Fetal Gestational Age Estimation Using Ultrasonic Transverse Cerebellar Diameter in a Sub-Saharan African Population.

Background: To explore the relationship between fetal Transverse Cerebellar Diameter (TCD) and menstrual gestational age (GA) and to generate normative references (nomogram) of the fetal TCD in some pregnant women in Southwest Nigeria. Methods: Four hundred pregnant women with a singleton fetus between 14 and 38 weeks GA were enrolled. The TCD and other biometric parameters (biparietal diameter, head circumference, abdominal circumference, and femur length) as well as the cerebellar appearance were analyzed and correlated with the GA. Results: The mean TCD increased from 13.3 ± 0.3 mm at 14 weeks to 52.3 ± 3.3 mm at 38 weeks of pregnancy. A strong positive correlation was observed between TCD and GA, which was best represented by a linear regression equation: Predicted GA = 0.557 × TCD + 8.840. The regression analysis indicated a statistically significant strong positive relationship between TCD and GA (r = 0.972 and P < 0.001). The cerebellar appearance based on shape and echogenicity was graded into Grade I: 230 fetuses (57.5%); Grade II: 74 fetuses (18.5%) and Grade III: 96 fetuses (24.0%). Median GA and TCD were 21 weeks and 21.2 mm for Grade I; 29 weeks and 35.5 mm for Grade II; and 35 weeks and 48.1 mm for Grade III, respectively. Conclusion: The TCD increased in a linear fashion with advancing GA in the evaluated fetuses. The TCD is, therefore, a good marker for GA estimation. There is a gradual ultrasonographic change in fetal cerebellar appearance with advancing gestation.

Posterior Tibial Nerve Ultrasound Assessment of Peripheral Neuropathy in Adults with Type 2 Diabetes Mellitus.

Background: Diabetic peripheral neuropathy (DPN) is a common and debilitating complication of type 2 diabetes mellitus (T2DM). Early detection and prompt institution of appropriate therapy could prevent undesirable outcomes such as paresthesia, pain, and amputation. Although the gold standard for diagnosing DPN is nerve conduction studies, high-resolution peripheral nerve ultrasonography may serve as a noninvasive and low-cost alternative for diagnosing and staging DPN. This study investigated the clinical utility of sonographic posterior tibial nerve cross-sectional area (PTN CSA) for diagnosing DPN in individuals with T2DM. Methods: Eighty consecutive adults with T2DM and 80 age-/sex-matched controls were recruited. Clinical information was obtained, including symptoms, disease duration, Toronto clinical neuropathy score (TCNS), and biochemical parameters. The left PTN CSA at 1 cm, 3 cm, and 5 cm above the medial malleolus (MM) was measured with a high-frequency ultrasound transducer and compared to the detection of DPN using the TCNS. Results: Based on the TCNS, 58 (72.5%) of the T2DM group had DPN. Of these, 14 (24.1%), 16 (27.6%), and 28 (48.3%) participants had mild, moderate, and severe DPN, respectively. All the mean PTN CSA (aggregate, 1 cm, 3 cm, and 5 cm above MM) of the participants with T2DM and DPN (T2DM-DPN) were significantly higher than those of T2DM without DPN (WDPN) and controls. All the PTN CSA increased significantly with increasing severity of DPN. The PTN CSA at 3 and 5 cm levels correlated weakly but significantly with fasting plasma glucose and glycated hemoglobin levels. Conclusion: The PTN CSA is significantly larger in T2DM-DPN than in T2DM-WDPN and healthy controls. PTN ultrasonography can be an additional tool for screening DPN in patients with T2DM.

Flow-mediated Dilation of the Brachial Artery in Women with Hypertensive Disorders of Pregnancy.

