Ionizing radiation protection and the linear No-threshold controversy: Extent of support or counter to the prevailing paradigm.

This study has developed a relationship that categorized radiation protection and allows for a proper, clear, and concise review of the different classifications in terms of principles of protection, dose criteria, categories, fundamental tools, exposure situations, applications and control measures. With the groundwork laid, advances of the linear no-threshold (LNT) model which has attracted attention in the field of radiobiology and epidemiology were examined in detail. Various plausible dose-response relationship scenarios were x-rayed under low-dose extrapolation. Intensive review of factors opposing the LNT model involving radiophobia (including misdiagnosis, alternative surgery/imaging, suppression of ionizing radiation (IR) research); radiobiology (including DNA damage repair, apoptosis/necrosis, senescence protection) and cost issues (including-high operating cost of LNT, incorrect prioritization, exaggeration of LNT impact, risk-to-benefit analysis) were performed. On the other hand, factors supporting the use of LNT were equally examined, they include regulatory bodies' endorsement, insufficient statistical significance, partial DNA repair, variability of irradiated bodies, different latency periods for cancer, dynamic nature of threshold and conflicting interests. After considering the gaps in the scientific investigations that either support or counter the scientific paradigm on the use of LNT model, further research and advocacy is recommended that will ultimately lead to the acceptance of an alternative paradigm by the international regulators.

Sonographic Measurement of Liver Length And Percentiles Among Children in Warri, Nigeria.

PURPOSE: To use sonography to measure liver longitudinal length and determine liver longitudinal length percentiles among children in Warri, Delta State, Nigeria. METHODS: Midclavicular liver longitudinal length was measured in a sample of 320 children 10 years and younger. Mean liver longitudinal length was calculated for boys and girls separately, boys and girls combined, and each age group. The liver longitudinal length was correlated with age, height, weight, body surface area (BSA), and body mass index (BMI). The 10th, 25th, 50th, 75th and 95th percentiles were calculated. RESULTS: The mean liver longitudinal length for the boys and girls combined was 9.1 ± 0.6 cm. The relationship between liver longitudinal length and age, height, and weight was linear (r = 0.896, 0.906 and 0.910, respectively). A negative correlation was observed between liver longitudinal length and BMI (r = -0.424), but the relationship between liver longitudinal length and BSA was positive (r = 0.929). The 10th, 25th, 50th, 75th and 95th percentiles of the liver measurements conformed to the typical growth pattern of the liver. DISCUSSION: Although an increase in liver size was in line with expected somatic growth in infants and children 10 years and younger, increases in liver length was progressive and most rapid in the first year of life in the cohort of children in this study. In children 10 years and younger, sexual dimorphism in liver size appears to be of doubtful clinical significance because it tends to be transient. CONCLUSION: When age or any other anthropometric parameter is known, the presented typical values of liver longitudinal length, percentiles, and regression equations can serve as reference values during sonographic assessment of liver size among children in Warri, Nigeria. Furthermore, the use of different growth curves and different reference values during sonographic evaluation of the liver among children might be unnecessary.

Routine Ultrasonography for Intensified Tuberculosis Case Finding in High Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) Burdened Countries: A Proposed Frame Work.

Sonography has proven to be valuable diagnostic imaging equipment in the work-up of patients infected with acquired immune deficiency syndrome (AIDS) and tuberculosis (TB) coinfection. An extensive literature search was conducted between 1994 and 2021 for original peer-reviewed articles in the English language on ultrasound application in the diagnosis of extrapulmonary TB (EPTB), ultrasound application in infectious diseases in resource-constrained settings, point-of-care ultrasound in resource-scarce settings among others, across various electronic databases including MEDLINE, PubMed, POPLINE, Scopus and Google Scholar, among others and some gray literature were also retrieved. Emerging themes were identified by their recurrence in literature. Ultrasound imaging is a rapid diagnostic tool and can accurately identify and characterize pathologic findings in patients infected with HIV/AIDS and TB co-infection, such as enlarged lymph nodes, pericarditis, and pleural effusion, among others for prompt patient management. Ultrasonography is cheaper and portable; interfacing software has become more users friendly and image quality significantly improved, making it possible for the provision of imaging services in an increasing number of clinical settings in resource-limited settings where access to diagnostic imaging is scarce. The use of focused assessment with sonography for HIV (FASH) for prompt diagnosis of EPTB in regions with a high incidence of HIV/AIDS and TB co-infection will aid in prompt diagnosis and treatment of patients with undifferentiated TB, thus impacting on morbidity and mortality. The training and deployment of sonographers in endemic regions with a high prevalence of HIV/AIDS and TB co-infection, to diagnose EPTB using FASH protocol is a viable option that is in line with the global drive for intensified case finding and treatment algorithm, with a view to meeting the sustainable development goals target of ending HIV and TB epidemics and achieving universal health coverage.

Reliability of Sonographic Estimation of Fetal Weight: A Study of Three Tertiary Hospitals in Nigeria.

