Prevalence of Silent Gallstones on Ultrasound in a Nigerian Population.

BACKGROUND: Gallstones detected incidentally during imaging are termed 'silent' or asymptomatic gallstones and they account for 80% of all gallstones. About 1-2% of patients with silent gallstones develop symptoms yearly; however, determining those who will develop symptoms is a major challenge. Ultrasonography is the most sensitive and specific method of detecting gallstones with an accuracy greater than 95%. The study aims to determine the prevalence of ultrasound-diagnosed silent gallstones in a Nigerian population and to determine its association with age and gender. METHODS: This was a retrospective analysis of abdominal ultrasound scans performed at the Radiology department of a tertiary institution between January 2013 and December 2015. Data retrieved included age, sex, and sonographic findings. Data analysis was done by simple proportions and percentages using the Statistical Package for Social Sciences version 20.0 software. RESULTS: Two thousand, one hundred and thirty-eight patients had abdominal ultrasound scans for various reasons during the study period. These included 915 males and 1223 females. Incidental findings of gallstones were observed in 52 patients, giving a prevalence of 2.4%. The prevalence of gallstones increased with age (p=0.051) with the highest prevalence seen in the 5th decade. Gallstones prevalence was higher in females with a male-to-female ratio of 1:3.5. CONCLUSION: The prevalence of silent gallstones is low in our environment, but given the complications that may arise, follow-up for early detection of complications in the patients is therefore strongly recommended.

CONTEXTE: Les calculs biliaires détectés fortuitement lors de l'imagerie sont appelés calculs biliaires "silencieux" ou asymptomatiques et représentent 80% de tous les calculs biliaires. Environ 1 à 2 % des patients atteints de calculs biliaires silencieux développent des symptômes chaque année ; cependant, déterminer ceux qui développeront des symptômes est un défi majeur. L'échographie est la méthode la plus sensible et la plus spécifique pour détecter les calculs biliaires avec une précision supérieure à 95 %. L'étude vise à déterminer la prévalence des calculs biliaires silencieux diagnostiqués par échographie dans une population nigériane et à déterminer son association avec l'âge et le sexe. MÉTHODES: Il s'agit d'une analyse rétrospective des échographies abdominales réalisées au service de radiologie d'un établissement tertiaire entre janvier 2013 et décembre 2015. Les données récupérées comprenaient l'âge, le sexe et les résultats échographiques. L'analyse des données a été faite par proportions et pourcentages simples à l'aide du logiciel Statistical Package for Social Sciences version 20.0. RÉSULTATS: Deux mille cent trente-huit patients ont subi une échographie abdominale pour diverses raisons au cours de la période d'étude. Il s'agissait de 915 hommes et de 1223 femmes. Des calculs biliaires ont été observés chez 52 patients, soit une prévalence de 2,4 %. La prévalence des calculs biliaires augmente avec l'âge (p=0,051), la prévalence la plus élevée étant observée au cours de la cinquième décennie. La prévalence des calculs biliaires était plus élevée chez les femmes avec un ratio homme/femme de 1:3,5. CONCLUSION: La prévalence des calculs biliaires silencieux est faible dans notre environnement, mais compte tenu des complications qui peuvent survenir, un suivi pour la détection précoce des complications chez les patients est donc fortement recommandé. Mots-clés: Calculs biliaires silencieux, Échographie, Nigérian.

RETROSPECTIVE EVALUATION OF MRI PATTERN OF GLIOBLASTOMA IN A TERTIARY HOSPITAL IN NIGERIA.

Introduction: Malignant gliomas, especially glioblastomas, are among the most aggressive and devastating of cancers, commonly producing profound progressive disability and leading to death in most cases. Conventional magnetic resonance (MR) imaging with gadolinium-based contrast agents is the most widely established and most useful tool in the characterization of cerebral tumors including Glioblastomas. This study aims to describe the imaging characteristics of Glioblastoma in African patients using conventional MR imaging. Methodology: This was a retrospective cross-sectional study carried out at a Nigerian tertiary hospital. The demographic data, MR images and reports of patients with imaging and histological diagnosis of Glioblastoma between January 2003 and September 2017 were retrieved and reviewed. All the recorded data were analyzed using simple proportion and descriptive statistics with the Statistical Package for Social Sciences (SPSS) version 20.0 software for Windows. Results: One hundred and twenty-two (122) patients had brain tumors during the review period, out of which 14 (11.5%) had histologically confirmed glioblastoma. The male- to -female ratio was 2.5 to 1.0. The age ranged between 14 and 72 years with a mean age of 49.6 years SD ±16.3. Twelve (85.7%) patients had solitary tumors and 2 (14.3%) had multiple tumors. Six (42.9%) were found on the right hemisphere only, 5 (35.7%) were found on the left hemisphere while 3 (21.4%) traversed both hemispheres. All tumors showed inhomogeneous enhancement and significant midline shift to the contra-lateral side of greater than 3mm. Only 1 (7.1%) tumor showed evidence of intra-tumoral bleed detected on T2* sequence. Conclusion: Glioblastoma is a known aggressive brain tumor with unique MR imaging characteristics. While midline shift is typical, intra-tumoral bleeding may be an uncommon finding at presentation in our center.

