Papers by AKINWUMI O KOMOLAFE
Journal of Community Medicine and Primary Health Care, Sep 1, 2015
Nigerian Journal of Family Practice, Feb 7, 2018
Background: The postmortem examination is a veritable means of ascertaining the correct diagnoses... more Background: The postmortem examination is a veritable means of ascertaining the correct diagnoses. Over the years, there has been a severe drop in the number of requests for postmortem examination despite its numerous advantages and benefits. The study is aimed at showing the pivotal role of the autopsy in medical education and qualitative patients' care. Materials and Methods: A retrospective review of (total number of cases) full post mortem dissections done, some including histological examination were comprehensively reviewed. The clinical diagnoses were evaluated along with postmortem diagnoses. The ages of the patients were reviewed along with organ systems thought to have problems and those missed. Results: Out of 62 complete autopsy dissections, 25 (40.32%) of our cases were discrepant while 37 (59.68%) cases were concordant. Most cases of discrepant diagnoses were in the 4 th decade of life accounting for 9 (36%) of discrepant cases. While diagnoses were more usually correct in the 3 rd decade of life accounting for 10 (27.05%) of concordant diagnoses. The bulk of incorrect diagnoses was in the 3 rd to 7 th decade of life. Five commonly missed diagnoses were 4 cases of systemic hypertension, 3 cases of intracranial haemorrhage, 4 cases of lobar pneumonia, 3 cases of hepatocellular carcinoma and 2 cases of renal cell carcinoma accounting for 16 (64%) of all missed cases. Conclusion: The postmortem examination remains the gold standard for the ultimate diagnoses. All health institutions especially secondary and tertiary health institutions should put structures in place for conducting autopsies and auditing patients care. Keywords: Correlation, antemortem, postmortem, diagnoses, discrepancies
Journal of Infection Prevention, Sep 14, 2022
Backgound Hepatitis B virus (HBV) infected persons often suffer stigma. Stigma can come from the ... more Backgound Hepatitis B virus (HBV) infected persons often suffer stigma. Stigma can come from the society or be self-induced. This study assessed the gender differences and stigma experience of patients with HBV. Methods Prospective cross-sectional design with a qualitative element using a pretested interviewer administered questionnaire and an in-depth oral interview of HBV infected patients. Quantitative data obtained were entered into SPSS version 20 and analyzed using simple descriptive and inferential statistics, while content analysis was used for the qualitative data. Results Total of 242 respondents answered the quantitative questionnaire. There were 142(58.7%) males and 100 (41.3%) females; age range was 18–72 years with mean (SD) of 35.4(10.7) years. Overall stigma rate was 23.1%. Stigma resulted from a positive HBsAg test, and the experience was unaffected by other markers of HBV infection. Stigma was higher in the domain of disease transmission for both single and married respondents and was particularly higher among males than females. Stigma among females affected pre-marital engagements and also caused marital disharmony among married respondents. In-depth oral interview of 23 HBV infected respondents revealed that many exhibited self-stigma, had wrong knowledge of HBV infection modes, complications, and interpretation of HBV internet information which aggravated stigma reactions. Conclusions Stigma of HBV is high and majorly in the domain of disease transmission. It is higher in males than females. Enlightenment campaign targeting singles and married couples and HBV infection modes is advocated.
Research Journal of Health Sciences, 2019
Background: Breast cancer is one of the most common cancers in Nigeria. The tumour grade is an im... more Background: Breast cancer is one of the most common cancers in Nigeria. The tumour grade is an important prognostic factor and is also important in treatment of patients. Fine needle aspiration cytology can be used as an initial diagnostic tool for planning definitive management. Grading of tumours on cytology further guides therapeutic decisions. The aim of this study is to compare the correlation between the cytological and histological grading of malignant breast lumps using the Robinson's cytological grading system and Nottingham histological grading system respectively. The Objectives are, to determine the age distribution of breast cancer in our environment, to grade breast cancers cytologically using the Robinson's cytological grading system and to grade breast cancers histologically using the Nottingham histological grading system. Methods: This was a one year prospective study that involved 30 patients who had malignant smears on fine needle aspiration cytology of their breast lump. These smears were graded using the Robinson's cytological grading system and compared with the Nottingham histological grading systems of same lumps obtained from either tissue biopsies or mastectomies. Results: The mean age of the study participants was 50.23±10.11 years with a range of 35-70 years. Most (56.7%) malignat smears were of cytologic grade 3. The histological grade was 2 in 16(53.3%) and 3 in 14(46.7%) of the same breast tissue samples. The grade 2 tumours had the highest concordance rate of 83.3%. The absolute concordance rate between Robinson's cytological and Nottingham histological grading system of breast cancers was 73.3%. Conclusion: The Robinson's cytological and Nottingham histological grading systems showed good correlation.
