Effiong Akang

Publications

• 3.20

  Impact points

  Body fat distribution and breast cancer risk: findings from the Nigerian breast cancer study.

  Temidayo O Ogundiran, Dezheng Huo, Adeniyi Adenipekun, Oladapo Campbell, Rasaaq Oyesegun, Effiong Akang, Clement Adebamowo, Olufunmilayo I Olopade

  Cancer causes & control : CCC. 02/2012; 23(4):565-74.

  The relationship between overall obesity and breast cancer risk has been well recognized, but the role of central obesity in breast cancer development is uncertain. Between 1998 and 2009, 1,233 invasive breast cancer cases and 1,101 community controls were recruited into the Nigerian Breast Cancer S... [more] The relationship between overall obesity and breast cancer risk has been well recognized, but the role of central obesity in breast cancer development is uncertain. Between 1998 and 2009, 1,233 invasive breast cancer cases and 1,101 community controls were recruited into the Nigerian Breast Cancer Study at Ibadan, Nigeria. Logistic regressions were used to calculate multivariate odds ratio (OR) and 95% confidence intervals (CI), adjusting for age, body mass index (BMI), and other known risk factors for breast cancer. The OR for the highest quartile group of waist circumference relative to the lowest was 2.39 (95% CI, 1.59-3.60; P-trend <0.001). Comparing women with waist/hip ratio (WHR) in the lowest quartile group, the OR for women in the highest quartile category was 2.15 (95% CI, 1.61-2.85; P-trend <0.001). An inverse association was observed between hip circumference and breast cancer, with an OR of 0.36 for the highest quartile (95% CI, 0.24-0.55; P-trend <0.001). The effects of these three measures existed in both pre- and postmenopausal women. Of note, we found a significant interaction between WHR and BMI (P-interaction = 0.016): the OR comparing the highest to the lowest WHR quartile was 2.81 (95% CI, 1.90-4.16) for women with BMI < 25 kg/m(2) and 1.70 (95% CI, 1.11-2.61) for women with BMI ≥ 25 kg/m(2). These results suggest that central adiposity, measured by waist circumference and waist/hip ratio, was an important risk factor for breast cancer in Nigerian women, and the effect of central adiposity was strong in normal-weight women.
• 0.86

  Impact points

  A fifteen-year review of lymphomas in a Nigerian tertiary healthcare centre.

  A Olayiwola Oluwasola, John A Olaniyi, Jesse A Otegbayo, Gabriel O Ogun, Titi S Akingbola, Cornelius O Ukah, Effiong E U Akang, Yetunde A Aken'Ova

  Journal of health, population, and nutrition. 08/2011; 29(4):310-6.

  In Africa, epidemiological data on the effect of the HIV epidemic on the occurrence of lymphomas are scanty. The 1990s witnessed the alarming rates of HIV/AIDS in Nigeria. The prevalence of HIV/AIDS in Nigeria increased from 1.8% in 1991 to 4.4% in 2005. The aim of this study was to determine whethe... [more] In Africa, epidemiological data on the effect of the HIV epidemic on the occurrence of lymphomas are scanty. The 1990s witnessed the alarming rates of HIV/AIDS in Nigeria. The prevalence of HIV/AIDS in Nigeria increased from 1.8% in 1991 to 4.4% in 2005. The aim of this study was to determine whether there have been any changes in the frequency and pattern of lymphomas in view of the HIV/AIDS epidemic in the country. This is a retrospective study of all lymphoma cases diagnosed during 1991-2005. The prevalence of lymphomas declined from 1.4% to 0.7% of surgical biopsies during 1991-2005. There was a decline in the proportion of high-grade non-Hodgkin lymphoma and Burkitt's lymphoma from 79.1% and 45.8% respectively to 21.1% and 13.6% respectively. There is a suggestion that the HIV/AIDS epidemic in the country may not have influenced the pattern of occurrence of both major histomorphological types of lymphoma in Ibadan.
• 4.60

  Impact points

  Lymphomas in sub-Saharan Africa - what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research?

