RESUMO
Objectives: To understand the pattern of hysterosalpingographic (HSG) findings and annual trends among Ghanaian women with infertility over a five-year period. Methods: We retrospectively evaluated the hospital medical records of women with infertility who underwent HSG at a major tertiary center in Ghana between January 2018 and December 2022. The data was statistically analyzed. Results: The subjects comprised of 2324 Ghanaian women diagnosed with clinical infertility. HSG identified 1685 (72.5%) with primary infertility and they were also younger women with a mean age of 32.2±4.5 years. The remaining 639 (27.5%) women had secondary infertility and were older (34.2±5.3 years; p < 0.001). Primary infertility rate decreased with increasing age (p < 0.001). Bilateral tubal blockage was seen in 701 (41.6%) women with primary infertility and 365 (57.1%) women with secondary infertility. Hydrosalpinx was present in 236 (10.2%) women, fimbrial adhesions in 444 (19.1%), Asherman's syndrome in four (0.2%), and bilateral beaded tubes/tubercular salpingitis in five (0.2%). HSG was unable to detect infertility-related abnormalities in 513 (22.1%) women despite their clinical infertility. The majority of patients (1502; 64.6%) had tubal blockage: bilateral in 1066 (45.9%) and unilateral in 436 (18.8%). Conclusions: Infertility rates among Ghanaian women increased at an accelerating rate over the years. Primary infertility was significantly more prevalent among younger women. Tubal and cervical abnormalities were the most prevalent HSG findings.
RESUMO
Background and Aim: Goiter is a major source of morbidity in the world, especially in the developing world, where dietary iodine deficiency, a known cause of this condition, is endemic. The diagnosis is mostly by ultrasonography (USG) scan, which can give anatomical, pathological, and functional information for the management of goiter. This study aimed to determine the commonest ultrasound findings of goiter in Ghana. Method: The records of all 213 patients with goiter diagnosed by USG scan over a 5-year period were retrieved. Data collected were sociodemographics, ultrasound features, thyroid nodules diameter, and Thyroid Imaging Reporting and Data System (TI-RADS) scores, which were analyzed using GNU PSPP, version 1.2.0-3. χ 2 and two-tailed independent samples t-test were also employed, with p ≤ 0.05. Results: A total of 213 patients with goiter diagnosed by USG scan were obtained over the study period. The mean age of the participants was 50.01 ± 17.27 years, with an age range of 16-92 years and females constituting the majority (82.16%). The commonest ultrasound features were well-defined solid nodules. The lesion sites for most patients were the whole thyroid (28.17%), both lobes (24.41%), and the right lobe (20.19%). The mean difference in sizes of cysts and solid nodules among genders was 0.26 (CI: -0.14 to 0.67, p = 0.20) and 0.12 (CI: -0.43 to 0.66, p = 0.67), respectively. The TI-RADS score featured TI-RADS 4 (36.62%), TI-RADS 1 (28.17%), TI-RADS 3 (25.82%), TI-RADS 5 (5.16%), and TI-RADS 2 (4.23%). Solid nodules (49.32%, p = 0.001) and cysts (35.71%, p = 0.003) were more common within 41-60 years and less frequent in those <21 years. A p ≤ 0.05 was considered significant in this study. Conclusion: The predominant ultrasound features were well-defined solid nodules, simple cysts, and solid nodules with cystic changes, mostly located in the entire thyroid gland and least located in the isthmus only. Cysts and solid nodules were mostly seen in the 41-60 years age group.
RESUMO
Congenital radioulnar synostosis is a rare musculoskeletal disorder of the elbow, occurring as a result of variable degree and length of the congenital fusion of the proximal radioulnar joint. Patients presents early to the hospital depending on the severity of the synostosis and its effect on elbow function. It may have psychosocial effects on the affected individuals as they grow older especially when the deformity is dramatic. Treatment may be conservative, surgical (which may have a variable degree of success) and psychotherapy.
RESUMO
Incidentally diagnosed situs inversus totalis is a rare condition that is compatible with life when not associated with pathologies like primary ciliary dyskinesia. The etiology is not known but may be associated with certain cardiopulmonary conditions. Diagnosis is usually made when patient presents with other medical concerns as in this case report. Patients diagnosed with this condition must be counseled and reassured that they can live a normal life and be ready to divulge their anatomical variation to physicians when necessary. Clinicians must be on a lookout for this condition during their surgical work-up.
