Procjena razloga za istodobnu upotrebu konvencionalne i računalne radiografije u dvije savezne bolnice u Maiduguriju u Saveznoj državi Borno

Objectives: To determine the rationale behind the concurrent practice of conventional and computed radiography systems in two federal hospitals and to determine the advantages and disadvantages Methodology: Fifty-one questionnaires comprising 22 items and divided into four sections were distributed to radiologists, radiographers and intern radiographers. Analysis was carried out using the Statistical package for Social Sciences (SPSS) version 19.0. Chi-square was used to test the hypothesis with the significance level of p<0.05. Results: Most respondents (68.6%, n=35) agreed that the incidence of preference of one radiographic system over the other by referring physicians was the main rationale for the concurrent practice of both radiographic systems in their departments. Majority (88.2%, n=45) agreed that the main advantage of the concurrent practice of both radiographic systems was that each radiographic system could serve as backup in the event of breakdown of one system. Majority (66.7%, n=34) agreed that the main disadvantage of the concurrent practice of both radiographic systems was that it was expensive to practice and maintain both systems concurrently. Chi square value was statistically significant p<0.005. Conclusion: The major rationale was preference by referring physicians. The study revealed the advantages of the concurrent practice of both radiographic systems and the provision of a backup system in the event of break down. The disadvantage of the concurrent practice of both radiographic systems is the cost of maintenance and the incidence of undue preference of one radiographic system over another. Acknowledgement: we acknowledge the management and staff of Radiology departments of the two hospitals where the study took place.Cilj: Utvrditi razloge za istodobnu upotrebu konvencionalnog i računalnog radiografskog sustava u dvije savezne bolnice te utvrditi njihove prednosti i nedostatke. Metodologija: Radiolozima, radiološkim tehnolozima i stažistima podijeljen je 51 upitnik od 22 tvrdnje koji se sastoji od četiri dijela. Analiza je provedena primjenom Statističkog paketa za društvene znanosti (SPSS), verzija 19.0. Za testiranje hipoteze primijenjen je hi-kvadrat test s razinom značajnosti od p < 0,05. Rezultati: Većina ispitanika (68,6 %, n = 35) složila se da je liječnikova preferencija jednog radiografskog sustava glavni razlog za istodobnu upotrebu obaju radiografskih sustava na njihovim odjelima. Većina (88,2 %, n = 45) se složila da je glavna prednost istodobne upotrebe obaju radiografskih sustava da svaki od njih može poslužiti kao rezervni u slučaju kvara jednog od sustava. Većina (66,7 %, n = 34) se složila da je glavni nedostatak istodobne upotrebe obaju radiografskih sustava visok trošak primjene i održavanja dvaju sustava istodobno. Vrijednost hi-kvadrata bila je statistički značajna s p < 0,005. Zaključak: Glavni razlog za upotrebu obaju sustava bila je sklonost liječnika jednom od ta dva sustava. Istraživanje je otkrilo prednosti istodobne upotrebe obaju radiografskih sustava i osiguravanje rezervnog sustava u slučaju kvara. Nedostatak je istodobne upotrebe obaju radiografskih sustava trošak održavanja i neopravdana preferencija jednog radiografskog sustava u odnosu na drugi

Paediatric Diagnostic Reference levels in low Resource Settings: A Guide for developing Country Practitioners with excerpts from ICRP 135