  Kikkeri N Naresh, Martine Raphael, Leona Ayers, Nina Hurwitz, Valeria Calbi, Emily Rogena, Shahin Sayed, Omar Sherman, Hazem A H Ibrahim, Stefano Lazzi, [......], Bessie Byakika, Emma Moshi, Muheez Durosinmi, Babatunde J Olasode, Olayiwola A Oluwasola, Effiong E Akang, Yetunde Akenòva, Melissa Adde, Ian Magrath, Lorenzo Leoncini

  British journal of haematology. 06/2011;

  Approximately 30 000 cases of non-Hodgkin lymphoma (NHL) occur in the equatorial belt of Africa each year. Apart from the fact that Burkitt lymphoma (BL) is very common among children and adolescents in Africa and that an epidemic of human immunodeficiency virus (HIV) infection is currently ongoing ... [more] Approximately 30 000 cases of non-Hodgkin lymphoma (NHL) occur in the equatorial belt of Africa each year. Apart from the fact that Burkitt lymphoma (BL) is very common among children and adolescents in Africa and that an epidemic of human immunodeficiency virus (HIV) infection is currently ongoing in this part of the world, very little is known about lymphomas in Africa. This review provides information regarding the current infrastructure for diagnostics in sub-Saharan Africa. The results on the diagnostic accuracy and on the distribution of different lymphoma subsets in sub-Saharan Africa were based on a review undertaken by a team of lymphoma experts on 159 fine needle aspirate samples and 467 histological samples during their visit to selected sub-Saharan African centres is presented. Among children (<18 years of age), BL accounted for 82% of all NHL, and among adults, diffuse large B-cell lymphoma accounted for 55% of all NHLs. Among adults, various lymphomas other than BL, including T-cell lymphomas, were encountered. The review also discusses the current strategies of the International Network of Cancer Treatment and Research on improving the diagnostic standards and management of lymphoma patients and in acquiring reliable clinical and pathology data in sub-Saharan Africa for fostering high-quality translational research.

• A retrospective histopathological review of oral squamous cell carcinoma in a Nigerian teaching hospital.

  B F Adeyemi, B M Kolude, E E U Akang

  African journal of medicine and medical sciences. 06/2011; 40(2):153-8.

  This study was undertaken to describe the demographic pattern of oral squamous cell carcinoma (OSCC) in Ibadan, Nigeria and compare our findings with that of other countries. It involved a retrospective review of OSCC diagnosed at the University College Hospital Ibadan, Nigeria between 1990 and 2008... [more] This study was undertaken to describe the demographic pattern of oral squamous cell carcinoma (OSCC) in Ibadan, Nigeria and compare our findings with that of other countries. It involved a retrospective review of OSCC diagnosed at the University College Hospital Ibadan, Nigeria between 1990 and 2008. A review of studies from other countries was done with respect to the three most frequently affected sites by OSCC, as well as mean ages and gender ratios. OSCC comprised 181 (43.7%) of the 414 malignant neoplasms diagnosed in the oral cavity within the study period. The most frequently affected sites were the maxillary gingiva (24.9%) and mandibular gingiva (21.5%). There was a slight male preponderance; with a male to female ratio of 1.2:1. The peak age was in the eighth decade of life. About 17.7% of cases were diagnosed in patients below the age of 40 years and 1.1% of cases occurred in children. Worldwide, the tongue is the most frequently affected site by squamous cell carcinoma followed by the floor of the mouth. Males are also more frequently affected. In conclusion, OSCC remains an important cause of morbidity and mortality among middle aged individuals in our environment and worldwide, but sometimes affecting younger individuals.
• 0.52

  Impact points

  Pattern of homicide coroner's autopsies at University College Hospital, Ibadan, Nigeria: 1997-2006.

  U O Eze, E E U Akang, W O Odesanmi

  Medicine, science, and the law. 01/2011; 51(1):43-8.

