ABSTRACT
Background: The objective was to assess the diagnostic efficacy of hepatobiliary scintigraphy (Tc99 mebrofenin) in case of cholestatic jaundice in pediatric practice. Method: Study conducted on 45 cases from 0-6 yrs. of age. Out of 45 pt 20 pt excluded from study Hepatobiliary Scintigraphy (Tc99m Mebrofinin) was performed in 25 cases. Injection of Tc99m mebrofinin (1-2 mCi) IV was given to each subject. Dynamic hepatic scan was done upto initial 1 hour study and additional delayed images were taken at 4 & 24 hrs only in case of non-visualization of tracer in the intestine after initial 1 hr. study. Results: In this study hepatobiliary scintigraphy was 100% sensitive, 93.73% specific, 80% positive predictive values, 100% negative predictive value, 6.23% false positive result and virtually no false negative result for biliary atresia. Conclusion: It is concluded that Tc99m mebrofenin hepatobiliary scintigraphy has proven to be reliable noninvasive imaging modality in evaluating cholestatic jaundice in pediatric practice as it carries a high sensitive & specific value, good positive & no negative predictive value, few false positive & virtually no false negative results.
ABSTRACT
The study was conducted in 35 cases of acute tubular necrosis of varied aetiology. Cases were divided in 2 groups, Group A--17 cases treated conservatively and Group B--18 cases managed by early haemodialysis. Criteria for early haemodialysis were blood urea < 120 mg% and serum creatinine < 7 mg%. Before starting therapy both the groups had comparable biochemical and renal parameters (p > 0.05). Overall mortality was lower in Group B as compared to Group A (22.2% Vs 29.4). Complication events such as uraemic encephalopathy, pulmonary oedema, haematemesis and malena, thrombophlebitis and vomiting were significantly lower in Group B (p < 0.05). Hospital stay was also significantly lower (p < 0.05) in Group B (18 +/- 2.5 days Vs 28 +/- 3 days), this can reduce the cost of treatment also.