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ABSTRACT: This study is to assess the effect of CD4 T lymphocytes, on features of pulmonary tuberculosis on HIV positive patients with co-existing tuberculosis attending clinic in university of Benin Teaching Hospital Benin Nigeria.
University of Benin Teaching Hospital Benin, Nigeria.
This study was carried out on 200 patients who had laboratory confirmation of HIV, CD4 T lymphocytes measured, with tuberculosis co-infection, and control group of 100 patients, who were HIV negative, but positive for tuberculosis infection, between 1st July, 2003 and 30th May, 2004, were further examined with chest radiography, in the hospital. The standard procedures of chest radiography were used, with minor adjustment to allow good image quality on the radiograph. Two Radiologists analyzed these on standard image viewing box.
The average CD4 T lymphocyte count in the study group (HIV sero-positive) was 173.90 cells/nl and median of 172 cells/nl. 128 (64%) subjects had CD4 T lymphocyte counts less than 200 cell/nl while 72(36%) subjects had CD, lymphocyte count above or equal to 200 cells/nl. 111 (86.72%) subjects with a CD4 T lymphocyte count less than 200 cells/nl and 31 (43.1%) subjects with CD4 T lymphocyte count 200cells/nl or more had an atypical chest radiographic pattern of primary pulmonary tuberculosis. Atypical chest radiogra phic pattern was more frequent among patients with CD4 T lymphocyte count less than 200 cell/nl (86.72%) compared with patients with CD4 T lymphocyte count greaterthan 200 cells/nl (43.1%) (P < 0.001).
There is significant relationship and correlation between immune status of HIV positive patient and pulmonary pattern of tuberculosis. The variation on pulmonary pattern of tuberculosis noted also collaborated well with the level of CD4 T lymphocyte in the patients.
Nigerian journal of clinical practice 09/2010; 13(3):254-9. · 0.19 Impact Factor
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ABSTRACT: To find out the state of radiation protection and monitoring practices of the public and private X-ray centres in Edo state.
Survey visits were made to all the functional X-ray facilities in Edo state and the available facilities identified, staff interviewed and collected data analyzed.
There are 18 functional X-ray facilities comprising 10 (55.56%) publicly owned and eight (44.44%) privately owned. Only two (20%) of the public and five (62.5%) of the private X-ray units have personnel and environmental monitoring. All the X-ray centers in both public and private hospitals have effective lead aprons. All the public (100%) and only four (50%) of the private centers have gonadal shield although none is using them on a routine basis. Qualified radiographers are available only in five (50%) of the public and six (75%) of the private centers. Only three (30%) of the public X-ray centers have the services of radiologists. Among the private X-ray units, five (62.5%) have radiologist while three (37.5%) have no radiologist. Only one (10%) of the public centers and one (12.5%) private X-ray centre have a purpose-built adequately designed X-ray unit with barium plasters and lead lining of walls and doors. There is also only limited lead lining of doors and walls in three (37.5%) private units while no lead lining or barium plasters are used in five (62.5%) of the private units. No X-ray unit in Edo state uses digital radiography or computerized information system. This means that lost hard copy must be repeated, leading to more radiation to patients and staff.
There are inadequate radiation protection and monitoring practices in most of the functional X-ray facilities in Edo state with only five (62.5%) of the private and two (20%) of the public X-ray units monitored. There is poor adherence to the advice of the medical physicists due to the cost implications of the implementation.
Nigerian journal of clinical practice 14(3):308-10. · 0.19 Impact Factor
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ABSTRACT: 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.
To report a case of isolated dextrogastria in an 18-year old woman who was seen during pre-university admission medical examination.
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.
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.
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.
West African journal of medicine 28(4):270-3.
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ABSTRACT: Acute abdomen is a clinical diagnosis and not a definitive one. The use of ultrasound in management and diagnosis of acute abdomen is rarely invoked in our environment. The importance of definite diagnosis in surgical and medical management cannot be overemphasized
To report a case of ultrasound diagnosis of retrocaecal appendicitis.
A nine-year-old male child presented with vomiting, vague abdominal pain, diarrhoea, and fever, which led to the following differential diagnoses; acute food poison gastro-enteritis, typhoid enteritis, malaria and acute appendicitis. He was investigated along these lines. He had abdominal ultrasonography and CT scan .
The ultrasound showed evidence of acute appendicitis. The findings on CT and surgery confirmed the diagnosis. Post-operatively, he made uneventful recovery.