  There is relatively little information regarding the pattern of homicides in developing countries such as Nigeria. This study is aimed at determining the pattern and demographic factors associated with homicide cases seen in a Nigerian Teaching Hospital. It is a descriptive autopsy study of homicide... [more] There is relatively little information regarding the pattern of homicides in developing countries such as Nigeria. This study is aimed at determining the pattern and demographic factors associated with homicide cases seen in a Nigerian Teaching Hospital. It is a descriptive autopsy study of homicide cases seen at the University College Hospital (UCH), Ibadan over a 10-year period from January 1997 to December 2006. All the coroner's autopsies for the period, of homicides or suspected homicides, were reviewed with emphasis on the following: gender, age, occupation, circumstances surrounding event, likely motive, type of weapon used, site(s) of injury and mechanism of death. Homicides accounted for 153 (3.1%) of the 4928 coroner's cases at the UCH within the study period. One hundred and thirty-seven of the 152 cases were men, and the overall age range was 4-83 years. The mechanism of death was haemorrhagic shock in 91 cases (59.9%); severe raised intracranial pressure in 58 cases (38.2%); septicaemic shock in two cases (1.3%); and asphyxia in one case (0.7%). Gunshot injuries accounted for 64.5% of the fatalities, sharp objects 21.1% and blunt force 14.5%. Most were victims of armed robbery attacks. The head, abdomen, chest and lower limbs were single sites of injuries in descending order of frequency and most of the cases sustained multiple injuries involving two or more of these sites. Gunshot deaths were the commonest form of homicides in the period under review. Young males and victims of armed robbery attacks were most susceptible.

• Clinico-pathological profile of head and neck malignancies at University College Hospital, Ibadan, Nigeria.

  Akinyele O Adisa, Bukola F Adeyemi, Abideen O Oluwasola, Bamidele Kolude, Effiong E U Akang, Jonathan O Lawoyin

  Head & face medicine. 01/2011; 7:9.

  This retrospective study analysed head and neck malignancies seen over a 19-year period at the University College Hospital, Ibadan. One thousand, one hundred and ninety two patients with head and neck malignancies were analysed according to age, gender, topography and histology. There was an annual ... [more] This retrospective study analysed head and neck malignancies seen over a 19-year period at the University College Hospital, Ibadan. One thousand, one hundred and ninety two patients with head and neck malignancies were analysed according to age, gender, topography and histology. There was an annual hospital frequency of 62 cases per year. The overall mean age for these malignancies was 43.9 (SD ± 19.3) years. The lesions from the respiratory tract were the most frequent (43.2%) of all cases. The palate was the most frequent intra-oral site (13.8%). Epithelial malignancies constituted 73.4% of all cases with a male: female ratio of 2:1, a mean age of 48.1 (SD ± 17.5) years and were mostly located in the larynx (19.7%). Lymphomas constituted 17.5% of all head and neck cancers with a male: female ratio of 1.6:1, a mean age of 35.1 (SD ± 20.6) years and nodal involvement (39.7%) was most common. Sarcomas constituted 8.9% of all malignancies with a male: female ratio of 1.5:1, mean age of 27.1 (SD ± 16.7) years and the maxillofacial bones (42.5%) were most commonly involved. Neuroendocrine malignancies accounted for 0.2% of head and neck malignancies with a male: female ratio of 1:1, a mean age of 28.5 (SD ± 6.4) years and both cases involved the nose. This study has further confirmed that carcinomas remain the most frequent cancers of the head and neck region in south-western Nigeria.

• Histopathological pattern of renal cell carcinoma in Ibadan.

  M O Odubanjo, A O Oluwasola, S O Ikuerowo, E E U Akang

  African journal of medicine and medical sciences. 12/2010; 39(4):317-21.

  There has been a paucity of Nigerian studies on renal cell carcinomas (RCC). This retrospective review analyzes cases of RCC diagnosed in the University College Hospital, Ibadan from January 1960 to June 2007. Cases were typed using the 2004 World Health Organization classification of renal tumours.... [more] There has been a paucity of Nigerian studies on renal cell carcinomas (RCC). This retrospective review analyzes cases of RCC diagnosed in the University College Hospital, Ibadan from January 1960 to June 2007. Cases were typed using the 2004 World Health Organization classification of renal tumours. Papillary RCC were further grouped into Type 1 or 2 and Fuhrman's nuclear grade was determined for clear cell and papillary RCC. There were 159 cases, 108 being females, with a male to female ratio of 1:2.1. Peak age of occurrence was in the fourth decade. The right kidney was more commonly affected (58.6%). Papillary RCC was the most common variant accounting for 27 of the 62 cases that were available for review. Six (22.2%) of the 27 papillary RCC had the distinctive histological features that have been associated with Xp 11 translocation carcinoma. All 27 cases of papillary RCC were Type 2. Twenty-one (61.8%) RCC were Fuhrman's nuclear grade 1 and 2. Renal cell carcinoma in Ibadan occurs two decades earlier than in Caucasians. Papillary RCC is the most common histological sub type of RCC in Ibadan, and Xp translocation carcinomas may be more common in this environment than earlier described in America. This is in contrast to the observation that clear cell carcinomas is the most common histological sub type of RCC in Caucasians series.

