Eric Ihekwoaba - Academia.edu (original) (raw)

Papers by Eric Ihekwoaba

portal: Libraries and the Academy, 2015

This paper seeks to examine the current state of academic utilization of government publications ... more This paper seeks to examine the current state of academic utilization of government publications in Nigerian university libraries. Using a descriptive survey, the study focused on three academic libraries in Southeastern Nigeria serving a population of 11,996 undergraduate and postgraduate student library users, 592 of whom answered a questionnaire. The study relied on questionnaires, interviews, and observation checklists for data collection. Means, frequency counts, and percentages were used to analyze the data. The study recommended that libraries should make the reading spaces and environment in government document sections more comfortable and that government document libraries should engage fully in online subscriptions to government publications.

SAGE Open Medical Case Reports

Transverse vaginal septum is a congenital anomaly in which a membrane obstructs the vagina. This ... more Transverse vaginal septum is a congenital anomaly in which a membrane obstructs the vagina. This can be partial or complete in type. Although rare, it presents peculiar challenges in symptomatology, diagnosis, and ultimate management. To our knowledge, we are the first to report a shortest vaginoplasty-conception interval following successful repair of previously failed repair of partial transverse vaginal septum. A 28-year-old Nigerian married nulliparous lady who presented to us with history of inability of penile–vaginal penetration with the presence of normal menstrual flow after two previous failed attempts at repair. She had a vaginoplasty with placement of a vaginal mold to prevent stenosis. She was subsequently able to have successful sexual intercourse and achieved pregnancy after 2 months, without recurrence of vaginal stenosis. When transverse vaginal septum is encountered in a married nullipara, a thorough clinical evaluation of the viability and feasibility of a vaginop...

Tropical Journal of Medical Research, 2017

Background: Palpable breast masses are common presentations in resource-poor societies. Clinical ... more Background: Palpable breast masses are common presentations in resource-poor societies. Clinical and ultrasonographic breast examinations are commonly available means of evaluation. Objective: The objective of this study was to compare the accuracy of clinical breast examination (CBE) and ultrasonography in the diagnosis of palpable breast masses. Methodology: Consenting females presenting with palpable breast masses at the general surgical outpatient clinic were assessed clinically by the most senior surgeon, ultrasonographically by two radiologists, and the diagnosis compared with histologic examination. Results: One hundred and thirteen patients were recruited during the study period from January 2013 to April 2014. Of these, 53 patients (46.9%) had breast core biopsy, while 60 (53.1%) had open surgical biopsy. Only 67 (59.3%) patients had their histological results available. The mean age was 41.58 years (range 16–78). CBE achieved a sensitivity of 82.1%, specificity 67.9%, positive predictive value (PPV) 78%, negative predictive value 73%, overall accuracy 76.1%, false positive rate 32.1%, and false negative rate 17.9%. Breast ultrasonography had a sensitivity of 86.8%, specificity 72.4%, PPV 80.5%, negative predictive value 80.8%, overall accuracy 80.6%, false positive rate 27.6%, and false negative rate 13.2%. Conclusion: This study revealed no statistical significant difference between the accuracy of CBE and breast ultrasonography. We recommend that both should be used in the evaluation of palpable breast masses.

Orient Journal of Medicine, 2013

Background : Breast cancer is believed to affect a disproportionate percentage of young females i... more Background : Breast cancer is believed to affect a disproportionate percentage of young females in the 3 rd world. These women are outside the age range recommended for screening. Hence, breast cancer diagnosis in this group of women is not improved by population screening. Objective : To examine the pattern of presentation and adherence to treatment of young patients with symptoms and signs of breast cancer. Methodology : Prospective study of the pattern of presentation and adherence to treatment of patients aged 30years and below with breast cancer attending the breast clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi from 2004 to 2008. Results: Breast cancer was suspected in 275 patients of which 22 were aged 30years and below with a mean (SD) of 26.6 (3.14) years. Ten patients had advanced disease at presentation, while one patient discovered her breast lump by BSE. Only 5 accepted mastectomy, and 1 patient completed adjuvant chemotherapy and radiotherapy. Conclusion:...

