Impact of 10-Day Fulbright Specialist Program and Project Pink Blue Education Sessions on Medical Oncology Knowledge Among Physicians Who Treat Cancer in Nigeria.

Despite an estimated population of over 201 million and over 115,950 yearly diagnosed new cases of cancer, Nigeria does not have dedicated medical oncologists. Most oncology care is delivered through surgical and clinical oncologists, who are trained in both radiation and medical oncology and they number fewer than 50 in the country. With a limited number of oncology professionals, cancer patients in Nigeria experience poor health outcomes, with an estimated cancer mortality rate of 75,000 deaths per year. Participants from 15 Nigerian states were selected to attend the medical oncology training. Through the support of Fulbright Specialist Program and Project PINK BLUE, two of the authors delivered 10 days of lectures based on ASCO, ESMO, and NCCN guidelines. Mean scores of both the pre- and post-course tests as well as a 1-year follow-up test were compared using GraphPad Prism 7.0a by paired t-tests. Forty-four clinical oncologists were selected for participation. Twenty-five (57%) completed the pre- and post-course tests. Of the 25 that completed both tests, percentage of correct answers increased from 45 to 59% (2-sided p-value < 0.0001). Improvements were seen in attending doctors 45 to 59% (p = 0.0046) and resident doctors 45 to 59% (0.0007). Eleven doctors responded to the 1-year follow-up test. Although not statistically significant, a numerical pattern for the benefits was maintained 1 year after the program (45% pre-course versus 52% post-course correct answers, Fisher's exact, p = 0.4185). In the short term, the training improved medical oncology knowledge in Nigeria, regardless of the participant's carrier stage. Long-term benefits were not sustained in a small sample of participants, and continuing education strategies are necessary. Similar models may be employed across Africa.

Profiles of Tuberculosis Patients: A Single-Center Experience in a Semi-Urban Tuberculosis Center in Southeast Nigeria.

BACKGROUND AND OBJECTIVES: Tuberculosis infection (TB) is a global healthcare problem. In Sub-Saharan African countries TB-HIV co-infection is an evil duo. This study sought to evaluate TB characterization and mortality rate in TB subjects in a semi-urban tuberculosis center in Southeast Nigeria. METHODOLOGY: This was a retrospective study of 241 TB patients between September 2014 and August 2017. Data on clinical profiles, demography, anthropometry, occupation, HIV status, treatment, treatment outcome, and loss to treatment were retrieved and compared within subgroups. RESULTS: The male subjects were 97(40.2%) and female 144(59.8%). TB rate was low at extremes of age. Traders (38.2%) and artisans (17.4%) have high TB rate, with male preponderance, p=0.039. TB cure rate was 11.2%, death rate 17.4%, treatment completion 29.5%, loss to follow-up12.5%. TB-HIV co-morbidity rate was 42.3% and was high among traders, artisans, dependents, drivers, as well as civil servants, p=0.039 and specifically higher in females, p = 0.039. Low TB cure rate (25.0%) and high TB mortality rate (66.7%) occurred with TB-HIV co-infection, p=0.003. CONCLUSION: TB infection declined at extremes of age, and was high among traders and artisans. TB-HIV co-infection rate was high overall, associated with low TB cure rate and high mortality rate in this study.

Performance of Multiple True or False Options with Negative Scoring Schemes Against Single Best of Five Answer Options in a Medical School.

