Comparative analysis of umbilical artery doppler indices of normal and suspected IUGR fetuses in the third trimester.

BACKGROUND: Intrauterine growth restriction (IUGR) is an important cause of perinatal morbidity and mortality, the prevalence of which is six times higher in developing countries. The sequelae of IUGR extend into adulthood with higher risk of neurodegenerative diseases for the patients. Umbilical artery (UA) Doppler is an affordable and noninvasive tool for predicting perinatal outcome in IUGR pregnancies. AIMS: The objective of this study is to compare the predictive ability of UA Doppler ultrasonography in discriminating normal from growth-restricted pregnancies and to find out if there is any relationship between antenatal Doppler indices and perinatal outcomes. PATIENTS AND METHODS: This is a cross-sectional study including 100 normal and 100 IUGR-suspected pregnancies, respectively. Each participant had a third trimester UA Doppler scan. Data were analyzed using SPSS version 18.0 (PASW Statistics for Windows, Version 18.0, Chicago: SPSS Inc.). Means were compared using Student's t-test and ANOVA. Tests of relationship and prediction were done using linear regression analysis and receiver operating characteristics. P ≤ 0.05 was considered statistically significant. RESULTS: As pregnancy advanced, the mean values of UA Doppler indices decreased in normal and IUGR fetuses; however, they were significantly higher in the latter. UA systolic/diastolic (S/D) ratio showed the highest sensitivity (0.80) and specificity (0.91) for predicting IUGR compared to PI and RI. Cutoff values for PI, RI, and S/D ratio were 0.93, 0.67, and 2.93, respectively. CONCLUSION: IUGR fetuses had higher UA flow velocimetric indices compared with normal fetuses. UA Doppler study is highly sensitive in the prediction of IUGR.

Delayed Interval Delivery following Early Loss of the Leading Twin.

This was a case of a nulliparous woman with reduced chance of conception following unilateral salpingectomy and years of infertility. She eventually conceived following ovulation induction resulting in twin pregnancy. She had miscarriage that led to loss of one of the twins at 17 weeks of gestational age. The pregnancy was however continued for 116 days following meticulous management with eventual delivery of a live female baby with good outcome.

Sonographic Analysis of Adult Polycystic Kidney Disease: Retrospective Data from South-East Nigeria

Background: Autosomal dominant polycystic kidney disease (APKD); an inheritable multisystem disease characterized by intrarenal and at times extrarenal disease; has been studied extensively among Caucasian populations. Despite the fact that being black is a risk factor for progressive disease; there is paucity of local published data. As a result; true local incidence and peculiarities in clinical and sonographic characteristics are unknown.Aim: To present data from 19 patients diagnosed with APKD in a medium-sized facility over a 16-year period.Materials and Methods: A retrospective search was done on the ultrasound registers for patients who had undergone abdominal ultrasound in 16 years (1997-2013). Of the 29 sonographic diagnoses of bilateral PKD made; only 19 had complete records and were included in the study. Data extracted were- age; sex; working diagnosis; renal size; diameter of renal cysts; presence or absence of extrarenal cysts; family history of renal cystic disease; blood pressure at diagnosis; and patient outcome.Results: A total of 19 diagnoses of APKD were made- 12 males and seven females with a sex ratio of 1:0.6. Total mean age was 54.8 years (range 31-79 years)- 40.1 years for females and 57.2 years for males. In 89.5 of cases; no family history of APKD was obtained. Only six (31.6) patients were hypertensive at presentation and three patients (16) were already in renal failure. Ultrasound showed a mean renal size of 88.92 cm 2 for the right kidney and 98.97cm 2 for the left. Mean cyst diameter was 3.46 cm (range 2.08-4.85cm). Only one patient had documented extrarenal cystic disease. Two patients were lost to renal failure and congestive cardiac failure.Conclusion: APKD appears to be uncommon in our environment; however; more studies may be elucidatory. Standard sonographic protocol for collecting data from patients with APKD is needed

Hurthle cell tumor of the thyroid gland: report of a rare case and review of literature.

