Prevalence and outcome of increased nuchal translucency in usmanu danfodiyo university teaching hospital, Sokoto, Nigeria: A cohort study.

BACKGROUND: An important component of the first-trimester scan is nuchal translucency thickness at 11 weeks to 13 weeks 6 days of gestation. A nuchal translucency ≥3.3 mm is a significant early pregnancy scan finding associated with Trisomies 13, 18, and 21 and congenital heart diseases. AIMS: To determine the prevalence and outcome of increased fetal nuchal translucency among pregnant women. SUBJECTS AND METHODS: A prospective cohort study at the Obstetrics and Gynaecology Department of Usmanu Danfodiyo University Teaching Hospital Sokoto. This was a prospective study of 265 consecutively recruited women in the first trimester of pregnancy who presented to antenatal clinics over a 20-week period. An NT scan was conducted at 11 weeks to 13 weeks 6 days followed by an anomaly scan at 18-22 weeks. Patients were followed up to delivery and 6-week post-partum. The neonates were examined at delivery and at 6-week postnatal life. Data entry and analysis was done with IBM SPSS version 20. The level of significance was set at less than 0.05. Frequency distribution; student t-test and Chi-squared test. RESULTS: The 95th percentile NT was 3.3 mm and the prevalence of increased NT above 3.3 mm was 3%. The mean maternal age of the participants was 28.1 ± 5.1 years and the modal parity was Para 0. The most common anomalies associated with increased NT were ventricular septal defect and spina bifida. A congenital anomaly was significantly associated with increased NT (P < 0.001). CONCLUSIONS: The prevalence of increased fetal nuchal translucency is relatively high in our environment and is associated with congenital fetal defects. Routine screening with first-trimester ultrasound will help detect congenital anomalies early.

Knowledge of Radiation Hazards, Radiation Protection Practices and Clinical Profile of Health Workers in a Teaching Hospital in Northern Nigeria.

INTRODUCTION: Use of ionizing radiation in medical imaging for diagnostic and interventional purposes has risen dramatically in recent years with a concomitant increase in exposure of patients and health workers to radiation hazards. AIM: To assess the knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in UDUTH, Sokoto, Nigeria. MATERIALS AND METHODS: A cross-sectional study was conducted among 110 Radiology, Radiotherapy and Dentistry staff selected by universal sampling technique. The study comprised of administration of standardized semi-structured pre-tested questionnaire (to obtain information on socio-demographic characteristics, knowledge of radiation hazards, and radiation protection practices of participants), clinical assessment (comprising of chest X-ray, abdominal ultrasound and laboratory investigation on hematological parameters), and evaluation of radiation exposure of participants (extracted from existing hospital records on their radiation exposure status). RESULTS: The participants were aged 20 to 65 years (mean = 34.04 ± 8.83), most of them were males (67.3%) and married (65.7%). Sixty five (59.1%) had good knowledge of radiation hazards, 58 (52.7%) had good knowledge of Personal Protective Devices (PPDs), less than a third, 30 (27.3%) consistently wore dosimeter, and very few (10.9% and below) consistently wore the various PPDs at work. The average annual radiation exposure over a 4 year period ranged from 0.0475mSv to 1.8725mSv. Only 1 (1.2%) of 86 participants had abnormal chest X-ray findings, 8 (9.4%) of 85 participants had abnormal abdominal ultrasound findings; while 17 (15.5%) and 11 (10.0%) of 110 participants had anemia and leucopenia respectively. CONCLUSION: This study demonstrated poor radiation protection practices despite good knowledge of radiation hazards among the participants, but radiation exposure and prevalence of abnormal clinical conditions were found to be low. Periodic in-service training and monitoring on radiation safety was suggested.

Morphological Variation of Third Ventricle Using Computerized Tomography among Different Gender and Age Groups: A 5-Year Retrospective Study in Usmanu Danfodiyo University Teaching Hospital; Sokoto; North - West Nigeria

Background: Many methods have been described for measurements of the third ventricle as a means of evaluating brain atrophy during the normal aging process and disease. Enlargement of the cerebral ventricles is one of the most frequently replicated neurobiological findings in schizophrenia. The aim of this morphological study was to examine the range in the normal size of the third ventricle of individuals living in Sokoto and to assess its association with gender and age. Materials and Methods: All available brain CT in the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto; Nigeria; from 2007 to 2012 (a 5-year period) and reported as normal by the radiologist were recruited for the study. Films were viewed on the computer monitor. Measurements were made with Dragon V 3.1.1 Philips and Neusoft Medical System Company Limited software; the software provides a meter rule with which measurements were done. Results: A total of 252 CT scan images where used in the study. Of this number; 156 (61.9) were CT scan images of males and 96 (38.1) were CT scan images of females. The mean width was 8.38 mm and mean anteroposterior length was 12.16 mm. These differences were statistically significant; P = 0.0209 (0.05). Conclusion: Our findings provide a base line data for the measurement of the third ventricles using CT scans in our environment and this may be applied in various clinical conditions involving the third ventricle

Multiple embolisations in rheumatic heart disease: a case report.