BACKGROUND AND OBJECTIVES: The multiple true or false (MTF) options with different negative scoring schemes and the Single Best of Five Answer (SBOFA) option of multiple choice questions are used in assessing knowledge in medical schools in Nigeria. There are diverse reasons for specific institutions to use a given scheme. These include large candidates' population, time pressure on those conducting the examination and limited resources. This study was set out to compare the performance of two negative scoring schemes of the MTF pattern of objective questions with the SBOFA pattern as the standard objective questions pattern in a medical school Methodology: In this cross-sectional comparative study, selected response items were administered to medical students. A set comprised of SBOFA options (taken here as A-score) and the other two, MTF options with different negative marking schemes; negative marking (-1/2) as B-score, and negative marking (-1) as C-score. The mean scores were compared among the three schemes. Cutoff or pass mark was 50% across-board. Correlation statistics, Bland Altman plots and ROC analyses were used to compare the two negative scoring schemes of the MTF pattern with the SBOFA pattern as the standard objective questions pattern Results: The mean scores of the students for the schemes were A-score 42.9%, B-score 45.6% and C-score 35.0%. The correlation between A-score and B-score was significant (r=0.351, p=0.009). A-score also correlated significantly with C-score, (r=0.381, p=0.004). In B-score versus A-score the bias was -2.6 (47.4%), limits of agreement -29.4 - 24.1 (20.6% -74.1%). In C-score versus A-score the bias was 8.1 (58.1%) and limits of agreement -21.5 - 37.7 (28.5%-087.7%). For B-score and A-score area under receiver operator curve (AUROC) was 0.720 and for C-score and A-score 0.714. B-score at best cutoff mark 45.0% (sensitivity 93%), predicted A-score 50.0%. C-sore at best cutoff mark 33.0% (sensitivity 93%) predicted A-score 50%. CONCLUSION: The MTF objective questions with negative marking scheme of -1/2 as penalty and the SBOFA scheme were more closely related than the MTF with -1 as penalty and SBOFA option. The SBOFA option had better correlation with the MTF with -1 as penalty while the -1/2 penalty had a much higher pass rate.

Prevalence and distribution of hypertension in overweight and obese subjects in an urban community in Enugu, South East Nigeria. A post hoc analysis.

BACKGROUND: Most recent studies in Nigeria have documented high prevalence of hypertension, diabetes, and obesity. Several mechanisms may link hypertension and obesity hence the high prevalences of both disorders in Nigeria. There are however no studies on the prevalence of hypertension among the obese in urban settings. AIMS: The aim of this study was to describe the prevalence and pattern of hypertension in overweight/obese individuals in a community. METHODS: We conducted a post-hoc analysis on obese subjects 20 years and above from two urban settlements within Enugu metropolis. For database management and statistical analyses, we used the SPSS version 22. RESULTS: Data from a total of 301 individuals with obesity who met the selection criteria were re-analyzed. A total of 198 (65.8%) individuals were found to have hypertension most of whom were newly diagnosed 110 (55.6%). The prevalence of hypertension was 65.8% and increased with age and BMI. CONCLUSION: Individuals with overweight/obesity have very high rates of hypertension. The prevalence of hypertension also increased with and BMI. Thus, there is need for targeted health education in adults to address the burden of obesity and hypertension to reduce the burden of cardiovascular disease in the community.

Sustaining tuberculosis preventive therapy scale-up through direct supportive supervision.

BACKGROUND: Tuberculosis preventive therapy (TPT) is recommended for tuberculosis (TB) prevention among people living with HIV (PLHIV) and other high-risk groups. The Nigerian Military HIV Program embarked on TPT-specific 'direct supportive supervision' (DSS) in May 2018 to increase TPT initiation and completion rates. METHODS: Interventional approaches included site visits to conduct root cause analysis, didactic teaching approach on the concepts of quality improvement and mentorship to address barriers. The DSS introduced TPT monitoring tools, sticker reminders on clients' folders, and bi-weekly data collection and review for decision making. RESULTS: TPT initiation increased from a monthly pre-intervention median of 323 clients to monthly medians of 2611 during the 'surge' and 1212 clients during the 'sustained' phases. Due to an isoniazid stock-out, a 'dip phase', with a median of 559 clients was recorded. Overall, 10 463 clients were started on TPT in fiscal year (FY) 2018 and 12 596 in FY2019, with an overall initiation rate of 79%. Completion rates were respectively 73% and 70% for FY2018 and FY2019. CONCLUSION: With the implementation of a tailored DSS, programmatic barriers to TPT were easily identified and quickly addressed to increase initiation and completion rates.

