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    Image gently .One size does not fit all
    (Book Builders. Editors Africa. 2 Awosika Avenue, Bodija, Ibadan, Nigeria, 2010-07) Atalabi, O. M.
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    Baseline chest radiograhic features among antiretroviral therapy naïve human immuno-deficiency virus positive children in a pediatric care program
    (2012-01-12) Atalabi, O. M; Oladokun, R.; Adedokun, B,; Obajimi, M. O.; Osinusi, K.
    Background: Pulmonary diseases are commonly seen in children with HIV infection, and their etiology is often unclear. The radiological appearances of these conditions are often non-specific. Conventional radiographs play an important role in the management of chest conditions especially in resource poor settings. Objective: This retrospective study was carried out to determine the chest radiographic pattern in children with HIV infection. Materials and Methods: The baseline chest X-ray of 150 HIV-positive but antiretroviral drug naïve children were analyzed between July 2008 and December 2009 at the University College Hospital in Ibadan, south-west Nigeria. All children were screened for tuberculosis (TB) by one or combination of mantoux, acid-fast Bacilli (AFB) sputum, and erythrocyte sedimentation rate. The CD4 count was also taken as part of baseline laboratory test. Chi-squared test was used to determine association between the pattern of chest X-ray findings, and sex, age, and CD4 counts. Results: The mean age of the study group was 51.6 months, with children older than 5 years dominating and there was no statistical difference in the sex distribution. A total of 115 children (76.7%) had abnormal chest X-ray, with lymphadenopathy accounting for 45.3% followed by parenchymal lesions with 37.3%, miliary shadows, and cavities accounted for 6.7% and 2.6%, respectively. Cavities were found to be common in patient who tested positive to AFB than AFB-negative patients. Other findings like reticulonodular or diffuse patterns, lymphadenopathy, pleural effusion, or soft tissue swelling were also commoner in the AFB-positive patients. The CD4 count was available for 42% of the patient and there was no significant association between the chest radiographic changes and the CD4 count. Conclusion: Definitive diagnosis of pulmonary disease might be difficult based on chest X-ray alone, however, chest X-ray is a basic radiological test and almost the easiest to perform in both resource poor or rich setting and it is still recommended that routine chest X-ray should remain part of investigation of HIV-positive children to serve as adjunct to other investigations in early detection of TB.
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    Misconception about ultrasound among Nigeiran women attending specialist and tertiary health institutions in Ibadan
    (2012-08) Adekanmi, A. J; Morhason-Bello, I. O; Atalabi, O. M.; Adedokun, B. O.; Adeniji-Sofoluwe, A. A.; Marinho, A. O.
    Background: In women health, ultasound is well established as a safe tool, and it is often the first imaging modality employed in the, screening, investigation and treatment of conditions in obstetrics and gynaecology. However, women's misconceptions about health issues, aetiology and treatment of diseases conditions may have negetive impact on thier health care seeking behaviour. Client's perspective of diagnosis including investigation process is therefore crucial in health care. This study aimed at finding out the misconceptions expressed by clients about ultrasound, and the potential predictors associated with this attitude among women in Nigeria. Method: A descriptive cross-sectional survey was conducted among 3137 women who presented for transabdominal ultrasound scan between August and November 2010 in two referral hospitals in Nigeria. Data were obtained using a questionnaire. Descriptive and multivariate analysis was performed applying logistic regression analysis; predictors of misconceptions expressed by clients about ultrasoung, and misconception among women in Nigeria were identified using SPSS statistics (SPSS Inc, Chicago, IL) version 17 software. Results: The mean age of the women was 33.8 years (standard deviation=7.0), with 88.8% currently married. More than half of the respondents had tertiary education (56.6%), followed by secondary school education (34.5%), primary education(7.8%) and no formal education (1.1%). There were 59 women who held the misconception that ultrasound was dangerous to health accounting for 1.9% of the study population. The reasons given by this group of women included; 'ultrasound can kill or destroys the body cells'(35.6%); 'it can cause cancer' (15.3%); 'the radiation is only dangerous to some organs of the body' (6.8%); 'it can harm or deform the fetus'(6.7%); 'it is only dangerous when exposure is frequent'(5.1%) and 'only dangerous when handled by unskilled medical personnel' (1.7%). Conclusion: This study provides insight to the wide range of issues about clients' perception and misconception regarding ultrasound safety. These issues have to be addressed to improve better compliance and patronage about ultrasound scans in Nigeria. We suggest that robust conseling sessions is imperative to address all the views and possible concerns of clients to improve better service delivery.
