Ultrasound Mis-Diagnosis Of Biliary Sludge As A Gall Bladder Neoplasm-A Case Report

Background: Cholecystosonography is the Ultrasound examination of the gall bladder and ducts. It has the advantage of not using ionising radiation, but may be operator dependent. Thus misinterpretation of the images may sometimes occur especially in the untrained hands. Case Report: A 24 year old male student was admitted into the medical ward of the University of Benin Teaching Hospital (UBTH) with symptoms of weakness, fever, nausea, pruritus, passage of yellowish urine, jaundice of about 4 weeks. Initial ultrasound examination done by a private practitioner interpreted the image findings as gall bladder tumor. Subsequently, the patient was referred to the UBTH, Nigeria. There the repeat scan done revealed the diagnosis of biliary sludge. Patient was treated appropriately. Conclusion: By this report, the possibility of misinterpretation of ultrasound images is documented, especially by untrained personnel is highlighted. KEY WORDS: Cholecystosonography, biliary sludge, Interpretation, Misdiagnosis

Prenatal Ultrasound Diagnosis Of Discordant Occipital Encephalocele In Multiple Pregnancy - A Case Report

Background: Pre-natal sonographic examination is the primary modality of imaging in pregnancy which allows direct, real-time assessment of the fetus, and accurate diagnosis of congenital anomalies. One such anomaly is encephalocele. Case Report:The case of a 38 year old gravida 14, Para 13+1 with a diagnosis of discordant encephalocele multiple (twin) pregnancy made during routine sonographic examination is presented. One twin showed showed an occipital skull defect in association with a sonolucent area with well-defined margins continuous with the fetal scalp. There were no other associated anomalies. Conclusion:Caution must be taken when performing a pre-natal sonographic examination to rule out congenital anomalies. This is important for the management of the pregnancies. KEYWORDS: Ultrasonography, Intrauterine twin pregnancy, Encephalocel

Measurement of normal ocular volume by the use of computed tomography

Background: Reduction or increase in ocular volume may indicate ocular pathology. Unfortunately the reference values utilized for ocular volume had been that of non-Africans. It is therefore pertinent to have a reference value of normal for Africans.Objective: To document the computer tomography (CT) scan measured ocular volume in Benin City, which may serve as a reference for African.Materials and Methods: The ocular volume of 200 consecutive ‘normal’ patients (400 eyes) who had CT scan done (using Somatom AR.T, CT scanner, and Siemens) was calculated. The dimensions were obtained at mid-ocular axial slices with maximum anterior-posterior dimension and maximum size of the eye lens.Result: The mean (mean ± 2 SD) ocular volume for both eyes was 5282.23 mm3±1755.13 mm3 (right eye was 5264.26 mm3 ± 1781.12 mm3; left eye was 5300.20 mm3 ± 1771.57 mm3). The mean ocular volumes was different for either eyeball and sex (in males the right eye was 5289.80 mm3, left eye was 5224.31 mm3; while in females the right eye was 5338.18 mm3, left eye was 5240.79 mm3). Ocular volume correlated with the patients’ ages P = 0.006 for the right eye, P = 0.008 for the left eye and P = 0.006 for total eyeball volume.Conclusion: Ocular volume correlated positively with the age of the patients to about 50 years after which some reduction was observed. We noted that males had slightly larger eyeballs in comparison to females, although not at statistical significant level.Key words: Computed tomography, CT, eye volume, ocular volum

Review of Safety of Diagnostic Ultrasound in Medical Practice

In Nigeria, there is a dearth of scientific literature about the safety of ultrasound as a diagnostic modality. Because of its low cost, real-time image display and lack of evidence of bio-effects, ultrasound is a fast growing imaging modality. The impact of ultrasound in the care of women and children is most obvious. Information was sourced from journal articles, internet yahoo/google search, medline/pubmed search and personal experience of the authors. Several parameters for the measurement of safety of diagnostic ultrasound machines, thermal and mechanical indices, were defined. The potential bio-effects (thermal and non-thermal effects), principle of ALARA (as low as reasonably achievable) were described. Nowadays almost every pregnant woman will have routine antenatal ultrasound. The trend of increasing use of ultrasound also happens in other specialties. There is therefore a need for information about the potential bio-effects of ultrasound

Sonographic Assessment of Renal Size and its Correlation with Age and Gender in Apparently Healthy Adults in Benin City, Nigeria.

