ABSTRACT
Objective: To validate diagnosis of acute appendicitis using grey scale ultrasound. Study Design: Cross sectional validation
Material and Methods: All the patients were referred to the sonography section of Emergency Radiology Department for suspected diagnosis of acute appendicitis. All patients of suspected appendicitis had ultrasound of abdomen. Indication of any above stated criteria resulted in appendicectomy of the patient. Patients were operated by conventional method of appendicectomy. Results regarding appendix by ultrasonography and surgical outcome were recorded on the proforma. Data entry and analysis were done by using SPSS 21. Place and Duration of Study: The study was conducted at Radiology Department, Armed Forces Institute of Radiology and Imaging [AFIRI] Rawalpindi, from Mar 2013 to Aug 2013
Results: Mean age of patients was 21.39 +/- 4.332 years. There were 77 [48.1%] male and 83 [51.9%] female patients. Clinically, there were 126 [79%] patients positive for appendicitis and on ultrasound findings 121 [76%] patients had appendicitis. Surgical outcome showed 125 [78%] patients as positive. Sensitivity and specificity of ultrasound for the diagnosis of appendix was 87.20% and 65.71%. While positive predictive value [PPV] and negative predictive value [NPV] of ultrasonography was 90.80% and 58.97% respectively. Overall diagnostic accuracy of ultrasound was 82.5%
Conclusion: In patients who present with clinically suspected acute appendicitis, imaging with ultrasound was effective technique to confirm the clinical diagnosis
ABSTRACT
Objective: To determine the diagnostic accuracy of Diffusion-Weighted Imaging [DWI] and Apparent Diffusion Coefficient [ADC] mapping in differentiating benign from malignant thyroid nodules by taking histopathology as the gold standard
Study Design: A cross-sectional analytical study
Place and Duration of Study: Department of Radiology at Combined Military Hospital [CMH], Lahore, from August 2012 to July 2013
Methodology: Thirty-five patients, who were referred to radiology department of CMH, Lahore, for ultrasound or Fine Needle Aspiration Cytology [FNAC] of thyroid gland, fulfilling the inclusion and exclusion criteria, were included in the study. They were evaluated on 1.5 Tesla MRI machine with T1- and T2-weighted imaging as well as fat suppressed technique. DWI was done using b-values of 0 and 1000 s/mm[2] and ADC values were calculated for the thyroid nodules. All of these patients were subjected to ultrasound guided core biopsy and histopathology results were correlated with ADC values
Results: The benign nodules showed facilitated diffusion while malignant nodules showed restricted diffusion. T-test was used to assess the difference in mean ADC values between benign and malignant nodules. The mean ADC value of the malignant thyroid nodules [0.94 +/- 0.16 x 10[-3] mm[2]/s] was significantly lower than that of the benign thyroid nodules [1.93 +/- 0.13 x 10[-3] mm[2]/s] [p-value < 0.05]. ADC value of 1.6 x 10[-3] mm[2]/s was used as a cut-off, for differentiating benign from malignant thyroid nodules. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of DWI and ADC values in differentiating benign from malignant thyroid nodules were 93%, 95%, 93%, 95% and 92.3%, respectively
Conclusion: DWI is a non-invasive diagnostic tool for characterization and differentiation between benign and malignant thyroid nodules. It not only decreases the burden of unnecessary surgeries when pre-operative FNAC and biopsy are inconclusive, but is also helpful in reaching a definite diagnosis when a nodule is not amendable to biopsy due to any reason
ABSTRACT
To know efficacy of combination of standard interferon alpha2b and ribavirin in chronic hepatitis C. Prospective and analytical. CMH Bahawalpur. Nov 2008 to Dec 2009. A total of 126 patients, 104 males and 22 females, fulfilling inclusion and exclusion criteria were started combination treatment. Of these, 110 [87.3%] completed the treatment while 16 [12.7%] patients couldnot complete the treatment so they were dropped out of this study. Patients were started on Interferon alpha2b in a dose of three million units sub-cutaneous [s/c] thrice a week along with daily Ribavirin 1000 milligram [mg] and 1200 mg orally for patients weighing less or more than 75 kilogram [kg] respectively. The primary outcomes, normalization of ALT and undetectable HCV-RNAby PCR, were determined at end of three and six months of treatment. From Nov 2008 to Dec 2009, a total of 110 patients were treated with combination of Interferon alpha2b and Ribavirin for 24 weeks. Sixty eight patients [62%], 52 males and 12 females showed [end of treatment response] [ETR]. Results of the study show effectiveness of the combination therapy of standard interferon and ribavirin for Chronic Hepatitis C. Results of this study are comparable to local and international studies
Subject(s)
Humans , Male , Female , Interferon-alpha , Ribavirin , Drug Therapy, Combination , Treatment Outcome , Prospective StudiesABSTRACT
Tumors of the colon and rectum are among the commonest of all gastrointestinal malignancies. It is a potentially curable disease, highly dependant on early diagnosis. The two most widely used diagnostic tools are the double contrast barium enema and colonoscopy. This study compares their diagnostic value in correlation with histopathology. This prospective study was conducted at Radiology Department, CMH Bahawalpur from September 2008 to September 2010. Total of 49 patients fulfilled the inclusion criteria. Patients of both sex and different age groups were included in the study. They underwent barium enema examination by the radiologist at Combined Military Hospital, Bahawalpur. In each of these patients colonoscopy was carried out after 02 weeks of barium enema by standard methods after proper preparation. Biopsies of all positive and suspicious lesions were obtained during colonoscopy. Histopathology was carried out at the laboratory. The findings were recorded and analyzed on SPSS 10.0. Of the 49 patients, 33 [67%] were males and 16 [32.65%] were females. The mean age of the study group was 53.5 Yrs [Range 25-82 yrs]. Histopathology revealed that out of 49 patients 46[93%] had colorectal carcinoma. Barium enema correctly diagnosed neoplastic lesions in 38 [77.55%] patients, whereas colonoscopy diagnosed correctly in 32 [65.30%] patients. Barium enema and Colonoscopy are complementary examinations with almost comparable sensitivity. Barium enema is safer, cost effective and more tolerated by the patients than colonoscopy therefore it should be preferred for initial evaluation of the colorectal carcinoma in our setup