Transfontanelle ultrasonography of infant brain: analysis of findings in 114 patients in Benin City, Nigeria

No Abstract

Computed Tomography Study Of Complicated Bacterial Meningitis

To monitor the structural intracranial complications of bacterial meningitis using computed tomography (CT) scan. Retrospective study of medical and radiological records of patients who underwent CT scan over a 4 year period. AUniversityTeachingHospital in a developing country. Thirty three patients with clinically and laboratory-proven cases of bacterial meningitis who had clinical features of central nervous systemcomplication of the disease. Only patients with available complete records were studied with material obtained from themedical records and radiology departments of the hospital. Persistent headache (30.3%), persistent fever (18.18%), seizures (15.5%) and torticollis (12.12%) were the most common presenting features that necessitated the request for CT scan. Communicating hydrocephalus (36.36%), cerebral abscess (12.12%), multiple areas of cerebral infarction (12.12%) and subdural empyema (9.09%)were themost common CTscan findings. The complicationsweremore common in children aged less than 15 years. Computed Tomography is an accurate and useful means of diagnosing intracranial complications of bacterialmeningitis. Early and effective diagnosis of treatable lesions such as hydrocephalus, cerebral abscess and subdural empyema will help improve prognosis of the patients. There appears to be no alternative to prevention, adequate and early treatment of this condition to reduce its long-term neurological sequelae. Keywords: Computed tomography, Bacterial, Meningitis, Complications, Brain. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 351-35

The state of occupational radiation protection and monitoring in public and private X-ray facilities in Edo state, Nigeria

Aims and Objectives: To find out the state of radiation protection and monitoring practices of the public and private X-ray centres in Edo State.Materials and Methods: Survey visits were made to all the functional X-ray facilities in Edo state and the available facilities identified, staff interviewed and collected data analyzed.Result: There are 18 functional X-ray facilities comprising 10 (55.56%) publicly owned and eight (44.44%) privately owned. Only two (20%) of the public and five (62.5%) of the private X-ray units have personnel and environmental monitoring. All the X-ray centers in both public and private hospitals have effective lead aprons. All the public (100%) and only four (50%) of the private centers have gonadal shield although none is using them on a routine basis. Qualified radiographers are available only in five (50%) of the public and six (75%) of the private centers. Only three (30%) of the public X-ray centers have the services of radiologists. Among the private X-ray units, five (62.5%) have radiologist while three (37.5%) have no radiologist. Only one (10%) of the public centers and one (12.5%) private X-ray centre have a purpose-built adequately designed X-ray unit with barium plasters and lead lining of walls and doors. There is also only limited lead lining of doors and walls in three (37.5%) private units while no lead lining or barium plasters are used in five (62.5%) of the private units. No X-ray unit in Edo State uses digital radiography or computerized information system. This means that lost hard copy must be repeated, leading to more radiation to patients and staff.Conclusions: There are inadequate radiation protection and monitoring practices in most of the functional X-ray facilities in Edo state with only five (62.5%) of the private and two (20%) of the public X-ray units monitored. There is poor adherence to the advice of the medical physicists due to the cost implications of the implementation

Comparative ultrasound measurement of normal thyroid gland dimensions in school aged children in our local environment

Objective: The objective of this study was to determine the measurement of normal range of ultrasound (US) thyroid gland dimensions in school-aged children (6-16 years) in our environment and compared with what is obtained elsewhere.Setting and Design: A prospective ultrasound measurement study done in University of Benin Teaching Hospital Benin, Nigeria.Materials and Methods: A prospective ultrasound (US) study of thyroid dimensions of 500 school-aged children in our environment consisting of 227 boys and 273 girls was done from 1 December 2006 to July 2007. The subjects were examined by the authors and subjects with palpable abnormal thyroid gland were excluded from the study. The thyroid dimensions (length, height, and diameter) were taken for each lobe by means of ultrasound (US). In addition volume of each thyroid lobe was calculated and the summation of volume of the lobes was taken as thyroid gland volume of each subject. Also height and weight of patients were documented from which the subject’s body surface was calculated. Incidental thyroid gland lesion in US was excluded from the study. Using the Statistical program of social science (SPSS) and INSTAT (Graph Pad Inc. USA) the data were analyzed. Informed consent was obtained from all the subjects and the study was done in line with the ethical guidelines of the centers.Results: The US thyroid gland volume in school-aged children in Benin City from this study ranges between 1.17 cm3 and 7.19 cm3, mean volume range of 1.76-4.95 cm3, median volume range of 1.73–4.73 cm3, and range of standard deviation from 0.39 cm3 to 1.49 cm3. The average mean thyroid volume is 2.32 cm3 with the following average dimensions; anteroposterior right lobe =1.06 cm, mediolateral right lobe = 1.01 cm and craniocaudal right lobe = 2.34 cm, and anteroposterior left lobe = 1.01 cm, mediolateral left lobe = 1.04 cm and craniocaudal left lobe = 2.41 cm for both boys and girls respectively. These data are significantly lower than data obtained by European based World Health Organization/International Council for the Control of Iodine Deficiency Disorders (WHO/ICCIDD) 1997. However there is significant similarity with data obtained in similar environment.Conclusion: Ultrasound thyroid gland dimensions in school-aged children in our environment are reproducible and the data obtained are comparable to those obtained in other environment. The values may be better used in our environment as reference data for screening purposes

