Clinical and Laboratory Profile of ARV Naive HIV Infected Children in the Era of Highly Active Anti-retroviral Therapy in Enugu, South-East Nigeria.

Background: HIV/AIDS is one of the most dynamic epidemic infectious diseases. An estimated 1000 children are newly infected with HIV every day, most of them in sub-Saharan Africa. They often present with various clinical and laboratory manifestations that complicates their management. Objectives: To determine the baseline clinical and laboratory features of HIV-infected children presenting at the University of Nigeria Teaching Hospital (UNTH) Ituku/Ozalla. Methods: Clinical and laboratory data were collected from HIV infected children seen at the Pediatric HIV Clinic of UNTH between July 1st 2010 and June 30th 2012. Clinical and immunological staging of the patients were done using the WHO criteria and data analysis was with SPSS version19. Results: Two hundred and ten children were enrolled into the study. The most common route of HIV infection was vertical transmission (95.2%). Common presenting clinical and laboratory data were: anaemia (92.9%), cough (76.2%), fever (63.3%), popular rash (62.9%) and poor weight gain (61.0%). Thirty-four children (16.2%) each had severe and moderate acute malnutrition while 92 children (43.8%) were stunted. Tuberculosis, hepatitis B and C co-infections were seen in 32.4%, 1.9% and 3.3% of the children respectively. Most of the patients had either a WHO clinical stage III (42.4%) or II (39.0%) disease. Severe immunosuppression based on CD4% or count was seen in more than half of the patients (59.1%). Conclusions: Anaemia was the most common clinical/laboratory finding; followed by cough. Although our patients were likely to present with WHO clinical 2 or stage 3 disease, severe immunological suppression was common.

Women's perception of transvaginal sonography in a tertiary hospital in Nigeria

Available studies suggest that pregnant women's views on the desirability of routine ultrasound are influenced by their perceptions of its potential benefits and concern about possible adverse effects. To assess women's views of transvaginal sonography and to determine any correlation between their perception of the procedure and their prior knowledge and experience of it. Radiology department, federal medical centre, Asaba, Niger Delta, Nigeria. We surveyed women presenting with various gynecologic problems or complications of the first trimester. Data collection was by self-administered questionnaires using convenience sampling technique on women attending the clinic over a period of one year. Only women who had transvaginal sonography were included. A total of 250 women were recruited and interviewed. Transvaginal sonography was considered not embarrassing by 76%, acceptable by 86%, not painful by 87.2% and not stressful by 82% of the women. There were no statistically significant differences in the women's perception of the procedure whether they had prior knowledge and previous experience of the procedure or not [P > 0.05]. The majority of the women perceived transvaginal sonography favourably. Their perception of the procedure was favourable whether they had prior knowledge and previous experience of it or not

Latex Glove Sensitivity amongst Diagnostic Imaging Healthcare Personnel: a Study in Southeastern Nigeria

The paper reports a cross-sectional study to determine the prevalence and type of symptoms; causal agents and awareness of latex glove reactions amongst four professional groups. The study was done at diagnostic imaging departments within ten major hospitals in Southeastern Nigeria. Radiologists/resident radiologists; radiographers; radiology nurses and darkroom technicians who were occupationally exposed to latex gloves were investigated between June and September 2006 to determine the level of latex hypersensitivity. The results show that prevalence is similar to that demonstrated elsewhere with 12.4of individuals expressing latex associated symptoms. Symptoms included itching and redness of hands; dry cracked skin; soreness of eyes; and upper respiratory tract complaints. There are strong relationships between number of gloves used per day; duration of glove use and expression of symptoms. About 62.8(n=76) of the respondents had previous knowledge of hypersensitivity reaction to latex gloves prior to this investigation. The paper concludes that latex hypersensitivity is a real problem amongst diagnostic imaging healthcare personnel in our locality. This preliminary work; therefore; provides the basis of a much larger controlled study in the future

