Browsing by Author "Yahaya, J. J"

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Aneurysmal bone cyst of the mandible: a rare case report and literature review
(Annals of Medicine & Surgery, 2023) Yahaya, J. J; Morgan, E. D; Abraham, Z. S; Othieno, E
Introduction and importance: Aneurysmal bone cysts (ABCs) are benign, non-neoplastic cystic lesions composed of multiple blood-filled cavities, which are separated by connective tissue septa and they constitute ~6 and 1.5% of all cases of the skull and jaws lesions, respectively. Case presentation: Herein, the case of an 80-year-old male with a histologically confirmed diagnosis of ABC involving the body of the left mandible was presented. The patient underwent partial mandiblectomy after confirmation of the diagnosis using orthopantomography, a computed tomography scan, and a tissue biopsy. The patient was free from pain after 1-year of follow-up, and the control orthopantomography showed no evidence of recurrence. This was followed by reconstruction of the healed part of the bone with titanium plates and a piece of bone from the lateral two-thirds of the left femur and thereafter he was cosmetically well. Clinical discussion: Patients with ABCs present with expansile and radiolucent bone lesions, which may be associated with displacement and loss of teeth due to alveolar bone erosion. Complete excision of the lesions is mandatory for the prevention of recurrence and increased morbidity. Conclusion: ABCs that involve the jaws are extremely rare and are more likely to pose a diagnostic challenge as they are more likely to be confused clinically with other expansile radiolucent bone lesions such as ameloblastoma, osteoblastoma, and giant cell tumor among many others. Also, those with extensive bone matrix formation may sometimes be confused histologically with other bone forming tumors including osteosarcoma. Recurrence is common but it can be avoided or minimized by complete resection of the lesion.
Disseminated peritoneal leiomyomatosis as an incidental finding: A case report
(John Wiley & Sons Ltd., 2023-02-16) Morgan, E. D; Kahiye, M; Kule, I; Yahaya, J. J; Othieno, E
We present the case of a 23-year-old female with multiple diffuse and nodular masses of different sizes involving predominantly the posterior wall of the uterus, omentum, and peritoneum which were histopathologically confirmed to be dis seminated peritoneal leiomyomatosis. Meticulous investigation and accurate di agnosis are of utmost importance for the establishment of the correct diagnosis. Additionally, proper management of the patient while considering choice of the patients including close follow-up of the patients is mandatory for the reason of ensuring early detection of recurrence.
Duodenal Strongyloides stercoralis infection in a 56-year old male: A case report
(International Journal of Surgery Open, 2023) Yahaya, J. J; Morgan, E. D; Othieno, E
Introduction and importance: The infection caused by Strongyloides stercoralis (S stercoralis) is usually an asymptomatic condition particularly in immunocompetent individuals and the condition may remain unnoticed even for decades, however, strongyloidiasis is more severe in patients who are immunocompromised. Case presentation: The patient is a 56-year old male who presented with nine months history of episodes of abdominal pain, nausea loss of appetite, and chronic diarrhea. His diarrhea had mucus and trace blood. His oesophagogastroduodenoscopy (OGD) revealed erythematous, hypertrophied, and ulcerating lining mucosa of the duodenum. The specimen sampled showed sections of the duodenum with numerous Strongyloides stercoralis larvae, some inside the crypts with associated active duodenitis. Clinical discussion: Despite the asymptomatic nature of Strongyloides stercoralis infectious condition especially for immunocompetent patients, the infection may sometimes result into serious complications including exudative enteropathy and paralytic ileus. The clinical outcome of patients with strongyloidiasis is usually better despite severe infection may develop and it is associated with slightly increased morbidity and even mortality. Conclusion: Diagnosis of Strongyloides stercoralis infection in individuals residing in tropical or subtropical countries who present with chronic diarrhea, abdominal pain should always be considered so as to avoid delay of diagnosis. This may help in preventing unnecessary complication such as severe anaemia, intestinal perforation or even death.
