Sonographic Assessment of Normal Fetal Cerebral Lateral Ventricular Diameter at Different Gestational Ages

Abnormal dilatation of ventricles has been shown to be the most common abnormality of the brain & fetus in most of the geographical zones, but the normal dimension of the fetal lateral ventricle in south-south geopolitical zones of Nigeria has not been evaluated. The aim of this study was to determine the normal feto-lateral ventricular diameter using ultrasound at different gestational ages. Measurement of the fetal-lateral ventricular diameter was obtained from 685 fetuses of pregnant mothers that met the inclusion criteria during routine ultrasound scan in Calabar metropolis. Measurement of the ventricular diameter was taken at the level of the atria, measured according to Australian society for ultrasound in medicine guidelines. The result shows that the mean lateral ventricular diameter of fetuses in the studied region is 6.62 ± 2.51 mm with a range of 4.12-9.54 mm. The lateral ventricular diameter and the fetal head circumferences, as well as the gestational age, do not show any significant correlation throughout gestation. Conclusion: Fetuses in Calabar Metropolis have a lateral ventricular diameter that ranges from 4.12 - 9.54 mm. Ventricular diameter above this normal range in this region and could be considered as an abnormal and may demand further investigations.

Resurrection in 1 Peter

This study observes the literary role of the language of "resurrection" in developing the message of 1 Peter. The term itself goes mainly unexplained, and must be understood as part of the "retranslation" process in which the author is engaged--a process by which a dominant Roman political ideology is challenged as believers are encouraged to "rewrite" their lives in terms of experiencing the sufferings as a "normal" dimension of Christian existence.

Sonographic Measurement of Spleen in Relation to Age: A Prospective Study among Adult Nepalese People in Western Nepal

Introduction: Splenomegaly is an enlargement of the spleen which is a quite common problem in any part of the world. Spleen is enlarged in various clinical disorders e.g. infections, metabolism or storage disor­ders and hematological abnormalities. Splenomegaly is an indicator of pathologic process that may be of primary splenic origin but also may be a reflection of disease in virtually any other organ system. Thus, it is important to estimate the splenic size in vivo in the diagnosis, treat­ment and prognosis of a variety of disorders.Objective: The objective of this study was to determine the normal dimension of the spleen in the adult Nepalese people.Methods: This is a prospective study in which 320 adults subjects were scanned by using 3.5 MHz curvilinear probe. We used ultrasonography to examine 160 males and 160 females, not to have any condition likely to be associated with splenic enlargement. The measurement for the length and thickness of spleen were obtained in right lateral position.Results: This study revealed the splenic dimensions for males were greater than in females. The men spleen length were (10.07 ±0.7 cm, 10.1 ±0.54 cm, 9.5 ±0.7 cm and 9.0 ±0.43 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females spleen length were (9.83 ±0.53 cm, 9.58 ±0.58cm, 9.2 ±0.64 cm and 8.8 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respec­tively). The men spleen thickness were more (4.1 ±0.5 cm, 4.05 ±0.58 cm, 3.43 ±0.38 cm and 3.0 ±0.36 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively). The females splenic thickness were 4.06 ±0.47 cm, 3.78 ±0.48 cm, 3.38 ±0.35 cm and 2.29 ±0.23 cm for age group of 16 - 30, 31 - 45, 46 - 60 and 61 - 75 years respectively. Thus significant differences between male and female splenic dimen­sions were found for each age group chosen (P <0.05).Conclusions: The results show that the splenic length and thickness decreased with increase in age in both males and females and all the di­mensions were greater in males than in females. This study established normogram that can be more reliably used as both a complementary modality to clinical evaluation and as a more sensitive means of evalu­ating and screening patients for splenic disorders for any pathologi­cal enlargement or reduction of size in clinical practice in a Nepalese populations.Journal of Gandaki Medical College Vol. 10, No. 1, 2017, page: 11-16

Informational Stocks and e-Logistic Management of a Tourism Company

The huge development of the Internet, increasing number users, low cost Internet access access and cutting access and cutting access and cuttingaccess and cuttingaccess and cutting -edge connection technology equipment are forcing companies to adapt rapidly to e-commerce, and thus change the classic logistics process, including changes for logistics functions. Moreover, tourism companies feel this dynamic market and its flexibility, primarily due to the supply chain actors of touristic products – the tourism – who adapted themselves quickly to the new technological offers and already mastered web interfaces specialized in selecting anddelivering travel packages. Moreover, their feedback is often instantly. Barely arrived at the destination they point out their opinions, send picture in social networks, based on their own logistic type have developed themselves. It is clear that courism companies have to adapt tp e-logistic, since the operate beyond tourism products themselves, primarily with information products. A tour operator can develop destinations that can be managed in a stock that can be called informational stock. With this virtual copmonent touristic product can be changed quickly depending on the feedback that classic tour packages stock is required b their spesial cost management and their ability to change and adept faster to the market. E-logistics required to adapt the supply chain process to the informational chain that leaves the point of origing and reach the end point ato meet such customers requirements in this new medium of the Internet where the space or time notions have a new understanding and lose their normal dimension.

Plain Abdominal Radiographs: Can we Interpret Them?

INTRODUCTION Plain abdominal radiographs commonly form a part of medical assessments. Most of these films are interpreted by the clinicians who order them. Interpretation of these films plays an important diagnostic role and, therefore, influences the decision for admission and subsequent management of these patients. The aim of this study was to find out how well doctors in different specialties and grades interpreted plain abdominal radiographs. MATERIALS AND METHODS A total of 76 doctors from the Departments of Accident & Emergency, Medicine, Surgery and Radiology (17, 32, 23 and 4, respectively) participated in the study which involved giving a diagnosis for each of 14 plain abdominal radiographs (5 ‘normal’ and 9 ‘abnormal’). They were also asked the upper limit of normal dimensions of small bowel and large bowel. One point was awarded for correctly identifying whether a radiograph was normal/abnormal, 1 point for the correct diagnosis and 1 point for the correct bowel dimensions, giving a total score of 30. RESULTS Mean scores out of 30 for specialties were as follows: Accident & Emergency 13.1 (range, 2–22), Medicine 11.2 (range, 2–23), Surgery 15.0 (range, 8–24) and Radiology 17.0 (range, 14–20; P = 0.241). Mean scores out of 30 for different grades of doctors were as follows: pre-registration house officers 10.8 (range, 4–20), senior house officers 13.0 (range, 2–22), registrars/staff grades 13.8 (range, 2–23) and consultants 17.3 (range, 12–24; P = 0.028). Fifteen out of 76 (19.7%) doctors correctly identified the upper limit of normal dimension of small bowel; 24 out of 76 (31.6%) correctly identified the upper limit of normal dimension of large bowel. DISCUSSION The level of seniority positively correlated with skills of plain abdominal radiograph interpretation. A large number of doctors were unable to give the correct upper limit of normal dimensions for small and large bowel. CONCLUSIONS All doctors could benefit from further training in the interpretation of plain abdominal radiographs. This could perhaps take place as formal teaching sessions and be included in induction programmes. Until then, plain abdominal films should ideally be reported by radiologists where there are clinical uncertainties; important management decisions made by junior doctors based on these films should at least be confirmed with a registrar, if not a consultant.