ABSTRACT
Background: Accurate estimation of the age of an ischaemic stroke lesion is clinically important because therapeutic decisions are strongly dependent on time from stroke onset. Non-contrast computed tomography (NCCT) remains the most accessible first-line neuroimaging modality for stroke assessment particularly in resource-constrained settings. However, temporal changes in infarct appearance may be subtle and difficult to characterise consistently by visual assessment alone; quantitative texture analysis combined with machine learning may provide an objective approach to automated lesion-age classification. This study compared the performance of an Artificial Neural Network (ANN) and a k-Nearest Neighbour (k-NN) classifier for classifying ischaemic stroke lesion age using statistical texture features extracted from NCCT images. Methods: A prospective cross-sectional purposive study was conducted among 197 patients with clinically diagnosed ischaemic stroke who underwent NCCT at three diagnostic centres in Nigeria. Following radiological confirmation, 316 regions of interest (ROIs) comprising 158 normal brain tissue ROIs, 58 acute lesions, 50 subacute lesions and 50 chronic lesions were analysed. Four classes of statistical texture descriptors—Histogram, Grey-Level Co-occurrence Matrix (GLCM/COM), Run-Length Matrix (RLM) and Absolute Gradient were extracted from the selected ROIs. Feature reduction was performed using the Fisher coefficient and the most discriminating parameters from each texture class were used for classification. A multilayer feed-forward ANN and a k-NN classifier with k = 1 were implemented using scikit-learn. The dataset was divided into 80% training and 20% testing subsets using stratified sampling. Classification performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1-score, Cohen's kappa, and area under the receiver operating characteristic curve (AUROC).

ABSTRACT
Background: Diagnosis of pulmonary embolism (PE) is challenging as the symptoms of PE are non-specific. Computed tomographic pulmonary angiography (CTPA) has emerged in recent years as the imaging modality of choice. However, the wide availability of Computed tomography (CT) has led to concerns about the overutilization of CTPA. Use of D dimers and clinical probability scoring tools like the revised Geneva scores are invaluable in stratifying patients according to the probability of PE. Therefore, the study aimed to calculate the diagnostic yield, clinical probability scores and overutilization of CTPA in patients with suspected PE. Objective: To determine the diagnostic yield, clinical probability score, utility and overutilization of CTPA in patients with suspected pulmonary embolism at Moi Teaching and Referral Hospital (MTRH). Methods: This was a cross-sectional study conducted at the MTRH between September 2022 and August 2023. A consecutive sampling technique was applied and recruited 102 adult patients. Demographics, revised Geneva scores and D dimers results were recorded. Patients were subsequently categorized into low, intermediate and high probability for PE. Results: The diagnostic yield was 29.4%. On the Revised Geneva score, 7 (6.9%) were low risk, 84 (82.4%) moderate risk and 11 (10.8%) high risk. 0%, 25% and 81% in the low, intermediate and high risk groups were diagnosed with PE respectively. 50(49.0%) of participants had positive conventional D dimers while 52(51.0%) were negative. The revised Geneva score had a sensitivity, specificity, positive predictive value and negative predictive value of 83.3%, 44.4%, 38.5% and 86.5% respectively. 7 patients (6.9%) had negative D dimers, low risk on the revised Geneva score and no PE on CTPA. Conclusion: The use of D dimers combined with the revised Geneva clinical probability score will stratify patients into risks groups for PE and help to reduce overutilization of CTPA.

ABSTRACT
The examination of the brain in children is best done using the non-ionizing modality of the magnetic resonance imaging (MRI). The quality and resolution of the examination, which have a direct bearing on the outcome of the examination and patient management are better with a high-field equipment, with at least the 1.5 Tesla magnetic field strength. The aim of this research was to audit the findings in children (0 – 17 years) imaged in our department over a 2-year period (January 2024 – January 2026). The records of the department of radiology, Babcock University teaching Hospital, Ilishan-Remo, South-West Nigeria, which has a General Electric 1.5 Tesla MRI equipment was reviewed retrospectively. The MRI images were reviewed by 2 experienced specialist radiologists. The indications and the MRI findings were recorded on Microsoft Excel and then entered into and analyzed using SPSS version 25. Approval for the research was obtained from the Babcock University’s Research Ethics Committee. The commonest indications were seizures (34.9%), headaches (14.2%), meningitis (5.7%) and traumatic brain injury (4.7%). A total of one hundred and six (106) children were examined, out of which thirty-six (34.0%) had normal findings while seventy (66.0%) had abnormalities. The commonest abnormalities in the brain were infarcts (9.4%), general cerebral atrophy (4.7%), gliosis (3.8%), encephalitis (3.8%), meningitis (3.8%), hypoxic ischemic encephalopathy (HIE) (2.8%), subdural empyema (2.8%) and focal cortical dysplasia (2.8%). Our findings are varied widely but comparable with many previous studies in our environment and other parts of the world.

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
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
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.