Papers by Flavious Nkubli
In a world that has been affected by the global COVID-19 pandemic, the idea of keeping ICRP recom... more In a world that has been affected by the global COVID-19 pandemic, the idea of keeping ICRP recommendations fit for purpose is one whose time has come! However, the idea of keeping the ICRP recommendations fit for purpose cannot be achieved in isolation without a global North-South collaboration. Radiation protection experts from the global North who are versatile in the science and practice of radiation protection will have to collaborate with those from the global South and end-users to ensure that the system of radiological protection designed by ICRP to protect patients, workers, the public and the environment meets the need of endusers and produces the desired impact. End-users of radiation protection all work in diverse settings and contexts. Hence, the application of ICRP recommendations may vary for those in conflict and fragile settings who are often a neglected group. Authors of this paper who also work in conflict and fragile settings argue that there is a need for greate...
Journal of Radiography and Radiation Sciences
Background: There is a human resource crisis in the healthcare sector in Nigeria. This is because... more Background: There is a human resource crisis in the healthcare sector in Nigeria. This is because of the existing inequitable distribution of the available meagre workforce which is itself not helped by the increasing and currently trending brain drain.Purpose: This study aimed at assessing the factors that influence radiographers' choice of career in rural settlements in Northeastern Nigeria.Methods: A cross-sectional study was conducted among Radiographers in Northeastern Nigeria. A 21-item, self-administered semi-structured questionnaire was distributed over a six (6) month period, where 130 questionnaires were distributed. The questionnaire consisted of two sections; a: on demography; b: on factors (attractors and detractors) for career choice in rural areas. Content analysis was used to analyze qualitative data; descriptive statistics were used to analyze quantitative data. Statistical Package for Social Sciences (SPSS) version 21.0 was used.Results: A total of 91 questionn...
Journal of Radiography and Radiation Sciences
Background: The concept of mentorship has gained widespread popularity in literature across dif... more Background: The concept of mentorship has gained widespread popularity in literature across different walks of life owing to the significant benefits attached to it. Purpose: This paper intends to discuss the need for mentorship in radiography, as an indispensable tool for a sustainable healthcare transformation, taking clues from other health science disciplines and medicine. Method: Authors reviewed relevant literature on the subject to have an in-depth and updated knowledge both in the health sciences as well as in other disciplines. Search engines such as Google Scholar, My Websearch, and data base such as Science Direct, Hinari, Taylor and Francis and Medknow were consulted. Several articles that discussed mentorship across various disciplines were reviewed. Those with ideas and concepts that fit into the purpose of the study were included. Results: Several definitions and types of mentorship exist across different walks of life based on literature. However, we decided to ado...
Journal of Radiography and Radiation Sciences, 2020
Background: The practical implementation of Diagnostic Reference Level in paediatric imaging is a... more Background: The practical implementation of Diagnostic Reference Level in paediatric imaging is a complex task due to their unique individuality in terms of high sensitivity to radiation, varying body sizes and presenting pathology. Hence, good knowledge of medical technology, skill to perform patient dosimetry and to analyze mage quality is required. Purpose: To provide a guide on the methodological requirements for the establishment of Paediatric Diagnostic Reference Levels (PiDRLs) based on the revised and updated guidelines from the current ICRP publication 135 on Diagnostic Reference Levels (DRLs). Materials and method: An extensive review of the ICRP report Publication 135 on Diagnostic Reference levels in medical imaging with a focus on paediatric imaging and other related studies were undertaken. Results: The ICRP report 135 updates and refines the recommendations of 2001. It highlights that the application of DRLs in paediatrics alone is not sufficient for the optimization ...
