Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria

<p>Abstract</p> <p>Background</p> <p>Though the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antiretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available. Purpose: To describe the findings and evaluate the clinical utility of abdominal ultrasonography in HIV/AIDS patients in Ibadan, Nigeria</p> <p>Methods</p> <p>A Prospective evaluation of the abdominal ultrasonography of 391 HIV-positive patients as well as 391 age and sex-matched HIV-negative patients were carried out at the University College Hospital, Ibadan.</p> <p>Results</p> <p>Of the 391 cases studied, 260 (66.5%) were females; the mean age was 38.02 years, (range 15–66 years). The disease was most prevalent in the 4th decade with an incidence of 40.4%. Compared with the HIV-negative individuals, the HIV+ group of patients had a significantly higher proportion of splenomegaly (13.5% vs. 7.7%; p < 0.01), lymphadenopathy (2.0% vs. 1.3%; p < 0.70), and renal abnormalities (8.4% vs. 3.8%; p < 0.02). There were no differences in hepatic and pancreatic abnormalities between the HIV+ and HIV- groups. There were significantly fewer gallstones in the HIV+ group (1.4% vs. 5.1%; p < 0.01).</p> <p>Conclusion</p> <p>AIDS is a multi-systemic disease and its demographic and clinical pattern remains the same globally. Ultrasonography is optimally suited for its clinical management especially in Africa. Its accuracy and sensitivity may be much improved with clinico-pathologic correlation which may not be readily available in developing countries; further studies may provide this much needed diagnostic algorithms.</p

Cranial computed tomographic findings in Nigerian women with metastatic breast cancer

Introduction: Brain metastases (BM) occur in up to one-fifth of patients with metastatic breast cancer (MBC). Imaging plays a key role in diagnosis. The pattern and distribution of these changes are also crucial to their management. These patterns have not been fully studied in Nigerian women. Materials and Methods: Retrospective analysis of the findings on the cranial Computed Tomography (CT) scans performed in 59 breast cancer patients with suspected BM treated at the University Teaching Hospital in Ibadan, between 2005 and 2010. The imaging features were evaluated in relation to their clinical characteristics. Results: In the 59 patients studied (mean age 50.9 years ± 11.75 SD), headache (40.7%) and hemiparesis/hemiplegia (16.9%) were the commonest clinical presentation. Lytic skull lesions were seen in 15 patients (25.4%), most commonly in the parietal bones. Thirty-nine patients (66.1%), had parenchymal brain lesions, and only 8 (20.5%) of these were single lesions. Most of the lesions were isodense (19/39; 51.4%) the parietal lobe was the most common site with 50.8% (30/59) occurrence and the leptomeninges the least with 13.6% (8/59). Orbital or sellar region involvement occurred in only two patients. The size of the lesions, was <2 cm in 17 (28.8%), 2-5 cm in 14 (23.7%) and >5 cm in 5 patients. Sixteen (27.1%) patients were free of any lesion either in the skull or brain. Patient presenting with multiple brain lesions were more likely to have skull lesions though this was not statistically significant ( P = 0.584). Conclusion: The brain continues to be a sanctuary site for breast cancer metastases and CT imaging remains an invaluable tool in the clinical evaluation and therapeutic management of Nigerian women with BM from MBC. It also appears that the demographic and imaging findings in these patients are similar to other racial groups

Pattern of breast cancer risk factors among pre and post-menopausal women at a Primary Care Clinic in Nigeria

Context: The incidence of breast cancer is increasing worldwide. In black women, breast cancer is associated with aggressive features and poor survival. Objective: Identification of risk factors such as early age of menarche, obesity and family history of breast cancer may permit preventive strategies. Study Design: A cross-sectional comparative study design was used and questionnaires were administered to 400 adult women at a tertiary health centre in Nigeria. The data was analyzed with the Statistical Package for the Social Sciences version 17; the level of significance set at alpha = 0.05. Results: There was significant association between pre-menopausal and post-menopausal women with positive family history of breast cancer with P = 0.010. Majority of the respondents with a positive family history of breast cancer were menopausal (P = 0.010). There was a statistically significant association between menopausal status and ever consuming alcohol-based herbal concoctions (P = 0.010) and in those whose partners smoked cigarettes (P = 0.001). Majority of respondents were not currently on any form of contraceptives. Parity, breastfeeding and use of hormonal contraceptives were all statistically significant (P < 0.001, P < 0.001 and P = 0.004, respectively). Almost all the women in our study, 97%, had never had a mammogram. There was a significant association between pre-menopausal and post-menopausal women with positive family history of breast cancer (P = 0.010). Conclusion: With increasing incidence of breast cancer worldwide and late presentation in developing countries with high morbidity and mortality, effective screening for risk factors will go a long way in reducing the incidence of breast cancer

Longitudinal sonogram of liver showing hepatomegaly and increased parenchymal echogenicity with posterior shadowing (*) compatible with fatty infiltration

<p><b>Copyright information:</b></p><p>Taken from "Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria"</p><p>http://www.biomedcentral.com/1471-2342/8/5</p><p>BMC Medical Imaging 2008;8():5-5.</p><p>Published online 29 Feb 2008</p><p>PMCID:PMC2275264.</p><p></p

Longitudinal sonogram of liver showing a large retroperitoneal lymph node adjacent to the gall bladder in a 27 year-old asymptomatic HIV patient

<p><b>Copyright information:</b></p><p>Taken from "Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria"</p><p>http://www.biomedcentral.com/1471-2342/8/5</p><p>BMC Medical Imaging 2008;8():5-5.</p><p>Published online 29 Feb 2008</p><p>PMCID:PMC2275264.</p><p></p

Longitudinal sonogram demonstrates normal sized right kidney with increased cortical echogenicity

Diffuse increased cortical echogenicity is associated with a poor prognosis.<p><b>Copyright information:</b></p><p>Taken from "Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria"</p><p>http://www.biomedcentral.com/1471-2342/8/5</p><p>BMC Medical Imaging 2008;8():5-5.</p><p>Published online 29 Feb 2008</p><p>PMCID:PMC2275264.</p><p></p