Marah Simakando - Academia.edu (original) (raw)

Papers by Marah Simakando

Journal of Virology & Antiviral Research, 2017

Background: Breast cancer is the most commonly diagnosed cancer in women and the second leading c... more Background: Breast cancer is the most commonly diagnosed cancer in women and the second leading cause of death of women in Africa. Management of breast cancer depends on availability of robust clinical and pathologic prognostic and predictive factors to guide decision making and the choice of treatment options. Objective: We set out to determine the common histological phenotypes of breast cancer in indigenous Malawian women presenting at Queen Elizabeth Central Hospital (QECH). Methods: We analyzed 63 samples of breast cancer Formalinfixed paraffin-embedded (FFPE) tissues and determined the prevalence of breast cancer over the three year period. Histological phenotypes were matched for age, tumor grade and clinical signs at presentation. The pathology files were retrieved from January 2012 through December 2013 and January through December 2015. Sixty-three breast cancer cases were analyzed for our results showed an increase in the prevalence of breast cancer from 2012 to 2015 as follows 2012 (22/99) 22.2%, 2013 (25/66) 37.9% and 2015 (16/48) 33.3%. Data was analyzed using IBM SPSS® version 20.0 for windows. The chi-square statistical test was used and a p-value of equal to or less than 0.05 was used to indicate statistical significance of the results Results: The histological phenotypes were categorized as follows, invasive ductal carcinoma (IDC) 26 (41.3%), lobular carcinoma 17 (27%), Lobular plus ductal 4 (6.3%), medullary carcinoma 5(7.9%) and papillary intra ductal carcinoma 3(4.8%). Rare breast cancers were 1.6% each with the following proportions, clear cell carcinoma1, Paget disease and squamous cell carcinoma of surface origin1, invasive micro papillary carcinoma 1, oncocytic carcinoma1, solitary myeloma 1, malignant mesenchymal tumor 1, nonkeratinizing squamous cell carcinoma of surface origin plus Ductal carcinoma in situ 1(DCIS) and signet ring variety of mucinous carcinoma1. The common histological grade were grade 2, 32 (50.8%), grade 1,22 (34.9%) and grade 3,4 (6.4%), 5 (7.9%) cases could not be graded Conclusion: The commonest histological phenotype of breast cancer was invasive ductal carcinoma (IDC) followed by lobular carcinoma, and grade two was the commonest histological grade followed by grade one. Most affected age groups were below 50 years of age with a peak at 41 to 50 years of age

International Journal of Applied and Basic Medical Research, 2017

Context: The diagnosis and evaluation of impaired renal function remains a challenge owing to lac... more Context: The diagnosis and evaluation of impaired renal function remains a challenge owing to lack of reliable biomarker for assessment of kidney function. The existing panel of biomarkers currently displays several limitations, and recently kidney injury molecule-1 (KIM-1) has been suggested as a sensitive biomarker of renal function and proposed to enter clinical practice. Aims: This study was conducted to determine the diagnostic value of serum creatinine, urea, and microalbuminuria (MAU) in relation to the novel biomarker, KIM-1. Materials and Methods: Serum creatinine, urea, MAU, and KIM-1 were measured in forty individuals with and forty without kidney disease. Data were analyzed using multivariate methods of assessing diagnostic efficiency, test agreement, condition effects, and variability. Results: The area under the receiver-operator characteristic curve revealed a diagnostic advantage of creatinine (0.924 ± 0.0066) and urea (0.925 ± 0.0068) over MAU (0.880 ± 0.078) and KIM-1 (0.35 ± 0.124). Overall diagnostic efficiency was higher for creatinine and urea (89.5% and 90.9%, respectively), followed by MAU (85.7%) and then KIM-1 (56.3%). Logistic regression analysis showed that creatinine and urea (R 2 = 0.75 and R 2 = 0.72, respectively, P < 0.001 for both) were better predictors of kidney disease than MAU (R 2 = 0.64, P < 0.001) and KIM-1 (R 2 = 0.046, P = 0.116). Further analysis of agreement showed that urea had an excellent agreement with creatinine (kappa r = 0.835, P < 0.001), with KIM-1 (kappa r =-0.198, P = 0.087) showing a poor agreement with creatinine. Conclusion: Our results indicate that elevated serum creatinine and urea above specific cutoff points reliably identifies patients with acute kidney injury or chronic kidney disease. However, more researches are warranted to further validate the diagnostic efficiency and application of MAU and for KIM-1 before its implementation in clinical practice.

