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


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.

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

➡ 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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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 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.


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



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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…


7TH Year medical student
Faculty of Health Sciences University of Buea,



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Department of Medicine and Surgery,
College of Medicne,
University of Ibadan,
PMB 5116,
Oyo State,




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


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


Colon, carcinoma, peculiarities and review.


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.


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


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.


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.


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.


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.


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



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.


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.


  1. 1. N. Okobia, “Cancer care in sub-Saharan Africa- urgent need for population-based cancer registries,” The Ethiopian Journal of Health Development, vol. 17, pp. 89-98, 2003.
  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.
  6. A. Z.  Sule,  B. M. Mandong,  and D.  Iya,  “Malignant  colorectal  tumours:  a  ten  year  review  in  Jos, Nigeria,” West  African  Journal  of  Medicine, vol. 20, no. 4, pp. 251–255, 2001.
  7. S. T. Edino, A. Z. Mohammed, and O. Ochicha, “Characteristics of colorectal carcinoma in Kano, Nigeria: an analysis of 50 cases,” Nigerian Journal of Medicine, vol. 14, no. 2, pp. 161–166, 2005.
  8. D. O.  Akinola  and  A.  O.  Arigbabu,  “Pattern  and  presentation  of  large  bowel  neoplasms  in  Nigerians,”  Central  African  Journal  of  Medicine, vol. 40, no. 4, pp. 98–102, 1994.
  9. A. A.  Adesanya  and  J.  T.  da  Rocha-Afodu,  “Colorectal  cancer  in  Lagos:  a  critical  review  of  100  cases,”  The  Nigerian  Postgraduate  Medical Journal, vol. 7, no. 3, pp. 129–136, 2000.
  10. Irabor D., Adedeji O.A., “Colorectal cancer in Nigeria: 40 years on. A review” Eur J Cancer Care (Engl). 2009 Mar;18(2):110-5. doi: 10.1111/j.1365-2354.2008.00982.x.
  11. O. B. Alese  and  D.  O.  Irabor,  “Adenomatous  polyposis  coli  in  an  elderly  female  Nigerian,”  Ghana  Medical  Journal,  vol.  43,  pp.  139–141, 2009.
  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.
  14. B. J.  Olasode  and  O.  A.  Olasode,  “Missed  diagnosis—adenomatous  polyposis  coli,”  The Central African  Journal  of Medicine,  vol.  43,  no.  11, article 339, 1997.
  15. D. O. Irabor,  A.  Arowolo,  and  A.  A.  Afolabi,  “Colon  and  rectal  cancer  in  Ibadan,  Nigeria:  an  update,”  Colorectal Disease,  vol.  12,  pp.  e43–e49, 2010.7
  16.  I.  Segal,  “Rarity  of  colorectal  adenomas  in  the  African  black  population,”  European  Journal  of  Cancer  Prevention,  vol.  7,  no.  5,  pp.  387–391,1998.
  1. E.A. Badoe, E.Q. Archampong, J.T. da Rocha-Afodu. Principles of Practice of Surgery including pathology in the tropics. Ghana publishing Corporation. 4th edition. Pages 721-728. Published in 2009.
  2. H. Boytchev, S.  Marcovic,  and  G.  J.  Oettle,  “The  characteristics  of  large  bowel  cancer  in  the  low-risk  black  population  of  the Witwatersrand,”  Journal  of  the  Royal  College  of  Surgeons  of  Edinburgh,  vol.  44,  no.  6,  pp.  366–370,  1999.
