Comparative analysis of umbilical artery doppler indices of normal and suspected IUGR fetuses in the third trimester.

BACKGROUND: Intrauterine growth restriction (IUGR) is an important cause of perinatal morbidity and mortality, the prevalence of which is six times higher in developing countries. The sequelae of IUGR extend into adulthood with higher risk of neurodegenerative diseases for the patients. Umbilical artery (UA) Doppler is an affordable and noninvasive tool for predicting perinatal outcome in IUGR pregnancies. AIMS: The objective of this study is to compare the predictive ability of UA Doppler ultrasonography in discriminating normal from growth-restricted pregnancies and to find out if there is any relationship between antenatal Doppler indices and perinatal outcomes. PATIENTS AND METHODS: This is a cross-sectional study including 100 normal and 100 IUGR-suspected pregnancies, respectively. Each participant had a third trimester UA Doppler scan. Data were analyzed using SPSS version 18.0 (PASW Statistics for Windows, Version 18.0, Chicago: SPSS Inc.). Means were compared using Student's t-test and ANOVA. Tests of relationship and prediction were done using linear regression analysis and receiver operating characteristics. P ≤ 0.05 was considered statistically significant. RESULTS: As pregnancy advanced, the mean values of UA Doppler indices decreased in normal and IUGR fetuses; however, they were significantly higher in the latter. UA systolic/diastolic (S/D) ratio showed the highest sensitivity (0.80) and specificity (0.91) for predicting IUGR compared to PI and RI. Cutoff values for PI, RI, and S/D ratio were 0.93, 0.67, and 2.93, respectively. CONCLUSION: IUGR fetuses had higher UA flow velocimetric indices compared with normal fetuses. UA Doppler study is highly sensitive in the prediction of IUGR.

The prevalence of cervical ribs in Enugu, Nigeria.

BACKGROUND: Cervical rib is an important cause of nontraumatic thoracic outlet neurovascular compression. This study was undertaken as there is no known documented report on its prevalence in the study environment. AIMS: To evaluate the prevalence of cervical ribs and its variation with sex and age among patients presenting at radiological facilities for a chest radiograph. SETTINGS AND DESIGN: Retrospective evaluation of plain posterior-anterior view chest radiographs done in radiological facilities in Enugu, Southeast, Nigeria. SUBJECTS AND METHODS: Evaluated in this study were all 6571 chest radiographs consecutively obtained between 2009 and 2012 in three randomly selected radiological facilities in Enugu. STATISTICAL ANALYSIS USED: SPSS version 17 software was used in data analysis. Chi-square and student t-tests were used to test for the significance of findings at 95% confidence level. RESULTS: This study reports the overall prevalence of cervical ribs as 48 (0.7%) with a significantly higher rate in females 43 (1.1%) when compared to males 5 (0.2%) (P = 0.000). In 27 (0.4%) cases, the cervical ribs were bilateral; whereas in 21 (0.3%) cases, they were unilateral with 8 (0.1%) on the left and 13 (0.2%) on the right. There was no age-related variability with prevalence (P = -0.813). CONCLUSIONS: The prevalence of cervical rib in the study population is low and within the known range as seen in other geographical regions of Nigeria.

Use of fetal biometry in the assessment of gestational age in South East Nigeria: Femur length and biparietal diameter.

BACKGROUND: Fetal growth is influenced by many factors such as race, socioeconomic status, genetics, geographical location, maternal diseases, and number of babies. Consequent upon these, fetal growth charts may vary from one location to another even within the same geographical entity. OBJECTIVE: This study was designed to establish the fetal growth chart in antenatal women who had ultrasound scanning at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria. PATIENTS AND METHODS: This is a descriptive analysis of fetal biometric measurement of antenatal women. Four hundred and seventy pregnant women were studied. RESULTS: The nomogram for the femur length (FL) and biparietal diameter (BPD) for the different weeks of gestation (from 13th to the 40th week) were established. Correlation coefficients between gestational age and the various fetal parameters were also reported. Growth charts using both FL and BPD were plotted. A regression model for prediction of fetal age using the fetal biometry was also deduced for the studied population. CONCLUSION: The fetal parameters used in this study were consistently smaller than reported values from European studies up to the 34th week of gestation after which a catch-up growth till the 40 weeks was observed. Fetal parameters observed in this study were larger than most of the reported Asian values.