Background: Hypertensive disorder of pregnancy (HDP) comprise chronic hypertension, gestational hypertension, preeclampsia/eclampsia, and preeclampsia superimposed on chronic hypertension. HDP complicate up to 10% of pregnancies worldwide and carry significant risks of maternal and perinatal morbidity and mortality. The aim of this study was to evaluate the derangement and characteristics of brachial artery flow-mediated dilation (BAFMD) in women with HDP. Methods: The BAFMD of the right brachial artery of 80 women with HDP (pregnant HDP), 80 normotensive pregnant women (pregnant non-HDP), and 80 healthy nonpregnant women (nonpregnant controls) was evaluated with B-mode ultrasound. The age, blood pressure, body mass index (BMI), brachial artery diameter, and BAFMD of the participants were compared. P ≤ 0.05 was statistically significant. Results: The pregnant HDP group had significantly lower mean BAFMD compared to pregnant non-HDP and nonpregnant controls (6.9% ± 2.53% vs. 8.32% ± 3.4% vs. 9.4% ± 2.68%; P < 0.001). There was no significant difference between the mean BAFMD of the pregnant HDP subgroups: preeclampsia (5.81% ± 1.7%) versus gestational hypertension (6.43% ± 3.02%); P = 0.57. BAFMD diminished with advancing gestational age in both the pregnant HDP and pregnant non-HDP groups. On regression analysis, BAFMD was a poor marker for HDP, while BMI was an independent predictor for HDP. Conclusion: Even though HDP were associated with significantly diminished BAFMD, it was not a good marker for HDP.

Magnetic Resonance Imaging Infarct Volume Correlates with Carotid Intima-Media Thickness and Plaque Echotexture in Ischemic Stroke.

Objective: To determine the correlation between cerebral infarct volume, carotid intima-media thickness (CIMT), and plaque echotexture in patients with ischemic stroke. Materials and Methods: This was a cross-sectional study of 70 patients with ischemic stroke who were imaged using the head coil of a 1.5T Toshiba magnetic resonance machine. The volumes of infarcts were documented and calculated using the manual tracing of the infarct perimeter method. The common carotid CIMT was measured on ultrasound using a linear high-frequency 7.5 MHz transducer. Results: Seventy subjects were evaluated. The mean magnetic resonance imaging cerebral infarct volume was 8.07% volume. Hyperechoic plaques were the most prevalent (36.7%) compared to the hypoechoic (33.3%) and isoechoic (30%) plaques. There was a moderate positive correlation between CIMT and infarct volume (r = 0.70; P = 0.001) in the entire study population. Similarly, positive correlations between CIMT and infarct volume were recorded in both the male (r = 0.73; P = 0.001) and female (r = 0.67; P = 0.001) subjects. Furthermore, subjects who presented in the acute phase (1-3 days) of ictus showed a moderate positive correlation (r = 0.621; P = 0.0001) between CIMT and infarct volume, while there was a strong positive correlation (r = 0.74; P = 0.0001) in subjects that presented in the subacute phase (4-7 days). Conclusion: Common carotid artery CIMT correlated positively with cerebral infarct volume in patients with ischemic stroke. Furthermore, hyperechoic plaques were associated with significantly larger infarct volumes compared to hypoechoic and isoechoic plaques.

Drivers of Global Health Care Worker Migration.

The migration of health care workers on a global scale has emerged as a complex and critical issue, profoundly affecting the dynamics of health care systems worldwide. The authors delve into the multifaceted drivers behind the unprecedented migration of health care professionals, seeking to illuminate the interconnected factors that propel this phenomenon. The investigation encompasses economic, social, and professional dimensions, acknowledging the intricate interplay of factors influencing the decision of health care professionals to migrate. Economic disparities, inadequate working conditions, and limited career advancement opportunities in home countries are examined as primary push factors, while attractive employment prospects, higher remuneration, and improved quality of life in destination countries are explored as compelling pull factors. This study contributes to a deeper understanding of the intricate web of factors influencing global health care worker migration, providing insights that can inform evidence-based policies, strategic workforce planning, and international collaborations aimed at addressing the challenges posed by this phenomenon.

Correlation of Doppler ultrasound resistive index in the prostatic gland with severity of male lower urinary tract symptoms, prostate volume, and concomitant diabetes mellitus.