B-cell Non-Hodgkin's lymphomas are a heterogeneous disease entity, accounting for about 21 differ... more B-cell Non-Hodgkin's lymphomas are a heterogeneous disease entity, accounting for about 21 different subtypes and 85% of all NHLs. This heterogeneity often makes clinical management of these patients difficult. Currently very little is known about the immunophenotype of the B-cell NHLs in Zambia. Immunohistochemistry plays a crucial role in the proper classification, determination of prognosis and an optimum therapeutic schedule in these lymphoid malignancies. This study was aimed at characterizing the immunohistochemical expression of 5 proteins (CD10, BCL-2, BCL-6, CD23 and Cyclin D1) in 28 cases of B-cell NHLs. This was a cross-sectional study conducted to evaluate 28 conveniently sampled B-cell NHLs formalin fixed paraffin embedded tissues from the year 2012 at the University Teaching Hospital for a six month period. The following panels of primary antibodies were used: CD10, CD23, CyclinD1, BCL-2 and BCL-6 (Dako, Glostrup, Denmark). The Labelled Streptavidin Binding (LSAB) staining was used to amplify and view the reaction. Fisher's exact test was used to indicate statistical significance of the findings. The B-cell NHLs showed positive expression to the markers as follows; Diffuse large B cell lymphoma CD10 3/11(27.4%), BCL-2 6/11(54%) and BCL-6 1/11(9.1%). Burkitt lymphoma, CD 10 4/5(80%) and BCL-6 4/5 (80%). Small lymphocytic lymphoma, CD10 1/2(50%), BCL-2 1/2(50%) and, CD 23 2/2(100%). Mantle cell lymphoma CD10 ¼(25%), BCL-2 3/4(75%) and Cyclin D1 4/4(100%). Follicular lymphoma was CD10 1/2(50%). About 4 cases (14.3%) of the B-cell NHL were unclassified and they were positive only for CD10 3/4(75%). The B-cell NHLs has shown variable expression of the surface membrane proteins. Specifically the over expression of BCL-2 and reduced expression of CD10 and BCL-6 by DLBCLwhich accounted for the majority of the B-cell NHLs is suggestive of a very aggressive NHL prevailing among indigenous black Zambians.

Asian Academic Research Journal of Multidisciplinary

ABSTRACT

African Health Sciences, 2018

Background: Zinc, copper and selenium are known important trace elements playing a vital role as ... more Background: Zinc, copper and selenium are known important trace elements playing a vital role as cofactors of enzymes such as superoxide dismutase and glutathione peroxide. They form part of the first line antioxidants enzymes in red blood cells and plasma. The study aimed at determining the serum levels of zinc, copper and selenium in asymptomatic sickle-cell anaemia patients. Methods: This was a case control study conducted from the specialist Haematology and Oncology Clinic 4 at the University Teaching Hospital, Lusaka, Zambia. 5mls of whole blood was collected from 46 sickle-cell anaemia patients and 46 healthy controls from Out-Patient Department after consent. Using Atomic Absorption Spectrometry, serum levels of zinc, copper and selenium was determined. Independent t-test was used to compare the means and a binary logistic regression for the likelihood of developing a sickling crisis, using SPSS version 20. Results: The mean serum levels of zinc in patients were lower 86.92±2...

Hepatocellular carcinoma (HCC) is the most common f rm of primary hepatic tumour which develops f... more Hepatocellular carcinoma (HCC) is the most common f rm of primary hepatic tumour which develops from hepatocytes and is the 5 th most common cancer worldwide. A greater burden of HCC occurs due to hepatitis B virus (HBV) and hepat itis C viruses (HCV) which are endemic in regions that are mostly resource constrained sub-Sa haran Africa. HCC may also occur due to exposure to aflatoxin B1 and chronic alcoholism. This study was carried out to determine the distribution of HCC subtypes at the University Teaching Hospital in Lusaka, Zambia. Aim: To determine the distribution of the histological s ubtypes of hepatocellular carcinoma across all ages and sex groups at the University Teaching Hosp ital, Lusaka. Materials/Methods: This was a retrospective cross-sectional study tha t w s conducted at the University Teaching Hospital (UTH) from February 20 16 to July 2016.These were tissues diagnosed as HCC from January 2012 to December 2015. Seventee narchival formalin-fixed paraffin embedded ...