• Immunohistochemical analysis of undifferentiated and poorly-differentiated head and neck malignancies at a tertiary hospital in Nigeria.

  Akinyele O Adisa, Abideen O Oluwasola, Bukola F Adeyemi, Bamidele Kolude, Effiong Eu Akang, Jonathan O Lawoyin

  Head & neck oncology. 11/2010; 2:33.

  This is a retrospective analysis of poorly-differentiated head and neck malignancies at University College Hospital, Ibadan. Eighty-six poorly-differentiated neoplasms were categorized as carcinomas, sarcomas, lymphomas or neuroendocrine cancers with a panel of 7 antibodies (cytokeratin AE1/AE3, vim... [more] This is a retrospective analysis of poorly-differentiated head and neck malignancies at University College Hospital, Ibadan. Eighty-six poorly-differentiated neoplasms were categorized as carcinomas, sarcomas, lymphomas or neuroendocrine cancers with a panel of 7 antibodies (cytokeratin AE1/AE3, vimentin, desmin, myogenin, leukocyte common antigen and neuron-specific enolase). Immunohistochemical and original hematoxylin-eosin diagnoses were contrasted.The male: female ratio was 2.5:1, with mean age of 38.9 years. Nasopharynx, nose and maxillofacial bones were the most common locations. Immunohistochemistry confirmed 54.8% of carcinomas, 70.6% of sarcomas and 80% of lymphomas.Hematoxylin-eosin was able to distinguish between sarcoma and lymphoma but differentiation between a carcinoma and neuroendocrine lesion was poor. Further studies are required to maximize the role of immunohistochemistry as an ancillary diagnostic tool in the West African sub-region.
• 5.59

  Impact points

  Case-control study of body size and breast cancer risk in Nigerian women.

  Temidayo O Ogundiran, Dezheng Huo, Adeniyi Adenipekun, Oladapo Campbell, Rasaaq Oyesegun, Effiong Akang, Clement Adebamowo, Olufunmilayo I Olopade

  American journal of epidemiology. 09/2010; 172(6):682-90.

  Previous studies have shown that weight is inversely associated with premenopausal breast cancer and positively associated with postmenopausal disease. Height has been shown to be positively correlated with breast cancer risk, but the association was not conclusive for premenopausal women. These pre... [more] Previous studies have shown that weight is inversely associated with premenopausal breast cancer and positively associated with postmenopausal disease. Height has been shown to be positively correlated with breast cancer risk, but the association was not conclusive for premenopausal women. These previous studies were conducted primarily in Western countries, where height is not limited by nutritional status during childhood. The authors assessed the association between breast cancer and anthropometric measures in the Nigerian Breast Cancer Study (Ibadan, Nigeria). Between 1998 and 2009, 1,233 invasive breast cancer cases and 1,101 controls were recruited. The multivariate-adjusted odds ratio for the highest quartile group of height relative to the lowest was 2.03 (95% confidence interval (CI): 1.51, 2.72; P-trend < 0.001), with an odds ratio of 1.22 (95% CI: 1.14, 1.32) for each 5-cm increase, with no difference by menopausal status. Comparing women with a body mass index in the lowest quartile group, the adjusted odds ratio for women in the highest quartile category was 0.72 (95% CI: 0.54, 0.94; P-trend = 0.009) for premenopausal and postmenopausal women. Influence of height on breast cancer risk was quite strong in this cohort of indigenous Africans, which suggests that energy intake during childhood may be important in breast cancer development.

• Review of fine needle aspiration cytology in the management of goitres in Ibadan, Nigeria.

  A O Afolabi, A O Oluwasola, O O Akute, E E U Akang, T O Ogundiran, J O Ogunbiyi, D O Irabor

  Nigerian journal of clinical practice. 06/2010; 13(2):163-6.

