Sensitivity of uterine artery Doppler pulsatility index in screening for adverse pregnancy outcome in first and second trimesters.

PURPOSE: In a poor resource country where screening for adverse pregnancy outcomes using maternal biomarkers seems unattainable, there is a need to search for credible alternatives. This study is, therefore, aimed at determining the sensitivity of uterine artery Doppler pulsatility index (UtAD-PI) in predicting pregnancy outcomes in the first and second trimesters and to establish any statistical difference in mean UtAD-PI in first and second trimesters screening of women with normal and abnormal pregnancy outcomes respectively. METHODS: This clinical-based, longitudinal, and unpaired cohort study involved 500 pregnant women, who were screened for adverse outcomes using UtAD-PI and delivered in the hospital. These were divided into two groups, each having a training set and a test set. The training set was used to generate the receiver operator characteristic curve and cut-off point while the test set was used to test for sensitivity and specificity of the Ut-ADI in each trimester. RESULTS: The sensitivity and specificity of UtAD-PI in first-trimester screening are 97% and 76.5% while second-trimester gave sensitivity and specificity of 57.5% and 63.3% respectively. The uterine artery Doppler pulsatility index shows statistically significant differences between normal pregnancy and pregnancy with adverse outcomes (p-value = 0.000). CONCLUSION: The uterine artery Doppler pulsatility index is a good screening tool for adverse pregnancy outcomes. First-trimester screening of patients for adverse outcomes is more sensitive than the second-trimester screening using UtAD-PI. There is also a statistically significant difference between mean UtAD-PI between normal pregnancy and pregnancy with adverse pregnancy outcomes.

Renal echotextural changes in Nigerian workers chronically exposed to petroleum-based liquid fuels.

Background: Exposure to hydrocarbon is associated with an increased risk of development of chronic kidney disease. Ultrasound, which is a non-invasive imaging modality, provides very important information about kidney morphology. Objective: The aim of this study was to evaluate the effects of chronic exposure to some petroleum products on the kidney of exposed workers using sonography. Materials and methods: This was a prospective cross-sectional study involving 415 workers with chronic workplace exposure to petroleum fuel in Enugu metropolis. The study population comprised 164 petrol station attendants, 175 automobile mechanics and 76 petrol tanker drivers aged between 20 and 65 years. Abdominal ultrasound was performed, as well as serum urea and creatinine were measured to assess the kidneys of these workers chronically exposed to petroleum fuels, and the findings were compared to findings in an aged-matched, non-exposed control group. Results: Increased echogenicity of the kidneys was observed in 21 subjects from the study group and this differed significantly (p <0.05) from the findings in the control group. Conclusions: The study has shown that chronic exposure to petroleum fuel affects renal echotexture and that ultrasound may serve as a useful non-invasive tool for routine use in the assessment of petroleum-induced nephropathy.Background: Exposure to hydrocarbon is associated with an increased risk of development of chronic kidney disease. Ultrasound, which is a non-invasive imaging modality, provides very important information about kidney morphology. Objective: The aim of this study was to evaluate the effects of chronic exposure to some petroleum products on the kidney of exposed workers using sonography. Materials and methods: This was a prospective cross-sectional study involving 415 workers with chronic workplace exposure to petroleum fuel in Enugu metropolis. The study population comprised 164 petrol station attendants, 175 automobile mechanics and 76 petrol tanker drivers aged between 20 and 65 years. Abdominal ultrasound was performed, as well as serum urea and creatinine were measured to assess the kidneys of these workers chronically exposed to petroleum fuels, and the findings were compared to findings in an aged-matched, non-exposed control group. Results: Increased echogenicity of the kidneys was observed in 21 subjects from the study group and this differed significantly (p <0.05) from the findings in the control group. Conclusions: The study has shown that chronic exposure to petroleum fuel affects renal echotexture and that ultrasound may serve as a useful non-invasive tool for routine use in the assessment of petroleum-induced nephropathy.

Bone mineral density in an urban and a rural children population-A comparative, population-based study in Enugu State, Nigeria.

INTRODUCTION: Osteoporosis is one of the non-communicable diseases linked to urbanisation. The foundation of osteoporotic fractures stems from childhood. Therefore, studies that promote maximising peak bone mass are strongly advocated. Studies have shown that there are differences in the incidence of osteoporotic fractures in rural and urban communities. No study has investigated urban-rural differences in BMD of Nigerian children. This study, therefore, aimed to investigate urban-rural differences in BMD of Nigerian children and the association with physical activity, demographic and anthropometric variables. METHODS: In a cross-sectional, study in Enugu, Nigeria, estimated bone mineral density (eBMD) was measured at the calcaneum using the QUS densitometer, Hologic Sahara, in 457 urban (Enugu metropolis) and 559 rural (Nsukka community) children aged 6-14 years. Height, weight and physical activity were measured. Independent sample t-test was used for comparative analysis while Pearson correlation coefficients and multiple regression models were used to examine the relationship between the eBMD and the other parameters. RESULTS: The mean (S.D) eBMD of the urban children [0.52(0.09) g/cm2] were significantly higher (p < 0.05) than their age- and gender-matched counterparts in the rural areas [0.51(0.08) g/cm2]. Age and weight predicted (p < 0.05) the eBMD in the urban subjects while only age was the predictor (p < 0.05) in the rural subjects. The physical activity pattern had no relationship with eBMD in both urban and rural children in Enugu, Nigeria. CONCLUSIONS: The eBMD of rural children is lower than that of their age- and gender-matched urban counterparts.

Echocardiographic assessment of left ventricular function in thyrotoxicosis and implications for the therapeutics of thyrotoxic cardiac disease.

INTRODUCTION: Thyrotoxicosis is an endocrine disorder with prominent cardiovascular manifestations. Thyroid hormone acts through genomic and non-genomic mechanisms to regulate cardiac function. Echocardiography is a useful, non-invasive, easily accessible, and affordable tool for studying the structural and physiological function of the heart. AIM: We studied thyrotoxicosis patients in a Nigerian Teaching Hospital and employed trans-thoracic echocardiography to find out if there were abnormalities in the hearts of these patients. METHODS: Fifty adult thyrotoxicosis patients diagnosed with clinical and thyroid function tests in the medical out-patient unit of the hospital were recruited and we performed transthoracic echocardiography with a Sonos 2000 HP machine. RESULTS: We documented the presence of abnormalities in the following proportion of thyrotoxicosis patients: left ventricular enhanced systolic function in 30%, enhanced diastolic function in 34%, diastolic dysfunction in 34%, heart failure with preserved ejection fraction in10%, heart failure with reduced ejection fraction in 6%, and left ventricular hypertrophy in 34%. CONCLUSION: Echocardiography was useful in the stratification of cardiac function abnormalities and is indispensable as a guide in the choice of therapeutic options in patients with thyrocardiac disease. The finding of left ventricular enhanced systolic and diastolic functions signify early echocardiographic detectable cardiac abnormalities in thyrotoxicosis, and the clinical management includes the use of anti-thyroid drugs and ß-adrenoceptor blockade. Diastolic dysfunction in thyrotoxicosis patients asymptomatic for cardiac disease should be treated with anti-thyroid drugs, and ß-adrenoceptor blockade. The judicious application of clinical therapeutics will guide the use of anti-thyroid drugs, diuretics, digoxin, angiotensin inhibitors, and ß-adrenoceptor blockade in the successful management of thyrotoxicosis patients with heart failure and reduced, preserved, or increased ejection fraction: parameters which are derived from echocardiography.