Ductography (DG), also called galactography, is an important imaging diagnostic tool for evaluating patients with suspicious nipple discharge (SND). It is practical and cost-effective yet it is heavily underutilized in resource-constrained countries. The aim of this review was to explore the use of conventional DG as a diagnostic tool in the management of patients with pathologic or SND. This is a review of available literature on DG and SND over the past 36 years. In patients with SND, conventional DG is still a valuable, simple, and cost-effective imaging tool for the accurate localization of causal intra-ductal lesions including breast cancer. In resource-challenged environments, therefore, promoting ductographic diagnosis is cost-effective and attractive because it also affords curative targeted duct excisions.

Background: Total knee replacement (TKR) is a viable option for the management of osteoarthritis, and it has proven to be both effective and successful. Optimization of the patellofemoral joint kinematics is important for surgeons who choose to resurface the patella during TKR. The whole idea is to get the final patellar bone-prosthesis composite thickness to match the original patellar thickness before the surgery. Aim: To correlate patella height (PH) and patella width (PW) with patella thickness (PT) as well as build a regression model through which the dimensions can predict the thickness among the native knees of the South East Nigerians. Materials and Methods: This is a correlational, nonexperimental, and observational study conducted on 60 knees from 30 male cadavers taken from the anatomy laboratory of the University of Nigeria, Enugu Campus. The PH, PW, and PT were measured by using specific endpoints and the observed data were subjected to statistical correlation analysis. Results: PH and PT were strongly positively correlated, r(59) = 0.797, P < 0.001. Results of the multiple linear regression indicated that there was a collective significant effect between the PH, PW, and PT (F(2, 57) = 51.486, P < 0.001, R² = 0.644). The individual predictors were examined further and indicated that PH (t = 4.931, P < 0.001) was a significant predictor whereas PW (t = 1.153, P = 0.254) was not a significant predictor in the model. The patella’s predicted thickness is equal to 1.734+0.328 (PH in cm) +0. PT increased 0.328 cm for each centimeter of height. The PH was the only significant predictor of PT. Conclusion: This study was able to establish a correlation between the PH, PW, and PT, and it was able to demonstrate PH and PW as predictors of PT among the population of South East Nigeria.

Background: Adequate knowledge of human immunodeficiency virus (HIV), its modes of transmission, and methods of prevention can facilitate its prevention and control among any people. This study evaluates the impact of health interventions on the knowledge, perception, attitude, and misconception of HIV infection in Bonny Kingdom of Rivers State, Nigeria. Materials and Methods: This is a quantitative survey that used a structured questionnaire to determine the impact of community-based interventions (awareness education, free counseling and testing, etc.) on the prevention of HIV/acquired immune deficiency syndrome (AIDs) among a representative sample of the general population aged 15 to 49 years in Bonny Island, Nigeria. The data obtained include the demographics; age, sex, education, occupation, marital status, and sexual-related information. Data were analyzed by using SPSS, version 25.0. Result: The study comprised 1215 participants in each of the pre- and postintervention surveys. Before intervention, only 47.2% could correctly identify three transmission routes of HIV, as compared with 82.8% after the interventions (P < 0.0001). The intervention participants were 5.37 (95% CI. 4.46–6.48) more likely to have good knowledge of HIV transmission routes than respondents without interventions. The odds of misconception about HIV transmission routes before intervention were 3.52 (95% CI 2.48–5.01; P < 0.0001). About 80.7% and 45.9% believed that they were not at risk of contracting HIV at the baseline and postinterventions, respectively. Postintervention respondents were 4.04 (95% CI 3.41–4.79; P < 0.0001) willing to share meals, 4.84 (95% CI 3.94–5.94) willing to care for, 3.73 (95% CI 3.14–4.44) willing to allow teachers infected with HIV in school, and 3.14 (95% CI 2.60–7.80) willing to buy food from an infected person as compared with the preinterventions survey (P < 0.0001). Conclusion: This study has demonstrated the positive impacts of community-based intervention programs on the knowledge, prevention methods, and levels of misconception of HIV in Bonny Kingdom. Similar interventions are needed in other rural communities to promote the quest to end HIV/ AIDS by the year 2030.

