Ademola A Adeyekun

Severe pentasomide Armillifer armillatus infestation complicated by hepatic encephalopathy

BACKGROUND Diagnosis of Armillifer armillatus infestation is usually incidental, commonly via autopsy or radiography. Affected individual are usually asymptomatic. The case presented here, however, had severe thoracic and abdominal involvement with clinical manifestations. AIM To report a case of heavy A. armillatus infestation in an adult female Nigerian rural dweller complicated by hepatic parenchyma damage. SETTING Case report from semi-urban southern Nigeria, using clinical records and imaging findings. MATERIALS AND METHODS Clinical case records, including laboratory results and radiographic /computed tomography images. CONCLUSION Parenchymal damage with organ dysfunction can be seen with severe A. armillatus infestation. Thus, there is a need for regular health education regarding the risk of A. armillatus infestation for individuals who consume snake meat.

Contact tracing / pre-employment screening for pulmonary tuberculosis: Should positive mantoux test necessitates routine chest X-ray?

BACKGROUND Pulmonary tuberculosis (PTB) remains a scourge in most developing countries. Mantoux skin test and more commonly chest radiography are some of the methods of diagnosing the disease, especially with regard to contact tracing and pre-employment screening. Regular use of radiography has both safety and cost implications. This study aimed at establishing if any justification exists in requesting for chest radiographs in asymptomatic subjects with a positive Mantoux skin test reaction. METHODS 174 adults comprising PTB contacts and newly employed/admitted university staff/students were recruited into the study. They were 89 males (51.1%) and 85 females (48.9%). All subjects had Mantoux test (using purified protein derivative, PPD). Patients who had positive Mantoux reaction subsequently were subjected to posteroanterior chest radiographic examination. Mantoux test and chest radiographic findings were then correlated with each other. RESULTS 102 subjects (59.2%) had positive Mantoux reactions, while 27 subjects (31.1%) had abnormal chest radiographs. There was no significant correlation between Mantoux readings and chest radiographic findings (P=0.106). CONCLUSION It is concluded that other ancillary tests like sputum examination and/or, where available, Interferon and ESAT tests should be carried out before chest radiograph is requested in subjects with positive Mantoux reaction.

Relationship between amniotic fluid index and ultrasound estimated fetal weight in healthy pregnant african women.

Introduction: Fetal weight (FW) estimation in late pregnancy is an important guide in obstetric care. Amniotic fluid protects the fetus against traumatic and infective insults. There possibly exists a relationship between FW and amniotic fluid index (AFI) that can be estimated by ultrasonography. Materials and Methods: Two hundred and fifty-eight low-risk pregnancies were prospectively studied by means of ultrasound over a 12-month period. FW was estimated using a combination of fetal parameters; bi-parietal diameter, fetal trunk cross sectional area, and femur length. AFI was assessed using the 4-quadrant method. Spearmans correlation was used to test possible relationship between amniotic fluid indices and estimated FW pairs. The level of statistical significance was set at P ≤ 0.05. Results: The mean AF1 and estimated fetal weight (EFW) pairs were as follows: at 27-29 weeks the values were 172.1 mm and 1,250.2 g; at 30-32 weeks AF1 and EFW values were 170.3 mm and 1,648.0 g; at 33-35 weeks values were 162.3 mm and 2,273.5 g; at 36-38 weeks values were 144.09 mm and 2,906.1 g; at 39-40 weeks AF1 and EFW values were 125.0 mm and 3,222.6 g. Overall, there was no statistically significant relationship between AFI and EFW (P > 0.05; r = 0.241). Conclusion: While FW calculations and amniotic index showed variations in value in late pregnancy, there does not appear to be a linear relationship between ultrasound estimate of FW and amniotic index. The implication of this is that fetal size need not be taken into cognizance when alterations in amniotic fluid values are noted.

Comparative ultrasound evaluation of thyroid nodule incidence among diabetics and healthy adults without overt thyroid disease

Background: Diabetes mellitus is associated with increased incidence of thyroid abnormalities, including thyroid nodules and gland enlargement, compared to healthy individuals. Some of these nodules can be malignant. Ultrasound is a valuable tool in assessing the thyroid gland, for such parenchymal abnormalities. We assessed by means of ultrasound, the incidence of thyroid nodules and other parenchymal changes in diabetic patients, and compare same with apparently healthy controls. Materials and Methods: One hundred and twenty adult diabetic patients and an equal number of apparently healthy adults were sonographically examined. In each subject, both lobes of the gland were scanned with a 5-12 MHz linear array transducer of a Sonoace ultrasound scanner. The thyroid was examined for nodules and other parenchymal abnormalities. Results: Thyroid nodules were noted in both diabetic and control groups. Both male and female diabetic patients had significantly greater number of thyroid nodules compared to controls; 18 male diabetics or 34.6% against 2 male controls or 4.5%; P = 0.001 and 22 female diabetics or 32% against 13 females controls or 17%; P = 0.033. Gender did not influence the detection of thyroid nodules among diabetics. Conclusion: Diabetic patients have higher frequency of thyroid nodules compared to apparently healthy individuals. It is recommended that the nodules be subjected to further imaging studies/biopsy for possibility of malignancies.

