Background:Thyroglossal duct cyst (TGDC) is the most common congenital midline abnormality in the Head and Neck region, commonly presents as, a painless slowly progressive midline swelling, which moves with deglutition, and tongue protrusion. The aim of the study is to assess the clinical presentation and treatment of TGDC at a tertiary hospital in Kaduna, North-Western Nigeria. Methodology:It was a retrospective descriptive study; medical records of patients diagnosed with TGDC from January 2013 to September 2025 were reviewed. Data were collected from medical records, with variables including demographics, clinical presentation, investigations, and treatment outcomes. Categorical variables were presented in frequency tables and percentages, continuous variables were presented in mean and standard deviation, the relationship of variables was analysed using Chi-square and Fisher's exact test, level of significance was set at p value <0.05. Results:Forty-six patients (74.2%) had complete records and were reviewed. Their ages ranged from 1-54 years (mean 15.0 ± 14.5 years), with males accounting for 54.3%. Most patients (80.4%) presented within five years of symptom onset, predominantly with neck masses (97.8%), while 8.7% had discharging sinuses. Central (69.6%) and infrahyoid (63.0%) lesions were most common. Twelve patients had infected cysts, with three requiring incision and drainage. Half underwent Sistrunk's procedure, while the remainder defaulted. Five patients developed complications, but no recurrence occurred. FNAC was significantly associated with undergoing Sistrunk's procedure (p = 0.008), unlike age or gender. Conclusion:The Sistrunk procedure provided a good outcome with minimal complications among those treated. However, there is significant patient default that needs further investigation in order to gain insight into the reasons.
Introduction:Chronic kidney disease (CKD) is a multisystem disease of increasing prevalence and thus of great public health importance. CKD-associated pruritus (CKD-aP) is a common dermatologic manifestation of CKD, and it has been associated with increased occurrences of mood and sleep disorders, increased rates of infection and hospitalization, reduced overall quality of life and increased mortality rates. Methodology:This cross-sectional descriptive study was carried out in a tertiary hospital in Southern Nigeria between June 2024 and August 2024 to determine the prevalence and pattern of CKD-aP in 171 pre-dialysis patients with stages 3-5 CKD. Results:The mean age in this study was 59.9 ± 16.9 years, with females comprising 43.9% of study participants. The prevalence of CKD-aP was 26.9%. The majority (73.9%) had pruritus of moderate severity, and the distribution of pruritus was generalized in 39.1% of those with CKD-aP. There was no significant association observed between gender and aetiology of CKD. (p = 0.364), between gender, aetiology of CKD and pruritus, and between gender, CKD etiology, CKD stage and pruritus severity. CKD stage was a predictor of CKD-aP. (Adjusted odds ratio [AOR]: 2.49; 95% CI: 1.24-5.19; p = 0.011). Conclusion:CKD-aP was relatively common among pre-dialysis CKD, and there was no statistically significant association observed between pruritus, gender, CKD aetiology and CKD stage. It is therefore recommended that CKD-aP should be assessed periodically and managed in all patients with CKD, as this may improve their quality of life and reduce morbidity and mortality.
Background:Challenging behaviours are highly prevalent among children with neurodevelopmental disorders (NDDs), particularly those with speech impairments. Speech and language therapists in low- and middle-income countries, including Nigeria, frequently encounter these behaviours during service delivery but often report limited training in effective behavioural management approaches such as Functional Behavioural Analysis (FBA). This study aimed to evaluate the effectiveness of a behavioural management training programme on the knowledge and self-efficacy of speech therapists managing children with NDDs. Methodology:A quasi-experimental one-group pre-post intervention design was employed, conducted in three phases: baseline, intervention, and post-intervention. Sixteen participants were recruited using purposive sampling. Pre- and post-intervention knowledge and self-efficacy related to challenging behaviour management were assessed. Data was analysed using descriptive and inferential statistics. Results:The intervention resulted in significant improvements in both knowledge and self-efficacy. Mean knowledge scores increased from 10.69 (± 1.40) at baseline to 11.50 (± 0.73) post-intervention. Self-efficacy scores also improved significantly, rising from 5.06 (± 2.08) to 7.50 (± 1.21). The effect size (Cohen's d = 1.03) indicates a large effect, suggesting that the intervention is potentially effective in improving participants' skills and confidence in managing challenging behaviours. Conclusion:Behavioural management training based on FBA appears effective in improving knowledge and self-efficacy among speech and language therapists working with children with NDDs. Integrating such training into professional development programmes may strengthen service delivery, improve access to care, and optimise outcomes for children in low-resource settings.