This article presents a case of Hurthle cell adenoma (HCA) of the thyroid gland with a review of literature on Hurthle cell tumors. This case presented is that of a 57-year-old woman with a recurrent thyroid swelling. She previously underwent a right hemithyroidectomy for thyroid mass 10 years prior. A left lobectomy was done and microscopic examination revealed a HCA of the thyroid. The patient was discharged on thyroid replacement therapy and has remained healthy after more than 24 months of follow-up. The literature review highlights the criteria for diagnosis, the role of imaging and fine needle aspiration cytology (FNAC) in preoperative diagnosis.

Pattern of second primary malignancies in thyroid cancer patients.

Many factors, including relatively young age of thyroid cancer diagnoses and improved survival, have led to increased concerns about the occurrence of second primary malignancies. This paper describes the pattern of occurrence of second primary malignancies in patients who were treated for malignant thyroid neoplasms in an Indian hospital. There were 21 affected patients of the approximately 4500 seen over 25 years. Most of the second primary cancers are solid tumors, and when nonthyroid cancers are the second tumors, ductal carcinoma of the female breast is the most common. Most of these tumors have very short detection intervals (including synchronous occurrences), suggesting that therapy with internal radiation was not contributory to the tumor development. When thyroid malignancies were the second primary cancers, they usually follow radiotherapy to the head and neck region for treatment of the first primary tumor and tend to be of aggressive histologic types than the common well differentiated thyroid carcinomas.

The utility of ultrasonography in the management of undescended testis in a developing country.

BACKGROUND: The use of ultrasonography to localize the testis in children with undescended testis is still controversial. This study was designed to determine the value of ultrasound in the preoperative assessment of children with undescended testis in a resource-limited setting. METHODS: A retrospective evaluation of all boys undergoing operation for undescended testes at the University of Nigeria Teaching hospital Enugu from June 2005 to December 2009 was performed. The operative findings were compared with the preoperative findings on clinical and ultrasound examinations. RESULTS: Overall, 49 boys with 60 undescended testes (unilateral in 38, and bilateral in 11 cases) were operated on during the study period. The median age of the patients was 5 (range, 1-14) years. At operation, 39 (65%) testes were located at the inguinal region, 17 (28.3%) were intra-abdominal, and 4 (6.7%) were vanishing testes. Of the inguinal testes, 30 (77%) were clinically palpable, and 38 (97.4%) accurately localized by ultrasound (p = 0.006). The intra-abdominal testes, the vanishing testes, and one inguinal testis were not identified with ultrasound. However, two testes identified as inguinal by ultrasound were found intraabdominal at operation, and two of the vanishing testes were recognized as viable testes by ultrasound. CONCLUSIONS: Ultrasound may identify some otherwise nonpalpable inguinal testes and hence affect therapeutic approach. It may, however, be unhelpful in truly abdominal and vanishing testes.

Pattern of Second Primary Malignancies in Thyroid Cancer Patients

Many factors; including relatively young age of thyroid cancer diagnoses and improved survival; have led to increased concerns about the occurrence of second primary malignancies. This paper describes the pattern of occurrence of second primary malignancies in patients who were treated for malignant thyroid neoplasms in an Indian hospital. There were 21 affected patients of the approximately 4500 seen over 25 years. Most of the second primary cancers are solid tumors; and when nonthyroid cancers are the second tumors; ductal carcinoma of the female breast is the most common. Most of these tumors have very short detection intervals (including synchronous occurrences); suggesting that therapy with internal radiation was not contributory to the tumor development. When thyroid malignancies were the second primary cancers; they usually follow radiotherapy to the head and neck region for treatment of the first primary tumor and tend to be of aggressive histologic types than the common well differentiated thyroid carcinomas

Retro-orbital metastasis from differentiated thyroid carcinoma in a radioiodine therapy-naïve patient: any lesson learned?.

OBJECTIVE: To present the case of a radioiodine therapy-naïve thyroid cancer patient with postthyroidectomy diplopia. CLINICAL PRESENTATION AND INTERVENTION: A 63-year-old male patient presented with goiter. Histology performed after thyroidectomy proved follicular thyroid cancer. Without (131)I therapy, diplopia occurred from metastasis to the right medial rectus muscle. Improvement followed after one therapy dose of (131)I. CONCLUSION: Postoperative radioiodine was important in managing this patient with differentiated thyroid cancer. This case showed that retro-orbital metastasis should be considered as a differential diagnosis in a patient with thyroid cancer who presents with unilateral diplopia.