Annals of Medical and Health Sciences Research, 2017

Objective: To evaluate the hormone receptor status of breast cancer in indigenous women of southe... more Objective: To evaluate the hormone receptor status of breast cancer in indigenous women of southeast Nigeria. Materials and Methods: We collected data on clinical parameters and histologic characteristics - from case notes and histology reports - of women diagnosed of breast cancer and paid for immunohistochemical analyses of their formalin-fixed, paraffin wax-embedded tissue cassettes for hormone receptor status. The relevant clinical data and histologic and immunohistochemical characteristics were analyzed using predictive analytical software, version 17 (IBM, SPSS Inc., Chicago, IL, USA). Comparisons of discrete data were done using Chi-square test, with levels of significance being set at P ≤ 0.05. Result: Within the 6 years study period, 1,410 breast surgical cases were received; 28.2% (397/1,410) of which were diagnosed as breast cancers. Ultimately, 31% (123/397) of these women had IHC (ER, PR, and HER-2/neu) done on their specimens. The age range of the women was 24 to 85 ye...

International Journal of Immunotherapy and Cancer Research, 2020

Background: Majority of the solid cancer patients seen in our Centers come with advanced diseases... more Background: Majority of the solid cancer patients seen in our Centers come with advanced diseases. Some of the cancers are locally advanced, while others are metastatic. Most of these patients who present late belong to the poverty-stricken group in our community. Only few of them can afford costly drugs for their treatment. The government Health Insurance Scheme does not cover cancer patients in Nigeria. Aim: To highlight the importance of immunotherapy in the management of metastatic cancers. Objective: We wish to share our experience in the use of immunotherapy (Bevacizumab) for metastatic cancers in the few patients who could afford the drug, and to highlight the need for reduction of the prices of immunotherapeutic drugs, or for government to subsidize the costs. Methods: From the 1,135 solid cancer patients treated in our two Centers in three years (February 2017 to January 2020), those who presented with metastasis were slated for immunotherapy after we had obtained their immunohistochemistry results. Results: Six hundred and one (601) patients (53.0%) presented late. Three hundred and fi ve (305) of these late presenters (50.7%) came with metastasis. Only 67 (22.0%) out of the 305 metastatic patients could afford immunotherapy, because of high cost. With the exception of one female patient, each of the remaining 66 patients was able to afford only one single dose of Bevacizumab (Avastin) R. Of these patients, one died of Tumor Lysis Syndrome following one single dose of 600 mg of Bevacizumab. There were measurable shrinkages of the tumor burdens, as well as improvement in the quality of life of the remaining 66 patients. Conclusion: Following these encouraging results, immunotherapy for metastatic carcinomas is to be encouraged for wider use, even in resource-deprived economies. Repeated doses will offer the patient greater benefi ts. Government should subsidize the cost of immunotherapeutic drugs so that they would become affordable by majority of those who need them.

Nigerian Journal of Clinical Practice, 2020

Background: Preparation for surgery has traditionally included the removal of body hair from the ... more Background: Preparation for surgery has traditionally included the removal of body hair from the intended surgical wound site. The effect of this practice on postoperative wound infection is yet to be fully elucidated.Aims: This study sought to determine if preoperative chemical depilation reduces the risk of surgical site infection (SSI). Methodology: Two methods of preoperative hair removal: razor shaving and depilatory cream were compared. The eligible patients were randomized into two groups and the presence of postoperative wound infection was evaluated using the Southampton wound grading system. Data were analyzed using SPSS version 21 Chicago-Illinois, statistical significance was inferred at Pvalue ≤ 0.05. Results: In total 100 patients were analyzed with 20 patients excluded due to co-morbidities and noncompletion of the study. The overall prevalence of SSI was 18.0% (7 (14.0%) and 11 (22.0%) in the depilatory cream and razor shaving groups, respectively). The difference in the rate of SSI was not statistically significant (P = 0.436). Hair was completely removed in 47 (94.0%) compared to 38 (76.0%) patients in the razor shaving group (P = 0.012) while skin injuries were noted in 21 (42.0%) vs 1 (2.0%) patients who had razor shaving and chemical depilation(P = <0.0001), respectively. Conclusion: There was no significant difference in SSI rates in patients that had preoperative chemical depilation when compared with razor shaving.