Introduction: Benign prostatic enlargement (BPE) and type 2 diabetes mellitus (T2DM) are common in elderly men. This study aimed to correlate the Doppler resistive indices of prostatic arteries with the severity of lower urinary tract symptoms (LUTS) and prostate volume in men with concomitant BPE and T2DM. Material and methods: Fifty men with T2DM and BPE (BPE-DM) as cases and 50 age-matched men with BPE but no T2DM (BPE-ND) as controls were enrolled. B-mode and power Doppler ultrasonography of the prostate gland were done for both groups. Results: The mean total prostatic volume of the BPE-DM was 79.18 ±8.9 ml, while that of BPE-ND was 60.73 ±10.6 ml (p <0.0001). The mean prostatic resistive index (PRI) was significantly higher among BPE-DM than BPE-ND (0.74 ±0.02 vs 0.68 ±0.09 for right capsular artery; 0.77 ±0.04 vs 0.71 ±0.02 for left capsular artery; and 0.76 ±0.04 vs 0.70 ±0.02 for the urethral artery). BPE-DM with higher glycated haemoglobin, fasting plasma glucose, and longer duration of T2DM experienced more severe lower urinary tract symptoms and had higher PRI. Conclusions: In conclusion, the BPE-DM group presented larger prostate glands and more bothersome LUTS, which correlated with higher PRI. Strict glycaemic control is necessary in men with co-existing BPE and T2DM.

Association of Cervical Spine Magnetic Resonance Imaging Abnormalities with Chronic Neck Pain in Southern Nigeria.

Objective: This study was done to evaluate the relationship between cervical spine magnetic resonance imaging (MRI) findings and clinical features in adults with chronic neck pain (NP) at our tertiary hospital. Materials and Methods: This was a prospective cross-sectional study of the cervical spine MRI of 90 adult patients with chronic NP. The clinical history, biodata, and cervical spine MRI findings were analysed. Statistical tests were considered significant at P ≤ 0.05. Results: The mean age of the participants was 54.72 (13.51) years (range = 28-79 years). There were 52 (58%) males and 38 (42%) females. Cervical disc desiccation and disc herniation were the most prevalent MRI findings. C4/C5 and C5/C6 disc levels were most commonly affected. Disc height reduction correlated with shoulder pain (r = 0.23, P = 0.030), unsteady gait (r = 0.27, P = 0.010), and lower limb weakness (r = 0.23, P = 0.029). Vertebral collapse correlated with shoulder pain (r = 0.22, P = 0.036), upper limbs burning sensation (r = 0.33, P = 0.001), and loss of dexterity (r = 0.22, P = 0.037). Spondylolisthesis correlated significantly with unsteady gait (r = 0.34, P = 0.001), dizziness/vertigo (r = 0.29, P = 0.005), painful neck movement (r = 0.32, P = 0.002), loss of dexterity (r = 0.37, P < 0.001) and sphincteric dysfunction (r = 0.23, P = 0.031). Modic changes correlated with loss of dexterity (r = 0.39, P < 0.001) and upper limbs burning sensation (r = 0.21, P = 0.048). Cervical canal stenosis did not correlate significantly with any symptom. Conclusion: Cervical disc disease (C4/C5 and C5/C6 levels) was the most prevalent finding on MRI. Disc height reduction, vertebral collapse, spondylolisthesis, and Modic changes correlated with various clinical symptoms.

Portal vein congestion index in patients with and without chronic liver disease.

Aim of the study: Portal vein congestion index has shown promise in detecting early portal venous hemodynamic changes in chronic liver disease. The aim of this study was to compare the portal vein congestion index of adult patients with chronic liver disease to that of healthy controls, and to evaluate the differences in portal vein congestion index, if any, between the common etiologies of chronic liver disease (chronic viral hepatitis, alcoholic liver disease, and non-alcoholic fatty liver disease). Method and materials: Eighty participants with chronic liver disease and 80 healthy controls had their sociodemographic variables, anthropometric indices, liver size/echotexture, spleen size, presence of ascites, and portal vein parameters (diameter, cross-sectional area, velocity, and congestion index) evaluated. P ≤0.05 was considered statistically significant. Results: There were 48 (60%) males and 32 (40%) females in the control group, while 56 (70%) males and 24 (30%) females were included in the chronic liver disease group (p = 0.185). Of the eighty people with chronic liver disease, 57 (71.2%) were diagnosed with alcoholic liver disease, while 23 (28.8%) were diagnosed with chronic viral hepatitis. There were no cases of non-alcoholic fatty liver disease during the study period. The mean liver spans of the control and chronic liver disease groups were 13.45 ± 0.85 cm and 16.50 ± 4.96 cm, respectively. All the controls had normal hepatic parenchymal echogenicity, while 45 (56.3%) subjects with chronic liver disease (36 alcoholic liver disease and 9 chronic viral hepatitis) had increased hepatic echogenicity. The mean values of the portal vein congestion index for the control and chronic liver disease groups were 0.0775 ± 0.02 cm/sec and 0.1037 ± 0.03 cm/sec, respectively (p <0.0001). Conclusion: The chronic liver disease group showed a significantly higher mean portal vein congestion index than the control group.

