Evaluation of Cervical Disc Degeneration in Patients with Neck Pain on Magnetic Resonance Imaging

Background: Cervical disc degeneration is the most common pathology that in most of the cases  clinically present as Objective: To evaluate the cervical region abnormalities in patients with neck pain on magnetic resonance imaging. Methodology: In this descriptive study 180 adult patients were included. All patients had been collected from DHQ hospital Gilgit and Ghurki Trust teaching hospital. After informed consent, data were collected through 1.5 tesla GE (closed bore) and 0.35 tesla Hitachi (open bore) MRI machines. Results:  Findings show that among 180 adult patients, 136 presented with disc degeneration among which 81 were males and 55 were females. Among 81 males, 63 had disc degeneration at multiple levels while 18 had single disc degeneration. In females 35 patients showed multiple disc degeneration while 20 involved a single disc. Conclusion: It is concluded that disc degeneration is prevalent in males than females. Disc degeneration at multiple levels is higher than single disc degeneration in both genders. Keywords: Disc degeneration, magnetic resonance imaging. DOI: 10.7176/JHMN/99-03 Publication date: April 30th 2022

SONOGRAPHIC FINDINGS IN FEMALES OF REPRODUCTIVE AGE WITH ACUTE PELVIC PAIN

Background: Acute pelvic pain can result from the gynecological, urological systems and/or gastrointestinal. Ultrasound can be used as an initial imaging modality in the evaluation of acute pelvic pain. To determine sonographic findings in females of reproductive age coming with acute pelvic pain. Objective: To determine Sonographic findings in females of reproductive age with acute pelvic pain. Methodology: Toshiba Xario ultrasound machine with a standard gray scale and Doppler ultrasound convex probe of 3.5 MHz – 7.5 MHz or trans-vaginal probe of 5 MHz - 7.5MHz is used. Both transvaginal and trans-abdominal probes were used in this study. The study was conducted at Ultrasound University Clinic, Township, Lahore. Data of 163 patients was collected through convenient sampling. Statistical software for social sciences (SPSS version 22.0) is used for the analysis of data. Results: A total of 163 patients were examined in the study. The age incidence of the cases in this study varied between 15 years to 45 years. The mean age of the patients in the study was 29.8712 years. The uterine fibroid is most commonly involved in acute pelvic pain and is seen in 30.1% cases followed by simple ovarian cyst in 20.2% cases, hemorrhagic cyst in 14.1% cases. 8.6% cases with pelvic pain have no abnormal sonographic findings. Adenomyosis, PID and endometrial polyp in 4.3% each. Endometrial hyperplasia in 3.1%. Follicular cyst, simple adnexal cyst and complex adnexal cyst in 1.8% each, followed by ovarian endometrioma in 0.6% cases and dermoid cyst in 0.6%. In obstetric patients of acute pelvic pain; RPOCs are most common, constituting 1.8% of total acute pelvic pain, molar pregnancy in 1.2%, ectopic pregnancy in 0.6% patients, subchorionic bleed in 0.6% cases. Conclusion: Ultrasound is a very good modality for acute pelvic pain, as it can easily diagnose and characterize the causes of pelvic pain. The wide availability, radiation free and cost effectiveness makes it a first line investigation in acute pelvic pain. In the present study, the most common cause of pelvic pain is uterine fibroid. Key words: Ultrasound (US), Pelvic inflammatory disease (PID), acute pelvic pain, retained products of contraceptives (RPOCs), pouch of Douglas (POD). DOI: 10.7176/JHMN/71-14 Publication date: February 29th 202

COMPARISON OF URINE JET VELOCITY IN VARIOUS GRADES OF HYDRONEPHROSIS IN THE CASE OF URETERIC OBSTRUCTION BY REAL-TIME

Introduction: Hydronephrosis is a common complication of the kidney that is caused by obstruction to kidney ureters and bladder. The renal pelvis and pelvicalyceal system of the kidney become dilated. The obstruction may either be in the upper or lower urinary tract. Upper urinary tract obstruction includes ureteropelvic junction obstruction, renal stone, tumours, and vesicoureteric junction obstruction while lower tract includes benign prostatic hyperplasia, prostate tumours posterior urethral valves. Material & Methods: This cross-sectional study was conducted at the Department of Radiology Lady Reading Hospital Peshawar, Pakistan. The study duration was 9 months (September 2020 and May 2021). A total of 120 participants were presented with a history of flank and are suspicious for renal stone causing hydronephrosis. 30 patients were taken as control with no renal disease while 90 were cases having renal disease. Grading of hydronephrosis and Urine jet velocity was recorded by using real-time and spectral doppler ultrasound. Results: A total of 120 participants were included in this study. The mean jet velocity in the normal individuals was recorded as 50.37 ± 6.4 cm/s, however, in patients with mild, moderate, and severe hydronephrosis the mean jet velocity was recorded as 14.23 ± 10.47 cm/s, 7.32± 8.14 cm/s and, 1.5 ± 3.98 cm/s respectively. Conclusion: Urine jet velocity is a good indicator of ureteric obstruction in a patient with various grades of hydronephrosis. The velocity of the urine jet reduced significantly with increasing the severity of hydronephrosis

