Nigerian Postgraduate Medical Journal最新文献

{"title":"Acute Kidney Injury in Pregnancy among Kidney Transplant Recipients.","authors":"Chimezie Godswill Okwuonu, Oluchi Justina Chimezie, Efosa Oviasu","doi":"10.4103/npmj.npmj_595_25","DOIUrl":"10.4103/npmj.npmj_595_25","url":null,"abstract":"<p><p>Acute kidney injury (AKI) in pregnancy among women with kidney transplants is rarely addressed in the literature. There is no consensus definition of AKI among this population, and limited data exist on the different aetiologies and outcomes, thereby creating a significant knowledge gap. Pregnancy among patients with a kidney transplant is considered high risk due to the possibility of foetal and maternal risks, AKI and graft loss during pregnancy. This is a case series report of two post-kidney transplant patients who developed multiple episodes of AKI in the course of pregnancy. There was no identifiable pre-renal, intrinsic renal, post-renal or transplant-specific cause for the AKI. There was a failure of the first-trimester dip in serum creatinine in both patients. In addition, the serum creatinine stabilised between 6 and 12 months post-delivery, albeit at a higher level. The renal biopsy done was negative for rejection or polyoma virus nephropathy. Failure of the first trimester dip in serum creatinine may be a risk factor for AKI in pregnant transplant patient which may in turn have deleterious short term and long term outcomes on kidney function.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 2","pages":"280-284"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Mycological Profile of Dermatophytosis in a Rural Tertiary Care Hospital, Central India.","authors":"Aditi Pradeep Warghade, Dipika Shaw, Gargi Mudey","doi":"10.4103/npmj.npmj_291_25","DOIUrl":"10.4103/npmj.npmj_291_25","url":null,"abstract":"<p><strong>Background: </strong>Dermatophytosis is a superficial fungal infection that has emerged as a significant public health concern. The present study investigated the clinical and mycological characteristics of dermatophytosis from the central India rural tertiary care hospital.</p><p><strong>Aim and objectives: </strong>To characterise the clinicomycological profile of dermatophytosis from the tertiary care hospital in central India.</p><p><strong>Materials and methods: </strong>A total of 95 patients with suspected dermatophytosis were enrolled during a period of 1 year and 9 months. Demographic details, clinical history and clinical samples from infected sites (skin, hair and nail) were collected after patient consent. Dermatophytes' growth was identified based on the phenotypic methods.</p><p><strong>Results: </strong>A total of 95 clinically diagnosed dermatophytosis cases were enrolled, and the most common clinical manifestation was tinea corporis 73.68% (n = 70), followed by tinea cruris 9.47% (n = 9). In addition, 52.63% (n = 50) were females and 47.37% (n = 45) were males. A higher number of cases accounted for chronic dermatophytosis (50.52%), followed by recurrent dermatophytosis (40%). The contact history of animal and soil contact was found to be 11.57% each. Of the 95 samples, dermatophyte growth was observed in 44.21% (n = 42) isolates, where Trichophyton mentagrophytes complex was the predominant organism 33.68% (n = 32), followed by Trichophyton rubrum 9.47% (n = 9) and Trichophyton tonsurans, 1.05% (n = 1).</p><p><strong>Conclusion: </strong>T. mentagrophyte complex is the predominant dermatophyte in central India. Tinea corporis is a significant clinical finding reported; further, the animal's contact history is an essential risk factor associated with this disease.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 2","pages":"227-231"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Mean Platelet Volume and Platelet Distribution Width as an Early Marker of Neonatal Sepsis: A Case-Control Study.","authors":"Nisha R Aglave, Rupali S Rokade, Pooja Bhimshankar Nagrale","doi":"10.4103/npmj.npmj_65_25","DOIUrl":"10.4103/npmj.npmj_65_25","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis (NS) is one of the greatest concerns in developing countries and the leading cause of mortality in the neonatal intensive care unit. Due to non-specific and overlapping signs, it poses a difficulty for early diagnosis of sepsis. Blood culture, though the gold standard for diagnosis of sepsis, takes at least 72 h to show positive growth. Early indicators are the need of the hour to predict NS, so that early empirical antibiotics could be initiated.