Pattern and presentation of spine trauma in Gwagwalada‑Abuja, Nigeria

Objective: The objective was to demonstrate the correlations and effects of age, gender, and cause of accident on the type of vertebral fracture as well as on the likelihood to sustain neurological deficit following trauma in Nigeria. Background: Spinal column injury is a well‑documented problem but literature has been mute on this problem in Nigeria unlike the many papers on spinal cord injury. Materials and Methods: A retrospective review of spinal cord injured (SCI) patients was performed. Age, sex, cause and level of injury, fracture pattern and distribution, and neurologic presentation of SCI patients from 1997 to 2007 were studied from case notes. Results: There were 202 patients with male preponderance and a mean age of 38.9 ± 11.4 years over the 11‑year period. The most common cause of spine injury was road traffic injury (79.7%). Cervical spine injury (10.4%) accounted for the highest number of cases with complete neurologic deficit. The majority of patients, 119 (58.9%) sustained a type A fracture, 37 (18.3%) a type B fracture, and 41(20.3%) patients experienced a type C fracture. All patients had neurologic deficits. Age (P=0.032) and road traffic injury (P=0.029) were independently associated with type of fracture after multivariate analysis. Age (P=0.038), road traffic injury (P=0.027), and cervical spine fracture (P=0.009) were also independently associated with neurologic deficit. Conclusion: These data showed the correlation between trauma mechanism and the type of fracture seen, and also the type of fracture and the incidence of neurologic deficit. The predictors of fracture types are age and road traffic injury while age, road traffic injury, and cervical spine fractures predict neurologic deficit.Keywords: Cervical spine injury, correlate, Gwagwalada, road traffic injuryNigerian Journal of Clinical Practice •Jan-Mar 2012 • Vol 15 • Issue

Bilateral Supernumerary Kidneys: Incidental Finding in a Three-Month-Old Infant

Supernumerary kidney (SNK) is a rare congenital anomaly with fewer than 100 cases reported in the English literature. The majority of these were unilateral and only five bilateral cases have been reported. We report an infant with six kidneys, incidentally diagnosed at ultrasonographic imaging after presenting with an anterior lower chest wall abscess. Confirmation of the diagnosis was confirmed by excretory urography. To our knowledge, this is the highest number of SNK reported.Key Words:  Supernumerary kidneys, bilateral, anomaly, infan

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

Common Radiographic Findings in Patients with Low Back Pain a Major Nigerian Teaching Hospital

Objective: To identify common radiographic findings among patients presenting with low back pain.Methodology: A retrospective study was carried out on 160 patients with low back pain that underwent x-ray of the lumbosacral spine at ABUTH. The collected data was organized and classified into groups based on age, sex, radiographic findings, location on the lumbar spine and patients’ occupation. Mean, standard deviation and percentages were calculated and tabulated.Results: Findings show that, low back pain is mostly in patients between 41-50 years of age accounting 28.1%.Likewise, those engaged in more than one activity 71.3%. Abnormal radiographic findings were mostly seen on L4 vertebral body representing 26.5%, and lumbar spondylosis is the most frequent finding with 51.2%.Conclusion: The study has established various radiographic findings in patients with low back pain, and lumbar spondylosis is the most frequent in both males and females gender

Radiographic Features of Pulmonary Tuberculosis Among HIV Patients in Maiduguri, Nigeria

