Radiology residents' perception of working and training from home during covid-19 pandemic

Introduction: The spread of coronavirus disease 2019 (COVID-19) pandemic disrupted the personal and profes-sional lives of many throughout the world. To mitigate the spread of the virus, Addis Ababa University introduced an online teaching/learning method which minimized the physical engagement of faculty members and residents. Online teaching is a major shift in the history of the country's oldest and largest university. Objectives: This study aimed to investigate how trainees managed to cope up with the sudden changes in the teach-ing/learning system, and assess the ensuing satisfaction with the new method of teaching/learning. Methods: Descriptive research design was implemented and analysis of variance (ANOVA) and T-tests were used to test hypotheses. Analysis of data collected from 58 radiology residents found that, the residents appreciated the participatory nature of the newly introduced online learning method. Results: The results showed that residents have accepted the new teaching/learning method and are satisfied with it. Furthermore, tests of hypotheses revealed that there is no significant difference in level of satisfaction between female and male residents as well as throughout the three years of radiology residency training. Conclusion: The new method of teaching/learning has a positive acceptance among trainees and there was high level of satisfaction with the new method. Poor internet network, reduced in-person mentoring, failure to make engaging discussions due to large number of participants were the common challenges to online teaching in the setting.

Public­private partnerships in Nigerian teaching hospitals: Potential and challenges

Background: Public­private partnership (PPP) has become a popular model used by public sector organizations that are usually under-funded by their respective governments to render services in fulfillment of their egalitarian responsibilities and goals. Lately, the health sector has been a recipient of such initiatives and the trend is growing. However, the successful delivery of services to patients is sometimes hampered because of difficulties encountered in both the development and interpretation of clauses contained in agreements including Memoranda of Understanding between the parties. The anticipated outcomes and impact often remain elusive due to the tensions encountered during implementation.Aim and Objective: The aim of this study was to determine the current operational status as well as explore potential benefits and challenges of the use of the PPP model in radiology departments of selected teaching hospitals within three South-Western States of Nigeria (Lagos, Ogun, and Oyo). It is hoped that the study findings would provide useful data needed for improvement of the PPP model as it is being currently practiced.Materials and Methods: This was a qualitative study in which 138 closed- and open-ended questionnaires were administered to all cadres of staff in radiology departments of the selected hospitals teaching hospitals within three South-Western States of Nigeria (Lagos, Ogun, and Oyo).Results: There was a 100% response from the participants. The age range of the participants was 25­65 years. Study findings showed that almost all radiological equipment can be acquired through PPP. There was improved service delivery and residency training with PPP. Jurisdictional conflict was the greatest challenge.Conclusion: PPP is a viable option that should be encouraged by government for the purchase of equipment in hospitals

COVID radiology preparedness in Nigeria: How ready are we?

The novel human coronavirus (COVID-19) began in Wuhan China as an interstitial pneumonia of unidentifiable origin in December 2019 and thereafter spread its tentacles all over the world.There is a need for radiology departments in both government and private facilities to be prepared to meet this crisis. Their efforts should be geared not only toward diagnosis, but also to preventing patient-to-patient, staff-to-patient, and staff-to-staff transmission of infection by utilizing social distancing measures and personal protective equipment (PPE).Aim: To evaluate the preparedness of radiologic departments of government hospitals and private centers, by assessing the outlay of the facility and likelihood to attend to COVID patients, type of equipment in the centers, and plans in place for protection of staff and the public.Materials and Methods: The radiology departments of government and private facilities in each geopolitical zone of the country were randomly selected to discuss radiology preparedness in Nigeria using preset guidelines which were sent to radiologists at the facilities. Written informed consent was obtained from the radiologists at the participating centers. Ethical approval was also obtained from the Lagos University Teaching Hospital Health Research Ethics Committee.Results: A total of twelve centers were included in the study, comprising eight government and four private centers. All had plans in place to attend to COVID patients; majority were in the process of developing standard operating procedures (SOPs). Majority of the government facilities lacked mobile equipment and adequate PPEs, with only one computed tomography machine and no holding area in some of the facilities for symptomatic patients unlike the private facilities. They, however, had infection control teams in place.Conclusion: Private radiological centers appear better prepared and more equipped to cope with the crisis than government hospitals. Adequate PPEs, mobile equipment, and isolation rooms need to be provided for the government facilities. Radiology information systems should be installed for remote viewing. Training and retraining on COVID management and decontamination should be conducted periodically. SOPs should be drafted universally and modified for each facility