Armillifer armillatus infection

We report a case of human pentastomiasis in a 70-year-old retired long-distance driver/farmer whose diagnosis was made incidentally while being investigated for a 1-month history of cough and abdominal pain. The chest X-ray revealed multiple comma-shaped and rounded opacities in keeping with Armilliferinfection, most likely Armillifer armillatus. The patient made an uneventful recovery after a 10-day course of mebendazole (an antihelminthic) tablet and ciprofloxacin (antibiotic) capsules and was discharged home. He is presently being followed up. This is the first case we have seen in our medical unit thus we are reporting it

An Audit Of Rejected Repeated X-ray Films As A Quality Assurance Element In A Radiology Department

To find out the causes, number, percentage and sizes of rejected radiographic filmswith a view of adopting measures that will reduce the rate and number of rejected films. Radiology Department of a University Teaching Hospital. Over a two-year period (1 April 2002 to 31 March 2004), the total number of x-ray films utilized for radiographic examinations, rejected films and sizes of rejected films were collected retrospectively from the medical record of radiology department. All the rejected films were viewed by a radiologist and three radiographers for the causes of the rejects which was arrived at by consensus. The data was analysed. A total of 15,095 filmswere used in the study period and 1, 338 films (8.86%)were rejected orwasted. The rate of rejected films varied from 7.69% to 13.82% with average of 8.86%. The greatest cause of film rejects was radiographers\' faults 547 (40.88%), followed by equipments faults 255 (19.06%), and patients\' faults 250 (18.90%).The highest reject rate (13.82%)was for films used for examination of the spine (15 x 30) cm size. This is followed by 9.92% for skull (18 x 24) cm films and 8.83% for small sized films (24 x 30)cm used for paediatric patients.Of a total of 1,338 rejected films, 1276 (95.37%) additional exposurewere done to obtain the basic desired diagnostic information involving 1151 patients; 885 (76.89%) of these patients needed at least one additional hospital visit to take the repeat exposure. Rejected films are not billable; patients receive additional radiation and may even come to hospital in another day for the repeat. Radiographer\'s work is increased as well as that of the support staff. The waiting room may be congested and waiting time increased. The cost of processing chemical and films are increased, thus if work is quantified in monetary terms, the cost of repeats is high. Rejected-repeated film analysis is cheap, simple, practicable, easy to interpret and an effective indictor of quality assurance of radiology departments. Keywords: Audit, Rejected, Repeated, Wasted, x-ray, Films, Radiography, Radiology, Quality Assurance. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 355-35

Aetiology and pattern of bone and joint infection presenting at a regional orthopaedic hospital

BACKGROUND: Bone and joint infection is one condition that can either be rewarding,or a night mare to the surgeon.This work reports the causes and pattern of presentation of bone and joint infections in our sub region.METHOD: A retrospective review of 73 cases of non granulomatous bone infection seen over two years from January 2012 to December 2013 was done. Patients' biodata,complaint,time to presentation in the hospital and if any intervention by the traditional bone setters, limbs involved, primary cause, diagnosis, organism cultured and retroviral status were obtained from the folders.Results:Commonest age group involved was in the second decade with 21.9%. Male to female ratio is 2.2:1. Chronic osteomyelitis was the commonest infection with 46.6% (34 patients) followed by septic arthritis with 26%.The lower limb was more involved than the upper limb with a ratio of 5.6: 1.A significant number of patients 59 (80.8%) presented more than two weeks after onset of symptoms while 27 patients (36.9%) visited the traditional bone setters for treatment before presenting to the hospital. Staphylococcus aureus was the commonest organism isolated.CONCLUSION: Chronic osteomyelitis is the commonest bone and joint infections in our environment mainly from trauma and closely followed by improperly treated haematogenous acute osteomyelitis.Acute osteomyelitis is a rare occurrence as late presentation and patronage of traditional bone setters is rife.KEY WORDS: Bone infection,joint infection,aetiolog

A profile of wound infections in National Hospital Abuja

Background: Wound Infections cause prolonged hospital stay, increased costs and also can result in increased patient morbidity and mortality.The current spread of multi -drug resistant bacteria has further heightened the need for regular bacteriological review of infected wounds and regular antibiotics surveillance studies so as to avoid the unguided empirical treatment of wound infections which is quite common in this environmentAim: To determine the distribution of the isolates from wound specimens submitted to the medical microbiology laboratory of National Hospital Abuja for processing.Method: A review and analysis of 380 woundspecimens results from various wards in the hospital over a period of 10 months (1st Marto Dec 31st 2010) was conducted.Result: A total of 314 isolates were recovered from the 380 wound specimens giving a yield of 83%. 240(76%) yielded single isolates of various pathogens, while 74(24%) were poly-microbial. Gram negative bacilli constituted 66% of all the pathogens with Pseudomonas aeruginosa (19%) and Proteus species (18%) as the most frequent, while gram positive isolates made up 33% with S aureus (27%) as most predominant and most frequently isolated bacteria from all the wound specimens. Two candida species comprised about 1% of the isolates. Frequency of infection was highest in surgical wards (27%), gynaecology ward (14%) and accident and emergency unit (12%). The fluoroquinolones, aminoglycosides, and Beta-lactam antibiotics were the most effective drugs for most of the isolates. Staphylococcus aureus was most sensitive to amikacin (83%) and erythromycin (79%); Pseudomonas aeruginosa to imipenem (96%) and amikacin (83%) and Proteus species to amikacin (100%) and imipenem (78%).Conclusion: S aureus, Pseudomonas aeruginosa and Proteus species were the predominant bacteria from wounds, with surgery and gynaecology wards having the highest prevalence. Resistance to commonly used antibiotics is high. There is need to institute antibiotic stewardship and effective and efficient infection control measures in the hospitalKeywords: Wound infections, National Hospital , Abuj