ABSTRACT
The intrauterine device (IUD) remains the mainstay of family planning measures in developing countries, however it is associated with serious complications such as bleeding, perforation and migration to adjacent organs. Although perforation of the uterus by an IUD is not uncommon. We report here a case of perforation of the uterus by an IUD.

ABSTRACT
Objective: To evaluate the diagnostic performance of magnetic resonance imaging (MRI) for diabetic foot osteomyelitis (DFO) and to examine the feasibility and turnaround advantage of targeted resistance-gene polymerase chain reaction (PCR) as an adjunct to conventional microbiology. Methods: This prospective single-center pilot study included 80 consecutive adults with type 2 diabetes and suspected deep foot infection or osteomyelitis. All participants underwent standardized 1.5-T MRI and reference-standard classification based on histopathology when available, with bone culture and blinded multidisciplinary adjudication used as supportive or alternative evidence when histology was unavailable or nondiagnostic. Targeted PCR assessed mecA, blaCTX-M, blaTEM, blaSHV, blaKPC, blaNDM, and blaOXA-48. MRI diagnostic estimates were calculated from a patient-level 2 × 2 table and reported with 95% confidence intervals. PCR-specific analyses used available valid molecular results, and 90-day clinical outcomes were descriptive. Results: DFO was confirmed in 46/80 participants (57.5%). MRI yielded 91.3% sensitivity (95% CI, 79.2–97.6), 82.4% specificity (65.5–93.2), 87.5% positive predictive value, 87.5% negative predictive value, and 87.5% accuracy. The positive and negative likelihood ratios were 5.17 and 0.11, respectively. Conventional culture recovered pathogens in 38/46 confirmed DFO cases (82.6%) and required 62.4 ± 9.3 hours. Valid PCR results were available for 60 participants; predefined resistance determinants were detected in 28/60 (46.7%), most frequently mecA, blaCTX-M, and blaNDM. Molecular and corresponding phenotypic resistance results showed 85.0% agreement (Cohen’s κ = 0.71). PCR results were available in approximately 5 hours, about 57.4 hours earlier than final culture on average. Antimicrobial modification after PCR availability and before the final culture report occurred in 22/60 tested participants.

ABSTRACT
Sturge-Weber syndrome (SWS), also called encephalotrigeminal angiomatosis, is a neurocutaneous disorder with angiomas that involve the leptomeninges and the skin of the face. It is a rare congenital non-hereditary disorder with incidence of 1: 20,000 – 50,000. Both sexes are affected equally. Presentation is usually in childhood. Imaging is the most useful investigation in evaluation of the disease. A 28-year woman was referred for brain CT. She presented to the maxillo-facial unit with complain of right facial swelling and discoloration since birth. There was history of developmental delay, recurrent headache and weakness of the left upper and lower limbs. There were occasional episodes of seizures. No history of loss of vision. On examination, significant findings were port-wine stain, swelling on the right side of the face and reduce power on the left upper and lower limbs. Cranial CT images revealed loss of right cerebral volume with extensive tram track calcifications involving predominantly the right parietal and occipital lobes a diagnosis of SWS was made. Patient is currently on medical management.

ABSTRACT
Intrauterine device (IUD) is a widely used method of reversible contraception worldwide. Though considered as one of the best methods of long-acting, safe contraception, their administration can lead to several complications. A 30-year old para 2+0 2 alive woman referred to do pelvic ultrasound on account of suspected missing IUD. The IUD was inserted 1 year earlier following her last delivery by caesarean section, which was performed for prolong labour. Pelvic ultrasonography did not demonstrate an IUD within the uterine cavity. However, sonographic evaluation of the urinary bladder revealed a linear echogenic structure measuring about 4.5cm in length partially traversing the anterior bladder wall, with an appearance suggestive of a migrated IUD. An abdominal radiograph revealed the IUD projected over the pelvic region. The migrated IUD was surgically removed by open cystotomy.

