O. Olowoselu, E. Uche, A. Ogunlade, O. Oyedeji, O. Ajie, V. Osunkalu, A. Akinbami, Jeremiah Oyedemi
{"title":"The use of antithrombin as a predictive tool in determining the development of stroke in patients with sickle cell anemia based on transcranial doppler ultrasound risk group","authors":"O. Olowoselu, E. Uche, A. Ogunlade, O. Oyedeji, O. Ajie, V. Osunkalu, A. Akinbami, Jeremiah Oyedemi","doi":"10.4103/atp.atp_38_19","DOIUrl":"https://doi.org/10.4103/atp.atp_38_19","url":null,"abstract":"Background: Stroke affects up to 10% of individuals with sickle cell anemia (SCA), and its development has been linked to excessive intravascular hemolysis and arterial thrombosis Increased intracerebral blood flow (CBF) velocity as measured by the transcranial Doppler ultrasonography (TCD) identifies children with SCA with an increased risk of development of stroke. This study measured antithrombin (AT) levels among SCA patients as a predictor of TCD risk groups for the development of stroke. Materials and Methods: A total of 180 participants consisting of 135 SCA patients and 45 age-matched hemoglobin phenotype AA (HbAA) controls were enrolled into the study. CBF velocity was measured with TCD and results were used to classify the SCA group into standard risk, conditional risk, and high risk. AT functional activity, prothrombin time (PT), and activated partial thromboplastin time (APTT) of all participants were measured. Statistical tools including independent t-test, analysis of variance, Pearson's correlation, hierarchical multiple regression, and forward liner regression were used to analyze all continuous variables. P <0.05 was considered statistically significant. Results: The AT levels were 83.01 ± 15.40% and 106.12 ± 14.79% in HbAA and SCA participants, respectively, with t = −7.294 and P = 0.001. The PT and APTT of the SCA and control groups were 15.51 ± 1.22 s, 13.78 ± 0.94 s, and 35.98 ± 3.24, 33.62 ± 2.49 s, respectively. Using ANOVA, there was a statistical difference (P = 0.001) in the AT levels of the standard-risk (89.07 ± 14.26%) and high-risk groups (73.10 ± 12.35%). Using Pearson's correlation, there was a significant negative correlation between AT levels and CBF (r = −0.405). With the use of multiple regression, AT showed the highest predictive value for CBF (R2 = 0.155; P ≤ 0.001; F = 17.677). Conclusion: AT functional activity levels were reduced in the SCA group compared with the HbAA-matched controls.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121912347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rajat Piplani, Sufian Zaheer, D. Bagga, S. Acharya
{"title":"Histology of the terminal end of the distal rectal pouch and fistula region in varying the severity of anorectal malformations: Is it useful?","authors":"Rajat Piplani, Sufian Zaheer, D. Bagga, S. Acharya","doi":"10.4103/atp.atp_33_19","DOIUrl":"https://doi.org/10.4103/atp.atp_33_19","url":null,"abstract":"Aims: To Study the histology of the terminal end of distal rectal pouch and fistula region in cases of anorectal malformations (ARMs) and to get an insight on the usefulness of excising or preserving this region during its reconstruction. Materials and Methods: This was a prospective observational study of 20 consecutive cases of ARMs that underwent posterior sagittal anorectoplasty (PSARP) in our hospital over 6 months' period. The histopathological evaluation of the terminal end of the distal rectal pouch and fistula region in all cases with ARM was done. Complicated and redo cases were excluded from this study. Tissue specimen of about 0.5–1.0 cm from the most distal part of the rectal pouch and close to the fistula region was taken. Biopsy specimens were obtained from all patients undergoing a PSARP performed after a defunctioning colostomy or as a primary procedure without colostomy, and histopathological evaluation was done in all cases. Further, the internal sphincter and its morphology, hypoganglionosis or aganglionosis, anal glands and crypts, thickened nerve trunks, and other miscellaneous histopathological aberrations were studied. Based on these histological findings, conclusions were derived whether to preserve or excise this region during ARM reconstruction. Results: Out of the 20 ARM patients included, 12 patients (60%) were male and 8 (40%) were female. An internal sphincter was identified in all the patients. However, the smooth muscle bundles were disorganized in all the 20 patients (100%). While ganglion cells were absent in 90% cases, hypertrophic nerve bundles were a common histological finding (90% of patients). The abnormal mucosal finding was also noted in majority of the patients (75%). Conclusions: An atrophic or disorganized internal sphincter, absent ganglion cells, and abnormal anal mucosal findings in majority of these patients on histology would justify its excision during PSARP. However, further follow-up of these ARM patients in whom the terminal end of the distal rectal pouch and the fistula region is excised or retained is recommended.