Renal anthropometry is an important tool in the diagnosis and prognosis of renal diseases. Ultrasound presents a safe, readily available and repeatable method of assessment of renal dimensions. The aims of this study are to determine: 1) The accuracy and repeatability of ultrasound measured renal dimensions. 2) The relationship between renal dimensions with gender and age and thus help create a baseline data of our population. This is a prospective study of600 randomly selected apparently healthy adults was carried out in University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Analysis of the results showed that of the subjects, 309 were (51.5%) males and 291 (48.5%)females. In males, the mean kidney length was (IO.7cm ± 1.0 and 11.0cm ± 0.9), while in females, it was IO.4cm ± 0.9 and IO.8cm ± 0.9 for the right and left kidneys respectively. This study showed that males have significantly longer kidneys than females and the left kidney was significantly longer than the right kidney in both males and females. The kidney length was found to increase with age until about the 4th decade and decreased progressively from the 6th decade of life onwards.Key words: Ultrasound, Renal Sizes, Nigerians, Age, Sex

A comparative study of the second and third trimester of pregnancy, umbilical artery doppler velocimetry indices in Benin-City.

Introduction: Doppler evaluation of the umbilical artery is a standard foetal surveillance undertaken globally to assess for foetal well-being. We undertook this study to establish the normal reference values of foetal umbilical artery Doppler indices in our environment. Methods: One hundred and fifty five women with uncomplicated pregnancies were recruited voluntarily into the study. The free floating middle third segments of the umbilical arteries were interrogated by Doppler triplex scan using a 3.5MHz curvi-linear probe of Philips HDI 4000. Statistical analysis was by SPSS version 16. Results: The mean age of the women was 29 years and their average gravidity was 2. The mean value of the foetal umbilical artery was PSV 41.7cm/s, EDV 18.6cm/s, MeanV 25.2cm/s, RI 0.57, PI 0.98 and S/D 2.83. The values of PSV, EDV and MeanV were higher in 3rd trimester when compared with 2nd trimester foetuses, whereas RI, PI and S/D were lesser. All the measured Doppler indices correlated with gestation age of the foetuses. Conclusion: Local values of umbilical artery Doppler velocimetry indices were obtained in this study which may be adopted as normative values in Benin City.Keywords: Umbilical artery, doppler velocimetry, normal Doppler indices, umbilical Doppler, foetal Doppler

Facial Index of Bini Tribe on Plain Skull Radiograph

Anthropometry is the quantifying of the human body whether dead or alive and facial anthropometry quantifies the facial phenotype based on parameters such as facial length, width and index. In this retrospective study a total of 216 antero-posterior skull radio graphs of 216 patients (125 males and 91 females) were selected. The biodata of each subjects were obtained from the request forms and entered into a data sheet. Facial diameters were measured on the radiographs on a viewing box using a meter rule. The facial length (FL) was measured as the longitudinal distance between the naso-frontal suture and the symphysis menti. The facial width (FW) was taken as the distance between the most lateral parts of the zygomatic bones and the facial index was calculated based on the equation shown below: Facial index= (FL/FW) x 100. The shapes of the faces were classified based on the facial index. The mean facial length measured 11.8cm ± 1.8 and 11. 6cm ± 1.0 while the mean facial width, measured 13.5cm ± 1. 7and13.3cm ± 1.0 for males and females respectively. Facial index was higher in females than males, measuring 87.8 ± 5. 6 and 86.8 ± 6.5 respectively. The dominant facial type in this study was mesoprosopic for males with a prevalence of 32.8% (41) and leptoprosopic for females with a prevalence of 32.9% (30). This survey has documented the facial dimensions and type of the Bini tribe based on skull radiograph and this will be indispensable to anthropologists, forensic experts and plastic surgeons.Keywords: facial index, facial length, facial width, skull radiograph, facial type

Retrospective Audit of the Morbidity Pattern in Radiotherapy: A Hospital Based Study in the University of Benin Teaching Hospital (UBTH), Nigeria.

