Hysterosalpingographic findings in patients with infertility in South eastern Nigeria.

BACKGROUND: Hysterosalpingography (HSG) is still an integral part of gynecological evaluation of infertile couple and its value has not been underestimated in modern gynecological practice, especially in developing countries. The study aims to evaluate the findings at HSG in patients presenting with infertility at the Ebonyi State University Teaching Hospital, Abakaliki, Southeastern Nigeria. METHODOLOGY: A retrospective analysis of 100 consecutive HSG results of patients presenting with infertility was done between January 2005-April 2008. Their clinical records and radiological findings were analyzed for demographic data, and cervical, uterine and tubal, pathology. RESULTS: The commonest age group was between 25 -34 years. Sixty-five percent presented with secondary infertility while 35% presented with secondary infertility. Hysterosalpingographic findings were abnormal in 80% of patients (primary infertility 20% and secondary infertility 60%). Bilateral tubal blockage and bilateral fimbrial adhesion were the commonest tubal factor abnormalities while intracavitary mass impression and cervical synechia were the commonest findings for uterine and cervical factor abnormalities respectively. CONCLUSION: Tubal blockage and tubal factor infertility are still common among infertile couples. This may probably be due to chronic pelvic inflammatory disease or pelvic infection following sexually transmitted infections, mismanaged pregnancies and septic abortions, as most of the patients presented with secondary infertility. Measures to prevent the occurrence of these infections are highlighted.

Hysterosalpingographic Findings in Patients with Infertility in South Eastern Nigeria

Background:Hysterosalpingography (HSG) is still an integral part of gynecological evaluation of infertile couple and its value has not been underestimated in moderngynecological practice; especially in developing countries. The study aims to evaluate the findings at HSG in patients presenting with infertility at the Ebonyi State University Teaching Hospital;Abakaliki; Southeastern Nigeria. A retrospective analysis of 100 consecutive HSG results of patients presenting with infertility was done between January 2005-April 2008. Their clinical records and radiological findings were analyzed for demographic data; and cervical; uterine and tubal; pathology. Results: The commonest age group was between 25 -34 years. Sixty-five percent presented with secondary infertility while 35presented with secondary infertility. Hysterosalpingographic findings were abnormal in 80of patients (primary infertility 20and secondary infertility 60). Bilateral tubal blockage and bilateral fimbrial adhesion were the commonest tubal factor abnormalities while intracavitary mass impression and cervical synechia were the commonest findings for uterine and cervical factor abnormalities respectively. Conclusion:Tubal blockage and tubal factor infertility are still common among infertile couples. This may probably be due to chronic pelvic inflammatory disease or pelvic infection following sexually transmitted infections; mismanaged pregnancies and septic abortions; as most of the patients presented with secondary infertility. Measures to prevent the occurrence of these infections are highlighted

Hysterosalpingographic Findings in Patients with Infertility in South Eastern Nigeria

Hysterosalpingography (HSG) is still an integral part of gynecological evaluation of infertile couple and its value has not been underestimated in modern gynecological practice; especially in developing countries.The study aims to evaluate the findings at HSG in patients presenting with infertility at the Ebonyi State University Teaching Hospital;Abakaliki; Southeastern Nigeria. A retrospective analysis of 100 consecutive HSG results of patients presenting with infertility was done between January 2005-April 2008. Their clinical records and radiological findings were analyzed for demographic data; and cervical; uterine and tubal; pathology.The commonest age group was between 25 -34 years. Sixty-five percent presented with secondary infertility while 35presented with secondary infertility. Hysterosalpingographic findings were abnormal in 80of patients(primary infertility 20and secondary infertility 60). Bilateral tubal blockage and bilateral fimbrial adhesion were the commonest tubal factor abnormalities while intracavitary mass impression and cervical synechia were the commonest findings for uterine and cervical factor abnormalities respectively. Tubal blockage and tubal factor infertility are still common among infertile couples. This may probably be due to chronic pelvic inflammatory disease or pelvic infection following sexually transmitted infections; mismanaged pregnancies and septic abortions; as most of the patients presented with secondary infertility. Measures to prevent the occurrence of these infections are highlighted

Sonographic Evaluation of Cervical Length Changes during Normal Pregnancy

This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age; the absence of any risk factors for preterm birth; and uncomplicated pregnancy. Cervical length was measured in a straight line. Height; age and weight of patients were also obtained. There was a relationship between gestational age and cervical length; which could be described with a linear regression (R = 0.44; P0.05). Our study shows an increase in cervical length with gestational age. Reference ranges constructed for the whole gestational period could be more clinically applicable and useful than a single cut off value for more efficient prevention and management of preterm birth

Radiological assessment of the uterus and fallopian tubes in infertile women at Abakaliki, Nigeria.

