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ANTIBIOTICS RESISTANCE

Antibiotics are substances that are able to destroy or inhibit the growth of bacteria and other similar organisms. Antibiotic resistance occurs when bacteria change and they no longer respond effectively to antibiotics that were initially used to treat infections they cause and therefore they continue to multiply and cause more harm.

There are several factors that contribute to antibiotic resistance:

  • Over-prescription of antibiotics. This includes prescribing many potent drugs to a patient and this could be due to seeking medical attention in different hospitals or clinics without giving adequate history of previous treatment.
  • Overusing antibiotics in the meat supply chain. More than 50% of all antibiotics globally are used in the meat supply chain to prevent rather than treat infections, to promote rapid growth and weight gain.
  • Failure of patients to finish their treatment. Bacteria are able to mutate in such a way as to avoid being destroyed by the drug since they gotten to know how the antibiotic works.
  • Poor control of infections in hospitals and clinics. Patients admitted in hospital have a risk of developing hospital-acquired infections, some of are caused by strains of resistant bacteria such as Methicillin Resistant Staphylococcus aureus (MRSA).
  • Failure to develop new antibiotics. Bacteria are constantly undergoing mutation and failure to develop new antibiotics leads to development of resistant strains.
  • Poor sanitation and hygiene. This results in infections that require treatment with antibiotics and eventually lead to emergence of resistant strains of bacteria that fail to respond to antibiotics used to treat them.

Antibiotic resistance is a global problem. The following are ways to eradicate this scourge:

  • Accounting for all the antibiotic used. This applies to both healthcare providers and farmers. With this, healthcare providers and farmers will avoid irrational use of antibiotics.
  • Adoption of a policy that fosters protection of human health by restriction of non-therapeutic use of antibiotics in livestock.
  • Practicing proper hygiene by washing hands thoroughly and handling food hygienically decreases the risk of getting food-borne illnesses hence antibiotics for treatment may not be needed frequently.
  • Offering civic education to the people through mass media can come in handy in the eradication of antibiotic resistance. Lack of knowledge on the dangers of drug abuse such as use of non-prescription medication has contributed immensely to antibiotic resistance. Plato said ignorance is the root and stem of all evil. Therefore, educating the masses on antibiotic resistance and how to deal with it can greatly help eradicate this problem.
  • Adequate training of healthcare professionals on the use of antibiotics. Healthcare professionals are in charge of dispensing medication to patients and the general population. With adequate training, healthcare professionals should uphold their professionalism and exercise integrity at all times.

Next time you think of self-medication or not finishing your treatment remember you could be developing superbugs that will be harmful to you and others as well. Eradication of antibiotic resistance begins with YOU!

Nalianya Emma
Kenyatta University, Nairobi, Kenya.
+254705087428
emmanalianya@gmail.com

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AMR Week. Call for Articles

FAMSA – CALL FOR ARTICLES, NOVEMBER 2017

FEDERATION OF AFRICAN MEDICAL STUDENTS’ ASSOCIATIONS (FEDERATION DES ASSOCIATION DES ETUDIANTS EN MEDICINE) FAMSA is a Non-Governmental, Non Profit Oriented Organisation for all medical students in Africa to play a significant role in improvement of the health of the African people and the problems of African society.

This week is Antibiotics Awareness Week. This year’s theme for the A.A.W is Seek advice from a qualified Health Care Professional before taking antibiotics. Antibiotics are important in treatment of disease and so it is of paramount importance that we know when, why and how to use them.

We are therefore making a call to Medical Students interested in writing articles within the A.A.W theme for 2017.

If you are interested in the above theme and you would like to share your ideas with Africa and the World as a whole and publish on the FAMSA’s website – famsanet.org and FAMSA blog,

Please send us your full article on any topic of your choice under the above theme.

Deadline is 11:59pm GMT Friday, 18th November, 2017.

Incoming articles should adhere to the following specifications:

1⃣ Clearly defined brief topic

2⃣ Not more than 1,500 words

3⃣ Full details of writer including name, school, country and contacts.

4⃣ All articles should be sent to ngigi.jackie@gmail.com and famsaarchives@gmail.com

Change can only start from you and me. Let us not wait for others to act on our behalf.

FAMSA; Towards The Improvement Of Health In Africa.
Chairperson, SCOPUB, FAMSA 2017.

