Sonographic Correlation of Thyroid Nodules with Ultrasound Aided Fine Needle Non Aspiration Cytology

Objectives: To describe the sonographic patterns of thyroid nodules in patients undergoing thyroid ultrasound; to correlate sonographic characteristics of thyroid nodules to ultrasound aided fine needle non aspiration(US-FNNA) cytology and to determine the sensitivity and specificity of Ultrasound in characterising thyroid nodules. Design: Cross sectional study. Setting: The department of Radiology at Mulago Teaching and National Referral Hospital in Kampala Uganda. The Hospital is a 1;500-bed unit providing tertiary diagnostic; curative; rehabilitative; preventive and teaching services. Patients were recruited from both Medical and Surgical outpatient thyroid clinics. Subjects: All patients with thyroid nodules 5 mm and who consented to have US aided-FNNA were enrolled consecutively. Results: One hundred and eighty one (181) participants were enrolled and final diagnoses were concluded in 177 of the participants (analysed) while four participants were excluded due to inadequate samples. The participants' age range was 19 to 83 years (mean age - 42 years ) and 93% were females. Five percent (n=9) were malignant; 18% suspiscious (n=34) and benign (n=134). The sonographic characteristics that were significantly correlated with final cytology diagnosis were a taller than wide AP diameter; micro-calcifications; heterogeneous and hypoechoic echo-patterns. Heterogeneous; hypoechoic and central vascularity had the highest sensitivity while wider than tall; anteroposterior diameter; no lymphadenopathy; and macro/no calcifications had the highest specificity. Conclusion: Sonographic features of micro-calcifications; taller than wide AP diameter; central vascularity and hypoechogenicity warrant US-FNNA. A bigger study correlating thyroid sonography with histological diagnosis is recommended

Knowledge and Practice of Breast Self Examination among Female Students in a Sub-Saharan African University

Background: Breast cancer is the most common cancer among women in many parts of Africa. Facilities for screening and early detection are extremely limited yet early diagnosis improves survival. This study explored the practice of Breast Self Examination among female university students as a means of screening and early detection in a low resources environment.Subjects and Methods: A cross sectional descriptive study at a Sub Saharan university. A call for volunteers to the study was made; a pretested standardised questionnaire was used for data collection. The process was limited to an interview and a physical examination. IRB approval was granted before the study began.Results: A total of 320 participants volunteered; 314 were recruited. The majority were aged between 21 and 25. The range was between 19 to 31 years. There was a high awareness of Breast Self Examination (BSE) of 81.5; 30had ever performed a BSE; 14performed it regularly; 8knew the correct monthly timing; the technique was accurately demonstrated by 1of participants. 4.8 were found to have breast lumps.Conclusion: There is a likelihood of most young women in the country practicing BSE inadequately. There is a need for widespread BSE campaigns emphasizing the correct technique and a need to evaluate BSE efficacy. The prevalence of breast lumps among young women attending this university was comparable to other community prevalence studies in this age group

Thyroid Dysfunction among Young Adults in Uganda

Background: Most studies on thyroid dysfunction have been on patients refereed for treatment; little is known about the prevalence in the general populations. The importance of knowing such prevalence data lies in that fact that subclinical thyroid dysfunction is an important risk on development of heart disease; osteoporosis; hypercholesterolemia and mental illness. This study set out to determine thyroid dysfunction prevalence in a health young adult population. Methods: A cross sectional study carried out at the College of Health Sciences; Makerere University enrolled 100 Undergraduate medical students by invitations through notices and announcements. Informed consent was sought after approval from research ethics committee. Results: Of the 100 students enrolled and the samples drawn; 83 tests for TSH and 82 tests for FT4 were successfully run. Three results were abnormal making a prevalence of 3.6for thyroid dysfunction; a high TSH (5.71) with a normal fT4 (19.2); a normal TSH (1.67) with a high fT4 (22.31) and one with a low TSH (0.03). The mean age of participants was 23 years; there were slightly more males 1.3:1.Conclusion: The prevalence of thyroid dysfunction in this cohort was low but falls in the range found elsewhere. These findings could inform the criteria of screening asymptomatic otherwise young health adults