</p><p><strong>Aim of the study: </strong>To evaluate Mean platelet volume (MPV) and Platelet distribution width (PDW) as early diagnostic marker of neonatal sepsis and to compare their values between septic and non septic neonates.</p><p><strong>Subjects and methods: </strong>This was a prospective case-control study conducted in a tertiary care centre over a period of 1 year from January 2022 to December 2022. Fifty-three neonates who met the inclusion criteria according to the operational definition of NS were included as cases, while another 53 neonates served as controls. Blood culture, sepsis screen and platelet indices, mean platelet volume (MPV) and platelet distribution width (PDW), were performed on all these babies. Relationship between various factors like gestational age, gender, onset of sepsis, blood culture and outcome, with MPV and PDW in cases and control were analysed.</p><p><strong>Results: </strong>During the study period, 53 neonates were included in the case group and 53 neonates in the control group. Early-onset sepsis (EOS) was more frequent in this study, with 32 (60.38%) neonates being diagnosed with EOS. Blood culture was positive in 26 out of 53 (49.06%) of cases, with the most frequent isolate being Burkholderia cepasia followed by Klebsiella pneumoniae. Gram-negative organisms were the most common organisms seen in 17 (65.38%) of cases with positive blood culture. Mean value of MPV and PDW in cases were 11.3 ± 2.26 and 57.20 ± 18.91, respectively, while that in the control group were 9.13 ± 1.30 and 47.73 ± 20.02, respectively, with P = 0.00001, which was statistically significant (P < 0.05). Receiver operating curve for MPV and PDW, considering blood culture as the gold standard, showed the area under the curve for MPV and PDW were 0.831 and 0.644, respectively.</p><p><strong>Conclusions: </strong>MPV and PDW are increased in neonates with sepsis, both in term and preterm. MPV is a better predictor of sepsis compared to PDW. So, both MPV and PDW can be used as a surrogate marker of NS and as a predictor of mortality.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 2","pages":"262-268"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Previously Undiagnosed Glaucoma and Suspects through Annual Screening of Hospital Staff in a Nigerian Tertiary Hospital.","authors":"Tarela Frederick Sarimiye, Steve Oluwaseun Adebusoye, Mary Ogbenyi Ugalahi, Ezinne Obioma Onebunne","doi":"10.4103/npmj.npmj_83_25","DOIUrl":"10.4103/npmj.npmj_83_25","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma, a leading cause of irreversible blindness globally, disproportionately affects the persons of African descent. In Nigeria, delayed diagnosis and advanced disease presentation are common.</p><p><strong>Aims: </strong>This study evaluated the uptake and screening outcomes of targeted glaucoma screening among hospital staff at a tertiary hospital in Nigeria.</p><p><strong>Subjects and methods: </strong>This cross-sectional study recruited staff who participated in a 1-day workplace screening. Data collected included prior screening experience, medical and family history and comprehensive eye examinations. Glaucoma and suspects were identified using the International Society of Geographical and Epidemiological Ophthalmology Criteria.</p><p><strong>Results: </strong>Ninety-six staff were screened. The median age was 44.0 years (interquartile range: 39.0-52.0), with 67.7% (n = 65) younger than 50 years. Glaucoma was identified in 5.2% (2.3%-11.6%; n = 5) and 14.6% (8.8%-22.9%; n = 14) were glaucoma suspects. Over half (58.3%, n = 56) had never undergone previous eye screening. Participants with a family history were more likely to have had previous screening (odds ratio [OR] = 12.7 [2.9-55.8]). Participants with glaucoma/suspect status were modestly older (median 48 vs. 44 years), supported by a Mann-Whitney probability OR of 3.41 (1.45-13.93), showing increased probability of elderly amongst the affected group. Family history was associated with glaucoma/suspect classification (OR = 5.03 [1.54-16.45]).</p><p><strong>Conclusions: </strong>The high proportion of undiagnosed glaucoma and glaucoma suspects, even amongst a relatively young population, underscores the value of targeted, opportunistic workplace screening. Early detection is vital to prevent irreversible vision loss. Promoting family-based discussions and glaucoma disclosure and enhancing targeted awareness campaigns may improve screening participation and public health outcomes.