Sonographic assessment of the normal limits of the spleen in healthy school children in South-East Nigeria.

BACKGROUND/OBJECTIVE: Ultrasonogrphy is a good modality for the detection of splenomegaly even when it is not clinically palpable. The objective of this study was to establish the normal values of splenic length in healthy school children in South-East, Nigeria and to correlate them with body indices. MATERIALS AND METHODS: This is a cross-sectional prospective study of 1315 children (633 boys and 682 girls) between the ages of 5 and 17 years. The splenic length was measured between the most superiomedial and the most inferiolateral margins, at the level of the hilum. Only the spleens that had normal shape and echotexture were measured. The mean splenic length and the 5 th and 95 th percentiles were determined for each age. The length was correlated with the sex, age, weight (WT), height, body mass index (BMI) and body surface area (BSA) of the subjects. A regression model for prediction of spleen dimension from age and body habitus was computed. RESULTS: There was a significant correlation between splenic length and age, P < 0.001. Males had statistically significant longer spleen length than females. The splenic length correlated best with BSA, followed by body WT and least with BMI. CONCLUSIONS: This study noted racial variation between the established Nigerian values and results from other countries of the world. For the first time, a baseline value for splenic size for the Nigerian Children of various ages has been established with a regression model for predicting the splenic sizes.

Dark age of sourcing cadavers in developing countries: a Nigerian survey.

Throughout the history of medical science, the sourcing, storage, and management of cadavers for the study of gross anatomy have been problematic issues. As presented in this report, a study of these issues was conducted in the departments of anatomy of medical schools in Nigeria. To establish the extent and depth of the prevailing difficulties in the sourcing of cadavers, 18 (62.1%) of the Departments of Anatomy that qualified for this study were used. In sum, 94.4% of these schools reported an inadequate number of cadavers for study. The estimated ages of the cadavers were between 20 and 40 years and 85% of the schools reported more than 75% of the cadavers to be from the lower socioeconomic class. Altogether, 94.4% of the schools reported a male dominance of more than 95%. More than 72% of the schools reported that more than 90% of the cadavers were criminals that had been killed by shooting, less than 10% were unclaimed and unidentified corpses, and 0% originated from body bequest. No form of screening exercises for diseases and infective microorganisms was noted for all the schools, and there were no set standards for the acceptance or rejection of cadavers. Causative factors for the profile of available cadavers such as culture and religion were noted. This study was designed to look at various issues associated with the sourcing of cadavers for Anatomy education in typical developing African countries like Nigeria. As outlined in this report, the creation of legislation and the promotion and funding of programs highlighting the importance of body donation are crucial for improving the field of medical education.

Assessment of body mass index and blood pressure among university students in, Enugu, South East, Nigeria.

BACKGROUND: Body Mass Index (BMI) has been described as a significant predictor of Blood Pressure (B.P) but few studies have demonstrated this association in our environment. The study aims to determine the pattern of relationship between BMI and blood pressure in our environment. METHODOLOGY: Two thousand and ninety six (2096) students in two Universities located in Enugu, South East Nigeria completed the study. The blood pressure, weight and height were measured. Body mass index was calculated as weight in Kilograms divided by height in meters square (kg/m2). RESULTS: More females than males were underweight (9.4% versus 4.7%). More males than females were overweight (8% versus 4%).Obesity occurred more in males than females (7% versus 0.9%). Blood pressure parameters increased significantly with BMI (p < 0.0001) with higher values in males than in females; (the mean systolic blood pressure 124.88 +/- 10.97 mmHg versus 114.93 +/- 6.82 mmHg, P < 0.0001; the mean diastolic blood pressure was 80.1 +/- 7.2 mmHg versus 73.36 +/- 6.82 mmHg, p = 0.035 and the mean arterial Pressure (MAP) 95.02 +/- 7.78 mmHg versus 87.2 +/- 9.58 mmHg, p < 0.0001). CONCLUSION: A significant relationship between BMI and Blood pressure was demonstrated among university students in South East Nigeria.