Ultrasonographic Intravesical Prostatic Protrusion in Men with Benign Prostatic Hyperplasia in Southwest Nigeria.

Objectives: To study the relationship between sonographically measured intravesical prostate protrusion and international prostate symptoms score (IPSS), as well as prostate volume, in men with benign prostatic hyperplasia at a single health facility. Materials and Methods: This was a cross-sectional observational study of one hundred men (age >40 years) diagnosed with benign prostatic hyperplasia. Their International Prostate Symptoms Score (IPSS) was assessed using the standardised IPSS instrument. Abdominal ultrasound was done to measure the intravesical prostatic protrusion (IPP), while prostate volume was estimated transabdominally and transrectally. Correlations between parameters were quantified with Spearman's correlation test. P ≤ 0.05 was statistically significant. Results: The mean age was 62.84 ± 9.0 years (Range =42-79 years). The mean IPSS was 20.99 ± 6.42 (range of 5-30). Seventy-three percent of the men in this study had intravesical prostatic protrusion on ultrasound. The mean IPP was 13.0 ± 4.0 mm. Of the 73 men with IPP, 17 (23.3%), 29 (39.7%), and 27 (37%) had grade I, grade II and grade III IPP, respectively. The mean transabdominal prostate volume (TPVA) and transrectal prostate volume (TPVT) were 71 ± 14 ml and 69 ± 13 ml, respectively. IPP had a statistically significant positive correlation with all the other parameters. The strongest correlation (very high correlation) was with the TPVA (r=0.797, P < 0.0001), followed by a moderate correlation with the IPSS (r =0.513, P < 0.0001). TPVT, transition zone volume, transition zone index, presumed circle area ratio, and quality of life score yielded slightly weaker moderate correlation with IPP, while IPP correlated weakly with age. Conclusion: IPP correlated well with multiple clinical and sonographic parameters. It correlated better with TPVA than TPVT.

Comparative Doppler Ultrasound Findings of Foot Arteries in Patients with Type 2 Diabetes Mellitus and Normoglycaemic Patients.

Aim of the Study: The aim of this study was to investigate lower extremity peripheral artery disease (LEPAD) in the foot arteries of patients with type 2 diabetes mellitus, with and without clinical symptoms of arterial insufficiency, using triplex Doppler ultrasound. Materials and Methods: Forty-seven consecutive adult subjects with type 2 diabetes mellitus (T2DM) and 47 age-matched and sex-matched non-diabetic controls were recruited (94 limbs each). Ankle-brachial index (ABI), fasting blood glucose assay, glycated haemoglobin assay and triplex sonography of the dorsalis pedis artery (DPA) and the distal posterior tibial artery (PTA) in both feet were performed. Results: The mean age of the subjects and controls were 60.21 ± 7.68 years and 56.81 ± 9.05 years (P > 0.05). The mean duration of diabetes mellitus was 10.4 ± 5.8 years. Crampy calf pain was the most common presenting symptom. Twenty-one (22.3%) of the 94 limbs of T2DM subjects had an abnormal ABI. Abnormal triplex Doppler waveform was seen in more than half of the PTA (57/94; 60.6%) and DPA (55/94; 58.5%). Forty-one (43.6%) of the 94 diabetic limbs had plaques in the PTA, while plaques were present in the DPA of 52 (55.3%) diabetic limbs. Conclusion: LEPAD is common in T2DM with a higher prevalence on triplex Doppler sonography compared to ABI values.