Endometriosis of the umbilicus in a 36-year-old woman: a case report and literature review
(Annals of Medicine and Surgery, 2023) Yahaya, J. J; Morgan, E. D; Abraham, Z. S
Introduction and importance: Extrapelvic endometriosis is quite rare, with a reported prevalence ranging between 0.5 and 1%, and the condition is more likely to pose diagnostic challenges. This condition is more likely to pose clinical diagnostic challenges as it may mimic metastasis such as Sister Mary Joseph’s nodule. Case presentation: Herein is reported the case of a 36-year-old woman who presented with a hard nodular dark-bluish umbilicus mass that had a tendency to increase in size and was accompanied by severe pain during menstruation for ∼2 years is reported. Laparotomy revealed a normal uterus without involvement of any other pelvic organ by the endometrial tissue except the umbilicus part. Histological evaluation revealed endometriosis of the umbilicus. Clinical discussion: By far, primary endometriosis of the umbilicus is extremely rare, and most of the time, extrapelvic endometriosis involving the umbilicus would be secondary to surgical procedures involving the abdominal cavity as it was for the presented patient. Although endometriosis is rare, it should always be considered among women of reproductive age presenting with cyclic pains. Conclusions: Meticulous investigation of patients suspected to have umbilical endometriosis helps to confirm the diagnosis and hence expedites proper management of the patients; this also prevents chances of malignant transformation of the condition despite such possibilities being extremely rare.
Immunohistochemical expression of Ki-67 and p53 and their prognostic role in ameloblastoma: A longitudinal study.
(Oman Medical Journal, 2024) Yahaya, J. J; Bwambale, P; Morgan, E. D; Abraham, Z. S; Owor, G; Wabinga, H
Objectives: Ameloblastoma, comprising approximately 11% of all odontogenic tumors, is a locally aggressive tumor with a high recurrence rate. This study aimed to assess the immunohistochemical expression of Ki-67 and p53 and their association with clinical and pathological factors among patients with ameloblastoma. Methods: Retrospective follow-up data of patients histologically confirmed with ameloblastoma at Makerere College of Health Sciences in Kampala, Uganda from January 2012 to December 2018 were retrieved. Factors associated with Ki-67 and p53 immunohistochemical expression were determined using one-way one-way analysis of variance. Chi-square and Fisher’s exact statistical tests were used to assess factors associated with recurrence. A two-tailed p < 0.05 was considered statistically significant. Results: A total of 40 patients confirmed histologically with ameloblastoma were included in the analysis. The majority (62.5%) of cases were of the conventional type of ameloblastoma. The expressions of Ki-67 and p53 were 52.5% and 85.0%, respectively. Recurrence was found in 47.5% of patients and it was associated with conventional histological type (p = 0.042), segmental resection (p < 0.001), tumor size (p < 0.001), and high p53 expression (p = 0.041). Conclusions: Almost half the cases in this study had recurrence. The immunohistochemical expression of p53 was significantly higher than that of Ki-67.
Immunohistochemical expression of P53 protein in nephroblastoma: a predictor of unfavorable prognosis
(Journal of the Egyptian National Cancer Institute, 2023) Morgan, E. D; Yahaya, J. J; Ngaiza, A. I; Othieno, E; Livex, O. A
Objective Immunohistochemical expression of P53 protein is so closely related to status of mutation of P53 gene which is tightly linked with pathogenesis of nephroblastoma or Wilms tumor. This study aims to determine the immunohistochemical expression of P53 protein and its predictors in formalin-fixed paraffin-embedded tissue blocks of patients with nephroblastoma. Materials and methods A series of 83 histologically diagnosed cases of nephroblastoma from formalin-fixed paraffin-embedded tissue blocks archived at the Department of Pathology, Makerere University, in Kampala, Uganda, were analyzed. Monoclonal anti-p53 antibody (DO-7, DAKO) was used to assess the expression of P53 protein expression. Multivariable logistic regression analysis was performed to determine the predictors of P53 protein immunohistochemical expression, and statistical significance was considered when p-value was less than 0.05. Results: Most (42.2%, n = 35) of the cases were in advanced tumor stages (III–V), and almost one-quarter (21.7%, n = 18) of the cases were in high-risk group. The immunohistochemical expression of P53 protein was (8.4%, n = 7), and there were more (83.3%, n = 5) positive anaplastic cases for P53 protein compared with (2.6%, n = 2) of P53 expression for non-anaplastic cases. High risk (AOR = 3.42, 95% CI = 7.91–12.55, p = 0.037) and anaplasia (AOR = 1.41, 95% CI = 13.85–4.46, p = 0.001) were potential predictors of immunohistochemical expression of P53 protein. Conclusion: Most of patients with nephroblastoma in resources-limited settings are diagnosed with advanced clinical stages. Association of P53 protein with anaplasia found in this study indicates the possibility of having novel target therapy for treatment of patients with anaplastic form of nephroblastoma with a focus of identifying molecules that lead to its suppression in such subpopulations of patients with nephroblastoma.