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127367485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Challenges of pleural aspirate cytology: A 5-year review","authors":"I. Obahiagbon, M. Udoh","doi":"10.4103/atp.atp_30_19","DOIUrl":"https://doi.org/10.4103/atp.atp_30_19","url":null,"abstract":"Introduction: Pleural effusion is a common medical condition, and the aspiration of the pleural cavity is a minimally invasive, cheap, and simple technique with the potential to achieve a clinically useful diagnosis. Challenges in the optimization of this investigative modality, however, occur in our everyday practice. Aim: The purpose of this review was to highlight the challenges in the cytopathological evaluation of pleural aspirates in our environment. Materials and Methods: The data regarding pleural fluid (PF) aspirates received for cytopathological evaluation between January 1, 2010, and December 31, 2014, were retrieved from departmental records and analyzed. Results: PF aspirates from 69 patients, with a male–female ratio of 1:1.03, were studied. The modal age group was 30–39 years, and the mean age was 45 ± 21.40 years. Of 69 smears, 40.6% were categorized as unsatisfactory/nondiagnostic, 44.9% were in the “negative for malignancy/normal/benign” category, 1.4% were in the “atypical-favor reactive” category, 4.3% were “atypical-suspicious for malignancy,” and 8.7% were “positive for malignancy.” The male–female ratio of patients with malignant pleural effusions was 1:5, and 66.7% of malignant smears were from persons above 50 years. Thirty-nine percent of total smears wear “inflammatory.” The large number of unsatisfactory smears is a major challenge. Conclusion: Pleural aspirate cytology can be a useful investigative tool with the potential for definitive diagnosis or other useful information for clinical decision-making. To maximize its diagnostic potential in our environment, however, the current challenges must be overcome.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129722527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microsatellite instability in gastric carcinomas in Kano, Nigeria","authors":"Abdullahi Ahmad, A. Mohammed","doi":"10.4103/atp.atp_3_20","DOIUrl":"https://doi.org/10.4103/atp.atp_3_20","url":null,"abstract":"Background and Objectives: Gastric carcinoma, though relatively less prevalent in most parts of Africa and Nigeria, usually presents at an advanced stage in most of our patients. This makes the elucidation of clinical and molecular factors relating to prognosis an important avenue to explore. Gastric carcinomas exhibiting microsatellite instability (MSI) are said to have better prognosis, but there has been no study in Northern Nigeria. We, therefore, undertook this study to evaluate the proportion of MSI gastric carcinoma in our center. Methodology: This retrospective 5-year study was done on 48 histologically diagnosed gastric carcinomas to evaluate the immunohistochemical expression of mismatch repair DNA proteins: MLH1 and MSH2. Results: Forty-eight gastric cancer (GC) biopsies fulfilled the study criteria. They were from patients aged 23–80 years, with a mean of 52.1 years (standard deviation [SD] ±12.79) and male to female ratio = 3.4:1. Twenty cases (42%) had MSI, with a mean age of 51.7 years (SD ± 12.75; P = 0.67). The remaining 28 cases were microsatellite stable (MSS), with a mean age of 53.3 years (SD ± 12.92). Male preponderance was more marked in the MSS group (6:1) than in the MSI group (2.3:1). Intestinal carcinoma was by far the most common histologic type in both MSI (75%) and MSS (70%) groups. Conclusion: Forty-two percent of gastric carcinomas were harboring MSI. Although our sample size was small, it nonetheless provided useful insight and baseline data for MSI gastric carcinoma in our center. MSI GC appears to be more common in our center than an earlier Southern Nigerian study. This is consistent with the widely differing proportion of MSI gastric carcinoma across the globe, sometimes within the same country. Further studies are therefore required to make sense of this seemingly conflicting data.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131131519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Solitary intraparotid plexiform neurofibroma: Case report and literature review","authors":"R. Vhriterhire, M. Agwa, A. Adekwu","doi":"10.4103/atp.atp_8_20","DOIUrl":"https://doi.org/10.4103/atp.atp_8_20","url":null,"abstract":"Solitary plexiform neurofibroma is a peripheral nerve sheath tumor with proliferation of Schwann cells accompanied by mast cells and fibroblasts laying down collagen. The occurrence of this tumor in the salivary gland of an individual in the absence of neurofibromatosis 1 (von Recklinghausen disease) is rare. We present a case of sporadic solitary intraparotid neurofibromatosis in an 8-year-old female. The 8 cm × 6 cm × 2 cm mass removed through superficial parotidectomy showed the characteristic irregular bundles of Schwann cells, fibroblasts, mast cells, and strands of collagen. Tissue biopsy is indispensable in the diagnosis of this tumor and its differentiation from other more benign condition such as pleomorphic adenoma which it mimics clinically.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122309274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spectrum of homicidal injuries in a tertiary hospital in North-central Nigeria","authors":"R. Vhriterhire, I. Akpor, J. Ngbea, B. Ojo","doi":"10.4103/atp.atp_28_19","DOIUrl":"https://doi.org/10.4103/atp.atp_28_19","url":null,"abstract":"Background and Objectives: There has been an upsurge in fatal crimes and violent conflicts in Nigeria, with the victims dying from a variety of injuries. This study analyzed the pattern of injuries found during postmortem examination of the bodies of victims of homicidal deaths. Materials and Methods: A retrospective audit was done on the cases of alleged homicidal deaths on which autopsies were performed over a period of 5 years in the pathology services unit of a tertiary hospital in the North-central region of Nigeria. Results: There were 236 