Early scaphoid fractures are better diagnosed with ultrasonography than X-rays: A prospective study over 114 patients / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Wrist has a complex anatomy and undergoes complex injuries. Scaphoid fracture is one of such injuries. It is the most common fracture in carpal bone. Most of the scaphoid fractures are missed on initial X-rays. Magnetic resonance imaging (MRI) is considered as a gold standard for diagnosing scaphoid fractures. Ultrasonography (USG) is emerging as a good alternative to make an early diagnosis of scaphoid fractures. Our aim is to throw light upon the role of USG in detection of scaphoid fractures.</p><p><b>METHODS</b>The study was centered upon 114 patients in the age range 10-65 years, with traumatic wrist injury and were clinically suspected to have scaphoid fractures. Patient with non-traumatic history, bilateral wrist injury and late presentation were excluded. X-rays, USG using high frequency probe and MRI were done for all patients. MRI was considered to be the gold standard test. Patients were followed up at 6 weeks.</p><p><b>RESULTS</b>Of the 114 patients, X-ray could diagnose scaphoid fractures in 48 patients, 30 of which were confirmed by MRI. USG results were positive in 74 patients, of which MRI was positive in 67 patients. The accuracy of scaphoid fracture detection with USG was 98.04% in comparison to X-ray (20.58%), which was statistically significant.</p><p><b>CONCLUSION</b>USG provides a more accurate and reliable method of making an early diagnosis of scaphoid fracture than X-rays. It is non-invasive, non-expensive and allows better visualisation of cortical disruption.</p>

Two easy and early methods for the diagnosis of h. pylori i.e: serum anti h. pylori antibodies and stool antigen

OBJECT: Two easy methods for the diagnosis of h pylori i.e: Serum Anti H Pylori Antibodies and Stool Antigen

MATERIALS AND METHODS: Hundred serum and stool samples collected from the department of surgery, and Medicine were registered at Department of Pathology and Diagnostic and Research Lab LUMHS, Jamshoro/ Hyderabad for performing H. pylori diagnosis were included in this Study. Patients of all age groups and both sexes with complain of dyspepsia, or having the linical suspicion of H. pylori associated gastritis were included. Patients having H/O NSAIDs, or eradication therapy were excluded. A specially designed proforma was used for recording the relevant data. The Period of study was 15-10-2009 to 28-02-2011

RESULTS: From 100 cases of, H. pylori antibodies were found in 68 [68 %]. 38 [55.9%] were male and 30 [44.1%] were females. Sensitivity of this technique was 75.55% and specificity 60%. P value 0.007. From stool samples collected from 100 patients H. pylori antigen were positive in 48 [48%] cases detected on immunochromatography technique. Stool antigen positive was in 28 [58.3%] males and 20 [41.7%] Female patients. The stool antigen sensitivity was 52.74% and specificity 90% P value [0.011]

CONCLUSION: H. pylori positivity is highly significant in histological examination of endoscopic biopsies on H and E and Giemsa Stains The detection of anti H. pylori antibodies from serum by ELISA method and the H. pylori antigen from stool samples by immunochromatographies method, can be non invasive simplest, least expensive and alternatives in patients unwilling for endoscopy