ABSTRACT
Background: Palpable abnormalities in the breast are a major cause of concern in females from their adolescence topostmenopausal state. Majority of the palpable lesions are benign but malignant lesions are always dreadful. Imaging provides a wide spectrum of noninvasive choices for evaluating these lesions ranging from x-ray mammography to magnetic resonance mammography. Ultrasonography of breast (sonomammography) is most suitable in majority of cases and is not only noninvasive but also radiation-free. Introduction: Due to wide availability, sonomammography is the most popular imaging tool for noninvasive evaluation of palpable breast lesions. Sonoelastography, a recent advancement in the field of ultrasound imaging has added a new dimension to sonomammography allowing differentiation of benign and malignant lesions based on their stiffness. Malignant lesions are usually harder than benign lesions. Methods: Fifty female patients with palpable breast lesions were evaluated with x-ray mammography and sonomammography with sonoelastography in tandem on the same day. The results obtained were compared with final histological diagnosis in terms of benign & malignant lesions followed by statistical evaluation and conclusions. Results &Conclusions:Observations when analysed revealed higher sensitivity, specificity, positive & negative predictive values and accuracy of sonomammography than x-ray mammography. The figures further improved when sonoelastography was added to sonomammography. Based on these results, we conclude that sonoelastography should be added in the sonomammography protocol of evaluating any breast lesion not only to prevent invasive procedure but also to provide image guidance when such invasive features are indicated.
ABSTRACT
Background: Deficiency of vitamin D leads to mal skeletal growth in children; moreover it is becoming an epidemic throughout the world. Decrease level of vitamin D can cause diverse of skeletal disorders in children like rickets, osteopenia etc. The relationship of vitamin D, obesity and insulin resistance is still not clear in the literature. Vitamin D deficiency may induce the altered glucose tolerance in obese children. Therefore the present study was designed to investigate the relationship of vitamin D and insulin resistance in obese children.Methods: The present study was a cross sectional type of study which was conducted in paediatric department of TMMC & RC, Moradabad. This study included 120 obese children (60 males and 60 females) of mean age 12 ± 2.6 years in group I. Control group II contained 100 healthy none obese children (50 males and 50 females) of 12.2 ± 1.8 years. Insulin resistance was calculated from fasting plasma measurements using HOMA-IR (insulin (mU/L) × glucose (mmol/l)/22.5). Insulin resistance criteria were HOMA-IR >2.5 for children. Vitamin D was measured by ELISA method (kit manufactured by Cayman chemical company, Ann Arbor, USA). Results: There was an insignificant difference in the FBG (>0.05) of group I obese children and group II control. Insulin (<0.05) and HOMA-IR (<0.01) were significantly low in obese children in comparison of none-obese children. Vitamin D (<0.01) was significantly lower in obese children compare to healthy children. vitamin D was negatively correlated with BMI (r = -0.42, r2 =0.1764, p<0.05) in obese children. There was a negative correlation between vitamin D and insulin resistance (r = -0.52, r2 =0.2704, p<0.05) in obese children. Conclusion: Present study suggests that there was strong relation between insulin resistance and obesity. Vitamin D was negatively correlated with BMI and insulin resistance. These findings strongly suggest vitamin D level may found insufficient or deficient in obese children. Therefore, obese children should be screened for vitamin D deficiency for their normal skeletal growth.