  3. O. G.  Ajao,  M.  O.  Adenuga,  and  J.  K.  Ladipo,  “Colorectal  carcinoma  in  patients  under  the  age  of  30  years:  a  review  of  11  cases,”  Journal  of the Royal College of Surgeons of Edinburgh, vol. 33, no. 5, pp. 277–279, 1988.
  4. J. Sack and  J.  M.  Rothman,  “Colorectal  carcinoma:  natural  history  and  management,”  Hospital Physician,  vol.  36,  pp.  64–73,  2000.
  5. Kumar V., Abbas A., Fausto N., Mitchell R. Robbins Basic pathology. Saunders Elsevier Publishing. 8th edition. Pages 620-621. Published in 2007.
  6. Mirna H Farhat, Kassem A Barada, Ayman N Tawil, Doha M Itani, Hassan A Hatoum, and Ali I Shamseddine, World J Gastroenterol. 14(45): 6981–6985. Dec 7 2008.
  7. Zhang H, Evertsson S, Sun X. Clinicopathological and genetic characteristics of mucinous carcinomas in the colorectum. In J Oncol. 1999;14:1057–1061.
  8. Consorti F, Lorenzotti A, Midiri G, Di Paola M. Prognostic significance of mucinous carcinoma of colon and rectum: a prospective case-control study. J Surg Oncol. 73:70–74. 2000.
  9. Wu CS, Tung SY, Chen PC, Kuo YC. Clinicopathological study of colorectal mucinous carcinoma in Taiwan: a multivariate analysis. J Gastroenterol Hepatol. 1996;11:77–81.
  10. Suma KS, Nirmala V. Mucinous component in colorectal carcinoma–prognostic significance: a study in a south Indian population. J Surg Oncol. 1992;51:60–64.
  11. Messerini L, Vitelli F, De Vitis LR, Mori S, Calzolari A, Palmirotta R, Calabro A, Papi L. Microsatellite instability in sporadic mucinous colorectal carcinomas: relationship to clinico-pathological variables. J Pathol. 1997;182:380–384.
  12. Negri FV, Wotherspoon A, Cunningham D, Norman AR, Chong G, Ross PJ. Mucinous histology predicts for reduced fluorouracil responsiveness and survival in advanced colorectal cancer. Ann Oncol. 2005;16:1305–1310.
  13. Glasgow SC, Yu J, Carvalho LP, Shannon WD, Fleshman JW, McLeod HL. Unfavourable expression of pharmacologic markers in mucinous colorectal cancer. Br J Cancer. 2005;92:259–264.
  14. Takemura M, Osugi H, Lee S, Kaneko M, Tanaka Y, Fujiwara Y, Nishizawa S, Iwasaki H. [Choice of chemotherapeutic drugs for colorectal cancers by DPD and OPRT activities in cancer tissues] Gan To Kagaku Ryoho.
  15. Papadopoulos VN, Michalopoulos A, Netta S, Basdanis G, Paramythiotis D, Zatagias A, Berovalis P, Harlaftis N. Prognostic significance of mucinous component in colorectal carcinoma. Tech Coloproctol. 2004;8 Suppl 1:s123–s125.
  16. Nozoe T, Anai H, Nasu S, Sugimachi K. Clinicopathological characteristics of mucinous carcinoma of the colon and rectum J Surg Oncol. 2000;75:103–107.
  17. Kang H, O’Connell JB, Maggard MA, Sack J, Ko CY. A 10-year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum. Dis Colon Rectum. 2005;48:1161–1168.
  18. David Omoareghan Irabor. Colorectal Carcinoma: Why Is There a Lower Incidence in Nigerians When Compared to Caucasians? Journal of Cancer Epidemiology Volume 2011 (2011), Article ID 675154
  19. Salaspuro M. “Acetaldehyde as a common denominator and cumulative carcinogen in digestive tract cancers”. Scand J Gastroenterol. 2009;44(8):912-25.
  20. Lachenmeier DW , Kanteres F, Rehm J. Carcinogenicity of acetaldehyde in alcoholic beverages: risk assessment outside ethanol metabolism. Addiction. 2009 Apr;104(4):533-50.
  21. Bardou M , Barkun AN, Martel M. Obesity and colorectal cancer. Gut. 2013 Jun;62(6):933-47.
  22. E. E. Frezza, M. S. Wachtel, and M. Chiriva-Internati. “Influence of obesity on the risk of developing colon cancer”. Gut. 2006 Feb; 55(2): 285-291
  23. Chao A., Thun M.J., Jacobs E.J., Henley S.J. et al. “ Cigarrette Smoking and Colorectal Cancer Mortality in the Cancer Prevention Study II”. J Natl Cancer Inst (2000) 92 (23): 1888-1896.
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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,



