Clement Osime - Academia.edu (original) (raw)

Papers by Clement Osime

Annals of Medical Medicine , 2008

Background: Breast cancer is often associated with severe morbidity and mortality especially when... more Background: Breast cancer is often associated with severe morbidity and mortality especially when the patients present late. A major reason why patients present late is the lack of awareness about breast cancer, its complications and the management. Methods: The study was carried out using a structured questionnaire. A total of 400 female civil servants were enlisted in the study, but only 385 respondents completed and returned the forms. Results: Two hundred and seventy seven (72.0%) respondents had tertiary level of education. Sixty six (17.1%) respondents were in the 30-34-year age group. Three hundred and twelve (81.0%) respondents knew correctly that breast lump is usually the first symptom of presentation of breast cancer. One hundred and forty four (37.5%) respondents knew that a positive family history of breast cancer is a risk factor, while two hundred and seventy four (71.2%) respondents answered that cancer of one breast in a woman increases her chances of having cancer of the other breast. Three hundred and twenty one (83.4%) respondents knew that breast cancer could spread from one breast to the other and two hundred

African Journal of Reproductive Health, 2010

Intussusception in pregnancy is rare and making a preoperative diagnosis is extremely difficult. ... more Intussusception in pregnancy is rare and making a preoperative diagnosis is extremely difficult. The objective of this paper is to report a case of intussusception in a pregnant woman and to review the literature on the subject with a view to highlighting the peculiarities of this condition. The case file of a 26 year old Gravida 3, Para 0+2 lady who had appendectomy 5 years earlier and now presented at 33 weeks of gestation with features of intestinal obstruction was evaluated. Ultrasound scan showed dilated bowel loops suggestive of intestinal obstruction. At operation, an ileo-ileal intussusception was found without a lead point. Histology of the resected bowel segment showed haemorrhagic infarction without evidence of malignancy. Even though bands and adhesions are the commonest causes of intestinal obstruction in a patient that has had a previous abdominal surgery, possibility of other aetiological factors should always be considered (Afr J Reprod Health 2010; 14[1]:145-148). RĖSUMĖ Intussusception pendant la grossesse : Un compte rendu. L'intussusception dans pendant la est peu commun et la diagnostic préopératif est extrêmement difficile. Cet article a pour but de rapporter un cas d'intussusception chez une femme enceinte et de passer en revue la littérature sur le sujet en vue de mettre l'accent sur les particularités de cet état. Nous avons évalué le dossier d'une jeune femme de 26 ans (gravide 3, nullipare 0 + 2) qui a su l'appendicectomie cinq ans plus tôt et qui maintenant présente après 33 semaines de gestation, les traits de l'occlusion intestinale. Au cours de l'intervention chirurgicale on a découvert une intussusception iléo-iléale sans point de dérivation. L'histologie du segment de l'intestin réséque a montré l'infarctus hémorragique sans l'évidence de la malignité. Bien que les brides et les adhésions constituent les causes les plus communes de l'occlusion intestinale chez une patiente qui ont déjà subi une intervention chirurgicale, il faut considérer la possibilité d'autres facteurs étiologiques (

BMC Women’s Health , 2021

Background: Prevention of BC of which the cornerstone is creating awareness and early detection i... more Background: Prevention of BC of which the cornerstone is creating awareness and early detection is important in adolescents and young women because of their worse outcomes. Early detection strategies such as mammography are currently beyond the reach of most women in sub-Saharan Africa.. Lack of awareness and late presentation contribute to the poor outcomes. Awareness creation among adolescents may result in modification of some risk factors for BC with adoption of healthy life styles including accessing early detection activities. This study determined the effect of peer education as a strategy to create awareness on BC and breast self examination (BSE) among in-school female adolescents in Benin City. Methods: This was a pre-post interventional study carried out in October-December 2016 on female students of four secondary schools in Benin City. Pre-peer training, using a pre-tested selfadministered questionnaire, knowledge about BC and BSE was assessed in about 30% of each school population. This was followed by training of 124 students selected from the schools (one student per class) as peer trainers. The peer trainers provided training on BC and BSE (the intervention) for their classmates. Within two weeks of peer training knowledge about BC and BSE was reassessed in 30% of each school population. Selection of students for assessment pre and post intervention was by systematic sampling. Correct knowledge was scored and presented as percentages. Chi square test, student t test and ANOVA were used to assess associations and test differences with level of significance set at p < 0.05. Results: There were 1337 and 1201 students who responded to the pre and post-training questionnaires respectively. The mean BC knowledge score (20.61 ± 13.4) prior to training was low and it statistically significantly improved to 55.93 ± 10.86 following training p < 0.0001 Following peer training, statistically significant improvement (p 0.037-< 0.001) occurred in most knowledge domains apart from symptomatology. Pre-peer training 906(67.8%) students knew about BSE but only 67(4.8%). Significantly more students 1134(94.7%) knew about BSE following peer training. Conclusions: Peer education strategy can be used to improve BC and BSE knowledge in adolescents. This strategy is low cost and could be very useful in low resource settings.

