Inaugural lecture

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  • 1. CONTRIBUTIONS OF IBADAN TO THE DEVELOPMENT OF PATHOLOGY IN THE TROPICS Prof. EEU Akang FMCPath, FWACP INAUGURAL LECTURE 27 July 2007
  • 2. “I returned, and saw under the sun, that the race is not to the swift, nor the battle to the strong, neither yet bread to the wise, nor yet riches to men of understanding, nor yet favour to men of skill; but time and chance happeneth to them all.” Eccl. 9:11, KJV
  • 3. PATHOLOGY? Pathology is the clinical diagnostic science that underpins patient care (Royal College of Pathologists, 2006)
  • 4. PATHOLOGY? Histopathology, Chemical Pathology, Haematology and Medical Microbiology Histopathology- includes cytopathology, forensic pathology, oral pathology, neuropathology and
  • 5. DEATH AND DYINGPERSPECTIVES OF DISEASE Prof. AA Abioye PhD, FMCPath, FWACP INAUGURAL LECTURE
  • 6. THE LADY AND THE LOOKING GLASSBREAST CANCER IN NIGERIAN WOMEN Prof. PU Aghadiuno MD, FRCPath, FMCPath, FWACP INAUGURAL LECTURE
  • 7. HEADS OF PATHOLOGY WD SILVERA  BGT ELMES  GM EDINGTON  AO WILLIAMS  BO OSUNKOYA  AA ABIOYE  TA JUNAID  PU AGHADIUNO  JO THOMAS  JO OGUNBIYI 
  • 8. CONTRIBUTIONS OF IBADAN TO THE DEVELOPMENT OF PATHOLOGY IN THE TROPICS Prof. EEU Akang FMCPath, FWACP INAUGURAL LECTURE
  • 9. DEFINITIONS NEOPLASM- new growth  TUMOUR- swelling An abnormal mass produced by autonomous, uncontrolled, purposeless proliferation of cells derived from a single cell in which mutations have occurred. May be benign (harmless) or malignant (CANCER) 
  • 10. DEFINITIONS TERATOMA( τερατοσ (Gr.)monster) Tumour that originate s from germ cells displaying derivatives of three germ layers (endoderm, ectoderm and mesoderm) 
  • 11. TERATOMA- MACROSCOPIC APPEARANCE
  • 12. HISTORY OF TERATOMA Ancient Babylon (2000 BC) Records on cuneiform tablets Scultetus (1659) Earliest medical record of teratoma Calbet (1893) Escape of primordial cells from growth control Meckel (1880) Foetus in foetu (theory of suppressed second twin) Bosaeus (1926) Parthenogenesis
  • 13. TERATOMA- MICROSOCOPIC APPEARANCE
  • 14. S IT E A N D S EX D IS T R IB UT IO N O F T ER A T O M A S A ka ng e t a l, 1994 O the r 6 1 4 0 8 8 0 C he s t T e s ti s Ne c k Sa c r um 4 Ovar y 15 FE MA LE MA LE 22 342 0 0 50 100 150 200 250 Numbe r of c a s e s 300 350 400
  • 15. A G E A N D S EX D IS T R IB UT IO N O F T ER A T O M A S A ka ng e t a l, 1994 2 70- 79 0 60- 69 0 50- 59 1 40- 49 8 11 31 3 30- 39 FE MA LE 1 20- 29 5 33 1 0- 9 44 12 0 MA LE 69 3 10- 19 77 20 40 60 Numbe r of c a s e s 80 100
  • 16. CHILDHOOD TERATOMA IN IBADAN- Akang EE et al: Hum Pathol 1992 Bimodal peak age incidence  Female: male ratio = 5:1  Sacrococcyx and ovary are 2 most common sites  81% mature; 15% immature; 4% malignant 
  • 17. RETINOBLASTOMA IN IBADANAjaiyeoba et al: Afr J Med Med Sci 1993     Malignant embryonal childhood intraocular neoplasms displaying retinal differentiation More common in developing countries Worse outcome in younger patients Dismal outcome in Nigerian children
  • 18. CHILDHOOD MORTALITY IN IBADANAkang EE et al: Nig J Paediatr 1992; 19:30-36 Bronchopneumonia, meningitis, gastroenteritis  Tuberculosis, measles, malaria  Most deaths preventable  High perinatal death toll (pregnancy and early childhood problems) 
  • 19. PAEDIATRIC PATHOLOGY  Congenital malformations (Pediatr Pathol 1993; 13:659-70)  Childhood cancer (Pediatr Pathol Lab Med 1996; 16:791800)
  • 20. BURKITT’S LYMPHOMA  Declining incidence in Ibadan Okpala et al 1991; Akang 1996; Ojesina et al 2002;
  • 21. NEUROPATHOLOGY   Malomo et al 1990- Report of a case of cerebral coenurosis- Trop Geogr Med Ibadan-Indianapolis
  • 22. NEUROPATHOLOGY    Osuntokun et al 1994- Low incidence of plaques and tangles in elderly Africans- Lancet Park et al 1997- Report of a case of subacute sclerosing panencephalitisAm J Ophthalmol Ogunniyi et al 2002- Lewy body disease case report- Int Psychogeriatr
  • 23. IBADAN PATHOLOGISTSContributions        Practising pathologists at every level in the country and in the Diaspora A former State governor Acting Vice Chancellors Provosts Deans Vice Deans Professors of Pathology, both at home and abroad.
  • 24. M E D L IN E T OT A L A N D P A T HOL OG Y C IT A T ION S 900000 800000 70 0 0 0 0 600000 50 0 0 0 0 400000 300000 200000 10 0 0 0 0 0 T OT A L P A T HOL OG Y
  • 25. MEDLINE PATHOLOGY CITATIONS 3500 3000 2500 2000 1500 1000 500 0
  • 26. M ED LIN E T O T A L A N D P A T H O LO G Y C IT A T IO N S 3000 2500 2000 1500 1000 500 0 T OT AL P A T HO LO G Y
  • 27. George Millar Edington Co-author of Pathology in the Tropics  Started professional career in Ghana (1950-1960)  In Ibadan (1960-1976)  Zaria  Maiduguri (Acting ViceChancellor) 
  • 28. Akin Olufemi Williams One of most prolific African Pathologists  First Nigerian Head of Pathology  Established Pathology in Calabar  Ambassador to OAU  Laboratory of Molecular Virology at NIH 
  • 29. Babatunde O. Osunkoya  Burkitt’s lymphoma Ayinla A. Abioye   Amoebiasis First inaugural lecture Ed ‘B Attah   Tropical pathology, cardiac pathology Zaria, Calabar
  • 30. T. Abisogun Junaid  Gynaecological pathology Patrick U. Aghadiuno   Breast cancer Second inaugural lecture Jaiyeola O. Thomas-Ogunniyi  Renal pathology, cytology and lymphoma J. Olufemi Ogunbiyi  Liver pathology, hypertension and prostate cancer
  • 31. FUTURE DIRECTIONS  Gastrointestinal and liver pathology  Breast and cervical cancer  Soft tissue and skin tumours  Forensic pathology  Renal pathology
  • 32. “ It is not so much as what Nigeria can do for you as what you can do for Nigeria ”
  • 33. ACKNOWLEDGMENTS         My parents My siblings My teachers My students My friends and brethren in Christ Pathology Department co-workers My collaborators My wife and children
  • 34. FINIS “Therefore let us also, seeing we are surrounded by so great a cloud of witnesses, lay aside every weight and the sin which so easily entangles us, and let us run with patience the race that is set before us” Hebrews 12:1, KJV