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 2","pages":"269-275"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Predictors of Substance Use and Psychological Distress in Adolescents from Slum Areas of Dibrugarh, Assam, India.","authors":"Munpi Mayurakshi Mahanta, Varalakshmi Chandra Sekaran, Amrtavarshini Radhakrishna, Vidya Prabhu, Lena Ashok","doi":"10.4103/npmj.npmj_185_25","DOIUrl":"10.4103/npmj.npmj_185_25","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the prevalence and determinants of substance use and psychological distress amongst adolescents living in the slum areas of Dibrugarh, Assam.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted with 276 adolescents aged 12-19 years from randomly chosen four slums of Dibrugarh of India. This study has utilised two standard questionnaires: the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (WHO ASSIST V3.0) for assessing substance use and the Strengths and Difficulties Questionnaire for adolescent psychological distress.</p><p><strong>Results: </strong>The prevalence of substance use was found to be 35.8% and 23.9% of participants reported abnormal total difficulty scores. The key determinants included age, gender and family type.</p><p><strong>Conclusions: </strong>The findings highlight the urgent need for targeted interventions addressing both substance use and mental health issues in this vulnerable population.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 2","pages":"187-191"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study Assessing Patch Test Results in Hand and Foot Eczema Patients at a Tertiary Care Hospital.","authors":"C Balakumaran, G Sukanya, N Ashok Kumar, A Sakthi Megalai, M P Sankeerthana, Kavya Rajeev","doi":"10.4103/npmj.npmj_167_25","DOIUrl":"10.4103/npmj.npmj_167_25","url":null,"abstract":"<p><strong>Background: </strong>Eczema of hand and foot is one of the most common dermatological conditions encountered in the outpatient clinic. Both endogenous and exogenous factors can cause eczema identification and elimination of the triggering factor becomes essential.</p><p><strong>Aims and objectives: </strong>The primary objective of the study was to assess the diagnostic outcomes of patch testing in hand and foot eczema and to study the distribution of clinical patterns and aetiologies causing hand and foot eczema.</p><p><strong>Materials and methods: </strong>Thirty patients diagnosed with hand and foot eczema had a patch test using Indian standard battery series. This prospective observational study was carried out over 18 months at a tertiary care hospital in Chromepet, Chennai, Tamil Nadu, India. Data entry was done on Microsoft Excel and data analysis was done using SPSS 22 version. P < 0.005 was considered to be significant throughout the study. Patients diagnosed with hand and foot eczema had patch test done using indian standard battery series. The patients were followed up at 48 and 72 h, respectively, and the results were interpreted using international contact dermatitis research group (ICDRG) grading.</p><p><strong>Results: </strong>The study population comprised predominantly of 18 (60%) males and 12 (40%) females with 16 (53.3%) of the entire study population being 41-60 years. Hand eczema was the most common presentation: 19 (63.3%) patients, with itching reported in 29 (96.75%) patients and dryness in 24 (80%) patients, bilateral involvement was observed in 25 (83.3%) cases. The most common exposure was to gloves in 15 (50%) patients followed by detergents in 9 (30%) patients. Hyperkeratotic hand and foot eczema was the most frequent morphological finding documented in 6 patients (20%). Of the 30 patients who had patch testing done, 9 patients (30%) had one positive antigen, 3 had (10%) had three positive antigens, 1 patient (3.3%) had two positive antigens and 17 (56.7%) patients had no positive antigens. The most common antigen was potassium dichromate (25%).</p><p><strong>Conclusion: </strong>Hand and foot eczema remains a challenging dermatological condition due to its chronicity and multifactorial aetiology. Hand eczema is more prevalent than foot eczema and comprises a major part of occupational dermatoses. Patch test being a non-invasive tool helps in ascertaining the causative allergen and plays a significant role in the management of eczema, as avoidance of the allergen forms the cornerstone in the treatment of eczema.