Background: It is not uncommon to hit children in Nigeria, hence there is an increased possibility of encountering children with non-accidental injury (NAI). Radiographers are one of the first-line caregivers in a hospital setting, hence it is important that they are able to identify and act appropriately in cases of suspected NAI in children Objective: The objective of this study was to establish Nigerian radiographers’ awareness and role both before and after identifying NAI in children. Materials and Methods: This was a descriptive cross-sectional survey that assessed radiographers’ awareness and role in identifying NAI in children. A Google Form link was distributed through various Nigerian radiographers’ WhatsApp groups, inviting interested radiographers to participate in the survey. Data were analyzed by using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Results were presented by using tables and charts. Results: Ninety-eight radiographers working across the federation participated in the online survey. A total of 53.1% of the respondents clearly understood what NAI meant, whereas 59.2% never participated in the imaging of a child for NAI investigation. Only 12.3% were confident that they were very competent in identifying radiological signs of NAI in children. Conclusion: Although most radiographers understand what NAI means, very few agree that they have been formally trained in pediatric imaging, hence they lack the expertise in acting appropriately in cases of suspected NAI in children. The radiographers strongly believe that they would benefit from proper training to handle cases of NAI in children.

Background: COVID-19 pandemic is a global emerging viral disease caused by SARS- COV-2, 2019. It is a respiratory disease first reported in China in December 2019. It impacts on global health, economic, and social life with tremendous challenges. This study evaluates the impact of COVID-19 pandemic on orthopedic practice in Nigeria. Materials and Methods: A cross-sectional electronic survey of the impact of COVID-19 pandemic on orthopedic practice among orthopedic surgeons in Nigeria was done. The demographic characteristics, attitudes of orthopedic surgeons, available infrastructures, equipment, and the impact of COVID-19 pandemic on their practices were assessed. Results: A total of 87 respondents participated. The age of respondents ranged between 30 and 70 years with most involved being between 41 and 50 years age group (51.72%). Males constituted 96.5%. Majority, 47 (54%), of the respondents were not satisfied with the level of preparedness of their hospitals for COVID-19 pandemic. There was inadequate laboratory testing for COVID-19, personal protective equipment (PPE), and water supply. Elective surgical services were suspended and only emergency surgical interventions were allowed in many of their hospitals. Though the outpatient clinics were open, services were scaled down in the majority of hospitals to reduce workloads and maximize the use of scarce hospital consumables and resources. Conclusion: The impact of COVID-19 on orthopedic practice in Nigeria is huge with many unresolved challenges, absence of laid down protocols, basic equipment, testing materials, and PPE required for the management of COVID-19 pandemic. We recommend that the government provides adequate facilities and resources in hospitals to ensure optimal care during this pandemic.

Background: The pulmonary affectation by diabetes mellitus (DM) has not received adequate attention, and as such, there is paucity of data on the impact of DM on ventilatory function especially in South-Eastern, Nigeria. This study, therefore, aimed to determine the impact of type 2 DM on ventilatory function as observed at a tertiary health care facility in South-Eastern Nigeria. Materials and Methods: This was a comparative cross-sectional study of 100 consenting type 2 DM patients aged between 30 and 65 years, and 100 consenting, normal, adequately matched subjects. Anthropometric parameters were obtained from both study groups, and spirometry was done using spirolab III, version 1.7. Predicted ventilatory parameters were calculated using Nigerian equations. SPSS version 21 was used for data analysis. Results: A total of 100 type 2 DM patients and 100 normal control subjects were studied. There were 49 males and 51 females with type 2 DM. Comparatively, 51 of the control group were males while 49 were females. The mean FVC, FEV₁, FEF_25-75, and PEFR, were significantly lower in the type 2 DM group than in the control group (P values of 0.010, 0.015, <0.001, 0.006 respectively). Likewise percentage predicted FVC, FEV₁ and PEFR were significantly lower in the type 2 DM patients (P values <0.05). As much as 22% of the type 2 DM subjects had restrictive pattern while 2% had obstructive pattern. Long duration of DM (10 years or more) was associated with increased likelihood of developing restrictive ventilatory pattern (P < 0.001, odds ratio 14.224). Conclusion: Type 2 DM is associated with restrictive ventilatory dysfunction. Duration of DM of 10 years or more is an independent predictor of restrictive ventilatory pattern among type 2 DM subjects.

Introduction: With increasing evidence of thromboembolic events among pregnant Nigerian women and associated high maternal mortality rates, there is a need to document the plasma levels of some markers of thrombosis in this population to aid prompt management of thromboembolic events. Objectives: To determine the plasma levels of free protein S (fPS), protein C (PC) antigen (PCAg), and PC activity (PCAc) in normal pregnancy, and any correlations with maternal age, gestational age (GA), and blood group. Materials and Methods: A cross-sectional study of eligible pregnant women receiving antenatal care in a tertiary hospital in south-south Nigeria. The plasma concentrations of fPS, PCAg, and PCAc were measured using enzyme-linked immunosorbent assay and Protac methods. Statistical analysis was both descriptive and inferential and done using SPSS, version 21, for windows. A P-value of <0.05 was considered statistically significant. Results: Eighty pregnant women at a GA of 25–42 weeks (mean 35.4 ±5.2) were recruited with a mean age of 30.4 ± 5.1 years. The mean plasma levels and range of fPS, PCAg, and PCAc were 47.2 ± 10.3%, 77.5 ± 23.2% and 110.4 ± 27.6%, respectively. There were significant positive correlations between PCAg and GA (r = 0.229, P = 0.041), PCAc and GA (r = 0.223, P = 0.046), and fPS and maternal age (r = 0.254, P = 0.023). Conclusion: Plasma concentration of PCAg and PCAc increased as pregnancy advanced, although fPS was below the reference limit, it increased with advancing maternal age. This information should be considered while evaluating pregnant women.

