Ultrasound measurement of fetal kidney length in normal pregnancy and correlation with gestational age.

BACKGROUND: Belated booking for antenatal care remains a common practice among pregnant women in developing countries. Many of the existing conventional ultrasonographic indices used for assessing gestational age (GA) become increasingly unreliable beyond the 2nd trimester. MATERIALS AND METHODS: A prospective cross-sectional study of booked healthy pregnant women with regular menstrual cycles and certain last menstrual period (LMP) were examined using ultrasound over a 6-month period. Fetal kidney length (FKL) was measured, beginning from 20 to 41 weeks of gestation. RESULTS: A total of 400 pregnant women were examined. The mean left FKL was slightly but significantly higher than the mean right FKL across the various weeks of gestation (P < 0.05). The mean combined FKL (MKL) was 32.18 ± 5.96 mm, with a reference range of 20.87 ± 0.75 mm to 41.41 ± 0.07 mm from 20 to 41 weeks of gestation. There was strongly positive significant correlation between MKL in millimeters and GA by the LMP in weeks (r = 0.997, P = 0.000). The standard error of prediction (SE) of GA was least for MKL (±7.17 days), followed by femur length (FL) (±8.38 days), head circumference (HC) (±9.02 days), abdominal circumference (AC) (±9.14 days), and biparietal diameter (BPD) (±10.36 days). The best multiple regression model for predicting GA included the five variables such as MKL, FL, BPD, HC, and AC, with a SE of prediction of (±6.31 days). CONCLUSION: FKL can serve as an additional reliable parameter for accurate dating of GA during obstetric scan.

Comparative sonographic evaluation of the anteroposterior dimensions of the pancreas in diabetics and nondiabetics.

BACKGROUND: The pancreas is an insulin-producing gland and is prone to varying degrees of destruction and change in patients with diabetes mellitus (DM). Various morphological changes including reduction in the pancreas dimensions have been described in DM. OBJECTIVES: To determine pancreatic anteroposterior (AP) dimensions in diabetics by sonography and compare with nondiabetics. To also evaluate the correlation of the AP dimensions with patient's anthropometry, as well as the duration of the disease in comparison with nondiabetics. MATERIALS AND METHODS: This is a comparative cross-sectional study involving 150 diabetics with 150 sex and age matched healthy normoglycemic group used as controls. Sonographic measurements of the AP dimensions of the pancreatic head, body, and tail of both study groups were performed with the use of 3.5 MHz curvilinear array transducer of a SonoAce X4 ultrasound machine. Data were analyzed using Statistical Package for Social Sciences version 17 (SPSS Inc., Chicago, IL, USA). A statistical test was considered significant at P ≤ 0.05 and 95% confidence interval. RESULTS: Pancreas AP dimensions were significantly smaller in diabetics compared to those of the controls. The mean dimensions were 1.91 ± 0.26 cm, 0.95 ± 0.12 cm, and 0.91 ± 0.11 cm for the head, body, and tail, respectively, in diabetics and 2.32 ± 0.22 cm, 1.43 ± 0.19 cm, and 1.34 ± 0.20 cm in the control (P < 0.001 in all cases). The dimensions were also significantly smaller in the Type 1 diabetics compared to Type 2 (P < 0.001 in all cases). The mean duration of illness for the Types 1 and 2 diabetics were 3.09 ± 1.38 and 3.78 ± 3.12 years, respectively. Longer duration of illness was associated with smaller pancreas body and tail dimensions, while pancreas head dimension was not significantly affected by the duration of illness. CONCLUSION: Diabetics have smaller pancreas AP dimensions compared to the normal population.

Comparative Sonographic Evaluation of the Anteroposterior Dimensions of the Pancreas in Diabetics and Nondiabetics

Background: The pancreas is an insulin­producing gland and is prone to varying degrees of destruction and change in patients with diabetes mellitus (DM). Various morphological changes including reduction in the pancreas dimensions have been described in DM.Objectives: To determine pancreatic anteroposterior (AP) dimensions in diabetics by sonography and compare with nondiabetics. To also evaluate the correlation of the AP dimensions with patient's anthropometry, as well as the duration of the disease in comparison with nondiabetics.Materials and Methods: This is a comparative cross­sectional study involving 150 diabetics with 150 sex and age matched healthy normoglycemic group used as controls. Sonographic measurements of the AP dimensions ofthe pancreatic head, body, and tail of both study groups were performed with the use of 3.5 MHz curvilinear array transducer of a SonoAce X4 ultrasound machine. Data were analyzed using Statistical Package for Social Sciences version 17 (SPSS Inc., Chicago, IL, USA). A statistical test was considered significant at P ≤ 0.05 and 95% confidence interval.Results: Pancreas AP dimensions were significantly smaller in diabetics compared to those of the controls. The mean dimensions were 1.91 ± 0.26 cm, 0.95 ± 0.12 cm, and 0.91 ± 0.11 cm for the head, body,andtail,respectively, in diabetics and 2.32 ± 0.22 cm, 1.43 ± 0.19 cm, and 1.34 ± 0.20 cm in the control (P < 0.001 in all cases). The dimensions were also significantly smaller in the Type 1 diabetics compared to Type 2 (P < 0.001 in all cases). The mean duration of illness for the Types 1 and 2 diabetics were 3.09 ± 1.38 and 3.78 ± 3.12 years, respectively. Longer duration of illness was associated with smaller pancreas body and tail dimensions, while pancreas head dimension was not significantly affected by the duration of illness.Conclusion: Diabetics have smaller pancreas AP dimensions compared to the normal population

Mammographic screening and reporting: a need for standardisation. A review.

