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.

Background: Gynaecological emergencies are a common cause of morbidity and mortality among women of reproductive age group worldwide and can be life threatening. They can be easily managed if diagnosed early. Ultrasonography (USS) is a readily available and excellent diagnostic tool in the prompt and accurate diagnosis of these conditions. This is a comparative study aimed at evaluating the ultrasonographic findings in gynaecological emergencies and comparing with the clinical diagnosis. Methods: 400 patients presenting with suspected gynaecological emergencies at the National Hospital, Abuja were evaluated. The USS findings of these patients were recorded and matched with their socio-demographic parameters and the radiological diagnosis was then compared with the clinical diagnosis at presentation. Results: The mean age of participants was 34.2±7.5 years. Pregnancy related emergencies were the most common, making up 65.8%. Abortion was the most common emergency seen. Pregnancy related cases were commoner in the younger age group 20-39 years. A higher proportion of USS diagnosis for pregnancy related cases (96.7%) corresponded with the clinical diagnosis when compared to a smaller proportion for non-pregnancy related cases (80.6%), and this had significant correlation (x2=256.12, df=1, p<0.0001) Conclusions: USS evaluation of gynaecological emergencies as seen in this study, allows for quick and accurate diagnosis so that appropriate emergent care can be instituted to improve the outcome in these cases.

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Purpose: The aim of this article is to evaluate the agreement of placenta thickness (PT) with other foetal biometric parameters in the determination of gestational age (GA) in normal singleton foetuses. Materials and Methods: The study was a cross-sectional descriptive study conducted among 406 consecutively recruited pregnant women with singleton foetuses at 15–40 weeks of gestation at the National Hospital, Abuja, Nigeria from October to December 2019. Biparietal diameter (BPD), femur length (FL), head circumference (HC), abdominal circumference (AC), and PT were measured using standard measurement protocols. Bland and Altman (BA) plots were used to compare PT and other foetal biometric parameters. The significant statistical level was determined at a critical value of P < 0.05. Results: The mean age of study participants was 31.8 ± 4.8 years. The BA plot of PT and HC demonstrated a normal distribution; the mean difference was around zero (3.968) and 95% of the measurements fell within 2SD of the mean. The BA plot of HC and AC measurements also showed that the 95% limits of agreement for differences fell within 10% of the mean of the measurements (-4.236 to 15.987 with a mean difference of 5.876), indicating good agreement between the two pairs of variables. However, BA plots between PT and BPD as well as PT and FL showed no agreement. Conclusion: This study indicates that there is good agreement or comparability between PT and HC measurements as well as between PT and AC measurements. Hence, either HC or AC measurements may be interchangeable with PT measurements in the ultrasound determination of GA. However, PT measurements did not agree well with BPD and FL measurements, respectively.

Background: Hysterosalpingography is dreaded by women due to pain. Pain intensity varies with different stages of the procedure and the search for an effective analgesia continues. Objective: To compare the effectiveness of suppository diclofenac (100mg), cervical lidocaine 25mg -prilocaine 25mg cream (5% EMLA) and placebo in pain relief for hysterosalpingography. Methodology: This was a prospective, randomized, double-blinded, placebo-controlled study conducted at National Hospital Abuja, Nigeria, between November 2018 and March 2019. Participants were allocated to three groups (A, B, C). Group A received suppository diclofenac 100mg plus placebo cream, group B got EMLA cream plus placebo suppository while group C received placebo suppository and cream. Pain levels were assessed using Visual Analogue Scale (VAS) at baseline, during 4 different stages of the procedure, at 30 minutes and 24 hours after the procedure. Patients' satisfaction and side effects were also assessed. Data were analyzed using SPSS version 22 (SPSS Inc., Chicago, IL, USA). P value < 0.05 at 95% confidence interval was regarded as statistically significant. Results: The most painful step of the procedure was during uterine distension with contrast medium with mean VAS score of 6.33±1.539, 5.37±1.377, 7.03±1.245 in group A, B and C, respectively (p-value <0.05). Mean pain scores during 4 steps of the procedure were found to be significantly lower in EMLA group. Intervention groups were also more satisfied after the procedure. Conclusion: EMLA 5% cream is a more effective analgesic for HSG compared to both diclofenac and placebo. Keywords: Analgesia; EMLA; diclofenac; hysterosalpingography; visual analogue scale.