Lichen sclerosis: a rare cause of urethral stricture in blacks, managed by buccal mucosal graft urethroplasty

Penile Lichen Sclerosus is a chronic progressive inflammatory disease of the foreskin. Balanitis Xerotica Obliterans is a traditional terminology used to refer to Lichen Sclerosus affecting the foreskin and glans penis. Involvement of the urethra by Lichen Sclerosus is quite uncommon in our region butcan result in urethral stricture. Method: We reported a case of urethral stricture secondary to Lichen Sclerosus, which was managed by Buccal Mucosal Graft Urethroplasty with a satisfactoryoutcome. Conclusion: High index of suspicion helps in diagnosing this case allowing the best treatment option to be instituted. Early circumcision is one of the preventive measures

Sonographic evaluation of the common bile duct size in normal adults at university of maiduguri teaching hospital, Nigeria

Despite ultrasound safety, affordability and its widespread use in evaluation of the diseases of biliary tree, paucity of literature on the sonographic measurements of the size of the normal adult common bile duct (CBD) in this environment exists. Objectives: To determine the normal adult diameter of the CBD in this environment using ultrasonography. Methods: This was a cross-sectional prospective study carried out at the University of Maiduguri Teaching Hospital between January to June, 2011. Results: There were 224(56%) females and 176(44%) males aged between18 and 87 years (Mean±SD, 36.88 ±16.97 years). The mean AP and transverse CBD diameters (±SD) were 3.68±0.82mm and 3.89±0.86mm, respectively. The average mean for the two measurements (± SD) was 3.78±0.84mm (range = 2.0 – 6.0 mm). The mean transverse diameter was slightly greater than AP diameter (p = 0.0004).The CBD diameter was strongly correlated with age (r = 2 0.798; p = 0.000; r = 0.629). The least squares regression slope of 0.039mm±0.001 (mean±SD) was obtained suggesting 0.039mm±0.001 increase in the CBD diameter per year. There was significant correlation between the CBD diameter with weight (r = 0.504; p = 0.000) and BMI (r = 0.454; p = 0.000). No significant difference between the mean CBD diameter in males and females (p= 0.084)was observed. Conclusion: The mean and range of CBD size in normal adult population were determined and significantly correlated with age, weight, and BMI

Evaluation of hypofunctioning thyroid nodules with technetium-99m MIBI and ultrasonography

Background: Fine needle aspiration cytology (FNAC) cannot reliably differentiate follicular adenoma from follicular carcinoma (FC), which requires histological evidence of capsular or vascular invasion. FC is the most predominant thyroid cancer in our loco-regional environment, indicating the need for improvement in preoperative diagnostic accuracy of thyroid nodules to ensure appropriate and timely interventions. Objective: The purpose of this study was to assess the role of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scintigraphy and ultrasonography (USG) in the differential diagnosis of thyroid nodules. Methods: Forty-two patients with hypofunctioning thyroid nodules were prospectively studied with 99mTc-MIBI scintigraphy and USG to differentiate benign from malignant nodules. An injection of 740 MBq of 99mTc-MIBI was intravenously administered, followed by semiquantitative analysis of dual-phase scans using a 4-point (0 to 3) scoring system. USG was subsequently performed and interpretation was based on some sonographic criteria for malignancy. In the following days and weeks, patients underwent FNAC followed by surgery and histopathologic examination. Results: All malignant nodules were positive on 99mTc-MIBI and all but two malignant nodules were positive on USG. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy are, respectively, 100%, 70%, 65%, 100%, and 81% for 99mTc-MIBI scintigraphy; 87%, 78%, 68%, 91% and 81% for USG; and 83%, 100%, 100%, 96% and 64% for FNAC. There was no statistically significant difference between 99mTc-MIBI scintigraphy and USG performance for both benign (p = 0.317) and malignant (p = 0.573) nodules. Conclusion: 99mTc-MIBI scintigraphy and USG are important imaging modalities in the evaluation of thyroid nodules, particularly follicular neoplasms which are frequently associated with non-diagnostic cytology

Sonographic Determination of Common and Internal Carotid Intima Media Thickness in Normal Adult Population in Northeastern Nigeria

Background: Intima-media thickness (IMT) assessment of the common carotid artery (CCA) is a predictor of atherosclerosis. Early detection of this disease is important in management of cardiovascular complications. Objectives: The study aimed at establishing the baseline values of IMT for the Northeastern part of Nigerian for reference purposes. This is in order to create standards for defining abnormalities. Ultrasonography is readily available, relatively cheap and does not use ionizing radiation making it an ideal imaging modality to measure the IMT of carotid arteries. Method: This was a cross-sectional study carried out at the University of Maiduguri Teaching Hospital from February to October, 2011. Four hundred adult males and females above 18 years underwent carotid artery ultrasonography for measurement of the IMT of the common and internal carotid arteries. The influence of age, sex, weight, height, and the body mass index (BMI) on these parameters was also investigated. Results: There were 239 (59.80%) males and 161 (40.20%) females aged between 18 to 81 years (Mean ± SD, 36.74±14.79 years). The mean ± SD IMT for RCCA, LCCA, RICA, and LICA was 0.73±0.14mm, 0.73±0.14mm, 0.72±0.14mm, and 0.71±0.14mm respectively. The IMT of the carotid arteries increased significantly with age. The mean ± SD values were 1.11mm ± 0.09 and 1.08mm ± 0.11 at <20 years for CCA and ICA respectively but 1.90mm ±0.07 and 1.95mm ±0.05 at >70 years in males and 1.13 ±0.23 and 1.13mm ±0.14 for CCA and ICA respectively at less than 20yrs but 2.00 ±0.00 and 1.80mm ± 0.00 at >70 years. IMT also increases with BMI. The IMT in the CCA was 0.73mm ± 0.89, 0.73mm ± 0.13 and 0.79mm ± 0.09 for underweight, normal and overweight, respectively. There was no definite orderly pattern in sex and IMT. Conclusion: Normal values of the IMT of CCA and ICA have been established in this environment using ultrasonography. The data may be useful in the prevention of cerebrovascular disease which is related to IMT of carotid arteries

Clinical and Psychometric Validation of the Geriatric Depression Scale (GDS) for Portuguese Elders

The main purpose of this study is the adaptation and psychometric validation of the Geriatric Depression Scale (GDS) for the Portuguese population. The analyses of temporal (a (27 items) = .995) and internal (.91) consistencies, inter-rater reliability (Kappa = .87), and concur- rent (.83) and factorial (3 factor) validities demonstrate that GDS is highly reliable as a screening instrument for geriatric depression. This conclusion was further validated by both discriminant function analysis and diagnostic value testing, which showed a sensitivity of 100%, a specificity of 83%, a positive predictive value of 93%, and a negative predictive value of 100%. The study has also evaluated GDS applicability to clinical assessment and therapeutic intervention with elders suffering from moderate feelings of loneliness linked to recurring suicidal ideation

Domestic Waste Water Treatment By Using Bio-soil Filter

Water resource management major challenge for development worldwide. While water demand will continue to increase, the limited amount of natural fresh water available will always be problematic in term of water resources management. Large portion of domestic waste water in small and remote communities few discharge in environment without effective treatment in areas with low population densities and dispersed household, waste water system strategies are needed which are environmentally ,socially and economically sustainable. A waste water treatment and disposal method the study aim to present the removal of suspended solid, bacterial indicators of fecal contamination, dissolved solid and parasites using bio-soil filter consist of three glass column .Two column contain gravel, red soil, murum, brick and rock wool