Clinical pattern of gynecological/early pregnancy complaints and the outcome of pelvic sonography in a private diagnostic center in Ilorin

Background: Gynecological and early pregnancy complaints (GEPC)/lower abdominal complaints (LAC) are common in female patients seeking medical advice or treatments. Clinical limitations of GEPC or LAC are better resolved through appropriate laboratory and imaging investigation, among which the ultrasound examination (USS) is one.Aim: To determine the distribution/clinical pattern of female patients with GEPC/LAC, and to evaluate the correlation between the clinical and sonographical diagnoses, as seen in a private diagnostic center in the Ilorin metropolis.Materials and Methods: Records of 253 consecutive cases with GEPC/LAC, who had USS, were retrieved using 3.5 and 5 MHZ probes with SIEMENS Sonoline SL-1 machine, from January 2004 to December 2006, and retrospectively analyzed for the following variables: Age, occupation, complaints of vaginal bleeding, with or without pain, history of amenorrhea or infertility, clinical and ultrasound impression of early pregnancy complaints, including ectopic pregnancies and pelvic inflammatory diseases (PID), with exclusion of urogenital and gastrointestinal complaints/cases. Pregnancies greater than 12 weeks were excluded, bringing the total number of cases examined to 242.Results: Mean age was 30.44 years, median = 29.00; Mode = 25.00; with an STD of 7.69973. The youngest patient was 15-years-old while the oldest was 70 years. Cases of bleeding per vaginam Bleeding per vaginam (BPV), with or without pain, were the highest, 149 cases (61.6%), followed by threatened abortion, 45 cases (18.6%), and non-viable or incomplete abortions, 13 cases (5.4%). In contrast dysfunctional uterine bleedings (DUB) ranked the highest among the USS results, with 62 cases (25.6%), incomplete abortion cases were 44 (18.2%), while the non-viable pregnancies (missed abortions, blighted ovum, and early intrauterine fetal deaths (IUFD) cases) contributed to 26 cases (10.7%). Viable pregnancies were nine; incomplete abortions, nine; DUB, seven; Non-viable pregnancies, six; Threatened abortions, four; PID, four; complete abortions, two; Query-infected or degenerating fibroids, two; and others two. Threatened abortion ranked the highest among the definite clinical diagnoses.Conclusions: Bleeding per vaginam ranked the highest among GEPC/LACS in this environment, while there was poor correlation between clinical impressions and USS findings

Relationship between age, radiographic normal heart size and cardio-thoracic ratio in a Nigerian population

Background: Cardio-vascular disease (CVD) is now on the increase. The precise diagnosis of CVD is of immense clinical importance to the cardiac surgeons, pathologist and also for cardiologists. However, information on normal values for various cardio-vascular structures in Nigeria, a country with the highest population of blacks in the world is sparse. In this regard the age-related radiographic sizes of a Nigerian cohort of patients with non-cardiogenic complaints or consultations were therefore assessed.Objectives: To evaluate the limits of normal cardiac size in our environment , determine if there was a relationship between the age and size of the heart and to evaluate the relationship between sex and cardiac size and cardio-thoracic ratio.Design: A cross-sectional study.Setting: The Radiology department of University of Ilorin Teaching Hospital, Ilorin, North Central Nigeria between January to June 2012.Subjects: One Hundred patients were consecutively recruited and their chest radiographs examined after fulfilling the inclusion criteria.Results: Males accounted for 55% of the study population. The age range was 1 month to 73 years, (Mean = 29.3, SD =2.41668). The mean cardiac size was 11.7cm. The average cardiac size for adult males and females, were 11.6cm and 11.5cm respectively while that of thoracic size was 29.0cm and 26.8cm respectively. Correlation between age and cardiac size was 0.66; age and thoracic size was 0.64 and between cardiac size and thoracic size was 0.89. The paired sample t-test for age and cardiac size was less than 0.05 (p value <0.05).Conclusion: knowing the average values of cardiac size for adult males and females (11.6cm and 11.5cm) and thoracic size (29.0cm and 26.8cm) respectively from this study presents a base line for early detection of variation from normal cardiac measurements in this environment

Ultrasound In Diagnosis Of Herniae In Pregnancy: A Case Report And review of literature