alleged homicidal death cases and the ages ranged from 1.5 to 6 years. There were more male victims (87.7%) than females (12.3%), ratio of 7.1:1. Gunshot injuries and chop wounds accounted for 39.8% (n = 94) and 19.1% (45), respectively. The other injuries found in this study included lacerations, skull fractures, contusions, cerebral lacerations, stab wounds, burns, and incised wounds. Blunt force injuries (laceration, contusion, and abrasion) and sharp force injuries (incised, stab, and chop wounds) made up 18.6% (n = 44) and 21.2% (n = 50) of the total number of cases, respectively. Some of the victims had a combination of injuries. Most of the decedents were persons within the third decade and 67.4% of them were <40 years old. Conclusion: This retrospective review of homicidal injuries showed that most victims died from gunshot and sharp force injuries. Gunshot wounds were found to be more common on the chest and abdomen, whereas chop wound was more to the head, followed by the neck.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128616210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Usman, A. Dahiru, Usman Baguda, Shuaibu Adam, U. Abdulmajid
{"title":"Metastatic recurrent malignant phyllodes in 17-year-old female","authors":"A. Usman, A. Dahiru, Usman Baguda, Shuaibu Adam, U. Abdulmajid","doi":"10.4103/atp.atp_39_19","DOIUrl":"https://doi.org/10.4103/atp.atp_39_19","url":null,"abstract":"Malignant phyllodes tumor of the breast is extremely rare but what is rarer is its occurrence in adolescent girls younger than 18 years. It has a propensity for rapid growth and metastases. We present an uncommon presentation of recurrent and metastatic malignant phyllodes tumor in a 17-year-old female.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132920109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Juvenile fibromatosis: Report of a rare case","authors":"H. Aliyu, T. Sholadoye, S. Abdulkarim","doi":"10.4103/atp.atp_7_20","DOIUrl":"https://doi.org/10.4103/atp.atp_7_20","url":null,"abstract":"Fibromatosis is a rare benign tumor arising from the myofibroblast. It is a locally aggressive tumor with a high rate of recurrence but no malignant potential. Fibromatosis can occur anywhere in the body. It is rare in the head-and-neck region and even rarer in children. We report a case occurring in the neck of a child. A 7-year-old boy presented with progressive left-sided, posterior neck swelling of 4 years and 3 years history of the loss of ability to vocalize. Imaging studies revealed a mass at the base of the skull and posterior neck on the left, with the preserved surrounding bone. The patient had a complete excision of the mass and histology confirmed juvenile fibromatosis. Juvenile fibromatosis of the head-and-neck region is a rare benign tumor of childhood. Tissue biopsy confirms the diagnosis. The recurrence rate is high following wide local excision.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123926347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Applications of induced pluripotent stem cells in clinical practice","authors":"F. Garba","doi":"10.4103/atp.atp_34_19","DOIUrl":"https://doi.org/10.4103/atp.atp_34_19","url":null,"abstract":"Stem cell research has shown a promising future in understanding and treating diseases from cellular level, factoring minimum patients' suffering in terms of toxicity and persistent or endless therapy. Induced pluripotent stem cells offer a variety of opportunities that were unimaginable in the past. Developments and breakthroughs from this field of science are constantly evolving with quite remarkable or rather overwhelming articles published. This is a systematic review study with the aim to simplify the basic understanding of induced pluripotent stem cells. Its journey so far and prospects to confer the solutions in clinical practice.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117255739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cytolytic vaginosis: A common yet underdiagnosed entity","authors":"S. Puri","doi":"10.4103/atp.atp_18_19","DOIUrl":"https://doi.org/10.4103/atp.atp_18_19","url":null,"abstract":"Objective: The objective of this study is to determine the incidence of cytolytic vaginosis among patients undergoing cervicovaginal cytology for vaginal discharge, pruritus, dyspareunia, and other symptoms. Cytolytic vaginosis is also known as Lactobacillus overgrowth syndrome or Doderlein's cytolysis. It is characterized by an abundant growth of Lactobacilli resulting in lysis of vaginal epithelial cells. Methods: A total of 308 women presented to gynecological outpatient department. All of the patients were subjected to Pap test with the help of cytobrush. The cervicovaginal smears were fixed in methanol, stained with papanicolaou stain, and studied under a microscope independently by two pathologists. Results: Of 308 patients, 190 (61.7%) had an inflammatory lesion and were negative for intraepithelial malignancy. Of 190 cases, 31 (16.3%) were diagnosed with cytolytic vaginosis based on the clinical and morphological features. Conclusion: Cytolytic vaginosis is a fairly common entity often misdiagnosed as candidiasis. Morphological features play an important role in identifying cytolytic vaginosis. The results of this study may contribute to reports in the literature indicating the importance of cytolytic vaginosis which is not included in the current Bethesda system for reporting of cervical cytology.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134152757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}