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    Low field MR imaging of sellar and parasellar lesions: Experience in a developing country hospital
    (2011) Ogbole, G. I; Adeyinka, O. A.; Okolo, C. A.; Ogun, A. O.; Atalabi, O. M.
    Background: Magnetic resonance imaging (MRI), an advancement which followed computed tomography (CT) is expensive and inaccessible in most dveloping countries. However it is the procedure of choice in evaluating sellar and parasellar lessions. Its major advantages are its superior soft tissue contrast differentiation, its capacity for multiplanar imaging and nonexistence of ionising radiation. Its use is relatively new in Nigeria, a developing economy in Africa. Since its introduction in 2005, it has been utilised extensively for neuroimaging at the University College Hospital (UCH), Ibadan; a large hospital is south-western Nigeria. Objective: To review the role and pattern of low field MR imaging in sellar and parasellar lesions presenting to a tertiary care centre in Nigeria. Methods: All 62 patients with clinically suspected sellar and parasellar masses, referred to the department of Radiology, UCH Ibadan for MRI between December 2006 and January 2010 were retrospectively analysed. The examinations were performed using an open 0.2T permanent magnet MR unit. T1W, T2W,T2/ FLAIR, TOF and T1W post gadolinium DTPA sequences of the sellar region were obtained. Result: Of the 62 patients, there were 27 males and 35 females. The modal age group was 40-49 years with a mean age of 39.94 years (±16.65years). Twenty-four cases (38.7%) had histological daignosis, of which 20(83.3%) were consitent with initial MRI diagnosis. Pituitary adenomas were the commonest (58.06%) lesions of the sellar and parasellar regions. Others include parasellar meningiomas, cranipharyngiomas, and gaint aneurysms. Headache and visual impariment were the major presenting features and showed no significant correlation with tumor size. Conclusion: The use of low filed MRI in the diagnostic evalauation of patients with suspected sellar or parasellar lesions in developing countries of low economic resource is commendable as it provides beneficial outcomes in management.
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    Management and outcome of peyronie's disease in Nigeria- Initial Experience
    (2011-12) Takure, A. O; Atalabi, O. M
    Peyronie's disease is characterized by the formation of fibrous plaques within the tunica albuginea of the corpora cavernosa. It is a frustrating disease to the patient resulting in penile deformity and painful erection and erectile dysfunction. There is mixed response to medical therapy and the numerous surgical options implies no standardized procedure yet. The incidence appears to be increasing but this disease is rarely reported in Nigeria. We present three cases of dorsal and ventral Peyronie's disease treated and followed up for 2 years who responded to surgical and medical treatment with satisfactory sexual life and penile erection.
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    The lumbosacral radiographs in the initial screening of low back pain- is one view enough?
    (2011-07-09) Atalabi, O. M.; Ogunlade, S. O.; Agunloye, A. A.
    Background: Radiological imaging is mandatory, when investigating patients with low back pain (LBP). A minimum of three plain radiographic views of lumbosacral spine are routinely requested for by the attending clinicians. Objective: The study therefore carried out to determine if only one view will be sufficient in the initial screening of patients with low back pain. Material and Methods: The antero-posterior (AP) and lateral plain radiographs of patients referred to the radiology department on account of low back pains in an eighteen month period (June 2007 to Novermber 2008) were reported by two certified radiologists. The findings were subjected to statistical analysis. The kappa agreement for two independent reports was between 0.602 and 0.908. Results: The radiographs for 638 patients were reviewed. 365 (57.2%) were females and 273(42.8%) were males. The age ranged from 20 years to 85 years with a mean of 56.4 years. Within the age group of 20-69 years, females were found to significanlty present earlier than with LBP (P<0.041). The AP view had a significantly higher rate of reported normal findings that the lateral view (p<0.000). Osteophytic outgrowth was the commonest finding in both views although the rate of detection was higher on the lateral view, as with the other abnormal findings. Conclusion: This study shows that the lateral radiographs show significantly more findings than AP on plain radiographs. It is therefore recommended that lateral radiograph is adequate in the initial screening of patients with low back pain.
