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Papers by Ndukauba Eleweke

Abia State University Medical Students' Association Journal, Jul 2, 2019

East African Medical Journal, Aug 19, 2021

Abia State University Medical Students' Association Journal, Nov 3, 2015

Background: Diseases of the cervix continue to pose a major public health problem in developing c... more Background: Diseases of the cervix continue to pose a major public health problem in developing countries. Objective: To ascertain the pattern and frequency of cervical lesions in Aba, and the findings compared with the records of other workers elsewhere. Design: A retrospective analysis of hysterectomy, trachelectomy and surgical biopsy materials. Setting: Abia State University Teaching Hospital and Aba Diagnostic Center, Aba, Nigeria. Method: The Departmental Surgical Registers from 2007-2013 were studied. The original request cards and case notes were retrieved and scrutinized for patients' age, presentation and initial clinical diagnosis. The biopsy slides were retrieved from the departmental archive and studied using light microscope. The cases were categorized into neoplastic and non-neoplastic conditions. The neoplastic cases were grouped into benign and malignant conditions, and further classified using 2004 World Health Organization (WHO) scheme. The data was processed using EPI-INFO version 2000 series. Results: A total of 4,624 surgical specimen were received by the department within the 7-year study period. There were 356 samples from the cervix, 342 of which met the inclusion criteria for this study. Two hundred and two 202(59.1%) of the cases were non-neoplastic, while 140(40.9%) were neoplastic conditions. The commonest non-neoplastic lesion was chronic nonspecific cervicitis. The commonest benign neoplastic condition was cervical polyp. The commonest malignant condition was Squamous cell carcinoma. The age range was 17 to 93 years with a mean age of 44.5 years.The peak age group for the non-neoplastic and malignant conditions were 40 and 49years respectively. Conclusion: There is a high frequency and early onset of diseases of the cervix in our setting; in contrast to what is traditionally described from Western countries. Keywords: Histopathological pattern, Diseases, Cervix

Open Access Journal of Translational Medicine & Research, 2017

Background: People have various reasons for choosing medicine as a career. We decided to carry ou... more Background: People have various reasons for choosing medicine as a career. We decided to carry out a questioner survey among students in Abia State University Uturu to find out the factors that influenced them to choose medicine as a career. Materials and methods: A questionnaire-based study was carried out among clinical students of 400.500 and 600 levels. The information obtained was analyzed by simple impositions. Results: There were 188 respondents. 106(56.4%).were males, while 82(43.6%) were females. The desire to save life was the strongest motivating factor in 150(79.8%), while peer pressure was the least motivating factor in 9(4.8%) of the study population. 49(26.1%) of the respondents strongly agree that economic reasons was their motivating factor. 122(64.9%) respondents strongly agree that interest in medicine was their motivating factor. Conclusion: The desire to save life is the strongest motivating factor to choose medicine as a career, while peer pressure was the least motivating factor.

Abia State University Medical Students' Association Journal, 2014

Background : External abdominal wall hernias are common surgical conditions worldwide. In Africa,... more Background : External abdominal wall hernias are common surgical conditions worldwide. In Africa, they not only make up a significant part of the surgeons workload, but are a major cause of mechanical intestinal obstruction. They are a leading cause of work loss and disability with lethal complications at times. Knowledge of external abdominal hernias is essential for the doctor. This study examines the pattern of anterior abdominal wall hernias in Abia state University Teaching Hospital (ABSUTH), Aba, Nigeria. Objective : To determine the pattern of external abdominal wall Hernias in adults in ABSUTH. Materials and Method : This is a one year retrospective study. Records of adult patients (18 years and above) seen at Surgical Out Patient Department of ABSUTH from April 1, 2013 to March 31, 2014 were retrieved and relevant information extracted. These were analyzed for age, sex and type of hernia using simple ratios and proportions Result : 112 patients with 114 hernias were seen during the period. Inguinal hernias were the most common hernias in this study. It accounted for 73.3% of the hernias. The other hernias followed in the following descending order – Umbilical 14.3%, Incisional – 6.3%, Epigastric – 5.5%, Spigelian, Lumbar and femoral hernias constituted less than 1.0% of the hernias. Conclusion : Inguinal hernias are the commonest hernias in ABSUTH in both male and female patients with right inguinal hernias being more common than left. Umblical, incisiional and epigastric hernias were commoner in females than in males. Key Words : external, Abdominal Wall. Hernias,