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For the purpose of getting our terminologies right, lets understand that “all refugees are migrants but not all migrants are refugees”. They’ve been persecuted in their homeland, fleeing the crisis, and now, seeking asylum. A refugee isn’t your typical immigrant. Over the years, the world has had to deal with issues of migration which led to the formation of the Office of the United Nations High Commissioner for Refugees (UNHCR), a programme mandated by the United Nations (UN) to protect and support refugees while assisting in their integration, resettlement or voluntary return to country of origin. However in 2015, crisis began all over the European continent as immigration numbers skyrocketed from unauthorized foreign migrants. These foreign migrants encompassed not only the vulnerable mass seeking refuge, but also some hostile agents.

The world has experienced the highest number of forcibly displaced people since World War 2-about 59.5million-and by 2015,over a million entered the European region and about 3700 died/went missing during the journey. The point is; this is a global crisis and concerted efforts should be made globally, not just by the European Union. Addressing the migration crisis, the Vice President of Nigeria, Professor Yemi Osinbajo stressed the need for care and respect for the migrants as most of them were forced to leave their ancestral homes. He also advised the International Organization of Migration (IOM) to ensure the proper documentation of all migrants.

Analyses from the World Health Organization (WHO) reviews the health status and access of a refugee from their country of origin, to their transit country and finally in their destination country.

In Syria alone, over 7 million people are internally displaced with the unrest causing shortages of qualified medical personnel and other medical aid and support. Interventions made by the WHO and partners include provision of supplies for treatment of critical conditions like diabetes and heart disease; vaccination against diseases like measles, rubella and polio; prevention of vector borne diseases like malaria; delivery of integrated primary health care, including mental health services; deployment of surgical teams and supplies; support for mobile clinics and outreach services for reproductive, maternal and newborn child health; and strengthened disease surveillance and outbreak response. All these are considered very important for integration in their destination countries as well as it helps to prevent the spread of communicable diseases amongst the refugees during transit.

Refugees in transit are usually vulnerable because their finances are usually limited. Therefore, special care and assistance should be rendered at this level. In countries like Turkey, Lebanon and Greece hosting the refugees, the


WHO works with the governments to improve access to basic healthcare needs by setting up clinics especially for the refugees; providing medical supplies, equipment and fuel; training for frontline health workers; collecting and analysing health data to shape decision-making and providing Ministries of Health and other partners with technical guidance on key public health issues.

Finally, even with the unprecedented influx of refugees in the European region, the WHO supports the receiving countries by performing joint assessments with Ministries of Health to assess health-system capacity to manage large influxes of refugees and migrants; giving policy advice on contingency planning for the health sector; providing emergency medicines and supplies; providing maternal and child health care services; providing mental health and psychosocial care; training for health workers; technical and financial assistance for outbreak response and immunization campaigns; dissemination of health information and educational materials to refugees and health workers; and cross-border collaboration for improved data collection and analysis.

It is in fact now widely understood that being and staying healthy is not only part of migrants’ human rights, but also a fundamental precondition for them to work, be productive and contribute to the social and economic development of their communities, both of origin and destination. Therefore, coordinated efforts are needed to ensure that migrant health is addressed throughout the migration cycle, as are efforts to adapt and strengthen the resilience of local health systems in light of more diverse population health profiles. Addressing the health of migrants and affected local populations reduces long-term health and social costs, is good public health practice, facilitates integration and contributes to social and economic development. The healthier migrants are and remain the more efficient and balanced the future of our highly mobile and globalized society will be.




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End of the year thoughts to all beautiful FAMSAites and acquaintances all over the world

2016 has been a positively eventful year for us all in FAMSA (although with hurdles), loaded with lots of programs, conferences and awareness. Just as our constitution stated … play a significant role in improvement of the health of African people and the problems of African society in as much as they fall within the purview of medicine and the realization… we have played our role and made our impact at various levels. This could be seen in our vast Social media Campaigns, website upgrade, our Antibiotics awareness week Campaigns, world Hepatitis Day Campaign, world blood Donor Day campaign and various outreaches, talks/symposia and events by our standing committees (SCOHE, SCOPUB, SCOPA, SCOMER and SCOPE) in the different member country of the association.

Therefore, as 2016 comes to an end in grand style and we move into the New Year, below are the thoughts of FAMSA Executives (2016/2017 Administration) to you for the year;

“Let’s raise our toast to yesterday’s achievements and tomorrow’s brighter future. Happy New Year FAMSAites”.

Njang M. Emmanuel,
FAMSA President


“As we come to the end of this year 2016, I want to appreciate everyone that participated or contributed in one way or the other to achieve the goal of “our FAMSA” towards the improvement of health in Africa. I pray that we all will experience a fruitful 2017 as we continue to work hard and work together to make our continent a healthy place. Merry Christmas and Happy New Year”.

