Gray scale ultrasonography, color doppler and laparoscopy in evaluating pelvic adnexal masses

In this study 46 patients with adnexal masses were evaluate. Of clinical, sonographic, Doppler and laparoscopic examinations were compared after correlation with histopathological examination. Clinical examination had the same sensitivity as ultrasound in evaluating malignant lesions. Sensitivity and specificity for diagnosis of malignant ovarian masses were 100%, 71.05% and 66.67%, 84.85% for gray-scale and Doppler respectively. Combination of gray-scale and Doppler improved the diagnostic accuracy to 85%. Laparoscopy had the highest sensitivity [100%] and specificity [97.06%] in evaluation of adenxal masses and in differentiating ovarian from other adenxal lesions. So, it is considered as the best diagnostic modality for diagnosis of doubtful cases of adenxal lesions and differentiating the anatomical origin of such masses. The most characteristic gray-scale sonographic criteria for diagnosis malignant varian tumour were presence of solid component, papillary projections, thick septa and ascites. Neovascularization with peripheral and central blood vessels and low Doppler indices were important Doppler features of malignant lesions. A cut off value of 0.96 for PI and 0.4 for RI gave the most reasonable sensitivity and specificity for discriminatin benign and malignant lesions

Immunological and virological regulation of Human Rh IgG [anti-D] for prophylaxis of rhesus Rh immunization

Rh immunoglobulin [anti-[D]] has been remarkably successful in prevention of sensitization to the Rh antigen. The immunological role and possibility of viral infection transmission through routine administration of human Rh Ig[G] immediately after delivery to Rh negative mothers were studied. Non of Rh Ig[G] receivers showed anti-[D] antibody level> 16 i. e. Rh unsensitized, while Rh sensitization occurred among non-receivers, [5/21, 238%], P<0.005. This prevalence is significantly increased [50%, 4/8] among mothers having history of abortion [P<0.05]. The possibility of viral infection transmission through Rh Ig[G] was excluded as the prevalence of HBV and HCV infection among mothers receiving anti-[D] was not significantly different from that among anti-[D] non-receivers and among different Egyptian groups [in other studies]. In addition non of the studied mothers showed HIV antibodies. This result was highlighted by the fact that all anti-[D] [Rhesonative and BPL] vials were free from viral markers, HBsAg, HCV ab, anti HIV ab, when tested by enzyme immunoassay [EIA] after absorption of Rh Ig[G] [anti-[D]] by blood group [0] Rh positive red cells and confirmed by immunoblot methods. So, it is the [Rh Ig[G]] present in anti-[D] vials in high concentration that causes false positive HCV ab and HIV ab in EIA in which anti-human globulin is utilized while HBsAg as negative [non reactive] in EIA before and after anti-[D] Ig absorption because anti-human globulin is not used in HBsAg Kit. Rh Ig[G] [Rhesonativ and BPL] vials are free from viral markers and they effectively and successfully prevent sensitization to Rh antigen among Rh negative mothers as well