CONTEXTE: Le traitement préventif de la tuberculose (TPT) est recommandé pour la prévention de la tuberculose (TB) parmi les personnes vivant avec le VIH (PVVIH) et pour d'autres groupes à risque élevé. Le programme VIH de l'armée au Nigeria a rencontré de nombreux défis dans sa mise en œuvre. MÉTHODE: En mai 2018, le programme s'est lancé dans une « supervision directe de soutien ¼ spécifique du TPI (DSS) en vue de son expansion et de la réduction de la transmission de la TB chez les PVVIH. Les approches d'intervention mises en œuvre ont inclus des visites sur le terrain afin d'analyser les causes profondes, une approche didactique d'enseignement relatif aux concepts d'amélioration de la qualité et un tutorat afin de surmonter les obstacles. On a eu recours à l'introduction d'un outil de suivi du TPT, à des rappels sous forme de stickers sur les dossiers des clients et à un recueil de données et à une revue destinée à la prise de décisions bi hebdomadaire. RÉSULTATS: La mise en route du TPT a augmenté d'une médiane mensuelle avant l'intervention de 323 clients à 2611 et 1212 clients pendant les phases de lancement et de continuation respectivement. En raison d'une rupture de stock d'isoniazide, une phase de chute avec une médiane de 559 clients a été enregistrée. Au total, 10 463 et 12 596 clients ont débuté le TPT en FY2018 et FY2019 respectivement, avec un taux d'ensemble d'initiation de 79%. Les taux d'achèvement ont été de 73% et 70% respectivement pour FY2018 et FY2019. CONCLUSION: Grâce à une stratégie sur mesure de supervision et de soutien et en tenant compte des contextes particuliers du terrain, les obstacles programmatiques à la mise en œuvre du TPI ont été facilement identifiés et rapidement affrontés pour une meilleure prise en charge du patient.

Gastrointestinal Parasitic Infections and Immunological Status of HIV/AIDS Coinfected Individuals in Nigeria.

BACKGROUND: Parasitic infections of the gastrointestinal tract is one of the highest causes of morbidity and mortality among HIV infected individuals. This is due to the colonization of the intestinal tract by parasites influenced by induced enteropathy caused by HIV infection. CD+4 t-lymphocytes count is a marker of the immune status of HIV infected individuals. OBJECTIVE: This study investigated the prevalence of gastrointestinal parasitic infections among HIV coinfected individuals in relation to their immunological status. METHODS: CD+4 t-lymphocytes count was determined using fluorescence-activated cell sorting (FACS) count system. Parasitological examination of faecal samples was conducted using direct wet mount, modified Z-N and Giemsa stain techniques. All prepared slides were examined under x10 and x40 objectives. FINDINGS: Out of the 891 HIV seropositive participants on antiretroviral therapy that were studied, 641 (71.9%) had CD+4 counts equals to or greater than 500 cells/mm3. All other seropositive participants had CD+4 counts below 500 cells/mm3. Gastrointestinal parasitic infections were recorded in 187 (20.9%) seropositive participants, with females (n = 108, 12.1%) having more infections than males. Multiple gastrointestinal parasitic infections were recorded in 28 (3.1%) seropositive participants. Out of the 150 seronegative participants, 79 (52.7%) of them had at least one gastrointestinal parasitic infection. Female seronegative participants also accounted for higher infection rate (n = 42, 28.0%) than males (n = 37, 24.7%). Multiple infections were also recorded in 18 (12.0%) seronegative individuals. The overall prevalence rate of infection between both positive and negative individuals was 25.5%. There was statistical significant difference in the infections of Cryptosporidium parvum (p < 0.003), Cyclospora cayetanensis (p < 0.011) and Cystoisospora belli (p < 0.011) between HIV seropositive and HIV seronegative individuals. Also, there was statistical significant difference in the infections of hook worm (p < 0.002) and Trichuris trichiura (p < 0.020) between seronegative and seropositive individuals. Gastrointestinal parasitic infection rate was significantly higher among seropositive participants with CD+4 counts between 200 and 350 cells/mm3 (n = 109, 58.3%). CONCLUSION: The study shows that HIV infected individuals continue to experience gastrointestinal infections even with antiretroviral treatment, especially those with CD+4 counts below 350 cells/mm3. Health care providers should prioritise routine screening of HIV patients for gastrointestinal parasites and provide prompt treatment. Antiparasitic drugs should also be provided as prophylaxis.

Sonographic analysis of adult polycystic kidney disease: retrospective data from South-East Nigeria.

