ABSTRACT
Background: biliary obstruction or cholestasis is a common medical or surgical problem. Broadly speaking, the causes can be divided into intrahepatic and extrahepatic. The diagnosis of biliary tree can be done by different imaging modalities starting from transabdominal ultrasonography, to magnetic resonance cholangeopancreatograpy [MRCP] to endoscopic ultrasonography [EUS] and endoscopic cholangeopancreatography [ERCP] for diagnosis and treatment
Aim of the present work: this study aimed to evaluate the accuracy of these different modalities when compared to ERCP as diagnostic methods for diagnosis of different biliary tree abnormalities
Patients and methods: eighty-four patients with obstructive jaundice were included and categorized into two groups group I: 56 patients with calcular obstructive jaundice, group II: 28 patients with non-calcular obstruction. Patients underwent history taking, clinical examination and routine laboratory investigations as well as tumor markers. Patients were examined by US, MRCP, EUS, ERCP and the findings of each modality were compared to ERCP
Results: the sensitivity and specificity of US in diagnosis of intrahepatic biliary dilatation [IHBRD] and common bile duct [CBD] dilatation were 81% , 100% and 33% and 100% for diagnosis of pancreatic tumors respectively. The sensitivity and specificity of MRCP in diagnosis of IHBRD was 97% and 100% successively and for CBD dilatation 79% and 100% successively and for diagnosis of pancreatic tumors 100% and 96% successively. The sensitivity and specificity of EUS in diagnosis of IHBRD were 100% and 100% successively and for CBD dilatation were 100% and 100% successively but in diagnosis of pancreatic tumors were 100% and 94% successively
Conclusion: Both MRCP and EUS were good diagnostic modalities for biliary obstruction and pancreatic tumors with sensitivity and specificity of >90% when compared to ERCP
ABSTRACT
Systolic time intervals were measured in 55 non insulin dependent diabetic patients having no clinical and electrocardiographic evidence of ischaemic heart disease [29 male and 26 female with mean age 50.3 +/- 11.5]. Results were compared to 19 normal subjects [12 male and 7 female with age 44.6 +/- 15.6]. PEPI was found prolonged among diabetics [133.7 +/- 8.2] compared to normals [129.9 +/- 5.7], P<0.05. LVETI was found shortened in diabetics [408.02 +/- 12.5] compared to the control group [416.4 + 9.01] P <0.02. QS2 changes were insignificant. The ratio PEP/LVET was significantly increased in diabetics 360.6 +/- 33.02, compared to control group, 339.4 +/- 19.5 P<0.02. Echocardiographic EF and FS showed no significant difference in diabetics compared to the control group. The ratio PEP/LVET showed positive linear relationship with the blood glucose levels in diabetics [r = +0.77]. Thus, it was apparent that systolic time intervals as sensitive parameter of left ventricular function showed variations in non insulin diabetics compared to normal subjects as LV function was affected in diabetics while echocardiographic EF and FS showed no significant difference. So, these parameters could by applied serially for early detection of development of diabetic cardiomyopathy