Twin Gestation Consisting of Hydatidiform Mole and a Live Fetus: A Case Report

Twin gestation consisting of hydatidiform mole and a live fetus is a rare entity. A 22-year-old gravida 2 para 1+0, 1 alive patient presented with 14 weeks amenorrhoea and vaginal bleeding. Ultrasonography revealed hydatidiform mole and a viable fetus. She had suction curettage at 16weeks gestational age because of heavy vaginal bleeding. Histology confirmed benign hydatidiform mole. Urinary HCG level declined progressively and was negative by 4 weeks post-evacuation. Eight months after, she was 20 weeks gravid. She had uneventful pregnancy, labour and delivery of a baby boy. The baby (now a year old) and the mother remain well

Posterior reversible encephalopathy syndrome in a adult female

Posterior reversible encephalopathy syndrome is a clinico-neuroradiologic diagnosis, with rapidly evolving neurologic condition, characterized by headache, confusion, altered mental status, seizures, cortical blindness, lethargy, stupor, and occasionally, focal neurological signs accompanied by a typical computed tomography or magnetic resonance imaging pattern. With early recognition and treatment, complete resolution of symptoms occurs. Typical imaging findings characteristically involve the white matter bilaterally in the parieto-occipital regions. Atypical imaging finding of contrast enhancement of lesion can occur, but is less common. A 20-year-old primiparous lady presented with posterior reversible encephalopathy syndrome. To the best of our knowledge, this is the first documented case in Nigeria. This case-report highlights the importance of recognizing the salient imaging features in this lethal but reversible entity with prompt management.Keywords: Female, leukoencephalopathy, Nigerian, posterior, reversibl

Evaluation of Transverse Lie at Term by Ultrasonography

Context: Transverse lie at term may have adverse consequences on both the mother and the foetus.Evaluating transverse lie at term by ultrasonography may reduce these adverse consequences andimprove both the maternal and fetal outcome.Objectives: To determine predisposing factors to persistent transverse lie at term using abdominalultrasonography and the outcome of such pregnancies.Study- Design, Setting and Subjects: This was a cross-sectional study of pregnant women at term withpersistent transverse lie referred to the Ultrasound Unit of the Federal Medical Centre, Lokoja, Nigeria.Results: Out of a total of 1296 scanned during the evaluation period, 42 (3.2%) had transverse lie atterm. Five (11.9%) patients were primigravida and 37 (88.1%) multipara. No predisposing factors wereseen on ultrasound in 25 women (59.5%). Placenta praevia was diagnosed in 11 (26.2%), lower segmentfibroid in 5 (11.9%) and pelvic kidney in 1 (2.4%). Thirty nine patients (92.1%) were delivered bycaesarean section (CS). Three (7.1%) spontaneously converted to longitudinal lie [1 Breech and 2Cephalic]. All 3 were delivered per vaginam. There were no maternal deaths but there were 2 stillbirths.Conclusion: Majority of the patients had no predisposing factor seen on ultrasound and were largelymultiparous women. Placenta praevia was the commonest predisposing factor found atultrasonography. Caesarean section rate was very high, largely due to the fact that external cephalicversion (ECV), which has been advocated as an alternative mode of delivery of infants lying transverselyat term, is not currently practised in our centre.Key Words: Transverse Lie, Malpresentation, Ultrasound, Caesarean Sectio

Intranasal Endoscopic Repair of Bilateral Choanal Atresia in a Male Newborn with Crouzon's Syndrome