This study documents the current evidence of cancer burden seen over 4 years in the department of radiotherapy and oncology of University of Benin Teaching Hospital, Benin City, Nigeria. Cancer, a noncommunicable disease, is the second most common cause of death only after cardiovascular disease. There is a dearth of literature on hospital based research concerning the morbidity of cancers in Edo State. The aim of the study was to review the pattern of presentation and the morbidity of patients attending a referral care centre in Nigeria. This was a retrospective study made up of 686 cases seen in UBTH and undergoing their radio-therapeutic clinic visits. Patients were seen following referral from UBTH and other referral centres. Patients seen in the oncology unit may not reflect therefore the full spectrum of cancer seen in the hospital. The data were collected from the register, categorized according to diagnosis and place of residence over a period of 4 years from 2013- 2016. The data was analysed using SPSS version 20. A total of 686 cancer patients were registered. Out of these from 24 different states, males were 190 (27.7%) and females were 496 (72.3%). The common cancer sites amongst males were naso-pharyngeal carcinoma (40 cases or 5.8%) and prostatic carcinoma (16 cases or 2.3%). For females, the common cancer sites were the breast cancer (250 cases or 36.4%) and cervical cancer (120 cases or 17.5%). The age ranged between 1 - 98 years. Male to female ratio was 1.0 to 1.5. The study highlights the pattern of cancer among patients in a referral healthcare centre in Nigeria. Therefore, there is an inherent bias, the leading sites of malignancies amongst males and females as it varied with the geographic region of Nigeria was demonstrated. This variation may be attributable to various cultural, environmental, dietary, life style, genetic contributory factors in the study population and finally, comparison was made with other studies analysed. Retrospective study, morbidity pattern, common cancers, Nigerian study population.Keywords: retrospective study, mobility pattern, common cancers, Nigerian study populatio

An audit of 3859 preadmission chest radiographs of apparently healthy students in a Nigerian Tertiary Institution

Background: Chest radiographs are routinely requested as part of the medical screening process prior to admission to institutions. Literature on the yield of such an exercise is sparse especially in the Nigerian setting. This study was therefore carried out to assess the usefulness of routine chest radiography for students at the time of admission. Materials and Methods: This was a prospective study of 3859 chest X-rays taken at the department of radiology, University of Benin Teaching Hospital for one admission screening for the 2008/2009 academic year. The age and sex of the subjects were also recorded. The heart, lung fields and bony thorax were examined for any abnormality. Results: Out of the 3859 pre-admission chest radiographs studied, there were 1951 males or 50.56% and 1908 females or 49.44% subjects. The mean age for males was 21.15±3. Conclusion: This study has shown that pre-admission routine chest radiography in asymptomatic patients remains a relevant screening tool for medical fitness during admissions into institutions. However because of dangers of exposure to ionizing radiation, we advise that a detailed medical history and physical examination be done to restrict its use to only those subjects with signs and symptoms suggestive of disease.Key words: Benin city, chest radiographs, preadmissio

The trend of presentation of vesico-vaginal fistula (VVF) and recto-vaginal fistula (RVF), in our environment

This is a case report of an unmarried 16 year old unbooked (P1+0) female patient with a diagnosis of vesico-vaginal fistula and recto-vaginal fistula following four day obstructed labour is presented. Following an intravenous urography (IVU), evidence of contrast in the bladder, vagina and rectum due to fistulous connection between vagina and bladder, vagina and rectum referred to as triple density was demonstrated. The value of commonly used IVU in our environment in diagnosis and follow-up management is discussed in this report. Keywords: Vesico-Vaginal Fistula, Recto-Vaginal Fistula, Obstructed Labour, Intravenous Urograph