European Journal of Breast Health, 2020

European Journal of Breast Health (Eur J Breast Health) is an international, scientific, open acc... more European Journal of Breast Health (Eur J Breast Health) is an international, scientific, open access periodical published by independent, unbiased, and double-blinded peer-review principles. It is the official publication of the Turkish Federation of Breast Diseases Societies, and Senologic International Society is the official supporter of the journal.

World Journal of Surgery, 2018

Background Very few studies have assessed the quality of life (QoL) of patients living with breas... more Background Very few studies have assessed the quality of life (QoL) of patients living with breast cancer in a resource-poor setting like Nigeria. The aim of our study was to comprehensively examine the measures of QoL in breast cancer patients using the Functional Assessment of Cancer Therapy-Breast (FACT-B) version 4 in order to deepen the literature on QoL among breast cancer patients to include non-Western/northern patient populations. Patients and methods Purposive sampling of stable patients who attended general surgery clinics with histopathologically diagnosed breast cancer was done. Eligible patients were assessed using five domains of the FACT-B questionnaire including: the breast cancer-specific symptoms (BCS), emotional well-being (EWB), functional wellbeing (FWB), physical well-being (PWB), and social & family well-being (SWB). The questionnaire was administered in a face-to-face interview by trained research assistants. In addition, the five domains were compared among three different age categories, pre-menopausal and post-menopausal, and patients who have had surgery and chemotherapy alone. The SPSS (IBM Corp. Released in 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.) and the Microsoft Excel (11. Corporation Microsoft, Redmond, WA, USA) were used for statistical analysis. Statistical significance was inferred when p \0.05. Results Among the 60 enrolled participants, total score of the five domains (n = 144) was 74.59 ± 17.72, FACT-G score (n = 108) was 53.49 ± 12.56, Trial outcome index (n = 112) was 49.20 ± 13.13, PWB (n = 28) was 10.95 ± 6.37, SWB (n = 28) was 18.41 ± 6.48, EWB (n = 24) was 6.98 ± 4.15, FWB (n = 28) was 17.15 ± 7.12, and the BCS (n = 36) was 21.10 ± 8.93. EWB was significantly less in post-mastectomy patients on adjuvant chemotherapy (p = 0.031) and pre-menopausal women (p = 0.041) as well as in patients less than 40 years when compared with patients more 50 years (p = 0.049). Conclusions Breast cancer patients in resource-poor countries have a profoundly impaired quality of life. This study showed significantly lower emotional well-being domain scores in post-mastectomy patients on adjuvant chemotherapy, pre-menopausal women having breast cancer and in younger female patients. There is need to address this anomaly.

Case Reports in Obstetrics and Gynecology, 2016

Background. Acute intestinal obstruction during pregnancy is a very challenging and unusual nonob... more Background. Acute intestinal obstruction during pregnancy is a very challenging and unusual nonobstetric surgical entity often linked with considerable fetomaternal morbidity and mortality. When it is synchronous with abdominal pregnancy, it is even rarer.Case Presentation. A 28-year-old lady in her second pregnancy was referred to Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, at 27 weeks of gestation due to vomiting, constipation, and abdominal pain. Examination and ultrasound scan revealed a single live intra-abdominal extrauterine fetus. Plain abdominal X-ray was diagnostic of intestinal obstruction. Conservative treatment was successful till the 34-week gestational age when she had exploratory laparotomy. At surgery, the amniotic sac was intact and the placenta was found to be adherent to the gut. There was also a live female baby with birth weight of 2.3 kg and Apgar scores of 9 and 10 in the 1st and 5th minutes, respectively, with the baby having right clubbed f...