Background:&nbsp;The practical implementation of Diagnostic Reference Level in&nbsp;pediatric&nbsp;imaging is a complex task due to their unique individuality in terms of&nbsp;high sensitivity to radiation, varying body sizes and presenting pathology.&nbsp;Hence, good knowledge of medical technology, skill to perform patient&nbsp;dosimetry and to analyze mage quality is required. Purpose:&nbsp;To provide a guide on the methodological requirements for the&nbsp;establishment of Paediatric Diagnostic Reference Levels (PiDRLs) based on the&nbsp;revised and updated guidelines from the current ICRP publication 135 on&nbsp;Diagnostic Reference Levels (DRLs). Materials and method:&nbsp;An extensive review of the ICRP report Publication 135&nbsp;on Diagnostic Reference levels in medical imaging with a focus on paediatric&nbsp;imaging and other related studies were undertaken.&nbsp; Results:&nbsp;The ICRP report 135 updates and refines the recommendations of 2001.&nbsp;It highlights that the application of DRLs in paediatrics alone is not sufficient for&nbsp;the optimization of protection. Image quality must be evaluated. Quantities used for&nbsp;DRLs should be appropriate to the imaging modality being evaluated, assess the&nbsp;amount of ionizing radiation applied to perform a medical imaging task, and be&nbsp;measured directly. For interventional procedures, the complexity of the procedure&nbsp;may be considered in setting DRLs. DRLs shall not be used for individual&nbsp;patients or as trigger (alert or alarm) levels for individual patients. Appropriate&nbsp;weight bands (generally with 5 or 10 kg intervals) are recommended for&nbsp;establishing paediatric DRLs and should be promoted. Conclusion:&nbsp;The amount of radiation used for examinations of children can vary&nbsp;tremendously due to the great variation in patient size and weight from neonates to&nbsp;adult-sized adolescents. This variation in patient radiation dose is appropriate.&nbsp;However, variation in patient doses due to inappropriate technique or failure to&nbsp;child-size the imaging protocol is not appropriate. This forms the basis of the&nbsp;new ICRP guideline and should form the basis of developing PiDRLs.&nbsp

Utjecaj zdravstvenog obrazovanja u zajednici na upravljanje primarnom zdravstvenom zaštitom u nigerijskoj populaciji

Introduction: Primary health care (PHC) is based on practical, scientifically sound and socially acceptable methods that are universally accessible to individuals and families in the community. Aim: To determine the impact of community-based health education (CBHED) in the implementation of the PHC program in Bauchi state, Nigeria. Methodology: The study employed a cross-sectional survey research design. 20 development areas were studied and each of these wards had one PHC centre. The study consisted of two groups; a provider survey (health workers) and a household survey (community members). 317 questionnaires were administered, but only 312 were returned. A 25-item questionnaire had three sections: demographics, level of participation and acceptance. Data was analysed using the Statistical Package for Social Sciences, version 21.0. A chi-squared test was used to determine the relationship between the levels of education and acceptance of community-based health education in primary health care at p < 0.05. Result: 136 (43.6%) were men, while 176 (56.4%) were women. The age distribution indicates that the majority of the study respondents were within the age range of 25‒41, n = 181 (58.0%). There was no relationship between the age of the study participants and their level of participation in CBHED in PHC (p < 0.005). There was no relationship between the source of information and participation in PHC (p < 0.05). Conclusion: There is a need to also extend the CBHED approach to other health-related services which would target community-level implementation.Uvod: Primarna zdravstvena zaštita (PHC) temelji se na praktičnim, znanstveno dokazanim i društveno prihvatljivim metodama koje su univerzalno dostupne pojedincima i obiteljima u zajednici. Cilj: Odrediti utjecaj zdravstvenog obrazovanja u zajednici (CBHED) u sklopu provedbe programa PHC-a u saveznoj državi Bauchi, Nigerija. Metodologija: Provedeno je transverzalno anketno istraživanje. Istraženo je 20 razvojnih područja, a u svakom od tih područja nalazi se jedan centar za PHC. Istraživanje se provodilo u dvije skupine: anketirani su pružatelji usluge (zdravstveni radnici) i domaćinstva (članovi zajednice). Podijeljeno je 317 upitnika, a vraćeno ih je 312. Upitnik se sastojao od 25 pitanja podijeljenih u tri dijela: demografski podaci, razina sudjelovanja i prihvaćanje. Podaci su analizirani uporabom programa Statistical Package for the Social Sciences, verzija 21.0. Hi-kvadrat test primijenjen je za određivanje povezanosti između razine obrazovanja i prihvaćanja zdravstvenog obrazovanja u zajednici u primarnoj zdravstvenoj zaštiti uz p < 0,05. Rezultati: Ispitano je 136 (43,6 %) muškaraca i 176 (56,4 %) žena. Većina ispitanika u dobnom je rasponu od 25 do 41 godine, n = 181 (58,0 %). Nema povezanosti između dobi sudionika istraživanja i njihove razine sudjelovanja u zdravstvenom obrazovanju u zajednici u primarnoj zdravstvenoj zaštiti (P < 0,005). Nema povezanosti između izvora informacija i sudjelovanja u PHCu (p < 0,05). Nema povezanosti između dobi sudionika istraživanja i njihove razine sudjelovanja u zdravstvenom obrazovanju u zajednici u primarnoj zdravstvenoj zaštiti. Zaključak: Potreban je prošireni pristup CBHED-a na druge zdravstvene usluge koji bi bio usmjeren na provedbu na razini zajednice

