Background: SCD is one of the most common inherited hemoglobinopathies worldwide. It is a major health problem in Madhya Pradesh and surrounding states. The present study was undertaken to infer the value of ultrasonography in evaluating abdominal organs in a SCD patient. Study design: This is a prospective hospital based study. Method: 100 SCD patients were assessed for abdominal pathologies by USG, the results thus analyzed and prevalence was calculated. Result: Hepatomegaly is the most common association observed in 69% of patients followed by splenomegaly in 31% patients & increased renal size in 29% patients. Cholelithiasis (17%), increased renal medullary echogenecity (14%), Auto-splenectomy (11%), Bright liver (9%), Splenic calcification (8%), Increased GB wall thickness (6%), Splenic infarct (5%) and Increased pancreatic echogenicity (3%) are the other associated findings. Conclusion: Real time ultrasonography is a simple, cheap, rapid, easily accessible, non-invasive, non-ionizing screening procedure in all cases of SCD patient for assessment of pathological changes occurring in the various abdominal organs. The high rates of abdominal pathologies being diagnosed on ultrasonography underscores the need for it to be established as a standard screening procedure with established protocols.
Abstract:Characterizing a hepatic lesion as benign or malignant is very essential for correct therapeutic plan and surgical triage. USG plays crucial role in screening of a liver lesion. The aim is to study the characteristics of various hepatic lesions using USG, differentiating benign hepatic lesions from malignant and correlating features of USG findings with clinical, histopathology or post-operative findings. This is cross sectional hospital based study of 100 patients with clinical suspicion of liver pathology and hepatic masses. All patients underwent ultrasonography examination with subsequent follow up, histopathology correlation and accuracy, sensitivity and specificity of ultrasound for evaluation of hepatic lesions were calculated. Statistical analysis was done using computer software (SPSS IBM version 20).Qualitative data were expressed in proportion and percentages and quantitative data expressed as mean and standard deviations. Difference in proportion was analysed by using chi square test and difference in means were analysed by using student T Test [unpaired]. Significance level for tests was determined as 95%. Thus difference was significant if p <0.05. USG proved to be a good screening modality with a sensitivity of 82.7% , specificity 95.6 % , PPV 82.7 % and NPV 95.6 % (p value <0.001 , kappa value 0.678) . Malignant hepatic lesions can be diagnosed by USG with accuracy of 87 %, sensitivity and specificity of 90 % and 82.5 % respectively and PPV and NPV of 88.5 % and 84.6 % respectively. Ultrasonography must be performed in all patients with clinical suspicion of hepatic masses, for initial detection and localisation of lesions. It has high accuracy, sensitivity and specificity to characterize a lesion as benign or malignant. Also it is widely available, less expensive and with no radiation exposure.
To observe the role of ultrasonography in evaluation of causes of obstructive jaundice. A total of 100 patients were enrolled in this cross-sectional study done in Department of Radio-diagnosis, Gandhi Medical College, Bhopal. Ultrasonography was able to detect the presence of biliary obstruction in 100% of cases. Liver function tests were altered in all the patients with alkaline phosphatase raise out of proportion to the AST/ALT. The highest incidence of biliary obstruction was found in 61-70 years' age group with mean (±SD) age of the patient was 62.7 ± 12.64 years. Sensitivity, specificity and accuracy of ultrasonography in detecting the various causes of obstructive jaundice was 84.15%, 98.86% and 97% respectively. Accuracy and specificity for ultrasonography is high in detecting the causes of biliary obstruction with a slightly low sensitivity. Considering these attributes, ultrasonography can be used as a very effective screening modality in cases of obstructive jaundice.
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