No Abstract

Blindness in Tuberous Sclerosis: A Case Report

Tuberous sclerosis (TS) is inherited as an autosomal dominant trait with variable penetrance characterised by glial cell tumor which arises from the cerebral and the retina. Blindness in association with Tuberous sclerosis (TS) is rare. When visual loss occurs it may be associated with hamartomas from retinal or optic nerve involvement or from intracranial (brain) tumours that affect either the part of the brain that processes visual information or from optic nerve damage following raised intracranial pressure. Very few cases of TS with blindness have been reported globally. Deterioration in academic performance might be the first pointer to the visual impairment. We report a case of a 13 year old girl who presented with increasing number of facial rash over an 11 years period, recurrent headache and deteriorating academic performance of 1 year and loss of vision of 6 months with a recent episode of convulsion. Similar skin rashes without other associated symptoms were noticed on the mother and one of the younger siblings. She was a Tanner stage one in development. She had facial angio fibromas, shagreen patches over the left hypochondria, back regions and face. Ophthalmic evaluation showed a visual acuity of being able to count fingers at not more than one meter from the face and only perception of light in the right and left eye respectively, both eyes had brisk pupillary activities, good mydriasis and clear media. The retinal and optic nerve head appeared normal in the right eye whereas in the left eye was a huge tuberous hamartoma of the optic disc and macular as well as generalised vascular occlusion and subretinal fluid. The Computerized tomography (CT) scan showed an Intraventricular tumour, with calcification within the tumours and subependymal. There was associated obstructive hydrocephalus. Patient was managed by a multi disciplinary team of ophthalmologists, neurosurgeons and radiologists, coordinated by a paediatrician.Conclusion: The diagnosis of tuberous sclerosis complex (TSC) was based on the lesions found on clinical examination, imaging, and pathologic studies. The blindness was multi-factorial in cause including intracranial, retinal and optic nerve tumours. Comprehensive medical history, detailed physical examinations and neuroimaging study are essential in making a diagnosis of TSC. Our patient was mis-diagnosed at various health facilities for many years. This delay in making appropriate diagnosis and instituting treatment could have contributed to the eventual outcome.Keywords: Tuberous Sclerosis, Blindness, Deteriorating Academic Performanc

Foreign Bodies in the Upper Aerodigestive Tract of Nigerian Children

Aim/Background This is an audit of number, nature, sites of impaction and methods of removals and treatment outcome of upper aero-digestive foreign bodies among children in an urban University hospital in Nigeria. Patients and Methods This is an 8year retrospective review of foreign body in upper aero-dgestive tract of children (January 2001 to December 2007) was conducted at the ENT department of the University of Ilorin Teaching Hospital, Ilorin, Nigeria . Case notes of the patients were retrieved and the following were data extracted: demographic, clinical, operative and outpatient visits outcome. Results 81 children aged 9months to 16years were seen (mean 4.28, SD 2.95) with 49 males and 32 females and a male: female ratio of 1.5: 1.0.The commonest age group was 9months to 4years (76.5%). Most common of impaction sites were nasal cavity in 31 cases (38.3%), oesophagus in 23 cases (28.4%), oropharynx in 16 (19.8%) and larynx in 6 (7.4%)).The commonest FBs was coins in 33 (40.7 %) in the oesophagus and 37.5% of pharyngeal FBs .Inanimate FBs in the nose constituted 31(38.3%) [Non vegetative 27(87.1%), vegetative 4(12.9 %)]. Fish bones were seen in 11 cases (13.6%) [6 in the larynx and 5 around the tonsillar fauces] and miscellaneous objects in 6 cases. Conclusion Upper aero-digestive foreign bodies are common especially among the under fours', commonest sites being the nose and pharyngooesophageal region with coins and inanimate FBs constituting about four-fifth. There is the need for parental health education on object placements, and a high index of suspicion among practitioners to facilitate early referral and avoid preventable complications

Mycetoma of the hand with underlying bone involvement

No Abstract.Tropical Journal of Health Sciences Vol. 14 (2) 2007: pp.54-5

Longitudinal evaluation of foetal transverse lie using Ultrasonography

The purpose of this study was to assess the risk of persistence of transverse lie detected earlier in pregnancy and associated predisposing factors using follow-up ultrasound (US). A longitudinal study was carried out from January 2004 to august 2004 at Federal Medical centre, Lokoja, Nigeria. All singleton pregnancies, with ultrasound diagnosis of transverse lie, between 24-28 weeks were followed to term. At 24-28 weeks, 183 fetuses presentedwith transverse lie. Thirty seven were lost to follow-up; out of the remaining 146 babies, 22 persisted to term. Overall persistence rate was 15.1%. No identifiable predisposing factors were seen in 91.1%, placenta previa in 5.5%, lower segment fibroids in 2.7%, and ectopic kidney in 0.7%. In conclusion, transverse lie detected early inpregnancy is transient, and majority would convert to a longitudinal lie at term. Potential predisposing factors highlighted above increases the risk of persistent transverse lie at term, with placenta previa and lower segment fibroids being the major predisposing factors (Afr J Reprod Health 2010; 14[1]:129-133)

Adequate Filling of Radiology Request Forms: An Audit Assessing Local Practice at The University of Ilorin Teaching Hospital, Ilorin

Click on the link to view the abstract.The Tropical Journal of Health Sciences Vol 21 No 1 (January, 2014