Pattern of Head Computed Tomography Requests and Findings in a Specialist Hospital in Bauchi State, Nigeria

Background:&nbsp;Computed tomography (CT) has become a useful imaging modality in medical imaging and its role is increasing and diversifying in the past decades, most especially in the assessment of head pathologies. &nbsp; Objective:&nbsp;The objective of this study is to assess the pattern of head computed tomography referrals, requests and findings among patients in State Specialist Hospital, Bauchi State. &nbsp; Methodology:&nbsp;This study is a prospective cross-sectional study conducted from the month of May to August 2016. Thirty six (36) patients who presented for head CT scan were studied. Data collected include demographic information such as date of examination, age and gender of patients, referring clinic, indications for the examinations, and radiological diagnosis. Statistical analysis were done using SPSS version 21.0. Descriptive statistics were presented and Pearson’s correlation was used to determine the relationship between the findings and referrals. Statistical significance was set at p &lt; 0.05. &nbsp; Results:&nbsp;There were 27 (75%) males and 9 (25%) females aged 18 to 94 years. A significant proportion of referrals (69.4 %; n = 25) were patients from Abubakar Tafawa Balewa University Teaching Hospital Bauchi, a neighbouring tertiary hospital. The highest indication for head CT was head injury due to RTAs (27.8%), with infarction (25%) being the commonest findings. &nbsp; Conclusion:&nbsp;This study has shown that head injury due to road traffic accidents is the major indication for head CT in Bauchi with the commonest finding being infarction. Computed tomography is a useful modality for diagnosis of various pathologies. &nbsp; &nbsp

Ultrazvučna procjena fetalne prsne duljine kao prediktor gestacijske dobi kod nigerijske populacije

Background: The ultrasound machines used in our locality are programmed with software of non-indigenous normative values; furthermore, as pregnancy advances the accuracy of most biometric parameters in predicting GA varies due to racial morphological difference and error increases, hence the need for this study. Purpose: To determine local (black race) sonographic FTL normative values and to compare the values with that of the Caucasian population. Material and Methods: Women with a singleton pregnancy that was conceived naturally and who met the individual inclusion criteria were recruited consecutively. The Helsinki declaration of 1975 was considered. A prospective cross-sectional study was conducted in the Federal Medical Center Azare, Bauchi. The study involved 253 women from 16 to 38 weeks of gestation. A 2D ultrasound scan was used to measure the FTL (that is from the root of the neck to the diaphragm) at the level of the four-chamber view. Results: Normal values of the FTL were developed and showed a linear and statistically significant correlation with the weeks of gestation (r2= 0.81, P≤0.001). The FTL has a growth rate of 0.182 cm per week. Conclusion: There is no statistically significant difference between the FTL of the population under study (black population) and that of the Caucasian population. Hence, the use of Caucasian FTL on black race is a valid estimate of GA. And the GA predictive equation is; y = 3.61x + 11.95. Where y = gestational age in weeks and x= thoracic length.Uvod: Ultrazvučni uređaji koji se upotrebljavaju u našem području koriste se softverskim programom koji sadrži normativne vrijednosti koje ne odgovaraju domaćem stanovništvu. Nadalje, kako trudnoća odmiče, točnost većine biometrijskih parametara u predviđanju gestacijske dobi varira zbog rasnih morfoloških razlika te se povećava mogućnost pogreške. Stoga postoji i potreba za ovim istraživanjem. Svrha istraživanja: Utvrditi ultrazvučne normativne vrijednosti fetalne prsne duljine za lokalnu populaciju (pripadnici crne rase) i usporediti s vrijednostima koje se primjenjuju za pripadnike bijele rase. Materijali i metode: Žene trudne s jednim djetetom, koje su zanijele prirodnim putem i koje su zadovoljavale pojedinačne kriterije za uključivanje u istraživanje, redom su uključivane u istraživanje. Prilikom istraživanja u obzir je uzeta i Helsinška deklaracija iz 1975. godine. Prospektivno presječno istraživanje provedeno je u Saveznom medicinskom centru Azare, Bauchi. Istraživanje je obuhvatilo 253 žene koje su se bile trudne između 16 i 38 tjedana. 2D ultrazvuk primijenjen je za mjerenje fetalne prsne duljine (od korijena vrata do dijafragme) na razini presjeka kroz četiri srčane komore. Rezultati: Dobivene su normalne vrijednosti fetalne prsne duljine koje imaju linearnu i statistički značajnu povezanost s tjednima trudnoće (r2 = 0,81, P ≤ 0,001). Fetalna prsna duljina ima stopu rasta od 0,182 cm tjedno. Zaključak: Nema statistički značajne razlike između vrijednosti fetalne prsne duljine za stanovništvo na kojem se vršilo istraživanje (crna populacija) i za bijelu populaciju. Stoga se vrijednosti fetalne prsne duljine koje se primjenjuju za bijelu populaciju mogu primjenjivati za valjanu procjenu gestacijske dobi kod crne populacije. Prediktivna je jednadžba za izračun gestacijske dobi: y = 3,61x + 11,95, gdje je y = gestacijska dob u tjednima i x = prsna duljina

