Sonographic determination of normal subcutaneous fat thickness in children in Southern Nigeria.

BACKGROUND: Subcutaneous fat is a highly active metabolic tissue that exerts control on numerous biochemical and physiological processes in health and disease. Children are particularly susceptible to nutritional problems, hence the need to measure subcutaneous fat thickness (SFT) which can be used to determine their body composition. Ultrasonography provides an affordable, noninvasive, available technique of achieving this. OBJECTIVE: The aim of this study was to determine the normal values of SFT at the triceps, subscapular, and abdomen in children age 1-5 years using ultrasound in southern Nigeria. MATERIALS AND METHODS: This was a prospective study of 1750 healthy children age 1-5 years in nursery and primary schools in Calabar, Nigeria. Their body mass indexes were calculated from their weights and heights, while their triceps fat thickness (TFT), subscapular fat thickness (SuFT), and abdominal fat thickness (AFT) were measured using a 7.5-MHz linear array transducer of a Hitachi portable ultrasound machine. RESULTS: The mean TFT value for girls was 4.6 ± 2.0 mm and 3.99 ± 1.8 mm for boys. Girls had mean SuFT value of 2.37 ± 1.41 mm and boys 2.14 ± 1.02 mm. The mean AFT value for girls was 5.53 ± 2.94 mm and for boys 4.53 ± 2.37 mm. The values at all sites were generally higher in females than in males. CONCLUSION: This work has provided a sonographic normogram of SFT at various sites for preschool children in Nigeria.

A reduction in radiographic exposure and image quality in film screen postero-anterior chest radiography.

PURPOSE: To develop a protocol for the optimization of diagnostic chest radiography examination, the effect of radiographic exposure reduction on image quality is investigated. PROCEDURE: Fourty-eight adult patients presenting for posterior-anterior (PA) chest radiography in a tertiary health care centre were categorized into 3 groups to assess the effects of exposure (tube current/time mAs) reduction on clinical image quality using in film screen (FS) chest radiography. Images were obtained at existing departmental exposure protocol (T1) while a record of the exposure factors was made. Test exposures obtained by reducing average mAs values by 20% (T2) and 50% (T3) were used to obtain radiographic images of patients following normal ethically based clinical practice. To make up for the reduction in mAs, a 4% increase in the T1 kVp was used. The quality of images obtained with each exposure protocol was studied by two consultant radiologists, using the image quality criteria of the Commission of European Communities (CEC). Assessors used the method of ranked scoring and worked independently. RESULTS: Results showed no change in image quality following the 20% exposure (mAs) reduction. However, there was a significant change in image quality at 50% reduction of mAs values (P < 0.05) with higher image quality scores suggesting improved perceptibility of all assessed criteria among the observers. CONCLUSION: Improving radiation protection of the patient while maintaining diagnostic quality of the radiographic image at reduced exposures is a clinically desirable development. This study will find application in current efforts at optimization of radiography procedures in the area of study.

Prevalence of Gallstone Disease in South-Eastern Nigeria

"Classically; gallstones are said to occur in a fat; fertile; flatulent female of fifty!1. in this prospective study; we found a prevalence rate of 3.3. the results did not correlate with the body mass index (BMI); weight (Wt) or complexion (Cpx). The mean BMI for those with stones was 24.43 with standard deviation (SD) of 1.97 as against mean BMI of 26.35 and SD of 4.98 for those without. The mean Wt. of those with gallstones was 65.43kg with SD of 9.55 while the mean Wt of those without was 68.01kg with SD of 15.43. regarding ""colour"". The Dark complexioned (Dc) were more common constituting 71.4of affected persons. The fair complexioned (Fc) constituted 28.6. Patients with tertiary education were the most frequently affected constituting 71.4and the same group constituted 51of those randomized. Patients with secondary school level of education constituted 33.14of those randomized and 28.43found with gallstones. In the studied sample; t6he female to male ratio in those affected was 6.1. the females also dominated the sample population to the tune of 84. In relation to occupation; the highest incidence was amongst civil servants who made up 43of those affected. Surprisingly; the unemployed came second making up 28.5and the professionals were 14.28of those affected. These results confirm a rising incidence of cholelithiasis in our population when compared with previous studies (0.007the sixties and 1.79in 2002. it also clearly demonstrates a different epidemiological profile from that classically described amongst the Caucasians."

Comparative evaluation of active learning and the traditional lectures in physiology: a case study of 200 level medical laboratory students of Imo State Unversity, Owerri.

Currently, understanding of physiology and disease patterns is undergoing a fundamental paradigm shift with attendant shift in education of health professionals worldwide towards active learning to encourage exploration of connections and their relationships. We introduced problem-based learning to physiology teaching of medial laboratory students to confirm worldwide reports that active learning environments offer better learning opportunities over the traditional methods which is the predominant teaching method in Nigerian universities. Our findings indicate that problem-based learning increases students' attendance/participation in classes and performance in examination. We recommend the integration of active learning into physiology curriculum of Nigerian Universities.

CD4 count levels and pattern of respiratory complications in HIV seropositive patients in Calabar, Nigeria.

A prospective observational study was carried out to describe the pattern of pulmonary complications in hospitalized patients with Human Immune-deficiency Virus (HIV) infection at the University of Calabar Teaching Hospital, Calabar between January 2005 to December 2006. One hundred and twenty-four patients which consists 60 males and 64 females, aged between 20-60 who met the inclusion criteria formed the subjects for the study. The mean age of the subjects was 34.60 +/-1.2 years. A structured questionnaire was used to obtain the demographic data, clinical information and CD4 lymphocyte count. Radiological analysis of chest was done with the chest X-ray of each subject. Chronic productive cough topped the list of respiratory symptoms (89%) followed by chest pain (74%) and dyspnea (62 %). Lung consolidation was the commonest respiratory sign as seen in 44 % of the cases. Hilar lymphadenopathy was seen in (35 %), Pleural effusion (32%), lung fibrosis (21%) and finger clubbing (15%). The clinical and radiological pattern of most patients with chronic cough was highly suggestive of mycobacterial infection such as tuberculosis, although only 40% of cases had positive acid fast bacilli. The mean CD4 lymphocyte count level was 174.8 +/- 5.4 cells/microlitre and this may be responsible for the respiratory findings as opportunistic lung infections are said to be commoner at CD4 count levels below 200 cells/microlitre. However, four patients had mediasternal masses which may suggest neoplasms. Concerted efforts and continuous evaluation of these patients are needed to determine the spectrum of respiratory illnesses among HIV positive patients in Calabar.

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