An audit of licensed Zimbabwean radiology equipment resources as a measure of healthcare access and equity

Introduction: approximately two-thirds of the world's population has no access to diagnostic imaging. Basic radiological services should be integral to universal health coverage. The World Health Organization postulates that one basic X-ray and ultrasound unit for every 50000 people will meet 90% of global imaging needs. However, there are limited country-level data on radiological resources, and little appreciation of how such data reflect access and equity within a healthcare system. The aim of this study was a detailed analysis of licensed Zimbabwean radiological equipment resources.Methods: the equipment database of the Radiation Protection Authority of Zimbabwe was interrogated. Resources were quantified as units/million people and compared by imaging modality, geographical region and healthcare sector. Zimbabwean resources were compared with published South African and Tanzanian data.Results: public-sector access to X-ray units (11/106 people) is approximately half the WHO recommendation (20/106 people), and there exists a 5-fold disparity between the least- and best-resourced regions. Private-sector exceeds public-sector access by 16-fold. More than half Zimbabwe's radiology equipment (215/380 units, 57%) is in two cities, serving one-fifth of the population. Almost two-thirds of all units (243/380, 64%) are in the private sector, routinely accessible by approximately 10% of the population. Southern African country-level public-sector imaging resources broadly reflect national per capita healthcare expenditure.Conclusion: there exists an overall shortfall in basic radiological equipment resources in Zimbabwe, and inequitable distribution of existing resources. The national radiology equipment register can reflect access and equity in a healthcare system, while providing medium-term radiological planning data

Les traumatismes majeurs du rein : aspects diagnostiques et thérapeutiques au CHU-Gabriel Touré de Bamako au Mali

Le but de ce travail était d'évaluer la prise en charge des traumatismes majeurs du rein dans un hôpital de troisième référence au Mali.Patient et méthodes:Il s'agit d'une étude rétrospective portant sur 7 cas de traumatismes majeurs du rein, colligés au service d'urologie de l'Hôpital Gabriel Touré de Bamako sur une période de 15 mois.Résultats : Les patients se répartissaient en 6 hommes et 1 femme.Nous avons enregistré6 cas de traumatisme fermé et 1 cas de plaie pénétrante du rein. L'âge moyen était de 19 ans. Les étiologies étaient dominées par les accidents de la circulation. Les principaux signes cliniques étaient l'hématurie et les lombalgies. L'état hémodynamique était stable à l'entrée.L'échographie puis la tomodensitométrie rénale ont été réalisées chez tous les patients permettant le diagnostic de traumatisme rénal.Le bilan radiologique permettait de classer les traumatismes selonl'AAST (American Association for the Surgery of Trauma) en : 3 cas de grade IV, et 4 cas de grade III.Notre prise en charge, a consisté en un traitement conservateur chez 5 patients et une chirurgie différée chez 2 patients. L'exploration chirurgicale réalisée a aboutit à une néphrectomie. Par ailleurs, 1 patient a présenté un urinome ayant régressé spontanément au cours de l'hospitalisation. L'évolution clinique était favorable chez tous les patients avec un délai moyen de 3 mois. La tension artérielle était normale chez tous les patients de même que le dosage du taux sérique de la créatinine. Le contrôle radiologique effectué chez les patients ayant présenté un traumatisme au stade IV a montré une reconstruction du rein et une absence d'extravasion de produit de contraste.Conclusion :Les traumatismes du rein sont de plus en plus fréquents. Cette situation est liée à l'augmentation des accidents de la voie publique. Le traitement conservateur même en cas de traumatisme majeur reste la méthode thérapeutique de choix en l'absence d'instabilité hémodynamique. Une surveillance accrue des traumatismes pénétrants par armes à feu semble indispensable pour une exploration chirurgicale précoce en cas de nécessité