  The use of Fine Needle Aspiration Cytology (FNAC) in the investigation of goitres was introduced into our practice more than a decade ago. This is a review of its diagnostic accuracy for thyroid carcinoma seven years after the first evaluation and following the establishment of the 'FNAC Clinic&... [more] The use of Fine Needle Aspiration Cytology (FNAC) in the investigation of goitres was introduced into our practice more than a decade ago. This is a review of its diagnostic accuracy for thyroid carcinoma seven years after the first evaluation and following the establishment of the 'FNAC Clinic'. This is a retrospective study of patients who had FNAC of goitres and the histopathology of their thyroidectomy specimens between 1995 and 2004. The accuracy of the cytology reports were evaluated against the histology reports. The turnaround time of the patients for surgery was also determined. There were 130 females and 21 males with an age range of 7-86 years. The diagnostic accuracy of the procedure for carcinoma was 89% with a sensitivity of 35%, specificity of 97%, positive predictive value of 64%, and a negative predictive value of 91%. The average turnaround time for surgery was 178.7 +/- 248.7 days with a range of five days to three and a half years. The diagnostic accuracy of FNAC of goitre for carcinoma improved in the period under review. However, the long surgery turnaround time may reduce the usefulness of the procedure. The accuracy may be improved further by a protocol of ultrasound guidance, capillary collection with no-aspiration technique, on-site review of slides with a repeat of FNA as necessary.

• Keratoameloblastoma of the mandible

  B Adeyemi, A Adisa, A Fasola, E Akang

  Journal of Oral and Maxillofacial Pathology. 01/2010;

  Keratoameloblastoma is a very rare ameloblastoma variant defined by extensive squamous metaplasia and keratinization. There are 13 previously reported cases in the literature, with a male predilection of 3:1. A 38-year-old male presented with a painless mandibular swelling which had been progressive... [more] Keratoameloblastoma is a very rare ameloblastoma variant defined by extensive squamous metaplasia and keratinization. There are 13 previously reported cases in the literature, with a male predilection of 3:1. A 38-year-old male presented with a painless mandibular swelling which had been progressively increasing in size for 18 months. The incisional biopsy was misdiagnosed as basaloid squamous carcinoma. Owing to financial constraints, the patient had mandibular resection a decade after first noticing the growth, during which the clinical course was essentially benign, thus casting doubt on the initial diagnosis. The final histological diagnosis for both the incisional and resection biopsy specimens was keratoameloblastoma.

• Benign childhood tumours in Benin City, Nigeria.

  A P Igbe, W O Akhiwu, J U Aligbe, D E Obaseki, E E U Akang

  African journal of medicine and medical sciences. 06/2009; 38(2):197-201.

  A retrospective analysis of benign tumours seen in children aged 0-14 years over a 10-year period (1993-2002) was carried out in Benin City Nigeria, in order to determine the various histological types of such tumours. A total of 76 cases were seen during the study period, out of which 32 occurred i... [more] A retrospective analysis of benign tumours seen in children aged 0-14 years over a 10-year period (1993-2002) was carried out in Benin City Nigeria, in order to determine the various histological types of such tumours. A total of 76 cases were seen during the study period, out of which 32 occurred in males and 44 in females. The commonest histological categories were tumours of connective tissues, peripheral nerve and teratoma. Haemangioma and neurofibroma occurred with equal frequency and were the single most common histological types of benign childhood tumours. Head and neck was the most common anatomic region to be involved with childhood benign tumours.
• 0.52

  Impact points

  Pattern of coroners' autopsies at Ring Road State Hospital, Ibadan, Nigeria: a retrospective study (1994-2000).

  E E U Akang, T Akinremi, E M Oje, A O Oluwasola, T O Ipadeola

  Medicine, science, and the law. 05/2009; 49(2):117-22.