Assessment of Body Mass Index and Blood Pressure among University Students in; Enugu; South East; Nigeria

Body Mass Index (BMI) has been described as a significant predictor of Blood Pressure (B.P) but few studies have demonstrated this association in our environment. The study aims to determine the pattern of relationship between BMI and blood pressure in our environment Two thousand and ninety six (2096) students in two Universities located in Enugu; South East Nigeria completed the study. The blood pressure; weight and height were measured. Body mass index was calculated as weight in Kilograms divided by height in meters square (kg/m ). More females than males were underweight (9.4versus 4.7). More males than females were overweight (8versus 4).Obesity occurred more in males than females (7versus 0.9).Blood pressure parameters increased significantly with BMI (p

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.

Indices of obesity derived from height and weight in a Nigerian adult population.

BACKGROUND: Obesity is a rapidly growing health risk all over the world. Even in mild degrees, it has serious adverse effects and is associated with diminished life span. The study was aimed at determining the most suitable obesity index derived from height and weight in a young adult Nigerian population. METHODS: A cross-sectional study of students of University of Nigeria Enugu Campus was done. Heights and weights of 402 males and 268 females aged between 20 and 28 were measured. Weight-height ratio (W/H), body mass index (W/H2), Rohrer's index (W/H3) and ponderal index (H/W(1/3)) were calculated. RESULTS: Zero-order correlation coefficients of these indices with height and weight showed that body mass index was the only index not significantly correlated with height in both sexes. Weight-height ratio and Rohrer's index underestimated the degree of obesity in short subjects and overestimated it in tall subjects. The reverse was the case for ponderal index. CONCLUSIONS: Body mass index (W/H2) is the most suitable index derived from height and weight for the assessment of obesity in our study population. We recommend its use in busy clinical practice and epidemiological studies.

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

Performance of students in anatomy in the 2nd MBSS examinations in some Nigerian universities

Aim: The aim of our study was to compare the pass rates of medical students in anatomy with those of medical biochemistry and physiology. Method: The 2nd MBBS (Part I MBBS) examination results of some medical schools in Eastern Nigeria over a variable period of 3-5 years were obtained. The schools were those of Abia State University (ABSU); Nnamdi Azikiwe University (NAU); University of Port Harcourt (UNIPORT) and University of Nigeria; Enugu Campus (UNEC). The performance of students in anatomy; medical biochemistry and physiology were compared. Result: ABSU and NAU had relatively smaller populations of students than UNIPORT and UNEC The percentage passes in anatomy in ABSU; NAU; UNIPORT and UNEC were 78.31; 79.3; 41.24and 54.7respectively. The performance of students in schools with small populations was better in anatomy than in either medical biochemistry or physiology. The reverse was the case in schools with large populations of students. Conclusion: Class size plays an important role in the performance of students in anatomy. The lower the population of students; the greater the chances of adequate exposure of students to the study materials; and consequently the better the performance

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.

Aortic arch diameter in frontal chest radiographs of a normal Nigerian population.

BACKGROUND: The objective of our study was to establish age, sex, weight and height specific nomogram of radiographic aortic arch diameter in a normal adult Nigerian population. METHODS: The aortic arch diameter of 303 normotensive males and females aged between 20 and 93 years were measured in normal posteroanterior chest radiographs. RESULTS: The mean values for the 20-39, 40-59 and the > or = 60 year-old males were 5.3, 5.5 and 6.3 cm respectively while the corresponding values for females were 4.9, 5.3 and 5.9 cm. The aortic arch diameter increased progressively with age in both sexes and was larger in males than in females. It correlated better with body mass index than with weight, height or body surface area. The proportion of males and females below the age of sixty that had aortic arch diameter of > or = 6.0 cm ranged from 0.9 to 9.7%. For the > or = 60 year-old, the proportion was 30% for females and 70% for males. CONCLUSION: The study showed that whereas radiographic aortic arch diameter seemed to be a good index of systemic hypertension for the under sixty it is not so for the > or = 60 year-old.