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

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

Adverse reactions from community directed treatment with ivermectin (CDTI ) for onchocerciasis and loiasis in Ondo State, Nigeria

Onchocerciasis is an endemic disease in Ondo state, Nigeria. Community directed distribution of ivermectin is currently on-going in some local government areas of the state. Randomly selected persons (2 331 males and 2 469 females) were interviewed using a modified rapid assessment procedure for Loa loa (RAPLOA) to assess community directed treatment with ivermectin. The retrospective study evaluated the coverage, impacts and adverse reactions to the drug treatment. A questionnaire was administered by house-to-house visit in six local government areas, implementing community directed treatment with ivermectin (CDTI) in this bioclimatic zone. A total of 2,398 respondents were reported to have participated in the treatment. The overall ivermectin coverage of 49.96% was recorded (range 0 - 52% in different communities). Adverse reactions from ivermectin administration were experienced in 38% of individuals. Diverse adverse reactions experienced included predominantly itching (18.50%); oedema, especially of the face and the limbs (8.2%); rashes (3.4%) and body weakness (2.4%). Expulsion of intestinal worms occurred in 0.96% of the respondents. The occurrence of adverse reactions in relation to age categories was statistically significant. Neither fatal nor severe adverse reactions were reported by respondents. Significantly, despite experienced adverse reactions, continued participation, acceptability and compliance to ivermectin treatment was expressed by the various communities. This attitude is in consonance with the African Programme for Onchocerciasis Control (APOC) objectives. Rev. Biol. Trop. 56 (4): 1635-1643. Epub 2008 December 12.<br>La oncocercosis es endémica en el estado Ondo, Nigeria. Se seleccionaron 4 800 personas al azar para evaluar con encuesta retrospectiva la cobertura, efectos y reacciones al tratamiento farmacológico con ivermectina administrado por la misma comunidad. La cobertura global de ivermectina fue 50 % con reacciones adversas en 38 % de los individuos. Estas fueron comezón picazón (18%), edema, especialmente de la cara y las extremidades (8%), erupciones cutáneas (3%) y debilidad (2%); dependieron de la edad y no hubo reacciones más graves. La expulsión de las lombrices intestinales se produjo en 96% de los encuestados. A pesar de las reacciones adversas, hubo continuidad, aceptación y cumplimiento del tratamiento con ivermectina, en consonancia con los objetivos del Programa Africano para el Control de Oncocercosis (APOC)

Hydrostatic Reduction of Intussusception under Ultrasound Guidance: An Initial Experience in a Developing Country

Intussusception is one of the most common causes of acute intestinal obstruction in children. Hydrostatic reduction with barium enema is the widely accepted and preferredmode of treatment of uncomplicated intussuception. The aim of this study was to report our initial experiencewith hydrostatic reduction of intussusception. We present our initial experience in which 8 patients had ultrasound guided hydrostatic reduction of intussusception over a period of 2 years. All patients that presentedwithin 48hours of onset of symptoms were recruited into the study. Clinical diagnosis of intussusceptions was made in all of them while abdominal ultrasoundwas used to confirm the diagnosis. Half of the patients presented after 24 hours of onset of symptoms. Five patients (62.5%) had a successful reduction of their intussusception while three patients (37.5%) had incomplete reduction which was completed by surgery. There was only one (12.5%) recurrence and there was no peritonitis. Ultrasound guided hydrostatic reduction of intussusceptions in this environment is possible when patients present early with low risk of complication and low recurrence rate. Keywords: Intussusception, ultrasound guided, hydrostatic reduction, recurrence. African Journal of Paediatric Surgery Vol. 4 (2) 2007: pp. 68-7

Adverse reactions from community directed treatment with ivermectin (CDTI ) for onchocerciasis and loiasis in Ondo State, Nigeria

Onchocerciasis is an endemic disease in Ondo state, Nigeria. Community directed distribution of ivermectin is currently on-going in some local government areas of the state. Randomly selected persons (2,331 males and 2,469 females) were interviewed using a modified rapid assessment procedure for Loa loa (RAPLOA) to assess community directed treatment with ivermectin. The retrospective study evaluated the coverage, impacts and adverse reactions to the drug treatment. A questionnaire was administered by house-to-house visit in six local government areas, implementing community directed treatment with ivermectin (CDTI) in this bioclimatic zone. A total of 2,398 respondents were reported to have participated in the treatment. The overall ivermectin coverage of 49.96% was recorded (range 0 - 52% in different communities). Adverse reactions from ivermectin administration were experienced in 38% of individuals. Diverse adverse reactions experienced included predominantly itching (18.50%); oedema, especially of the face and the limbs (8.2%); rashes (3.4%) and body weakness (2.4%). Expulsion of intestinal worms occurred in 0.96% of the respondents. The occurrence of adverse reactions in relation to age categories was statistically significant. Neither fatal nor severe adverse reactions were reported by respondents. Significantly, despite experienced adverse reactions, continued participation, acceptability and compliance to ivermectin treatment was expressed by the various communities. This attitude is in consonance with the African Programme for Onchocerciasis Control (APOC) objectives

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