Radiation Protection Practices of Staff During Extra-Corporeal Shock Wave Lithotripsy at Okada, Nigeria

Background: The study was designed to find out the radiation protection practices of radiologists and other staff involved in the first extra-corporeal shock wave lithotripsy in Nigeria, performed at Igbinedion Hospital and Medical Research Centre, Okada. Methodology: Some members of staff who were present when the extra-corporeal shock wave lithotripsy (ESWL) was used in the hospital at Okada were interviewed between November 2002 and August 2003. Radiology records of the hospital were studied. Literature search involved available publication on the procedure in local and international journals with interest in precautions to reducing radiation exposure. Results: Only lead apron and lead gloves were used by the radiologists for radiation protection and shielding during fluoroscopy procedures. The fluoroscopy was the screen type with TV monitor. Multiple sessions were used in several patients with multiple pre- and post- treatment radiographic studies including contrast studies with average of two sessions per patient. All the patients were adults aged between 26 and 65 years with mean age of 42.5 years. 627-6000 shock waves were delivered over 45-135 minutes at intensity of 143-19KV depending on patients build and the size of the stones. The sizes of the patients varied from very obese with large bulk to slim built. Radiation monitoring of the staff and patients was not done. Staff believed that radiation effect from the lithotripsy procedure was low therefore adequate radiation monitoring and radiation reducing alteration in the procedure was rarely adopted. Conclusion: Extended fluoroscopy time, multiple fluoroscopy examinations, multiple treatment sessions and multiple x-ray examinations which increased both the patients/' and staff/'s radiation exposures were noted. Proper radiation protection and monitoring of patients and staff are necessary to avoid the risks from low-level exposure to radiation such as in ESWL

Relationship between sonographic renal length and renal parenchymal thickness in normal adult southeast Nigerians

Aim: To determine the relationship between sonographic renal parenchymal thickness (RPT) and renal length (RL) in normal adult Nigerian. Study design: The RL and RPT of 309 normal subjects within the age range of 18 - 80years were measured sonographically and prospectively. Correlation was performed between RL values and RPT using Pearson Linear `r' test Results: The range of RL value were 8.5-12.9cm and the corresponding mean were 10.33+ 0.7cm and 10.45+ 0.63cm for the right and left kidneys respectively. The range of values for the RPT was 1.40 - 2.4 and the corresponding mean values were 1.91+ 0.20cm and 1.95+ 0.19cm for the right and left kidneys respectively. There was a strong positive correlation between RPT and RL (r = 0.72 and 0.77 for the right and left kidney respectively. However for RL values above 11.0cm the RPT values fluctuated. Conclusion: From this study; for RL above 11.0cm there was no relationship with RPT. The study suggests that for our population groups; kidneys with RL lower than 8.5cm and RPT of 1.40cm or less should not be biopsied in contrast to webb's criteria

Survey of patient satisfaction with obstetric ultrasound service at University of Nigeria Teaching Hospital; Enugu; Nigeria

A semi-structured questionnaire study of 326 randomly selected pregnant women referred for ultrasound examination at the ultrasound Laboratory of University of Nigeria Teaching Hospital (UNTH); Enugu was undertaken. The main objectives of this survey included assessment of women's perception and satisfaction with obstetric ultrasound service at UNTH; Enugu and to reflect on our practice. Questions were asked about gestational age; reasons for the scan; information provided before and during the scan; the women's expectations when attending for the scan; their waiting time; their opinion regarding the scan service and suggestions to improve services. Results showed that majority of the patients (66; N = 215) were not given adequate in formation required to make a knowledgeable decision about their scan. Large number of the women (67.5; N = 220) waited for a long time (1-4 hours) before their scan. About half of the respondents (53; N = 173) were satisfied with the way the result of the scan was communicated to them. Results suggest that full implementation of informed consent; reduced waiting time; better communication; explanation and counseling of scan findings to patients would improve the quality of our obstetric ultrasound service