Ultrasound is a very important imaging modality in the management of antenatal cases. Its utiliza... more Ultrasound is a very important imaging modality in the management of antenatal cases. Its utilization by expectant mothers is largely dependent on how necessary they think it is. This study aims at determining the level of awareness of the need for ultrasound scan amongst antenatal patients. A structured questionnaire on maternal biometrics and level of awareness was used as instrument for data collection and the results analyzed using descriptive statistics. Out of the 218 respondents, 96.3 % (n = 201) knew about ultrasound. 69 % (n = 152) received the information from the antenatal clinic. The major reason for undergoing an ultrasound scan was to check for fetal well-being and rule out complications in pregnancy. Parity significantly influenced women’s choices as they were more likely to go for and not turn down an ultrasound referral if they had more children. Ante-natal patients in our centre showed a commendable degree of knowledge on the need for antenatal ultrasound scan, a p...
Objective: The work aims to determine the radiographers ’ preference between primary and sec-onda... more Objective: The work aims to determine the radiographers ’ preference between primary and sec-ondary radiation fields for imprinting anatomical markers on radiographs. Methodology: Proc-essed radiographs from the darkroom with evidence of radiographic anatomical markings were selected randomly and reviewed using a viewing box, within a 4-week period. The radiation field in which markers were placed was noted for each radiograph. Faintly-appearing and partly coned-off markers were excluded. Simple statistical tools were used to derive central tendency. Result: 623 radiographs were assessed. 89.0 % (n = 555) had markers in the primary radiation field while 11.0 % (n = 68) were in the secondary radiation field. 98 % (n = 611) of markers did not obstruct essential anatomy while 2 % (n = 12) did, but the radiographs were neither repeated nor rejected because of the twin reason of reportability and the need to avoid additional radiation dose to pa-tients. Conclusion: Radiographers in the c...
Background: Diagnostic reference levels for a number of common diagnostic radiological exami-nati... more Background: Diagnostic reference levels for a number of common diagnostic radiological exami-nations against which individual centres could compare their performance have been recom-mended by relevant international agencies. Due to variations in different populations globally, lo-cal and national diagnostic reference levels are more reliable. To the best of our knowledge, no centre-specific study has been carried out and national surveys are not available. Objective: To establish a preliminary local and national diagnostic reference level in Nigeria. Methods: A pros-pective and cross-sectional study involving 30 conscious paediatrics and adult patients referred for head computed tomography scan. They were positioned supine and scanned according to the standard protocol for head computed tomography with manual mA selection. The total dose-length products were recorded at the end of the pre-contrast and post-contrast sequences respec-tively. The pre-contrast dose was taken into cogniz...
Collimation of x-ray beam is an important factor in optimization; good collimation will both mini... more Collimation of x-ray beam is an important factor in optimization; good collimation will both minimize the radiation dose to the patient and improve image quality because the amount of scattered radiation will increase as if a large volume of tissue is irradiated. This study aimed to assess the level of collimation for pediatric plain chest radiographs in Aminu Kano Teaching Hospital as an optimization tool. A retrospective audit was conducted on pediatric plain chest radiographs from May 2016 to May 2019 in Aminu Kano Teaching Hospital (Kano, Nigeria) using a simple random sampling technique. Data were collected and recorded using self-developed data capture sheet based on the European Guidelines on quality criteria for diagnostic radiographic images in pediatrics which captures the gender, age, projection, collimation (4 ways, 3 ways, 2 ways, 1 way, no and under collimation). The results showed that the most predominant age group exposed in the study was within 0 to 1 year represe...
To determine the common pattern of findings among suspected infertile women and to relate the fin... more To determine the common pattern of findings among suspected infertile women and to relate the findings with age. A retrospective cross sectional review of 290 reports investigated for infertility from May, 2013 to May, 2014 using a convenient sampling technique. Data capture sheet was used to elicit information and designed to include patient’s age, clinical indication and findings. Out of the total 290 patients’ report reviewed, normal findings were 181 (62.41%), findings classified to be tubal blockage are 33 (11.38%) and those classified under uterine fibroid are 16 (5.52%). From the study, more pathologies can be classified as multiple myoma 5 (1.72%), bilateral tubal adhesion 6 (2.07%), uterine adhesion 24 (8.28%), cervical adhesion 6 (2.07%), cervico-uterine adhesion 7 (2.41%), hydrosalpinx with spillage 10 (3.45%), and rotated uterus 2 (0.69%). The age range of 20-29 has the highest frequency of 136 and the lowest frequency was 12 which were seen in 10-19 years age range. And...