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    Transvaginal ultrasonography: a survey of the acceptability and its predictors among a native African women population.
    (Dove Medical Press Ltd, 2012) Atalabi, O. M; Morhason-Bello, I. O; Adekanmi, A. J.; Marinho, A. O.; Adedokun, B. O.; Kalejaiye, A. O.; Sogo, K.,; Gbadamosi, S. A.
    Objective:To determine the acceptability of transvaginal ultrasonography (TVU) and associated factors among Nigerian women. Method: A cross-sectional survey was conducted among 3137 women who presented for transabdominal ultrasound scan between August and November 2010 in two referral hospitals in Nigeria. Data were obtained using a questionnaire. Descriptive and multivariate analysis was performed applying logistic regression analysis; predictors of willingness of participants regarding transvaginal ultrasound were identified using SPSS Statistics (SPSS Inc, Chicago, IL) version 17 software. Results: The mean age of the women was 33.8 years (standard deviation =7.9), with 88.8% currently married. About 84% were willing to have TVU, while 54.2% were indifferent about the gender of the sonologist. About 17.3% believed that the procedure is painful. Significant predictors of willingness to have TVU were previous sexual experience and douching, prior painful vaginal examination, and vaginal surgery. Conclusion: The majority of Nigerian women expressed a willingness to have the TVU pro-cedure without necessarily opting for any gender preference of the operator. Women should be adequately counseled on the operations of the procedure so as to be able to psychologically prepare for them.
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    Imaging of congenital diaphragmatic hernias
    (2009) Taylor, G. A
    Congenital diapharagmatic hernias are complex and life-threatening lesions that are not just anatomic defect of the diaphragm, but represent a complex set of physiologic derangement of lung, the pulmonary vasculature, and related structures. Imaging plays an increasingly important role in the care of these infants. Prenatal sonograpyh and MRI have allowed early and accurate identification of the defect and associated anomalies. These tools have also been the key to defining the degree of pulmonary hypoplasia and to predicting neonatal survival and need for aggressive respiratory resue strategies. In the postnatal period, conventional radiography supplemented by cross-sectional imaging in selected cases can be very useful in sorting out the diffential diagnosis of intrathoracic masses, in the detection of associated anomalies, and in the management of complications. Understanding the pathogenesis of diaphragmatic defects, the underlying physiologic disturbances, and the strengths and limitations of current imaging protocols is essential to the effective and accurate management of thses complex patients
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    X-ray hysterosalphingography: the most painful part in the Nigerian woman
    (2011-06) Atalabi, O. M; Osinake, B. B.
    Background.Hysterosalphingography(HSG)despite the accompanying pain still remains relevant in gynaecological practice.For effective analgesia.it is important to ideutifv the most painful step of this procedure .Numerical Rating Scale(NRS) and the Categorical Pain Scale(CPS) were used to identify the most painful step of HSG procedure and to find out if age,parity and the degree of infertility affect pain perception in this group of patients.Patients and Methodology: Ninety Four women referred for HSG due to infertility were recruited into this study.Their background pain and perceived pain of each step of the procedure was graded using the NRS and the CPS. The data collected were statistically analvsed. Results:Participant's age ranged from 21 to 34 vears with a mean on 33.3±4.8years. Cervical traction with introduction of cannula and instillation of contrast was found to be the most painful step of the procedure both having a median score of 6 (range 0- 10) based on the NRS and were rated to be moderate to worst possible pain based on the CPS .Almost 65% of the patients perceived the pain to be more than expected and nearly 100% would have preferred one form of analgesia or the other. Conclusion:The most painful step of HSG was found to be the same for the Nigerian women as in other parts of the world.These women should be offered effective analgesia for pain during HSG procedure.