Background: Normative value of spleen size

Background: Uterine myomas co-existing with pregnancy could cause obstetric complications. Objectives: To assess sonographically the frequency of occurrence and effect of uterine myomas co-existing with pregnancy. Methods: A longitudinal study was conducted during a period of 23 months. A convenience sample of 816 consecutive consenting pregnant women who met the inclusion criteria was evaluated during routine prenatal ultrasound scan. The women were referred for prenatal sonography. One hundred of the subjects who had myoma co-existing with pregnancy and another 100 subjects without myoma were selected for follow-up. These groups were followed up till delivery and obstetric complications and outcomes were documented. Any changes in size and growth rate of myoma were documented. Results: Subjects with myoma co-existing with pregnancy were 12.3%. This was commoner with increasing maternal age. An increase was observed in myoma mean size from 60mm to 63mm from the 1 st scan sequence to the 2 nd scan sequence and a reduction from 63mm to 59mm in the 3 rd scan sequence. Myoma growth rate was 0.667mm per week. Myomas in pregnancy especially large ones caused more complications during delivery when compared to pregnancies without myomas. Conclusion: Routine sonography is important in pregnancy management of uterine myomas co-existing with pregnancy.

Background:The accuracy of common ultrasound parameters for the estimation of gestational age (GA) decreases as pregnancy advances in age. Hence, there is need to explore other parameters that may complement the established fetal biometric parameters in predicting GA in late pregnancy.Aim:The aim of this study is to determine the relationship between the sonographic placental thickness (PT) and GA in the second and third trimesters.Subjects and Methods:A cross-sectional study of 627 normal pregnant women with GA between 14 and 40 weeks was conducted at the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu from May 2013 to February 2014 by sonography. Anteroposterior diameter of the placenta was measured at the level of the umbilical cord insertion. The last menstrual period of the women, femur length, biparietal diameter, head circumference, and abdominal circumference of the fetus were measured for GA estimation. Descriptive statistics, regression analysis, and independent sample t-test were used in statistical analysis.Results:Mean PT was 23.2 (2.8) mm in the second trimester and 36.1 (3.6) mm in the third trimester. There was a significant difference between the values in the present study and values from similar studies in other populations (P < 0.04). There was a strong relationship between GA and PT and the following mathematical relationships for the second and third trimesters were obtained in the GA = 0.982 (PT) + 3.614 and GA = 0.977 (PT) + 3.354, respectively.Conclusion:Population-specific charts for PT may be used to estimate GA in the second and third trimesters.

Background: Regional variations in size and parenchyma echo-texture of the spleen among sickle cell disease (SCD) patients have been documented in various publications. The objectives of this study were to assess the size and parenchyma echo-texture of the spleen of SCD patients and ascertain the relationship of age, height and weight with the spleen sizes. Methods: This was a cross sectional study involving 103 each of SCD and age matched control subjects. Aloka ST-550 -3500 ultrasound machine with 3.5 and 5 MHz convex transducers was used to scan the subjects over a 15 months period (September, 2012 to November, 2013. The age, height and weight of each subject were recorded. Results: The spleen sizes of SCD patients were generally larger than those of the controls (p < 0.05). Abnormal spleen parenchyma of varied appearances was found among the SCD subjects. There were negative correlations between mean spleen sizes and height, weight and age in SCD patients but positive correlations were found between them in the controls. Conclusion: Routine sonographic assessment of spleen size and echo-texture is useful in the management of SCD patients. Sci. 2015;15(3):949-58. doi: http://dx.doi.org/10.4314/ahs.v15i3.32

BackgroundNigeria ranks 10 out of the 22 countries in the world with the highest TB burden. Contact tracing enhances case finding and increases the probability of cure. The purpose of the study is to improve the contact tracing skills of tuberculosis patients at the major TB centre in Enugu State, Nigeria.MethodsThe study is an educational intervention with a study and a control groups selected using multi-stage sampling techniques. A calculated sample size of 190 patients was used for each group. The instrument was a pre-tested semi-structured interviewer administered questionnaire. Data entry and analysis was done using Epi-info version 3.3.2. Chi-square test and student t –test were used at p < 0.05 level of significance and 95 percent confidence interval.ResultsAwareness of contact tracing at baseline and post intervention were respectively 18.2% and 85.2% (X2 = 158.4, DF = 1, p = 0.000; CI: 15.8-82.2) for the study group; 18.4% and 26.0% (X2 = 3.31, DF = 1, p = 0.069; CI: -9.9-24.7) for the control group. Knowledge that contact tracing involve bringing all household contacts of TB patients for screening was 79 (44.9%) and 33 (19.2%) for the study and control groups at baseline (X2 = 26.32, p = 0.000; CI: 7.2-44.1), but 151 (85.8%) and 36(20.9%) for the same at post-intervention (X2 = 147.22, p = 0.000; CI: 49.3-80.1). At baseline, only 5 (2.8%) of the study and 6(3.5%) of the control groups ( X2 = 0.12, p = 0.730; CI: -14.2-12.8 ) brought two or more contacts for screening. At post-intervention, the figure rose to 114 (64.8%) and 9 (5.2%) (X2 = 134.94, p = 0.000; CI: 44.3-74.9) for the study and control groups respectively. Over 50% of the contacts brought for screening were less than 10 years; 31 (18.3%) at baseline to 138 (81.7%) post-intervention in the study group (CI: 47.6-79.2), and 26 (35.1%) to 38 (51.4%) for the control group (X2 = 12.472, p = 0.000; CI: 0.1 -32.5).ConclusionIntensive planned health education intervention has been used to improve the contact tracing skills of the TB patients in a major TB centre in Enugu State, Nigeria. Further training and re-training of TB patients on contact tracing is highly recommended.

Background: Some kidney diseases are usually associated with changes in kidney size. Objective: To determine sonographically the normal limits and percentile curves of the kidney dimensions according to age, gender and somatometric parameters among school-age children. Methods: A prospective cross-sectional research design and convenience sampling method were utilized. Participants included 947 normal subjects (496 boys and 451 girls) aged 6−17 years old. The sonographic examination was performed on a Shenzhen DP-1100 machine with 3.5 MHz convex transducer. Longitudinal and transverse dimensions of the kidneys were obtained in coronal plane with the subject in the supine or left lateral decubitus position.

The use of information and communication technology for health care delivery, particularly in poor settings where access to medical services is inadequate, holds promise in expanding health care access. In rural or impoverished environment, where disease is prevalent, doctors are scarce, and health care infrastructure is inadequate, telemedicine holds a good prospect in improving the health conditions of the people. However, telemedical practice in Africa cannot be without challenges because some aspects are often difficult to implement in underdeveloped settings where ignorance and poverty are rife. Apart from nonavailability of facilities and poor communication, most Africans have different understanding of ailments, which often affect the health system. Considering the increasing disease burden in Africa and the need for tremendous progress in achieving the health component of the millennium development goals, telemedicine should be of concern to health policy makers. This paper critically examines the prospects and challenges of telemedical practice in Africa through a systematic review of 31 relevant publications which, in addition to the authors' knowledge and experience in biomedical care in Africa, supported the information as presented.

Sonographic determination of pathologic changes in the size of the kidneys necessitates knowing the normal ranges of its lengths especially with respect to height in school-age children.