BACKGROUND: Autosomal dominant polycystic kidney disease (APKD), an inheritable multisystem disease characterized by intrarenal and at times extrarenal disease, has been studied extensively among Caucasian populations. Despite the fact that being black is a risk factor for progressive disease, there is paucity of local published data. As a result, true local incidence and peculiarities in clinical and sonographic characteristics are unknown. AIM: To present data from 19 patients diagnosed with APKD in a medium-sized facility over a 16-year period. MATERIALS AND METHODS: A retrospective search was done on the ultrasound registers for patients who had undergone abdominal ultrasound in 16 years (1997-2013). Of the 29 sonographic diagnoses of bilateral PKD made, only 19 had complete records and were included in the study. Data extracted were- age, sex, working diagnosis, renal size, diameter of renal cysts, presence or absence of extrarenal cysts, family history of renal cystic disease, blood pressure at diagnosis, and patient outcome. RESULTS: A total of 19 diagnoses of APKD were made- 12 males and seven females with a sex ratio of 1:0.6. Total mean age was 54.8 years (range 31-79 years)- 40.1 years for females and 57.2 years for males. In 89.5% of cases, no family history of APKD was obtained. Only six (31.6%) patients were hypertensive at presentation and three patients (16%) were already in renal failure. Ultrasound showed a mean renal size of 88.92 cm² for the right kidney and 98.97 cm² for the left. Mean cyst diameter was 3.46 cm (range 2.08-4.85 cm). Only one patient had documented extrarenal cystic disease. Two patients were lost to renal failure and congestive cardiac failure. CONCLUSION: APKD appears to be uncommon in our environment; however, more studies may be elucidatory. Standard sonographic protocol for collecting data from patients with APKD is needed.

Sonographic Analysis of Adult Polycystic Kidney Disease: Retrospective Data from South-East Nigeria

Background: Autosomal dominant polycystic kidney disease (APKD); an inheritable multisystem disease characterized by intrarenal and at times extrarenal disease; has been studied extensively among Caucasian populations. Despite the fact that being black is a risk factor for progressive disease; there is paucity of local published data. As a result; true local incidence and peculiarities in clinical and sonographic characteristics are unknown.Aim: To present data from 19 patients diagnosed with APKD in a medium-sized facility over a 16-year period.Materials and Methods: A retrospective search was done on the ultrasound registers for patients who had undergone abdominal ultrasound in 16 years (1997-2013). Of the 29 sonographic diagnoses of bilateral PKD made; only 19 had complete records and were included in the study. Data extracted were- age; sex; working diagnosis; renal size; diameter of renal cysts; presence or absence of extrarenal cysts; family history of renal cystic disease; blood pressure at diagnosis; and patient outcome.Results: A total of 19 diagnoses of APKD were made- 12 males and seven females with a sex ratio of 1:0.6. Total mean age was 54.8 years (range 31-79 years)- 40.1 years for females and 57.2 years for males. In 89.5 of cases; no family history of APKD was obtained. Only six (31.6) patients were hypertensive at presentation and three patients (16) were already in renal failure. Ultrasound showed a mean renal size of 88.92 cm 2 for the right kidney and 98.97cm 2 for the left. Mean cyst diameter was 3.46 cm (range 2.08-4.85cm). Only one patient had documented extrarenal cystic disease. Two patients were lost to renal failure and congestive cardiac failure.Conclusion: APKD appears to be uncommon in our environment; however; more studies may be elucidatory. Standard sonographic protocol for collecting data from patients with APKD is needed

Epidemiology of intestinal helminth parasites in stray dogs from markets in south-eastern Nigeria.

A survey of gastrointestinal helminth parasites of stray dogs (Canis familiaris) was conducted at Obollo-Afor and Ekwulobia markets, in Enugu and Anambra States, south-eastern Nigeria, respectively, to determine the patterns of infection among dogs in different parts of south-eastern Nigeria. Faecal samples collected, using long forceps, from every dog encountered in the markets between June 2007 and December 2008 were analysed by the Kato-Katz technique. Out of 413 dogs examined in both markets, 217 (52.6%) were infected with at least one of five parasites (Toxocara spp., Dipylidium caninum, Ancylostoma caninum, Taenia spp. and Trichuris vulpis). Overall faecal egg intensity of infection was 49.9 ± 58.7 eggs/g (epg). The prevalence of infection was comparable between the markets and between the male and female dogs, but varied significantly (P < 0.05) by age, decreasing from 78.9% in pups to 36.0% in adult dogs. The mean intensity pattern was similar to that of prevalence, decreasing from 86.7 ± 63.0 epg in pups to 22.1 ± 34.4 in adults. The most important individual parasite infection was Ancylostoma spp. (39.2%; 30.0 ± 41.2 epg) while T. vulpis was the least important (1.9%; 0.7 ± 5.4 epg). Generally, prevalence and intensity patterns of each parasite were also comparable between the markets and between sexes, but significantly (P < 0.05) age-dependent. The implications of these findings to public health in Nigeria and other endemic countries are discussed in relation to options for cost-effective control design and implementation.

