Background Chronic lymphocytic thyroiditis or Hashimoto’s thyroiditis (HT) is a common form of organ specific autoimmune disease mediated by anti-thyroid autoantibodies. Ultrasound including Doppler is helpful diagnostic tool in the diagnosis of Hashimoto’s thyroiditis. This study aimed to evaluate the ultrasound and Doppler characters of Hashimoto thyroiditis and to analyze the relationship between these ultrasound, Doppler features and thyroid hormones level. Results Thyroid gland sonographic parenchymal abnormalities (septations, undulation, micronodularity, gland hyper vascularity, hypoechogenicity, sizable nodules as well as enlarged para-tracheal lymph nodes) were significantly higher in Hashimoto cases compared to control group (P value is < 0.001). Undulation of thyroid gland margin was the most sensitive sonographic sign seen in about 72% of studied cases. Thyroid stimulating hormone (TSH) level was significantly high in cases with grade 2 echogenicity compared to cases with grade 0 and grade 1 echogenicity and was significantly high in cases with para-tracheal abnormal enlarged lymph nodes (p < 0.05). TSH & thyroxine (T4) levels were significantly high in cases with high gland vascularity in Doppler study (p < 0.05). Conclusions Ultrasound is a very good diagnostic tool in HT with established signs. It can suggest hypothyroidism (high TSH) in cases of grade 2 parenchymal echogenicity, high vascularity and para-tracheal lymph nodes enlargement. These finding could be helpful in patient management and can contribute in better understanding the disease progression.
Background During the second wave of COVID-19, there is an increasing incidence of reported cases in children compared to the early wave. Data on the clinical and laboratory characteristics of COVID-19 in children are evolving, and reports on the characteristics and outcomes of severe COVID-19 in children are still under evaluation. We aimed to describe the clinical, laboratory, and radiological characteristics and outcomes of children with COVID-19 infection admitted to the pediatric intensive care unit (PICU). Results The study included 27 children with COVID-19 infection. Fever, respiratory, and gastrointestinal (GIT) symptoms were predominant presenting symptoms in our patients. The median age of our patients was 9 months (2 m–12 years). Comorbidity was reported in 59.3%. The typical laboratory findings were leukocytosis, lymphopenia, elevated C-reactive proteins levels, and elevated d-dimer levels. The most frequent radiological findings were ground-glass opacities in 100% of patients and bilateral findings in 96%, while cardiomegaly was found in 44% of patients. The multisystem inflammatory syndrome was reported in 33% of patients with GIT symptoms were the most frequent presenting symptoms. Myocarditis was reported in 22% of patients. The mortality rate in this cohort was 14.8%. On multivariate analysis, the only predictor of mortality was the development of MIS-C. Conclusions COVID-19 is more severe in children with comorbid conditions. Fever, respiratory and gastrointestinal (GIT) symptoms were predominant presenting symptoms. MIS-C is of increasing concern in children with high mortality rates.
Aim:The goal of this study was to determine changes in portal pressure hemodynamics of HCC patients after their management using transarterial chemoembolization (TACE). Twenty five patients with HCC underwent TACE. Medical history in addition to investigations were carried out including Doppler ultrasound for assessment of portal hypertension (PHT )parameters, and then repeated 3 months after TACE. Results: TACE had resulted in a markedly increased liver vascular index with significant reduction in hepatic artery resistive index following therapy. TACE was accompanied by improvement of PHT parameters. Doppler ultrasound might be used as a reliable and efficient tool for assessment of PHT changes. Conclusion: Locoregional therapy has become increasingly pivotal for HCC patients as a result of advances in approaches, survival benefit, and a favorable safety profile, despite curative measures including surgical resection and liver transplantation are still the gold standard.
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