A 26-year old trader presented with abdominal pain with a four month old pregnancy and was diagnosed clinically, (wrongly of course) as a case of peptic ulcer in pregnancy, with co-existing uterine fibroid. Ultrasound scan (USS) revealed an incarcerated supra-umblical (anterior abdominal wall) hernia as the cause of her pain. She had no evidence of previous abdominal surgery or incisions. The importance of imaging studies in diagnosis of similar cases in pregnancy most especially non-clinically visible congenital diaphragmatic hernia is highlighted with a review of literature.Keywords: sonography, pregnancy, hernia and diagnosis errorsThe Tropical Journal of Health Sciences Vol 19 No 1 (January 2012

Anterior Urethral Diverticulum – A Case Report

No abstract available African Journal of Urology Vol.11(1) 2005: 74-7

Clinical and Plain Radiograph Pattern of Joint Dislocations and Subluxations in Ilorin

Background: Dislocation is derangement of a joint; aetiology varies from motor vehicle accident (MVA) to simple fall. Plain radiograph is an integral part of early assessment of patients' evaluation, though newer imaging modalities such as magnetic resonance imaging (MRI), computerized tomography (CT) and ultrasonography (US) are now available for detailed evaluation of cases.Aims: To evaluate the correlation between the clinical and radiological diagnoses of joint dislocation and determine distribution of patients with joint injuries, and match them with their etiologies in this environment.Method: A retrospective analysis of plain radiograph records of 123 patients assessed clinically or radiologically as having dislocations or joint injuries; spanning a period of three years (January 2004 to December 2006) was conducted.Result: Radiological diagnoses of dislocation was 78 (63.4%), and subluxation 45 (36.6%), compared to clinical diagnoses of 42 (34.1%) and 7 (5.7%) respectively. The students are the most affected occupational group, 41 (33.3%) cases, while 10-29yr olds are the most frequent age groups, contributing 43 (35%) of the cases. Surprisingly injuries from Road Traffic Accidents (RTA/RTI), 24 (14%) cases came second to injuries from fall from heights/sport with 48 (29.4%). The gleno-humeral joint is the most involved in dislocation, 35 cases (44.30%) out of 78 cases,followed by elbow joints with 16 cases (20.25%).Conclusion: The shoulder joint is the most frequently dislocated and a conventional plain radiograph is still valuable as a first line investigative modality in evaluation of joint injuries

Sonographic Assessment of Fallopian Tube Patency in the Investigation of Female Infertility in Ilorin, Nigeria

This study was conducted to bring into focus the value of pelvic sonograms in assessing tubal patency in order to overcome the radiation hazard associated with hysterosalpingogram (HSG), reduce cost of examination and encourage it as first-line office-based procedure for management of female infertility. Fifty consecutive female patients primarily designated for HSG underwent pre- and post-HSG pelvic sonograms and the results were documented. Agreement between HSG and SHSG was established in 89 of 100 (89%) fallopian tubes. The sensitivity of sonohysterosalpingography (SHSG) in diagnosing tubal patency was 85.5% and the specificity 96.8%. Analysis of the raw data gave positive predictive value of 98.3% and negative predictive value of 75%. It is accepted that there is no statistically significant difference (p = 0.237) between the results of the two methods (HSG and SHSG). SHSG is found to be a reliable, relatively inexpensive diagnostic and therapeutic (guided hydrotubation) procedure in the management of female infertility. (Afr J Reprod Health 2001; 5[1]: 100-105) RÉSUMÉ Evaluation sonographique de la perméabilité de trompe utérine dans l'étude de la stérilité féminine à Ilorin, Nigéria. Cette étude avait pour but de mettre au point la valeur des sonogrammes dans l'évaluation de la perméabilité tubaire afin de surmonter le hasard radique associé à l'hystérosalpinogramme (HSG), de réduire le coût d'examen et de l'encourager en tant qu'un procédé majeur basé au bureau, pour le traitement de la stérilité féminine. Cinquante patientes consécutives qui sont essentiellement désignées pour le HSG ont subi les sonogrammes pelviens avant-et post-HSG et les résultats ont été documentés. La correspondence entre le HSG et la SHSG a été établie dans 89 sur 100 trompes utérines (89%). La sensibilité de la sonohystérosalpinographie (SHSG) dans la diagnositique de la perméabilité tubaire était de 85,5% alors que la spécificité était de 96,8%. Une analyse des premières approximations des données a donné une valeur prévisionnelle positive de 98,3% et une valeur prédictive négative de 75%. On admet qu'il n'y a pas de différence statistiquement significative (p = 0,237) entre les résultats des deux méthodes (HSG et SHSG). Le résultat montre que la SHGH est un procédé diagnostique et thérapeutique (hydrotubaire guidé) fiable, relativement bon marché dans le traitément de la stérilité feminine. (Rev Afr Santé Reprod 2001; 5[1]: 100-105