Alexandria journal of medicine, Dec 1, 2018
This study examines the association between body mass index (BMI), waist-to-hip ratio (WHR), and ... more This study examines the association between body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC) and allcause and cardiovascular mortality in elderly women in a 5-year longitudinal study of 575 female outpatients 60 years and over. The highest BMI, WHR, and WC quartiles and predefined BMI categories were analyzed as predictive variables. Death occurred in 88 (15.4%). Underweight (BMI < 18.5kg/m 2) was associated with all-cause mortality in uni-and multivariate analyses, regardless of age bracket. The survival curves and univariate analysis showed that the highest WHR quartile (≥ 0.97) was associated with all-cause mortality. However, after adjustment for age, smoking, and previous cardiovascular diseases, the increase in WHR was positively associated only in women from 60 to 80 years of age. None of the anthropometric measurements was associated with cardiovascular mortality. The results indicate that underweight and increased waist-to-hip ratio were predictors of all-cause mortality in elderly women, mainly among those under 80 years.
International Journal of Clinical and Experimental Pathology, 2022
The main oncologic events in pleomorphic adenoma (PA) are the translocations of Pleomorphic adeno... more The main oncologic events in pleomorphic adenoma (PA) are the translocations of Pleomorphic adenoma gene 1 (PLAG1) on chromosome 8q12 and High-mobility group AT-hook 2 (HMGA2) on chromosome 12q14.3 with various fusion partners. These translocations result in the transcriptional up-regulation of PLAG1 and HMGA2 proteins. We carried out a preliminary evaluation of PLAG1 translocation by fluorescence in-situ hybridization (FISH), immunohistochemistry (IHC) and HMGA2 IHC on twenty-five archived formalin-fixed paraffin-embedded tissues of PAs and its clinicopathologic features. Only eight cases were successfully hybridized and 50% of the interpretable cases were considered positive for PLAG1 translocation. PLAG1 IHC was only positive in 2 (8%) of the 25 cases stained, including one of the positive PLAG1 translocation cases. HMGA2 IHC was positive in 12 (48%) of the 25 cases stained including 2 (50%) of the 4 cases identified with PLAG1 translocation by FISH, 3 (75%) of the 4 cases negative for PLAG1 translocation by FISH and 7 (41%) of the 17 cases with failed hybridization. Overall, 15 (60%) of the 25 PA cases demonstrated PLAG1 and/or HMGA2 alterations confirmed either by FISH or IHC. In conclusion, PLAG1 and HMGA2 alterations were confirmed either by FISH or IHC in this cohort and HMGA2 alteration is a common event in PAs of salivary gland.
International Journal of Medical Reviews and Case Reports
Introduction: Childhood cancer is fast becoming a growing global challenge and gaining global att... more Introduction: Childhood cancer is fast becoming a growing global challenge and gaining global attention especially in low and middle-income countries (LMIC) where there is associated high morbidity and mortality. This review is to determine the patterns of malignant childhood solid tumours in our hospital and to compare this with previous studies. Methods: A 10-year retrospective review in which all histologically diagnosed malignant solid tumours between ages 0-15 years were analysed. The surgical daybook and the histopathology request cards were retrieved and the patients biodata, nature of specimen and tumour sites were extracted. Subgrouping of the various types of tumour was done based on the third edition (2005) of International Classification of Childhood Cancers (ICCC-3). Results: There were 124 cases of malignant childhood solid tumours with an average of 12.4 cases per year. Seventy-eight cases (62.9 %) were male, while 46 cases (37.1%) were female, hence a male to female...
Pan African Medical Journal, 2018
We present a case of cardiac tamponade that was precipitated by thoracocentesis and discovered at... more We present a case of cardiac tamponade that was precipitated by thoracocentesis and discovered at autopsy.
Cancer Prevention Research, 2021
Cancer incidence is rising in low- and especially middle-income countries (MIC), driven primarily... more Cancer incidence is rising in low- and especially middle-income countries (MIC), driven primarily by four high-burden cancers (breast, cervix, lung, colorectal). By 2030, more than two-thirds of all cancer deaths will occur in MICs. Prevention and early detection are required alongside efforts to improve access to cancer treatment. Successful strategies for decreasing cancer mortality in high-income countries are not always effective, feasible or affordable in other countries. In this review, we evaluate strategies for prevention and early detection of breast, cervix, lung, and colorectal cancers, focusing on modifiable risk factors and high-risk subpopulations. Tobacco taxation, human papilloma virus vaccination, cervical cancer screen-and-treat strategies, and efforts to reduce patient and health system–related delays in the early detection of breast and colorectal cancer represent the highest yield strategies for advancing cancer control in many MICs. An initial focus on high-ris...
