Accuracy of single versus combined use of ultrasonography or computed tomography in the localization of parathyroid adenoma

To assess the accuracy of a single versus combined use of ultrasound [US], or computed tomography [CT] in the localization of diseased parathyroid glands. Forty-one patients with hyper-parathyroidism treated surgically between January 2004 to December 2007 at tertiary referral hospital in K.S.A [Saudi Arabia], were included in this study. Preoperative ultnasonographic and CT findings were reviewed and compared to the intraoperative and pathologic diagnosis of diseased parathyroid glands. The mean age of patients was 46 years [range 16-70, 15 males and 26 females].Parathyroid adenoma was confirmed in 33 patients and hyperplasia of the parathyroid glands in 8 patients. Preoperative evaluation was carried out in32 patients[CT scan], and in 23 patients [US].In 18 cases, the diagnosis of parathyroid disease was based on CT findings alone and in 9 cases the diagnosis was based on single US findings.Combined CT and US evaluation was carried out in 14 cases and accurate localization was reached in 12 cases yielding 86% sensitivity and 100% positive predictive value. The independent use of these techniques alone resulted in low [39%] sensitivity for US and high [78%] sensitivity values for the CT. Neck CT scan evaluation has almost an equivalent sensitivity to combined CT and neck US in the preoperative localization of diseased parathyroid glands, however the combined use of these techniques provides the best diagnostic accuracy

New intralesional therapy for basal cell carcinoma by 2% Zink sulphate solution

To assess the effectiveness of intralesional injections of 2% Zink sulphate in the treatment of basal cell carcinoma [BCC]. This is an open-label case interventional study conducted at the department of surgery at Al Rashid general hospital [Saudi Arabia] between January 2007 to January 2008. 11 patients were treated by intralesional injection of 2% zinc sulphate solution. 11 patients [10 males and one female] with BCC were included in this study, they had 25 lesions ranging from 1 to 3 lesions per patient. Their ages range from 46 to 70] while the duration of the disease was between 7 months and 36 years [11.35 +/- 8.46] [median: 2]. A total of 25 lesions of BCC, 12 [48%] nodulr, 10 [40%] superficial pigmented, 2 [8%] nodulo-ulcerative, and one [4%] cystic. 10 lesions were injected with 2% zinc sulphate solution while 15 were infiltrated with 4% zinc sulphate solution and 2% xylocaine. 11[44%] was in the scalp, 9 [36%] in the face,4[16%]in the cheek and one [4%] in the chest. The number of injections for each lesion ranged from 1-4 injections. All lesions showed clinical cure: 6 [24%] after first injection, 13 [52%] after second injections, 5 [20%] after third injections and one after fourth injection. This is a new effective, safe, non-costly local therapy of BCC. It is advised in all patients and in all types of BCC especially when the number of lesions is multiple, small and in elderly individuals