Relationship Between the Computed Tomographic Volumetry of the Eyeballs and Lacrimal Glands in a Nigerian Population.

Aim: The aim of this article was to obtain measurements of the eyeballs/globes and lacrimal glands in normal subjects using cranial computed tomography (CT) scan. Understanding the normative approximations of these measurements could help in diagnosing and evaluating orbito-ocular pathologies. Materials and Methods: This retrospective study examined 220 globes/eyeballs and 220 lacrimal glands of 110 consecutive participants. The eyeball volume was calculated using both the ellipsoid and spherical formulas, whereas lacrimal gland volume was approximated using the ellipsoid formula only. Results: The mean age of the subjects was 51.18 ± 14.85 years and ranged from 22 to 85 years. The study population was 53.6% male (n = 59) and 46.3% female (n = 51). The mean volumes of all globes in this study were 5.82 ± 0.77 and 5.98 ± 0.75 cm3 using the ellipsoid and spherical formulae, respectively. The mean volume of all lacrimal glands was 0.42 ± 0.14 cm3 using the ellipsoid formula. The mean globe volumes using the ellipsoid and spherical formulae (6.02 ± 0.84 and 6.02 ± 0.84 cm3) in males were significantly larger than the corresponding mean globe volumes in females (5.59 ± 0.62 and 5.80 ± 0.65 cm3) (P < 0.0001 and P = 0.001, respectively). There was no significant difference between the lacrimal gland volumes of males (0.42 ± 0.14 cm3) and females (0.42 ± 0.14 cm3) (P = 0.84). Conclusion: Males have larger eyeball/globe volumes than females. Eyeball and lacrimal gland volumes did not correlate significantly. Eyeball volume showed an inverse relationship with age. Age did not affect lacrimal gland volume.

Magnetic Resonance Imaging of Ankle Disorders in Adult Nigerians in Lagos.

Objectives: The aim of this study was to establish the frequency, distribution, and spectrum of abnormalities on ankle magnetic resonance imaging (MRI) in adult Nigerians. Materials and Methods: A retrospective analysis of ankle MRI of 50 adult patients was conducted at a single health facility. All adult Nigerians with complete clinical data, MRI images, and radiologists' reports were included. The clinical history and ankle MRI findings were recorded and analysed. The threshold for statistical significance was established at P≤0.05. Results: There were 50 subjects comprising 27 males (54%) and 23 females (46%) aged 25-66 years (mean age = 42.84 ± 9.63 years). The right ankle was evaluated in 27 subjects (54%), while the left ankle was studied in 23 (46%). There was a history of trauma in 40 subjects (80%; 27 right ankles and 13 left ankles). Ankle joint effusion was the most common abnormality-seen in 50% of all subjects and in 62.5% of those with antecedent trauma. Achilles tendinosis and Kager (pre-Achilles) fat pad oedema (8-12%), deltoid ligament tear (8%), and medial malleolar fracture (4%) were the other frequently detected pathologies. The other pathologies detected were posterior tibial tendinosis (2%), plantar fasciopathy (2%), and talar contusion (2%). Joint effusion was significantly more prevalent in post-traumatic ankles than in the non-traumatic ankles and in the right ankles than the left ankles. There was no significant difference in the frequency of ankle abnormalities between the male and female subjects and between subjects younger than and older than the mean age. Conclusion: Joint effusion, deltoid ligament tear, and Achilles tendinopathy were the prevalent derangements in evaluated ankle joints. Trauma was the main indication for ankle MRI in this study.

Ultrasonographic Study of the Effects of Essential Hypertension on the Luminal Diameter and Doppler Velocimetric Indices of the Abdominal Aorta in Adults.

