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.

Implementing a hospital based injury surveillance system: a case study in Nigeria.

A pilot study of violent injury surveillance was implemented in two hospitals in Kano, Nigeria, in two phases: a formative evaluation including training and arranging the collection of hospital information, followed by a 6 month prospective data collection. Road traffic injuries constituted about 80 per cent of the cases, gunshot injuries were the commonest in victims of interpersonal violence (IPV). The causes and context of IPV, the relationship of victims and perpetrators, and the place, related activities and anatomical site of injuries from IPV are summarized.

Informed consent: the radiologist administering radiological contrast media

This study represents the understanding and practice of radiologists in Nigeria in obtaining informed consent from patients before administering radiological contrast media. 120 questionnaires were sent to radiologists practicing in Nigeria. 78(65%) responded, 60(76.9%) of the respondents understood informed consent to mean informing a patient about a procedure and obtaining consent to carry out the procedure. Whereas for consent to be informed it must include the nature of the procedure, purpose, risks and benefits. 52(66.7%) obtained either written or verbal consent while 26(33.3%) neither informed patient nor obtained consent. However, all respondents understood that failure to obtain consent may result in possible litigation by patient or relative while 69(88.5%) requested for a specific policy regarding informed consent. It is concluded that the radiologist in Nigeria does not fully understand the concept of informed consent. A specific policy should be made by the appropriate professional body in Nigeria as to what constitutes the requirements of a truly informed consent since there are simply no guidelines for now. Also informed consent forms, simple enough for patients to understand should be designed. These will assist the individual specialist in the conduct of their practice

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

Nutritional rickets in Calabar, Nigeria.

The features of 20 cases of nutritional rickets who presented at the University of Calabar Teaching Hospital, Calabar in south-eastern Nigeria over a 9-year period (January 1985-December 1993) are presented. The aim is to compare them with those in the only other reports from Nigeria between 18 and 42 years ago from Ibadan in the west of the country. The ages at presentation ranged between 6 months and 5 years with no sex preponderance. Most of the children were well nourished with the major features being delay in walking, swollen wrists and ankles and genu varum. The majority of cases in the present study occurred among children of elite and middle class parents who deprived their children of sunshine by keeping them indoors most of the day while they were at work. Reasons for the comparatively low prevalence of rickets in Calabar are social and cultural factors which enhance the exposure of children to sunlight. In addition, the relative availability of seafood and vegetables in this coastal city enhances rickets prevention.

Radiological observations in the colon of Nigerians with chronic enema abuse.

Barium enema examination performed on the indigenes of Calabar community (the Efiks) demonstrated redundancy (dolichocolon) in various segments of the colon in a high proportion (71%) of habitual enema abusers compared to non-abusers (19%). Comparatively, the descending colon appeared the most vulnerable segment of the gut. The typical features of enema colitis was not found in any of the subjects probably because of the non-corrosive nature of the concoctions they used in clearing their gut. It is concluded that prolonged stimulation of the colon with enema together with the instruments used to deliver the concoction results in the redundancy. To enhance accurate radiological evaluation of colonic lesions amongst Nigerians of Efik origin, chronic enema abuse should be considered.