Background:Overweight and obesity are growing global public health challenges driven by genetic, environmental, and behavioural factors. In Nigeria, their prevalence is increasing amid epidemiological transition, but local sociodemographic determinants remain poorly understood. This study investigated sociodemographic factors associated with overweight and obesity among overweight and obese adults in Uyo, Nigeria. Methodology:A hospital-based cross-sectional study was conducted at the General Outpatient Clinic of the University of Uyo Teaching Hospital from July to December 2017. Using consecutive sampling, 385 overweight and obese adults aged ≥ 18 years were enrolled. Data were collected via interviewer-administered questionnaires and anthropometric measurements. Analysis was performed using IBM SPSS version 17.0, employing chi-square tests and multivariable logistic regression. Results:Of 380 completed responses (98.7% response rate), 73.7% (n=280) were obese and 26.3% (n=100) were overweight. Class I obesity was most prevalent (55%). Factors significantly associated with overweight and obesity in bivariate analysis were female gender (χ2 = 32.69, p < 0.001), being married (χ2 = 26.39, p < 0.001), age ≥ 40 years (χ2 = 12.74, p < 0.001), Ibibio ethnicity (χ2 = 22.62, p < 0.001), and occupational class (χ2 = 16.06, p = 0.01). In the adjusted multivariable model, independent predictors of overweight and obesity were: female gender (aOR=6.33, 95% CI: 3.33-12.07), Ibibio ethnicity (aOR=2.02, 95% CI: 1.15-3.58), tertiary education (aOR=2.29, 95% CI: 1.02-5.17), and higher occupational classes (Class 2: aOR=5.30, 95% CI: 1.71-16.40; Class 3N: aOR=12.97, 95% CI: 1.45-115.76; Class 4: aOR=8.44, 95% CI: 2.57-27.79). Conclusion:Female gender, older age, marital status, higher occupational class, Ibibio ethnicity, and tertiary education were significantly associated with overweight and obesity among the study participants. These findings highlight the necessity for targeted, culturally sensitive lifestyle intervention programs, particularly for women in higher socioeconomic groups, to address the increasing burden of overweight and obesity in Southern Nigeria.
Prostate cancer remains a major public health challenge in Nigeria, being the most commonly diagnosed cancer and the leading cause of cancer-related mortality among men. Despite recent improvements in cancer policies, registries, and selected diagnostic and treatment investments, access to timely, equitable, and guideline-concordant care remains limited. Current evidence indicates persistent late presentation, delays in diagnosis and staging, high out-of-pocket costs, and significant disparities in access to specialist services. Although curative treatments such as radical prostatectomy, radiotherapy, and brachytherapy are available in selected centres, many patients present with advanced disease or experience delays that limit their effectiveness. Consequently, androgen-deprivation therapy remains the predominant treatment modality. Improving outcomes requires strengthening the entire care pathway through early risk-based detection, efficient referral systems, faster pathology services, expanded financial protection, multidisciplinary management, and robust monitoring of treatment outcomes.
