hospital, Trivandrum. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Of the 137 patients the peak age incidence was 16 – 30 years. Cholesteatoma was present in 32% of which 91% had canal wall down mastoidectomy. 64% patients, mostly chronic otitis media- mucosal and inactive squamosal, underwent canal wall up procedure. In 62% cases the ossicular chain was eroded, which was mainly incus (87%). Abnormalities encountered within the mastoid during surgery were mainly dehiscent facial canal (17.5%), low lying dura (16.8%) and contracted antrum (15.3%). A positive association could be noted between contracted antrum and the position of sinus and dural plates, and was statistically significant. Co-existence of facial canal dehiscence with lateral canal fistula and dural plate dehiscence were also noted. The tympanoplasty procedures commonly employed in canal wall up procedures was Type I and 2, and in canal wall down procedure was Type 3. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Adequate skill development of the ear surgeons in the tertiary centre should be ensured, to individualize the procedure appropriate for each patient and optimize the outcome of surgery. Early referral to the nearby otological centre should be promoted not only to prevent complications but also for better post-surgical functional outcome.&lt;/span&gt;&lt;/p&gt;