Prevalence of abnormal umbilical arterial Doppler indices in apparently normal pregnancies in Calabar.

Intrauterine growth restriction (IUGR) may occur in the presence of normal fetal growth parameters, with resultant unanticipated perinatal morbidity and mortality. Umbilical arterial Doppler evaluation determines the fetuses susceptible to compromise by detecting IUGR early enough for successful intervention measures to be implemented. This study was aimed at determining the prevalence of abnormal umbilical arterial Doppler indices (UADI) in apparently normal pregnancies and to assess its correlation with amniotic fluid index (AFI). In this prospective cross-sectional study, obstetric sonographic examination and UADI evaluation were done on 310 apparently normal pregnant women between 26 to 40 weeks within a 6-months period. Abnormal UADI had a prevalence of 10.3%. Educational level (P = 0.000) and employment status (P = 0.000) were significantly associated with abnormal UADI. Abnormal umbilical arterial resistivity index (RI) had a significant correlation with EFW (P = 0.000) and HC/AC (P = 0.000) but no significant relationship with AFI (P = 0.593). The prevalence of abnormal umbilical arterial Doppler indices was high in apparently normal pregnancies mostly among women with low socio-economic status, with no demonstrable association with AFI.

An audit of the appointment booking system and patient waiting time in an ultrasound unit in Nigeria: A need to eliminate congestion in our public hospitals.

BACKGROUND: Congestion of patient waiting areas at commencement of work is the usual scenario in Nigeria's public hospitals. This strains the personnel and facilities. Patients are dissatisfied and lose faith in the system. This study aims to audit the booking system, patient waiting time, and causes of congestion in an ultrasound unit. MATERIALS AND METHODS: This is a prospective, descriptive study involving 350 patients referred from general outpatient and specialist clinics to the ultrasound unit, twice weekly for 6 weeks. Patients were grouped into two: those with scheduled appointments and the unbooked. The time of scheduled appointment and arrival in the unit and the time of commencement and conclusion of the examination were recorded. RESULTS: Three hundred and eighteen patients had scheduled appointments, while 32 were unbooked. Half of the later were emergencies and the other half were walk-ins. There was no consistency in number of slots and block size. Large blocks of over 20 patients were observed on 33.3% of the days and 51.26% of the patients were given 8:00 am appointments. The average patient waiting time is 132.11 minutes but range from 62 to 220 minutes daily. The radiologists resumed work between 8:17 and 9:29 am each scan day. The average waiting time is shorter for patients who arrived after 11:00 am. CONCLUSION: Ineffective booking of appointments and Sonologist's tardiness are major predisposition to congestion. Appointments in small blocks at 30 minutes intervals will eliminate congestion, reduce patient waiting time, and improve satisfaction. Point-of-care ultrasound should be introduced in outpatient clinics.

Intimate patient examinations: The awareness, acceptance and practice preference of transvaginal ultrasound scan among women in a South-southern State of Nigeria.

BACKGROUND: Transvaginal ultrasound scan (TVS) is a relatively new routine intimate examination in Nigeria carried out only in fertility clinics, specialist radio-diagnostic centres and a few public hospitals. It is a procedure, which many patients find intrusive and may result in anxiety. The gender of the practitioner and the presence of a third person in the room may influence patient's acceptance to undergo the procedure. Centres offering this service do not routinely ask for the patient's opinion, which negates the patient-centred care principle. The aim of this study is to assess women's awareness, acceptance and practice preference of TVS to get their opinion about the preferred gender of sonologist and presence of a third person during the procedure in comparison to other intimate examinations. MATERIALS AND METHODS: It is a questionnaire-based prospective survey involving women referred for various indications to the radiology department of a Navy Hospital in south-southern Nigeria for 1 month. RESULTS: We recruited 204 women. Although only 20.6% knew about TVS, 98.5% accepted to undergo TVS. Forty-six percent were indifferent about the gender of the sonologist, while 45% and 9% preferred a female and a male, respectively. About 50.3% wanted a third person in the room during the TVS and majority preferred their husbands (44.7%) to a chaperone (35.8%). CONCLUSION: The awareness of TVS is low, but it enjoys wide acceptance. Patient's preference for practitioner's gender and chaperone use are variable similar to findings from other intimate examinations, so consent should be sought before the procedure.

An audit of the completion of radiology request forms and the request practice.

OBJECTIVE: To assess the degree of utilization of the radiology request form (RRF), the extent of completion each form, the frequency of filling the fields in all the forms, and its effectiveness as a communication tool between the referring clinicians and radiologists. MATERIALS AND METHODS: All the RRFs for conventional radiographic examinations were audited over a 3-month period. A database containing all the fields in the form, type of request paper used, and legibility of the physician's handwriting was created. A few resident radiologists in the plain film reporting unit were recruited to join in collecting the data daily. We used simple statistical methods to analyze the extent of completion of each form, frequency of completion of the fields in all the request forms, frequency of use of the appropriate form, and frequency of legibility of the physician's handwriting. The results are expressed in percentages. RESULTS: Five hundred eighty (580) requests were analyzed, consisting of 180 for males and 400 for females. The most-completed request form was 86.67% filled, while the least-completed was 26.67%. The most frequently filled field was the requested examination (99.66%). Of the clinicians, 28% did not use the RRF for their referrals, while 7.37% had illegible handwriting. CONCLUSION: A significant number of the referring clinicians did not make the best use of the radiology department by not using the institution's approved RRF as an effective means of communication with the radiologists, mainly due to the inadequate completion of the forms.