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CALL FOR SCOPUB EDITORIAL TEAM

The Standing Committee on Publications (SCOPUB) is responsible for all FAMSA publications including; Afromedica journal, FAMSA Newsletter, Introducing FAMSA and other related publications.

SCOPUB also assists member associations in publication problems and is responsible for establishing and keeping contacts of local medical student publications.

Membership is open to all members of FAMSA. The positions available are as follows:

  1. Design Directors:
Two (2)
 Roles:
-Assist the Chair of SCOPUB in the organization and commissioning of any art work needed in SCOPUB Publications.
  2. Copy Editors:
Two (2) 
Roles:
- To assist the SCOPUB Chair in getting articles from interested writers for purposes of FAMSA Publications.
  3. Proof Readers:
Two (2) 
Roles:
-To assist the SCOPUB Chair in checking all written material for spelling and grammar errors.

Guidelines:
It is strongly encouraged that the team be composed of Medical Students from all the African Member States. This includes members from: Central Africa Region, West Africa Region, South Africa Region, East Africa Region.

Requirements:
-Resume highlighting relevant experience.
- Motivation Letter expressing why you are interested in any of the above positions. -Plan of Action.
Submit your work to famsaarchives@gmail.com

Deadline:
Deadline for submissions is 20th November, 2017 at 11:59PM GMT.

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CALL FOR CHAIRPERSON, STANDING COMMITTEE ON PUBLICATIONS (SCOPUB)

The Federation of African Medical Students’ Associations hereby opens a call for application for the position of Chairperson, Standing Committee on Publications (SCOPUB).

Details of the role of this position can be found here  

How do you apply?

– You must send your application to famsaarchives@gmail.com before 20th October 11:59pm GMT.

– Only Non-Nigerian African medical students are eligible.

– Send the following documents to famssarchives@gmail.com before 20th October 11:59pm GMT:

  1. Résumé
  2. Cover letter (Not longer than 1 page)
  3. Plan of Action
  4. Letter from your MSA president
  5. Evidence of studentship

 

Incomplete applications will not be considered. If you have any questions regarding the application process, please feel free to email us at famsaarchives@gmail.com

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FEDERATION OF AFRICAN MEDICAL STUDENTS’ ASSOCIATIONS (FAMSA) 31st GENERAL ASSEMBLY

⁠⁠⁠🌍 Federation of African Medical Students’ Associations (FAMSA)🌍

presents

31st General Assembly

Date 🗓 : 13th-17th September, 2017.

Venue 🏫 : Niger Delta University, Yenagoa, Bayelsa State, Nigeria.

This historic event is an annual platform where medical students from over 30 African countries come together to discuss health issues pertaining to Africa.

Featuring:
🛑 Scientific Seminars/Lectures
⚫ Inter medical school Quiz
🔵 Sight seeing
✳ Native Dinner
🌐 General Election

DELEGATE FEES
➡ Nigerian: $16
➡ Foreign : $32

It promises to be enlightening, fun and adventurous. We look forward to your arrival at Yenagoa!
FAMSA….Towards the improvement of health in Africa

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DEPRESSION – A CALL TO ACTION

The study, published in the Public Library of Science (PLOS) Journal of Medicine, found that globally, the prevalence of depression was 4.4 per cent, while Afghanistan and the Palestinian territories were amongst the most depressed states.

According to the research, depressive orders are second only to lower respiratory infections when it comes to inflicting the most years of disability on people throughout the world.

Clinical depression is defined as involving at least one major episode in which the affected individual experiences a depressed mood almost all day, every day for at least two weeks.

The researchers used data on the prevalence, incidence, remission rates and duration of depression and dysthymia (a milder, chronic form of depression that lasts for at least two years), and on the excess deaths caused by these disorders from published articles.

They found that the prevalence of depression for women was almost twice as high than it was for men.

More than five per cent of people in the Middle East, North Africa, Eastern Europe, sub-Saharan Africa and the Caribbean have depression, the researchers found.

However, it is important to note the research was based on the rate at which people were diagnosed with clinical depression, rather than actual rates of depression.