CONTEXT: There is a dearth of sonologists in Nigeria, yet sonographic estimation of actual birth weight (ABW) is important in antenatal care. AIM: To determine the reliability of estimated fetal weight (EFW) by sonographers and sonologists in Lagos Nigeria. SETTINGS AND DESIGN: In the cross-sectional study, a convenience sample of 663 healthy women with singleton pregnancy at term was selected. Ethical approval for the study design and consent of participants were obtained. SUBJECTS AND METHODS: Three sonographers and three sonologists used a single ultrasound scanner with Hadlock-3 algorithm to measure biparietal diameter, abdominal circumference, and femur length in three centers while three midwives used a single neonatal weighing scale to measure ABW. STATISTICAL ANALYSIS USED: Medical® statistical software version 12.5 was used to analyze data. Descriptive and inferential statistics, as well as Bland/Altman plots were used to determine reliability of EFWs. Results were tested for statistical significance at P ≤ 0.05. RESULTS: Majority (76.2%) of babies had normal weight while mean EFW and ABW were 3.50 ± 0.10 kg and 3.45 ± 0.12 kg, respectively and the difference between them is not statistically significant (P > 0.05). For sonographers and sonologists in each center, mean error and coefficient of variation were very small while Pearson's correlation coefficient as well as intra- and interclass correlation coefficients was very high. CONCLUSION: Independent estimation of ABW by sonographers in Lagos metropolis was very reliable. Sonography was also highly reliable in predicting macrosomia.

Validation of Siriraj Stroke Score in southeast Nigeria.

The aim of the study is to validate the use of Siriraj Stroke Score (SSS) in the diagnosis of acute hemorrhagic and acute ischemic stroke in southeast Nigeria. This was a prospective study on validity of SSS in the diagnosis of stroke types in southeast Nigeria. Subjects diagnosed with stroke for whom brain computerized tomography (CT) scan was performed on admission were recruited during the study period. SSS was calculated for each subject, and the SSS diagnosis was compared with brain CT scan-based diagnosis. A total of 2,307 patients were admitted in the hospital medical wards during the study period, of whom 360 (15.6%) were stroke patients and of these, 113 (31.4%) adult subjects met the inclusion criteria. The mean age of the subjects was 66.5±2.6 years. The mean interval between ictus and presentation was 2.5±0.4 days. Ischemic stroke was confirmed by CT in 74 subjects; however, SSS predicted 60 (81.1%) of these subjects correctly (P<0.05). Hemorrhagic stroke was confirmed by CT in 39 subjects, and SSS predicted 36 (92.3%) of them correctly (P<0.05). In acute ischemic stroke, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SSS were 92%, 94%, 97%, 86%, and 93%, respectively, while in patients with hemorrhagic stroke, the corresponding percentages were 94%, 92%, 86%, 97%, and 93%, respectively. SSS is not reliable enough to clinically differentiate stroke types in southeast Nigeria to warrant interventions like thrombolysis in acute ischemic stroke.

CT-detected intracranial hemorrhage among patients with head injury in Lagos, Nigeria.

PURPOSE: To evaluate the computed tomography (CT) findings of intracranial hemorrhage among patients with head trauma in Lagos, Nigeria. METHODS: In this retrospective, cross-sectional study, a convenience sample of 500 patients with head trauma who had diagnostic cranial CT scans was selected. All the radiological reports and CT scans of patients with head trauma were retrieved in the hospitals selected as study sites. The reports were sorted into 2 groups - normal findings and intracranial bleeding. The reports of intracranial bleeding were sorted again into different classes of intracranial bleeding as identified by the radiologist who reported it. All data were analyzed using the Epi Info public domain software package. The chi-square test was used to measure the statistical significance of study results at P < .05. RESULTS: Most of the study subjects (68%) were men. Traffic accidents accounted for 44% of all the head traumas found in the study, and 58% of the head traumas resulted in intracranial bleeding. Among the hemorrhages found, 37% were intracerebral, 25% were subdural, 16% were intraventricular, 15% were subarachnoid, and 7% were epidural. DISCUSSION: Intracranial hemorrhage was a common consequence of acute head trauma sustained from traffic accidents in the population studied, with intracerebral hemorrhage being the most prevalent type. CONCLUSION: Traffic accidents are the main cause of acute head trauma in Lagos, Nigeria. The use of CT for early diagnosis of intracranial hemorrhage appears justifiable.

Uterine Roundness Index: Model Formulation and Nomogram for a Nigerian Population

This study was aimed to establish a nomogram for uterine roundness index (UTRI) for a Nigerian population. Seven hundred Nigerian girls and women in the premenarche; nulliparous; multiparous and postmenopausal groups with normal uteri were evaluated by pelvic ultrasound. The length; anteroposterior and transverse diameters of the uterus were measured and the UTRI calculated as the ratio of anteroposterior diameter to the length. The age; height; and parity of the subject were recorded. The mean UTRI +SD were 0.44457+0.0629 for premenarche; 0.5880+0.1118 for nulliparous; 0.6005+0.1046 for multiparous and 0.5269+0.1037 for postmenopausal. Pearson's correlation analysis showed significant correlation between UTRI and age; height and weight in premenarche group and weight in the nulliparous; multiparous and postmenopausal groups (p 0.05). Significant negative correlation between UTRI and age occurred only in the postmenopausal group (p 0.05). The study has established a nomogram for UTRI in a Nigeria population which will be of gynaecological importance to sonographers and referring clinicians in assessing the normality of uterine shapes and contour