Ultrasonographic findings of liver in chronic liver disease and its complications and their association with the duration of the disease

Objective: To evaluate the ultrasound abdomen findings in patients having viral chronic liver disease [CLD] and build correlation of these findings with the duration of disease

Study Design: Cross-sectional analytical study

Place and Duration of Study: Department of Medicine, Liaquat University Hospital, Hyderabad and Jamshoro, Pakistan, from February to July 2016

Methodology: Known cases of CLD were inducted. Data was collected using a standardized form which included details of patients, duration of disease and their ultrasound abdomen findings, like liver size, echo pattern and echogenicity, nodularity, intrahepatic vessel [IHV] obliteration, ascites and splenomegaly. Data were analyzed using SPSS version 16. The association of duration of the disease on ultrasound findings was studied by means of chi-square test

Results: A total of 193 subjects [92 males, 101 females; age range 14-80 years] were taken. The average measured liver span was 13.99 +/- 3.14 cm, with most coarse echo pattern. About a quarter, i.e. 26.94% of the cases, had no complications; 17.62% only had ascites and 16.06% presented with IHV obliteration, and ascites with splenomegaly. The duration had no significant association with liver size, echo pattern and echogenicity, and nodularity of the liver [p-values of 0.182, 0.331 and 0.268], respectively or complications [p=0.164]

Conclusion: The duration of CLD had no significant association with the ultrasound findings of liver

Dual phase MIBI scintigraphy in diagnosis of parathyroid adenoma followed by ultrasound guided percutaneous alcoholic ablation

Primary Hyperparathyroidism [HPT] is an inappropriate hyper secretion of parathyroid hormone [PTH]. Primary HPT is caused by parathyroid adenoma in 80-85% of patients. Clinical manifestations are kidney stones, abdominal groans, painful bones, psychic moans, and fatigue overtones. Ultrasonography is widely used in suspected cases for localization of parathyroid adenoma. There is considerable intra-observer variation and it is difficult for ultrasound alone to differentiate parathyroid lesion form that of thyroid. Dual phase Tc-99m MIBI scinitigraphy for detection of parathyroid adenomas has sensitivity and specificity values ranging from 82% to 100% and from 89% to 100%, respectively. Percutaneous ethanol injection for parathyroid glands can be applied effectively in selected cases when surgery is unadvisable either for technical reasons e.g., recurrence of hyperplastic glands in the neck after subtotal surgery or intrathyroideal parathyroid tumors or the poor clinical state of the patient

Safety of losartan in hypertensive patients with thiazide induced hyperuricemia

Objective: To determine the safety of Losartan in hypertensive patients with Thiazide induced hyperuricemia. Design: Randomized, open label, prospective, comparative study. Setting: Basic Medical Sciences Institute Jinnah Postgraduate Medical Centre Karachi from February 2006 to July 2006

Methods: Total 60 hypertensive hyperuricemic patients were enrolled in this study, selected from medical OPD of Jinnah Postgraduate Medical Centre, Karachi. Patients were divided in three groups. Group DR-1 patients were treated with Thiazide 50 mg/day, Group DR-2 with Losartan + Thiazide 50 mg/day, and Group DR-3 with Losartan 50 mg/day. The effect on serum uric acid level was measured fortnightly

Results: Treatment with Thiazide + Losartan group DR-2 and Losartan group DR-3 significantly showed decrease in serum uric acid level. Whereas, Thiazide group DR-1 increased serum uric acid level. In contrast to Thiazide and Losartan + Thiazide, Losartan alone led to a greater reduction in serum uric acid level. The average percentage reduction in serum uric acid level in Thiazide + Losartan group was -12.75% and the average percentage reduction of serum uric acid level was -24.60% in Losartan group

Conclusion: These finding suggest that, Losartan in hypertensive hyperuricemic patients is more effective drug in lowering serum uric acid level. It may be worth pointing out that the serum uric acid level lowering effect of Losartan might be particularly useful in hyperuricemic patients those on Thiazide diuretic [for hypertension and heart failure]