ABSTRACT
Objective: To assess the diagnostic accuracy of CT scan in detecting paranasal sinus fungal infections
Study Design: Cross-sectional, observational study
Place and Duration of Study: Department of Radiology, Ziauddin University Hospital, Karachi, from April to September 2014
Methodology: Patients with clinical suspicion of fungal sinusitis were included in this study. Patients with already diagnosed or history of recurrent fungal infections were excluded. All these patients underwent CT scan examination of paranasal sinuses. Findings were recorded. Final diagnosis was based on smear analysis for fungal culture. Accuracy analysis was conducted for CT diagnosis using smear analysis as the gold standard. Kappa analysis was conducted to determine agreement
Results: Out of the 120 patients, 71 [59%] were male. The sensitivity, specificity, positive predictive value and negative predictive value of CT were 96.19%, 93.33%, 99.01%, 77.77%, respectively. The diagnostic accuracy was 95.83%. Kappa statistics showed 82% agreement beyond chance
Conclusion: CT scan is highly accurate in diagnosing and characterizing fungal infection of paranasal sinuses. It also determines the extent of disease which eventually aids in deciding the surgical approach to be used
ABSTRACT
Ectopic pregnancy [EP] is one of the leading causes of maternal mortality. Its frequency in Pakistan is 1:13 pregnancy.1 Tubal ectopic often becomes symptomatic in first trimester by eroding the tubal wall and causing hemorrhage and shock. It is very rare for an ectopic to progress into second trimester and remain asymptomatic2. We are reporting a rare case of tubal ectopic pregnancy which ruptured at 16 weeks of gestation with non-viable fetus. We report a case of 27-year-old female who presented to the emergency of Dr. Zia Uddin Hospital, North Nazimabad, Karachi, with bleeding per vagina and abdominal pain with history of 4 months of amenorrhea. Ultrasound showed 16 weeks fetus in abdomen without cardiac activity and severe hemoperitoneum. She was diagnosed as a case of non-viable, ruptured, tubal ectopic pregnancy of 16-week gestational age. Diagnosis of ectopic pregnancy in first trimester can avert rupture and potential mortality and morbidity. Very few cases of second trimester ectopic pregnancy are reported. The purpose of this case report is to draw the attention for the potential of such incidence in this region and prompt management of such situation.
ABSTRACT
Objective: To determine the diagnostic accuracy of Computed Tomography [CT] in patients with neck and mediastinal lymphoma and correlate with gold standard histopathology results. Period: This study was conducted during six months period extended from March 2013 to September 2013. Setting: Department of diagnostic radiology, Dr. Ziauddin University Hospital, Karachi
Methodology: A total of 366 patients presenting with sign and symptoms such as fever, night sweats, weight loss or having any swelling in the cervical region were included and CT was performed; regardless of scan result suggestive of either presence or absence of lymphoma; patients were followed and histopathological findings of each patient was collected and recorded on Performa. Other demographic variables were also obtained and data were analyzed by Statistical Package for the Social Sciences [SPSS] -17
Results: Sensitivity, specificity, positive and negative predictive value as well as accuracy of computed tomography in the detection of neck andmediastinal lymphoma were found to be 75%, 89.9%, 59.2, 94.8% and 87.4% respectively. For patients with 10 months duration of disease, the accuracy of CT scan was observed as 84.7% and 93.6% respectively
Conclusion: CT scan is cross-section modality of choice for evaluating patients with suspected malignant tumors. CT is readily available and has high accuracy in distinguishing a mass compared with other tumors