ABSTRACT
Background: A lump in the breast is a cause of great concern. High frequency high resolution ultrasonogram helps in its evaluation. With major advances in ultrasonographic technology during the past 20 years, ultrasonogram can now distinguish benign and malignant solid breast lumps. Knowledge of the specific benign and malignant ultrasonographic characteristics of breast lumps is imperative for accurate diagnosis and optimal patient management. Objective: To determine the validity of ultrasound in the assessment of palpable breast lump by detecting the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasonogram in distinguishing benign and malignant breast lumps. Materials and Methods: This cross sectional study was done in the department of Radiology and Imaging of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka in collaboration with the department of Pathology of BSMMU for histopathological correlation during July 2008 to June 2009. A total of 100 patients who were clinically suspected of having breast lump were included in this study. Data on clinical presentation, ultrasonographic findings including histopathological reports were collected and documented in structured forms. Analysis was done using SPSS 13.0 version. Results: The study was done in 100 women of 18–70 years of age with mean age 41.46 ± 11.62 years. Breast lumps were found with associated clinical presentation of pain in 26 (26%) cases, discharge in 12 (12%) cases, skin changes in 28 (28%) cases, nipple retraction in 10 (10%) cases, and palpable lymph nodes in 10 (10%) cases. On ultrasonogram, lesions were diagnosed as benign in 62% cases and malignant in 38% cases. Out of sonographically diagnosed 62 benign lesions 58 (93.5%) were also proved benign histopathologically and 4 (6.5%) as malignant. Out of 38 sonographically malignant lesions, 34 (89.5%) were also proved as malignant histopathologically and 4 (10.5%) as benign. Conclusion: Ultrasonographic findings of benign and malignant breast lumps correlated well in most of the cases with the histopathological results. Therefore, it can be concluded that ultrasonogram is a useful imaging tool to discriminate benign and malignant breast lumps and thus we can reduce unnecessary breast biopsies, patient discomfort and anxiety in addition to increase in cost of the patient.
ABSTRACT
Background: Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness which is usually preventable if retinopathy is diagnosed early and treated promptly. In ophthalmology, color Doppler imaging is a new method that enables us to assess the orbital vasculature. It allows for simultaneous two dimensional anatomical and Doppler evaluations of hemodynamic characteristics of retinal artery. Objective: To observe the difference between Doppler flow velocity indices (peak systolic velocity, end diastolic velocity and resistive index) of retinal artery in type 2 diabetic subjects without retinopathy and those of normal controls. Materials and Methods: This case-control study was carried out in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) in collaboration with Ophthalmology Outpatient Department, BIRDEM, Dhaka from July 2011 to June 2013. Eighty diabetic patients without retinopathy aged 27–68 years were enrolled as cases and age and sex matched 80 healthy subjects were selected as controls. Type 1 diabetic patients, type 2 diabetics with retinopathy, hypertensive and dyslipidemic subjects were excluded from the study. All the selected subjects underwent duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHZ linear phase transducer. Duplex color Doppler findings including spectral analysis (PSV, EDV and RI) were recorded. Unpaired t test was done to compare blood flow velocity indices of retinal artery in type 2 diabetic patients without retinopathy and that of healthy control subjects. p value <0.05 was considered as significant. Results: Majority (42.5% and 47.5%) of subjects were in 4th decade of life in both groups with predominance of males. The mean duration of diabetes was 4.56 ± 2.1 years. Mean peak systolic velocity (PSV) in 80 diabetic patients without retinopathy was 10.70 ± 1.50 cm/sec ranging 5.30–16.10 cm/sec and that of 80 healthy subjects was 11.27 ± 0.98 cm/sec ranging 9.0–13.10 cm/sec. Mean end diastolic velocity (EDV) in 80 diabetic patients without retinopathy was 2.58 ± 0.67 cm/sec ranging 1.00 –5.10 cm/sec and that of 80 healthy subjects was 4.11 ± 2.7 cm/sec ranging 3.00–4.60 cm/sec. Mean resistive index (RI) in 80 diabetic patients without retinopathy was 0.75 ± 0.04 ranging 0.66–0.81 and that of 80 healthy subjects was 0.64 ± 0.02 ranging 0.60–0.70. Mean difference of retinal arterial RI of diabetic subjects without retinopathy and healthy control eyes was statistically significant (p<0.001). Conclusion: From the present study it can be concluded that, there is statistically significant difference between retinal arterial RI of type 2 diabetic patients without retinopathy and that of healthy control adult subjects.
ABSTRACT
Fibrodysplasia Ossificans Progressiva (FOP) is an inherited disease in which progressive ossification of striated muscles, tendons, ligaments and other connective tissues forming bridges of extra bones across the joints leads to severe disability and there are associated characteristic congenital skeletal malformations. FOP is also known as Stoneman's syndrome. The case we report here is a 23-year-old male with the clinical and radiologic characteristics of FOP.