Factors associated with urinary schistosomiasis in two peri-urban communities in south-western Nigeria.

In Nigeria, there is only very limited epidemiological information on which the control of human urinary schistosomiasis could be based. In a cross-sectional study, therefore, the prevalences and intensities of, and risk factors for, human infection with Schistosoma haematobium infection were explored in two endemic peri-urban villages in the south-western state of Osun. The villagers' knowledge about the infection and demographic, socio-economic and environmental variables were recorded using a structured questionnaire. Of the 1023 individuals who were investigated, 634 (62.0%) were found infected, with a mean (S.D.) overall intensity of 114.2 (327.7) eggs/10 ml urine. The subjects aged 10-14 years had both the highest prevalence (83.6%) and the highest mean (S.D.) intensity of infection [196.67 (411.7) eggs/10 ml urine]. Most (70.0%) of the subjects appeared to have no knowledge of the transmission of S. haematobium. The results of multivariate regression analysis indicated that infection and moderate-heavy infection (i.e. >50 eggs/10 ml urine) were both associated with: a low family income, of

Regional cancer control in south-eastern Nigeria: a proposal emanating from a UICC-sponsored workshop.

There is an impending cancer epidemic in Africa. In Nigeria, this disease is causing untold devastation, and control measures are desperately needed. Breast, cervical, prostate, and liver cancers are the most common types in Nigerian adults. In children, the predominant malignant diseases are Burkitt's lymphoma, acute lymphoblastic leukemia, neuroblastoma, and Wilm's tumor (nephroblastoma). The focus of efforts to control cancer in Nigeria should be directed at prevention with adequate attention to planning/policy making, early detection, accurate diagnosis, treatment and palliative care. National and regional allocation of sufficient resources is required, accompanied by measurable objectives and appropriate emphasis on accountability.

Breast disease in children and adolescents in eastern Nigeria--a five-year study.

AIMS AND OBJECTIVES: (1) To define the spectrum of breast diseases in the children and adolescents in Eastern Nigeria. (2) To provide where possible, an international comparison of statistical variations of both benign and malignant lesions in these age groups. MATERIALS AND METHODS: The Morbid Anatomy Department of the University of Nigeria Teaching Hospital (UNTH) Enugu is a referral center for over 30 million people. The laboratory receives around 2,000 surgical pathology specimens per year. Virtually all children and adolescents (4-19) years who complained of a breast mass had a biopsy, and results of all excised breast specimens from children and adolescent age groups from 4 to 19 years were included in the study. The case files of these patients were retrieved and reviewed to ascertain the size and duration of the breast lesions. The number of phyllodes tumors seen in the child and adolescent population was compared to those seen in the adult population at the same period. Two independent pathologists reviewed the slides, and their results compared. RESULTS: A total of 1050 breast specimens were received in the department of morbid anatomy from all age groups, from January 1, 2000 to December 31, 2004, out of which 121 (11.5%) were breast specimens from the children and adolescent age groups. On the average most patients with benign breast lesions presented within 3-5 months of their symptoms, which usually was a palpable lump detected in all cases by either the child or the mother. Their sizes vary from 2-3 cm and only ten were multiple but they were all confined to one breast. Those with phyllodes presented typically within 3 months probably because of the faster rate of growth. Their sizes varied from 5-13 cm and they were all unilateral. Phyllodes tumor in this age group constitute 28.6% of all phyllodes seen in this period and were all benign. The mean age was approximately 11.5 years while the median age was 18 years. Three cases were malignant. CONCLUSION: Fibro adenoma, fibrocystic breast disease, and low grade phyllodes tumor were the most common breast lesions seen in our children and adolescent population. The three cases of malignancy observed included invasive intraductal carcinoma, a non-hodgkin lymphoma, and metastases involving the lymph nodes from an uncharacterized secondary malignancy. Phyllodes tumors were typically larger in size and tended to present earlier. Genetic characterization of such lesions is recommended for future studies as well as their relationship to lesions seen among other Africans in Diaspora.