Ultrasound assessment of thyroid gland volume in diabetic patients without overt thyroid disease.

Background: Diabetes mellitus and thyroid disease are known to mutually influence each other. Thyroid disease can worsen glycaemic control in diabetes, and patients with diabetes mellitus have increased incidence of thyroid disorders such as increase in size, compared to the normal population. Aims/Objectives: The aim of the study was to sonographically assess thyroid gland volume in Nigerian adult diabetic patients and compare with apparently healthy adults (controls). Subjects and Methods: The study setting was the Department of Radiology, University of Benin Teaching Hospital (UBTH) Nigeria. The thyroid gland in 120 diabetic subjects and equal number of apparently healthy controls was scanned with a 5-12 MHz linear transducer of a SONOACE X4 Machine. Thyroid gland volume was assessed. Statistical analysis was done with Statistical Package for the Social Sciences (SPSS) version 17 (SPSS Inc, Chicago, IL, USA). Results: Diabetics had significantly increased thyroid volume compared to age matched male and female control subjects (11.5 ± 5.2 cm3 vs 7.4 ± 1.9 cm3; P < 0.001 for males) and (9.9 ± 6.2 cm3 vs 7.1 ± 3.4 cm3; P < 0.001 for females) respectively. Gender did not significantly influence thyroid volume among diabetics. Conclusion: Diabetics have higher thyroid gland dimensions, compared to apparently healthy subjects. Gland proliferation from circulating insulin may play a role. This is not influenced by gender.

Relationship between two-dimensional ultrasound measurement of placental thickness and estimated fetal weight

Background/Aim: The placenta plays a major role in fetal well-being, and fetal weight is very important to neonatal survival. There probably exists a relationship between placental dimension and fetal size. Data on ultrasound assessed placenta thickness and fetal weight are scanty in the Nigerian literature. This study aimed to establish a relationship between ultrasound estimated placental thickness and fetal weight. Materials and Methods: Four hundred and twenty apparently healthy pregnant women at gestational age 15-40 weeks were sonographically examined, with a 3.5 MHz curvilinear transducer of a Sonoace X6 machine (Medison Co., Korea). Placenta thickness, in millimeters, and fetal weight, in grams, was estimated for each subject. Correlation between the two parameters was assessed. P ≤ 0.05 were considered to be significant. Results: Mean placental thickness (PT) ranged from 22.6 ± 2.5 mm at 15 weeks to 40.9 ± 7.2 mm at 30 weeks, while estimated fetal weight (EFW) ranged from 147.0 ± 16.5 g at 15 weeks to 3.304.8 ± 284.6 g at 40 weeks. The mean values of placenta thickness and EFW throughout gestation were 35.5 ± 7.0 mm and 1555.0 ± 1004 g, respectively. There was significant correlation between placenta thickness and EFW r = 0.668; P = 0.000. Conclusion: The study established a fairly linear relationship between placental thickness and EFW. A normogram of ultrasound estimated placenta thickness and fetal weight is derived.

Sonographic evaluation of gallbladder dimensions in healthy adults in Benin City, Nigeria

Background: Several disease conditions can affect gallbladder (GB) size and wall thickness (WT). Imaging methods are superior to clinical evaluation in assessing GB dimensions. Ultrasonography is a relatively safe, inexpensive and reproducible imaging modality for assessing normal or diseased GB. There are few reports on normal GB dimensions in the Nigerian medical literature. This study therefore set out to contribute to data on GB dimensions among Nigerians. Materials and Methods: This was a prospective study. Three hundred and twenty-two healthy adult volunteers, consisting of 133 males and 189 females were assessed, by ultrasound, following over night fasting. GB length, width, height and WT were measured for each subject. GB-V was calculated by the ellipsoid formula. Data analysis included descriptive statistics and comparison of measurements with biometric parameters. Statistical significance between the variables was done with the Students t-test, with ′P′ value set at ≤0.05. Results: One hundred and thirty-three males (41.3%) and one hundred and eighty-nine females (58.7%) were studied. The mean age of subjects was 31.92±11.7 years. The mean values of the length (L), height (H), and width (W) of the GB were 6.16±1.09 cm; 2.75±0.58 cm; and 2.98±0.59 cm respectively. Mean GB-V was 27.2±12.8 cm 3 and WT 0.25±0.04 cm. Age and gender did not significantly influence GB measurements. Conclusions: A normal range of GB dimensions for the Benin City locality has been established. The study confirmed the non-dependence of GB measurements on age and gender.