OBJECTIVES: This study is aimed at determining the pattern of abnormalities in the Hysterosalpingograms of patients who attended the Radiology Unit of Ebonyi State University Teaching Hospital, Abakaliki. METHOD: The 188 hysterosalpingograms conducted between January 2002 to December 2005 were analysed.. RESULTS: The mean age in this study was 31 years. Forty-one (21.8%) Hysterosalpingograms were normal. Abnormality of the Fallopian tubes constituted 54.6% of all abnormalities recorded, uterine 33.6% and cervical 11.8%. Cornual occlusion and hydrosalpinx were the leading abnormalities of the Fallopian tube, 32.2% and 20.3% respectively, while beading of the Fallopian tubes was the least tubal abnormality recorded in 1.4%. Uterine fibroid was the leading uterine abnormality in the study (44.5%), and uterine unicornis unicollis and bicornuate uterus were the least abnormalities of the uterus recorded with 0.8% respectively. Cervical synechiae was the only cervical abnormality recorded in the study (11.8%). CONCLUSION: Hysterosalpingogram is relevant in outlining abnormalities of the fallopian tube and uterus especially in patients with infertility. The study suggests that abnormalities of the Fallopian tube are probably still a prominent contributor to infertility in our community.

Radiological features of pulmonary tuberculosis in HIV-positive and HIV-negative adult patients in south-eastern Nigeria

Pulmonary tuberculosis (PTB) is the most common clinical presentation of tuberculosis. This study was carried out to appraise the radiological features of PTB in adult HIV-positive and HIV-negative pa-tients. The chest radiographs of the patients were evaluated in the tuberculosis, leprosy, and endemic disease (TBL) clinic, Ebonyi State University Teach-ing Hospital (EBSUTH), Abakaliki, south-eastern Nigeria, from April 2004 to June 2006. Of the total of 117 individuals studied, 68 (58.1) were males and 49 (41.8%) females, indicating a male preponderance of 1.4:1. Up to 49.6% of the subjects had PTB/HIV co-infection. The highest prevalence of PTB/HIV co-infection was recorded among males aged 31­40 (12.8%), and females aged 21­30 (11.1%). The com-monest radiological features observed were cavitory lesions (64.1%), patchy opacities (44.4%), and hilar opacities (38.5%). Bilateral cavitory lesions, patchy opacities and hilar opacities were more prominent than the right-sided or left-sided ones and appeared more frequently among individuals with PTB/HIV co-infection. Perihilar patchy opacities, consolidation and pleural effusion were seen in 19.6%, 6.0%, and 4.3% of all cases, respectively. There was no statisti-cally significant difference in the association between the radiological features and patient category (χ2 = 17.74, df = 18, p = 0.47). The chest radiography re-mains an important tool in the diagnosis of PTB and will continue to provide essential information for the management and follow-up of patients

Idiopathic central precocious puberty in a Nigerian boy.

A case of idiopathic central precocious puberty, a rare condition is reported in a 2 1/2 year-old Nigerian boy. He presented with progressive genital growth, a growth spurt, advanced skeletal maturation, and inappropriately high serum concentrations of pituitary and gonadal sex homones for his age. There was no family history of precocious puberty. Physical examination and investigations revealed no identifiable cause for his precocity. Despite the overwhelming problems of malnutrition and infectious diseases in our environment, clinicians must have a high index of suspicion for endocrine disorders.

Radiologic management of impacted coin in the oesophagus--a case report.

The incidence of swallowed foreign body is high in children and young adults. The common age of occurrence is below 10 years of age. It is a well known paediatric emergency often requiring urgent oesophagoscopy. Majority of swallowed foreign bodies (FBs) are impacted at sites known conventionally as constrictions. The commonest FB swallowed by children is coins; by adults - bones, fish bones and large bolus of meat, and in the older age group - dentures. The most common presenting symptoms are drooling of saliva, dysphagia and odynophagia. The anatomic proximity of the upper airway and oesophagus permit the development of respiratory symptoms like cough and stridor. Long standing foreign body impaction with weight loss, consolidated lungs and failure to thrive are documented presentations of FB in the oesophagus. We present a case of a 20 year old male who inadvertently swallowed a coin which got impacted at the thoracic inlet - one of the conventional areas of constriction. He presented late with cough, stridor, odynophagia and weight loss. The presentation of weight loss that could arise from unduely prolonged odynophagia rather than from complications like fistula, empyema thoracis or ominous predisposing lesions like malignancy was noted. The case highlighted the oddity of an adult swallowing a coin, its impaction in the, oesophagus of an apparently healthy adult and the non-surgical retrieval of the FB by fluoroscopic guidance.