Maymunah Yusuf Kadiri a consultant Neuro Psychiatrist and Psychotherapist, Medical Director at pinnacle medical service, in an interview with Kemi Ajumobi of Business day newspaper, Nigeria. Depression affects people of all ages, from all walks of life, in all countries. It causes mental anguish and impacts on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living. At worst, depression can lead to suicide, now the second leading cause of death among 15-29-year olds. When mild, people can be treated without medicines but when depression is moderate or severe they may need medication and professional talking treatments. The risk of becoming depressed is increased by poverty, unemployment, life events such as the death of a loved one or a relationship break-up, financial challenges, physical illness, abuse-physical, sexual, emotional and drug, conflicts, economic instability and recession.

There can’t be a better time to spring into action than now when there is an upsurge of depression around the world. At a time where conflicts are daily arising among nations and communities causing economic instability and recession making life more difficult for people especially in Africa and in the Middle East.

According to Prof. Lourens Schlebusch, there are at least 23 suicides a day in South Africa – which may be underestimated due to the stigma involved in suicide. However, data on suicides and other unintentional injury deaths are not systematically tracked by any agency in the country making accurate statistics hard to come by, says SA’s largest mental health NGO, the South African Depression and Anxiety Group (SADAG).

Depression is the most prevalent mental illness in the developing world. In Africa, it’s devastating: 66 million women are suffering. The great majority have no medical services to turn to for help–strong minds.org. If this number of our women ( clinically diagnosed alone)are suffering from severe depressions in a continent Where most women are housewife’s, how will they be able to Take adequate care of our children emotionally. I hope we are not breeding a “depressed future generation”.

From being some of the happiest people on earth, Nigerians have slumped to the rank of the most depressed in Africa. This was the conclusion contained in the latest figures released by the World Health Organisation (WHO), which show that Nigeria has 7,079,815 sufferers of depression, that is 3.9 per cent of the population.

Also, 4,894,557 Nigerians, that is 2.7 per cent of the population, suffer anxiety disorders. The country is closely followed by Ethiopia with 4,480,113 sufferers, that is 4.7 per cent of her population; Democratic Republic of Congo with 2,871,309 sufferers (3.8 per cent); South Africa with 2,402,230 sufferers (4.6 per cent); and Tanzania with 2,138,939 sufferers, that is 4.1 per cent. Seychelles has the lowest number of depressed persons with just 3,722 that is 4.0 percent

One thing about depression is that you can’t sufficiently know how it feels and what debilitating impact it Can have until one goes through depression. Unlike myriads of other clinical illness, it can’t be readily diagnosed and can even be easily missed. It’s like a smothering fire. It gradually and quietly eats away the sufferer’s life. Most of the time, their health parameters may even be normal yet there’s this huge sore in their lives which can’t be picked by any new generation medical diagnostic kit.

Depression is pilfering our lives and future; let’s curb it.

 

AKINDE TITUS GBOYEGA
5th year medical student,
University of Ibadan,
Oyo state, Nigeria.

 

 

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DEPRESSION: A CALL FOR ACTION

On Wednesday 8th October 2014; my re-sit results were out and I failed. I had to re-do my 5th year of medical training. Where do I start? How do I get over this? ‘‘One day at a time….″ I told myself.

As the days turned into weeks, I felt my strength literally leave me. I was going through a downward spiral of mental anguish, unable to carry out even the simplest of tasks; I slept a lot, thought a lot but ate little. Then I figured; I was depressed.

It was difficult, oh yes, it was! Some days, I woke up with the world on my shoulders, some other days, I didn’t just care. I saw myself as a failure, a disappointment to my parents, my relatives, my friends and above all, myself.

I knew I had to act fast, to stop the “haemorrhage”, so i got to my feet and picked myself up again. I began to talk to other medical students who had repeated, I listened to motivational talks and I prayed a lot. Thank God it helped, it wasn’t all rosy but I got better, I felt better…. “All is well that ends well…” I said to myself.

Then it hit me, what about the “other medical students” who had experienced or will experience what I just went through? What about people from other walks of life?  How did or do they cope? Do they know they are depressed? Do they get the help they actually need? Then I concluded; depression is real.

Depression is an illness characterised by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carryout daily activities for at least two weeks (WHO). It affects people of all ages, from all walks of life and in all countries, yes even Cameroon, my country.

It can be long lasting or recurrent, substantially impairing a person’s ability to function at work or school, or cope with daily life. At its most severe, depression can lead to suicide.

According to WHO, depression is the second leading cause of death among 15 -29 year olds.

When mild, depression can be treated without medications but when moderate or severe, people may need medications and professional involvement treatments.