  This study reviews 1,993 coroners' autopsies performed at the Adeoyo and Ring Road State Hospitals, Ibadan, over a seven-year period (January 1994 to December 2000). The most common indication for a coroner's autopsy was accidental death (59.6%), followed by homicidal death (20.7%), sudden n... [more] This study reviews 1,993 coroners' autopsies performed at the Adeoyo and Ring Road State Hospitals, Ibadan, over a seven-year period (January 1994 to December 2000). The most common indication for a coroner's autopsy was accidental death (59.6%), followed by homicidal death (20.7%), sudden natural death (11.6%), maternal death (1.4%) and suicidal death (0.4%). The overall male to female ratio was 2.8:1 and the majority of victims were in the fourth decade of life. Road traffic accidents were the leading cause of accidental death. Homicidal deaths were 9.3 times more common in male than female victims and the most common mode of death was firearm injuries. In contrast to an earlier study from University College Hospital, Ibadan, the present study has revealed a predominance of accidental and homicidal deaths, with a relatively lower rate of maternal deaths.

• Paediatric head and neck malignancies in Ibadan, Nigeria.

  B F Adeyemi, B M Kolude, G O Ogun, E E U Akang

  African journal of medicine and medical sciences. 04/2009; 38(1):55-62.

  Studies on paediatric head and neck cancer are limited in the medical literature. Most studies have been restricted to specific histological types such as rhabdomyosarcoma, osteogenic sarcoma or Burkitt's lymphoma. This study describes the relative frequency of cancers seen in the head and neck ... [more] Studies on paediatric head and neck cancer are limited in the medical literature. Most studies have been restricted to specific histological types such as rhabdomyosarcoma, osteogenic sarcoma or Burkitt's lymphoma. This study describes the relative frequency of cancers seen in the head and neck region of children below 16 years of age at the University College Hospital, Ibadan, Nigeria. A total of 281 cases of paediatric head and neck tumours were diagnosed within the study period, out of which 84 cases were malignant. Fifty-four of these cases were males while 30 were females, giving a male to female ratio of 1.8:1. The age range for these cases was 3 days to 15 years with a mean age of 9.03 +/- 4.63 years. The most frequently diagnosed tumours were haematopoietic malignancies, accounting for 47.6% of cases, followed by sarcomas (27.4%) and carcinomas (21.4%). Burkitt's lymphoma constituted 28.6%, followed by rhabdomyosarcoma accounting for 17.9% of cases. Malignant neoplasms of the head and neck region are rare in the paediatric age group. The pattern of these neoplasms also differs from that in the adult population. However, malignant head and neck neoplasms in the paediatric age group also showed the male preponderance characteristic of head and neck malignancies in the adult population.

• Primary malignant bone tumours in Ibadan, Nigeria: an update.

  A B Omololu, C A Okolo, S O Ogunlade, T Y Oyebadejo, A O Adeoye, J O Ogunbiyi, E E Akang, V. K. Gopaldasani

  African journal of medicine and medical sciences. 03/2009; 38(1):77-81.

  Bone tumours are relatively rare compared to tumours of other sites. The frequency of primary malignant bone tumours is low in our environment, as was observed in an earlier study. The aim of this study is to update the information available on the pattern of primary malignant bone tumours at the Un... [more] Bone tumours are relatively rare compared to tumours of other sites. The frequency of primary malignant bone tumours is low in our environment, as was observed in an earlier study. The aim of this study is to update the information available on the pattern of primary malignant bone tumours at the University College Hospital (UCH), Ibadan, Nigeria. The medical records of 49 patients with malignant bone tumours documented in the Cancer Registry of UCH, Ibadan between January 2001 and September 2007 were reviewed retrospectively. The results were then added to those of the previous study published in 2002. This brought the number of cases of primary malignant bone tumours to 163 from January 1977 to September 2007. Primary malignant bone tumours represented 0.53% of the 30462 cases of cancer seen in the hospital in the period studied. The male female ratio was 1.5:1. About 44% of the tumours occurred among patients less than 20 years of age. Osteogenic sarcoma was the commonest malignant bone tumour. Important changes recorded in the seven years since the last review from this centre include; a rise in the prevalence rate of primary malignant bone tumours (49 new cases in the last seven years as compared to 114 cases over 23 years), the male-female ratio of Osteogenic sarcoma showed a decline (1.5:1 as compared to 1.6:1), and there was an increase in the prevalence of primary malignant bone tumours in the 0-9 years and > 60 years age groups. The significance of these findings will need to be determined by further studies.

