Excretory urography before prostatectomy.

A study of the pre-operative excretory urograms of 205 patients who had prostatectomy for benign prostatic hyperplasia, over a 5-years period is presented. Seventy-four per cent (74.1%) of the urographic abnormalities were a direct result of prostatic enlargement found on clinical examination. The significant upper tract abnormalities found in 11.0% of the cases were duplex kidneys (3.4%), poor renal excretion (3.8%) and small kidneys (3.8%). None of these was a contraindication to prostatectomy when the blood urea and creatinine levels became normal. No upper tract tumour nor calculus was found in these patients. We conclude that, for the management of patients presenting with urinary retention from BPH, routine pre-operative excretory urography has little or no value and is not worth the expense and delay.

Erect lateral pelvimetry and the outcome of labor in Lagos.

The erect lateral radiograph pelvimetry measurements was related to the outcome of labor in 173 patients. The most common indication for pelvimetry was one previous caesarean section in 90 (52%) patients. Sixty-nine (39.9%) pelvimetry measurements were performed because of suspected cephalopelvic disproportion, while 20 (11.6%) were done because of breech presentation. In patients with a cephalic presentation at delivery, the mean +/- standard deviation (SD) obstetric conjugate for the 87 women who delivered vaginally (group 1) was 11.42 +/- 1.5 cm, while that of the 45 women who had emergency caesarean section (group 2) was 10.77 +/- 1.5 cm. The mean +/- SD anteroposterior outlet diameter for groups 1 and 2 were 12.24 +/- 1.9 cm and 11.84 +/- 1.7 cm respectively. Both differences were found to be statistically significant (p < 0.001 and p < 0.05 respectively). The mean +/- SD birthweight of the babies in groups 1 and 2 were 3.34 +/- 0.79 kg and 3.42 +/- 0.86 kg respectively. There was no statistically significant difference between the two groups (p < 0.05). The critical obstetric conjugate for safe vaginal delivery was 9.88 cm while the corresponding value for the anteroposterior pelvic outlet diameter was 10.24 cm.

Computerised axial tomographic scanning in neuropsychiatric disorders.

The invention of the computerised tomography scanner - a product of modern bio-medical technology has significantly enhanced the diagnostic capability of physicians in the management of brain disorders such as cerebral atrophy, subdural haematoma, tuberous sclerosis, small calcifications and small intravascular clots. It is also useful in radiotherapy planning. The advantages of the CT scanner over the older conventional techniques, namely pneumoencephalography and arteriography are accuracy, reliability, and simplicity of operation. The major limitation is its diminished ability relative to angiography to precisely detect vascular disease, e.g. aneurysm. Furthermore, it is expensive and not precise in the differentiation of benign from malignant lesions. Despite the development of newer neuro-radiological equipment such as position emission tomography (PET) and nuclear magnetic resonance, the CT scanner remains a most invaluable diagnostic tool and should be given priority consideration in health vote allocation.

Computerised axial tomographic scanning in neuropsychiatric disorders

The invention of the computerised tomography scanner - a product of modern bio-medical technology has significantly enhanced the diagnosis capability of physicians in the management of brain disorders. Despite the development of newer neuro-radiological equipment; the CT scanner remains a most invaluable diagnostic tool and should be given priority consideration in health vote allocation