ABSTRACT
The aim of this study was to sonographically evaluate gall bladder changes in type 2 diabetes. One hundred type 2 diabetic subjects (50 with neuropathy and 50 without neuropathy) and 50 healthy controls un-derwent sonographic evaluation of the gall bladder. Fasting and postprandial gall bladder volumes (FGBV and PPGBV) were measured; and the gall bladder contractility index (GBCI) calculated. The presence of gallstones was also noted. It was found that patients with diabetic neuropathy had a significantly higher FGBV and PPGBV; and lower GBCI; compared with diabetic patients without neuropathy; PPGBV and GBCI also differed significantly from non-diabetic controls. Gallstones were present in 22% of diabetic patients with neuropathy; in 10% of those without neuropathy; and in 8% of controls. We conclude that diabetic patients with neuropathy have significant abnormalities of gall bladder function; presumably due to autonomic nerve dysfunction. These patients also have a higher prevalence of gallstones; suggesting that ultrasound screening may be worthwhile
Subject(s)
Diabetes Mellitus , Gallbladder , Prevalence , UltrasonographyABSTRACT
To determine the renal arterial hemodynamic changes induced by obstructive uropathy using Doppler ultrasonography.
60 adult subjects with suspected obstructive uropathy and 60 asymptomatic apparently healthy controls with normal renal ultrasound features were evaluated.
B-mode sonography of the kidneys and spectral Doppler examination of the renal interlobar arteries of all the participants were performed. The mean resistive indices (mRI) of both interlobar arteries were obtained and compared to that of the controls. The mRI of bilaterally obstructed kidneys were also compared with the mRI of unilaterally obstructed kidneys.
The mRI of the right and left kidneys of subjects were 0.72±0.04 and 0.69±0.06 while those of the controls were 0.64±0.04 and 0.63±0.03 respectively. The mRI for the grades of caliectasis increased from grade I (0.72±0.03) to grade II (0.73±0.03) and grade III (0.73±0.02) but fell within the most severe levels of obstruction (0.69±0.07). There was no statistically significant relationship between the grades of caliectasis and unilateral or bilateral obstruction for both kidneys. The results show a sensitivity and specificity of 86.7% and 90% respectively when mRI≥0.7 was used to determine presence of obstruction.
Renal duplex sonography is highly sensitive and specific for diagnosis of obstructive uropathy. Increased resistive index of the obstructed kidney may be a useful diagnostic tool in situations where intravenous urography cannot be done or is contraindicated.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Hemodynamics/physiology , Kidney Calices , Renal Artery , Ureteral Obstruction , Dilatation, Pathologic , Epidemiologic Methods , Kidney Calices/pathology , Kidney/blood supply , Nigeria , Reproducibility of Results , Renal Artery/pathology , Renal Artery/physiopathology , Ultrasonography, Doppler/methods , Ureteral Obstruction/physiopathologyABSTRACT
Background: Until recently; most published research focus more on infectious diseases and malnutrition giving the impression that endocrine disorders are uncommon. Reports on endocrine disorders in children in developing countries are few compared to developed countries reflecting the different level of prevalence in the different geographical locations and or level of awareness and availability of facilities for proper diagnosis. Objective: This study aims at defining the burden of paediatric endocrine disorders in Ibadan. Subjects/Methods: A review of records of children who presented at University College Hospital; Ibadan with paediatric endocrine disorders from 2002 to 2009 was carried out. Results: During the eight-year period; a total of 110 children presented with various endocrine disorders but only 94 had complete data for this study. There were 47(50) males and 37(39.4) females; and in 10(10.6) of them; had genital ambiguity at presentation. Patients' ages ranged from 2 weeks to 15 years with a median of 3 years. Many (35) patients were malnourished with weight less than 80 of the expected weight for age and only 9 were overweight. Yearly distribution of cases showed a steady increase in number of cases from 2005. Rickets and metabolic disorders constituted 56.4 of patients; Diabetes mellitus was diagnosed in 12.8; adrenal disoders in 10.6; pubertal disorders in 5.3 and growth disorders in 4.3 of the patients. Thyroid disorders were present in 6.4; obesity in 3.2 while the least common disorder was Diabetes insipidus (1). About 58 of the children had parents in the low socioeconomic status and the management of the cases were severely hampered by lack of funds. About 60.6 of these patients were lost to follow up; during the period. Conclusions: Paediatric endocrine disorders are associated with a high incidence of malnutrition. Most patients presented with rickets which is a preventable condition