Journal of the West African College of Surgeons, 2017

Background Missile injuries occupy a large segment of injuries treated in Southeast Nigeria, acco... more Background Missile injuries occupy a large segment of injuries treated in Southeast Nigeria, accounting for a significant proportion of morbidity and mortality. However, blast injuries are uncommon in this region. This study became necessary as a result of the rising spate of violence in various parts of Nigeria, particularly in the Northeast and in the Niger Delta regions, as well as the ever-present fear of kidnappers, armed robbers and occasionally, trigger-happy security agents. Aim To determine the types of missile and blast injuries in Southeast region, the circumstances that led to them, the management of the patients, and the outcome. Design of this study This is a collaborative, retrospective multi-centre study. Setting: 1. Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State. 2. Imo State University Teaching Hospital, Orlu, Imo State 3. Abia State University Teaching Hospital Aba, Abia State. 4. Federal Medical Centre, Owerri, Imo State. 5. University of Niger...

Journal of Clinical Oncology, 2011

1043 Background: Proliferating macrophages (promacs) are considered to be pathologic. We previous... more 1043 Background: Proliferating macrophages (promacs) are considered to be pathologic. We previously reported high promacs in estrogen receptor (ER) negative, high grade breast cancers with early recurrence. Given the technical complexities of double staining for promacs, we tested another macrophage marker associated with tumoral invasion in several cancer types, Mac387. We asked whether or not Mac387 would identify promac-rich tumors with early recurrences, and therefore, be a simpler potential marker to assess the impact of macrophage targeted drugs in breast cancer. METHODS We obtained fixed breast tumor tissue from 367 patients from UCSF, California Pacific Medical Center, Highland Hospital (Oakland, CA), Abia State University (Aba, Nigeria), and Ghana. Immunohistochemical stains for Mac 387 were read by two independent pathologists. Mac387 staining was dichotomized as < or >10% of a high powered field (hpf) and was compared to previously obtained promac counts ( >5 promacs/hpf versus <5 promacs/hpf). We used Stata Version 11 for analysis. RESULTS Like promacs, high Mac 387 counts were associated with ER negativity (p < 0.001), high tumor grade (p < 0.001), tumor necrosis (p = 0.001), younger age (p = 0.001), and decreased recurrence free survival (RFS, p = 0.04). Concordance between high Mac387 and high promacs was 0.3. 39% of tumors were high for both, 22% were low for both, 6% had low promacs but high Mac 387, and 33% had high promacs but low Mac 387. Those tumors that had both high Mac 387 and high promacs had a stronger association with decreased RFS (p = 0.005, Figure 1). The hazard ratio (HR) for recurrence was 1.7 (p < 0.05, 95% CI 1.01-2.8) among cases with high Mac387; the HR for cases high in both Mac387 and promacs was 1.9 (p = 0.006, 95% CI 1.2-3). CONCLUSIONS Tumors that were high in both Mac387 and promacs had the strongest association with early recurrence. However, Mac387 alone was also significantly associated with shorter RFS with an overlapping 95% CI as the combination, and is simpler to measure. Mac387 may identify a subset of promacs that are key players in promoting breast tumor invasiveness.

Annals of African Medicine, 2012

Background: Compared to the developed world, there are relatively few studies that describe the t... more Background: Compared to the developed world, there are relatively few studies that describe the tumor biology of breast cancer in African women. While little is known about the tumor biology, clinical and epidemiologic studies suggest that breast cancer in African women are characterized by presentation at late stage and poor clinical outcomes. Analysis of the biological features of breast cancers in Nigerian women was designed to bring additional insight to better understand the spectrum of disease, the phenotypes that present, and the types of interventions that might improve outcomes. Materials and Methods: We performed histological analyses for hormone receptors (estrogen and progesterone receptors), HER2, and tumor infiltrating macrophages (TAM) on 17 breast cancers, obtained from Abia State University Teaching Hospital (Aba, Nigeria), between November 2008 and October 2009. On a subset of these cases, we investigated the potential role of a virus in the etiology of these aggressive cancers. Results: The majority of cases in this cohort were characterized as high grade (100% were grade III), triple-negative (65%), and occur in young women (mean age 47 years). We observed high infiltration of TAMs in these tumors, but no evidence of a viral etiology. Conclusion: Our findings indicate that breast cancers in Nigerian women have a highly aggressive phenotype (high grade, hormone receptor negative), which is similar to other studies from Africa and other developing nations, as well as from African American women, but is significantly different from Caucasian women in the developed world. The presence of high numbers of TAMs in these tumors raises the possibility of targeting the immune microenvironment for therapeutic interventions.

