Tehran University Medical Journal

The purpose of prenatal diagnosis tests is insisting of diagnosis of neonatal disorders, preparing a range of informed choices and making couples at risk to be ready for having children with genetic disorders as well. The aim of this article is to investigate all of the tests in order to determine the best one which has the lowest risk and the highest sensitivity. Screening tests (maternal blood test and ultrasonography for first and second trimester) are testing patients without symptoms who are at low risk. These tests are carried out in the early stages of pregnancy, and the risk of genetic diseases would be estimated. They are safe and also might be helpful in determining whether invasive prenatal genetic tests including chorionic villus sampling, amniocentesis, and percutaneous umbilical blood sampling are needed. Diagnostic test is insisting of invasive tests: amniocentesis, chorionic villus sampling (CVS), cordocentesis, and preimplantation genetic diagnosis (PGD), which is a genetic test on cells removed from embryos to help select the best ones to avoid some of genetic diseases, fluorescence in situ hybridization (FISH), QF-PCR, multiplex ligation probe amplification (MLPA), next generation sequencing (NGS), comparative genomic hybridization (CGH), and non-invasive tests: ultrasound, prenatal sonography, cell free fetal DNA, triple and quadruple screen: alpha fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), inhibin-A). These tests are intended for patients who have apparent symptoms and the results of their early stages of pregnancy have been positive. Non-invasive prenatal tests (NIPT), sometimes called noninvasive prenatal screening (NIPS), have features of both screening and diagnostic tests, but, now screening test is more considerable. Small fragments of DNA would be analyzed by this testing in which they are circulating in a pregnant woman’s blood. While most DNA is found inside a cell’s nucleus, these fragments are free-floating and not within cells, at this point, they are called cell-free DNA (cfDNA) which usually contain fewer than 200 DNA building blocks (base pairs). Non-invasive prenatal tests is more sensitive with the high degree of specify to determine trisomy 13, 18 and 21 in women who are at increased risk of having offspring with genetic disorders.

Background: Rotator cuff injuries are the most common causes of shoulder pain and supraspinatus muscle is usually involved. Clinical tests are available and inexpensive tools for assessment of shoulder dysfunctions. The empty can (EC) and full can (FC) tests are considered as shoulder gold standard tests. Recently, hug up (HU) test has been developed to assess the supraspinatus. So far, no ultrasonographic study has compared supraspinatus muscle thickness in these testing positions. The present study aimed to compare the supraspinatus muscle thickness in the hug up testing position with the full can and empty can testing positions in young and healthy women.
Methods: Forty healthy women (mean age 21.62±2.4 years) participated in this cross-sectional-comparative study from April to June 2018 in the Biomechanic Laboratory of Rehabilitation School, Shahid Beheshti University of Medical Sciences in Tehran, Iran. The supraspinatus muscle thickness was scanned during rest and contracted states with a 0.5 Kg weight cuff. For contracted states, (A) EC testing position: the arm was at 90º abduction in the scaption plane with the thumb-down, (B) FC testing position: the arm was maintained at 90º abduction in the scaption plane with the thumb-up, (C) HU testing position: the palm of hand was placed on the opposite shoulder with the elbow flexed.
Results: The Bonferroni test showed significant differences (P<0.001) between the muscle thickness in the rest and the testing positions. The muscle thickness in the empty can testing position was significantly less than the full can testing position (P=0.001), no significant difference was found between the muscle thickness in the hug up testing position compared to the full can and empty can testing positions.
Conclusion: All of the empty can, full can and hug up testing positions demonstrated increased mean muscle thickness when compared to the rest position and the greatest muscle thickness was in the full can testing position. It seems that supraspinatus muscle thickness in hug up testing position is similar with empty can and full can testing positions.