Background:Bleeding during spine surgery can be significant enough to require intraoperative blood transfusion. Unnecessary blood transfusion is associated with significant risks. Therefore, the accurate determination of intraoperative blood loss is important. The visual estimation of blood loss is the commonly used method; however, its accuracy remains a subject of debate. Methodology:A total of 60 patients scheduled for posterior spine surgery were enrolled on the study. In the theatre, the patients' haematocrit level was determined before and after surgery using a hand-held hemoglobinometer, and a Bourke and Smith equation was used to calculate the blood loss. Blood loss was also visually estimated by the anaesthetist and documented. Statistical analysis was performed using SPSS 26 to compare both methods. Results:In all patients, the mean blood loss was 993.8ml by visual estimate and 754.6ml by haematocrit calculation (P = 0.006). When stratified, the mean blood loss for instrumented surgery was 1147.3ml for visual estimation, and 814.9ml for haematocrit calculation methods (P = 0.001). For lumbar spine surgeries, the mean blood loss was 1141ml for visual method and 773.9ml for the haematocrit method (P = 0.002). Conclusion:This study showed that the visual method of blood loss determination significantly overestimated the volume of intraoperative blood loss compared to the more objective haematocrit calculation method in patients undergoing posterior spine surgeries.
Background:Self-medication is a common health-seeking practice in Nigeria and is associated with inappropriate medicine use, adverse drug reactions, and antimicrobial resistance. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication in Nigeria and synthesize evidence on its patterns, determinants, and consequences. Methodology:A systematic search of PubMed, Google Scholar, and African Journals Online (AJOL) was conducted for studies published between January 2000 and June 2025. Eligible studies reported self-medication practices among Nigerian populations. Study selection followed PRISMA guidelines, and methodological quality was assessed using the Mixed Methods Appraisal Tool. Random-effects meta-analysis using a generalized linear mixed model was performed to estimate pooled prevalence with 95% confidence intervals (CI). A prediction interval was computed to estimate the expected range of true prevalence in future similar studies. The review protocol was registered in PROSPERO (CRD420251130710). Results:Ninety-one studies involving 37,359 participants were included, with 86 contributing to the meta-analysis. The pooled prevalence of self-medication was 67.8% (95% CI: 63.0%-71.0%), with substantial heterogeneity (I2 = 98.4%). Prevalence was highest among occupational groups (78.1%) and in workplace settings (81.3%). Antibiotics were the most commonly self-medicated drugs, followed by analgesics and antimalarials. Major drivers included perceived minor illness, previous treatment experience, time constraints, financial barriers, and easy access to medicines. One qualitative study was narratively synthesised but excluded from the quantitative meta-analysis. Conclusion:Self-medication is highly prevalent in Nigeria, with widespread non-prescription antibiotic use contributing to antimicrobial resistance. Strengthening medicine regulation, improving healthcare access, expanding health insurance coverage, enhancing public education, and implementing antimicrobial stewardship programmes are essential to curb inappropriate self-medication and its consequences.
Background:Infertility is a global health issue with profound social and psychological consequences, particularly in sub-Saharan Africa, where male factors are often underdiagnosed. Varicocele, a dilatation of the pampiniform plexus veins, is a leading correctable cause of male infertility. Seminal fluid analysis (SFA) remains the cornerstone for evaluating male fertility. Establishing correlations between ultrasound grading of varicocele and semen parameters may provide clinicians with predictive, non-invasive tools for managing infertility. The objective of the study is to correlate the ultrasound grading of varicocele with seminal fluid findings in infertile men. Methodology:This was a cross-sectional analytical study conducted on 225 infertile men aged 23-68 years with sonographically confirmed varicocele at Ahmadu Bello University Teaching Hospital, Zaria, between September 2023 and June 2024. Participants underwent scrotal ultrasonography using Sarteschi's criteria for varicocele grading, and semen analysis was performed in accordance with WHO 2010 guidelines. Data were analyzed with SPSS v23 using descriptive statistics, ANOVA, and Spearman correlation. Results:The modal age group was 31-35 years (28.4%). Left-sided varicocele was most common (44.4%), followed by right (35.5%) and bilateral (20%). Varicocele grade distribution was: I (20.4%), II (19.1%), III (24.4%), IV (14.2%), and V (21.7%). Higher varicocele grades correlated negatively with sperm count (r = -0.64, p = 0.001), motility (r = -0.40, p = 0.021), and morphology (r = -0.43, p = 0.013). Patients with grade IV-V varicocele showed significantly impaired semen quality compared to grades I-II. Conclusion:Increasing varicocele grade is associated with progressive deterioration in semen parameters. Ultrasound grading of varicocele may serve as a reliable predictor of seminal quality, assisting in clinical decision-making for the management of male infertility.
