Relationship between Renal Doppler Indices and Biochemical indices of Renal Function in Type 2 Diabetes Mellitus.

OBJECTIVES: Diabetic nephropathy is a common complication of diabetes mellitus due to microangiopathy leading to end stage renal disease. This study determined the relationship between renal resistivity index and pulsatility index with biochemical indices of renal function in patients with type 2 diabetes mellitus methods: This study involved 80 adults with type 2 diabetes mellitus. Urinary albumin excretion rate (UAER) and serum creatinine levels were measured, and the estimated glomerular filtration rate (eGFR) was calculated. Right renal resistivity index (RI) and pulsatility index (PI) values were determined. RESULTS: Mean renal resistivity index was 0.72±0.06 while the pulsatility index was 1.36 ± 0.24. Resistivity index was positively correlated with albuminuria (r = 0.426; p <0.001) and serum creatinine (r = 0.458; p <0.001), but negatively correlated with eGFR (r = -0.399; p <0.001). There was positive correlation between pulsatility index and albuminuria (r = 0.341; p = 0.002), and serum creatinine (r = 0.478; p = <0.001); and negative correlation between PI and eGFR (r = - 0.359; p = 0.001). CONCLUSIONS: Renal resistivity index and pulsatility index may provide valuable non-invasive estimate of predicting the presence and severity of renal dysfunction in patients with type 2 diabetes.

Gallbladder perforation complicating typhoid fever: report of two cases.

BACKGROUND: Gallbladder perforation (GBP) is rare and as a complication of typhoid fever is extremely rare. We present two consecutive patients with GBP diagnosed incidentally at laparotomy. METHOD: Information on the management of two patients with gallbladder perforation seen at Federal Medical Centre Azare in June and October 2008 was extracted from their case records. RESULTS: The two patients were both males aged 13 years and 16 years. They both presented with high fever of more than 2 weeks duration; and abdominal pain and distension. Both patients had features of generalised peritonitis. Pre-operative diagnoses of typhoid enteric perforation were made based on a positive Widal test. Intra-operative findings however, were that of bile peritonitis and gallbladder perforation. Both had cholecystectomy. Culture of the bile aspirate yielded Salmonella typhi. CONCLUSION: Gallbladder perforation secondary to typhoid fever should be considered as a differential diagnosis in patients with suspected typhoid enteric perforation in typhoid fever endemic region.