Invasive ductal carcinoma of breast in a 73-year old male: A rare case report and literature review
(International Journal of Surgery Case Reports, 2023) Yahaya, J. J; Ngaiza, A. I; Morgan, E. D; Abraham, Z. S; Othieno, E
Introduction and importance: Male breast cancers despite being similar to female breast cancers in various aspects; however, they have important distinctive characteristics such as molecular biology, increased tendency for axillary lymph node metastasis and late age at presentation. Presentation of case: We present the case of a 73-year old indigenous African male who had a 3-year history of right breast swelling which was associated with episodes of pain and tenderness. The assigned clinical stage for the patient was T2aNoMo. The mass was histologically confirmed to be invasive ductal carcinoma, not specified type (NST) without axillary lymph node involvement or distant metastasis. Immunohistochemistry also showed positive results for ER and PR hormonal receptors but negative for HER2. Clinical discussion: Considering the rarity nature of male breast cancers, this contributes to lack of evidence of the specific treatment approaches despite the noticeable difference in clinical presentation and even biological characteristics of male breast cancers, which are more likely to contribute to poor prognosis. Conclusion: The prevalence of male breast cancers has been reported to be less than 1 % of all male cancers. This contributes to the lack of analytical large studies that address the comprehensive data regarding the clinical outcomes of breast cancer among men and their predictors. Therefore, having prospective multicenter studies in future would help in providing high level of evidence on prognosis.
Malignant mixed mullerian tumor: A case report about a uterine Tumor’s case
(International Journal of Surgery Open, 2022) Morgan, E. D; Okecha, T; Yahaya, J. J; Othieno, E
Introduction: Malignant mixed Mullerian tumor (MMMT) is an exceedingly rare and aggressive tumor which occurs predominantly in postmenopausal women though it has been reported rarely in premenopausal women. Case presentation: A 54-year old nulliparous postmenopausal female presented with a 3-month history of vaginal bleeding, mild lower abdominal pain and weight loss. Ultrasound revealed markedly enlarged uterus with a hyper-echoic solid and cystic mass and a right adnexal complex mass. Total abdominal hysterectomy and bilateral salpingioopherectomy were done. Histopathological features were consistent with MMMT. The patient is currently stable after 6 cycles of adjuvant chemotherapy which consisted of paclitaxel and carboplatin. Clinical discussion: MMMT of the uterus is rare, high-grade neoplasms comprising only 1–2% of uterine cancers and 3–5% of all uterine malignancies. This tumor may arise in the ovaries, fallopian tubes and vagina. Histologically, MMMT is a biphasic tumor composed of both epithelial (carcinoma) elements and mesenchymal (sarcoma) elements; though, which component is responsible for the tumor’s aggressive biological behavior remains undetermined. Conclusion: MMMT is a rare and aggressive tumor which is commonly seen in postmenopausal women with high rate of recurrence therefore, Radical surgery and close follow-up is mandatory since the role of chemoradiotherapy remains unclear in the management of patients with this tumor. Both stage of the tumor and myometrial invasion are considered as potential prognostic factors.
Poor glycemic control and associated factors among patients with type 2 diabetes mellitus: a cross‑sectional study
(Scientific Reports, 2023) Yahaya, J. J; Doya, I. F; Morgan, E. D; Ngaiza, A. I; Bintabara, D
Glycemic control is of paramount importance in care and management for patients with type 2 diabetes mellitus (T2DM). Poor glycemic control is a major health problem that greatly contributes to the development of diabetes related complications. This study aims to assess the prevalence of poor glycemic control and associated factors among outpatients with T2DM attending diabetes clinic at Amana Regional Referral Hospital in Dar-es-salaam, Tanzania from December 2021 to September 2022. A face to face interviewer semi-structured questionnaire was administered during data collection. Binary logistic regression under multivariable analysis was used to determine the independent predictors of poor glycemic control. A total of 248 patients with T2DM were included in the analysis with mean age of 59.8 ± 12.1 years. The mean fasting blood glucose was 166.9 ± 60.8 mg/dL. The prevalence of poor glycemic control was 66.1% (fasting blood glucose > 130 mg/dL or < 70 mg/dL). Failure to adhere to regular follow-up (AOR = 7.53, 95% CI = 2.34–19.73, p < 0.001) and alcoholism (AOR = 4.71, 95% CI = 1.08–20.59, p = 0.040) were the independent predictors of poor glycemic control. The prevalence of poor glycemic control observed in this study was significantly high. Emphasis should be placed on ensuring that patients have regular follow-up for their diabetes clinics and they should also continue modifying some of lifestyle behaviors including refraining from alcoholism, this can help them to have good glycemic control.