Background:Accurate diagnosis of skin disorders relies heavily on clinical examination, supplemented by histopathological evaluation when biopsies are performed. The degree of concordance between clinical and histopathological diagnoses is a key quality indicator and educational tool in dermatologic practice. This study aimed to evaluate clinicopathologic diagnostic concordance in skin biopsies performed at a tertiary dermatology clinic in a sub-Saharan African country. Methodology:A retrospective analysis of skin biopsies was conducted to determine the rate of full, partial, and non-concordance between clinical and histopathological diagnoses. Concordance was also assessed across anatomical sites, patient demographics, and diagnostic categories. Results:Among the biopsies reviewed, the overall clinicopathologic concordance rate was 64.2%. Full concordance was significantly more common in males than females (55.7% vs 44.3%, p = 0.02). In bivariate analysis, sex was the only variable significantly associated with diagnostic concordance (p = 0.019), with higher concordance observed among male patients. In contrast, multivariable analysis identified eczematous disorders as being associated with a markedly increased likelihood of diagnostic non-concordance compared with tumor categories (AOR = 6.38; 95% CI: 2.06-19.8; p = 0.001). Concordance was highest among tumors, papulosquamous diseases, and infections, with pigmentation disorders also demonstrating relatively high concordance. Partial concordance was most frequently observed in collagen disorders, pigmentation disorders, and inflammatory dermatoses. Conclusion:These findings demonstrate a moderate clinicopathologic concordance rate for skin biopsies in this setting, with considerable variability across disease categories and patient characteristics. The results underscore the continued importance of histopathological evaluation, particularly for diagnostically challenging dermatoses, and identify opportunities to improve diagnostic performance. The findings have practical implications for dermatology training by highlighting disease categories with low concordance and may serve as a quality-improvement metric to inform targeted continuing medical education programs aimed at enhancing diagnostic accuracy.
Background:Nigerian neurosurgery has remained under the existential threat of poor political decisions of governments and the resultant socio-economic instability. Currently, the country is undergoing its worst form of insecurity and brain drain, as skilled professionals emigrate abroad to more secure and safer countries to improve their income and living standards. The health sector, especially neurosurgery, is one of the hardest hit. The objective of this study is to profile the available neurosurgery infrastructure and manpower in the 6 geopolitical zones of Nigeria. Methodology:This involves an online cross-sectional survey by questionnaire, phone calls, and social media chats of the neurosurgeons working in all 44 neurosurgery facilities listed on the Nigerian Academy of Neurological Science (NANS) website. This was matched with secondary data on the Nigerian regional population figures obtained from internet fact-checks. Descriptive statistics were used to interpret and analyse the collated data. Results:There were 44 neurosurgery facilities under the leadership of 111 out of the 166 certified neurosurgeons; the rest had emigrated due to the economic hardships of the country. The neurosurgeon: population ratio was 1:2.12million. The North-East Zone has the least number of neurosurgeons. Conclusion:The number of neurosurgeons per Nigerian population is poor. Furthermore, the abysmal statistics and the discrepancy in the regional distribution even make access worse in the North East region of the country.
