Quadriceps tendon rupture is an uncommon injury and mostly occurs among middle aged individuals that are involved in sports such as running or jumping. Spontaneous bilateral quadriceps tendon rupture is a rarer injury, however, can be debilitating. Patients with such injuries usually present with history of minor trauma, swelling and inability to actively extend the knee. Its occurrence secondary to minor trauma is mostly associated with chronic diseases and long-term use of certain medications. Occurrence of simultaneous bilateral quadriceps tendon rupture in the absence of trauma in a healthy patient with no known medical condition is yet to be reported and therefore requires a high index of suspicion for early diagnosis and effective management to avoid complications. The aim of this case report is to create awareness of the spontaneous occurrence of this injury in the absence of the reported risk factors. We report the unusual case of a 60-year old healthy man who presented with a spontaneous simultaneous bilateral quadriceps' tendon rupture in the absence of trauma and no medical risk factors. We report the unusual case of a 60-year old healthy man who presented with a spontaneous simultaneous bilateral quadriceps tendon rupture in the absence of trauma and no medical risk factors. Consent was taken from him to be used as a case report being a rare case. The man had full recovery after surgery and physiotherapy and was discharged home. Spontaneous bilateral quadriceps tendon rupture is a rare occurrence. The index case report is important as there was no history of trauma and it was bilateral.
Context: COVID-19 came suddenly, bringing to the fore the challenges inherent in the health system. In a developing country, such as Nigeria, which already had myriad problems with funds and equipment in the health sector. Aims: This study aims to examine the challenges encountered by the staff in Radiology facilities and how they combated the challenges. Settings and Design: A descriptive cross-sectional study of radiology facilities in Nigeria. Subjects and Methods: Radiologists from nine government and four private facilities who attended to COVID-19 patients were asked to fill questionnaires on challenges faced and their coping strategies. Responses were sent through E-mail. Statistical Analysis Used: Data from the responses were analyzed using Microsoft excel for Mac 2011 and presented as figures and tables. Results: Majority of the government 7 (77.8%) and private facilities 4 (100%) had no equipment dedicated only to COVID-19 patients. Seven (77.8%) government facilities complained of inadequate staff, poor availability of personal protective equipment (PPEs) 8 (88.9%), and lack of technology for remote viewing 7 (77.8%). Fear of cross-infection was a challenge in one of the facilities 1 (11.1%). Coping strategies adopted include ensuring less traffic in the department by discouraging walk-in patients and canceling non-emergent cases, booking suspected/confirmed cases for lighter times, using old film for face shields and cloth for facemasks, staff education on COVID-19 and preventive measures, and sending reports to physicians through E-mail. Conclusions: There were a lot of challenges during the COVID-19 crisis, with government hospitals experiencing more challenges than private facilities. The challenges included among others inadequate staff strength and lack of technology for remote viewing. Some were overcome using education and by production of facemasks/shields production using recycled materials.
Atherosclerotic cardiovascular disease is the leading cause of mortality in patients with chronic kidney disease (CKD). Measurement of the carotid artery intima-media thickness (CIMT) is being used by many investigators to detect an increased risk of coronary artery atherosclerotic disease and document treatment effects. This study compares CIMT measurements in 75 patients with chronic kidney disease to a matched cohort of 75 subjects with normal kidney function. In plaque-free arterial segments, the CIMT was measured manually in the longitudinal plane from the far walls of a segment of the common carotid artery 3 cm in length adjacent to the carotid bifurcation. Patients with CKD had a significantly higher mean CIMT compared to those with normal renal function (0.86 ± 0.42 mm vs 0.69 ± 0.21 mm; P < .01). Mean CIMT values did not differ significantly between patients with different stages of CKD (stage 3: 0.88 ± 0.14 mm; stage 4: 0.89 ± 0.18 mm; and stage 5: 0.87 ± 0.14 mm, P = .94). These data indicate that CIMT is significantly higher in patients with CKD compared with controls, regardless of the stage of their disease, and may be a readily available noninvasive means of further assessing cardiovascular risk in CKD patients.
COVID-19 is a global pandemic ravaging the whole world with large numbers of reported cases globally. It is a highly-contagious novel infectious disease that causes inflammation in the respiratory system. Chest imaging is a useful adjunct for diagnosis, documenting the extent of disease as well as observation of changes and is thus, strongly recommended in suspected COVID-19 cases, for initial evaluation, differential diagnoses and follow-up. Description of typical imaging findings abound worldwide with a dearth of similar publications in sub-Saharan Africa. This series documents the chest imaging findings from a single facility of four cases between the ages of 38 and 60 who all tested positive for COVID-19 with real-time, reverse transcriptase polymerase chain reaction of the nasopharyngeal swabs.
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