Grace Ben Inah

Intussusception in children: Comparison between ultrasound diagnosis and operation findings in a tropical developing country.

Background: Intussusception is one of the more common causes of intestinal obstruction in children. The diagnosis may be based mainly on clinical features; however, there are no classic signs and symptoms that are common to all cases. This study reports our experience at US diagnosis and operation findings of children with intussusceptions in a tropical developing economy. Materials and Methods: This was an 8 years retrospective review of intussusceptions in children in a tertiary health facility in a tropical developing country from January 2004 to December 2011. Results: Twenty-five out of 41 children (M:F = 2.2:1) admitted with intussusceptions within the period were studied. The median age was 6.0 ± 5.57 months (range 3 months- 7 years). US positively diagnosed intussusceptions in 20 (80%) cases. Conclusion: US can increase diagnostic confidence in intussusceptions.

Malignancies in AIDS patients: the experience of a tertiary hospital in a high prevalence zone

Material and methods A five year retrospective study was carried out to review the frequency of diagnosis of three tumours classified as AIDS defining malignancies (Kaposi sarcoma, non Hodgkin lymphoma, cervical cancer) and one non AIDS defining malignancy (squamous cell carcinoma of the conjunctiva), also commonly diagnosed in these patients. Records of the patients which are histologically confirmed and diagnosed between 1 January 2005 and 31 January 2009 were sorted out and their retroviral status classified.

Comparative study of radiological findings in pulmonary tuberculosis and paragonimiasis in children in a Southern Nigeria fishing community

Background: Paragonimiasis is one of the re-emerging public health diseases. Most of the presenting symptoms of pulmonary paragonimiasis are similar to those of tuberculosis (TB), which is also another major public health issue. Unfortunately both infections occur in the same environment of low socioeconomic status. Clinical and radiological differentiation between pulmonary paragonimiasis and tuberculosis can be difficult. Aim: This study was therefore designed to identify the chest radiological features that could be consistently used to differentiate between pulmonary TB and paragonimiasis in children. Materials and Methods: Two hundred and forty children aged five to eighteen years, were selected by stratified random samplings from a public primary and a secondary school in Ewang village, Mbo local government area of Akwa Ibom State, Nigeria. These children were screened for pulmonary paragonimiasis and pulmonary tuberculosis using sputum microscopy and Ziehl Neilson staining, respectively. Thereafter, the chest radiographs of children who were sputa-positive for paragonimus egg and acid fast bacilli were taken on full inspiration. Statistical Analysis: The data was analyzed with the STATA 10 software, produced by Stata Corp, Texas, USA. The results were expressed as means, standard deviations (SD), as well as percentages. A P < 0.05 was considered statistically significant. Results: A total of 204 children were examined; 91 (44.6%) were males and 113 (55.4%) were females. Ten (4.9%) of the subjects were sputum-positive for the paragonimus egg, while four (1.96%) of the subjects were sputum-positive for tuberculosis. The signs and symptoms of both diseases were similar. Radiologically, subcutaneous tissue wasting was an important differentiating feature between both diseases (P = 0.002). Conclusion: The study has shown that paragonimiasis and tuberculosis in children coexist in this locality. The clinical features of both conditions were similar hence differentiation on clinical grounds was difficult. Thus in a child being investigated for tuberculosis, the absence of subcutaneous tissue wasting radiologically should prompt further investigation for paragonimiasis.

Breast Evaluation Findings in Calabar, Nigeria

Abstract BACKGROUND: X-ray and sonomammography constitute a significant option in the early detection and management of breast diseases in the developed world. Unfortunately these modalities became available in Nigeria, only in the past few decades. AIM: The aim of this audit is therefore to document the imaging findings, in the past three years in a developing facility in Nigeria relating them with the demograghic features. METHODS: We prospectively studied the x-ray and sonomammography in all patients, presenting over a three year period, for breast evaluation with the hope of discerning the epidemiologic pattern of breast lesions in this environment. RESULTS: One hundred and forty-five females and four males. Median was 38 years (IQR=30-48). The commonest reason for evaluation was screening. Patients that were below 38 years showed no significant difference in frequency and type of lesion compared with patients over 38 years. The commonest breast pattern was fatty replaced. The upper outer quadrant was the commonest site. CONCLUSION: Patients presenting for breast evaluation in Calabar do so for screening mainly. Patients below 38 are nearly equally affected by malignant breast disease as their older counterparts. The commonest breast pattern was fatty replaced. Digital mammography should be available in all tertiary institutions.