Mammography has undergone significant improvement as screening tool for early diagnosis of breast cancer as a means of reducing mortality rate in them. The quality of mammograms and interpretative skills of the radiologist are important determinants required to achieve the favourable mortality reduction rates that have been established in randomised trials and also in service screening.Standardised reporting using the Breast Imaging Reporting And Data Systems (BI-RADS) lexicon, developed by the American College of Radiology (ACR) has been found useful as a practical way of communication between radiologists and clinicians compared with the free style, which is according to the opinion of each radiologist. This reporting system takes into account important features in the breast such as parenchyma pattern among others, which has been reported as an important risk factor in breast cancer. The objective of this review is to present this lexicon to radiologists and referring physicians as a reporting method which will enhance communication,improve patient management and auditing of performance.

Leptomeningeal cyst in a child after head trauma: a case report.

BACKGROUND: Leptomeningeal cyst is an uncommon complication of paediatric skull fractures. OBJECTIVE: To report a case of leptomeningeal cyst in a nine year old female. METHODS: A nine-year-old girl presented with a 13 month history of recurrence seizures. Full clinical evaluation was undertaken. This was followed by radiological investigations. RESULTS: The patient presented with a 13-month history of repeated seizures with no associated fever. The child had fallen from a one-storey building at the age of four years with temporary loss of consciousness and massive right sided head swelling but no radiological investigations were carried out at that time and she gradually recovered on conservative management. Physical examination showed a pulsatile depression on the right side of her head. Imaging studies confirmed this to be a leptomeningeal cyst, post traumatic cyst or growing fracture Conclusion: It is very important to carry out radiological investigations of all head injury patients no matter how subtle and to repeat such investigations especially when skull fractures are seen on initial investigations.

Isolated dextrogastria: a case report.

BACKGROUND: Isolated dextrogastria is a rare congenital anomaly in which the stomach is right-sided while the intestines, the organs in the chest, and the other organs in the abdomen are in normal situs. The importance of recognising the spectrum of situs anomalies is because the altered anatomy associated with these anomalies may result in misdiagnosis. OBJECTIVE: To report a case of isolated dextrogastria in an 18-year old woman who was seen during pre-university admission medical examination. METHODS: The routine chest X-ray of a young woman as a part of pre-admission medical examination showed the gastric air bubble under the right diaphragm rather than on the left. She was then subjected to further clinical and radiological evaluation. FINDINGS: The personal, past and family histories were uneventful as was the physical examination. Trans-abdominal ultrasonography showed a normal-sized and a normally sited liver in the right hypochondrium with normal gall bladder, and normally sited left and right lobes of the liver. The liver echo pattern was normal. The stomach was found below the lower border of the right lobe of the liver. The kidneys and the spleen were normal in number, position, size and architectural pattern. A barium meal showed a well-defined and a well developed stomach with a reverse J shape and duodenal C loop that was reversed in shape. CONCLUSION: The practice of the radiographer is always placing the marker before exposing the film instead of marking the radiograph after processing, which is the key to accurate identification of situs anomalies need emphasis.

The Role of Interventional Radiology in Modern Medical Practice

This is a subspecialty in diagnostic Radiology; which involves the use of minimally invasive targeted treatment options to manage various medical conditions; under imaging guidance. This treatment method is less invasive compared with surgery and most times does not require general anesthesia. They are most often done as outpatient treatment with reduced morbidity; mortality and shorter off duty period

Fibular hemimelia: a case report.

Fibular hemimelia is the congenital absence of the fibula and it is the most common congenital absence of long bone of the extremities. Shortening of the extremity is obvious at birth with leg-length discrepancy. On plain radiograph of the leg and foot, significant fibular deficiency (hypoplasia) or absence of the fibula can be seen. In this case report, a 6-month-old baby boy with fibular hemimelia is presented. The radiological diagnosis and differential diagnosis are discussed. The treatments which include repeated corrective osteotomies and leg-lengthening surgery are costly and associated with residual deformity.

Mature cystic renal teratoma in a 25-year-old woman with ipsilateral hydronephrosis, urinary tract infection and spontaneous abortion.

Benign cystic renal teratomas are uncommon clinical entities in our environment. To the best of our knowledge, it has never been reported here. Renal teratomas are rare and most have been dismissed as retroperitoneal teratomas secondarily invading the kidney. We report a case in which benign cystic renal teratoma was associated with ipsilateral hydronephrosis, urinary tract infection and spontaneous abortion, with histological confirmation in a 25-year-old woman.

Medical education in Nigeria: are we ready for the paradigm shift?

The information revolution is changing the way medicine is practised globally. Patients can now access the storehouses of knowledge, which hitherto were out of bounds, to acquire, process and use the medical evidence from a variety of sources such as the World Wide Web. The way medicine is being taught is changing. Many medical and dental schools have revised, or are in the process of revising their curricula. The ability to access information resources and apply up to date information, diagnosis and therapeutic protocols to their practice calls for a paradigm shift. Cybermedicine is fast becoming the twenty-first century practice. The challenge is real. If emphasis is being placed on fluency with information technology in the developed countries, learning to use the computer remains, in our opinion, the place to start from in the developing countries.

Comprehensive frontal cerebral tumour presenting with severe behavioural disorder: a case report.

The purpose of this report is to highlight the association of behavioural disorder as a tell tale sign of frontal cerebral tumor. A case study of a 27 year old female presenting with a 10 month history of behavioural disorder, associated with gradual to complete loss of vision. The case underlines the significance of behavioural changes as an early sign of intracranial tumor, and the need for early diagnosis with CT scan, irrespective of cost and or adversities.