ABSTRACT
Background: Antenatal diagnosis of placenta accreta spectrum (PAS) can ensure multidisciplinary management at center of excellence which can reduce maternal and fetal complications. This can be established by a scoring system which provides a standardized criterion for the diagnosis and management. The objective of our study was to assess the placenta accreta index (PAI) and its individual parameters for diagnosis of PAS in high-risk patients. Methods: A prospective study was conducted on 71 pregnant women with placenta previa and previous cesarean section. After informed consent, history was taken and ultrasonography was used to calculate the PAI for each patient. Definitive diagnosis was made clinically during cesarean section or by histopathology for those requiring hysterectomy. The data were evaluated using the latest version of Statistical Package for the Social Sciences software. Results: All ultrasound parameters of placenta accreta index were statistically significant for predicting PAS (p value < 0.001). ROC curve with AUC of 0.87 95% CI of 0.77-0.94 showed that a score of 4.75 was the best cutoff value to diagnose PAS. Out of the 30 patients found to have placental invasion, 22 had a PAI score of more than 4.75. The score was found to have a sensitivity of 73.3%, specificity 95.1%, positive predictive value 91.7%, negative predictive value 83% and diagnostic accuracy 85.9%. Conclusions: Women with placenta previa and history of previous CS should undergo screening by PAI, and a cutoff value of ≥ 4.75 should be viewed with high index of suspicion for the presence of PAS.
ABSTRACT
Retinoblastoma is the most common primary intraocular tumour of childhood. Though congenital, it is not diagnosed at birth, and is usually seen between 1-2 years of age. We here report a case of bilateral retinoblastoma with early presentation at the age of one month.
Subject(s)
Retinal Neoplasms/diagnosis , Retinoblastoma/diagnosis , Diagnosis, Differential , Female , Humans , Infant , Tomography, X-Ray ComputedABSTRACT
We reviewed seven patients with established non-union of a shaft of humerus fracture, treated by locked intramedullary nailing using the Intramedullary Supracondylar Nail (IMSC Nail; Smith & Nephew Richards, Memphis TN). The mean age of the patients was 65 years (range 48-78 years). Three of the fractures involved the proximal third of the diaphysis while the remaining four involved the middle third. Six of the original fractures were closed and one was an open fracture. The time interval between the original injury and final surgery averaged 9.3 months. All the nailings were done by the ante-grade approach with static locking. Six of the patients had closed nailing and one had open nailing with bone grafting. The mean follow-up was 8 months and osseous union was achieved in all seven cases at a mean of 5.6 months. We conclude that the Supracondylar Femoral Nail is a useful alternative implant in the management of non-union of fractures of the humeral shaft with wide medullary canals.
Subject(s)
Bone Nails , Fracture Fixation, Intramedullary/methods , Fractures, Ununited/surgery , Humeral Fractures/surgery , Aged , Evaluation Studies as Topic , Female , Follow-Up Studies , Fracture Healing , Fractures, Ununited/diagnostic imaging , Humans , Humeral Fractures/diagnostic imaging , Male , Middle Aged , RadiographyABSTRACT
We report CT and MRI findings in a girl with late-onset ornithine transcarbamylase deficiency, who presented with progressive somnolence. Both imaging methods showed signs of an acute cerebral ischaemia with new defects on follow-up. Despite an unusual clinical presentation, laboratory studies led to the diagnosis of this rare inherited metabolic defect.
Subject(s)
Amino Acid Metabolism, Inborn Errors/diagnosis , Brain/diagnostic imaging , Brain/pathology , Ornithine Carbamoyltransferase Deficiency Disease , Ammonia/blood , Child , Female , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
Effect of moderate changes in ambient temperature on autonomic activity was studied in male medical students. Autonomic function tests, i.e. Valsalva ratio, standing-to-lying ratio (S/L ratio), cold pressor response (CPR) and resting heart rate were carried out at two different ambient temperatures of 37.45 degrees +/- 0.52 degrees C and 32.54 degrees +/- 0.65 degrees C. At lower ambient temperature, there was decrease in the Valsalva ratio, increase in S/L ratio and lesser augmentation of systolic and diastolic blood pressure in CPR as compared to that at higher ambient temperature, indicating alteration in autonomic response with moderate changes in ambient temperature.
