ABSTRACT
BACKGROUND: Magnetic resonance imaging (MRI) in paediatric patients requires them to be calm during the procedure to avoid motion artefacts in the acquired images. Sedation and/or anaesthesia is a way to achieve this. We evaluated all paediatric MRI sedations since installation of an MRI device in our hospital. MATERIAL/METHODS: We retrospectively reviewed 69 paediatric MRI sedations performed over a 5-year period using records of patients' biodata, MRI date, indication, findings and scan time, sources of referral, body region scanned, type, dose, related adverse events and route of administration of sedatives as well as image quality. RESULTS: The median age and weight of the patients were 24 months {range of 0.3 months (10 days) to 132 months (11 years)} and 11.5 kg (range of 2.6 kg to 42 kg), respectively. Males constituted 50.7% of the patients. Most participants (94.2%) were in-patients of the hospital, mainly (60.0%) referred from the paediatric unit, with slightly over one third (36.2%) of the studies performed in 2015. The commonest indication and scanned body region were macrocephaly (18.8%) and the brain (76.8%), respectively. Hydrocephalus (17.4%) was the commonest MRI finding. Sedation was planned in 66 (95.7%) patients and was successful in 68 (98.6%). Midazolam and the IV route were the commonest sedative agent and route of administration, respectively. Image quality determined by age was fair to good in 68 (98.6%) patients with only 1 patient requiring re-scanning due to motion blur. No adverse events with sedation were recorded. CONCLUSIONS: Midazolam via the IV route with or without oral route is the drug of choice for MRI sedation in children in our institution with a success rate of about 99%.
ABSTRACT
PURPOSE: To assess blood flow velocity in newly diagnosed indigenous black-skinned Africans with primary open angle glaucoma (POAG). MATERIALS AND METHODS: Prospective case-control study at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria on 50 newly diagnosed POAG patients (POAG group) and 50 control patients (control group). Ocular Doppler Color Imaging was performed on subjects in the supine position using 9 MHz linear array transducer of a Fukuda Denshi Ultrasound. The Peak Systolic Velocity (PSV) and End Diastolic Velocity (EDV) values were obtained by finding the average of two readings each for the ophthalmic artery (OA) and central retinal artery (CRA). Resistive Index (RI) was calculated as (PSV - EDV)/PSV. Data were analyzed and statistical significance was defined at P < 0.05. RESULTS: The mean intraocular pressure (IOP) for the POAG group and control group was 28.1 ± 7.4 mmHg and 16.6 ± 2.0 mmHg, respectively (P < 0.001). The mean PSV for OA was 31.35 cm/s in POAG group and 37.61 cm/s for the control group (P < 0.001). The EDV for both OA and CRA were significantly lower in glaucoma patients as compared with the corresponding values in the control group (P < 0.001, both comparisons). The mean RI in the OA was 0.71 ± 0.05 and 0.63 ± 0.03 for the POAG and control group groups, respectively (P < 0.001). The increase in IOP in the POAG group was statistically significantly negatively correlated with PSV and EDV and positively correlated with RI for both OA and CRA. CONCLUSION: The outcomes of this study indicate that ocular blood flow alterations including reductions in PSV and EDV and increase in RI of the OA and CRA are present in black-skinned Africans with POAG.
