Frequemcy of Breast Diseases at a tertiary Hospital of Karachi

To see the pattern of breast diseases at our set up. A descriptive study. Jinnah Postgraduate Medical Centre, Karachi - Pakistan for a period of three years. A total of 300 patients attending breast care clinics were evaluated. They were followed up till biopsy. All patients were females between 11-90 years of age. Majority of the patients belonged to the lower socioeconomic group. Data was collected through a specifically designed proforma. Most common presenting complaint was breast lump with other symptoms. Majority presented to the clinician within 6 months of development of lump. Most of the patients were married [69%] and majority [67%] was in the reproductive age while 32% were postmenopausal. Only 1% of the patients were in premenarche age. Most common site was upper and outer quadrant of left breast. Most common breast disease was carcinoma [30%] followed by inflammatory diseases [25%], fibroadenoma [24%] and fibrocystic disease [20%]. Only 1% of patients had no disease. Invasive ductal carcinoma NOS was the most common histologic type [51%]. Breast cancer in this study shows a higher frequency of this disease in Pakistan when compared to the world standards and to the other studies carried out in our country

Ultrasonography of ovarian tumors: predictability of tumor type

Objective: To determine the accuracy of ultrasonography in predicting the tumor type, so that the diagnosis of malignancy can be suggested preoperatively and appropriate treatment planned. Design: Descriptive study. Setting: Department of Gynaecology and Obstetrics, Liaquat University Hospital, Hyderabad, Pakistan from 1996-2000

Patients and Methods: Case records of 87 patients with ovarian tumors were analyzed. All these patients had preoperative ultrasound examination. Ultrasound findings were compared with histopathological findings

Results: Four patients with false positive diagnosis of ovarian tumor were excluded from this study. Out of 83 cases, 59 were benign and 24 malignant ovarian tumors. Solid component was present in 80% cases of malignant tumors and 20% of malignant tumors were cystic with septations. Solid component was also seen in 27.58% of benign tumors. Unilocular clear cysts were all benign. Dermoid cysts were all diagnosed on ultrasound

Conclusion: Anechoic masses have high probability of being benign and possibility of malignancy increases with the presence of solid component. Sensitivity and specificity for diagnosing malignant tumor can increase with the use of transvaginal color Doppler Ultrasound and magnetic resonance imaging

Quantitative assessment of placental maturity by acoustic intensity histogram

Morphologic and sonographic changes appear progressively in the placenta as it matures with the advancing gestation. Ultrasonically these changes appear as 1-4 mm echogenic densities in the chorionic plate, placental substance, basal plate and in the intercotyledonary septa. On the basis of these changes placenta is classified into 4 grades from grade 0 to grade III. Ultrasonic placental grading system is a non invasive way to indirectly predict the placental functional maturity and fetal lung maturity. There is 100% correlation of grade III placenta with mature L/S ratio, 80% with grade II and 60% with grade I placenta. Ultrasonic placenta grading is subject to interobserver variation, to minimize this variation and to increase the accuracy of acoustic intensity histograms of placenta of patients with pregnancy of 30 weeks and over have been obtained and analysed. Histogram represent echo distributing intensity of the image. Information obtained from histogram consist of total number of pixels in a specified area [T], gray scale level of shade component that is most common in the specified area [L] and number of pixels of the shade component that is most common in specified area [M]. Relationship of the computer analysis of histogram echo pattern and conventional grading of placenta are shown in this preliminary study. Computer analysis appear superior to conventional impressions obtained by sonologists. Computer analysis can further be improved by methods discussed