Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography

STUDY DESIGN: Descriptive cross-sectional study. PURPOSE: To determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography. OVERVIEW OF LITERATURE: There is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries. METHODS: A retrospective study was conducted on abdominopelvic computed tomography (CT) scans performed between January 1st 2015 and December 31st 2015 for various clinical indications. Patients with lower back pain, with a history of trauma or road traffic accident, or referred from orthopedic or neurosurgery departments were excluded to avoid any bias. CT scans were reviewed in axial, sagittal, and coronal planes using bone window settings for evaluating spondylolysis and spondylolisthesis. RESULTS: Of 4,348 patients recruited, spondylolysis and spondylolisthesis were identified in 266 (6.1%) and 142 (3.3%) patients, respectively. Age was significantly higher in both spondylolysis and spondylolisthesis patients than in those without spondylolysis and spondylolisthesis (47.19±15.45 vs. 42.5±15.96, p60 years old, both spondylolysis (p=0.018) and spondylolisthesis (p=0.025) were significantly more prevalent in females. CONCLUSIONS: The prevalence of pars interarticularis fracture observed higher with gradual increase in the prevalence with advancing age. In particular, preponderance was significantly higher among older females.

Yield and safety profile of ultrasound guided fine needle aspiration cytology [FNAC] of lymph nodes

Objective: To determine the re-biopsy rate, positive yield and safety profile of ultrasound guided fine needle aspiration cytology [FNAC] in cervical lymph nodes in terms of its complications and repeat procedures

Study Design: An analytical study

Place and Duration of Study: Department of Vascular and Interventional Radiology, Dow University Hospital, Dow University of Health Sciences, Karachi, from June to December 2013

Methodology: Eighty neck swellings, which were found to be lymph nodes on ultrasound, underwent ultrasound guided FNAC, from outpatients. Lymph nodes which were included in the study were those that were not easily palpable, located near major blood vessels, where patient refused of direct palpation and wanted image guided FNAC, those directly sent by physician for image guided FNAC and where blind biopsy remained inconclusive. Patients who refused on explanation or did not give consent were excluded. Complications and repeat biopsy were noted

Results: This study consisted of 80 cases, of which 51 cases [63.75%] were female and 29 cases [36.25%] were male. Repeat biopsy was required in 1 case [1.6%]. There were no procedure-related complications. A total of 44 cases [55%] revealed evidence suggesting or confirming the existence of tuberculosis. Rest of the others showed other benign lesions, reactive lymphadenopathy and malignancy

Conclusion: Ultrasound guided FNAC is a safe procedure with low re-biopsy rate that aids diagnosis. The predominant cause of cervical lymphadenopathy in this study was tuberculous lymphadenitis

Evaluation of number of renal arteries in live related renal donors by CT angiography and conventional angiography

Renal transplantation represents the best available replacement treatment for patients with end stage renal disease patients than performing dialysis, and living donor transplantation has been shown to offer better graft survival than cadaver donor renal transplantation. It was demonstrated that kidneys from living, unrelated donors succeed as well as kidneys obtained from brothers and sisters who share half of the tissue matching antigens with kidney recipients. The study was carried out at department of Angiography, Sindh Institute of Urology and Transplantation [SIUT] from January 2009 to September 2011. A total of 30 patients were included in the study. Informed consent was taken from all patients. Result demonstrates a total of 115 renal arteries in 60 kidneys of donors were depicted at CT angiography [CTA]. Only 57 of kidneys showed more than one or multiple arteries, 52 of these had two renal arteries, and 6 had three renal arteries

Evaluation of patients undergoing transarterial chemoembolization [tace] for hepatocellular carcinoma with respect to tumor size, site and number of lesions

TACE is the combination of two procedures, an infusion of the mixture of chemotherapeutic agents [e.g. doxorubicin, cysplatin, or mytomycin C] and hepatic artery embolization in which particles such as polyvinyl alcohol or gelfoam, are injected simultaneously into selected branches of the hepatic artery supplying the tumor. Hepatocellular carcinoma is rarely seen before the age of 40 years and reaches a peak at around 70 years of age. Owing to its multicentricity, large tumor size and pre-existing cirrhosis most of these tumors were deemed unrespectable at the time of diagnosis. The purpose of this study was to evaluate the tumor size, site and number of lesions that is acquired on hepatic angiogram during TACE of the liver, and compare it with the information provided by pre-interventional contrast enhanced CT images as there is a possibility that CT may not show smaller lesions. This study was carried out in the Department of Angiography, Sindh Institute of Urology and Transplantation [SIUT] from May to October 2011. A total of 30 patients was included in the study. All individuals underwent pre-procedural imaging with contrast material, enhanced CT angiography or MR to ensure that the disease was liver-dominant and to visualize the blood vessels of the liver. This study included 30 patients age ranges 40-80 years, 22 of whom were males and 8 of them were females. HCC had been diagnosed in all patients. Each patient underwent selective Hepatic Chemoembolization in either the right, left or in both lobes.. In comparison to CT, the hepatic angiogram showed 14[46.6%]patients having single lesion, 7[23.3%] were having double lesions and 9 [30%] were having multiple lesions. So the overall sensitivity of hepatic angiogram in the detecting number of lesions is 75% - 80%. The size of 3cm were found in 7[21%] patients and HCC >4cm was found in 15[44.4%] patients.The size of the HCC which we found in most of the patients during our study is >4cm.