Background:The recognition that some 10% to 15% of the hypertensive population may have aldosterone excess has increased the frequency of measurement of the aldosterone-to-renin ratio (ARR) and the use of aldosterone antagonists. Whether this ratio will predict the blood pressure (BP) response to spironolactone is not clear.
A 32-year-old female with a past medical history of constipation (predominant irritable bowel syndrome (IBS) and gastro-esophageal reflux disease (GERD)) presented with a complaint of pain in the lower abdomen. She lost 20 pounds in three months with a current body mass index (BMI) of 19.5 kg/m2 (ref: normal level 18.5-24.9). Computed tomography (CT) of the abdomen with contrast showed very little intra-abdominal fat, enlarged proximal duodenum, and decreased aorto-mesenteric angle of 15.4
0
suggestive of superior mesenteric artery (SMA) syndrome. Per general surgery, the patient was managed conservatively: initially Nil Per Os (NPO), slowly transitioned to a clear liquid diet, soft diet, and solid diet. She tolerated the diet, improved clinically, and was discharged home.
Stroke is one of the main causes of disability and death globally. Although Magnetic Resonance Imaging (MRI) has completely changed how stroke victims are diagnosed and treated, its application to the Sudanese population has not yet been investigated. This study aimed to assess the diagnostic accuracy of MRI in detecting brain infarctions and to evaluate the correlation between patient demographics and MRI results in Khartoum State, Sudan. A cross-sectional study was conducted at the Radiology department, Omdurman Military Hospital, Khartoum, Sudan, from April 2019 to February 2023. A total of 222 stroke patients were included in the study, with a slight male predominance (51.0%). Routine brain MRI was performed using 3 orthogonal planes and at least T1, T2, and FLAIR weighted images. The study found that all four MRI sequences (T1, T2, FLAIR, and DWI) have similar accuracy in measuring brain infarction sizes, with T2 sequence being slightly more sensitive. The most common occupation among stroke patients was soldier (19.8%) and the most affected age group was 63-77 years (34.2%). Additionally, the study revealed a higher incidence of right-sided infarctions (53.1%) compared to left-sided (47.0%). These findings provide insight into the accuracy of MRI in diagnosing brain infarction and highlight the importance of considering demographic factors in stroke evaluation.
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