Routine antenatal hepatitis B surface antigen (HBsAg) screening and immunization of risk babies is very effective in preventing perinatal transmission of hepatitis B virus (HBV). We studied 1,800 parturients attending a public hospital to assess the rationale for such vaccination in Bangladesh. In one in every 29 deliveries (63 of 1,800 or 3.5%), the mother was found to be HBsAg positive. All were asymptomatic and many (41 of 63 or 65%) without risk factors would remain undetected if HBsAg screening were performed on selected groups. Most of the HBsAgpositive mothers (54 of 63 or 85.7%) were found to be chronic carriers and 30.2% (19 of 63) were also hepatitis B e antigen (HBeAg) positive, indicating high infectivity. Although 23 cord blood were positive for HBsAg or HBeAg, none were positive for IgM antibody to hepatitis B core antigen (IgM anti-HBc), suggesting transplacental transmission of the antigens rather than intrauterine infection. These findings are discussed in relation to the cost-effectiveness of routine prenatal screening and immunization of risk babies compared with universal infant immunization.
Diabetes mellitus is one of the systemic diseases affecting the kidneys. Diabetic nephropathy is a serious microvascular complication of diabetes mellitus. It is the most important cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So, diagnosis of diabetic nephropathy is paramount for the survivability of the diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing cardiovascular disease. A total number of 53 subjects were enrolled in this present cross sectional study in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration of Nephrology and Medicine of the same institution during two years (2011-13) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy referred to the department of Radiology and Imaging in BSMMU for ultrasonography of Kidneys, Ureters and Bladder (KUB) region or whole abdomen were selected as sample. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of intrarenal artery were correlated and analyzed. Only those patients biochemically were diagnosed as having diabetic nephropathy was included. Those with incomplete data, hydro nephrosis and renal calculus were excluded. Both the kidneys were visualized by commercially available real time scanner (GE Voluson) equipped with a curvilinear transducer operating at 3.5 MHz First Gray scale ultrasonography was done followed by Color Doppler of intra renal artery and then RI was measured. Majority (45.3%) patients were in 6th decade with the mean age was of 52.66±7.4 years and ranging from 38 to 65 years in patients. Male was found to be 54.7% of diabetic patients with male to female ratio 1.2:1. Resistive index of (≥ 0.7) was found in 73.6% patients with diabetes with the mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r=0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is useful diagnostic modality for detection of renal dysfunction in diabetic nephropathy patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.
This cross sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical College Hospital from July 2008 to June 2010 to compare the accuracy of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of clinically suspected cases of ectopic pregnancy. Initially 60 patients with clinical suspicion of ectopic pregnancy were included in this study after analyzing selection criteria 30 patients underwent both transvaginal and transabdominal ultrasonography. 'Histopathological diagnosis' was considered gold standard against which accuracies of two diagnostic modalities were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transabdominal ultrasonography as a diagnostic modality in evaluation of suspected ectopic pregnancy were 73.1%, 75%, 95%, 30% and 73.3% respectively where as transvaginal ultrasonography was found to have 92.3% sensitivity, 75% specificity, 96% positive predictive value, 60% negative predictive value and 90% accuracy. Transvaginal ultrasonography was superior to transabdominal ultrasonography in the evaluation of suspected ectopic pregnancies .so, transvaginal ultrasonography is important for early and accurate diagnosis of ectopic pregnancy.
Background:Detection ofabnormalities ofaxillary lymph nodes is important for the diagnosis of different pathologies. Objective:The purpose of this present study was to see the accuracy of conventional USG for the differential diagnosis of axillary lymph nodes. Methodology: This cross sectional study was carried out in the Department of Radiology & Imaging at Bangabandhu Sheikh Mujib Medical University, Dhakafrom July 2012 to June 2013 for a period of one year. In this study normal healthy woman who came for screening of breast disease without any symptoms and did not have any abnormality on USG was included and werecategorized as normal patient. Axillary lymph nodes from the normal patients werecategorized as benign lymph nodes. Patients, who came with the complaints of mastalgia with normal breast findings, were included as patients with mastalgia. The lymph nodes from the patients of mastalgia were considered as reactive lymph nodes and patients with known breast cancer and lymph node metastasis were included as malignant patients. Metastatic lymph nodes from breast cancer patients was included diagnosed by cytopathology or histopathology as metastatic lymph nodes. Following patients second visit or final diagnosis the patients were included in the data set. Long axis diameter was taken as longest diameter in long axis. Result: In benign vs reactive lymph node the area under curve for long axis diameter was 0.534 (asymptotic significance 0.307), short axis diameter was 0.589 (asymptotic significance 0.007), sinus length 0.492 (asymptotic significance 0.798), cortical thickness was 0.684 (asymptotic significance 0.0001) short long ratio was 0.570 (asymptotic significance 0.033). In reactive vs metastatic the area under curve for long axis diameter was 0.464 (asymptotic significance 0.391), short axis diameter was 0.741 (asymptotic significance 0.000), sinus length 0.257 (asymptotic significance 0.037), cortical thickness was 0.625 (asymptotic significance 0.003) short long ratio was 0.791 (asymptotic significance 0.000), sinus long ratio 0.279 (asymptotic significance 0.040) cortex short axis ratio .516 (asymptotic significance 0.708).The cut off for short-long axis diameter ratio was 0.43, for short axis was 0.66cm and for cortical thickness 0.37cm. In benign vs metastasis lymph node the area under curve for long axis diameter was 0.533 (asymptotic significance 0.417), short axis diameter was 0.797 (asymptotic significance 0.000), sinus length 0.254 (asymptotic significance 0.000), cortical thickness was 0.757 (asymptotic significance 0.0001) short long ratio was 0.847 (asymptotic significance 0.0001), sinus long ratio 0.241 (asymptotic significance 0.0001) cortex short axis ratio .661 (asymptotic significance 0.0001). Conclusion: To differentiate benign, reactive and metastatic lymph node, cortical thickness and shape are the important parameters. Journal of Science Foundation 2015;13(2):36-45DOI: http://dx.doi.org/10.3329/jsf.v13i2.27933
for a period of one year. Normal healthy woman who came for screening of breast disease without any symptoms and did not have any abnormality on USG was included as normal patient. Axillary lymph nodes from these normal patients were categorized as benign lymph nodes. Patients, who came with the complaints of mastalgia with normal breast findings, were included as patients with mastalgia. The lymph nodes from the patients of mastalgia were considered as reactive lymph nodes and patients with known breast cancer and lymph node metastasis were included as malignant patients. Metastatic lymph nodes from breast cancer patients were included. Result: In benign vs reactive the area under curve for long axis diameter was 0.534 (p=0.307), short axis diameter was 0.589 (p=0.007), sinus length 0.492 (p=0.798), cortical thickness was 0.684 (p=0.0001) short long ratio was 0.570 (p=0.033), sinus long ratio 0.445 (p=0.095) cortex short axis ratio 0.641 (p=0.0001). Conclusion: The accuracy of conventional USG is good diagnostic modalities for the differential diagnosis of axillary lymph nodes.
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