Depression often starts at a young age. It affects women more than men, and unemployed people are also at high risk.

It can affect anyone, no matter your social status. It can be caused by poverty, life events such as the death of a loved one, a relationship break-up, physical illness, and the list goes on and on.

Many of life’s experiences can predispose to depression:

How do you carter for your wife and kids when you just lost your job?

What do you do when you spend several years, looking for a job, but end up sitting at home with your degree in your pocket?

How do you carry on when you suddenly lose a loved one to the cold hands of death or a long term relationship which you cherished so dearly goes to waste?

When faced with such situations, we often feel worthless, useless and helpless. We then use unorthodox methods to mask or alleviate our pain (alcohol, marijuana, etc).

Don’t drown yourself in alcohol, don’t smoke that cigarette. It won’t help.

Find someone you trust; a relative, a friend, a spouse, or a medical professional and talk about it. I did so and it helped. You don’t have to do it all alone. Life is already hard as it is.

Depression is everywhere in our communities; unfortunately, it often goes unrecognized and is frequently attributed to “witch craft″. There’s also very little information available on the subject matter.

Non – specialists can reliably diagnose and treat depression as part of primary health care. Specialist care is needed for a small proportion of people with complicated depression or those who do not respond to first-line treatment.

Depression is treatable; we all have a role to play;

  • The governments health sector should organize awareness campaigns to educate the public on the subject matter.
  • Health care givers should empower themselves through workshops to be able to properly diagnose depression at its embryonic stage.
  • We should all be there for our loved ones when they are feeling down, let’s listen to them keenly, let’s talk with them, let’s let them know that they are not alone. This form of therapy is cheap, effective, and has no side effects.

Depression is more common than we think. Let’s pay attention, let’s talk…

 

NJANG MBENG EMMANUEL,
7TH Year medical student
Faculty of Health Sciences University of Buea,
Cameroon.

 

 

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COLON CARCINOMA: PECULIARITIES IN NIGERIA. A REVIEW.

COLON CARCINOMA: PECULIARITIES IN NIGERIA.  A REVIEW.

BY: EROMOSELE BENJAMIN O.

AS AT TIME OF WRITING, 2ND YEAR CLINICAL STUDENT, COLLEGE OF MEDICINE, UNIVERSITY OF IBADAN, IBADAN.

EROMOSELE BENJAMIN OSEIWE
Department of Medicine and Surgery,
College of Medicne,
University of Ibadan,
Ibadan.
PMB 5116,
Oyo State,
Nigeria.

 

ABSTRACT

BACKGROUND

Typically referred to as a disease of Caucasians, the incidence of colon carcinoma is growing in Nigeria. In this review, factors that may be accounting for this trend are looked at, as well as the peculiarities of the disease in Nigeria and Africa at large.

Colon carcinoma in Nigeria comes with its peculiarities such as, late presentation; such that most cases present at an advanced stage with incurable disease, increasing adoption of ‘Western’ diets and lifestyle; such as, consumption of high fat, low fibre diet, and reduced physical activity, which is suspected to be responsible for the increasing incidence of the disease, and a paucity of polyposis coli syndromes.

The aim of this review is to emphasize;

  • that colon carcinoma is not a disease of only Caucasians and that the incidence is even increasing among native Africans
  • the peculiarities of this disease among Nigerians in particular and Africans at large
  • the pointers to early diagnosis
  • preventive measures to this potential epidemic

MATERIALS AND METHODS

The materials used in this review article comes from studies and publications on colorectal carcinoma.

KEYWORDS

Colon, carcinoma, peculiarities and review.

INTRODUCTION

Colon carcinoma in traditional descriptions, is said to be uncommon among native Africans. Once the 10th most common malignancy in men from the Ibadan cancer registry four decades ago (1960 to 1969), now holds as the fourth most common malignancy [1]. This shows an increasing incidence.

Even with an increasing incidence, reports estimate that about 6 to 25 patients present annually in Nigerian tertiary health care centers[2-9]. This shows that it is still relatively uncommon compared to other westernized societies. Awarness must be put in place to halt this potential ‘outbreak’, considering resource constraint on the part of the government in solving issues such as this in Africa, with Nigeria in particular. This is further complicated by the fact that most Nigerian patients present late with advanced disease, with a significant proportion in comparison to Caucasian cases, being the mucin-producing adenocarcinoma which carries a worse prognosis [10].

