Factors Associated with the Survival Outcome of Hepatocellular Carcinoma Patients on Supportive Care in a Tertiary Hospital in South-West Nigeria

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer. This study assessed the factors associated with the survival outcome of HCC on supportive care. Methods: This was a prospective cohort study carried out from January 2010 to June 2016 on cases of HCC recruited into a cancer data registry. Clinical, laboratory and survival outcomes were obtained. Data obtained were analyzed using descriptive and inferential statistics. Results: A total of 149 cases were analyzed: 120 (80.5%) males and 29 (19.5%) females. Age range was 18-87years, with mean (SD) being 45.0 (14.3) years. Identifiable aetiological factors were hepatitis B and C viruses, alcohol and herbal preparations in 94% while no risk factor was identified in 6%. Some risks co-occurred in multiples in 71.2% of cases. The overall median survival was 20 days, and general survival was 59.1% at two weeks, 33.6 % at one month, and only 7.3% surviving beyond thirty one days to two years. The survival of cases, according to the Child-Pugh (CTP) class, was CTP A: 36 days (ranged 4 to 730 days), CTP class B: 22 days (ranged 1 to 210 days) and CTP class C: 14 days (ranged 2 to 660 days). Higher proportion of young cases was HBsAg positive. Factors significantly associated with survival outcome included older age, female sex, abdominal pain, jaundice, elevated creatinine, bilirubin, AST, ALT, white cell count and hyponatreamia. Conclusion: Overall survival outcome among cases of HCC was poor. It is necessary to prevent HBV, reduce alcohol use, detect and treat HCC early

Clinical audit of paediatric magnetic resonance imaging under sedation at a Nigerian tertiary institution

Background: Magnetic resonance imaging (MRI) in paediatric patients requires them to be calm during the procedure to avoid motion artefacts in the acquired images. Sedation and/or anaesthesia is a way to achieve this. We evaluated all paediatric MRI sedations since installation of an MRI device in our hospital. Material/Methods: We retrospectively reviewed 69 paediatric MRI sedations performed over a 5-year period using records of patients' biodata, MRI date, indication, findings and scan time, sources of referral, body region scanned, type, dose, related adverse events and route of administration of sedatives as well as image quality. Results: The median age and weight of the patients were 24 months {range of 0.3 months (10 days) to 132 months (11 years)} and 11.5 kg (range of 2.6 kg to 42 kg), respectively. Males constituted 50.7% of the patients. Most participants (94.2%) were in-patients of the hospital, mainly (60.0%) referred from the paediatric unit, with slightly over one third (36.2%) of the studies performed in 2015. The commonest indication and scanned body region were macrocephaly (18.8%) and the brain (76.8%), respectively. Hydrocephalus (17.4%) was the commonest MRI finding. Sedation was planned in 66 (95.7%) patients and was successful in 68 (98.6%). Midazolam and the IV route were the commonest sedative agent and route of administration, respectively. Image quality determined by age was fair to good in 68 (98.6%) patients with only 1 patient requiring re-scanning due to motion blur. No adverse events with sedation were recorded. Conclusions: Midazolam via the IV route with or without oral route is the drug of choice for MRI sedation in children in our institution with a success rate of about 99%

Cystolithiasis with coexisting nephrolithiasis: A radiodiagnostic discovery in an adult Nigerian male with lower urinary tract symptoms

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Sonographic guided hydrostatic saline enema reduction of childhood intussusception: a prospective study

Abstract Background The management of childhood intussusception in our sub-region is still via surgical intervention. Currently, the gold standard of treatment is non-operative reduction. We sought to assess the suitability of hydrostatic (saline) reduction of intussusception in children in our institution. Materials and methods A prospective study was conducted between January 2016 and June 2017 in all children with ultrasound confirmed intussusception at a tertiary teaching hospital in Nigeria. All children excluding those with signs of peritonitis, bowel gangrene and intestinal prolapse were selected for ultrasound-guided hydrostatic reduction (USGHR). We allowed a maximum of three attempts at reduction. Results The age range was 3 months to 48 months with a mean of 10.8 ± 9.1 months. Forty percent (N = 18) presented after 24 h of onset of symptoms. The success rate of hydrostatic reduction with saline enema was 84.4% (N = 38). Two (4.4%) perforations occurred during the procedure. Three (7.5%) patients had recurrent intussusception within six months. The duration of symptoms greater than 24 h, age and sex of patients did not influence successful reduction p > 0.05. The duration of admission between those who had successful non-operative reduction and those who subsequently had operative reduction and or resection attained statistical significant difference, p = 0.001. There was no mortality. We achieved a 68% decrease in the operative reduction of intussusception using USGHR as the primary modality of treatment. Conclusion Our study found out that USGHR is a suitable alternative for the treatment of childhood intussusception

Performance Characteristics of Radiographic equipment in Selected Healthcare Institutions in Southwest Nigeria

BACKGROUND: Evaluation of radiographic equipment performance is the recommended strategy for the verification of factors used in radiodiagnosis. Sometimes, the performance of the equipment is compromised due to the lack of adoption of the appropriate procedures and/or techniques. AIM: The aim of this study was to determine the performance quality of the radiographic equipment in the study area in order to optimize the radiation dose delivered to the patients using these facilities and enhance their safety. METHODS: The performance characteristic of selected radiographic equipment was determined using MagicMax quality control kits and test object. Radiographic equipment in eight selected radiodiagnostic centers designated as C1-C8 was assessed. RESULTS: The results showed that all the radiography units in the studied centers passed the kVp reproducibility and mAs linearity tests with the exception of center C2. The kVp deviation for the centers varied between 2.0 and 7.7%, with the highest deviation in center C5 and lowest value in center C6. Center C7 has the highest deviation (–13%) of mAs, while the lowest value was obtained in center C6 (0%). The dose was lowest in center C1 and highest in center C3. The half-value layer, mAs, and filtration values had a stronger correlation with the incident air kerma dose compared to the other parameters. In addition, 50% of the equipment passed all the performance tests. CONCLUSION: The study revealed that the performance characteristics of radiographic equipment in the studied area require improvement. Periodic monitoring of the equipment performance is recommended for adoption and enforcement to enhance quality practices and radiation safety