Diagnostic comparison between cord blood and filter paper for the screening of congenital hypothyroidism.

BACKGROUND: Cord-blood and heel-prick TSH levels are essential in diagnosing and preventing the serious complications of congenital hypothyroidism, which mainly include intellectual disability. The study aimed to compare between cord-blood and heel-prick TSH sensitivity and specificity in detecting congenital hypothyroidism (CH) among newborn screened babies. METHOD: The study included 21,012 newborn screened babies for congenital hypothyroidism starting from September 2013 until March 2019. Both cord-blood and heel-prick TSH were collected from each newborn. Heel prick and cord-blood TSH cutoff values of >21 µU/ml and >30 mIU/L respectively were considered positive. RESULTS: Out of the total screened newborns, 12 were confirmed for having primary congenital hypothyroidism. Nine cases were positive for cord-blood TSH (Sensitivity 75%, specificity 99.9%, and a recall rate of 0.004%), while 139 cases were positive for heel-prick blood TSH (Sensitivity of 100%, specificity of 99.3%, and a recall rate of 0.60%). CONCLUSION: For the screening of CH, heel prick is considered a superior method, but cord blood remains a practical option due to its cost-effectiveness, immediate action, and lower recall rate. Therefore, whenever recall is difficult and/or early discharge is the practice, cord blood is an alternative method to heel prick but not with cases of prematurity.

Pancreatic Adenocarcinoma in Patients with Type 2 Diabetes: Prognosis and Survival.

Introduction Pancreatic adenocarcinoma and type 2 diabetes mellitus (T2DM) are inter-related. The outcomes of this association were the topic of interest of a lot of prior research in this field. The primary objective of this research is the identification of the survival rate and mortality difference between patients with pancreatic adenocarcinoma and T2DM and those without. Methods A retrospective observational study included 83 patients who were diagnosed and managed between 2005 and 2015 at Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah. Patients with T2DM who were older than 18 years old and were diagnosed later with pancreatic adenocarcinoma were included. Results Out of 83 patients with pancreatic adenocarcinoma, 86.75% (n=72) had T2DM at the time of diagnosis. The median age at diagnosis was significantly higher than in patients without T2DM (p=0.003). The overall survival was not affected by T2DM (p=0.289). However, hypertension had a significant impact on survival rate regardless of the presence of T2DM (OR, 3.47 (95% CI: 1.09-10.98)). Conclusion Patients with pancreatic adenocarcinoma and T2DM were mostly women and aged around 60. T2DM did not have a significant effect on tumor profile. T2DM did not significantly affect survival, although other comorbidities, such as hypertension, did.