Gestational Diabetes (GDM) is becoming more common everywhere around the globe. Objective: To sonographically assess the complications of gestational diabetes in fetuses associated with gestational diabetes during 3rd trimester of pregnancy Methods: A cross-sectional investigation has been carried out in Mother Care Hospital, Gujranwala. All subjects signed an informed consent form in written prior to ultrasound examination. 700 participants were enrolled in this study, among them 60(8.1%) pregnant women during 3rd trimester and at term diagnosed with GDM by glucose tolerance tests as diabetics. Patients were 29.5 years old on average, and the average Gestational age was 30.4 weeks. Estimated fetal weight was derived from ultrasound measures using the Hadlock2 equation. Patients were assessed for eligibility in inclusion criteria. Results: Out of a total of 700 women, 60(8.1%) were diagnosed as GDM and studied. Their minimum age was 21 years and maximum age was 40 years, the mean age was 32±4.04 years. Other studies have found that increasing maternal age is connected with an increase in the prevalence of GDM. Among the studied cases, most frequent complication was macrosomia 27(45%) and 12(20%) have no fetal complication by GDM. LGA 7(11.7%), polyhydramnios 5(8.3%), SGA and placental changes 3(5%), SGA 2(3.3%) and placental changes 2(3.3%) was evaluate. Conclusion: 8.1 percent of pregnant women were diagnosed with GDM. The majority of the ladies were beyond the age of 25 and had many children. Macrosomia and Polyhydramnios were the most prevalent fetal complications, hence caesarean surgery was a typical technique of birth.
Aim: To see the predictability of the shear wave elastography assessment of placental elasticity (kpa) for early detection of hypotrophic fetuses Design: Cross sectional comparative.300 single tone pregnancies previously diagnosed as normal and hypotrophic fetuses were included, the placental elasicity assessed by shear wave elastography of both groups and compared. Methods: We took biometric measurements and Doppler indicis of the uterine, umbilical, and middle cerebral arteries in both groups and screened them for grayscale and colour doppler ultrasonography. The placental elasticity was measured by Shear wave elastography in these groups .The comparison of strain ratios between these groups were done. Statistical analysis was carried out using the Mann-Whitney test. By plotting ROC curves, cut-off values for elasticity were analysed. On Shear wave elastography measurements, the sensitivity and specificity and diagnostic accuracy of hypotrophic fetuses were planned and developed. Results: The mean placental elasticity in hypotrophic fetuses and normal group was 28.71 ± 7.28 and 5.64 ± 1.53 respectively while the median placental elasticity in IUGR group was 27 ± 7 and 5.50 ± 2 with statistically higher median in hypotrophic groups, p-value < 0.001. Conclusion: In hypotrophic fetuses, as placental stiffness values are much higher, therefore for early detection of compromised hypotrophic fetuses , as a non-invasive, supplementary tool to gray-scale and Doppler, the Shear-wave elastography can be used. Keywords: Hypotrophic fetuses, Shear-wave elastography, Placental Elasticity (kpa), IUGR, Uterine artery, Umbilical artery, Middle cerebral artery, resistive index, pulsatility index,
Background: Most common cancer in women that is 32 % of all newly diagnosed cancers is breast cancer. Breast cancer develops when cells of your breast multiply and divide uncontrollably, resulting in a lump of tissue known as a tumor. Screening type of mammography has played a key role in reducing breast cancer mortality. Aim: To evaluate role of three diagnostic modalities in the breast cancer. Methods: The data bases PubMed and other search engines were searched with the key words: breast cancer, mammography, ultrasound, MRI, sensitivity, specificity, from 1999 to 2020. For inclusion and exclusion of studies we screened the most relevant and irrelevant outcomes. Studies having information of breast cancer, mammography, ultrasound, MRI, sensitivity, specificity was included. Meta-analysis were excluded. Results: In total 39 studies with breast cancer the overall mean sensitivity of ultrasound, mammography and MRI were 76.81, 74 and 88.18 respectively. Overall mean specificity of ultrasound, mammography and MRI 79.65, 87 and 75.17 respectively. SD of Sensitivity and Specificity of MRI is 10.57 and 16.27. SD of Sensitivity and Specificity of mammography is 20.92 and 16.43. SD of Sensitivity and Specificity of ultrasound is 23.71 and 20.05. Conclusions: MRI, because of its limitations cannot be used routinely for diagnosing breast cancer. Mammography is readily available screening tool for breast cancer however it has low sensitivity for diagnosis of breast cancer and requires complimentary imaging. Ultrasound can be used as baseline modality as it saves time and safe in all conditions. Keywords: Breast Cancer, Mammography, Ultrasound, MRI, Sensitivity, Specificity