Nigerian Journal of Clinical Practice, 2016

Background: Accurate clinical diagnosis of fibroadenoma in young females is desirable because of ... more Background: Accurate clinical diagnosis of fibroadenoma in young females is desirable because of the possibility of nonoperative treatment for those desiring it. Objectives: To determine the accuracy of the clinical diagnosis of fibroadenoma in patients aged ≤ 25 years. Patients and Methods: A prospective study of all patients with breast disease presenting to the breast clinic was conducted from January 2004 to December 2008. Results: During the study period, 145 patients aged ≤25 years presented with breast lumps. In this group, a clinical diagnosis of fibroadenoma was made in 100 (69.0%), fibrocystic disease in 32 (22.1%), breast cancer in 4 (0.03%) patients, the remaining were benign lesions. Excision biopsy was done for 81 (55.9%) patients. Of these 81 patients, only 62 (76.5%) returned with histology report. The histological diagnosis was fibroadenoma in 45 (72.5%) patients with a mean age of 21.4 years. Their ages range from 18 to 25 years. The histological diagnosis was fibrocystic disease in 9 (14.5%) and malignant phyllodes in 1 (1.6%) patient. The remaining 7 (11.3%) patients had other types of benign lesions. For fibroadenoma, true positive cases were 42, false positive 7 and false negative 3, and true negative 10. Therefore, the sensitivity of clinical diagnosis of fibroadenoma was 93.3%, while specificity was 58.8%. Conclusion: The sensitivity of clinical diagnosis of fibroadenoma in patients aged ≤25 years was good, though specificity is low.

Nigerian Journal of Surgery, 2016

Breast pain is a common problem in the setting of both primary care and breast clinics. Some rese... more Breast pain is a common problem in the setting of both primary care and breast clinics. Some researchers have found it to be more common than breast cancer as a presentation. [1] Preece et al. [2] proposed a classification with six subgroups: Cyclical mastalgia, duct ectasia, Tietze's syndrome, trauma, sclerosing adenosis, and cancer. Mastalgia can be associated with premenstrual syndrome, fibrocystic breast disease, psychologic disturbance and rarely, breast cancer. [3,4] For the majority of women, it is a self-limiting condition, with the breast being normal and few sought treatment. [5-8] Nevertheless, in a few cases, severe, prolonged cyclical or noncyclical breast pain may cause a major disturbance to various aspects of life. [9] Confronted with the patients complaining of breast pain, clinicians have to determine whether it arises from a mammary or an extra-mammary source. If the problem originates from the breast, further management depends on its nature, severity, and duration. Also, it has been demonstrated that breast pain is not associated with increased risk for cancer. [10] This study aims to highlight the causes of breast pain and their distribution in patients presenting to our breast clinic. MAterIAls And Methods A prospective study of all consenting patients with breast disease presenting to the breast clinic was conducted from January 2004 to December 2008. The data of all patients presenting with breast pain form the basis of this study. The data included; age at presentation, presenting complaints, menstrual status, the relation of pain to the menstrual cycle, and the side of the breast affected. The clinical evaluation was done by a consultant general surgeon or a specialist senior registrar in general surgery. Simple frequencies and Chi-square analysis were done using SPSS statistical software

Tropical Journal of Medical Research, 2011

This study aims to screen adolescent girls in Nnewi, SouthEastern Nigeria for the presence of pot... more This study aims to screen adolescent girls in Nnewi, SouthEastern Nigeria for the presence of potential pathogens like genital mycoplasmas and also to know the associated risk factors predisposing them to these organisms. A cross-sectional study involving the use of high vaginal swabs (HVS) from 100 adolescent girls aged between 13 and 18 years was done. Molecular method was used to analyse the swabs using the polymerase chain reaction technique. Questionnaires were also used to obtain the bio data and evaluate the risk factors to these vaginal organisms. A prevalence rate was was 20% out of which 4% represented concomitant colonization by 2 or more different species. A breakdown of the organisms showed that the Ureaplasma species-Ureaplasma urealyticum and Ureaplasma parvum had 6% and 4% colonization rates respectively while the Mycoplasma species-Mycoplasma hominis and Mycoplasma genitalium had 4% and 6% rates respectively. Poor personal hygiene and sharing of personal effects were found to be risk factors in predisposing subjects to M. hominis acquisition. The high prevalence of these organisms among asymptomatic adolescents suggests strongly that they are not always associated with symptoms thus supporting the need for screening among this population.