Sonographic Evaluation of Cervical Length Changes during Normal Pregnancy

This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age; the absence of any risk factors for preterm birth; and uncomplicated pregnancy. Cervical length was measured in a straight line. Height; age and weight of patients were also obtained. There was a relationship between gestational age and cervical length; which could be described with a linear regression (R = 0.44; P0.05). Our study shows an increase in cervical length with gestational age. Reference ranges constructed for the whole gestational period could be more clinically applicable and useful than a single cut off value for more efficient prevention and management of preterm birth

Transverse thoracic diameter in frontal chest radiographs of an adult Nigerian population.

BACKGROUND: Normal standards for thoracic dimensions that are available in our environment are often based on studies conducted on Caucasians. Application of such published data to a Nigerian population may lead to erroneous conclusions in terms of clinical implication. OBJECTIVE: Our study aimed to establish age and sex specific transverse thoracic diameter (TD) for our environment. SUBJECTS AND METHODS: The TD of 303 males and females aged between 20 and 93 were obtained in a cross sectional study at a tertiary hospital. RESULTS: The mean values for the 20-39, 40-59 and the 3 60-year-old males were 29.6, 29.0, 27.8 cm respectively. The corresponding values for females were 26.3, 27.1 and 25.1 cm. Males had significantly larger thoracic diameter than females. The largest mean TD in males and females were in the 20-39 and 40-59 age groups respectively. The TD had a significant positive correlation with weight, height, body mass index and body surface area. The best correlations were with body surface area and weight. CONCLUSIONS: Nigerians have a smaller TD than Caucasians. Smaller TD in Nigerians is likely to be responsible for their high cardiothoracic ratios in comparison with Caucasians or Asians.

Relationship between sonographic renal length and renal parenchymal thickness in normal adult southeast Nigerians.

AIM: To determine the relationship between sonographic renal parenchymal thickness (RPT) and renal length (RL) in normal adult Nigerian. STUDY DESIGN: The RL and RPT of 309 normal subjects within the age range of 18-80 years were measured sonographically and prospectively. Correlation was performed between RL values and RPT usingPearson Linear 'r' test RESULTS: The range of RL value were 8.5-12.9 cm and the corresponding mean were 10.33 +/- 0.7 cm and 10.45 +/- 0.63 cm for the right and left kidneys respectively. The range of values for the RPT was 1.40-2.4 and the corresponding mean values were 1.91 +/- 0.20 cm and 1.95 +/- 0.19 cm for the right and left kidneys respectively. There was a strong positive correlation between RPT and RL (r = 0.72 and 0.77 for the right and left kidney respectively. However for RL values above 11.0 cm the RPT values fluctuated. CONCLUSION: From this study, for RL above 11.0 cm there was no relationship with RPT. The study suggests that for our population groups, kidneys with RL lower than 8.5 cm and RPT of 1.40 cm or less should not be biopsied in contrast to webb's criteria.

Fibrodysplasia ossificans progressiva in a Nigerian: a case report.

A case offibrodysplasia ossificans progressiva in a 3-year and 10-month-old Igala boy is presented. It was characterized by progressive ossification of connective tissue and muscles of the neck and chest. Characteristic digital anomalies particularly microdactyly of the hallux and pollex, hallux valgus, and clinodactyly were also noted. The 2nd to 5th metacarpals had epiphyses at both the proximal and distal ends instead of only at the proximal ends. Although the patient presented in the first year of life, the diagnosis was not made until in his fourth year of life. Early diagnosis of the disease is important in order to avoid all forms of trauma that may worsen the prognosis.