ONAGA, Zita Ugochukwu,
Administrator, FAMSA Administrator


“We can boldly say it’s been a fruitful and blessed year; one which we have created a massive awareness, had more schools involved in FAMSA’s activities and hosted a regional meeting In the University of Capecoast, Ghana. I can say we have found and implemented purpose.

We are the voice of Africa; we are the future of Africa’s health system, we are the next and most important indication of how the health system would look like in years to come. The 31st  FAMSA General Assembly is to hold in March, 2017 at the Niger Delta University, Bayelsa State, Nigeria and it promises to be explosive. Let’s come around and let’s meet each other. Myself and my team wishes you a Merry Christmas and Happy New Year ahead”.

Dr. Oyegbile Olajide
West Africa Regional Coordinator, FAMSA


As 2016 comes to an end, let’s take some time out to reflect on what an awesome or not so awesome year it was. Let’s make big changes based on these reflections and let’s hope for a beautiful 2017. To every FAMSAite out there, let’s keep on breaking boundaries and let’s be the change we want in Africa. Here’s to greater things in the year 2017! Merry Christmas and Happy New Year beautiful people!

OMIYE, Jesutofunmi Adesanmi
Director of Media Externa, FAMSA


2016 has come and gone, we forge ahead more powerfully into 2017 to do more exploit. On behalf of all Members of the Standing Committee of Publications (SCOPUB), Director of External Media (Mr. Omiye Jesutofunmi), all Regional Coordinators, all FAMSA Board Executives and other Standing Committees… We want to wish you the best of the year to come and we hope to see and have more of you in our various FAMSA activities for the year. And don’t forget to visit and join our different social media pages.

Compiled by
Agoyi M. Oluwakemisola
Chairperson, SCOPUB – FAMSA

Twitter: @famsa2
Instagram: Official_FAMSA
Facebook: Federation of African Medical students’ Associations (FAMSA)


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It was an exciting, educative fun-filled one week period where medical students all across Africa, under the umbrella of the Federation of African Medical Students Associations (FAMSA) raised their voices to create awareness on antibiotic resistance.

The sensitization campaign took place from Monday 14th – Sunday 20th November 2016; With theme ‘Stop antibiotics misuse’, FAMSA organized both online and offline activities to commemorate this event.

Some of which were;

  • Dissemination of electronic banners and billboards carrying messages on antibiotic resistance via all social media platforms using the hash tag ‘‘stop antibiotic misuse’
  • Pictures of medical students and other people from all walks of life carrying a message on antibiotic resistance.
  • In collaboration with a non-governmental organization (Dr. SEA initiative) we made a video in very simple language educating the general public on causes, consequences of antibiotic resistance as well as preventive measures to avoid this global upcoming crisis
  • Various medical student associations organized debates in their various institutions in the topic ‘Should antibiotics be used as an over-the counter drug’ and so much more.

About 1000 people took part in the campaign and it was a huge success. However, there is still a lot to be done with regards to the subject matter.

Antibiotics resistance is real so…… STOP ANTIBIOTIC MISUSE!!!



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World’s ANTIBIOTICS AWARENESS WEEK (Nov 14 – 20): Stop Antibiotics Misuse


Antibiotics have transformed medicine and saved millions of lives. This wonderful invention – which started with the discovery of penicillin by Sir Alexander Fleming in 1928 – has made many successful surgeries possible and put Infections under control. But the tragedy is; antibiotics are about to be rendered useless because of me and you – our adamant, inconsistent nature, our misappropriate use of antibiotics.

Benefits of antibiotics

Apart from saving people’s lives, antibiotics have also played crucial role in achieving major advances in medicine and surgery such as successfully preventing and treating infections in individuals receiving chemotherapy and people with acute and chronic diseases.

People in the US were expected to live for only 56.4years old in 1920, now however the US average life span is 80 years. Antibiotics have helped to extend expected life spans by changing the outcome of infections in general. It has done the same in developing countries like Nigeria where sanitation is still poor and has drastically decreased morbidity and mortality caused by food borne and poverty related infections.

Our Present situation

Bacteria resistance has evolved over the years, from penicillin resistance to methicillin resistance and now vancomycin resistance, the newer strains of the resistant bacteria are getting stronger and stronger as the new drugs being developed against them are getting stronger and stronger.

Penicillin resistant bacteria à Methicillin Resistance Staph. Aureus (MRSA) à Vancomycin Resistant Strains.