Background:Menstruation is an important indicator of female reproductive function. Advances in the management of sickle cell anaemia (SCA) have improved survival into adulthood, increasing attention to reproductive health outcomes, including menstruation. The objective of this study is to compare menstrual characteristics between women with sickle cell anaemia and age-matched controls. Methodology:A case-control study was conducted among women attending the sickle cell clinic of a tertiary hospital in North-west Nigeria. A total of 30 women with HbSS and 40 age-matched HbAA controls were recruited. Data on socio-demographic variables and menstrual history were collected using a structured questionnaire. Anthropometric measurements and haematocrit were obtained. Statistical analysis was performed using SPSS version 26, with the chi-square test and Pearson correlation. Significance was set at p < 0.05. Results:Mean age at menarche was higher in the SCA group compared to controls (15.9 ± 1.6 vs. 14.3 ± 1.8 years, p = 0.002). Menarche was significantly associated with BMI and haemoglobin genotype. Most participants in both groups had normal menstrual cycle length (21-35 days) and duration (2-7 days). Dysmenorrhoea was common in both groups (70% vs. 77.5%), with no significant difference in severity. A small proportion of SCA participants reported vaso-occlusive crises during menstruation. Conclusion:Women with sickle cell anaemia experience delayed menarche compared with controls, but most menstrual cycle parameters are comparable between groups. BMI is significantly associated with age at menarche.
Background:Diphtheria remains a vaccine-preventable disease of public health concern in low- and middle-income countries, with recurrent outbreaks linked to immunity gaps among older children and adolescents. In Nigeria, although routine infant immunisation coverage has improved, uptake of recommended booster doses among adolescents remains suboptimal. This study assessed factors associated with acceptance of the diphtheria booster dose among in-school adolescents in Kano metropolis, northern Nigeria. Methodology:A cross-sectional explanatory sequential mixed-methods study was conducted among 650 adolescents aged 10-19 years. Quantitative data were collected using a structured questionnaire and analysed with descriptive statistics, chi-square tests, and logistic regression. Qualitative data were obtained through focus group discussions and key informant interviews with adolescents, parents, and teachers, and analysed thematically to contextualise quantitative findings. Results:Overall, 81.8% of respondents expressed willingness to accept the diphtheria booster dose. In adjusted analysis, acceptance was significantly associated with being in senior secondary school (aOR = 2.21; 95% CI: 1.31-3.75). Parental marital status (aOR = 0.56; 95% CI: 0.34-0.91), parental education (aOR = 0.58; 95% CI: 0.35-0.94), and knowledge of the booster dose (aOR = 0.20; 95% CI: 0.10-0.41) were also significantly associated with acceptance. Qualitative findings revealed that willingness was often conditional on parental approval, perceived vaccine safety, and service availability. Key barriers included poor awareness, misconceptions, fear of side effects, and limited parental involvement, while facilitators included school-based health education, peer influence, parental encouragement, teacher support, and school-based vaccination platforms. Conclusion:Although stated willingness to accept the diphtheria booster dose was high, acceptance is influenced by school-related, parental, and perceptual factors. Strengthening school-based vaccination platforms, enhancing parental engagement, and implementing culturally sensitive communication strategies may improve booster uptake and prevent future outbreaks.
Background:Despite the global increase in contraceptive use, millions of women in developing countries still wish to delay or avoid pregnancy but are not using any method of contraception for various reasons. This gap contributes to unintended pregnancies, thereby increasing the risk of unsafe abortions, as well as maternal and neonatal morbidity and mortality. This study aimed to assess the geospatial distribution and predictors of unmet need for contraception among married women in Zaria LGA. Methodology:A community-based cross-sectional study was conducted among 2,880 women selected from 90 enumeration areas using a two-stage stratified cluster sampling technique. Data were collected using two adapted standardized questionnaires. Spatial analysis and binary logistic regression were performed to identify spatial distribution and predictors of unmet need for contraception, with statistical analysis conducted using Stata version 17 and ArcGIS Pro version 3.1. Results:The overall prevalence of unmet need for contraception was 25.7%, comprising 15.2% for spacing and 10.5% for limiting. Spatial analysis revealed significant clustering of unmet need for contraception, with hotspot areas predominantly located in the rural parts of the LGA. Significant predictors of unmet need included women in the second wealth quintile (aOR = 1.370, 95% CI: 1.025-1.831), women who had ever born 1-2 children (aOR = 0.530, 95% CI: 0.301-0.792), and women whose most recent childbirth occurred 1-2 years prior to the survey (aOR = 1.530, 95% CI: 1.178-1.987). Conclusion:Unmet need for contraception remains high in Zaria LGA. Spatial clustering and hotspot areas were predominantly observed in rural settings, highlighting persistent geographic inequities in access to and utilization of family planning services. Scaling up area-specific, community-based family planning interventions in identified hotspot areas may help reduce the burden of unmet need for contraception.