• Case control study of dry eye and related ocular surface abnormalities in Ibadan, Nigeria.

  C Bekibele, A Baiyeroju, A Ajaiyeoba, E Akang, B Ajayi

  International ophthalmology. 01/2009;

  Background Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. Objective To identify symptoms and surface abnormalities associated with dry eyes. Materials and methods One hundred and fifty-six eyes... [more] Background Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. Objective To identify symptoms and surface abnormalities associated with dry eyes. Materials and methods One hundred and fifty-six eyes of 78 subjects attending the Eye Clinic of the University College Hospital Ibadan were screened for dry eyes/tear instability using rose Bengal stain (graded 0-9), tear break-up time (TBUT), Schirmer's 1 tests, tear meniscus height and a standardised symptoms questionnaire. Grades 4-9 rose Bengal staining were considered as positive dry eye and were compared with grades 0-3 staining eyes as negative controls. Results Mean tear meniscus height, Schirmer's test and TBUT were lower among cases than their corresponding control eyes. The difference between the mean Schirmer's test values of cases and their controls were statistically significant (P = 0.00 for right eyes and P = 0.002 for left eyes). Rose Bengal grades were inversely correlated with the mean Schirmer's values (Pearson correlation -0.429, P = 0.05 for right eyes and -0.335, P = 0.03 for left eyes) and TBUT (Pearson correlation -0.316, P = 0.05 for right eyes and -0.212, P = 0.06 for left eyes). About 95.8% of the cases were symptomatic, as opposed to 70.4% of the controls (P = 0.01, Fisher's exact test) and 95.8% of dry right eyes compared to 61.1% of their controls had ocular surface abnormalities (P = 0.001), while 89.5% of dry left eyes compared to 62.7% of controls had surface abnormalities (P = 0.07). Conclusion A close relationship exists between ocular irritation symptoms, surface abnormalities and functional evidence of tear instability. Such patients should be treated empirically or screened for dry eyes.

• Intraepithelial and invasive squamous neoplasms of the conjunctiva in Ibadan, Nigeria: a clinicopathological study of 46 cases.

  Gabriel Ogun, Olufunmilola Ogun, Charles Bekibele, Effiong Akang

  International ophthalmology. 10/2008;

  Background/Aims To retrospectively evaluate the clinicopathological features, treatment modalities and factors affecting prognosis in patients with both conjunctival intraepithelial and invasive squamous neoplasms. Method Review and analysis of clinical and pathological records of all cases histolog... [more] Background/Aims To retrospectively evaluate the clinicopathological features, treatment modalities and factors affecting prognosis in patients with both conjunctival intraepithelial and invasive squamous neoplasms. Method Review and analysis of clinical and pathological records of all cases histologically diagnosed in the Department of Pathology, University College Hospital, Ibadan, Nigeria between January 1990 and December 2004. Results There were a total of 46 cases in 45 patients (eight intraepithelial carcinomas, 37 invasive squamous cell carcinomas (SCC) and a single case of mucoepidermoid carcinoma in a 71-year-old man). The intraepithelial neoplasms occurred in patients aged between 20 and 90 years. Seven of these patients had actinic changes on histology. For invasive SCC, patients' ages ranged from 18 to 84 years with a mean age of 53 years. Male to female ratio was 1:1. The majority presented with an orbital mass and loss of vision. Twenty-two (60%) of the patients with invasive SCC had enucleation or exenteration as the primary modality of treatment with or without radiotherapy or chemotherapy. Altogether for intraepithelial and invasive squamous neoplasms, the duration of presenting complaints ranged from 1 month to 5 years with an average of 2 years. Human immunodeficiency virus (HIV) infection and smoking were not significantly associated with these cases but a significant number had outdoor occupation. Low socioeconomic status and inability to afford treatment was common among our patients. Conclusion Patients with invasive SCC in Nigeria present late and have significant delay before having any form of treatment. This contributes to the poor outcome. Human papilloma virus (HPV) and actinic aetiology are possible strong causative agents in Nigerians.
• 2.92

  Impact points

  Histological determinant of mortality in retinoblastoma in Ibadan.