Head and Neck Pathology, 2020
Adenoid cystic carcinoma (AdCC) is a relatively rare malignancy of head and neck sites such as th... more Adenoid cystic carcinoma (AdCC) is a relatively rare malignancy of head and neck sites such as the salivary glands, lacrimal gland, sinonasal region, and pharynx and may arise in other exocrine glands. The oncologic event in AdCC is the translocation between MYB proto-oncogene transcription factor (MYB) and nuclear factor I/B (NFIB) resulting in t(6;9)(q22-23;p23-24). We carried out a preliminary evaluation of MYB-NFIB translocation by fluorescence in-situ hybridization on seven archived formalin-fixed paraffin-embedded tissues of AdCC of Nigerian patients and its clinicopathologic features. Only 3 of the 7 cases were successfully hybridized, all featuring MYB-NFIB translocations with a range of 14.7-83.3% of translocated cells in 60 cells examined. The 3 translocation positive cases were located in the maxillary sinus, buccal mucosa and parotid. Their morphologic appearances were cribriform-solid (1) & cribriform (2) and classified as grades III (1) & I (2), respectively. These patients may potentially benefit from MYB-targeted anti-neoplastic therapy.
International Journal of Medical Reviews and Case Reports, 2020
Introduction Endometriosis is a gynaecological disorder, defined as presence of endometrial gland... more Introduction Endometriosis is a gynaecological disorder, defined as presence of endometrial glands and/or stroma in any location outside the endometrial cavity and it is usually seen in women of reproductive age group. It involves many organs including the intestine and may cause acute large bowel obstruction. Case Presentation A 32-year-old nulligravida woman presented with 5 years history of recurrent constipation, recurrent lower abdominal pain, menstrual irregularities and dysmenorrhea. An assessment of intestinal obstruction and multiple uterine leiomyoma was made following series of investigations including plain abdominal x-ray, abdomino-pelvic ultrasound, CT and proctoscopy. She had exploratory laparotomy and a mass was found in the caecum and transverse colon with multiple mesenteric lymph nodes. She subsequently had extended right hemicolectomy with ileo-colic anastomosis and myomectomy. Postoperative condition of the patient was satisfactory. The diagnosis of bifocal intestinal endometriosis was made on histopathological assessment. Conclusion It is advised that endometriosis should be part of differential diagnosis in a young woman presenting with recurrent signs and symptoms of intestinal obstruction and colonic mass especially on a background of dysmenorrhea.
American Journal of Clinical Pathology, 2020
Introduction/Objective Breast cancer among Nigeria women had been found to occur at a much younge... more Introduction/Objective Breast cancer among Nigeria women had been found to occur at a much younger age compared with their Caucasian age groups. BRCA1 and BRCA2 were suspected to responsible for breast cancers at a young age, therefore this work examined the BRCA1 and BRCA2 dysfunction among women suffering from breast cancer in Osun State, Nigeria. Methods This cross-sectional study was carried out at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife and Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. The request cards and tissue blocks were sorted from the year 2014 to 2017. The breast tissue blocks were sectioned, stained with H&E. A representative tissue block was selected for each patient. Sections obtained from the blocks were stained with BRCA 1 and BRCA 2 antibody using a diaminobenzidine horseradish peroxidase technique. The cells were semi-quantitatively scored as percentage of tumour cells stained brown. Score 0-5% were taken as negative as...
British Journal of Medicine and Medical Research, 2016
Journal of Cancer Research and Experimental Oncology, 2019
Lipomas are common benign soft tissue tumors, with 15 to 20% of the cases affecting the head and ... more Lipomas are common benign soft tissue tumors, with 15 to 20% of the cases affecting the head and neck region and 1 to 4% involving the oral cavity. The literature has many reported cases of head and neck lipoma but few comprehensive studies hence, the aim of this study was to review and analyze the clinical and histopathologic features of head and neck lipomas in Nigerians. A fifteen-year retrospective study evaluated thirty-six cases of head and neck lipomas among Nigerians. Head and neck lipomas constituted about one-tenth (9.4%) of the total body lipomas seen over the study period. The peak age incidence was fifth decade of life and most (58.3%) of these patients were older than 40 years. There was male gender predilection with male to female ratio of 1.4:1. The most common site of occurrence was forehead (41.7%), followed by scalp and cheek (16.7% each). Lipomas were seen in two intraoral locations (lip and tongue) and these accounted for 13.9% of the head and neck lipomas and 1.3% of lipomas in the whole body. The average size of the lesion was 3.3 cm. Head and neck lipomas are fairly common among Nigerians who are more than 40 years of age. While the conventional and fibrolipoma were the two histologic variants recorded, complete surgical excision of the lesion offered satisfactory treatment outcome.
