Efficacy of umbilical artery doppler in detection and management of intrauterine growth retardation

To evaluate the efficacy of doppler flow study in umbilical artery in the diagnosis and management of fetal growth retardation in small for gestational age fetuses detected by clinical examination. Descriptive case series.This study was conducted at the Department of Obstetrics and Gynecology, Nishtar Hospital Multan from September 20, 2007 to June 19, 2008. Subjects were selected from clinically diagnosed pregnant ladies visiting antenatal clinic or admitted in labour. Umbilical artery doppler flow study was done and perinatal outcome was assessed. On the basis of umbilical artery doppler flow study, the subjects were categorized into abnormal [group A] or normal [group B]. Perinatal outcome of both these groups was compared on the basis of criteria mentioned in the proforma. Out of 50 patients, 21 [42%] patients were having abnormal umbilical artery doppler flow study [Group A] and 29 [58%] patients were having normal umbilical artery doppler flow study [Group B]. Emergency cesarean section, Preterm delivery, Low birth weight, admission of newborn to nursery, Low Apgar score [

Profound hypernatremia due to central diabetes insipidus

Diabetes insipidus is a rare endocrine disorder in paediatric patients. Polyuria is a cardinal manifestation that is extremely difficult to recognize in diapered infants. Careful urine quantification is the key to diagnosis in appropriate clinical setting. We report a case of a 4 months old infant presenting with an acute life threatening event following an episode of vomiting and decreased oral intake. She had profound hypernatremia which persisted after stabilization. Polyuria unrecognized by the mother was revealed by 24-hour urine output measurement. A diagnosis of diabetes insipidus was made after appropriate laboratory investigations including serum and urine osmolality. The central nature of the disease was confirmed by neuroimaging which showed holoprosencephaly

Moyamoya disease

A 4 years old boy presented with acute left hemiplegia. Preliminary neuroimaging suggested an arterial ischemic process. Clinical and laboratory evaluation excluded haematologic, metabolic and vasculitic causes. Cerebral angiography confirmed the diagnosis of Moyamoya disease. Treatment included physiotherapy and close follow-up for recurrence