Background: Diastasis Recti Abdominis (DRA) or increased inter-rectus distance (IRD) is among the most common pregnancy-related physical disorders in women. Studies are scarce on its correlates in an African population. Objectives: The aim of this study was to determine anthropometric and maternal correlates of DRA in Nigerian parous women. Materials and Methods: Eighty nine (89) consenting parous women (20–45 years) participated in this observational study. The IRD was measured with an electronic digital caliper at the umbilical level alongside other anthropometric measurements (weight, height, waist circumference (WC), hip circumference (HC)). Information on participants’ age, mode of delivery (MOD), parity, and age of last child (AOLC) was obtained. Data were analyzed with descriptive statistics and inferential statistics of Pearson’s and Spearman’s rank correlations, respectively, with subsequent linear regression analysis at an alpha level of P < 0.05. Results: The IRD significantly correlated with WC (r= 0.213, P = 0.045) and waist-to-hip ratio (WHR), (r = 0.357, P = 0.001). Significant regression equations were determined for the prediction of IRD based on WC and WHR. However, the other variables studied showed no significant (P > 0.05) correlation with IRD. Conclusion: WC and WHR are predictors of IRD in parous women, and these should be considered as important variables in the management of DRA associated with pregnancy.

Background: Childhood brain tumors (CBTs) constitute 5% of all childhood tumors and can involve any part of the brain disrupting brain structure, form, and function with associated high morbidity and mortality. The objectives of the study were to determine the clinicopathologic pattern and treatment outcome of brain tumor in children in our setting. Materials and Methods: A 3-year prospective multicenter observational study of children with brain tumors was undertaken. Relevant patients’ clinical data sought, included histological diagnosis, World Health Organization grade and survival pattern. Data were analyzed using SPSS version 21.0, whereas the level of statistical significance was set at P < 0.05. Results: Study participants were aged 2–16 (mean 7.93 ± 4.21) years. Fifteen were female (51.7%). The duration between; illness to presentation, presentation to confirmation of diagnosis, and from presentation to specific treatment were 4.40 ± 4.40, 5.0 ± 4.0, and 6.3 ± 6.0 months, respectively.Cerebellar tumors occurred most commonly 15 (51.7%). Majority of the cases, 21 (72.4%) were low grade. Central nervous tumor was first suspected in eight cases (27.6%) at the referring center. Eleven (37.9%) and ten (34.5%) patients, respectively, survived at 1 year and 3 years of follow-up post-diagnosis. The most common complication was hydrocephalus 12(41.4%). Mortality occurred in seven (21.4%) patients arising from their brain tumors. Conclusion: Poor knowledge of health care providers in referring centers, along with delay in initiating treatment contributed to mortality and morbidity.

Introduction: Pyrexia of unknown origin (PUO) still remains a challenge in paediatric practice. Appropriate history, physical examination, and exhaustive investigations are crucial in managing cases of PUO. Case Presentation: UU, was a 1-year-old female, who was seen at our facility on 16 January 2020, with a 4-day history of fever. Fever was high grade and intermittent. Examination revealed pyrexia of 38°c and no other remarkable findings. Lassa fever virus serology, hepatitis B surface antigen, hepatitis C surface antigen, C-reactive protein, erythrocyte sedimentation rate, full blood count, blood culture (with Bactec), malarial parasite, Mantoux, and CXR were all requested. Results of all these investigations were negative. Echocardiography done showed a 0.23 cm² vegetation at the septal leaflet of the tricuspid valve. A diagnosis of infective endocarditis was made and intravenous vancomycin, ceftriaxone, and metronidazole were commenced. Weekly urinalysis and serum electrolyte urea and creatinine monitoring were documented. After a 3-week course of intravenous antibiotics, patient still had fever with temperature higher than 38°c. A diagnosis of PUO was made and a follow-up plan was to do a bone marrow aspiration to rule out leukaemia and serology to rule out connective tissue disease. Conclusion: In managing a child with PUO, detailed history, appropriate physical examination and exhaustive investigations should be done. This is crucial in that even if diagnosis is not reached, several causes of PUO could have been ruled out.