In contrast to other westernized societies, there is a paucity of polyposis coli syndromes among Nigerians [10] such as Lynch syndrome which confers a hereditary predisposition to colon cancer. In Nigeria only four cases of adenomatous polyposis have been reported in the last thirty five years [11,12,13,14]. The mean age incidence of colon carcinoma in Nigeria is 41 years, with Ibadan as reference [15], with an incidence rate of 3.4/100,000[16], the increasing incidence may be attributed to an increasing adoption of westernized lifestyle, increasing life expectancy; due to an increasing access to better health care, since colon carcinoma is sometimes referred to as a disease of aging[17], among other reasons.

DISCUSSION

With an increasing incidence of colon carcinoma in Nigeria, the peculiarities of the typical Nigerian picture of colon carcinoma are discussed below

Pathogenesis

The carcinogenesis of colonic carcinoma among Nigerians is somewhat controversial. The typical adenoma-carcinoma sequence seems unlikely among Nigerians [4,15,18,19]. This is supported by the fact that studies show that it takes fifteen to twenty years for malignant change to occur in an adenoma[9,20], making it unlikely in Nigerians since the age incidence of clinical disease is relatively commoner among the younger age group. The microsatellite instability theory holds true more commonly for hereditary nonpolyposis colorectal carcinoma [21], which is rare among Africans.

This raises the suggestion that most cases of colon carcinoma in Nigeria occur sporadically, with an adequate environmental influence.

Presentation

The clinical presentation depends on the site affected. The most common site in Nigeria appears to be the caecum [10], which may present as an abdominal mass [17]. In right sided disease, presentation is usually that of an iron deficiency anemia due to chronic blood loss. In left sided disease, the features are those of obstruction such as change in bowel habit, chronic constipation; since the stenosing variant of colon carcinoma seems more common here [17]. In the transverse colon, the features here are determined by the proximity to either the right or left side. If closer to the right, features are similar to right sided disease and if close to the left; features are similar to those of left sided disease. Bleeding per rectum, hemorrhoids due to obstruction of the superior rectal vein [17] and tenesmus may also be seen. It is also noteworthy that most patients present late in Nigeria. Orthodox and traditional means are usually first sought before hospital presentation, causing most patients to present late with advanced and incurable disease. Most times in this case, palliative care may be offered with chemotherapy. In operable cases, surgery may be offered.

In this group of patients features in keeping with advanced disease such as weight loss due to elaboration of cachexin (TNF alpha), malignant peritonitis, colo-vesical fistula, colo-vaginal fistula and a host of other features due to local invasion, tumor infiltration and distant metastasis are seen.

Histologic Subtype and Mode of Spread

The mucin-producing adenocarcinoma has a higher proportion among native Africans compared to Caucasuians (it occurs in native Africans in a percentage of thirteen to twenty; while it occurs among Caucasians in a percentage of four to six) [34]. It is also known to carry a bad prognosis [10]. It is defined as a tumor displaying extracellular mucin in more than 50% of the tumor volume [22]. New evidence is showing that mucin-producing adenocarcinoma may have a distinct biological and genetic identity compared with non-mucinous adenocarcinoma [23,24]. Patients with mucin-producing adenocarcinoma are usually younger [25,26]; which most Nigerian cases fall into due to average life span demographics. In addition, these tumors may have distinct mutations and cytogenic abnormalities [23,27], and may be less likely to respond to chemotherapy[28-30]. These tumors are commonly right sided [31-33], and associated with advanced disease [24,25,31,32], which holds true for most cases in Nigeria

Spread may be by;

  • Direct infiltration, usually by a transverse means to encircle the bowel wall. Microscopically it does not spread beyond 5cm of the macroscopic edge longitudinally [17]. Thus the affected segment must be resected at least 5cm beyond the tumor edge [17].
  • Lymphatic spread first to the paracolic lymph nodes and through the intermediate nodes to the inferior and superior mesenteric lymph nodes [17]. The frequency of lymph node metastases is directly related to the degree of penetration of the intestinal wall and the histologic grade of the malignancy and not necessarily the size of the primary lesion [17].
  • Spread through the blood stream is usually through the inferior or superior mesenteric veins, and the portal vein; to the liver (33%), less frequently to the lungs (22%), adrenals (11%), kidneys and bone (11%) and the brain.[17]
  • Transperitoneal spread which may result in malignant peritonitis with ascites.

