Diagnostic accuracy of MR mammography in diagnosing malignant breast lesions taking histopathology as gold standard

Objective: To find out the diagnostic accuracy of MR Mammography in diagnosing malignant breast lesions taking histopathology as gold standard

Study Design: Cross-sectional survey

Place And Duration Of Study: Department of Radiology in collaboration with Department of Pathology, Sir Ganga Ram Hospital, Lahore, from April 2015 to April 2016

Methodology: 150 female patients with either suspicious mammographic findings or palpable lesions suspicious for malignancy referred from surgical OPD of Sir Ganga Ram Hospital were assessed. Dynamic contrast enhanced MRI was done on 1.5 Tesla MRI machine and the images were evaluated on morphological and kinetic basis. MR findings were then compared with preoperative FNAC and biopsy findings

Results: The mean age of the patients was 52.5 +/-13.4 years with maximum patients of age group 46-55 years. Out of 150, 118 [78.6%] patients were found to have malignant lesions on MRM while 116 [77%] patients were proved to have malignant lesions on histopathology. There was 93.9% sensitivity, 73.5% specificity, 89.3% diagnostic accuracy, 92.3% PPV, and 78.1% NPV of MR mammography in diagnosing malignant breast lesions taking histopathology as gold standard

Conclusion: Breast MRI has high sensitivity, specificity, and diagnostic accuracy in diagnosis of malignant breast lesions and must be used as primary imaging tool for proper characterisation of the breast lumps

Manual vacuum aspirator: a safe and effective tool for decentralization of post miscarriage care

To compare the efficacy and safety of Manual Vacuum Aspiration [MVA] performed as outpatient versus inpatient procedure in terms of success rate, blood loss, hospital stay and procedure related complications. A quasi-experimental study. Maternal and Child Health Centre [MCHC], Unit-I, Pakistan Institute of Medical Sciences [PIMS], Islamabad, from December 2009 to December 2010. Cases with early pregnancy failure [incomplete, missed and an embryonic] at gestational age less than 12 weeks were allocated to MVA as outpatient or elective procedure performed in the operation theatre. Studied variables were noted as above. A total of 177 women were eligible for study, out of whom 78 underwent MVA as outpatient procedure and 99 as indoor procedure. The baseline characteristics were comparable in both groups except significantly high multipara in the indoor group. Complete evacuation was achieved in 96.1% in outpatient vs. 79.7% in indoor cases [p=0.001]. Outpatient group had a shorter hospital stay [median 3 hours, IQR-1 vs. 10 hours, IQR-4; p < 0.001], though the median hospital cost was less but statistically insignificant [Rs. 800, IQR-25 vs. 735, IQR-1265; p=0.728]. Blood loss was comparable in both groups [median 60 ml, IQR-20 vs. 60 ml-IQR-30; p=0.350]. There were two uterine perforations noted in the inpatient group [2.02%] vs. none in outpatient setting. Outpatient based manual vacuum aspiration is a safe and effective tool for management of early pregnancy loss. A decentralized approach proved useful in reducing hospital stay

Prevalence, knowledge, attitude and practice of shisha smoking among medical and dental students of Karachi, Pakistan

To determine the prevalence of shisha smokers among medical and dental students of Karachi and assess their knowledge, attitude and practice regarding shisha, and the effect of discipline [medical/dental] and year of professional education with their responses. Cross sectional, observational study. One thousand two hundred and four students from the six medical/dental colleges of Karachi participated in the study. The present study was conducted during April and May of the year 2007. The questionnaire consisted of personal questions like gender, field of study, name, and year of study; smoking habits, frequency and place of smoking, attitude and knowledge about diseases developed due to shisha smoking. Chi-square test was used to find relationship between independent variables i.e. field of study [medical/ dental], and year of study [1[st], 2[nd], 3[rd], 4[th] and final year] with response variables. The mean age of the participants was 20.2 +/- 1.6 years. Two hundred and seventy three students [22.7%] indicated that they smoke shisha. One hundred and nineteen of the male students [41.2%] and 154 female students [16.8%] indicated positively for shisha smoking. Dental students showed 13% higher prevalence of shisha smoking than medical students [p<0.0001]. Eighty percent of respondents selected either restaurants or 'shisha bar' for the place of smoking. Sixty four percent of the respondents were influenced by their friends to adopt this habit. Eighty one percent of the respondents admitted that shisha smoking was harmful. Twenty eight percent of the respondents believed an association between shisha smoking and cancer, and about a quarter related it with heart diseases. Thirty eight percent of the shisha smokers were also involved in cigarette smoking. High prevalence of shisha smoking was observed among medical and dental students. However, most of them had adopted this habit as leisure and for socialization. The awareness about the health hazards due to shisha smoking is needed as an intervention to extricate them from this habit

comparison of efficacy and safety of vaginal misoprostol and dinoprostone for labour induction

To prove the efficacy of misoprostol for labour induction, to ascertain its safety and to determine the frequency of complications of the vaginal use. An interventional comparative study. April 2004 to March 2005. Fauji Foundation Hospital, Rawalpindi. The study was conducted for induction of labour at term by using two different kinds of labour induction agents [Dinoprostone and Misoprostol]. A total of 112 women were included in this study. With the vaginal use of these two drugs, data regarding obstetrical, fetal and neonatal outcomes was collected and analyzed. The mean induction to delivery interval was lesser in misoprostol group as compared to dinoprostone group [11.14 +/- 3.47 hrs versus 15.05 +/- 5.21hrs, p-value: <0.01]. Cesarean section rate was higher in dinoprostone group as compared to misoprostol group [30.35% vs 21.42%,]. Tachysystole and hyper stimulation were experienced more frequently in misoprostol group but was statistically insignificant [p-value: > 0.05]. The Apgar score of neonates in both groups was comparable at one minute [6.96 +/- 1.40 vs 7.18 +/- 1.08, and at 5 minutes [8.48 +/- 0.83 vs 8.66 +/- 0.64] Both misoprostol and dinoprostone appear to be effective agents for labour induction, but misoprostol has shorter induction to delivery interval, requires less oxytocin and has comparable neonatal outcomes