BackgroundFine needle aspiration cytology (FNAC) has been widely accepted to be a safe, accurate, prompt and inexpensive procedure for diagnosis of both neoplastic and infectious diseases in adult and pediatric populations. Despite its value for diagnosis, FNAC is underutilized in resource limited countries. We reviewed the utilization of FNAC after it was introduced at Kamuzu Central Hospital (KCH).MethodsA retrospective review of all FNAC performed at KCH laboratory during the period of January 2012 to July 2014 was conducted using an electronic database from KCH laboratory. We evaluated factors associated with a diagnostic sample using multivariate logistic regression model.Results750 FNAC were reviewed from 722 patients: 56.9% were adults >15 years and 54% were female. The number of FNAC increased annually from 56 (2012) to 379 (2013) to 315 (up to July 2014). Of 750 FNAC, 56.4% were performed by non-pathologists. The most common sites were lymph nodes (38.1%), abdomen (25.8%), breast (16.3%), and head & neck (15.7%). Most of the samples (77.6%) were diagnostic. FNAC was more likely to be diagnostic if performed by pathologists versus non-pathologists (OR 1.78, 95% CI 1.20–2.64), in 2013 compared to 2012 (OR 1.95, 95% CI 1.05–3.56), or performed on a deep lesion versus a subcutaneous lesion (OR 1.71, 95% CI 1.15–2.5), or if samples were taken from the head and neck (OR 2.4, 95% CI: 1.39–4.39), and abdomen (OR 2.66, 95%CI1.59–4.42) compared to those from the lymph nodes. The odds of a diagnostic test did not differ significantly according to gender, HIV status, or age groups.ConclusionMost FNACs successfully diagnosed the presence or absence of disease, with substantial improvements over time. However, training for non-pathologists may facilitate more diagnostic results.
Background: Type 2 diabetes (T2D) is associated with increased prevalence of non-alcoholic fatty liver disease (NAFLD) which mediates increased insulin resistance and is associated with cardiovascular disease (CVD) risk factors. Aim of the study was to understand the association of NAFLD with anthropometric and metabolic parameters in T2DM.Methods: A retrospective observation of data obtained from a private diabetes care centre in non-alcoholic T2D patients was performed. Association of presence of NAFLD with anthropometric, metabolic (glycemic, lipid) parameters, and also blood pressure were assessed. Patients were duly informed that the data collected pertaining to their illness could be used for research purposes. No changes or interventions in the management of the illness were made as part of this study.Results: In total, 300 cases were included in analysis. NAFLD was seen in 38.0% of the cases. Patients with fatty liver were much older than those without fatty liver (P<0.0001). A significant association of NAFLD was seen with all anthropometric (P<0.05 for each) and lipid (p<0.05 for each) parameters and also systolic and diastolic blood pressure measurements (p<0.0001 for both). There was no significant association with glycemic levels in patients with NAFLD. Other factors which had significant association with fatty liver include duration of diabetes, duration of hypertension and a known history of hypertension and dyslipidaemia (p<0.0001 for each).Conclusions: NAFLD has significant association with cardio-metabolic risk factors and may be an independent risk factor for CV disease. Further prospective studies with effect of diabetes treatment and progression/regression of NAFLD and its association with CV outcomes in T2D are warranted.
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