Objective: To investigate the effects of essential hypertension on the luminal diameter (caliber) and Doppler velocimetric indices of the abdominal aorta (AA) in adult patients with systemic hypertension. Materials and Methods: This was a prospective descriptive comparative study of 254 participants (127 with essential hypertension and 127 age/sex-matched controls). Their anthropometric parameters, fasting blood pressure, lipid profile, fasting blood sugar, and triplex sonography of the suprarenal and infrarenal abdominal aorta (Peak systolic velocity, PSV; End-diastolic velocity, EDV; Resistive Index, RI; and luminal diameter) were evaluated. Results: The mean age of the male subjects was 64.02 ± 10.02 years, while the mean age of the male controls was 63.14 ± 10.52 years (P > 0.05). The mean age of female subjects was 61.23 ± 10.09 years, while the mean age of the female controls was 61.76 ± 10.26 years (P > 0.05). The age group 60 - 69 years had the highest number of subjects and controls. The mean duration of hypertension in the subjects was 12.5 ± 5.2 years. The suprarenal and infrarenal abdominal aortic diameters (AAD) were higher in males than age-matched female counterparts. AAD increased with age mostly in hypertensive male subjects. PSV (in males) and RI (in both sexes) were elevated in hypertensive subjects compared to controls, while EDV (in both sexes) was significantly lower in subjects than controls. Multivariate linear regression showed that age and diastolic blood pressure were significant independent predictors for both suprarenal and infrarenal AADs. Conclusion: Systemic hypertension causes structural and hemodynamic changes in the abdominal aorta which are detectable on triplex sonography.

Comparative Study of the Umbilical Artery Doppler Indices of Healthy and Growth-Restricted Foetuses in Lagos.

Aim of the Study: This study compared the umbilical artery Doppler indices (UADI) in normal and foetal growth-restricted (FGR) foetuses to determine the relationship between the UADI and pregnancy outcomes. Materials and Methods: This was a case-control study that recruited one hundred and eighty pregnant women comprising 90 with FGR pregnancies and 90 with normal pregnancies. Foetal biometric parameters and UADI were measured in all the participants. The UADI and clinical outcomes (preterm delivery, birth weight, perinatal death, etc.) of the normal and FGR foetuses were compared. Results: The mean estimated foetal weights of the FGR pregnancies (subjects) and normal pregnancies (controls) were 2.76 ± 0.66 kg and 3.62 ± 0.37 kg, respectively (P < 0.0001). The mean APGAR score at 5 min was 6.93 ± 1.72 for subjects and 8.03 ± 0.94 for controls (P < 0.0001). Abnormal umbilical artery Doppler waveforms were detected: decreased end-diastolic flow in 25 (27.8%), absent end-diastolic in 7 (7.8%) and reversed end-diastolic flow in 4 (4.4%) of the FGR pregnancies. There were 74 (82.2%) preterm deliveries among the subjects, while only 7 (7.8%) of the controls had preterm deliveries. Six deaths (two perinatal and four neonatal deaths) were recorded among the subjects, while no death occurred among the controls. Conclusion: Foetuses with FGR showed significantly higher quantitative Doppler indices (increased RI, PI, SD ratio), and a higher prevalence of abnormal umbilical artery waveform pattern (qualitative) than the healthy foetuses (controls).

Fabella and patella variants: radiographic prevalence, distribution and clinical relevance in a population of black african descent.

To evaluate the radiographic characteristics and prevalence of fabella and patella variants in an indigenous African population. This retrospective observational study of orthogonal knee radiographs of 377 consecutive subjects was conducted in Lagos, Nigeria, from February 2017 to November 2017. The presence of bipartite/multipartite patella, as well as the presence of fabella were noted. The craniocaudal diameter, anteroposterior diameter, fabello-femoral distance and fabello-tibial distance of the fabella were measured. P≤0.05 represented a statistically significant result. Three hundred and seventy-seven subjects were enrolled. The average age was 41.22±21.37 years with a range of 3-100 years old. There were 158 male (41.9%) and 219 female (58.1%) subjects. The prevalence of fabella was 11.94%. There was a positive correlation between age <47 and ≥47 and occurrence of fabella, P<0.015. There was no statistically significant difference between the mean male and female measured fabella diameters. The overall prevalence of bipartite and multipartite patella in this study was 2.12%. Among male and female subjects, the difference in prevalence of bi and multipartite patella was statistically significantly, P=0.03. The prevalence of fabella and patella variants was lower in this study compared to the findings in other populations and ethnicities. Sex and age were significantly correlated with fabella prevalence. The results reported in this study will facilitate future studies examining the correlations between fabella and patella variants and various knee pathologies in a population of Black African descent.