Digital radiological surveillance of silicosis and related tuberculosis in the South African mining industry practical and technical considerations

The switch from analogue to digital radiography formats for surveillance for silicosis and tuberculosis in the South African mining industry raised the question of equivalence of formats for this purpose. As a result, the South African Mine Health and Safety Council (MHSC) sponsored a study, recently published, on the equivalence of digital and analogue radiography in this setting. This commentary aims to provide a summary of the study findings, accompanied by an overview of the practical considerations that arise in the use of digital radiographic surveillance in the South African mining industry. Through a clear understanding of the objectives of surveillance, use of quality and reference standards for hardware and software, and interpretation of digital images, avoidance of common pitfalls, and use of all the clinical and occupational health information on each miner, the contribution of surveillance to identification and control of silicosis and tuberculosis in the mining industry can be maximised

Place de la radiologie dans la pratique des chirurgiens-dentistes sénégalais

L'odontologie a naturellement bénéficié des innovations en imagerie médicale. L'examen radiologique est devenu une partie intégrante de la prise en charge odontologique. Ce travail avait pour objectif d'évaluer la place de la radiologie dans la pratique des chirurgiens-dentistes sénégalais.Matériels et méthodes.Il s'agissait d'une étude transversale descriptive réalisée auprès des chirurgiens-dentistes exerçant dans les secteurs du privé, et du public de la région de Dakar. Des questionnaires auto-administrés ont été distribués afin de recueillir les informations suivantes : le secteur d'activité, l'importance de la radiologie dans la pratique quotidienne, l'équipement en appareil radiologique, la fréquence de prescription des examens radiologiques. Les données ont été analysées avec le test chi-deux.RésultatsAu total, 132 chirurgiens-dentistes ont répondu aux questionnaires. Parmi eux 42% exerçaient dans le secteur privé, 28% dans le public et 20% étaient des praticiens hospitalo-universitaires. Le sexe ratio était de 2,14 et la moyenne d'âge était de 37 ans ± 11.Plus de 90% des chirurgiens-dentistes accordaient une grande importance aux examens d'imagerie dans leur pratique, 6,84% une importance moyenne. Les films argentiques étaient les plus utilisés avec 75% contre 25% de récepteurs numériques. Les examens radiologiques n'étaient prescrits de manière systématique que par 6,87% des chirurgiens-dentistes alors que 64,84% les prescrivaient de manière sélective et 27% utilisaient rarement.Conclusion: Cette étude a montré une insuffisance d'équipement radiologique et une attitude inadéquate de prescription des examens radiologiques des chirurgiens-dentistes de la région de Dakar Des formations continues en radiologie dentaire s'avèrent nécessaire pour une meilleure connaissance des examens radiologiques

Pulmonary Tuberculosis Sequelae: Spectrum of Radiologic Findings and Review of Literature

Pulmonary tuberculosis (TB) is a common worldwide infection and a medical and social problem causing high mortality and morbidity; especially in developing countries.In accordance with the virulence of the organism and the defenses of the host; tuberculosis can occur in the lungs and in extrapulmonary organs. A variety of sequelae and complications can occur in the pulmonary and extrapulmonary portions of the thorax in treated or untreated patients.In this article; we aimed to review the characteristic imaging findings of various sequelae of thoracic tuberculosis affecting the lung parenchyma; airways; vessels; mediastinum; pleura; and chest wall

Profil radiologique des traumatismes metaphyso-epiphysaires des membres de l'enfant a Yaounde - Cameroun