Since all they do is, seek refuge in our blood and make friends with these drugs we create to terminate them. Our usual practice of just taking the first and second dose of antibiotics prescribed to us, when we start seeing the physical manifestation of the drugs such as yellow coloured, drug smelling urine or our boil shrinking, is killing. As we only give room to the bacteria left from the good concentration urinated out of our body system to adapt to the lower toxicity of the drugs in our body.

The most alarming and hurtful part is that, the learned ones and medical oriented individuals partake in these practice even medical students. And we go about clinical coats, screaming in the market place, stop drug abuse, stop drug abuse!! This we do mostly under the umbrella of an association or a philanthropic group, after which we return to our various homes and continue the bad practice. Even among our relatives, we find this misuse and we do nothing to stop it. But then, it was discovered that this predicament is worldwide which brings us to the Question what is “misuse”? Or for the sake of appropriateness¸ “what are the causes of our antibiotic resistance crises”?


Overuse of drugs started way back, few years after penicillin – the first antibiotics –was invented, then, Sir Alexander Fleming raised an alarm but no one listened to him. An era of drug overuse clearly drives the evolution of drug resistance. The Bacteria, like every other living thing, inherit genes from their “parents”, get modified overtime and they build resistance to these drugs.

Despite warnings, antibiotics are overprescribed worldwide and this is worsened by the fact that Antibiotics are sold in many countries unregulated as OTC (Over The Counter drugs) without proper prescription. So people can freely buy and use any form of antibiotics based on discretion. And when even prescribed, studies have shown that treatment indication – choice of agent, duration of antibiotic therapy – Is incorrect in 30% to 50% of cases. In Addition, 30% to 60% of the antibiotics prescribed in intensive care units have been found to be unnecessary, inappropriate or suboptimal.

Another way of overuse is when we use them extensively for livestock. Treating livestock with antimicrobials is said to improve the overall health of the animals, producing larger yields and a higher quality the products. The antibiotics used in livestock are consumed by humans when they consume food and resistance starts to set in. All these are not so much under control, I mean, patients have to be treated and livestock have to be bred. But then, the next form of misuse which is underuse/incomplete doses and self-overuse is what is most important here in our environment today.

Incomplete doses/Under use

This is so rampart, there wouldn’t be need to emphasize. Drugs are supposed to be used adequately, not too much and too little. When we don’t complete our doses, and the blood concentration supposed to cause adequate therapeutic effect isn’t optimal, only some of the bacteria get eliminated while the others supposed to be susceptible start to build up resistance against the drug and then produce offspring that are also resistant.

And what makes the case worse is the Lack of new drug development by the pharmaceutical industries due to reduced economy incentives and challenging regulatory requirements and approval.

Consequences of Antibiotics Misuse

Antibiotics resistant infections are already widely spread across the globe. Many public health organizations have described the rapid emergency of resistant bacteria as a crisis or nightmare scenario that could have catastrophic consequences. CDC, WHO institute of medicine, federal interagency task forces have declared resistant bacteria as a substantial treat to the entire globe.

Here is fact; MRSAs kills more American each year than HIV/AIDS, Parkinson’s disease, emphysema and homicide put together. Now, Vancomycin which is supposed to be our refuge drug is no longer as effective because Vancomycin resistant enterococci and so many other additional pathogens are developing resistance to many common antibiotics.

In conclusion, rapidly emerging resistance bacteria threaten the extraordinary health benefits that have been achieved with antibiotics in time past. This crisis is global, reflecting the underuse and overuse of these drugs and the lack of development of new antibiotic agents by pharmaceutical companies to address the challenge. Now, to achieve a non-resistant environment for pathogens, we need to think on the following:

What should be done and is within our power to avoid this killing resistance?

Should antibiotics no longer be sold OTC? OR Should we keep campaigning to people to stop the misuse?


You can drop your own ideas on our social media (twitter) using the #StopAntibioticMisuse

Follow us on twitter @FAMSA2, Facebook “FAMSA”, Instagram “Official_Famsa” or visit our website


Karolinska Institute Investidators in Sweeden
CDC, World Health Organisation


Hameed Yussuf,
General Secretary,
Standing Committee on Publication (SCOPUB-FAMSA 2016/2017)


Agoyi Mary Oluwakemisola,
Chairman, Standing Committee on Publication (FAMSA 2016/2017),

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ABC’s of Antibiotic Resistance

I vividly remember being well beaten for being a destructive and stubborn kid. And the more I was beaten, the less I felt the pains till it reached the moment I felt no pains but irritations when I was beaten. I guess my pain receptors were dead. I am sure present day bacteria would tell a similar story in regards to antibiotics for they have been exposed to all sorts and grown immune to them rendering treatment ineffective.