Achilles tendon degeneration on ultrasound in type 2 diabetic patients.

AIM OF STUDY: The main goal of this study was to compare the various degenerative changes in the Achilles tendon of type 2 diabetic patients to that of controls. The influence of diabetic peripheral neuropathy, duration of diabetes mellitus, age, and body mass index on the occurrence of degenerative changes was also evaluated. MATERIALS AND METHODS: The Achilles tendons of both limbs were evaluated with high-resolution ultrasound in 80 type 2 diabetics and 80 age/sex-matched controls. A 10 g Semmes Weinstein monofilament was used to examine for peripheral neuropathy. Anthropometric measurements and biochemical assessment of glycemic control (fasting plasma glucose and glycated hemoglobin) were also done. RESULTS: The mean age of type 2 diabetic subjects and healthy controls was 60.9 ± 10.3 years (range 41-79 years) and 61.0 ± 10.3 years (range 40-79 years), respectively (p = 0.963). The median duration of diabetes mellitus was 42.0 months (range = 1-456 months). The prevalence of degenerative changes (calcifications, disorganized fibers and/or hypoechoic foci) was significantly higher in type 2 diabetic subjects than controls in both the right (55.0% vs. 18.8%, p <0.001) and left (52.5% vs. 18.8%, p <0.001) feet. CONCLUSION: The Achilles tendons of type 2 diabetic subjects have significantly more degenerative changes than their age/ sex-matched controls in our locality. Disorganized Achilles tendon fibers occur significantly more often among male than female type 2 diabetic subjects. Disorganization of Achilles tendon fibers and hypoechoic foci are significantly more prevalent in type 2 diabetic subjects with peripheral neuropathy than those without peripheral neuropathy. Body mass index did not affect the occurrence of degenerative changes in the Achilles tendon of participants.

Correlation of Foetal Liver Length with Gestational Age and Foetal Weight in Pregnant Nigerian Women.

Background: This study aims to determine the relationship(s) of fetal liver length (FLL) to the gestational age, biometric parameters (BPD, FL, AC, HC), and fetal weight in third trimester pregnancies. Methodology: This was a hospital-based cross-sectional study of 400 fetuses in normal third trimester pregnancies recruited from the Obstetrics and Gynaecology department of OAUTHC, Ile-Ife, Nigeria. The participants were between 20-45 years of age and their gestational ages ranged from 27-40weeks. The FLL, liver thickness and transverse diameter were measured on B-mode ultrasound. Fetal liver volume (FLV) was calculated using the ellipsoid formula. The expected gestational age (EGA) was determined from the date of the last menstrual period (LMP), early first-trimester crown-rump length (CRL), or early second-trimester biparietal diameter (BPD) ultrasound. The estimated gestational age (EGA) and EFW were calculated using computer-assisted analysis of ultrasound fetal biometrics. Results: The mean height, weight, and body mass index (BMI) of the participants were 1.62±0.08m, 72.07±13.26kg and 27±4.70kg/m2 respectively. FLL had a linear relationship and a positive correlation with EGA and EFW. There was also a positive correlation between FLL and fetal biometrics, maternal weight, and BMI. Percentile distribution of FLL and FLV for the GA 27-40weeks was developed. Conclusion: FLL could be used to predict GA in normal pregnancies especially when LMP is uncertain.

Diagnostic accuracy of ultrasonography in adults with obstructive jaundice.