The Breast, 2011

This study reports on the acceptance and adherence behaviors of patients presenting with a clinic... more This study reports on the acceptance and adherence behaviors of patients presenting with a clinical suspicion of breast cancer at a breast clinic in Nigeria during a 5-year period (2004e2008). Of the 275 study patients, 28.7% (79 patients) refused a biopsy needed for a definitive diagnosis. Of those who agreed to a biopsy, 10.2% (28 patients) did not return for a follow-up visit. Mastectomy was offered to 140 patients, 47.9% (67 patients) refused the surgery. Of the 53 patients diagnosed with locally advanced lesions offered neo-adjuvant chemotherapy, 28.3% (15 patients) completed the recommended therapy. Of the 44 patients offered adjuvant chemotherapy, 38.6% (17 patients) completed the recommended therapy. Only 23 of the patients advised to go for radiotherapy complied. Barriers to patient adherence to diagnostic and treatment recommendations included both patient barriers and system barriers.

Chinese Journal of Cancer, 2011

Neoadjuvant chemotherapy (NACT), which can reduce the size and therefore increase the resectabili... more Neoadjuvant chemotherapy (NACT), which can reduce the size and therefore increase the resectability of tumors, has recently evolved as a treatment for locally advanced cervical cancer. NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer. To further assess the effects of NACT on surgery and the pathologic characteristics of cervical cancer, we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or without NACT at the People爷s Hospital of Peking University between January 2006 and December 2010. Of 110 patients, 68 underwent platinum鄄 based NACT prior to surgery (NACT group) and 42 underwent primary surgery treatment (PST group). Our results showed 48 of 68 (70.6%) patients achieved a complete response or partial response to NACT. Estimated blood loss, operation time, and number of removed lymph nodes during surgery, as well as complication rates during and after surgery were not significantly different between the NACT group and the PST group. The rates of deep stromal invasion, positive parametria, positive surgical vaginal margins, and lymph node metastasis were not significantly different between the two groups. However, the rate of lymph鄄 vascular space involvement 渊LVSI冤 was significantly lower in the NACT group than in the PST group (P = 0.021). In addition, the response rate of NACT was significantly higher in the patients with chemotherapeutic drugs administrated via artery than via vein. Our results suggest that NACT is a safe and effective treatment for locally advanced cervical cancer and significantly decreases the rate of LVSI.

Nigerian Journal of Surgery, 2011

Background Objective Material and Methods Results Conclusion

International Journal of Medicine and Health Development, 2020

Background: Breast cancer is the most prevalent cancer and the second leading cause of cancer dea... more Background: Breast cancer is the most prevalent cancer and the second leading cause of cancer death among women, and understanding how obesity impacts this disease has important public health implications. Materials and Methods: This study was a prospective study that involved 100 participants managed for breast diseases from May 2015 to April 2017 at Nnamdi Azikiwe University Teaching Hospital, Nnewi (NAUTH). All the participants were formally diagnosed using clinical evaluation and core tissue biopsy. Waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), height and weight were measured, subsequently body-mass index was estimated as a ratio of an individual’s weight (kg)/height (m2). Results: The mean age (SD) of the subjects was 41.6 (9.3) years; all the participants were women. The mean (SD) body-mass index, WC and WHR of all the participants were 27.57 (6.85) kg/m2; 87.70 (16.36)cm and 0.87 (0.07) respectively. The mean (SD) body-mass index of pre-menopausa...

Infectious Agents and Cancer

Breast, 2011