Background:Breast imaging plays a vital role in the multidisciplinary approach to management of breast disease. A baseline data is apt and necessary for collaborative studies.Materials and Methods:This is a prospective descriptive study carried out between January 2009 and December 2013 at our institution. Patients who had breast imaging were recruited into the study. Film-screen mammograms were acquired with a General Electric (GE) Senographe DMR machine. Breast ultrasound done using an Aloka Prosound SSD-350+ ultrasound machine equipped with linear and curvilinear 7.5–10 MHz transducer. Findings were categorized using the ACR-BIRADS (American college of Radiologists-Breast imaging reporting and data system). Data was collated and analysed using social statistical package (SPSS) version 17.Result:The mammograms of 824 patients were evaluated during this study period. Their age ranged from 40–85 years with a mean age of 50.9 ± 8.1 years. Eight hundred and sixteen (99%) were females and eight (1%) were males. The commonest clinical indication was breast lump (23.9%). The commonest density pattern was BIRADS 2-scattered fibroglandular pattern (43.9%). Mammograms were normal in 266 (32.3%) and positive in 558 (67.7%). The final BIRADS assessment showed BIRADS 0, 1, 2, 3, 4, 5 and 6 constituted 6.6%, 30.1%, 29.7%, 22.2%, 5.9%, 5.0% and 0.5% respectively.Conclusion:The level of awareness of breast cancer is quite high with the positive mammographic yield emphasizing the value of a multidisciplinary approach in the management of breast diseases.
Summary Infantile meningitis is a clinical diagnosis. However, suspicion of its complications may warrant further investigations; and transfrontanelle ultrasound is a reliable and cheap way to evaluate the usefulness of ultrasonography in diagnosing the complications of infantile meningitis. This is a retrospective study of the transfrontanelle ultrasound findings in 40 infants presenting with clinical indicators of complicated acute bacterial meningitis. There were 20 boys and 20 girls aged 5–115 days (mean, 42.6 ± 30.1 days). The complications of meningitis detectable on ultrasound were: hydrocephalus (21[52.5%]); cerebral abscess (2[5%]); subdural empyema (2 [5%]); and ventriculitis (3[7.5%]). Twelve babies (30%) had no abnormal findings. Hydrocephalus is the most common complication of meningitis in our setting. Transfontanelle ultrasound proved to be very reliable in the initial diagnosis and follow-up of complicated meningitis.
Background AIM on ClearCanvas Enriched Stroke- phenotyping Software (ACCESS) is a novel standalone computer software application that allows creation of simple standardized annotations for reporting brain images of all stroke types. We developed the ACCESS application and determined its inter-rater and intra-rater reliability in the Stroke Investigative Research and Educational Network (SIREN) study to assess its suitability for multicenter studies. Methods One hundred randomly selected stroke imaging reports from five SIREN sites were reevaluated by four trained independent raters to determine inter-rater reliability of ACCESS (version 12.0) software for stroke phenotyping. To determine intra-rater reliability, six raters reviewed the same cases previously reported by them after a month interval. Ischemic stroke was classified using the Oxfordshire Community Stroke Project (OCSP), TOAST and ASCO protocols, while hemorrhagic stroke was classified using the SMASH-U protocol in ACCESS. Agreement among raters was measured with Cohen’s kappa statistics. Results For primary stroke type, inter-rater agreement was 0.98 (95%CI: 0.94–1.00) while intra-rater agreement was 1.00 (95%CI: 1.00). For OCSP subtypes, inter-rater agreement was 0.97 (95%CI: 0.92–1.00) for the Partial Anterior Circulation Infarcts (PACI), 0.92 (95%CI: 0.76–1.00) for the Total Anterior Circulation Infarcts(TACI) and excellent for both Lacunar Infarct (LACI) and Posterior Circulation Infarcts (POCI). Intra-rater agreement was 0.97 (0.90–1.00) while inter-rater agreement was 0.93 (95%CI: 0.84–1.00) for TOAST subtypes. Inter-rater agreement ranged between 0.78 (cardioembolic) to 0.91 (large artery atherosclerotic) for ASCO subtypes and was 0.80 (95%CI: 0.56–1.00) for SMASH-U subtypes. Conclusion The ACCESS application facilitates concordant and reproducible classification of stroke subtypes by multiple investigators, making it suitable for clinical and multicenter research.
Background: It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa. Objective: To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies. Methods: A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants' knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed. Results: Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability was associated with having at least post-secondary education (OR 1.51, 1.25-1.81) and a family history of stroke (OR 1.20, 1.03-1.39) while Islamic religion (OR¼0.82, CI: 0.72-0.94), being currently unmarried (OR ¼ 0.81, CI: 0.70-0.92), and alcohol use (OR ¼ 0.78, CI: 0.67-0.91) were associated with lower odds of awareness of stroke as a heritable disorder. Willingness to undergo genetic testing for stroke was associated with having a family history of stroke (OR 1.34, 1.03-1.74) but inversely associated with a medical history of high blood pressure (OR ¼ 0.79, 0.65-0.96). Conclusion: To further improve knowledge of stroke heritability and willingness to embrace genetic testing for stroke, individuals with less formal education, history of high blood pressure and no family history of stroke require targeted interventions.
Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: To investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-centre case-control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns. Results: Overall, mean age was 59.0±13.9 years, and 3992(54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95%CI) for risk of stroke by second and third tertiles (using the lowest (first) tertile as reference) of dietary patterns were; 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02) respectively for ‘poultry product and organ meat’; 1.69 (1.47, 1.96 and, 1.51 (1.31, 1.75) for ‘red meat’; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for ‘fried foods and sweetened drinks’; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for ‘vegetables’; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for ‘whole-grain and fruit drinks’; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for ‘fruits’ (P<0.05). Conclusions: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.
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