Frequency of pain associated with ultrasound guided percutaneous liver biopsy

To determine the frequency of pain associated with ultrasound guided percutaneous trucut needle liver biopsy. This prospective descriptive study was conducted in Radiology Department, Lady Reading Hospital Peshawar over a period of six months from April 2009 to October 2009. Cases were referred from wards as well as OPD. Patients of ages between 14 and 75 years [48.42+9.91], having diffuse or focal hepatic solid lesion [s] seen on ultrasound abdomen, were included and patients with pregnancy, moderate to marked ascites, abnormal PT and/or APTT even after correction, thrombocytopenia, coagulopathy and those using anticoagulants were excluded from the study. After informed written consent, procedure was done and data analyzed. Out of 52 procedures, pain occurred in 42 [80.8%] cases. Mild to moderate pain occurred in 41 [78.8%] cases whereas severe pain was observed in 1 patient [1.9%]. Frequency of pain was more in females [14/15=93.4%] than males [28/37=75.7%]. Frequency of pain was more in subcostal [18/21=85.8%] than intercostal [24/31=77.4%] approach. 27 of 33 [81.8%] patients with focal solid hepatic lesion and 15 of 19 [78.9%] patients with diffuse hepatic disease reported pain. Percutaneous ultrasound-guided liver biopsy is associated with low frequency of severe pain. This study shows that females report pain more frequently than males. The incidence of biopsy associated pain is more in patients who are addicted to narcotics

Hyperpustic thyroid gland; steroid hazards

The study was conducted to see the effects of dexamethasone [synthetic corticosteroid] on involution of hyperplastic thyroid gland in albino rats, and to evaluate its uses in thyroid diseases. Comparative histological study done in Postgraduate Medical Institute Lahore in 1998. 54 adult male rats were taken and divided at random into control group having 27 rats and experimental groups containing 27 rats. Control group was given normal diet along with 2 microgram of Potassium iodide for 21 days while experimental groups further subdivided into group A having 3 rats and group B and C containing 12 rats each. All the experimental groups were treated with Thiourea. Group A was sacrificed on day 22 after withdrawal of thiourea. Group B was given Potassium iodide after stoppage of thiourea on day 21 and were sacrificed on days 22, 26, 30 and 50 in 4 sub groups [B1- B4]. Group C was injected Dexamethasone daily from day 22 to day 50 and sacrificed on same days in 4 subgroups [C1-C2] to study involution process. Histologically experimental group A exhibited significant increase in width and length of follicular cells lining the small sized follicles having scanty colloid. The results of experimental subgroups B revealed early and complete involution whereas subgroups C showed significantly persistent hyperplastic changes in the form of tall follicular cells lining small empty follicles. Thus it was concluded that dexamehasone did retain hyperplastic changes during involution process, so steroid should consciously be used in thyroid diseases

Hyperplastic thyroid gland; vascular and follicular changes produced by dexamethasone during involution

The study was conducted to see the vascular and follicular changes induced by dexamethasone [synthetic corticosteroid] during involution of hyperplastic thyroid gland in albino rats. A comparative histological study done in Post Graduate Medical Institute Lahore in 1998. 54 adult rats were taken and divided at random into two control groups having 27 rats and experimental groups containing 27 rats. Control group was given normal diet along with 2 microgram of Potassium iodide intraperitonealy for 21 days while experimental groups further subdivided into group A having 3 rats and group B and C containing 12 rats each. All the experimental groups were treated with Thiourea for 21 days. Group A was sacrificed on day 22 after withdrawal of thiourea. Group B was given Potassium iodide intraperitonealy after stoppage of TU on day 21 and were sacrificed on days 22, 26, 30 and 50 in 4 sub groups [B1-B4] to study the involution process. Group C was injected dexamethasone from 22 to 50 days after withdrawal of TU and sacrificed on same days in 4 subgroups [C1-C4] as sub groups B. The results of experimental group. A showed increase in thyroid and relative tissue weight. Histologically this group exhibited significant increase in stromal congestion with tall follicular cells lining the small sized follicles having scanty colloid. The results of experimental groups B and C demonstrated increase in thyroid and relative tissue weight but microscopically subgroups B revealed early and complete involution whereas subgroups C showed significantly persistent hyperplastic changes in the form of stromal congestion, vessels wall remained well defined and tall follicular cells lining small empty follicles. It was concluded that dexamehasone did retain hyperplastic changes during involution evident by stromal congestion and small sized regular follicle lined by tall follicular cells, so it should be carefully used in thyroid diseases