ABSTRACT
Background: Accurately estimated foetal weight (EFW) is critical for obstetric management, yet conventional two-dimensional biometric foetal formulas often exhibit significant error margins due to their failure to account for foetal soft tissues. This study evaluated the reliability of 2-dimensional and 3-dimensional foetal thigh volume measurements as predictors of actual birth weight (ABW) within a Nigerian population. Materials and Methods: This cross-sectional study was conducted among 150 apparently healthy pregnant women (36–40 weeks gestation) at a diagnostic facility in Onitsha, Anambra State. Two-dimensional biometry was performed using the Hadlock IV formula, while three-dimensional thigh volumes were examined using a Mindray (EA6132B) volumetric transducer and analyzed offline via MicroDicom software. Statistical analysis was performed using Pearson’s correlation, linear regression, and Bland-Altman agreement analysis via IBM SPSS version 21.0. Results: The mean ABW was 3.76 ± 0.34 kg, while that of 2-D EFW was 3.63±0.36 kg. A significant positive correlation (p<0.001) was found for both 2-D (r=0.504) (p = < 0.001) and 3-D (r = 0.589) (p = <0.001) thigh volumes against the actual birth weight measured at birth. The Bland-Altman analysis revealed a systematic mean bias of −0.12 kg, confirming that conventional 2-D biometry consistently underestimates birth weight in the study population. High predictive power was observed in the derived 3-D regression model (R2 = 0.977). A novel prediction regression equation (3D ThV=94.947+0.276×2D ThV) was developed to estimate three-dimensional volumes from two-dimensional parameters. Conclusion: Three-dimensional foetal thigh volume is a more reliable predictor of birth weight than two-dimensional measurements, as it more accurately reflects subcutaneous tissue mass. The localized regression models developed in this study provides improved weight prediction and obstetric outcomes in resource-limited settings.

ABSTRACT
Background: Malaria can significantly affect the structure and function of the placenta, leading to changes in its thickness and morphology, which maybe common low resources income countries such as Nigeria. This study was designed to assess the impact of malaria on placental thickness and morphology in the second and third trimesters of pregnancy in Onitsha Anambra state, Nigeria. Materials and Methods: The study design was a case control carried among pregnant women with malaria and comparing with apparently health controls. Both groups undergo laboratory test for malaria and ultrasound scan for placental thickness and placental morphology using standard protocols. Descriptive and inferential statistical tools were used for statistical analysis with level of statistical significance set at p < 0.05. Results: Malaria status did not have a significant effect on placental thickness (F(1, 394) = 0.041, p = 0.84). There was a significant main effect of trimester (F(1, 394) = 9.233, p=0.001). There is no significant difference in placental morphology between malaria-affected pregnancies and healthy controls (F(1, 396) = 1.049, p = 0.31). Conclusion: Placental thickness differs between the second and third trimesters and increases from the second to the third trimester in both malaria-positive and healthy control groups. Malaria status did not meaningfully alter the pattern of placental growth across trimesters. There is no significant difference in placental morphology between malaria-affected pregnancies and healthy controls and placental morphology does not significantly differ between the second and third trimesters. Also, the interaction between malaria status and trimester was not statistically significant.

ABSTRACT
Background: The role of table salt (Nacl) as one of the most essential and indispensable ingredients in food cannot be overemphasized. Its usefulness in food seasoning and preservation is a common knowledge. However, its excessive consumption may pose adverse effect on human health. Being a product of our natural environment, it contains naturally occurring radionuclide material (NORMs) such as Potassium-40 (40K), Radium (226Ra) and Thorium-232 (232Th). Aim: to evaluate the Activity Concentrations and potential health Hazards associated with routine consumption of three popular brands of iodized Salt used in Anambra state, Nigerian, with emphasis on internal exposure to radiation. Salt samples were collected from major markets located within the study area. Materials and Methods: The samples were prepared and analyzed for radionuclides activity concentration using a pre-calibrated 76 × 76 mm NaI (Tl) gamma spectrometry. The activity concentrations (Bq/kg) range from 97.21–125.14 for 40K, 2.24–4.65 for 226Ra and 7.25–12.18 for 232Th. The estimated daily intake of salt among Nigerians is 5.8g per day (2118.45g/year). The total Annual Effective Dose due to ingestion range from 0.0061-0.0103 mSv per year which is lower than ICRP recommended dose of 1.0 mSv per year. Excess Lifetime Cancer Risk from Salt consumption ranges approximately between 2.36 x 10-5 to 3.98 x 10-5 which is relatively lower than the permissible value (0.29 x 10-3) recommended by UNSCEAR. Consequently, the risk of developing cancer from the estimated values range from one in 42,373 to one in 25,126 persons exposed to these Salt samples over their lifetime. However, it is worthy of note that the actual risk may vary depending on other several factors such as individual susceptibility and specific radiation exposure scenarios. This finding indicates that consumption of these Salt products does not pose significant Radiological Health hazard to the population.