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 2","pages":"285-288"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Scoring Systems (SMART-COP vs. CURB 65) in Predicting the Need for Vasopressor and Mechanical Ventilation Support in Patients with Community-acquired Pneumonia.","authors":"Karra Keerthi Reddy, S Siva Prakash, Nirmala Devi Chandrasekaran, Janardhana Subramonia Kumar, Raviteja Nalabothula, Manne Lakshmi Narasimha Sandeep","doi":"10.4103/npmj.npmj_401_25","DOIUrl":"10.4103/npmj.npmj_401_25","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) is one of the major causes of morbidity and mortality worldwide, and it often requires intensive care interventions with vasopressor support and mechanical ventilation. Accurate risk stratification is essential for optimising clinical decision-making. While both SMART-COP and CURB-65 scoring systems are used for CAP severity assessment, their predictive abilities for intensive care needs remain debated.</p><p><strong>Aims: </strong>The aim of the study was to see if SMART-COP or CURB-65 more accurately predicts the need for vasopressors and ventilators in CAP patients.</p><p><strong>Materials and methods: </strong>This prospective observational study observed patients over a 9-month period at SRM Medical College Hospital and Research Center, enrolling 98 adult CAP patients. Clinical and laboratory parameters were recorded at admission, and patients were stratified using SMART-COP and CURB-65 scores. Statistical analyses included sensitivity, specificity, Chi-square tests, logistic regression, and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>SMART-COP demonstrated superior sensitivity for predicting vasopressor support (85.7%) and mechanical ventilation (80.0%) compared to CURB-65 (42.9% and 36.0%, respectively). The area under the ROC curve for SMART-COP was higher (0.782 for vasopressor support, 0.745 for mechanical ventilation) than CURB-65 (0.612 and 0.595, respectively). Logistic regression confirmed SMART-COP as a stronger predictor of critical care interventions (P < 0.001).</p><p><strong>Conclusion: </strong>SMART-COP more accurately predicts the need for vasopressors and ventilators in CAP patients than CURB-65. These findings support its integration into clinical protocols for better risk stratification and resource allocation. Further studies are required to validate these findings in larger cohorts.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 1","pages":"97-102"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lost in the Digital World: The Effects of Internet Addiction and Internet Gaming Disorder on Sleep and Mental Well-being of Medical Students in the Konkan Region of India.","authors":"Avinash Borkar, Balwant Masurkar, Namita Deshmukh, Gajanan Velhal, Himani Shemar","doi":"10.4103/npmj.npmj_234_25","DOIUrl":"10.4103/npmj.npmj_234_25","url":null,"abstract":"<p><strong>Background: </strong>Internet Addiction (IA) and Internet Gaming Disorder (IGD) may provide significant challenges for medical students as it is linked to sleep and mental health can obstruct academic pursuits, affect long-term professional aspirations and yield extensive adverse effects on society at large.</p><p><strong>Objectives: </strong>To find the prevalence of IA, IGD, insomnia and depression amongst medical undergraduates and to examine their correlation.</p><p><strong>Materials and methods: </strong>A mixed-methods study was conducted amongst 402 undergraduate medical students at a rural medical college. Data were gathered by a semi-structured, self-administered questionnaire encompassing socio-demographic information, the Young Internet Addiction Test, the short form of the Internet Gaming Disorder Scale (IGDS-SF), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire. Focus group discussions were done with 56 students chosen for their high scores in IA and IGD. Thematic analysis was employed to discern patterns and themes within the qualitative data. Data triangulation was conducted to interpret and elucidate the quantitative results using qualitative observations.</p><p><strong>Results: </strong>The mean age of the study participants was 20.39 ± 1.43 years. IA was present in 41.04%, gaming disorder in 20.89%, insomnia in 36.56% and depression in 14.42% participants. Year of study and hostel stay had a statistically significant association with all (P < 0.002). There was a strong and statistically significant association found between IA and IGD with depression and insomnia (P < 0.0001). Furthermore, a statistically significant correlation was found between scores and grades of IA and IGD; and insomnia and depression.</p><p><strong>Conclusion: </strong>Internet usage amongst medical students was notably high (40%) and showed a significant association with insomnia and depression. Hence, early identification of students at risk for IA and IGD is crucial, as these addictions often overlap with other psychological issues.