Ultrasound prevalence of gallstone disease in diabetic patients at Ibadan, Nigeria

Background: Gallstones (GS) in the gallbladder (GB) can be responsible for a whole spectrum of disease entities which may lead to a surgical emergency with high mortality. Diabetes mellitus (DM) is a debilitating disease that affects all systems in the body, and literature documents a higher incidence of gallstone disease (GSD) and its complicationsin diabetics than in the non-diabetic population. Most local studies on the association between GS formation and DM have focused on type 2 diabetics. This study was therefore designed to determine the prevalence of GS in both type 1 and type 2 DM and elucidate the demographic and social factors associated with formation of GS in diabetic patients.Materials and Methods: Four hundred diabetic patients aged between 15 and 82 years had abdominal ultrasound to diagnose or exclude the presence of GS.Results: GS was found in 70 (17.5%) of the 400 patients. Positive cases had a male to female ratio of 3:4 and 59 (51.92%) were above the age of 40 years with type 2 DM. Body mass index (BMI) greater than 25 kg/m2 was seen in 56 (48.3%) patients; smoking and alcohol intake were insignificantly implicated. Jaundice was recorded in 8 (11.4%) while abdominal pain was in 24 (34.3%) patients, and 52 (74.3%) patients of those with GSD had had diabetes for more than 4 years.Conclusion: GSD in DM is influenced significantly by age, BMI, and duration of the disease, while gender, social factors, and parity do not influence as strong associated factors.Key words: Diabetes mellitus, gallstones, ultrasoun

The Yield from Routine Chest X-Rays in Stage 3 Breast Cancer Patients

Context: Cancer of the breast is a common malignancy in Nigerian women and various imaging examinations, including the chest radiograph are routinely requested in all patients with this disease.Objective: The objective of this study was to determine the positive yield from routine chest radiographs in Nigerian patients with locally advanced stage 3 breast cancers but who had no clinical symptoms or signs of pulmonary or pleural metastatic disease. Methods: This descriptive retrospective study evaluated clinical records and chest radiographs of 61 female Nigerian patients with local stage 3 histologically diagnosed breast cancers, who presented at the radiotherapy unit of the University College hospital, Ibadan, over a 12-month period. Allabnormalities on the chest radiographs were documented.Results: The ages of the study group ranged from 25 to 67 years with a mean of 47years. Fortyseven (77%) of the patients had normal chest radiographs. Of the 14 abnormal radiographs, bilateral lung parenchymal metastases were seen in 4 cases one of whom also had bilateralpleural effusion. Other abnormal findings included hilar adenopathy, right lower lobe collapse, lymphagitis carcinomatosis and cardiomegaly.Conclusion: The authors conclude that a 23% detection rate from these screening chest radiographs is high and should be recommended as over 70% of Nigerian Patients with breast cancers present with advanced tumors

The role of routine post-natal abdominal ultrasound for newborns in a resource-poor setting: a longitudinal study

<p>Abstract</p> <p>Background-</p> <p>Neonatal abdominal ultrasound is usually performed in Nigeria to investigate neonatal symptoms rather than as a follow up to evaluate fetal abnormalities which were detected on prenatal ultrasound. The role of routine obstetric ultrasonography in the monitoring of pregnancy and identification of fetal malformations has partly contributed to lowering of fetal mortality rates. In Nigeria which has a high maternal and fetal mortality rate, many pregnant women do not have ante-natal care and not infrequently, women also deliver their babies at home and only bring the newborns to the clinics for immunization. Even when performed, most routine obstetric scans are not targeted towards the detection of fetal abnormalities.</p> <p>The aim of the present study is to evaluate the benefit of routinely performing abdominal scans on newborns with a view to detecting possible abnormalities which may have been missed ante-natally.</p> <p>Methods-</p> <p>This was a longitudinal study of 202 consecutive, apparently normal newborns. Routine clinical examination and abdominal ultrasound scans were performed on the babies by their mother's bedside, before discharge. Neonates with abnormal initial scans had follow-up scans.</p> <p>Results-</p> <p>There were 108 males and 94 females. There were 12 (5.9%) abnormal scans seen in five male and seven female neonates. Eleven of the twelve abnormalities were in the kidneys, six on the left and five on the right. Three of the four major renal anomalies- absent kidney, ectopic/pelvic kidney and two cases of severe hydronephrosis were however on the left side. There was one suprarenal abnormality on the right suspected to be a possible infected adrenal haemorrage. Nine of the abnormal cases reported for follow- up and of these, two cases had persistent severe abnormalities.</p> <p>Conclusions-</p> <p>This study demonstrated a 5.9% incidence of genito urinary anomalies on routine neonatal abdominal ultrasound in this small population. Routine obstetric USS is very useful but inadequate availability of skilled personnel and cost implications create great challenges in poor resource settings like Nigeria. However, awareness should be created so that parents who can afford such investigations can make informed decisions.</p

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke - the second leading cause of death worldwide - were conducted predominantly in populations of European ancestry(1,2). Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis(3), and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach(4), we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry(5). Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries.</p

Splenic Size in Sickle Cell Anaemia Patients in A Tertiary Hospital

Sickle cell disease is one of the common haemoglobinopathies in the world. It can affect any organ in the body and one of the most common and an early organ to be affected in SCA is the spleen. Reports have shown that patients with sickle cell anaemia (HbSS) have an increased susceptibility to infection leading to increased morbidity and mortality. Autosplenectomy with the consequent absence or reduction of splenic function may explain the propensity to encapsulated bacteria infection. This study was carried out in order to provide an update on the incidence of anatomical autosplenectomy in sickle cell anaemia patients. A comparative cross sectional study of 40 sickle cell anaemia patients in steady state attending Haematology clinic and 40 age and sex-matched healthy HbA control was carried out. An interviewer-administered questionnaire was used to get information on biodata and malaria history. Splenic Ultrasound was done to determine spleen size. Data generated was analyzed using statistical package for social science version 17 (SPSS 17). Twenty (20%) of the sickle cell patients had autosplenectomy (spleen size less than 6cm) while 15% had splenomegaly (spleen size greater than 12cm) and 65% had normal sized spleen(spleen size of 6cm-12cm) on ultrasonography. There was no significance difference (p= 0.332) in the median spleen size of HbS and HbA individuals. Splenic ultrasonography is advocated in determining splenic size in patients with sickle cell anaemia, and could be done annually as a means of monitoring the trend of the size of the spleen in each patient.Key words: Sickle cell anaemia, Autosplenectomy, Splenomegaly, spleen Ultrasonograph

Case Report: Unusual computed tomographic features of intracranial tuberculoma: a case report

A case report of a 57-year old woman who presented with signs and symptoms of intracranial mass. Computed tomographic (CT) and clinical features were unusual and suggestive of a parasaggital Meningioma. However an accurate diagnosis of a tuberculoma was made at surgery and histopathological examination. (Nig J Surg Res 2003; 5: 67 – 69) Key words: Intracranial tuberculoma, computed tomography, meningiom