Predictors of microvascular complications in patients with type 2 diabetes mellitus at regional referral hospitals in the central zone, Tanzania: a cross‑sectional study
(Scientific Reports, 2024) Shillah, W. B; Yahaya, J. J; Morgan, E. D; Bintabara, D
Microvascular complications encompass a group of diseases which result from long-standing chronic effect of diabetes mellitus (DM). We aimed to determine the prevalence of microvascular complications and associated risk factors among patients with type 2 diabetes mellitus (T2DM). A cross-sectional analytical hospital-based study was conducted at Singida and Dodoma regional referral hospitals in Tanzania from December 2021 to September 2022. A total of 422 patients with T2DM were included in the analysis by determining the prevalence of microvascular complications and their predictors using multivariable logistic regression analysis. A two-tailed p value less than 0.05 was considered statistically significant. The prevalence of microvascular complications was 57.6% (n = 243) and diabetic retinopathy was the most common microvascular complication which accounted for 21.1% (n = 89). Having irregular physical activity (AOR = 7.27, 95% CI = 2.98–17.71, p < 0.001), never having physical activity (AOR = 2.38, 95% CI = 1.4–4.01, p = 0.013), being hypertensive (AOR = 5.0, 95% CI = 2.14–11.68, p = 0.030), having T2DM for more than 5 years (AOR = 2.74, 95% CI = 1.42–5.26, p = 0.025), being obese (AOR = 2.63, 95% CI = 1.22–5.68, p = 0.010), and taking anti-diabetic drugs irregularly (AOR = 1.94, 95% CI = 0.15–0.77, p < 0.001) were the predictors of microvascular complications. This study has revealed a significant proportion of microvascular complications in a cohort of patients with T2DM. Lack of regular physical activity, being obese, taking anti-diabetic drugs irregularly, presence of hypertension, and long-standing duration of the disease, were significantly associated with microvascular complications.
Predictors of recurrence and disease‑free survival for salivary gland tumors among children and young adults in Kampala, Uganda: a retrospective follow‑up study
(The Egyptian Journal of Otolaryngology, 2023) Vuhahula, E. A; Yahaya, J. J; Ngaiza, A. I; Morgan, E. D; Abraham, Z. S
Background: Salivary gland tumors are a group of tumors which are highly heterogeneous, and they are uncommon among children and young adults. We aimed to investigate the predictors of recurrence and disease-free survival for salivary gland tumors among children and young adults. Methods: We retrospectively extracted clinical, pathologic, and follow-up data of patients who were diagnosed histologically with salivary gland tumors from January 2013 to December 2018 at the department of pathology, Makerere University in Kampala, Uganda. Then, we applied Cox regression analysis to determine the predictors of disease-free survival using hazard ratio as the measure of probability of the survival with 95% confidence interval. We also used Kaplan–Meier curves to analyze the disease-free survival. P ˂ 0.05 was considered significant. Results: A total of 144 patients with salivary gland tumors were included in the present study who were aged not more than 20 years with mean age of 13.9 ± 4.5 years. Over one quarter (26.4%, n = 38) of the salivary gland tumors that were analyzed in the present study were malignant. The prevalence of recurrence was (27.1%, n = 39), and the mean disease-free survival was 58.7 ± 1.9 months. Category of the salivary gland (AHR = 1.36, 95% CI = 0.137–0.942, p = 0.037) and behavior of the tumors (AHR = 1.82, 95% CI = 0.729–0.990, p = 0.023) were the potential predictors of disease-free survival. Conclusion: Over one quarter of the patients had malignant salivary tumors, and also, one-third of the patients developed recurrence at the end of the follow-up period of 6 years. Involvement of minor salivary glands and having a malignant salivary gland tumor both have shown increased risk of recurrence as well as short disease-free survival. Therefore, patients with minor salivary gland involvement and those with malignant variants require optimal surgical resection of the tumors for possible prevention of early recurrence and increasing the survival of the patients without relapse of such tumors after initial resection of the primary lesions.