In pursuit of the global commitment of universal access to HIV services, there has been rapid sca... more In pursuit of the global commitment of universal access to HIV services, there has been rapid scale up of HIV programmes including care and support in Nigeria in the past few years. Consequently, more health care providers are increasingly being involved in the provision of HIV services; this however increases their risk of exposure to HIV infection. Most people accessing HIV services are also at risk of developing malignancies because they often present late as a result of stigma. Care providers attitude towards PLWHA has been shown to be the most important factor influencing uptake of HIV services [1]. The objective of this study is to ascertain health care workers knowledge of HIV and their attitude towards PLWHAs in Abia State, Nigeria. Methodology A cross-sectional, descriptive study, involving a total of 300 health care workers selected using stratified sampling technique from the list of registered health care workers in the State. Responses were elicited from them using semi...

Infectious Agents and Cancer, 2010

Background In pursuit of the global commitment of universal access to HIV services, there has bee... more Background In pursuit of the global commitment of universal access to HIV services, there has been rapid scale up of HIV programmes including care and support in Nigeria in the past few years. Consequently, more health care providers are increasingly being involved in the provision of HIV services; this however increases their risk of exposure to HIV infection. Most people accessing HIV services are also at risk of developing malignancies because they often present late as a result of stigma. Care providers attitude towards PLWHA has been shown to be the most important factor influencing uptake of HIV services [1]. The objective of this study is to ascertain health care workers knowledge of HIV and their attitude towards PLWHAs in Abia State, Nigeria. Methodology

Primary hyperparathyroidism (PHPT) is a rare endocrine disorder in which hypercalcemia is documen... more Primary hyperparathyroidism (PHPT) is a rare endocrine disorder in which hypercalcemia is documented. They do not produce compressive symptoms, present usually with nonspecific symptoms or may be asymptomatic. The objective of this report is to draw attention to this disorder said to be rare especially in the low and middle income countries where PHPT diagnosis is made late when skeletal and renal complications have occurred. Two post menopausal Nigerian women with a diagnosis of PHPT made in the USA were referred to our endocrine practice in Aba, Nigeria. The older patient opted out of surgery while the younger patient had a successful parathyroidectomy in USA. There is a concern about other women/patients out there who may have PHPT but do not have access to medical services in USA and the developed world. There is, therefore, a need for a high index of suspicion by healthcare professionals and good laboratory support services in Nigeria and similar countries to clinch the diagnos...

African Journal of Urology

Introduction: In scrotoschisis, there is a congenital defect on the scrotal wall through which th... more Introduction: In scrotoschisis, there is a congenital defect on the scrotal wall through which the testis extrudes and becomes extracoporeal lying outside the scrotal cavity. Observation: This is a rare congenital abnormality as only about 10 cases have been reported in the English literature. This is the first case of this condition reported in Aba, Abia State of Nigeria to the best of our knowledge. Conclusion: Scrotoschisis is treated by returning the testis to the scrotal sac followed by orchidopexy. The immediate and short term results of treatment are good, although there is need to follow up the patient until puberty.

Infectious Agents and Cancer

Annals of Surgical Oncology, 2012

PurposeMacrophages play a major role in inflammatory processes and have been associated with poor... more PurposeMacrophages play a major role in inflammatory processes and have been associated with poor prognosis in a variety of cancers, including breast cancer. Previously, we investigated the relationship of a subset of tumor-associated macrophages (PCNA+ TAMs) with clinicopathologic characteristics of breast cancer. We reported that high PCNA+ TAM counts were associated with hormone receptor (HR)-negative, high-grade tumors and early recurrence. To further understand the significance of elevated PCNA+ TAMs and the functionality of TAMs, we examined the expression of S100A8/S100A9 with the antibody Mac387. The heterodimeric S100A8/S100A9 complex plays a role in inflammation and is increased in several cancer types.MethodsWe performed immunohistochemistry using the Mac387 antibody on 367 invasive human breast cancer cases. Results were compared to previous PCNA+ TAM counts and were correlated with patient outcomes adjusting for HR status and histologic grade.ResultsLike PCNA+ TAMs, hig...