  I A Ajaiyeoba, O O Komolafe, B A Olusanya, E E U Akang

  The British journal of ophthalmology. 10/2008; 92(9):1297-8.
• 4.70

  Impact points

  Immunohistochemical and molecular subtypes of breast cancer in Nigeria.

  Clement A Adebamowo, Ayotunde Famooto, Temidayo O Ogundiran, Toyin Aniagwu, Chibuzor Nkwodimmah, Effiong E Akang

  Breast cancer research and treatment. 08/2008; 110(1):183-8.

  Objective Previous studies suggest that the majority of breast cancer in Africans are hormone receptor negative and thus differ from breast cancer in other populations. We decided to evaluate the hormone receptor status of patients seen in our practice to see if they indeed differ from that of other... [more] Objective Previous studies suggest that the majority of breast cancer in Africans are hormone receptor negative and thus differ from breast cancer in other populations. We decided to evaluate the hormone receptor status of patients seen in our practice to see if they indeed differ from that of other populations. Methods We prospectively collected and analyzed tumors from consecutive patients presenting to our clinic over an 18 months period from July 2004. During the period, we saw 192 patients without previous histological diagnosis and conducted routine histological and immunohistochemical analysis of their tumors for hormone receptor status. Results Most, 65.1% of tumors were ER+, 54.7% were PR+ and 79.7% were HER2 negative. Majority of the tumors, 77.6% were luminal type A, 2.6% were luminal type B, 15.8% were basal type and the remaining 4.0% (6/152) were HER2+/ER- subtype. We found an association between hormone receptor status and tumor grade but not with stage at presentation. Conclusion We conclude that there is no difference in the pattern of hormone receptors in breast cancer patients of African origin compared to other populations and urge more use of hormone manipulation for management of breast cancer in this population.
• 4.70

  Impact points

  Genetic polymorphisms in uridine diphospho-glucuronosyltransferase 1A1 and breast cancer risk in Africans.

  Dezheng Huo, Hee-Jin Kim, Clement A Adebamowo, Temidayo O Ogundiran, Effiong E Akang, Oladapo Campbell, Adeniyi Adenipekun, Qun Niu, Lise Sveen, James D Fackenthal, Donna Lee Fackenthal, Soma Das, Nancy Cox, Anna Di Rienzo, Olufunmilayo I Olopade

  Breast cancer research and treatment. 08/2008; 110(2):367-76.

  The UDP-glucuronosylatransferase 1A1 (UGT1A1) gene is involved in the metabolism of estrogen and detoxification of potential carcinogens. The number of TA repeats in the promoter region of UGT1A1 has been linked to breast cancer risk, but results varied by race. We performed a comprehensive assessme... [more] The UDP-glucuronosylatransferase 1A1 (UGT1A1) gene is involved in the metabolism of estrogen and detoxification of potential carcinogens. The number of TA repeats in the promoter region of UGT1A1 has been linked to breast cancer risk, but results varied by race. We performed a comprehensive assessment of genetic polymorphisms in the UGT1A1 gene, and examined these polymorphisms and TA repeats in relation to breast cancer risk in a case-control study in Nigeria. 512 breast cancer cases and 226 community controls were genotyped for UGT1A1. Compared with high-activity TA repeat genotypes, the odds ratios (OR) for low-activity and moderate-activity genotypes were 0.47 (95% confidence interval CI, 0.26-0.83) and 0.64 (95% CI, 0.39-1.06), respectively, in premenopausal women (P = 0.009 for trend), but no association was observed in postmenopausal women (P = 0.24). The effect of TA repeats was also differentiated by age: the OR was 0.39 (95% CI 0.21-0.71) for low-activity genotypes and 0.58 (95% CI 0.33-1.00) for moderate-activity genotypes in women <45 years old (P = 0.002 for trend), but no association was observed in women >/=45 years old (P = 0.15). Haplotype analysis showed that UGT1A1 haplotypes were highly diverse with blocked structures. We found a specific haplotype in block 2 that was significantly associated with a 2.1-fold elevated risk (95% CI 1.05-4.39; P = 0.04). In contrast with previous studies, we found low-activity TA repeat alleles were protective against breast cancer among premenopausal indigenous Africans, suggesting that the role of UGT1A1 in breast cancer development may vary by population, presumably due to different environmental and genetic modifier effects.