Prune belly syndrome in a set of twins, a family tragedy: Case report

We report prune belly syndrome, a rare congenital malformation, in a set of twins delivered to a young couple with a history of three previous first  trimester spontaneous abortions, discordant HIV seropositivity and antenatal ultrasound report that indicated renal abnormalities in only one of the twins. The challenges of management are discussed.Keywords: Prune Belly Syndrome, Twins, Nigeria, Management challenge

Assessment of insulin resistance by a 13C glucose breath test: a new tool for early diagnosis and follow-up of high-risk patients

<p>Abstract</p> <p>Background/Aims</p> <p>Insulin resistance (IR) plays an important role in the pathogenesis of diabetes and non-alcoholic fatty liver disease (NAFLD). Current methods for insulin resistance detection are cumbersome, or not sensitive enough for early detection and follow-up. The BreathID^®system can continuously analyse breath samples in real-time at the point-of-care. Here we determined the efficacy of the BreathID^®using the ¹³C-Glucose breath test (GBT) for evaluation of insulin resistance.</p> <p>Methods</p> <p>Twenty healthy volunteers were orally administered 75 mg of ¹³C-glucose 1-¹³C. An oral glucose tolerance test (OGTT) was performed immediately; followed by serum glucose and insulin level determinations using GBT. GBT and OGTT were repeated following exercise, which alters insulin resistance levels.</p> <p>Results</p> <p>Within-subject correlations of GBT parameters with serum glucose and serum insulin levels were high. Before and after exercise, between-subjects correlations were high between the relative insulin levels and the % dose recoveries at 90 min (PDR 90), and the cumulative PDRs at 60 min (CPDR 60). Pairwise correlations were identified between pre-exercise Homeostasis Model Assessment (HOMA) IR at 90 min and PDR 90; HOMA B (for beta cell function) 120 and CPDR 30; HOMA IR 60 and peak time post-exercise; and HOMA B 150 with PDR 150.</p> <p>Conclusions</p> <p>The non-invasive real-time BreathID^®GBT reliably assesses changes in liver glucose metabolism, and the degree of insulin resistance. It may serve as a non-invasive tool for early diagnosis and follow up of patients in high-risk groups.</p

Imaging in Urinary Tract Infectioin

The imaging of a child with a proven urinary tract infection (UTI) remains a significant dilemma especially in Africa where some imaging modalities are either unavailable or unaffordable. The role of imaging in UTI is to assist in confirming the infection, identify those children with risk factors that will predispose them to recurrent UTI and also identify those who have suffered complications. This review article provides an overview and suggested approach to imaging in UTI. The different imaging tools and the type of information they provide and their possible side effects would be discussed.Keywords; UTI (urinary tract infection), Imaging, VUR (vesicoureteric reflux), Renal scarrin

Optimal utilisation of gamma camera time in Tc-99m MDP bone scintigraphy

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