Evaluating Ultrasound Determined Thyroid Volume as a Predictor of Newborn Thyroid Hormone Function.

BACKGROUND AND OBJECTIVES: Congenital hypo-thyroidism is a cause of intellectual and developmental disabilities in the newborn. Early screening and prompt treatment can prevent the devastating outcomes of congenital hypothyroidism. The disease burden of congenital hypothyroidism in Nigeria is higher than in many parts of the world. Using ultrasound, the authors sought to determine the normal mean thyroid gland volume in newborns and establish the thyroid gland volume as a predictor of thyroid hormone function in the newborn. METHODS: This was a descriptive cross-sectional study. Healthy newborns had their length and weight measured, thyroid ultrasound scan performed, and a blood sample taken for thyroid-stimulating hormone values. RESULTS: The mean total thyroid volume was 0.51cm3 ± 0.25. The thyroid volume of the right lobe (mean volume= 0.27cm3 ± 0.13) was significantly larger than the volume of the left lobe (mean volume =0.24cm3 ± 0.12) (p<0.001). The thyroid-stimulating hormone (TSH) values ranged from 1.36µIU/ml to 35.03µIU/ml with a mean value of 7.73µIU/ml ± 7.04. There was no significant correlation between the thyroid volumes and the TSH of the newborns. CONCLUSION: This study determined the mean thyroid volume in newborns. There was no significant correlation between the thyroid volumes and the TSH values of the newborns implying that the thyroid gland volume is not a reliable predictor of thyroid hormone function. Newborn, Ultrasound.

Rational use of medicines: assessing progress using primary health centres in Shomolu local government area of Lagos, Nigeria.

BACKGROUND/OBJECTIVE: Medicines (drugs) are a critical component in the prevention and treatment of diseases. Their rational use is important to maximize their benefits and prevent undesirable effects. This study was conducted to assess progress with rational use of medicines at primary care level using recommended indicators. METHODS: The cross-sectional descriptive study was conducted in four primary health centres in Somolu Local Government Area (LGA) of Lagos State, Nigeria. It employed retrospective and prospective data collection methods. From the four centres, prescription notes of 600 clinical encounters spanning one year were analyzed for prescribing indicators and a checklist was administered for facility indicators. RESULTS: For the 600 clinical encounters studied, 2802 drugs were prescribed. The mean number of drugs per encounter was 4.7 ± 2.1; 75.6% of drugs were prescribed by generic name; prescriptions containing at least an antibiotic averaged 48.5%, while those with at least an injection prescribed were 21%. Of all the drugs prescribed, 83.2% were from the National Essential Drugs List (NEDL). On the average, 86.5% of key essential drugs were available in the health centres but none of the centres had a copy of the NEDL or drug formulary. There were wide variations in some of the indicators across the four facilities. CONCLUSION: The study showed progress in some indicators when compared with previous studies but gaps still exist. We recommend training on rational use of medicines for health workers in the facilities and distribution of copies of NEDL to all the facilities.

Awareness and knowledge of glaucoma among workers in a Nigerian tertiary health care institution.

PURPOSE: The aim of this study reports the level of awareness and knowledge of glaucoma among selected health care personnel at a health institution in southwestern Nigeria. MATERIALS AND METHODS: Health personnel at the Federal Medical Centre, Owo, Nigeria, a tertiary health care institution were stratified into a clinical and an administrative directorate. One-hundred twenty participants were selected from each directorate by a random sampling technique. A structured questionnaire was used to collect sociodemographic data and data on the level of knowledge and awareness of glaucoma. Statistical analyses included the independent t-test and Pearson's chi-square test for categorical variables. Statistical significance was indicated by P < 0.05. RESULTS: From the target population of 240 participants, 216 (98 males; 118 females) completed the questionnaire. The mean age of the participants was 35.07 ± 07 years. A total of 148 (68.6%) participants had heard of glaucoma comprising all participants from the clinical directorate and 28 participants from the administrative directorate. There was no statistically significant difference between the clinical and administrative directorates about the knowledge of the aspect of vision that is first affected by glaucoma, the painless nature of glaucoma among most Africans and the irreversible nature of glaucoma-related blindness (P > 0.05, all comparisons). CONCLUSION: There is the need to update the knowledge base of these workers if they are to be useful in propagating information of the irreversible blindness that could arise from delay in glaucoma diagnosis and treatment.