Risk Factors

The role of diet in the epidemiology of colon carcinoma is one that has been extensively studied [34]. Most traditional Nigerian diets are said to be protective due to its high fibre, mineral and vitamin content from locally available fruits and vegetable, high spice and pepper content [34], which translates to higher antioxidant levels. Local Nigerian diets are majorly carbohydrate based which has been shown to have protective effects too [34]. The high sunlight exposure Nigeria enjoys [34], appears to afford us more vitamin D, which is colon carcinoma protective.

The increasing incidence of colon carcinoma may be traced to adoption of westernized diets due to affluence. Most westernized diets have a low fibre and high fat content, which has been repeatedly shown to be a risk factor for colon carcinoma [37,38]. Intake of fruits and vegetables is reducing among Nigerians, with a concomitant reduced intake of minerals, vitamins, antioxidants and fibre contained in them, which are cancer protective [34].

The increasing adoption of tobacco smoking among Nigerians may also account for an increasing incidence of colon carcinoma [39].

Excessive alcohol intake has also been shown to be a risk factor for colon carcinoma and gastro-intestinal cancers in general, it is thought to be due to production of acetaldehyde which is a known carcinogen [35,36]. Due to increasing affluence among Nigerians, alcohol consumption is on increase.

Adoption of sedentary lifestyles with reduced physical activity is a risk factor for obesity. Obesity has been linked with colon carcinoma development [37,38]. Sedentary lifestyles are associated with less sunlight exposure, which amounts to less vitamin D in the body, with therefore an increased colon carcinoma risk, since vitamin D is known to be colon carcinoma protective [34].

The adoption of westernized lifestyle has been linked to increasing affluence among Nigerians and an ever increasing influx of foreign processed foods; most of which are associated with cancer risks, from developed countries into Nigeria.

Treatment options

Modality of treatment to be used is governed mainly by the stage of presentation and site affected.

Surgical treatment [17]

  • Caecum, ascending colon and hepatic flexure; right hemi-colectomy, that is resection of the last 15cm of the terminal ileum, ascending colon and proximal two-thirds of the transverse colon with ileo—transverse anastomosis
  • Transverse colon; resection of the transverse colon and both flexures
  • Splenic flexure; left hemi-colectomy that is resection of the distal colon and distal two-thirds of the transverse colon.
  • Descending colon; same as splenic flexure, but a more radical resection with removal of the pelvic colon is preferable.
  • Pelvic colon; pelvic colectomy with or without left hemicolectomy

Treatment is most commonly by open abdominal surgery using diathermy, stiches and staples.

Radiotherapy

It is given preoperatively if the tumor is tethered or with evidence of extra-peritoneal spread and/or positive lymph nodes or post-operatively if a tumor turns out to be Dukes’ B2 or C [17]. Radiotherapy may also be offered as a palliative measure in advanced disease.

Chemotherapy

5- fluoro uracil, an antimetabolite cancer chemotherapeutic agent is the major agent used. Leucovorin is usually added as an adjunct due to the associated risk of bone marrow suppression which may cause severe neutropenia. Other agents which may be used in combination with 5-flouro uracil, include the platinum based chemotherapeutic agent, oxaliplatin and irinotecan, a topoisomerase 1 inhibitor.

Bevacizumab is a humanized monoclonal IgG antibody which binds and neutralizes vascular endothelial growth factor (VEGF), which has shown so much promise with its use in the western societies, but with limited use in Nigeria due to cost implications.

Screening

Even though not yet realistic in this environment due to relatively low incidence rate, it is commonly practiced in high risk groups in the western societies, where it has become of public health concern. It includes;

  • Fecal occult blood sampling
  • Sigmoidoscopy
  • Colonoscopy

  

Conclusion

Colon carcinoma a major cause of morbidity in the developed climes and is gradually taking its root in Nigeria in particular, and Africa as a whole. This has been largely due to adoption of westernized lifestyle due to increasing affluence among Nigerians. Control and preventive measure must be put in place to stem this growing problem which has the potential to take its toll in Africa, being a resource poor environment.