Background:Paediatric goitre requiring surgery is uncommon and presents a unique clinical challenge. Data on its presentation and surgical outcomes in Nigeria are limited. This study reviews the clinical presentation, operative treatment, and outcomes of children and adolescents who underwent thyroid surgery at a mission hospital in Southern Nigeria. Methodology:This was a retrospective descriptive case series of children and adolescents aged 0-17 years who underwent surgery for thyroid disorders at a mission hospital in Abia State, Nigeria, between January 2015 and December 2023. Data were extracted from clinical records, operative notes, and histopathology reports. Variables included demographic characteristics, clinical presentation, thyroid function status, surgical procedure, histopathological diagnosis, and postoperative complications. Data were analysed using descriptive statistics. Fisher's exact test was used to compare postoperative complication rates between types of thyroidectomy. Results:Of 1,071 thyroidectomies performed during the study period, 43 paediatric cases met the inclusion criteria and were analysed. The median age was 16 years, with an interquartile range of 14-17 years, and 36 patients were female. Total thyroidectomy was performed in 34 patients, while nine underwent lobectomy. Histopathological diagnoses were benign in 39 patients and malignant in four. Diffuse thyroid follicular hyperplasia in Graves' disease was the most common clinicopathological diagnosis, followed by multinodular goitre. Postoperative complications were recorded in seven patients, with transient hypocalcaemia and neck haematoma being the most frequent. There was no apparent relationship between the type of surgery and postoperative complications. Conclusion:Paediatric goitre requiring surgery was uncommon and occurred mainly in female adolescents. Most lesions were benign, while malignancies were infrequent but clinically important. Short-term surgical outcomes were generally favourable, supporting the feasibility of paediatric thyroid surgery in a high-volume hospital setting.
Background:Surgical patients' attitudes and perceptions of pain often impact their post-surgical pain experience and treatment effectiveness. Inadequate education and unclear postoperative pain expectations have been associated with heightened pain perception. The objective of this study was to assess the effects of perioperative nurse pre-visits on the pain and recovery level of surgical patients. Methodology:A quasi-experimental design was employed among 128 surgical patients (64 in each of the experimental and control groups), scheduled for surgery at the University College Hospital in Ibadan, Nigeria. Ethical approval was obtained from the institution's ethical review board with approval number UI/EC/24/0180 (08/4/2025-7/4/2025). The experimental group were pre-visited by the operating room nurse and received individual preoperative education and counselling. The patients in the control group received the routine information and education from generalist nurses on the ward. Using the visual analogue scale, post-surgical pain was measured within one and 24 hours post-operation. Patients' recovery level was assessed 48 to 72 hours after surgery, using a post-recovery scale. The data was analysed utilising the Statistical Package for the Social Sciences (SPSS) version 23. The hypotheses were evaluated using the independent t-test. Result:Patients in the experimental group had a significantly lower pain score than the control group one hour and twenty-four hours following surgery (p < 0.001). Participants' post-operative assessments showed a significantly satisfactory recovery in 96.9% of the experimental group against 82.8% of the control group (p = 0.008). Conclusion:Pre-operative surgical nurse pre-visits had a significant effect on pain and recovery among surgical patients. Therefore, measures should be taken to incorporate it into clinical nursing protocols to improve patient satisfaction and recovery.
