Some peculiar lesions of traumatic brain injuries encountered in our practice with brief discussion-imaging manuscript

The advent of neuroimaging like computed tomography and magnetic resonance imaging has facilitated the diagnosis of traumatic brain injuries. Emphasizing certain diagnostic features of some peculiar traumatic brain injuries. The following lesions of traumatic brain injuries were pictorially depicted, namely Tension pneumocephalus, Blow out orbit, Bilateral subacute subdural haematomata, Acute-onchronic subdural haematoma, Middle cranial fossa acute epidural haematoma, Traumatic basal ganglial haematoma and Acute intra-ventricular haematoma. Mount Fuji sign is typical of tension pneumocephalus while herniation of extra-ocular muscles into the maxillary sinus is diagnostic of blowout orbit. Rabbit ear appearance is observable in bilateral subacute subdural haematomata

Clinical practitioners' knowledge of ionizing radiation doses in diagnostic radiology examinations in Calabar.

Background: Observation has shown a preponderance of irrelevant, unjustified and perhaps unnecessary radiological requests in the study area. The consequences of this on the patients' doses and population collective dose may be dire. Objective: To assess Clinicians/Referrers' knowledge of radiation doses of patients undergoing radiological examinations. Methodology: A prospective, non-experimental, cross-sectional survey of clinicians (except radiologists) in various hospitals in Calabar metropolis, Cross River State, Nigeria, was conducted. A pretested and validated questionnaire was designed to extract responses on rating of effective doses for commonly requested imaging examinations, using the value for the posterior-anterior (PA) chest x-ray as reference. Questions on radiosensitivity of different organs, imaging modalities that use ionizing radiation and considerations for the choice of ionizing radiation (IR) based examinations were included. Participants were also asked for their preferred methods of filling any knowledge gap on IR issues. Responses were presented in simple percentages. Results: A total of 104 respondents, made up of 63.5% males and 36.5% females participated in the study. At least 70% and 42% of the respondents, respectively, were aware that Ultrasound and Magnetic Resonance Imaging were not IR based modalities. About 67.3% of the respondents did not know the doses of commonly requested radiological examinations. This result was not dependent on clinicians' demography. A total of 61.5% of the respondents referred patients for IR examinations even when the result was unlikely to alter their diagnosis or treatment; but to reassure the patient (98.8% ), meet expectations of patients (35%) or to give the patient the feeling of being taken seriously (75%). Conclusion: Participating Clinicians in this study have showed poor knowledge of radiation doses of commonly requested radiological examinations. Most participants suggested improvement of their knowledge of radiation doses through continuous medical education and by the provision of referral guidelines.

Effect of x-ray exposure (mAs) on peroxide and acid values of honey.

Honey is used in most places as food sweetener and antibacterial agent for wounds. The antibacterial property of honey depends mainly on its peroxide value and acidity. This study investigated the possible effect that may be observed on the peroxide value and acidity if honey is exposed to x-ray at varying tube current values (mAs) in order to infer the possible implications of referring patients undergoing honey therapy for diagnostic x-ray examination. The acid and peroxide values were found to vary with changes in the exposure (mAs) value. It is therefore recommended that patients undergoing honey therapy should be referred for diagnostic x-ray examination with caution while radiotherapy should be avoided.

Diverse blood exposures associated with incident HIV infection in Calabar, Nigeria.

Few types of blood exposures have been assessed in relation to incident HIV infection in sub-Saharan Africa, despite evidence that penile-vaginal sex cannot account for the epidemic in the region. To investigate correlates of incident HIV infection in Calabar, Nigeria, we surveyed clients at voluntary HIV counselling and testing centres. Participating clients who tested multiple times were generally similar to those testing only once in terms of demographic characteristics, sexual and blood exposures and HIV prevalence. Blood exposures were common. Serial testers had a 10% annual incidence of HIV infection. Seroconverters and seronegative serial testers were similar on most demographic characteristics and sexual exposures. However, seroconverters were more likely than seronegatives to report blood exposures during the test interval, both for most specific exposures as well as summary measures of blood exposures. In particular, seroconverters were substantially more likely to report one of a set of blood exposures that cannot be explained as a consequence of unprotected vaginal sex or of health care for symptoms of HIV infection (adjusted odds ratio = 6.6, 95% confidence interval = 1.2-38). The study design we used is an inexpensive approach for describing the local epidemiology of HIV transmission and can also serve as the foundation for more definitive investigations that employ contact tracing and sequencing of HIV DNA.

Combined effects of temperature changes and radiation absorption on living tissue.

BACKGROUND: The need for the development of criteria for the referral of patients for radiographic examinations, especially in the face of the results of separate studies on temperature and radiation effects, formed the background to this study. The aim of this study is to determine the possible consequences of low dose radiation to living tissue in the presence of elevated temperatures, with a view to developing referral criteria for patients scheduled for radiodiagnostic examinations. METHOD: A two part procedure in the form of x-irradiation of water phantom at temperatures ranging from 25 and 45 degrees Celsius, to assess absorbed dose with temperature variation, as well as histological study of living tissue extracted from the skin and lungs of experimental animals, exposed to x-radiation at kilovoltage range between 50 and 90 and temperature values between 25 and 45 degrees Celsius. RESULTS: Results showed increased radiation absorption with rising temperature in the studied samples suggesting that radiation absorption and therefore effects, may be functions of the temperature of the absorbing medium, being more pronounced at higher temperatures, even at constant exposure. CONCLUSION: A combination of elevated temperatures and x-radiation, even at diagnostic exposures doses, may not be safe for patients, especially in paediatric radiography patients presenting with body temperatures in the neighborhood of 40 degrees Celsius. The application of this as a radiation protection measure in the use of ionizing radiation is recommended, especially where highly dividing tissue is involved.

Effect of delayed film processing and milliamperage changes on image quality

A study of the effect of delayed clinical processing and milliamperage changes on image quality was carried out at the Radiology Department; University of Calabar; Nigeria; using filmstrips exposed to x-radiation at milliamperage (mA) values of 50; 100; 200; 300; 400 and 500. Exposed film strips were processed over varied post exposure; peprocessing keeping times ranging from 0 hours (control) to the 18th day. Results show progressive decrease in optical densities measured on the film; with prolonged pre-processing keeping time; and this is more marked at low (50) mA procedures; and is less in high (500) mA procedures; at which mA also; the onset was highly delayed (commencing about the 12th hour). The implication of this in a developing economy is discussed

Assessment of chest radiographs for quality assurance and radiation protection

A retrospective study of 1000 chest radiographs randomly selected from various government and private owned hospitals in the southern part of Nigeria covering a period of twenty years was carried out. Accuracy in patient positioning; beam collimation and identification of radiographs were assessed as indicators for quality assurance and radiation protection. The result showed that for male 59 were rotated and 41 were not. For the female; 60 were rotated while 39 were not. 95.30 radiographs were inadequately collimated; and 69.30 were properly identified. This suggests poor quality and exposure of patients to unnecessary radiation though more attention was paid to identification of radiographs