BACKGROUND: Though systemic thromboembolism is not an infrequent complication of rheumatic valvular disease, multiple embolic phenomena are rare. OBJECTIVE: To present a patient with rheumatic heart disease associated with multiple embolic complications. CASE REPORT: A 44-year-old lady with rheumatic valvular disease and atrial fibrillation defaulted anticoagulant medication, and subsequently presented with acute chest pain, acute left ventricular failure, focal neurological deficit and gangrenous lower limb extremities. Electrocardiography showed atrial fibrillation and an old anteroseptal myocardial infarction. Echocardiography showed multiple valvular lesions and multiple thrombi in the left atrium. Computed tomogram scan demonstrated a large infarct involving the region supplied by the right middle cerebral artery. Bilateral above knee amputation was performed. Recovery from neurological deficit was complete. She had, during a 4-year follow-up and anticoagulation remained free of new clinically evident embolic complications. Serial echocardiography however showed that the atrial clots had persisted and presumably fibrosed. CONCLUSION: Multiple systemic thromboembolisms are serious complication of atrial fibrillation of valvular aetiology, and their prevention requires continuous anticoagulation.

Description of the normal variants of the anatomical shapes of the sella turcica using plain radiographs: experience from Sokoto, Northwestern Nigeria.

BACKGROUND: The anatomy of the sella turcica is variable in size and shape. It has been classified into three types: round, oval and flat. It can also be deep or shallow in both children and adults. The floor of the sella turcica which in most cases is concave may be, flat or even convex. In both anatomical and radiological practice in Nigeria, normal data in relation to the description of the normal variants of the anatomical shapes of the sella turcica are based on Caucasian studies. METHODS: All available lateral skull radiographs of subjects over a 3-year period, from 2002 to 2004, were retrieved from the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital, Sokoto for the study. Radiographs were mounted on the viewing boxes and sellae turcicae were stu died and classified. RESULTS: A total of 228 subjects were involved in this study. Of this figure, 171 (75%) were males, and 57 (25%) were females (m:f ratio = 3:1). The predominant shape of sella in the African subjects studied is oval, and the difference in frequency of oval shaped sella and that of round or flat types is highly statistically significant. (P < .001).The commonest type of sella floor in the African subjects studied is concave and the difference in frequency of concave shaped sella floor and that of flat and convex types is highly statistically significant.(P< .001). In both the various anatomical shapes of the sella turcica and the types of floor of the sella turcica in relation to sex of the subjects studied, the difference in frequency of males and females is highly statistically significant. (P < .001). CONCLUSION: It is concluded that the prevalence and the relative frequencies of the normal variants of the anatomical shapes of the sella turcica reported in this study on Nigerian subjects is similar to those reported in Caucasians. Further studies on a larger scale are needed to corroborate our findings.

Carotid occlusion and cerebral infarction from camel bite: case report.

A 30-year-old farmer was bitten by his camel on the left side of the neck. He suffered immediate loss of consciousness but recovered three days later with right-sided hemiplegia and complete aphasia. He bled minimally from the neck. CT scan of the brain and carotid Doppler ultrasonography confirmed left parietal lobe infarction and partial occlusion of the left carotid artery respectively. He was managed conservatively with physiotherapy and low dose aspirin. At six months of follow up, his speech remains slurred but comprehensible and is able to walk with a walking stick.

Sonographic diagnosis of congenital brain malformations: the Ilorin experience.

A retrospective study was done to determine the incidence of congenital malformation of the brain among African infants over a 5 year period. Transfontanelle ultrasound (US) was performed on 98 infants consisting of 45 males and 53 females. The mean age was 2.6 months (range 1-11 months). Congenital malformation was present in 25.5% of the 98 cases studied, most of which were associated with hydrocephalus. Cerebral aqueduct stenosis was the commonest congenital anomaly encountered and was found in 24% of case. This study shows that transfontanelle US is a useful tool for diagnosis of congenital brain malformations in infants.

Transfontanelle ultrasonography: an invaluable tool in the assessment of the infant brain.

Transfontanelle (cranial) ultrasonography was carried out in 98 Nigerian infants over a period of 5 years. Of the infants, 38 (38.8%) had hydrocephalus from various causes while 26 (25.5%) had congenital anomalies. As ultrasound equipment is becoming a more readily available and affordable tool in the developing countries, it should become much easier for medical staff in these countries to arrive at the correct diagnosis of intracranial diseases in infants.