Background:Scabies is a highly contagious parasitic infestation that causes substantial morbidity, especially in low-resource tropical regions. Diagnostic limitations, particularly poor sensitivity of microscopy and the impact of dark skin pigmentation on lesion visibility, contribute to persistent transmission. Dermoscopy offers a rapid, non-invasive method of direct visualization of mites, yet evidence from Africa remains scarce. This study evaluates the demographic characteristics, clinical presentation, and the diagnostic accuracy of dermoscopy compared with skin scraping microscopy among patients with clinically suspected scabies in Southeast Nigeria. Methodology:A cross-sectional study was conducted among consecutively recruited, consenting participants with symptoms suggestive of scabies at the Dermatology clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between March 2021 and March 2022. Sociodemographic characteristics, Clinical presentation, and dermoscopic assessment using a smartphone dermatoscope at × 200 magnification were obtained, with confirmatory skin-scraping microscopy. Sensitivity, specificity, predictive values, and 95% confidence intervals were calculated. Results:Among 170 patients (mean age 26.9 ± 17.2 years; 55.3% female). Dermoscopy identified mites in 86.5% of participants, while microscopy confirmed mites or eggs in 41%. Compared with microscopy, dermoscopy demonstrated a sensitivity of 100%, specificity of 16%, positive predictive value of 45%, and negative predictive value of 100% relative to microscopy. The "Delta Jet Wing" sign was observed in 71.8% of cases on dermoscopy. Conclusion:Scabies predominantly occurred among young adult females of lower socioeconomic status with papules as its most common clinical presentation. Dermoscopy demonstrates excellent sensitivity but poor specificity and is a useful diagnostic tool for scabies in resource-limited settings. Its integration into clinical dermatology practice in Nigeria may significantly improve early detection and limit community transmission.
Background:Adenomyosis is seen in women with infertility, with a significant impact on their lives. This study aims to evaluate the clinical characteristics, management strategies, and treatment outcomes of women diagnosed with adenomyosis. Methodology:This prospective study, conducted at Alps Hospitals and Diagnostics from June 2021 to December 2024, involved 44 women with adenomyosis. The clinical data were collected, reviewed, and analysed. Results:The mean age of participants was 39.5 ± 5.1 years. Most (77.3%) participants were nulliparous, with a mean duration of infertility of 7.4 ± 4.2 years. The most common (63.6%) presenting symptom was combined dysmenorrhoea and menorrhagia. Ultrasonography identified adenomyosis in 54.5% of cases.Diffuse adenomyosis was seen in 52.3% of women. Myomas were the most common (79.5%) co-existing pelvic pathology. Double-flap adenomyomectomy and wedge resection were done in 54.5% and 29.5% of participants, respectively. 13.6% of participants had medical treatment. Surgical site infection was the most frequent (6.8%) post-operative complication.Double flap adenomyomectomy and wedge resection resulted in reductions in Visual Analogue Scale (VAS) scores for dysmenorrhoea and menorrhagia. There was no significant difference (p-value> 0.05) when both surgical options were compared. GnRH analogues resulted in temporary symptom relief. Three women had positive pregnancy tests following In Vitro Fertilization (IVF), out of which 1 resulted in a live birth and 2 ended in miscarriages. Conclusion:Adenomyosis predominantly affects infertile nulliparous women in the late third decade of life with previous uterine surgeries. Combined menorrhagia and dysmenorrhoea are a common presentation, and conservative surgeries may provide sustained symptom relief with limited improvement in reproduction.
Rett syndrome (RTT) is a rare neurodevelopmental disorder characterized by developmental regression, loss of purposeful hand use, and stereotypic movements after apparently normal early development. We report a 26-month-old girl who presented with severe self-injurious behavior (SIB), including repetitive biting of the left forearm and head banging, associated with restlessness, frequent yelling, and poor sleep. Further evaluation revealed regression of motor, language, and hand skills with stereotypic hand wringing. Examination showed impaired social interaction, ataxic gait, and hypertrophic scars on the left forearm, while neurologic and systemic examinations were otherwise non-focal. Brain magnetic resonance imaging and electroencephalography were normal. In the absence of genetic testing, the diagnosis of RTT was established based on internationally accepted clinical diagnostic criteria. Parents were counseled for multidisciplinary care and followed up over a six-month period. This case highlights that prominent SIB may obscure the diagnosis of RTT and delay recognition, particularly in resource-limited settings where genetic testing is unavailable.