Computed Tomography Scan Findings in Children from a Tropical Region

BACKGROUND: Computed Tomography in the diagnosis of pathologies in children is becoming increasingly popular. AIMS: To document indications and findings of referrals for CT scan in children in a private Radio - diagnostic Center in a developing environment. METHOD: Children aged 6 months to 13 years referred to a private Radio - diagnostic Center, between June 2015 to June 2016 were studied. Patients were examined using GE CT Brivo 385 machine. RESULT: Forty - seven children were referred for CT scan during the period. Of these 45 (95.47%) were referred from the Teaching Hospital located in the same city. A brain scan was most commonly performed (93.6%) while the frequency of abdominal CT was (6.4%). The main indications for the referrals were delayed milestones (61.7%) and seizures (17.0%). The major findings were cerebral atrophy 26 (55.32%), and cerebral infarction 3 (6.38%). CONCLUSION: This study shows a predominance of brain CT scan request in children, delayed milestones and seizures being the most common indications, while cerebral atrophy and cerebral infarction were the common brain findings. In the absence of MRI, CT scan provides a suitable alternative for imaging of the brain and abdominal pathologies in a developing environment like ours.

Chest radiographic lateral soft-tissue thickness changes after complete anti-tuberculosis treatment in adults

Background: Pulmonary tuberculosis (PTB) has 95-98% of its mortality in developing countries. It is associated with marked weight loss which can be evident at the lateral soft-tissue thickness on chest radiographs. Objective: To determine the pattern of lateral soft-tissue thickness changes and gender predisposition on chest radiographs in PTB patients and after complete anti-TB treatment. Methodology: This prospective study was conducted over a 6 month period at the Radiology Department of Ahmadu Bello University Teaching Hospital, Zaria. Two hundred adults who were bacteriologically proven to have PTB were consecutively recruited into the study as cases, aged 18-70 years and followed up after 6 months of complete anti-TB treatment and found to be asymptomatic and bacteriologically sputum negative. Their lateral soft-tissue thickness on the chest radiographs was measured. Results: The mean and standard deviation of pretreated and posttreated PTB patients was 12.66 ± 2.63 mm and 21.13 ± 2.56 mm, respectively (P < 0.0001). However, significant increase is noted in lateral soft-tissue thickness after complete anti-TB treatment (P < 0.001) and female sex (P = 0.001). Conclusion: Lateral soft-tissue thickness reduction was seen in PTB patients and significant increase was observed after complete anti-TB treatment.

Diverticular disease of the colon in Calabar, Nigeria: A case report and review of the African literature

Diverticular disease of the colon, though common in the western world, was thought to be rare in sub-Saharan Africa. Studies have however shown that it may not be uncommon in Nigeria. This is a case report of a 61-year-old male patient who presented with rectal bleeding in Calabar, South-South Nigeria. Clinical examination revealed mild pallor and blood stained hard stool in the rectum. Barium enema showed multiple diverticular along the whole colon but sparing the rectum. Diagnosis of diverticular disease of the colon was made. Diverticular disease may be more widespread in Nigeria than previously thought and should be considered an important differential diagnosis in rectal bleeding.

The relationship between infrarenal and suprarenal transverse aortic diameter on ultrasound among adults in Zaria, Nigeria

Background: Cardiovascular disease (CVD) is now a public health problem due to its high prevalence and associated high morbidity and mortality. Measurement of aortic diameters can help in predicting CVD in patients. The objective of this study was to determine the normal value of infrarenal and suprarenal transverse aortic diameter and their relationship on ultrasound among adults in Zaria, Nigeria Patients and Methods: Three hundred consecutive Nigerian adults without CVD attending ultrasound unit of Radiology Department of Ahmadu Bello University Teaching Hospital, Zaria, were recruited for this study. Routine protocol for scanning the abdomen in the transverse, longitudinal and craniocaudal planes were used to scan the aorta for supra- and infrarenal dimensions. Results: The mean suprarenal aortic diameter (SAD) of the subjects was 1.79 ± 0.25 cm with a range of 1.15-2.61 cm. The mean infrarenal aortic diameter (IAD) was 1.63 ± 0.23 cm with a range of 1.01-2.46 cm. The mean ratio of infra- and supra-renal diameter was 0.91 (±0.04), in male subjects, it was 0.92 (±0.04) and in female subjects, it was 0.90 (±0.05). IAD, IAD/SAD ratio, and weight were independent predictors of SAD on multilinear regression analysis. SAD, IAD/SAD ratio, age and body mass index were also independent predictors of IAD. Conclusion: This study has established the normal ratio values of infrarenal to suprarenal transverse aortic diameter in healthy adults and the factors that correlate with transverse aortic diameter, as well as independent predictors of transverse aortic diameter in Zaria. These values would be of help to radiologists, surgeons, and other clinician in the diagnosis, management, and follow-up of cardiovascular patients.