ABSTRACT
Introduction: Rapid clinical and radiological evaluation provides the foundation for the immediate treatment of acute ischemic stroke (AIS) and transient ischemic attack (TIA), which are medical emergencies. In order to diagnose the etiology of AIS/TIA and aid establish the best course of treatment, there are international recommendations for performing head computed tomography (CT) scans. However, these researchers noticed that the radiographers, at the study sites in Zambia, employ the traditional plain pre-set brain CT scan imaging parameters. This research demonstrated the need to adjust these pre-set imaging parameters, so as to improve the resultant images. Aim: The aim of this study was to improve CT image quality for AIS/TIA patients. Methods: This study used a quantitative, comparative research design. The first step involved a quantitative, retrospective assessment of patient files to determine the current head CT scan parameters used in imaging patients with AIS/TIA. The reconstruction and implementation of the international criteria for the imaging of these patients constituted the subsequent prospective quantitative phase. Adjusted CT imaging parameters were applied after the retrospective and prospective data statistical analysis. The sample (N=202 images) was purposefully selected. Results: The study improved the ability to enhance the contrast of diagnostic images at lower radiation dose index output. Following the intervention, the average image contrast increased from 4.28 to 5.22Hu (21.96% increase) and the CT dosage index output was reduced by 72.42%. Conclusion: Our study has shown that the modified imaging system can be more effective than the traditional AIS/TIA imaging systems currently in use in Zambia

ABSTRACT
Background: Hypothyroidism has well-documented systemic effects, including alterations in renal hemodynamics and metabolism. These changes may lead to a reduction in estimated glomerular filtration rate (eGFR), potentially mimicking chronic kidney disease. Evidence from North-Eastern Nigeria remains limited. Objective: To assess the impact of hypothyroidism on estimated glomerular filtration rate among adults in North-Eastern Nigeria. Methods: This hospital-based cross-sectional comparative study included 150 adults comprising 75 patients with hypothyroidism and 75 euthyroid controls. Serum creatinine, thyroid-stimulating hormone (TSH), and free thyroxine (FT4) were measured. Estimated GFR was calculated using the CKD-EPI creatinine equation. Data were analyzed using independent t-tests, Pearson correlation, and multivariable linear regression. Results: Mean eGFR was significantly lower in hypothyroid participants compared with euthyroid controls (74.9 ± 21.6 vs. 94.3 ± 18.9 mL/min/1.73 m²; p < 0.001). Serum TSH showed a significant inverse correlation with eGFR (r = −0.45, p < 0.001). Hypothyroidism remained an independent predictor of reduced eGFR after adjusting for age, sex, and body mass index. Conclusion: Hypothyroidism is associated with significantly reduced estimated GFR among adults in North-Eastern Nigeria. Thyroid function testing should be considered in patients with unexplained reduction in eGFR to avoid misclassification of chronic kidney disease.

ABSTRACT
A 44-year-old-woman presented to the emergency department with a 3-day history of abdominal pain. Her temperature was 38.8°C. On physical examination, there was tenderness in the right upper quadrant of her abdomen and yellow skin. Two days before presentation, she had noted the appearance of tea color urine, Computed tomography (CT) of the abdomen revealed gallbladder stones, common bile duct stones (CBD) and findings consistent with cholangitis. A diagnosis of obstructive jaundice and cholangitis secondary to CBD stones was made. Endoscopic retrograde cholangiopancreatography (ERCP) was performed.

ABSTRACT
Background: Spinal dermoid cysts are rare congenital tumours, accounting for approximately 1% of spinal tumours. Rupture of these lesions is uncommon, and dissemination of lipid material typically occurs into the subarachnoid or intraventricular spaces. Isolated rupture with lipid spread into the central canal is exceptionally rare. Case Presentation: We report the case of a 20-year-old male who initially presented with bilateral lower limb weakness and urinary disturbances. Baseline MRI revealed a heterogeneous conus mass without evidence of rupture. During follow-up, the patient developed progressive neurological deficits over two years. Repeat MRI demonstrated multiple lipid droplets within a dilated central canal, consistent with rupture of the conus dermoid. Discussion: While ruptured spinal dermoid cysts have been described, dissemination of lipid material confined to the central canal is exceedingly uncommon. This case underscores the importance of long-term follow-up, as delayed rupture can result in progressive neurological deterioration. MRI plays a crucial role not only in identifying the primary lesion but also in tracking unusual dissemination patterns. Conclusion: Ruptured conus dermoid cysts with lipid dissemination into the central canal are rare. Early recognition and vigilant follow-up are essential for timely intervention and prevention of irreversible neurological deficits.