American Journal of Clinical Pathology, 2019
Objectives Nigeria has one of the highest morbidity rates from breast cancer; therefore, this wor... more Objectives Nigeria has one of the highest morbidity rates from breast cancer; therefore, this work examined the proliferation rate of breast cancer and the hospital presentation time lag among women in Osun State, Nigeria. Methods This cross-sectional study was carried out in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife and Ladoke Akintola University Teaching Hospital, Oshogbo, Nigeria. The request cards and tissue blocks were sorted from the year 2014 to 2017. The time lag it took the patients to report at the hospitals was retrieved from the request cards. The breast tissue blocks were sectioned, stained with H&E, and graded. A representative tissue block was selected for each patient. Sections obtained from the blocks were stained with Mki67 antibody using a diaminobenzidine horseradish peroxidase technique. The cells were semiquantitatively scored as percentage of tumor cells stained brown. The mean ± SD was calculated. Results Out of 240 breast cancer patients ...
Cancer Research, 2018
Prostate cancer (CaP) is the most common male gender cancer and present with a 5-year prevalence,... more Prostate cancer (CaP) is the most common male gender cancer and present with a 5-year prevalence, incidence and mortality rate in Nigerian Black men. There is disproportionate prevalence and poor understanding of CaP in Black men globally. The Prostate Cancer Transatlantic Consortium (CaPTC) has documented significant CaP burden among Nigerian black men in Nigeria and in the Diaspora. Notably, African ancestry is one of the most important risk factors of CaP globally. Increased levels of cortisol, a stress-related catabolic hormone is significantly associated to prostate specific antigen and poor prognosis in prostate cancer patients. Cortisol causes degradation of muscle proteins into amino-acids. Amino acids such as leucine, serves as a source of fuel for aggressive prostate cancer cells in a Warburg effect model through the L-amino acid transporters (LATs). The annexins are calcium and phospholipid binding proteins implicated in cancer development and progression. Overexpression ...
Journal of Interdisciplinary Histopathology, 2018
Background: Pleomorphic adenoma (PA) histopathologically represents a heterogeneous lesion with v... more Background: Pleomorphic adenoma (PA) histopathologically represents a heterogeneous lesion with varying proportion of mesenchymal and epithelial tissue. Due to its heterogeneity, identifying various subtypes often presents a diagnostic dilemma. Hence the aim of this study is to determine and compare activities of salivary myoepithelial (myo) and basal reserve cells (BRC) within subtypes of salivary PA using p63 and alpha smooth muscle actin (α-SMA) immunohistochemical markers. Method: In this retrospective study, 24 archival tissue blocks of PA (12 stroma-rich, 6 cell-rich and 6 classic subtypes) retrieved and subjected to immunohistochemistry using monoclonal p63 and α-SMA antibodies. Fraction of positive cells expressed as percentage of positive cells within each sample, Labeling Indices (LI) was computed. Result: PA samples subjected to immunohistochemistry showed 100% p63 and 95.9% α-SMA immunoreactivity. Statistically significant difference (p=0.01) was observed with p63 Mean LI across PA subtypes. Overall, p63 LI (37.1±13.5) was higher than α-SMA LI (26.5±9.5). Staining pattern for both markers was similar within epithelial and stroma elements. Conclusion: Disparity in Mean LI of the markers with higher index observed for p63, suggests additional activity of BRC, whose variable expression is associated with the differential ratio of epithelial to stroma components within PA subtypes.
East and Central African Journal of Surgery, 2016
Primary extraosseous osteosarcomas (EOO) are very rare and extraosseous osteosarcoma of the parot... more Primary extraosseous osteosarcomas (EOO) are very rare and extraosseous osteosarcoma of the parotid gland is even rarer. When they occur, EOO pursues a very aggressive cause. The consequence of the rarity of this malignancy and its aggressive course is that treatment guidelines are not yet standardized. We present a case of extraosseous osteosarcoma of the parotid gland we encountered in our practice
British Journal of Medicine and Medical Research, 2016
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Papers by AKINWUMI O KOMOLAFE