Aim of the study: To determine the sensitivity and specificity of ultrasound for detecting the causes of obstructive jaundice. Materials and methods: Eighty adult patients with clinical and biochemical features of obstructive jaundice were enrolled in this study. The causes, degrees and levels of ductal obstruction were evaluated sonographically via the transabdominal route. The ultrasonographic diagnoses were correlated with surgical findings and histopathological diagnoses. Results: The age range was 16 to 82 years, with a mean of 51.06 ± 14.95 years. The peak age group was the sixth decade with 23 (28.8%) patients. There were nearly twice as many females as males, with 28 (35%) males and 52 (65%) females, giving a male to female ratio of 1:1.9. On ultrasound, pancreatic carcinoma (28.0%) and choledocholithiasis (21.3%) were the most common malignant and benign causes of obstructive jaundice, respectively. Hepatocellular carcinoma (1.3%) was the least common etiology. There was a strong correlation between the definitive diagnosis and the sonographic level of obstruction. The overall sensitivity of ultrasound for detecting the cause of obstruction was 76.6%, while the specificity was 98%. Conclusion: Ultrasonography is a reliable imaging modality for diagnosing the cause and level of obstruction in surgical jaundice. The sensitivity is adequate to aid the early institution of surgical intervention, thereby preventing morbidity and mortality that may accompany late interventions in our setting.Aim of the study: To determine the sensitivity and specificity of ultrasound for detecting the causes of obstructive jaundice. Materials and methods: Eighty adult patients with clinical and biochemical features of obstructive jaundice were enrolled in this study. The causes, degrees and levels of ductal obstruction were evaluated sonographically via the transabdominal route. The ultrasonographic diagnoses were correlated with surgical findings and histopathological diagnoses. Results: The age range was 16 to 82 years, with a mean of 51.06 ± 14.95 years. The peak age group was the sixth decade with 23 (28.8%) patients. There were nearly twice as many females as males, with 28 (35%) males and 52 (65%) females, giving a male to female ratio of 1:1.9. On ultrasound, pancreatic carcinoma (28.0%) and choledocholithiasis (21.3%) were the most common malignant and benign causes of obstructive jaundice, respectively. Hepatocellular carcinoma (1.3%) was the least common etiology. There was a strong correlation between the definitive diagnosis and the sonographic level of obstruction. The overall sensitivity of ultrasound for detecting the cause of obstruction was 76.6%, while the specificity was 98%. Conclusion: Ultrasonography is a reliable imaging modality for diagnosing the cause and level of obstruction in surgical jaundice. The sensitivity is adequate to aid the early institution of surgical intervention, thereby preventing morbidity and mortality that may accompany late interventions in our setting.

Fetal Gestational Age Determination using Ultrasound Placental Thickness.

BACKGROUND: The purposes of this study are to sonographically measure the placental thickness (PT) in normal fetuses; to correlate it with gestational age (GA), fetal growth parameters, and estimated fetal weight (EFW); and to design a nomogram for the derived PT measurements. METHODS: This was a hospital-based cross-sectional study on 400 women with apparently normal pregnancy within the age range of 18-45 years recruited from the Antenatal Clinic of our hospital. The fetal GA was estimated by the last menstrual period (LMP). The fetal growth parameters were determined using standard sonographic methods while the PT was measured at the level of the umbilical cord insertion site. PT was then correlated with GA, fetal growth parameters, and the EFW. RESULTS: The mean PT (mean ± standard deviation) in the 1st, 2nd, 3rd trimesters and the whole duration of pregnancy were 14.5 ± 0.3 mm, 24.6 ± 3.9 mm, 34.8 ± 2.8 mm, and 29.6 ± 7.1 mm, respectively. PT ranged from 13.5 ± 1.9 mm at 11 weeks to 39.1 ± 0.6 mm at 40 weeks. PT (in mm) had a linear relationship and a statistically significant positive correlation with GA (in weeks) in all the trimesters, with most significant correlation recorded in the 2nd trimester (r = 0.79). There was also a statistically significant positive correlation between PT and the fetal growth parameters (biparietal diameter, head circumference, abdominal circumference, femur length and crown-rump length), and EFW. PT nomogram was developed from 11 to 40 weeks of gestation using a scatter plot with 95% confidence interval for our locality. CONCLUSION: PT has a linear relationship with GA, fetal growth parameters, and EFW and it can be used along with other fetal growth parameters to increase the accuracy for predicting GA in normal pregnancies, especially when the subject is not sure of or does not know her LMP.