Work-Related Musculoskeletal Disorders: Prevalence Among Clinical Radiographers in Teaching Hospitals in North-Western Nigeria

&nbsp; Background:&nbsp;&nbsp;The components and activities within the scope of radiography practice pose high risks of work-related musculoskeletal disorders (WRMSDs) to radiographers in the course of performing diagnostic and therapeutic procedures. Objectives:&nbsp;To determine the prevalence of WMSDs and identify the possible causes among radiographers within the study locality. Methods:&nbsp;A&nbsp;validated self-administered questionnaire was distributed to all registered and licensed radiographers working in teaching hospitals within the region. The questionnaire contained 21 questions, divided into 3 sections; “A” captured demographic data; “B” captured educational qualifications and work experience; and “C” captured the prevalence, possible causes and responses to WRMSDs. Results:&nbsp;The respondents were basically within the age range of 21 – 30 years (66.6%), with most of them being male. Most radiographers had clinical working experience between 1 to 10 years, and worked&nbsp;&nbsp;between 6-8 hours and above daily, with a case load of 30 patients and above. The reported case of WRMSD was 93.3%. The major identified causes of WRMSDs were maintaining of prolonged static position (20%), and&nbsp;frequent bending and twisting (16.7%).&nbsp;This study showed no statistically significant correlation between gender and WRMSDs. Conclusion:&nbsp;There was remarkable evidence of WRMSDs among the practicing clinical radiographers within the North-Western Nigeria. &nbsp; &nbsp

Comparison of Calculated Percentage Depth Doses at Extended Source-to-Surface Distance for 6 MV And 15 MV Photon Beam of a Linear Accelerator

Background: Research findings from percentage depth dose (PDD) are crucial in evaluating patient doses received in radiation therapy. Objective: To compare calculated percentage depth doses at an&nbsp;extended&nbsp;source-to-surface distance (SSD) for 6 MV and 15 MV photon beams of a linear accelerator. Methodology: Measured PDD values of the&nbsp;100 cm&nbsp;source to surface distance (SSD) and calculated values at extended SSDs for 6 MV and 15 MV photon beams of an Elekta NHA SLi 1998 linear accelerator were analyzed. The PDD data was collected by placing ionization chamber inside water phantom for depths ranging from z = 0 - 30 cm in a water phantom and using a square field sizes of 10 x 10 cm2. Photon energies of 6 MV and 15 MV were used for the measurement, with both gantry and collimator angles fixed at zero degree. PDD was calculated at extended SSD of 110 cm, 120 cm, 130 cm, and 140 cm from the measured PDD values of 100 cm SSD for both 6 MV and 15 MV photon energies using Mayneord factor. Results:&nbsp;&nbsp;The depth dose maximum (Dmax) for field size 10 x 10 cm2&nbsp;&nbsp;for 6 MV and 15 MV photon energies were 1.62 cm and 2.65 cm, respectively and the PDD at 10 cm&nbsp;&nbsp;(D10) were 67.9% and 75.9%, respectively. The mean deviation of the calculated PDD at extended&nbsp;SSDs&nbsp;was found to be between 0.2% and 1%. Conclusion: The calculated PDD values at extended SSDs are considered suitable for clinical use at all clinically relevant depths and field sizes. &nbsp