Port Harcourt Medical Journal, 2019

Background: Sickle cell disease (SCD) is a chronic lifelong disease seen typically in Sub-Saharan... more Background: Sickle cell disease (SCD) is a chronic lifelong disease seen typically in Sub-Saharan
Africans, the Mediterranean region and parts of Asia. The condition may be associated with other
clinical entities. Aim of Presentation: We present a case of malignant variant of paraganglioma in a
34-year-old SCD patient to highlight the fact that some very rare clinical entities may be found in
this category of patients. Case Report: Miss B.O. was a 34-year-old SCD patient who presented
with features of an intra-abdominal mass. Incisional biopsy done from a mass arising from the left
adrenal gland confirmed a malignant variant of paraganglioma. Post-exploratory laparotomy, the
patient's clinical state deteriorated and she died 25 days after surgery. Conclusion: Malignant
variant of a paraganglioma, a very rare clinical condition, may be found in SCD patients

Niger J Surg Sci, 2017

This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Archives of International Surgery, 2022

Acute appendicitis may mimic several acute abdominal conditions. In perforated peptic ulcer disea... more Acute appendicitis may mimic several acute abdominal conditions. In perforated peptic ulcer disease, the contents may track down the right iliac fossa to mimic the presentation of acute appendicitis. The objective of this study was to highlight the diagnostic dilemma encountered in differentiating perforated peptic ulcer (with gastric contents tracking into the right iliac fossa) and acute appendicitis. We present the case of a 45-year old man who had appendicectomy in a private medical center and later developed features of generalized peritonitis 10 days after surgery. Following a diagnosis of postoperative peritonitis, exploratory laparotomy was carried out, which revealed perforated gastric ulcer. The perforation was repaired and peritoneal lavage was done. He made an uneventful recovery and was discharged after 3 weeks on admission. Perforated peptic ulcer could mimic acute appendicitis. A high index of suspicion is vital in differentiating both conditions, to prevent the morbidity and mortality resulting from misdiagnosis.

Port Harcourt Medical Journal valedictory editorial, 2022

Background: Gastrointestinal stromal tumour are rare gastrointestinal tumour that probably origin... more Background: Gastrointestinal stromal tumour are rare gastrointestinal tumour that probably originate from the interstitial cells of Cajal and 95% express a specific molecular marker. They occur most commonly in the stomach (60%) followed by the small intestine (30%) and may present with gastrointestinal bleeding. Case Report: A 40year old man presented with passage of frank blood per rectum with associated haemodynamic instability necessitating several units of blood transfusion. Following adequate resuscitation, lower and upper GI endoscopy done were negative and subsequently had emergency laparotomy for continued gastrointestinal bleeding. We found a bleeding ileal tumour which was resected. Histopathology confirmed gastrointestinal stromal tumour. Conclusion: small bowel stromal tumour rarely and unusually presents with massive lower GI bleeding. Diagnosis may be delayed due to inaccessibility of the small bowel to routine upper and lower GI endoscopy. Mesenteric angiography, radionuclide RBC, capsule endoscopy, push enteroscopy depending on the fitness of the patient, may aid diagnosis. Prompt surgical resection and adjuvant imatinib therapy for malignant variants is the treatment of choice.