OBJECTIFS :Rapporter la distribution des lesions radiologiques des traumatismes epiphyso-metaphysaires des membres de l'enfant a Yaounde : MeTHODES etude descriptive; hospitaliere realisee dans les services de radiologie et des urgences du Centre Hospitalier et Universitaire (CHUY) et de l'Hopital Central de Yaounde (HCY). Les radiographies standards de 100 enfants faites pour un traumatisme des membres durant la periode d'etude ont ete revues. Les lesions radiographiques ont ete regroupees selon la classification de SALTER-HARRIS. Les autres donnees recueillies etaient l'age; le sexe; l'etiologie de la lesion et les lesions associees du squelette.ReSULTATS : Il y avait 66 garcons (66) et 34 filles (34). L'age moyen des sujets etait de 11.5 ans (ecart type : 3.28). Le traumatisme etait du dans 62 des cas a un accident de la voie publique. Le membre superieur a ete trois plus atteint que le membre inferieur. Les fractures etaient en regle non ou peu deplacees (96; fermees et avec conservation de l'anatomie regionale normale. Selon la classification de Salter et Harris; 70) de sujets etaient de type II; 12 de type IV; 7 de type III; 6 de type I et 1) avaient des lesions significatives des parties molles; qui ont ete mises en evidence par echographie. CONCLUSION : Les lesions traumatiques metaphyso-epipysaires des membres de l'enfant interessent avant tout le garcon et elles sont dues a des accidents de la voie publique ou a des accidents sportifs. La majorite de lesions sont de type II. La radiographie standard et l'echographie sont suffisantes pour la prise en charge de ces lesions

The Frequency of Various Indications for Plain Chest Radiography in Nnamdi Azikiwe University Teaching Hospital Nnewi (Nauth)

Background: With soaring advances in the field of medicine; the place of older radiologic imaging modalities is being reduced to basic screening tools. Yet the modern imaging modalities like computerized tomography (CT); magnetic resonance imaging (MRI); ultrasound and nuclear medicine are hardly available.Study Objectives: To study the frequency of various indications of plain chest radiography; remind us of its uses and to enhance the preparedness of the department to maximally accomplish the ideals of this investigation.Methodology: A total of 1476 consecutive patients for chest radiography in the department of radiology; NAUTH; Nnewi from the period of February 2009 and whose request form contain adequate data were recruited for this study. These data were analyzed using SSPS.Results: A total of 1476 patient were included in this study. There was female preponderance with male to female ratio of 1.3:1. Mean Age of the patients is 39.32 years (std19.56). The most frequent indication for chest radiography is certain infections and parasitic diseases (40.9 and the greatest source of referral for this study is General outpatient (GOPD)/family medicine department.Conclusion: The most frequent indications for chest radiography in the study are certain infection and parasitic diseases. Chest Radiography is the most frequent plain radiography study in our environment where infectious diseases are still very rampant. This makes chest radiography an important study for screening patient for possible diagnosis and classifying the need for further radiographic investigation of our patients

Grossesse et risques d'irradiations en radiodiagnostic : etat des connaissances des usagers au CHU de Yopougon

Objectifs : Evaluer l'etat des connaissances des usagers et des professionnels de la sante sur les risques d'irradiation de la femme enceinte au cours des explorations radiologiques et l'observation de l'application des regles de radioprotection relative a la femme enceinte par les utilisateurs de rayons X. Materiel et methodes : Notre etude prospective; realisee au CHU de Yopougon; a dure 6 mois. Nous avions interroge 60 femmes en grossesse ou susceptibles de l'etre; 30 medecins prescripteurs non radiologues; 29 techniciens d'imagerie medicale et 21 aides soignants sur les risques d'irradiation et les mesures de protection de la femme enceinte avant et pendant la realisation d'un examen radiologique utilisant les rayons X. Resultats : 73;68des medecins prescripteurs n'avaient pas de culture en radioprotection chez une femme enceinte ou en age de procreer. 93;10des patientes enceintes ou en age de procreer ignoraient l'existence des rayons X en radiodiagnostic et leur nocivite pour une femme enceinte ou susceptible d'etre enceinte. 80des manipulateurs de radiologie respectaient pas les regles elementaires de radioprotection. Conclusion : La sensibilisation des usagers des rayons X sur les risques d'irradiations chez une femme enceinte ou susceptible de l'etre est necessaire au CHU de Yopougon