Background: Tuberculosis infection may develop at any stage of HIV infection. Pulmonary tuberculosis produces a broad spectrum of radiographic abnormalities among HIV patients. Method:A cross-sectional study of the radiographic features of pulmonary tuberculosis in 60 consecutive confirmed HIV-seropositive patients aged between 18 and 55 years (Mean \ub1 SD: 33.9 \ub1 8.42) comprising of 34 males and 26 females. Chest x-rays were evaluated for the presence of apical opacities with or without cavitation (typical) or miliary, lower or mid-zone and reticulonodular opacities, pleural effusion, hilar adenopathy and normal radiograph (atypical). Results:The commonest clinical manifestation was productive cough (100%). Oral thrush (87%), weight loss (83%), night sweats (78%), fever (75%), chest pain (50%) and herpes zoster (5%) also occurred in the patients. Normal radiographs constitute the commonest radiographic finding and were seen in 15 (25%) patients. Hilar adenopathy was noted in 5 (8%) patients. Pleural effusion was seen in 10 (16.7%) patients (mean 194.5 \ub1 82.9/\u3bcl). Lower/mid-zone and reticulonodular opacities occurred in 7 (11.6%) and 2 (3%) patients respectively. Conclusion: Majority of patients in our study had normal chest radiographs. Absence of changes in chest radiographs should not exclude the diagnosis of PTB.Fond: L'infection de tuberculose peut se d\ue9velopper \ue1 n'importe quelle \ue9tape de l'infection par le HIV. La tuberculose pulmonaire produit un large \ue9ventail des anomalies radiographiques parmi des patients d'VIH. M\ue9thode: Une \ue9tude transversale des dispositifs radiographiques de latuberculose pulmonaire dans 60 malades de VIH-s\ue9ropositifs cons\ue9cutifs et confirm\ue9s \ue2g\ue9s entre 18 et 55 ans (moyen \ub1 : 33.9 \ub1 8.42) comportant de 34 m\ue2les et de 26 femelles. Des radiographies de la poitrine ont \ue9t\ue9 \ue9valu\ue9es pour la pr\ue9sence des opacit\ue9s apicales avec ou sans la cavitation (typique) ou miliaire, bas ou mi-zone et opacit\ue9s reticulonodulaires, effusion pleurale, ad\ue9nopathie hilar et radiographie normale (atypiques). R\ue9sultats: La manifestation clinique la plus commune \ue9tait la toux productive (100%). La grive oral (87%), la perte de poids (83%), les sueur de la nuit (78%), la fi\ue8vre (75%), la douleur de poitrine (50%) et zoster d'herp\ue8s (5%) se sont \ue9galement produits dans les malades. Les radiographies normales constituent la conclusion radiographique la plus commune et ont \ue9t\ue9 vues dans 15 (25%) malades. Ad\ue9nopathie de hilar a \ue9t\ue9 not\ue9 dans 5 (8%) malades. L'effusion pleurale a \ue9t\ue9 vue dans 10 (16.7%) malades (\ub1 82.9/ de moyen 194.5ml). Bas/ mi-zone et des opacit\ue9s reticulonodulaires se sont produites dans 7 (11,6 %) et 2 (3%) malades respectivement. Conclusion: la Majorit\ue9 de malades dans notre \ue9tude avait les radiographies de poitrine normales. L'absence de changements dans les radiographies de poitrine ne doit pas exclure le diagnostic de PTB

Attitude towards psychiatric treatment and referral pattern in the University of Maiduguri Teaching Hospital- A preliminary report

Objective: There is a paucity of literature on consultation-liaison psychiatry, in northern Nigeria. This study aimed to determine both the pattern of psychiatric referrals, and the attitudes of doctors toward the treatment of mental disorders in a teaching hospital, in northeast Nigeria. Method: In this cross-sectional survey, we used a modified version of the self-rated Kumar 12-item questionnaire and a basic socio-demographic questionnaire to assess a non-random convenient sample of 100 postgraduate resident doctors (with a response rate of 70%) from the University of Maiduguri Teaching Hospital (UMTH). We subjected the dataobtained to descriptive statistical analysis, using EPI info (2003), to report averages. Results: A relatively low percentage (57.1%) of doctors acknowledged treating patients with mental disorders in their practice, with a higher proportion acknowledging referral (75%). Nearly one in five (17.6%) of the respondents were unaware that patients with functional illness could have psychological disorders. We found more awareness for psychotherapy (44.1%) than other non-pharmacological treatment interventions, while10.3% were ignorant of non-pharmacological forms of treatment for psychological problems. Conclusion: Although this is a preliminary report, the research reported here demonstrated that doctors in the teaching hospital concerned recognized the need for psychiatric consultation and referral. It is difficult to draw further conclusions because of the limitations of this study.Keywords: Consultation; Liaison; Psychiatry; northern Nigeri

Estimation of entrance surface dose to adult patients undergoing plain chest radiographic examinations in a Northern Nigerian population.

