Specialization in the Radiography Profession: The Need for Postgraduate Education among Radiographers In Nigeria

To determine the level of postgraduate education and preferred areas of specialization among registered radiographers in Nigeria. A cross sectional observation analytic study was adopted to assess this. Questionnaires were distributed amongst radiographers working in public and private establishments. The respondents' demographic information, current area of specialization and preferred area of specialization were analyzed using Epi info version 3.5.1 data processing package. The results show that 135(90%) of the respondents have not acquired further education in their areas of specialization since qualification and only about 15(10%) had postgraduate education. The preferred areas of specialization are in this order: ultrasonography, magnetic resonance imaging, radiograph interpretation, computed tomography, mammography, radiotherapy and nuclear medicine. This study showed that a few number of radiographers had Postgraduate education andKeywords: Postgraduate education, Radiography profession, Specialization, Nigeria

Occupational Stress among Radiographers in Lagos, Nigeria

Background: Occupational stress induced injuries occur in various professions that require repetitive motion or physical exertion, such as Radiography. The injuries may involve body parts such as the neck, the upper back, mid back, low back (waist), knee, elbow, wrist and hand and eyes.Objective: To assess work related injuries medical radiographers are prone to, during practice of the profession in relation to their working conditions.Methods: This study was conducted among registered practicing radiographers in Lagos State, South-West, Nigeria. Lagos is one of Nigeria's most populated states and economic nerve centre of Nigeria. Due to its population, there are many hospitals with radiodiagnostic facilities and radiodiagnostic centres which are either government or privately owned. Eighty registered radiographers in 21 hospitals and diagnostic centres participated in the study. They include three federal government owned institutions, three State government owned institutions and fifteen privately owned diagnostic centres. The respondents' status were made up of 38 males and 42 females where 37 of them were between 20-30 years, 11 were between 41-50 years and those above 51 years were 12.Results: The results revealed that a majority (91.2%) of respondents stand during the course of their work. Waist, neck, heel, wrist and shoulder pains were common among the respondents. Some respondents frequently manifest frustration (78.7 %), insomnia (52.5 %), difficulty in concentration (56.2%), poor appetite (50.0%), irritation (67.5 %) and tension (63.8%) while lesser percentages experience such.Conclusion: This study showed that occupational stress sites susceptible to work induced stress injury. Musculoskeletal strain was the most common type. Waist/ low back, plantar/heel and wrist pains were also common among radiographers in Lagos, Nigeria.Keywords: Radiographer, stress, injury, pain, occupatio

Point of Care Testing/Central Laboratory Analysis of Glucose and Electrolytes in Diabetic Emergencies. Are They Comparable?

Prompt diagnosis of electrolytes and acid-base abnormalities in diabetic emergencies, and quick intervention is the key to a good outcome. In the Third world, there is a delay in reporting of central laboratory results due to a mirage of problems. POCT testing has been shown to be valuable in the management of diabetic emergencies as it provides quick results and expedite treatment. To find out in this study if there was an agreement between the analytes evaluated with central laboratory and Abbot I-STAT point of care. A prospective comparison of paired venous blood samples with Abbot I-STAT POCT testing and central laboratory (ion-selective electrode, SFRI analyzer ISE 6000) measurements were obtained from 30 diabetic patients. There was good agreement with electrolytes and glucose values between Abbot I-STAT POCT analyser and SFRI ISE 6000 analyser in diabetic emergencies. The Lin's concordance correlation (agreement) for glucose (pc) =0.999, mean difference of 0.04 mmol/L and 95% limit of agreement (LOA) from -4.702 to +4.622 mmol/L, p = 0.986. Sodium (pc) =0.996, mean difference of 0.027 mmol/L and 95% LOA from -0.191 to +0.245 mmol/L, p = 0.991. Potassium (pc) = 0.990, mean difference of 0.03 mmol/L, and 95% LOA from -0.032 to +0.078 mmol/L, p =0.919. Chloride (pc) =0.996, mean difference of -0.04 mmol/L and 95% LOA from -0.197 to +0.284 mmol/L, p = 0.983. Bicarbonate (pc) =0.949, mean difference of 0.37 mmol/L and 95% LOA from -0.49 to +1.23mmol/L, p = 0.832. Blood urea nitrogen (pc) =0.999, mean difference of 0.12 and 95% limit of agreement from -0.501 to +0.254mmol/L, p = 0.202. PCV (pc) =0.483, mean difference of -3.7% and 95% LOA -7.78 to +0.40, p= 0.991. The agreement  between central laboratory testing and I-STAT Abbot point of care testing was good for electrolytes and glucose.Keywords: POCT, Central laboratory, Bland Althmans, Diabetic emergencies

X-ray Pelvimetry And Labour Outcome In Term Pregnancy In A Rural Nigerian Population

