Objective:The aim was to assess the use of optic nerve sonography (ONS) as a quick, noninvasive diagnostic test tool for detecting raised the intracranial pressure (ICP).Materials and Methods:A prospective blinded observational study was conducted at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria. The study population consisted of 160 adult patients referred to the radiology department for cranial computed tomography (CT) scan. There were 80 subjects and 80 controls. Optic nerve sheath diameter (ONSD) was measured by a radiologist using a 7.5 Megahertz ultrasound probe while cranial CT was reviewed by other radiologists blinded to the ONSD.Results:Sixty-nine subjects (86.3%) had intracranial space occupying lesions (SOL) with cranial CT confirmed features of increased ICP, mean binocular ONSD of 5.7 ± 0.59 mm while 11 (13.7%) had intracranial SOL without any cranial CT evidence of increased ICP, mean binocular ONSD of 4.8 ± 0.39 mm. The difference of mean ONSD of the two groups was statistically significant (P = 0.0001). The controls had a mean binocular ONSD of 4.5 ± 0.22 mm and the difference in mean binocular ONSD for subjects with raised ICP and the controls were also statistically significant (P = 0.0001). A cut-off value of 5.2 mm (sensitivity 81.2% [95% confidence interval (CI): 69.9–89.6], specificity 100% [95% CI: 71.5–100]) was obtained from the receiver operator characteristics curve as the mean binocular ONSD that best predicts raised ICP confirmed by at least a sign on cranial CT.Conclusions:Optic nerve sonography can differentiate between normal and elevated ICP and may serve as a useful screening tool in resource-limited practice.

Twenty‐two patients with 24 fistulae were examined prospectively with real‐time sonography. Sonographic findings were compared with those of intravenous urograms and correlated with the findings at examination under anesthesia and at surgery. Various genital abnormalities not revealed by intravenous urography were demonstrated by sonography preoperatively. These included cervical injuries, vesicovaginal fistula showing "flat tire" sign and hourglass deformities, and identification of the site, size, and course of fistulae in seven (29%) of the cases. However, the demonstration of the fistulae by sonography is poor relative to that of examination under anesthesia, in which 21 (87%) of the fistulae were identified. The factors responsible for the difficulty in demonstrating the fistulae on sonography, which included size and multiplicity, are discussed. Sonography is complementary to examination under anesthesia in preoperative evaluation of the patients with obstetric fistulae in general and in those with previous unsuccessful repairs in particular.

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Diverticular disease is no longer a rare disease in Nigeria. It is a common cause of lower gastrointestinal bleeding in elderly patients. High index of suspicion for diverticular disease of the colon and its complications should increase in the country.

A 10-year review of infants with encephalocele was carried out in a multicentered teaching hospital. Out of 23,438 infants seen within the period, only 12 cases of encephalocele were seen, giving an incidence of 0.5/1000 births. Nine (75%) of patients had occipital encephalocele, two (16.7%) occipitoparietal and one (8.3%) fronto-nasal. Two patients had spina bifida as an associated neural tube defect while ocular abnormalities were seen in another two. None had neurological defects at birth but some showed evidence of hydrocephalus and delayed milestones after surgery. Ultrasonic diagnosis was made in one case only. The etiologic, prognostic and descriptive characteristics, in addition to obstetric management of encephalocele are discussed.