Introduction: Central nervous system anomalies are often severe and are the most common indications for therapeutic abortions. Ultrasound examination helps to identify and evaluate them well before birth.
ABSTRACT:One of the major factors affecting nephrogenesis in utero is intrauterine growth restriction (IUGR). Few studies showed reduced weight of the fetal kidney in IUGR fetuses as compared to normally grown fetuses. Reduced blood flow to the kidneys due to fetal hypoxemia in IUGR foetus leads to increased pulsatility index which is likely to be responsible for impaired nephrogenesis and decreased kidney volume. AIMS AND OBJECTIVE: To estimate if fetal renal artery Doppler could affect fetal renal volume in healthy and growth restricted fetuses after 26 weeks of gestation. STUDY DESIGN AND SETTING: Cross sectional study carried out in the Department radio diagnosis, Lata Mangeshkar hospital, Nagpur, Maharashtra, India. MATERIAL AND METHODS: Total 336 patients, which consisted of 309 normally grown fetuses and 27 intrauterine growth restricted fetuses were included in the study. Fetal renal volume of individual kidney, combined renal volume and relative renal volumes were calculated using 2 dimensional ultrasound for normal and IUGR fetuses. Fetal renal artery parameters particularly renal arterial pulsatility index were calculated for both the groups. Correlation of fetal renal Doppler parameters with renal volume was estimated for respective groups. RESULTS: Combined kidney volume was significantly reduced in growth restricted fetuses than normal fetuses i.e. mean combined kidney volume for growth restricted fetuses was 12.6cc and for normal fetuses was 19.29cc. Most of the fetal biometric indices were positively correlated with the combined kidney volume. Increased pulsatility index was seen in growth restricted fetuses i.e. on right side 1.37+/-0.35 and on left 1.40+/-0.35 i.e. >1 while for normal fetuses was 0.88 +/-0.08 on either side i.e. <1. Considerable negative correlation was found between fetal renal artery pulsatility index and renal volume. CONCLUSION: Increased fetal renal artery pulsatility index in intrauterine growth restricted fetuses is negatively correlated with renal volume resulting in reduced renal perfusion and impaired nephrogenesis.
Parotid gland is involved in many inflammatory and neoplastic conditions. Many a times, it is difficult to ascertain the type of swelling by clinical examination. The anatomy and various abnormalities of the glands are very easily visualized by high-frequency ultrasound. Ultrasound can confirm the presence of the mass with sensitivity up to 100%. It can demonstrate whether a lesion is located in the parotid gland or outside. It can help in differentiating benign from malignant neoplasms and local staging of the mass in malignant lesions. In addition, ultrasound can identify those entities that may not need surgical intervention. The glands appear enlarged and show altered echopattern in acute inflammation and may be normal or reduce in size in chronic inflammation. Other pathologies that involve salivary glands are sialolithiasis and various benign and malignant neoplasms. Ultrasound many times suggests final diagnosis or supplies important differential diagnosis. In this article, the use of high-frequency ultrasound in parotid disease is discussed, and sonographic features of different parotid pathologies are reviewed with examples illustrated. High-frequency ultrasound is the first and many a times the only imaging investigation done for evaluation of parotid glands.
Dear Sir, We would like to highlight a few points from the PCPNDT act, which need explanation whereas others are confusing or controversial. The act was formulated in 1994 specifically for pre-natal diagnostic techniques (invasive procedures) and centers were termed as genetic clinics. When the Supreme Court of India in 2001 gave a verdict on a petition filed by an NGO that ultrasound clinics should be brought under the act, the Government just added the term ultrasound clinic everywhere along with genetic clinic. Most of the problems we face are a result of this addition. The Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act 1994Chapter I. 2. Definitions (d) genetic clinic: Explanation: For the purposes of this clause, a Genetic Clinic includes a vehicle, where ultrasound machine or imaging machine or scanner or other equipment capable of determining sex of the fetus or a portable equipment which has the potential for detection of sex during pregnancy or selection of sex before conception, is used. [1,2] Confusion: Vehicle, e.g. car carrying the machine (not used for doing ultrasound) is to be registered or not. Registration charges to be paid or not. If registered as genetic clinic, separate monthly report to be sent or not.Current scenario: This clause is of no use as portable ultrasound is banned by the high court in Maharashtra and many other states by the appropriate authorities.Chapter I. 2. Definitions (i) "pre-natal diagnostic procedures" means all gynecological or obstetrical or medical procedures such as ultrasonography, fetoscopy, taking or removing samples of amniotic fluid, chorionic villi, blood or any other tissue or fluid of a man, or of a woman for being sent to a Genetic Laboratory or Genetic Clinic for conducting any type of analysis or pre-natal diagnostic tests for selection of sex before or after conception. [1,2] Explanation: Ultrasound is pre-natal diagnostic procedure as well as pre-natal diagnostic test.Chapter I. 2. Definitions (p) "Sonologist or imaging specialist" means a person who possesses any one of the medical qualifications recognized under the Indian Medical Council Act, 1956 or who possesses a postgraduate qualification in ultrasonography or imaging Techniques or radiology. [1,2] Explanation: Radiologist and registered medical practitioner (MBBS) have been equated. There should be AND in place of OR.
We present a case of 11-year-old girl with a history of prominent superficial veins over abdomen and thorax since birth. A superficial vein extending from either inguinal region joined in umbilical region and extended up to right supraclavicular region. Other features of Klippel-Trenaunay syndrome like nevus, limb edema were absent. On radiological investigations both external iliac veins could not be visualized and venous return from lower limbs was draining into the right subclavian vein via these superficial veins. Both external iliac veins could not be identified during surgery.
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