Background: X -ray pelvimetry is a radiological investigation that involves the measurement of different anthropometric dimensions of the pelvis. The pelvic inlet and outlet play important role in labour outcome. The query as to whether x-ray pelvimetry has a useful predictive value regarding labour outcome prompted this study.Objectives: To determine whether the use of X-ray pelvimetry is still relevant in term pregnancy, and its reliability in predicting labour outcome.Method: This was a retrospective study of pregnant patients who had X -ray pelvimetry at term and successfully delivered at a rural community based mission maternity hospital between 2005-2008. Each x- ray pelvimetry report was matched with the mode of delivery of the patient. 150 patients who were found suitable had data such as age, mode of delivery, etc, extracted.Results: In a review of 150 X -ray pelvimetry films, 119 (79.33%) were categorised as adequate pelvis, 10 (6.67%) borderline pelvis and 21 (14%) inadequate pelvis respectively based on the conclusions of the radiologist. Out of the 21 patients with inadequate pelvis, 14 (67%) had normal delivery and 7 (33%) had caesarean section. For the 10 patients with borderline pelvis, 7 (67%) had normal delivery and 3 (33%) had caesarean section.Conclusion: This study has demonstrated that X-ray pelvimetry may not be accurate but has fair predictive value on mode of delivery in term pregnancy.Keywords: X-ray pelvimetry, mode of delivery, term pregnancy, rural Nigerian population

The Accuracy of Ultrasonography in the Diagnosis of Breast Pathology in Symptomatic Women

Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of total cancer cases and 14% of cancer deaths worldwide. The developing countries are catching up with this trend. Breast ultrasound when properly performed and interpreted, is an indispensable tool in breast imaging. The early diagnosis and treatment of breast masses reduces the morbidity and mortality associated with delayed diagnosis of breast carcinoma. The use of breast ultrasound is gaining ground in recent time, this is due to current advances in ultrasound technology which permit greater spatial and contrast resolution and shortened scan time.Objective:To determine the sensitivity, specificity and positive predictive value of ultrasound in the detection of palpable breast masses and to correlate the findings of ultrasound with the findings of fine needle aspiration cytology, or histopathology.Methods: Breast ultrasound scanning was done in 100 patients with signs and symptoms of breast lesion referred from the Surgical out Patient Clinic to the Radiodiagnosis Department of Lagos University Teaching Hospital (LUTH). Histology reports were collected from either the case note or Morbid Anatomy department to correlate the findings with ultrasound diagnosis.Results: The mean age was 41.7 ±11.34 (18-59) years. Symptoms of breast lesion were highest in the age group 41-50 years 38 (38%), and least in 18-20 years 4 (4%). When the use of ultrasonography was compared with the histopathology report in the diagnosis of breast lesion in the studied population, the sensitivity was 100%, specificity (96.6%), accuracy (97%), posting predictive value (PPV) 81.3%, and negative predictive value (NPV) 100%. The accuracy, specificity and PPV however decreased with increasing age.Conclusion: Ultrasonography of the breast is useful in the diagnosis of breast lesions, because of the high sensitivity, specificity and diagnostic value it exhibited with histopathologic findings.Key words: Breast pathology, Accuracy, Ultrasonography

The Relationship Between Microalbuminuria, Cardiovascular Riskfactors and Disease Management in Type 2 Diabetes

Background :In patients with type 2 diabetes, microalbuminuria is an early clinical sign suggestive of vascular damage to the glomerulus. Microalbuminuria has also been currently reported as an important risk factor for cardiovascular disease and becomes relevant in the management of type 2 diabetes.Objectives :This study is to determine the prevalence of microalbuminuria, identify the risk factors associated with microalbuminuria in type 2 diabetes, and to asses the achievement of treatment goals for cardiovascular risk reduction in type 2 diabetics.Subjects and Methods : Seventy- two subjects with microalbuminuria were recruited from three hundred consecutively screened type 2 diabetics attending the Diabetic Clinic at the Lagos University Teaching Hospital. Clinical data were obtained by interviewing the participants. Anthropometric measurements were made and blood specimens were collected for analysis.Results: The prevalence of microalbuminuria was twenty four percent (24%)intype 2 diabetes. Multiple logistic regression identified duration of diabetes (odds ratio 1.3(95% CI; 0.03 – 1.58), hypertension(odds ratio5.2 (95%CI; 1.24-18.62), Body mass index (BMI) (odds ratio 1.27 (95%CI; 1.0 - 1.6),waist / hip ratio (WHR) (odds ratio 1.9 (95% CI; 1.3 – 3.5), andHbA c (odds ratio 6.6 (95% CI; 1 1.02 – 27) as independent risk factors associated with microalbuminuria in type 2 diabetics. Optimum blood pressure, glycemic and weight control were achieved in eighty five percent (85%), fifty eight percent (58%) and nineteen percent (19%) of the type 2 diabetes respectively.Conclusion : This study showed that microalbuminuria is common among patients with type 2 diabetes. It also showed improvement in glycemic control and modifiable cardiovascular risk factor control when compared with previous studies.Keywords: Type 2 diabetes, Microalbuminuria, Hypertension, Glycated haemoglobin (HbA c)