The concept of diagnostic reference level has been in existence for almost three decades. It has ... more The concept of diagnostic reference level has been in existence for almost three decades. It has also found its place in regulatory systems for nearly 20 years. Currently, national bodies are expected to establish their diagnostic reference level values. There is also provision for local and regional diagnostic reference levels. Also, almost all regulatory systems include the use of diagnostic reference levels for patient protection as an optimization tool. Despite the foregoing, there is still a lack of knowledge of the concept within the medical community. This prompted the International Commission on Radiological Protection (ICRP) to review its current document on diagnostic reference level with a view to come up with a new one consistent with current technology and practice. This paper seeks to review the concept, misconceptions and current trends in diagnostic reference level with special focus on some revised section in the new (ICRP) document. Key words; diagnostic reference...
Objective : To assess the adequacy of x-ray beam collimation as a parameter for radiation protect... more Objective : To assess the adequacy of x-ray beam collimation as a parameter for radiation protection in paediatric plain chest radiographs. Method: A total of 200 paediatric chest radiographs (≤ 18 years) were retrospectively assessed for good collimation practice as a means of radiation protection. Parameters assessed on the technique of collimation were the presence of silver lining as an evidence of x-ray beam collimation according to the European guideline on quality criteria for diagnostic radiographic images. Result: Of the 200 radiographs assessed for adequacy of x-ray beam collimation, 79.0% (n=158) showed evidence of adequate beam collimation while, 21.0% (n=42) were inadequately collimated. The results of the study showed adequate beam collimation practice in the Radiology department of the centre studied. Conclusion : The adequacy of x-ray beam collimation as parameter for radiation protection in paediatric plain chest radiographs was assessed. Majority of the paediatric ...
Journal of Global Radiology, Nov 14, 2017
Purpose: To survey structural designs of x-ray rooms and compliance to shielding design goals of ... more Purpose: To survey structural designs of x-ray rooms and compliance to shielding design goals of three x-ray imaging facilities. Methods and Materials: The survey was conducted in three radiodiagnostic centers in South East Nigeria, labeled X, Y and Z for anonymity. A stretchable non-elastic meter rule was used to measure x-ray room dimensions. A Vernier caliper was used to measure lead thickness while a calibrated digital survey meter Radalert 100x was used for radiation survey of controlled and uncontrolled areas. Simple statistical tools such as mean and standard deviation were used for analysis with the aid of Microsoft Excel version 2007. Results: Center X had a room dimension of 2.4 m × 2.1 m, Center Y had an x-ray room dimension of 3.6 m × 3.3 m, and Center Z had two x-ray rooms with identical dimensions of 6.3 m × 3.6 m. Measured exit radiation doses for controlled areas in all the centers were: 0.00152 mSv/wk; 0.00496 mSv/wk; 0.00168 mSv/wk; 0.00224 mSv/wk respectively. Lead was the common shielding material used. Conclusion: Based on the parameters studied, Center Z had the ideal room size and layout. Relative distances from the x-ray tubes to the nearest walls were not optimized in all the centers except in Center Z. Measured exit doses were within recommended limits except in Center Y. The location of the control consoles and measured doses were appropriate and within recommended design goals.