Assessment of Radiation Protection Measures in a Nigerian Tertiary Health Care Center

Radiation protection is critical and poses an increasing international concern in this era of evidence based practice and the approach to the use of ionizing radiation should be conscientious and cautious. Ionizing radiation in any quantity is potentially deleterious to health however, its benefit far outweighs the risk. This study was carried out in the radiology department of a tertiary health care center in Nigeria with the aim of assessing radiation protection measures in the hospital in comparism with international standard. Several factors were evaluated such as the integrity of the shielding used, the x ray room design , technical considerations, management's role in provision of good equipment, staff and training, effectiveness of workplace and personnel monitoring, quality  control and records as radiation protection tool. This study showed that  all the parameters assessed and radiation doses were acceptable and below the annual permissible dose indicating that the radiation protection measures employed by the hospital were good and complied with international standard, though record keeping seemed to be a major challenge. Keywords: Radiation protection, Ionizing Radiation, X-ray, Quality Control, Quality Assuranc

Assessment of Background Radiation Levels at the Radiology Department of a Tertiary Hospital in North-central Nigeria

Background: Background radiation has over the years become a public health concern. It is therefore, imperative to ascertain its levels within strategic areas in our radiology facility for monitoring and compliance with international standards.Objectives: To determine the background radiation levels in the Radiology Department of Federal Medical Centre (FMC), Keffi, Nigeria.Methodology: The design was prospective and cross-sectional and involved the measurement of background radiation levels at various locations in the radiology department. Calibrated thermo Scientific RadEye TM B20 / B20-ER survey meter, an associated scalar counter, and a stopwatch, were used for measurements at each point, based on standard guidelines recommended by the International Atomic Energy Agency (IAEA).Results: The least mean radiation (0.11µSv/hr) was detected in the computed tomography (CT) suite while the maximum value (0.13µSv/hr) emanated from the radiographers' common room. The coefficient of variation for the Chief Radiographers office, Head of Department's office and the Radiologist’s office were similar 8.3%. The radiographers’ common room was slightly higher (10.9%). The main diagnostic room and seminar room had 16.7%, while it was 9.09% for the CT suite. The standard error ranged between 0.002 and 0.004. There was statistically significant difference in all test values at a level of significance of 5% (p &lt; 0.05). Conclusion: Background radiation values obtained were within recommended standards. However, there is need for regular radiation monitoring as part of radiation safety culture in our radiology facility

Pattern of Pelvic Ultrasound Request and Findings in Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi

Background: Pelvic ultrasonography involves the evaluation of pelvic organs and structures. It is valuable in the diagnosis of pathological conditions which are likely causes of pelvic pain.Purpose: The objective of this study was to evaluate the pattern of pelvic ultrasound request and findings in Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi.Methods: A retrospective study was conducted in the radiology department of ATBUTH. A total of 1,320 ultrasonography records of patients for pelvic examination were reviewed from January 2016 to February 2017,and tabulated according to age, sex, clinical indication and ultrasound findings. Data were analyzed using SPSS version 20.0 to determine the mean, frequency and percentages. Pearson’s correlation was used to determine the relationship between clinical indication and ultrasound findings.Results: The age group of 21-30 years and 31- 40 years had the highest frequency (n = 627, 47.5 %) and (n = 321, 24.3%), respectively. Gender distribution were 1158 (87.7 %), for females and 162 (12.3 %) for males. Pelvic pain had the highest indication, 72.3% (n = 955), followed by PID, 9.2% (n = 121), then BPH, 3.4% (n=45) and, ovarian cyst, 2.7 % (n = 36). Conclusion: The highest indication and findings are pelvic pain and pelvic inflammatory diseases, among females while benign prostatic hypertrophy was the highest in males