British Journal of Medicine & Medical Research, 2016

This work was carried out in collaboration between all authors. Author DFM wrote the first draft ... more This work was carried out in collaboration between all authors. Author DFM wrote the first draft of the manuscript. Author MOU reported the histology slides, managed the literature searches and wrote the discussion. Author CO provided the clinical history, investigation and follow up details. Author UOI reported the immunohistochemistry and prepared the photomicrographs. All authors read and approved the final manuscript.

Front. Public Health , 2015

The epidemiological transition in sub-Saharan Africa (SSA) has given rise to a concomitant incre... more The epidemiological transition in sub-Saharan Africa (SSA) has given rise to a concomitant increase in the incidence of non-communicable diseases including cancers.
Worldwide, cancer registries have been shown to be critical for the determination of
cancer burden, conduct of research, and in the planning and implementation of cancer
control measures. Cancer registration though vital is often neglected in SSA owing
to competing demands for resources for healthcare. We report the implementation of
a system for representative nation-wide cancer registration in Nigeria – the Nigerian
National System of Cancer Registries (NSCR). The NSCR coordinates the activities
of cancer registries in Nigeria, strengthens existing registries, establishes new registries, complies and analyses data, and makes these freely available to researchers
and policy makers. We highlight the key challenges encountered in implementing
this strategy and how they were overcome. This report serves as a guide for other
low- and middle-income countries (LMIC) wishing to expand cancer registration coverage in their countries and highlights the training, mentoring, scientific and logistic
support, and advocacy that are crucial to sustaining cancer registration programs
in LMIC.

Port Harcourt Medical Journal, 2015

Background: Presently in Nigeria and most other jurisdictions, healthcare providers erroneously b... more Background: Presently in Nigeria and most other jurisdictions, healthcare providers erroneously believe that minors cannot give a valid consent to receive medical treatment. Aim: To critically appraise the current practices where minors are deemed incompetent to give valid consent for medical treatment and to provide legal authorities to buttress the point that some categories of minors can give valid informed consent. The paper also seeks to review situations involving minors indeed where parents refuse to give consent for life saving procedures. Methods: Google search was made to identify legal opinions on the subject of informed consent for medical treatment and minors. Findings from the search were analysed against the background of current practices of healthcare providers. Results: Virtually all legal authorities are in agreement that minors can indeed give valid informed consent for treatment (or make informed refusal) provided the minor is mature or emancipated. And for minors indeed, the overall best interest of the child should be taken into consideration with respect to parents or guardians who may not consent to medical procedures. Conclusion: Some categories of minors can give valid informed consent even when the parents refuse to consent to such treatment. A mature or emancipated minor can enjoy the same rights with respect to informed consent (or informed refusal) for medical treatment. However, there is need for healthcare providers to critically appraise the local challenges in order not to create hardship for the minor after he/she has given consent for treatment.

: African Journal of Medical and Health Sciences, 2014

Dermatofibrosarcoma protuberans (DFSP) of the breast is quite rare. Even rarer is DFSP of the mal... more Dermatofibrosarcoma protuberans (DFSP) of the breast is quite rare. Even rarer is DFSP of the male breast. The purpose of this article is to report a case of DFSP of the left breast in a 32-year-old man. This is with a view to creating awareness about this rare clinical condition. This is expected to aid clinicians in making an early diagnosis and ensuring prompt management of the condition.