West African Journal of Radiology, 2015
Objective: To link the greyscale appearance of radiographic artefacts with their origin, with a v... more Objective: To link the greyscale appearance of radiographic artefacts with their origin, with a view to understanding and minimizing their occurrence. Materials and Methods: A formula was used to establish a minimum sample size of 400 radiographs out of a population of 5500 radiographs produced between January 2013 and June, 2013. On a daily basis within the study period, all radiographs approved for reporting by the quality control radiographer with over 10 years' experience were scrutinized prospectively by the researchers with the aid of a giant 100 cm × 50 cm viewing box with brightness adjustment, until 400 artefactual radiographs were eventually isolated. The nature, greyscale appearance and origin of artefacts were arrived at by consensus and documented. Divergence in opinion and ambiguous artefacts were resolved through observation of radiographers and darkroom assistants at work, as well as darkroom simulations. The data on subdivision of artefacts was done using simple statistics. Result: 400 radiographs out of a population of 5500 were sampled for the study. Twelve specific artefacts were isolated and categorized into three distinct appearances of black, white and grey. Preprocessing, processing and postprocessing were established as a broad classification for artefacts. Dispersed dots emanating from preprocessing (grey) and occurring in cassettes had the highest frequency of 140 (35%) while grid lines, n = 3 (0.8%) was the least noted. Conclusion: All black artefacts arise during the preprocessing stage while processing and postprocessing have the middle-course greyscale appearance of artefacts.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 1988
Amniotic fluid volume (AFV) estimation is an important part of routine obstetric sonography. Desp... more Amniotic fluid volume (AFV) estimation is an important part of routine obstetric sonography. Despite the clinical importance placed upon excessive or diminished AFV in pregnancy, there is little uniformity in the way it is estimated sonographically. We compared AFV estimations obtained using two commonly employed sonographic methods "subjective" visual assessment and amniotic fluid pocket measurements. Estimates obtained using both methods correlated closely. In addition, there was excellent intraobserver and interobserver agreement among estimates obtained using subjective criteria. This supports the belief that experienced observers tend to agree on the sonographic appearance of normal, excessive or decreased AFV. Methods for AFV estimation and potential pitfalls are discussed.
Background: The practical implementation of Diagnostic Reference Level in paediatric imaging is a... more Background: The practical implementation of Diagnostic Reference Level in paediatric imaging is a complex task due to their unique individuality in terms of high sensitivity to radiation, varying body sizes and presenting pathology. Hence, good knowledge of medical technology, skill to perform patient dosimetry and to analyze mage quality is required. Purpose: To provide a guide on the methodological requirements for the establishment of Paediatric Diagnostic Reference Levels (PiDRLs) based on the revised and updated guidelines from the current ICRP publication 135 on Diagnostic Reference Levels (DRLs). Materials and method: An extensive review of the ICRP report Publication 135 on Diagnostic Reference levels in medical imaging with a focus on paediatric imaging and other related studies were undertaken. Results: The ICRP report 135 updates and refines the recommendations of 2001. It highlights that the application of DRLs in paediatrics alone is not sufficient for the optimization ...
Background of the Study: Apart from deterioration due to aging, very often lead aprons are damage... more Background of the Study: Apart from deterioration due to aging, very often lead aprons are damaged due to poor handling. Without quality control these lead aprons will, with time contribute significantly to radiation burden of the wearer. Purpose: The purpose of this study was to evaluate the protective feature of lead aprons used in radiology department performed at federal public hospitals by analysing quantitative and qualitative variety of methods including objective quality control. Materials and Methods: Forty seven (47) protective lead aprons used in Radiology departments was analyzed. All aprons were identified and registered according to types, thickness of the lead inside the aprons or its equivalent, by how long it has been used, its storage conditions and cleanliness. Radiographs of the aprons were taken using X-ray units and (35cm X 43cm or 35cm X35cm) films or phosphor storage plates. The radiographs were evaluated in terms of holes, cracks and other defects that were contained in their structures. Measurement of sizes of defects were taken using ruler and compared with standard rejection criteria. Results: regarding their internal structures, 31 (65.96%) aprons were not defected (free of defect) and 16 (34.04%) were defected. Cracks accounted for 9(56.25%) and hole 7(43.75%) of the total 16 defected lead aprons. And regarding quality control, only 9% of the aprons were periodically checked on annual basis and 72% of the lead aprons were not checked at all. It was also observed that 31(66%) of
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Papers by Flavious Nkubli