Background: Globally as growing occurrence ratio of ovarian cancer as well as efficacy of Gynecologic-Imaging Reporting-and-Data-System GI-RADS to diagnose pathologies like ovaries cancer, we designed for evaluating the presentation of diagnosis of this system to differentiate among the adnexal benign and malignant lesions. For routine gynecologic examinations, pelvic ultrasound is generally used, consequential in analysis of adnexal lesions, main stream of which are benign or functional. Though, because of probable difficulties including benign adnexal cyst (i.e. pelvic pain and adnexal torsion) as well as ultimate significance of initial analysis as well as cure of ovarian cancer, precise ultrasound analysis of adnexal lesions is important in clinical run through Methods: We searched google scholar and pubmed form 2000 to December 2019. Selection criteria reporting on the accuracy of GI-R-A-D-S system in ultrasound. Results: In this study, we evaluated 197 women with suspected appendicitis. The proportions of GI-RADS II, III, IV and V were 34.5 (69 cases), 38.0 (76 cases), 19.5 (39 cases) and 6.5 (13 cases). For the high-risk and low-risk GI-RADS subtypes, 72.5% were classified as GI-RADS II and III, and 26 were classified as GI-RADS IV and V, respectively. Conclusive histopathologic analysis was testified for 158 cases. Histopathologic assessment designated that 12(7.6%) of were malignant masses as well as 146(92.6%) were benign. Associating by histopathologic analysis, the GIRADS system specificity, sensitivity, negative predictive value and positive predictive value, as well as negative LR were 91.6, 80.82, 28.2, 99.1, 4.77, and 0.10, correspondingly. The accurateness of the scoring system was 81.64%. Conclusion: This systemic review concluded that by Gynecologic-Imaging-Reporting-Data System, we could measure the possibility of malignant stage through such an organized along with modest recording system thus that system could be valuable in clinician to perform a suitable clinical organization Keywords: Adnexal Diseases, Ovarian Neoplasms, Ultrasonography.
The frequency of caesarean sections has been gradually increasing in the past several decades. The usage of transperineal ultrasound (TPU) has been increasing. Many studies have demonstrated that TPU can provide valuable information for the clinician. Objective: To assess the role of transperineal ultrasound in fetal head engagement as indication of caesarean section taking mode of delivery as gold standard. Methods: A cross-sectional study was carried out in Radiology Department of Nawaz Medicare and DHQ hospital, Faisalabad. Written consent was taken from all patients before the ultrasound examination. Patients were assessed for eligibility in inclusion criteria. Confirmation of intrauterine living pregnancy, placenta site, fetal presentation, liquor amount and gestational age was done with routine obstetric ultrasound. Enrolled pregnant patients at term were assessed for the fetal head-perineal distance and cervical length by TPU examination. Results: One hundred and twenty-four (124) women participated in the investigation. Maternal age and gestational age were not determinants of outcomes of labor. Fetal head-perineal distance measured by TPU had a test sensitivity of 88.31 %, specificity of 78.72 %, the positive predictive value is 87.18%, the negative predictive value is 80.43% and diagnostic accuracy is 84.68%. Conclusions: The findings of this study shows that head perineal distance measured by TPU have higher sensitivity and is a non-invasive method which provides valuable objective measurements for fetal head engagement in primigravida at term and can be easily accepted and tolerated by women. Also, unnecessary caesarean section rate can be reduced by timely decision.
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