Nigerian Postgraduate Medical Journal , 2022

Aims and Objectives: To determine the difference in outcome between a 1-day and 5-day antibiotic ... more Aims and Objectives: To determine the difference in outcome between a 1-day and 5-day antibiotic regimen in the prevention of infective complications followingtransrectal prostate biopsy. Patients and Methods:This prospective comparative study was done in the urology unit of University of Benin Teaching Hospital over a period of 14 months. Eighty seven patients were randomly assigned to 2 groups prior to the procedure. The patients in group I (N=42) received oral ciprofloxacin (500mg, 12 hourly) and oral metronidazole (400mg, 8 hourly) for 1 day while those in group II (N=45) received same antibiotic combination for 5 days. Urine samples for culture were taken an hour before the procedure and then 5 days after in all patients.Temperature monitoring with an easy-to-use thermometer was done thrice daily by the patients. Post biopsy fever and positive urine cultures were indicative of infection. Results: The mean age of the patients was 68.5± 8.1 years. Infective complications occurred in 8(19%) in group I and 7(15.6%) in group II. Fever was noted in 5 patients in group I and 4 patients in group II (p=0.73) while positive urine culture was noted in 4 patients in each group (p=1.00). Complications were minor and transient except in a case of septicaemia in group II that required hospitalisation. Escherischia coli was the most common organism isolated from positive urine cultures. Conclusion:A 1-day antibiotic regimen of oral ciprofloxacin and metronidazole is as effective as a 5-day regimenin the prevention of infective complications following transrectalprostate biopsy.

Introduction: It appears most healthcare workers do not have a proper understanding of the meanin... more Introduction: It appears most healthcare workers do not have a proper understanding of the meaning of discharge against medical advice.

African Journal of Tropical Medicine and Biomedical Research, 2012

NIGERIAN RESEARCH JOURNAL OF CLINICAL SCIENCE, 2011

North American Journal of Medical Sciences, 2011

Background: Otitis Media continues to be a major presentation in the ear, nose and throat clinic.... more Background: Otitis Media continues to be a major presentation in the ear, nose and throat clinic. Aim: This study aimed to isolate, characterize and identify the bacteriological and mycological etiologic agents of otitis media in Benin city. Patients and Methods: Ear discharge from 569 (299 males and 270 females) patients diagnosed clinically of otitis media between August 2009 and August 2010 were processed to recover the bacterial and fungal etiologic agents. Susceptibility test was performed on all bacterial isolate. Result: Pseudomonas aeruginosa (28.3%) was the predominant bacteria isolate causing otitis media followed by Staphylococcus aureus (21.0%), Klebsiella sp (8.9%), Proteus sp (8.2%), Alkaligenes spp (4.3%), Streptococcus pneumoniae (3.9%), Escherichia coli (3.0%) and Citrobacter freundi (1.7%). Fungi isolated were Aspergillus niger (9.2%), Candida albicans (5.4%), Candida tropicalis (3.0%), Aspergillus flavus (2.1%) and Candida parasilopsis (1.5%). 413 had a single organism isolated from the middle ear culture while twenty (3.51%) patients had mixed organisms isolated. Infection was highest among 0-5 years, and lowest among aged 18-23. All bacterial isolates were poorly susceptible to the antibacterial agents. Conclusion: The study uncovers a high frequency of bacteria associated otitis media with the finding of fungi too as a significant etiologic agent.

North Am J Med Sci;, 2011

Benin Journal of Postgraduate Medicine, 2008

Port Harcourt Medical Journal, 2011

Journal of Gastrointestinal Cancer, 2010

Background: Gastric carcinoma is usually characterized with significant morbidity and mortality m... more Background: Gastric carcinoma is usually characterized with significant morbidity and mortality
mainly because of late presentation. Late presentation of gastric carcinoma is a prominent feature in
developing and poor countries.
Aim of study: The purpose of this study is to present our experience with the pattern and outcome of
gastric tumors at the University of Benin Teaching Hospital, Benin City, Nigeria; with emphasis on late
presentation of the patients.
Patients and methods: The case files of the patients that were managed at the University of Benin
Teaching Hospital for gastric tumors over a 5-year period (January 2004 to December 2006) were
analyzed for biodata, symptoms and signs of disease, findings at operation, treatment offered, and
outcome of treatment.
Results: The male/female ratio was 2.3:1, with the youngest patient being 38 years while the oldest
patient was 76 years old. Upper abdominal pain and a palpable mass per abdomen were the
commonest symptoms and signs, respectively. Alcohol ingestion was the commonest identifiable risk
factor. Only 30.4% of the patients presented within a year of the onset of symptoms. The gastric
antrum was affected in over 78% of the cases, and adenocarcinoma was found in about 90% of the
patients. Partial gastrectomy with gastrojejunostomy was the commonest procedure carried out. The
mortality rate was 39.1%, and of the patients that died, 66.7% occurred within a year from time of
diagnosis.