Antibiotic is the medical term to describe drugs used in treating diseases caused by bacteria. They play a very important role in reducing the presence and burden of diseases such as pneumonia, cholera, TB and sexually transmittable diseases like gonorrhea (call them communicable diseases) which are very much alive and active in our communities. With such as crisis like antibiotic resistance, treating people with HIV/AIDS would be difficult.

We cannot blame the bacteria for being resistant to antibiotics because adaptability is a natural process for them. The bulk of the blame falls on you and maybe me. Our attitude and habits towards drugs are contributing factors: the use of fake and counterfeit medicines from road side doctors and mobile pharmacies; poor prescription for health workers; and above all, stubbornness on your part to comply with treatment. Yes you! How often do you finish your treatment, especially for typhoid?

We never like to take blames no matter how obvious it might be, so we push it onto some other person. Thank goodness we have the government who would always carry the blame. We could blame it on government for the weak medical regulatory capacity and the circulation of substandard (counterfeit) drugs, or the weak laboratory capacity on antibiotic testing and reporting and lack of essential reagents and consumables. We could also blame government for the limited quality assurance and control; protocol or lack of antibiotic surveillance strategies. But you know if we did just the simple things like complying with treatment, we would not be facing most of these challenges right?

And hey, antibiotic resistant is NOT an African issue, it is thriving in all nations and communities just like ours. And did you also know that the famous gonorrhea would soon become resistant to all lines of treatment rendering it untreatable. Here is what would happen if gonorrhea is untreatable:

  • Increased rates of infertility,
  • Increased rates of pregnancy complications including miscarriages,
  • Blindness of new births
  • And you would hate sex and curse God for creating it.

But wait a moment, what is Antibiotic Resistance? Antibiotic resistance is the household name for Antimicrobial resistance which is resistance of microorganisms like; bacteria, fungi, viruses and malaria parasites to a drug that used to effective infections caused by these microorganisms. Antibiotic resistance is specific to bacteria while antimicrobial resistance covers all microorganisms including bacteria. Antimicrobial resistance kills people and slows the control and eradication of infectious diseases like malaria, syphilis, yellow fever and cholera without leaving out the famous gonorrhea. When infections become difficult to treat, new medications are introduced marking cost of treatment very expensive for many to afford and they end up dying.

This whole thing of antibiotic resistance is more complex than we think it is. It is influenced by many interconnected factors and as such, single isolated interventions have very little impact. Coordinated action is needed to minimize emergence and spread of antimicrobial resistance.

According to the WHO, all parties (individuals, health workers and pharmacies, government and pharmaceutical industries) can help in reducing antibiotic resistance and here is how;

  • Individuals;
    1. Wash our hands and avoid close contact with sick people to prevent bacterial and viral transmissions.
    2. Get vaccinated and keep vaccinated up to date.
    3. Using antimicrobial drugs only when prescribed by a certified health professional
    4. Complete the full treatment course
    5. Never share antimicrobial drugs with others or use leftover prescriptions.
  • Health workers and pharmacists can help by;
    1. Enhancing infection prevention and control in hospitals and clinics.
    2. Only prescribing and dispensing antibiotics which are truly needed,
    3. Prescribing and dispensing the right antimicrobial drugs to treat the illness.
  • Government can help by
    1. Improving monitoring around the extent and cause of resistance.
    2. Strengthening infection control and prevention.
    3. Promoting and regulating appropriate use of medicines.
    4. Making information widely available on the impact of antimicrobial resistance and how the public and health professionals can play their part.
    5. Recognizing and rewarding innovation and development of new treatment options and other tools.
  • Scientists and pharmaceutical industry can help by
    1. Fostering innovation, research and development of new vaccines, diagnostic tools and treatment options.

So now you have completed a 60 hours medical/pharmaceutical course in just 5 minutes. And with such knowledge we are counting on you to help conquer bacteria through the proper use of antibiotics.

You don’t want to go without watching this interesting video by Dr Susan Enjema on Antibiotics Resistance.

Nkwain Carlson.

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