Pan African Medical Journal

Introduction von Willebrand Disease (vWD) is the most prevalent bleeding disorder. Women are more... more Introduction von Willebrand Disease (vWD) is the most prevalent bleeding disorder. Women are more likely to manifest abnormal bleeding symptoms due to physiologic events and menorrhagia is the most common presenting symptom. Methods this case-control study included 168 women aged between 18 and 45. The cases had menorrhagia whilst the controls did not. Blood grouping, activated partial thromboplastin time and von Willebrand factor activity tests were performed on samples collected from consenting study participants. Results the mean age was 29.96 ± 7.37. Mean vWF activity of cases was 66.6% and of controls 97.8%. The mean activated Partial ThromboplastinTime (aPTT) of cases was 31.09s and of controls was 30.40s. There was no difference in the vWF activity between blood group O (86.3%) and non-blood group O (88.0%) participants. Eight women were diagnosed with von Willebrand disease, 6 cases and 2 controls. Higher odds of von Willebrand disease were seen in the cases (OR = 6.6). Epistaxis, von Willebrand and factor activity levels and family history of menorrhagia were associated with an increased risk for menorrhagia. Conclusion von Willebrand factor activity levels were associated with menorrhagia while activated partial thromboplastin time was not. vWF activity levels did not depend on any specific blood group. The prevalence of von Willebrand disease was significantly higher in participants with menorrhagia and repeated epistaxis and family history of menorrhagia pointed to a higher risk of menorrhagia.

International Journal of Applied and Basic Medical Research

Asian Journal of Medical Sciences

Background: Anaemia affects approximately 1.62 billion people globally corresponding to 24.8% of ... more Background: Anaemia affects approximately 1.62 billion people globally corresponding to 24.8% of the world's population. Iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) are the most common forms of anaemia. A hormone produced by the liver, hepcidin, is the primary regulator of iron homeostasis and its production increases in ACD and decreases in IDA. Usually, ACD and IDA coexist and sometimes look identical on peripheral blood smears. Aims and Objectives: The current study aims to evaluate the diagnostic value of hepcidin to predict ACD from IDA as well as the diagnostic value of hepcidin to predict ACD from a combination of IDA and ACD. Materials and Methods: Specimens presenting with haematological indices suggestive of IDA and/or ACD following World Health Organisation (WHO) standard case definitions were identified among samples coming to the Haematology laboratory for routine investigations. Serum hepcidin, serum ferritin, serum iron and total iron binding capacity (TIBC) were assessed. Demographic data was obtained from specimen requisition forms. Results: Of the 66 participants, 62.1% (n = 41) were females. IDA was more common among females (36.4%) than males (6.1%) while ACD was more common in males (19.7%) than females (12.1%). Iron Deficiency Anaemia participants had significantly lower hepcidin levels than ACD (p<0.001). There was a significant positive correlation between serum hepcidin and serum ferritin levels (p < 0.001). Conclusion: We found that IDA participants had significantly lower hepcidin levels than ACD and IDA/ACD combined. Therefore, serum hepcidin could be considered in diagnosing and distinguishing ACD from IDA or IDA/ACD as it also had high diagnostic sensitivity and specificity compared to other markers.

B-cell Non-Hodgkin’s lymphomas are a heterogeneous disease entity, accounting for about 21 differ... more B-cell Non-Hodgkin’s lymphomas are a heterogeneous disease entity, accounting for about 21 different subtypes and 85% of all NHLs. This heterogeneity often makes clinical management of these patients difficult. Currently very little is known about the immunophenotype of the B-cell NHLs in Zambia. Immunohistochemistry plays a crucial role in the proper classification, determination of prognosis and an optimum therapeutic schedule in these lymphoid malignancies. This study was aimed at characterizing the immunohistochemical expression of 5 proteins (CD10, BCL-2, BCL-6, CD23 and Cyclin D1) in 28 cases of B-cell NHLs. This was a cross-sectional study conducted to evaluate 28 conveniently sampled B-cell NHLs formalin fixed paraffin embedded tissues from the year 2012 at the University Teaching Hospital for a six month period. The following panels of primary antibodies were used: CD10, CD23, CyclinD1, BCL-2 and BCL-6 (Dako, Glostrup, Denmark). The Labelled Streptavidin Binding (LSAB) staining was used to amplify and view the reaction. Fisher’s exact test was used to indicate statistical significance of the findings. The B-cell NHLs showed positive expression to the markers as follows; Diffuse large B cell lymphoma CD10 3/11(27.4%), BCL-2 6/11(54%) and BCL-6 1/11(9.1%). Burkitt lymphoma, CD 10 4/5(80%) and BCL-6 4/5 (80%). Small lymphocytic lymphoma, CD10 1/2(50%), BCL-2 1/2(50%) and, CD 23 2/2(100%). Mantle cell lymphoma CD10 ¼(25%), BCL-2 3/4(75%) and Cyclin D1 4/4(100%). Follicular lymphoma was CD10 1/2(50%). About 4 cases (14.3%) of the B-cell NHL were unclassified and they were positive only for CD10 3/4(75%). The B-cell NHLs has shown variable expression of the surface membrane proteins. Specifically the over expression of BCL-2 and reduced expression of CD10 and BCL-6 by DLBCLwhich accounted for the majority of the B-cell NHLs is suggestive of a very aggressive NHL prevailing among indigenous black Zambians.