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A case of thanatophoric dysplasia with sudden death at term is hereby presented. Thanatophoric dysplasia is an uncommon, lethal skeletal dysplasia which is associated with mutation in the extracellular region of fibroblast growth factor receptor 3 (FGFR3). It is an autosommal dominant condition that has sporadic occurrence and early ultrasound scan has not been of great benefit in its detection. Diagnosis is mostly made in the third trimester. The fetal death is usually due to severe respiratory insufficiency from a reduced thoracic capacity and hypoplastic lungs and/or respiratory failure due to brainstem compression. In view of the autosomal dominance of TD, it will be advisable for a woman with previous history to have prenatal screening to relieve parental anxiety and prevent late detection. [ABSTRACT FROM AUTHOR]

Introduction: Fractures are known to be common among older and elderly persons of age 60 years and above, partly because of bone weakness or increase in frequency of falls and trauma. Data on fractures in elderly are scarce and there is need to document frequencies and predisposing factor in our community. Aim: To review the radiographs of patients aged 60 years and above and to determine the frequency of fracture, sex distribution, associated event, and bones involved. Materials and Methods: The present study was retrospective study in which the radiographs of elderly patients were collected from the radiology department between January, 2016 to November, 2018 and were reviewed to determine the prevalence and causes of fractures, as well as factors associated with them. Results: Of the 561 radiographs reviewed, fractures were found in 73, consisting of 28 in men and 45 in women. Thirtyeight, (53%) of the fractures occurred in the 60-70 years age group. Fracture on left side was more common and females had fracture more on the left side in 27 patients as against 17 on the right side, with one having fracture in the pubic bone. Fractures were associated with trauma, falls and Road Traffic Accidents (RTA) equally. The bones of the lower limbs were involved in 50 cases, while those of the upper limb were involved in 22 cases, with only one in the axial skeleton. The femur was involved in 23 (31.5%) of the cases. Conclusion: The study established the vulnerability of elderly people aged 60-70 years, particularly women, to fractures. There is a constant need for adequate social protection policy to be implied for such vulnerable group of people. [ABSTRACT FROM AUTHOR]

Diabetic myonecrosis is an uncommonly encountered and underdiagnosed complication of diabetes mellitus. It could be a manifestation of poor glycemic control, and hence, progressive microvascular disease; however, it is usually self-limiting. A known but poorly controlled type 2 diabetes mellitus patient presented with sudden onset and worsening right thigh pain and swelling. Magnetic resonance imaging showed hypertrophy and hyperintensity of the adductor muscles with non-enhanced regions denoting areas of necrosis. Conservative management of bed rest, analgesics, and controlled blood glucose yielded a positive response. Diagnosis of diabetic myonecrosis can be challenging as many diseases mimic this condition, resulting in delayed recognition, diagnosis, and initiation of prompt treatment. Magnetic resonance imaging findings rather than laboratory markers are the mainstay of diagnosis as it localizes the affected muscles and excludes other mimics. [ABSTRACT FROM AUTHOR]

Introduction: atherosclerosis develops insidiously, offering time and opportunities for early detection. Screening for subclinical atherosclerosis via structural wall changes and flow velocities among apparently healthy adults using carotid ultrasonography may help its early detection, offer timely intervention and reduce morbidity and mortality. Methods: a cross-sectional study of 100 participants with a mean age of 56.1 ± 6.9 years, were enrolled from a community population. Both carotid arteries were examined for plaques, carotid intima-media thickness (CIMT), and flow velocities - peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI) using 4-12MHz linear array transducer. Visceral obesity, serum lipids, and blood glucose were also evaluated and correlated with ultrasound findings. Results: the mean CIMT was 0.07 ± 0.02cm and 15% of the participants had increased CIMT. Statistically significance but weak correlations were observed between CIMT and FBG (r = 0.199, p = 0.047), EDV (r =0.204, p= 0.041), PI (r = -0.287, p = 0.004) and RI (r = -0.268, p =0.007). Statistically significance with modest correlations were observed between EDV and PSV (r = 0.48, p = 0.000), PI (r = -0.635, p = 0.000) and RI (r = -0.637, p = 0.000). The PI and RI showed strong correlation with statistical significance (r= 0.972, p = 0.000). Conclusion: statistical significance in the flow velocities, derived flow indices and increased CIMT may be an early indication of subclinical atherosclerosis. Therefore, ultrasonography may facilitate its early detection and possible prevention of complications. [ABSTRACT FROM AUTHOR]

Background: This study aims to identify the determinants of cognitive dysfunction and compare the effect of CPZ and LTC on cognition in WWE. Methods: An observational study involving 87 consenting adult WWE aged between 16 and 40 years on LTC or CZP monotherapy. At enrollment, an interviewer‐based questionnaire was used to obtain demographic and clinical information from participants. The diagnosis of epilepsy was mainly clinical and supported by electroencephalographic (EEG) features and classified based on recommendation by the 2017 International League Against Epilepsy (ILAE). Zung Self‐Reporting Depression Scale (ZSRDS) was used to assess the mood of participants. The Community Screening Interview for Dementia (CSID) was used to assess various cognition domains. The National Hospital Seizure Severity Scale (NHS‐3) was used to assess disease severity. Results: There were statistical differences between the CZP and LTC groups in all domains of cognition assessed except for orientation. The total CSID scores of the LTC group were 59.2 (4.9) as opposed to CZP group, 57.2 (5.0); p:.005. Those with focal onset seizures had lower median total CSID score (58; IQR: 54–62) when compared to those with generalized onset seizures (62; IQR: 58–62), p:.012. There was a significant correlation between ZSRD score and NHS‐3 score; rho: 0.30, p:.007. Bivariate analysis shows statistically significant correlation between total CSID score and ZSRDS (rho: −0.65), BMI (rho: 0.22), and NHSS‐3 score (rho: −0.36), respectively. However, the effect of AED on CSID scores was lost after multivariate quantile regression with only ZSRDS retaining significance. Conclusion: Depression, seizure severity, type and structural etiology were associated with cognitive impairment among WWE. However, on regression model, only depression was statistically significant. The presence of more risks for cognitive impairment in the CZP group limits possible conclusion of LTC superiority. [ABSTRACT FROM AUTHOR]

Objective: The study is aimed at comparing effects of older drugs like carbamazepine (CBZ) and newer agent like levetiracetam (LEV) on polycystic ovarian syndrome (PCOS) in women with epilepsy (WWE). Methods: An interviewer‐based questionnaire was used to obtain relevant clinical information from 50 WWE on CBZ and LEV monotherapy, respectively, and 50 age‐matched controls. The diagnosis of epilepsy was clinical with electroencephalographic features taken into consideration and the seizures classified using the 2017 International League Against Epilepsy classification. The diagnosis of PCOS was based on the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine. Results: The frequency of PCOS and its subcomponent were higher among WWE compare to controls. PCOS was present in 22 (44%) of LEV group compare to 8 (16%) CBZ group. The frequency of its subcomponent was higher among those on LEV except for comparable effect with regard to oligomenorrhea. The levels of the sex steroid hormone were comparable in both groups of WWE except luteal phase luteinizing hormone, which was lower among the LEV group (P.001). The follicular phase estradiol level was lower (P.021), and follicle‐stimulating hormone level was about 2‐fold higher (P.03) among WWE compare to controls. The mean value testosterone was significantly lower among controls compared to WWE. Conclusions: The increased frequency of PCOS and its subcomponent and the unsatisfactory effect of LEV compared to CBZ on reproductive endocrine function underscore the need for routine reproductive endocrine evaluation to improve overall quality of life. [ABSTRACT FROM AUTHOR]