Computerized tomographic study of normal Evans index in adult Nigerians.

BACKGROUND: The evaluation of degree of ventricular enlargement should be based on established indices rather than on personal experience as this is highly subjective. Our aim was to establish normal values for Evans index in a Nigerian adult population as none has been found in the Nigerian medical literature. MATERIALS AND METHODS: Axial computerized tomographic brain scans of 488 normal subjects were reviewed retrospectively. Of them, 319 (65.36%) of the patients were males and 169 (34.63%) were females; their ages ranged from 18 to 84 years with a mean age of 37.26 years. The images were acquired using a multi-slice GE Sigma excite scanner. Evans index was measured as the linear ratio of the total width of the frontal horns of the cerebral lateral ventricles to the maximum intracranial diameter. RESULTS: The mean value for Evans index for the studied population was 0.252 ± 0.04. The EI increased with age and it was slightly higher among males. The difference in Evans value in males and females was not statistically significant. Individuals above 60 years old had the highest Evans values in both sexes. CONCLUSION: This study has established ranges of normal value for Evans index in a Nigerian population. It agrees with the diagnostic cut-off value of > 0.3 for hydrocephalus and it compares well with that of the Caucasians.

Clinical presentation and outcome of toxoplasma encephalitis in HIV-infected patients from Zaria, Northern Nigeria: a case series of 9 patients.

Toxoplasma encephalitis (TE) is the most common cause of focal deficits in patients living with HIV/AIDS. Among 257 HIV-infected adult patients seen between January 2006 and December 2010 in a tertiary hospital in Zaria, northern Nigeria, 9 (3.5%) patients had clinical, serological, and brain imaging evidence of TE. All 9 patients had CD4 count of less than 50 cells/mm(3). Of the 9 patients, 7 were antiretroviral therapy (ART)-naive, while 2 were cases of ART-induced TE-immune reconstitution inflammatory syndrome. After administering intravenous dexamethasone for cerebral decompression and specific antitoxoplasma therapy, symptoms and signs resolved in 8 patients within 4 to 14 days, but 1 patient died. Our data suggest that even in the ART era in Nigeria, TE remains a fairly common cause of morbidity among HIV-infected patients due to late HIV diagnosis and significant immunosuppression at diagnosis. Early HIV diagnosis, early initiation of highly active ART, and routine prophylaxis against TE are imperative in combating the challenge of HIV/AIDS-related TE in Nigeria.

Calcaneal pitch and lateral talocalcaneal angle among nigerians / Inclinación calcáneo y ángulo talocalcáneo lateral en nigerianos

Various papers in the fields of Radiology, orthopaedics and radiographic anatomy have employed the use of angles measured on X-rays to make diagnoses, select treatment modalities in the management of foot disorders as well as predicting the outcome of interventions to these disorders. Calcaneal pitch (CP) and lateral talocalcaneal angle (L TCA) are angles that can be drawn on lateral standing radiographs of the foot and are used widely in the diagnosis, prognosis and choice of treatment modalities for various disorders of the foot. Data on these important radiological tools are lacking in Nigeria. Hence, the study is an attempt to bridge this gap. Using a hinge goniometer, the angles were measured from normal lateral standing radiographs of the foot. Mean CP was found to be 15.08 +/- 2.87 (n=63) and the mean L TCA was found to be 38.85°+/-8.20° (n=130). Differences in the means of the angles seen between the sexes were not statistically significant (CP, p=0.70; L TCA, p=0.60). No such significant difference was also observed in mean of the angles with respect to the sides of the body (CP, p=0.58; L TCA, p=0.13) or between ethnic groups (CP, p=0.30; L TCA, p=0.40).

Diversos trabajos en las áreas de la radiología, ortopedia y anatomía radiográfica han empleado los ángulos medidos en las radiografías para hacer diagnósticos, seleccionar las modalidades de tratamiento en el manejo de los trastornos del pie, así como para predecir el resultado de las intervenciones para estos trastornos. La inclinación calcánea (PC) y el ángulo talocalcáneo lateral (L TCA) son los ángulos que se pueden extraer desde las radiografías laterales de los pies y ser utilizados ampliamente en el diagnóstico, pronóstico y elección de modalidades de tratamiento para diversos trastornos del pie. Los datos sobre estos importantes instrumentos radiológicos no existen en Nigeria, y su estudio es un intento de obtener esta información. Usando un goniómetro bisagra, los ángulos se midieron a partir de radiografías normales permanentes lateral del pie. La media de CP se fue 15,08+/-2,87 (n = 63) y la media de TCA L fue 38,85°+/-8,20° (n = 130). Las diferencias en las medias de los ángulos observados entre los sexos no fueron estadísticamente significativas (CP, p = 0,70; L TCA, p = 0,60). No hubo diferencias significativas en la media de los ángulos con respecto al lado (CP, p = 0,58; L TCA, p = 0,13) o entre grupos étnicos (CP, p = 0,30; L TCA, p = 0,40).