Role of Radiology in Infectious Diseases; HIV/AIDS Overview

"INTRODUCTION: Since the first case of HIV/AIDS appeared in USA and Africa more than two decades ago; the incidence of HIV/AIDS has continuously been increasing worldwide. It is estimated that 42 million people lived with HIV/AIDS in 2009 among whom 29.4 million (70) were in Sub-Saharan Africa. Since there is no cure or vaccine presently available or in sight in near future; the current treatment strategy is to treat the opportunistic infections and HIV associated conditions. Developing countries account for about 60of prevalence and 90of new infections arise in the poor countries.2 In Africa the ""worst case"" scenario projections in the next 20 years are that: One quarter of the workforce will die; life expectancy will decrease from average of 63 to 47 years and 14 million children will be orphaned. OBJECTIVES: Emphasis on Diagnostic Imaging as the mainstay of management of patients with HIV/AIDS and related diseases. Demonstration of the role of radiology in the evaluation of patients; as guidance in interventional procedures such as drainages and biopsies as well as in the follow up of patients. Establishment of correct diagnosis of HIV associated conditions as they are very important so that patients can get appropriate treatment and less expenses are incurred during management. METHODOLOGY: This paper is a product of reviewing manuscripts and data available in journals;books and internet as stipulated in the reference section. The role of radiology in diagnosing and treating HIV/AIDS manifestations in each body system: HIV/AIDS spares no organ or system hence all radiological modalities have a role to play in the diagnosis and follow up of HIV/AIDS patients as is demonstrated in this imaging summary."

Learning Radiology in an Integrated Problem-Based Learning (PBL) Curriculum

Background: The Faculty of Medicine (FoM) has been training health professions in Uganda since 1924. Five years ago; it decided to change the undergraduate curriculum from traditional to Problem Based Learning (PBL) and adopted the SPICES model. Radiology was integrated into the different courses throughout the 5 year program. The objective was to improve the implementation of the integration of Radiology in the integrated PBL curriculum. Methods: This was a cross sectional descriptive study of radiologists and medical students using interviews and semi-structured questionnaires respectively. Results: Radiologists' and students' perceptions and opinions on Radiology training were gathered. A Radiology training rationale was developed. Learning outcomes for Radiology were defined and learning formats were chosen. Learning materials were identified and strategies to improve the implementation were formulated. Conclusions: This work has culminated into changes in Radiology integration in the curriculum and training at the FOM

Residents' Perception of Postgraduate Radiology Training in Nigeria

BACKGROUND: Literature on radiology residency in Nigeria is sparse; even for decades after its commencement. There is therefore the need to inquire into the problems and prospects of the programme; at least from the perspectives of the residents. OBJECTIVE: To determine residents' perception of the radiology residency programme; residents' view on state of facilities; and their opinion on the future of radiology training in Nigeria. METHODS: Self-administered semi-structured questionnaires; were given to residents to complete. Contacts were made with residents during update courses and radiologists' conferences or meetings. RESULTS: One hundred and twenty-five questionnaires were given out and 120 were completed and returned; giving a response rate of 96. Fifty-eight (48) respondents mentioned academic interest as the major influencing factor for enrolling into the programme. Only 20 (16) residents had made up their minds to do radiology residency as medical students. All the residents identified conventional radiography and ultrasound as the only regularly functioning modalities in their centres; while 72 (60) respondents mentioned same for cross sectional imaging modalities; that is CT and MRI. One hundred and ten (90) respondents had rotation through available modalities as the plank of their training programmes; and 96 (80) did not feel happy about the state of teaching aids at their centres. Ninety-six (80) of the residents expressed satisfaction at the efforts of the supervisory postgraduate medical colleges at organising update courses. Eighty respondents (65) mentioned limited (or lack of) exposure to modern imaging modalities as the greatest threat to the future of radiology residency in Nigeria. CONCLUSION: Nigerian radiology residents are concerned about lack of modern imaging tools; facilities at their centres; as well as opportunities for exposure overseas; and the likely impact of these on their training and the future of the specialty in Nigeria