Background:Traumatic brain injury (TBI) remains a major cause of morbidity and mortality worldwide, particularly in low- and middle-income countries where road traffic accidents constitute a significant public health burden. Neuroimaging, especially computed tomography (CT), plays a pivotal role in the early diagnosis, management, and prognostication of TBI. Understanding the spectrum of neuroimaging findings in affected patients is essential for improving patient care and resource allocation, which is the aim of this study. Methodology:This retrospective descriptive study reviewed cranial CT scans of patients diagnosed with traumatic brain injury at a tertiary healthcare institution in Uyo over a specified study period. Demographic data, mechanisms of injury, and computed tomographic findings were extracted from radiological records and patient case notes. CT findings assessed included, but were not limited to, skull fractures, extra-axial haemorrhages, intracerebral haemorrhage, cerebral contusions and midline shift. Data were analysed using descriptive statistics. Results:A total of 183 patients with traumatic brain injury were evaluated, with a male predominance of 80.3%. The majority of patients occurred within the economically active age group of 20-59 years. Road traffic accidents constituted the most common mechanism of injury at 70% (n = 128). The most frequent neuroimaging findings were scalp swelling (n = 137, 74.9%), cerebral contusion (n = 130, 71.0%), skull fracture (n = 109, 59.6%), Diffuse cerebral oedema (n = 101, 55.2%) and subdural haemorrhage (n = 84, 45.9%). Multiple intracranial lesions were identified in a considerable proportion of patients. Conclusion:Traumatic brain injury in Uyo predominantly affects adult males and is commonly related to road traffic accidents. Cranial CT demonstrated a wide spectrum of neuroimaging abnormalities, with extra-axial haemorrhages and cerebral contusions being among the most frequent findings. Prompt neuroimaging evaluation remains indispensable in the diagnosis and management of TBI patients and may aid in improving clinical outcomes.
Background:Neoadjuvant chemotherapy (NACT) is commonly used in locally advanced, inflammatory, and biologically aggressive breast cancers to downstage tumors, facilitate breast-conserving surgery, and guide adjuvant treatment decisions. Response assessment after NACT relies on clinical examination and imaging modalities such as ultrasound, mammography, and MRI, with variable diagnostic accuracy. This study aimed to evaluate the accuracy of combined breast ultrasound and mammography in assessing response to NACT. Secondary objectives included determining the rates of pathological complete response (pCR) and radiological complete response (rCR), as well as the sensitivity, specificity, positive predictive value, and negative predictive value of combined imaging in predicting pCR. Methodology:A total of 145 consecutive patients diagnosed with breast cancer between January 2021 and June 2024 were retrospectively analyzed. All patients received neoadjuvant chemotherapy (NACT), followed by post-treatment breast ultrasonography and mammography performed 2-3 weeks after completion of NACT, depending on the chemotherapy regimen. Radiologic response was subsequently compared with final postoperative histopathology. Results:The combined use of breast ultrasound and mammography demonstrated an overall accuracy of 89.7% (95% CI: 83.6-94.1) in predicting pathological response, with a sensitivity of 81.8% (95% CI: 69.1-90.9) and specificity of 94.4% (95% CI: 87.5-98.2). The positive predictive value was 90.0% (95% CI: 78.2-96.7). However, subgroup analysis showed lower performance in the HR-/HER2+ subtype, with an accuracy of 68.2% (95% CI: 45.1-86.1) and a sensitivity of 63.1% (95% CI: 38.4-83.7). Conclusion:Combined breast ultrasonography and digital mammography demonstrated good accuracy in predicting pathologic response; however, variability across tumor subtypes underscores the need to integrate imaging findings with tumor biology and clinical context when planning surgical management.