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 1","pages":"29-37"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of Brain Death amongst Neurologists, Neurosurgeons and Intensivists in Saudi Arabia: A Cross-sectional Study.","authors":"Lamees Fahad Alharbi, Maryam Waleed Shaheen, Rawan Saleh Alnaim, Sarah Nasser Alsherian, Noor Aljaffar, Kawther Hadhiah","doi":"10.4103/npmj.npmj_204_25","DOIUrl":"10.4103/npmj.npmj_204_25","url":null,"abstract":"<p><strong>Background: </strong>Brain death (BD) is the irreversible loss of brain function, assessed through consciousness, brainstem reflexes and apnoea testing. Previous research indicates that experienced physicians perform better in BD determination, underscoring the need for structured education.</p><p><strong>Objective: </strong>This study evaluates the level of knowledge about BD amongst physicians in Saudi Arabia, comparing expertise across neurology, neurosurgery and intensive care and investigating knowledge gaps.</p><p><strong>Subjects and methods: </strong>Amongst 162 physicians surveyed, the majority were aged 25-35 years (61.7%) and male (65.4%). Most were Saudi nationals (84.6%) and worked in governmental hospitals (92.0%). Intensivists comprised the largest speciality group (45.1%). Despite 95.1% having encountered BD patients, 41.4% felt that criteria were not well understood in their medical community. Confidence in diagnosis was 49.4%, while 51.9% had formal training. A cross-sectional study was conducted using an online questionnaire, targeting neurologists, neurosurgeons and intensivists through snowball sampling. Data were analysed using the SPSS 29.0.0.</p><p><strong>Results: </strong>Significant associations were found between knowledge levels and factors such as age (P < 0.001), nationality (P = 0.009), experience (P < 0.001), and confidence in diagnosis (P = 0.025). Multivariate analysis identified years of experience (P = 0.011, Exp (B) = 2.338, 95% confidence interval: 1.211-4.514) as the strongest predictor of high knowledge..</p><p><strong>Conclusion: </strong>The findings highlight the variability in physicians' understanding of BD, emphasising the need for enhanced training programmes and refresher courses to improve competency in diagnosis and criteria adherence.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 1","pages":"17-24"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Utility of Apparent Diffusion Coefficient Values of Spleen and Liver in Assessment of Severity of Portal Hypertension and Liver Cirrhosis.","authors":"Kommuri Siddhardha, S Jalaludheen, Senthil Kumar Aiyappan","doi":"10.4103/npmj.npmj_333_25","DOIUrl":"10.4103/npmj.npmj_333_25","url":null,"abstract":"<p><strong>Background: </strong>Portal hypertension (PH) is a significant effect of chronic liver disease (CLD), resulting in variceal haemorrhage, ascites and hypersplenism. Apparent diffusion coefficient (ADC) and diffusion-weighted imaging (DWI) values serve as potential non-invasive indicators for evaluating the PH and liver fibrosis.</p><p><strong>Aims: </strong>This study evaluated the impact of portal hypertension on the ADC values of the liver and spleen and related PH severity with the Child-Pugh score.</p><p><strong>Materials and methods: </strong>A cross-sectional study was performed with individuals exhibiting clinical and radiological indications of CLD and PH and also with healthy controls. Magnetic resonance imaging was employed to assess spleen and liver ADC values, which were linked with clinical severity of diseases.</p><p><strong>Results: </strong>Liver ADC levels were substantially reduced among patients with cirrhosis when compared with controls, suggesting the existence of fibrosis. Conversely, spleen ADC values were elevated in affected patients, signifying splanchnic congestion. A particular spleen ADC level showed elevated sensitivity and specificity for detecting severe illness. Liver ADC reduced and spleen ADC enhanced with worsening Child-Pugh classification. An increased spleen ADC correlated with variceal hypersplenism and haemorrhage.</p><p><strong>Conclusion: </strong>DWI-derived ADC values constitute a non-invasive, reliable method for assessing liver fibrosis and the severity of PH, hence validating their application in clinical evaluation and early management for patients with CLD.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 1","pages":"118-124"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}