Objective: The entrance surface doses (ESD) to adult patients undergoing postero-anterior (PA) chest radiography were measured at Shika Ahmedu Bello University Teaching Hospital (ABUTH) Zaria, Northern Nigeria. Method:A total of 30 patients were prospectively considered in the study. The ESDs were obtained using thermo luminescence dosimeter (TLDs) chips, and Kumar's formula. Results: The estimated ESD obtained were 1.08 mGy and 0.76 mGy for TLD chips readings and Kumar's formula respectively. Comparison was made between the two readings, and a statistically significant difference was noted (p<0.029). Conclusion: Procedural changes are suggested in order to lower the ESD and enhance the image quality of the radiographs. ESDs in this study were found to be generally higher compared with those reported in similar studies in Southern Nigeria, UK, and CEC. The results call for improved operators technique and application of quality Assurance Programme (QAP) in radiology departments, to ensure that doses are kept as low as reasonably achievable, and also for the formulation of local diagnostic reference levels (LDRL)

Use of Mitrofanoff and Yang–Monti Techniques as Ureteric Substitution for Severe Schistosomal Bilateral Ureteric Stricture: A Case Report and Review of the Literature

Distal ureteric stricture is a common complication of urinary schistosomiasis which is a disease more prevalent in the tropics and subtropics. The surgical management of this complication is more challenging when it affects more than half of both ureters. We report the case of a 17-year-old Nigerian with a long standing recurrent painless terminal hematuria associated with bilateral colicky loin pains. Ultrasound scan showed bilateral hydro ureters and hydro nephrosis with deranged biochemical renal function. The patient had bilateral tube nephrostomy and antibiotic therapy. Definitive bilateral ureteric substitution was done using Mitrofanoff technique for the right ureter and Yang–Montie technique for the left ureter. The patient’s renal function became normal and he was discharged home without complication. The related literatures were reviewed. Surgical nonurothelial ureteral substitution is necessary for long, extensive, severe bilateral ureteric strictures so as to prevent progressive renal damage and end stage renal failure.Keywords: Appendix, intestine, schistosomiasis, stricture, ureter, ureteric substitutionNigerian Journal of Surgery, Jan-Jun 2012 | Volume 18 | Issue

Ct findings in patients with head injury at a teaching hospital in Nigeria

There is paucity of data on computed tomography findings in head injury patients from this part of Africa inspite of the high number of trauma cases seen. Objectives: The objective of this study was to determine the pattern of findings on Computed Tomography (CT) scan of the head in patients with head injury in our locality, with the aim of detecting the pitfalls to help make improvements. Material: Seventy-eight patients with head injury, who had CT scan of the head conducted in the Radiology department, University of Maiduguri Teaching Hospital between September 2011 to December 2013 were retrospectively reviewed by two Radiology residents and a Consultant Radiologist. Data was retrieved from the CT record book in that unit. Results: Head injury sustained as a result of road traffic accident (RTA) is the most frequent indication for CT head imaging in our study, with the lowest coming from request in bomb blast patients. Linear skull fractures were the most frequent finding, while rupture of the globe and frontal sinomucoceole, amongst others were the least. Gender variation showed that males were four times more affected than females and the age range of patients was 9 -70 years. Conclusion: RTA was the most common cause of head injury for which request for CT scan was made, and linear skull fractures were the most frequent finding. Males between 20-40 years were the most affected. CT is the most efficient imaging tool for detection of injuries in acute cases

Diagnostic trials: a field guide

The Diagnostic Trials, conducted in Kenya, Malawi, Mali, Nigeria, and Tanzania, constitute a major part of Africa Soil Information Service agronomic activities. This guide provides a standard tool that is part of a structured approach for the diagnosis of soil health related constraints to crop production. It is intended for use by national and international agricultural research systems, development partners and extension services to ensure standard procedures in data collection that will feed to an Africa-wide database of diagnostic trials, allowing an increase in data density over time and an improvement of the reliability in the assessment of soil constraints and inferences