Transverse thoracic diameter in frontal chest radiographs of an adult Nigerian population

Background: Normal standards for thoracic dimensions that are available in our environment are often based on studies conducted on Caucasians. Application of such published data to a Nigerian population may lead to erroneous conclusions in terms of clinical implication. Objective: Our study aimed to establish age and sex specific transverse thoracic diameter (TD) for our environment.Subjects and methods: The TD of 303 males and females aged between 20 and 93 were obtained in a cross sectional study at a tertiary hospital. Results: The mean values for the 20-39; 40-59 and the 3 60 year-old males were 29.6; 29.0; 27.8cm respectively. The corresponding values for females were 26.3; 27.1 and 25.1cm . Males had significantly larger thoracic diameter than females. The largest mean TD in males and females were in the 20-39 and 40-59 age groups respectively. The TD had a significant positive correlation with weight; height; body mass index and body surface area. The best correlations were with body surface area and weight. Conclusions: Nigerians have a smaller TD than Caucasians. Smaller TD in Nigerians is likely to be responsible for their high cardiothoracic ratios in comparison with Caucasians or Asians

Relationship between sonographic renal length and renal parenchymal thickness in normal adult southeast Nigerians

Aim: To determine the relationship between sonographic renal parenchymal thickness (RPT) and renal length (RL) in normal adult Nigerian. Study design: The RL and RPT of 309 normal subjects within the age range of 18 - 80years were measured sonographically and prospectively. Correlation was performed between RL values and RPT using Pearson Linear `r' test Results: The range of RL value were 8.5-12.9cm and the corresponding mean were 10.33+ 0.7cm and 10.45+ 0.63cm for the right and left kidneys respectively. The range of values for the RPT was 1.40 - 2.4 and the corresponding mean values were 1.91+ 0.20cm and 1.95+ 0.19cm for the right and left kidneys respectively. There was a strong positive correlation between RPT and RL (r = 0.72 and 0.77 for the right and left kidney respectively. However for RL values above 11.0cm the RPT values fluctuated. Conclusion: From this study; for RL above 11.0cm there was no relationship with RPT. The study suggests that for our population groups; kidneys with RL lower than 8.5cm and RPT of 1.40cm or less should not be biopsied in contrast to webb's criteria

Transverse cardiac diameter in frontal chest radiographs of a normal adult Nigerian population.

BACKGROUND: The possibility of racial differences in heart dimensions has not been extensively investigated in our environment. Cardiac diameter is known to correlate with some anthropometric parameters. Our study was aimed at providing age and sex, specific normal standards of cardiac diameter in an adult Nigerian population. The data were correlated with various anthropometric parameters. METHODS: The transverse cardiac diameter of 303 males and females aged between 20 and 93 years were measured in normal frontal chest radiographs. RESULTS: The mean values for the 20-39, 40-59 and the > or = 60 year-old males were 13.3, 13.9 and 13.7cm respectively. The corresponding values for the females were 12.0, 13.4 and 13.6cm. The range was from 10.5 to 16.2cm in males and 9.5 to 15.7cm in females. Males had larger mean transverse cardiac diameter than females. The cardiac diameter showed a significant positive correlation with age, weight, body surface area, body mass index but not with height. The strongest correlation in males and females was with body mass index. The mean cardiac diameter of females in our study tended to be larger than the values for Caucasian females. CONCLUSION: The strong correlation between the cardiac diameter and body mass index suggests that the cardiac diameter is principally dependent on the body build.

Normal sonographic renal length in adult southeast Nigerians.

The renal lengths of 200 adults with normal renal and cardiac status were measured sonographically in the supine position to establish normative values of renal length for the locality and to correlate them with some anthropometric parameters. The ranges of normal kidney length obtained were 8.3 -12.8 cm and 8.0- 12.5 cm for the left and right kidneys respectively. The mean renal lengths of males were slightly higher than those of females. Renal length correlated positively with subject weight and not with the height or age of patients. This study was able to establish a normogram of renal length for the locality, with mean renal length of 10.6 cm and 10.3 cm for the left and right kidneys respectively. The renal lengths obtained showed no racial dependence. The positive correlation with body weight seems to substantiate the longer lengths of male kidneys versus female kidneys. The study also established a confidence interval of difference between right and left kidneys for the different age groups that could prove invaluable in making critical decisions on size differences in unilateral renal disease.