Clay as Thermoluminescence Dosemeter in Diagnostic Radiology Applications

As part of efforts to isolate and utilize local and naturally occurring materials for development of thermoluminescece dosemeters and other technologies; an earlier report had shown that Nigerian clay showed prospects of utility as a thermoluminescence dosemeter (TLD). This paper reports the investigation of the basic thermoluminescence properties of clay at x-rays in the diagnostic radiology range; including dose monitoring in abdominal radiography. Clay sourced from Calabar; Nigeria; was tested for thermoluminescence response after irradiation at diagnostic radiology doses; including application in abdominal radiography dose monitoring in a clinical setting. Results show that thermoluminescence (TL) output in natural clay is very low; but demonstrates enhanced performance with the addition of common salt. Specific TL characteristics of good repeatability for individual and batched pellets (variability index of 3.08) and a high degree of trap emptying were observed. It had a glow curve peak at 275 C; with traces of spurious thermoluminescence emission at the reader anneal temperature. There was evidence of good batch homogeneity ( 30) and a similar pattern of dose absorption in abdominal radiography with commercial Lithium Fluoride (LiF TLD-100). A high fading rate (over 30in twelve hours) and low sensitivity (12 times less than LiF TLD-100) however; signal the unacceptability of clay as aTLD in diagnostic radiology in the forms studied. Clay demonstrates poor TL response at diagnostic radiology doses. However; it's water absorbing property offers a means of overcoming the hygroscopic nature of common salt. This could be explored to improve the use of sodium chloride as a radiation detector

The Role of Interventional Radiology in Modern Medical Practice

This is a subspecialty in diagnostic Radiology; which involves the use of minimally invasive targeted treatment options to manage various medical conditions; under imaging guidance. This treatment method is less invasive compared with surgery and most times does not require general anesthesia. They are most often done as outpatient treatment with reduced morbidity; mortality and shorter off duty period

Safety Awareness in Selected X-ray Diagnostic Centres in Surulere and Ikeja Local Government Areas of Lagos State; Nigeria

Background: Health hazards are associated with exposure to ionizing radiations such as x-rays. Many private x-ray diagnostic clinics in Lagos State operate with inadequate safety and protection devices; which make the conditions unsafe to patient and environment. Objective: To assess the working conditions; protection measures put in place; safety awareness and attitudes of both employees and employers to safety and protection in radiodiagnostic centers in Surulere and Ikeja Local Government Areas.Methodology: Questionnaires were used for collecting information on socio-demographic data; occupational history; activities; working conditions; knowledge and experience of radiation hazards in x-ray centers. Interviews were conducted with Heads of Departments and Radiologists using the checklist adapted from the International Atomic Energy AgencyResults: 88.9 of the participating centers had adequate space and some safety assessment performed prior to installation of the facility. 81.5 had few basic protection devices. Only 40.7employed adequate and qualified staff while 25.9 provided personnel training and 22.2 had quality control programme. 14.8 had radiation protection programme. 60.2of respondents were aware of health hazards associated with radiation exposures; 57.8 of which were males. Conclusion : Operation conditions in most private diagnostic centers are below standard due to grossly inadequate provision of safety and protection devices. Employment of qualified staff and continuous education need be emphasized and enforced

The paediatric suprasellar cistern as an important CT review area

Pathology affecting the suprasellar cistern is varied in paediatric neuroradiology practice. Although MRI is the imaging modality of choice for lesions of the suprasellar cistern; abnormalities can be detected on CT with knowledge of the normal anatomy and a sound approach to the possible pathological entities. We present our approach to pathology affecting the suprasellar cistern and highlight this using various cases seen at our institution in the recent past