Acknowledgement

I want to specially acknowledge Dr. D.O. Irabor; Consultant Gastro-Intestinal Surgeon, who has spurred my interest in the field of gastro-intestinal surgery due to his prowess as a teacher and great skill as a surgeon. I also appreciate him, for accepting to be the Supervising Consultant of this review article, and for being my mentor and role model.

References

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  2. O. O. Adekunle and  A.  A.  Abioye,  “Adenocarcinoma  of  the  large  bowel  in  Nigerians:  a  clinicopathologic  study,”  Diseases  of  the  Colon  and Rectum, vol. 23, no. 8, pp. 559–563, 1980.
  3. Y. Iliyasu,  J. K. Ladipo, E. E. U. Akang, C. A. Adebamowo, O. G. Ajao, and P. U. Aghadiuno, “A  twenty-year review of malignant colorectal neoplasms  at  University  College  Hospital,  Ibadan,  Nigeria,”  Diseases  of  the  Colon  and  Rectum,  vol.  39,  no.  5,  pp.  536–540,  1996.
  4. O. O.  Akute,  “Colorectal  carcinoma  in  Ibadan,  Nigeria:  a  20-year  survey—1971  to  1990,”  Hepato-Gastroenterology,  vol.  47,  no.  33,  pp.  709–713, 2000.
  5. D. C.  Nwafo  and  J.  O.  Ojukwu,  “Malignant  disease  of  the  colon,  rectum,  and  anus  in  Nigerian  Igbos,”  Annals  of  the  Royal  College  of Surgeons of England, vol. 62, no. 2, pp. 133–135, 1980.
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  12. O. O. Adekunle and G. O. Ajao, “Colorectal cancer in adolescent Nigerians,” Scandinavian Journal of Gastroenterology, Supplement, vol. 21, no. 124, pp. 183–186, 1986.
  13. S. U.  Udofot,  M.  D.  Ekpo,  and  M.  I.  Khalil,  “Familial  polyposis  coli:  an  unusual  case  in  West  Africa,”  Central  African  Journal  of  Medicine, vol. 38, no. 1, pp. 44–48, 1992.
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 LIMITATIONS OF A NIGERIAN FEMALE CHILD

Being black might have been seen as a limitation, but when born into certain places you would realize that being black, is just the starting point of your problems. it comes as constant worry, that most female children are seen as rape victims, and other forms of disrespect , even if the country is developing some areas like their mind-set seem to be lagging behind.

The female psychology have been so greatly manipulated that they see themselves as mere  “kitchen tools”, or “baby breeding machines”. Well, you cannot blame them as they have gone through many things that have destroyed their self-respect, making them go for the scrap. Those who have been considered as money milking machines might actually even seem great since you are considered as something worth money. In most eastern part of the country, the female child is not seen as a child at all, the family only fully celebrates when the male child is finally born, because to the male figure head – a heir of the family has arrived and there is no need for worry. The females are only there to get married so that their parents can collect their bride price.

Most female children, highly applied in the northern part of Nigeria, are betrothed to men – men old enough to be their grandfather – whilst still young, without allowing the child to grow, fall in love or give a consensus to whatever relationship she is into; therefore she would be forced to grow and fall in love with some stranger. This has been going on the country for centuries and most times it seems that nobody cares, leading the children to become withdrawn, accepting whatever fate lies ahead of them.

Going to school would have been a good improvement if the world itself did not see the female sex as incapable of pursuing some select dreams. The world seems to favour the male irrespective. So what is the problem here? Our problem is that the norms and culture that seem to guide us, have subdued one sex and upheld the other. Yes, we know that this norms and culture made us what we are today, but truthfully, what are we today?… but a country on a verge of failing, because seemingly only the rich are heard and the poor are not; this is the same as the case of females, who are not put into consideration because to them they are the “weaker vessel”.  It should not be seen as news that even in the family, when there is a male child, his thoughts are supreme.

We are quite happy now that as the world is developing, most women have been allowed to work and not be full house wives as opposed to before. It is characteristically true that when girls are growing up, most girls were taught to cook and that their main job is to have a family and be a good wife – Only few families thought their daughters that there was more to life than that. That is why, when they go out, they most times are left there in the wild – clueless.

Someone might say these are just blatant excuses , but the truth remains, the female sex is being oppressed and limited, and nothing seems to be effectively working to curb it.

Thank You.

Ude Ucha Kalu,
College of Medicine,
University of Lagos,
Nigeria.

 

 

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