ABSTRACT
Objective: To determine frequencies of different MRI patterns of tuberculous spondylitis in a public sector hospital in Karachi
Methods: This descriptive multidisciplinary case series study was done from October 25, 2011 to May 28, 2012 in Radiology Department and Department of Medicine in the Jinnah Postgraduate Medical Center Karachi. MRI scans [dorsal / lumbosacral spine] of the Patients presenting with backache in Medical OPD, were performed in Radiology Department. Axial and sagittal images of T1 weighted, T2 weighted and STIR sequences of the affected region were taken. A total of 140 patients who were diagnosed as having tuberculous spondylitis were further evaluated and analyzed for having different patterns of involvement of the spine and compared with similar studies
Results: Among frequencies of different MRI pattern of tuberculous spondylitis, contiguous vertebral involvement was 100%, discal involvement 98.6%, paravertebral abscess 92.1% cases, epidural abscess 91.4%, spinal cord / thecal sac compression 89.3%, vertebral collapse 72.9%, gibbus deformity 42.9% and psoas abscess 36.4%
Conclusion: Contiguous vertebral involvement was commonest MRI pattern, followed by disk involvement, paravertebral and epidural abscesses, thecal sac compression and vertebral collapse
ABSTRACT
Objective: To estimate the effect of portal pressure lowering drug 'octreotide, by observing the Doppler waveform before and after the administration of intravenous bolus of octreotide and thus to assess indirectly its efficacy to lower the portal pressure
Methods: This quassi experimental study was carried out in Medical Department in collaboration with Radiology Department of Jinnah Postgraduate Medical Center Karachi Pakistan from September 10, 2015 to February 5, 2016. Cases were selected from patients admitted in Medical Wards and those attending Medical OPD. Diagnosis of cirrhosis was confirmed by Clinical Examination and Lab and Imaging investigation in Medical Department
Doppler waveform study was done by experienced radiologist in Radiology Department before and after administration of octreotide
Doppler signals were obtained from the right hepatic vein. Waveform tracings were recorded for five seconds and categorized as 'monophasic', 'biphasic and 'triphasic'. Waveform changes from one waveform to other were noted and analyzed
Results: Significant change i.e. from 'monophasic' to 'biphasic' or 'biphasic' to 'triphasic' was seen in 56% cases while 'monophasic' to 'triphasic' was seen in 20% cases. No change was seen in 24% cases. Improvement in waveform reflects lowering of portal vein pressure
Conclusion: Non invasive Hepatic vein Doppler waveform study showed improvement in Doppler waveform after administration of octreotide in 76% cases. Doppler waveform study has the potential of becoming non invasive 'follow up tool' of choice for assessing portal pressure in patients having variceal bleed due to portal hypertension