The use of ultrasound in acute abdomen is rarely invoked in our environment which may lead to unquantifiable consequences both in management and complications.
West African journal of medicine 30(2):136-9.
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ABSTRACT: Proforma information, instructions and procedures of training in radiology are lacking in Nigeria.
To describe the errors in ultrasonography performed by unsupervised trainee radiologists.
The radiology records of all ultrasound scans (USS) carried out and all reports that came back to the unit of the authors on account of misdiagnosis, doubtful diagnosis, misinformation or error in the reports were studied. The patients with the returned reports were rescanned where available by consultants and the collected data analysed.
A total of 4680 patients had ultrasound studies without supervision resulting in 605 (12.93%) queried reports. The USS scans of 235 (5.02%) patients were repeated with consultants in attendance resulting in significant change in reports of 95 (2.03%) patients. Analysis of the request cards of 605 queried reports showed omission of relevant clinical information 463 (76.53%), outright wrong information 65 (10.73%),and unconventional abbreviations 139 (22.98%), while 493 (81.49%) were completed by a nurse, medical student or junior resident. Typographical errors comprised 174 (28.76%) of the 605 queried reports. False negative error was the highest type of error seen in 55 (57.89%) of the 95 patients with significant change in their report after repeat scan as lesions not detected were not documented.
Trainee radiologists make significant errors in carrying out and reporting ultrasonography without adequate direct supervision of the study by their training consultants. Majority of the errors originate from lack of accurate filling of the patients request cards by the requesting physicians, lack of adequate preparation for the intended study, and typographical errors in writing reports. False negative reports are by far the greatest cause of errors recorded as lesions not detected were not documented.
West African journal of medicine 28(4):257-61.
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ABSTRACT: The objective of this study was to determine the measurement of normal range of ultrasound (US) thyroid gland dimensions in school-aged children (6-16 years) in our environment and compared with what is obtained elsewhere.
A prospective ultrasound measurement study done in University of Benin Teaching Hospital Benin, Nigeria.
A prospective ultrasound (US) study of thyroid dimensions of 500 school-aged children in our environment consisting of 227 boys and 273 girls was done from 1 December 2006 to July 2007. The subjects were examined by the authors and subjects with palpable abnormal thyroid gland were excluded from the study. The thyroid dimensions (length, height, and diameter) were taken for each lobe by means of ultrasound (US). In addition volume of each thyroid lobe was calculated and the summation of volume of the lobes was taken as thyroid gland volume of each subject. Also height and weight of patients were documented from which the subject's body surface was calculated. Incidental thyroid gland lesion in US was excluded from the study. Using the Statistical program of social science (SPSS) and INSTAT (Graph Pad Inc. USA) the data were analyzed. Informed consent was obtained from all the subjects and the study was done in line with the ethical guidelines of the centers.
The US thyroid gland volume in school-aged children in Benin City from this study ranges between 1.17 cm 3 and 7.19 cm 3 , mean volume range of 1.76-4.95 cm 3 , median volume range of 1.73-4.73 cm 3 , and range of standard deviation from 0.39 cm 3 to 1.49 cm 3 . The average mean thyroid volume is 2.32 cm 3 with the following average dimensions; anteroposterior right lobe =1.06 cm, mediolateral right lobe = 1.01 cm and craniocaudal right lobe = 2.34 cm, and anteroposterior left lobe = 1.01 cm, mediolateral left lobe = 1.04 cm and craniocaudal left lobe = 2.41 cm for both boys and girls respectively. These data are significantly lower than data obtained by European based World Health Organization/International Council for the Control of Iodine Deficiency Disorders (WHO/ICCIDD) 1997. However there is significant similarity with data obtained in similar environment.
Ultrasound thyroid gland dimensions in school-aged children in our environment are reproducible and the data obtained are comparable to those obtained in other environment. The values may be better used in our environment as reference data for screening purposes.
Nigerian journal of clinical practice 15(3):285-92. · 0.19 Impact Factor
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T T Marchie
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ABSTRACT: A case report of a fifty years old Hausa male from Sokoto town, Nigeria an endemic region of guinea worm infestation, who presented with sudden adult onset of asthmatic attack and was evaluated radiologically and the diagnosis of acute obstructive airway disease was confirmed. It was noted, that there were associated calcified chain of guinea worms in the lung parenchyma. A rare association of acute asthmatic attack. Patient responded there-after to an anti-asthmatic regime of management.
West African journal of medicine 18(3):214-6.
