ABSTRACT
The aim of the study was to evaluate the role of ascitic fluid fibronectin in the diagnosis of malignant ascites. Fibronectin is a glycoprotein which plays an important role in regulating the organisation of the cell cytoskeleton and cell morphology. Ascitic fluid samples from 35 patients, 20 with portal hypertension (Group-I) and 15 with malignant ascites (Group-II) were analysed for proteins, cell counts, fibronectin levels and malignant cell cytology. Mean ascitic fluid fibronectin level was found to be significantly higher in malignant ascites as compared to portal hypertension (p < 0.001). At a cut off value of 94.67 microg/ml, the sensitivity, specificity, positive accuracy, negative accuracy and overall diagnostic accuracy was found to be 100%, 95%, 93.8%, 100% and 97.1% respectively.
Subject(s)
Adult , Ascites/diagnosis , Ascitic Fluid/chemistry , Female , Fibronectins/analysis , Humans , Male , Middle Aged , Peritoneal Neoplasms/diagnosis , Prospective Studies , Reproducibility of ResultsABSTRACT
Most hepatic hemangiomas are small and symptomless. These are now being increasingly diagnosed with the greater use of scanning procedures. Hemangiomas can occasionally grow to a large size and become manifest to the patient and the clinician. Giant hemangiomas can produce symptoms including awareness of abdominal mass, pain due to thrombosis, and very rarely, rupture. Though ultrasound is known to be quite suggestive of the diagnosis, large hemangiomas may be mistaken for liver metastases due to their enormous size and variegated picture on the scanning procedure. Dynamic CT scan and at times MRI may be required for confirmation of the diagnosis. Needle biopsy is contraindicated if the diagnosis is suspected.
Subject(s)
Adult , Aged , Diagnosis, Differential , Female , Hemangioma, Cavernous/diagnosis , Humans , Liver Neoplasms/diagnosis , Male , Middle AgedABSTRACT
Pneumatic dilatation and surgery are equally effective in the treatment of achalasia cardia but carry some risk of complications. We report our initial experience with the use of botulinum toxin in the treatment of achalasia. Six of seven patients treated responded, with improvement lasting till the end of follow-up at 3 months. No adverse effect was observed.