Frequency of Different Types of Focal Hepatic Lesions on Triphasic Computed Tomography Scan in Adult Patients

Out of various pathologies that affect the liver, focal liver lesion form an important group. Triphasic computed tomography is the imaging modality most often used to evaluate focal liver lesions. The purpose of this study was to evaluate the role of computed tomography in the diagnosis of liver lesions and to determine frequency of these lesions.Keywords: Liver, focal lesion, liver parenchyma, enhancement, iso-dense, hypo-dense and hyper-denseDOI: 10.7176/JHMN/77-04Publication date:July 31st 202

Predicted risk factors associated with secondary infertility in women: univariate and multivariate logistic regression analyses

IntroductionInfertile women are those who regularly engage in unprotected intercourse for a period of at least 1 year and are unable to become clinically pregnant. Primary infertility means the inability of couples to conceive, without any previous successful pregnancies. Secondary Infertility refers to the inability to get pregnant for 12 months, after having a previous pregnancy for one time at least. The objectives of the current study were to analyze risk factors for secondary infertility and compare the predictive accuracy of artificial neural network (ANN) and multiple logistic regression models.MethodsThe study was conducted at The University Institute of Public Health collecting data from Gilani Ultrasound Center 18 months after approval of synopsis. A total of 690 women (345 cases and 345 controls) were selected. The women selected for the case group had to be 20–45 years of age, had any parity, and had a confirmed diagnosis of secondary infertility.ResultsMultiple logistic regression (MLR) and ANN were used. The chance of secondary infertility was 2.91 times higher in women living in a joint family [odds ratio (OR) = 2.91; 95% confidence interval (CI) (1.91, 4.44)] and was also 2.35 times higher for those women who had relationship difficulties with their husband [OR = 2.35; 95% CI (1.18, 4.70)]. Marriage at an earlier age was associated with secondary infertility with β being negative and OR being < 1 [OR = 0.94; 95% CI (0.88, 0.99)]. For the logistic regression model, the area under the receiver operative characteristic curve (ROC) was 0.852 and the artificial neural network was 0.87, which was better than logistic regression.DiscussionIdentified risk factors of secondary infertility are mostly modifiable and can be prevented by managing these risk factors

Carotid artery Disease Assessed by Color Doppler Flow Imaging: Comparison Between Diabetic and Non-Diabetic Patients

Background: Carotid artery disease is most often seen in hypertensive patients and in patients with diabetes mellitus. More than 50% stenosis of extra cranial internal carotid arteries is linked with about 8–15% of ischemic strokes. The incidence of carotid artery stenosis (CAS) among diabetic patients is rising as compared to non-diabetic patients.  Methods: A cross-sectional study was performed on 120 patients, out of whom 60 were diabetic and 60 non-diabetics with clinically suspected carotid artery disease.  The study was conducted at the university ultrasound clinic in Green Town by Doppler ultrasonography using the Toshiba XARIO XG, which features a linear probe of 5-7.5 MHz frequency. The data was analyzed with the help of SPSS version 25.0. Variables like age, gender, diabetes, and Intima-media thickness (IMT) were reported and the mean ± standard deviation of Pulsatility Index, Resistive Index, Peak Systolic Velocity, and End Diastolic Velocity were calculated with a significant p-value, which is less than 0.05. An independent t-test was applied to compare Doppler indices in diabetic and non-diabetic subjects.Results: Data was collected from 120 patients. IMT of right and left carotid artery, PI and RI of right carotid were observed to be statistically significant in diabetic and non-diabetic.Conclusions: This study concluded that there is a significant correlation found between carotid artery disease and diabetes. Through ultrasonography, the presence of plaque and stenosis was found in more diabetic patients than in non-diabetic patients.Keywords: Ultrasonography; Carotid artery disease; Carotid artery stenosis; Carotid plaque; Vascular ultrasound; Diabetes   

Sonographic Evaluation of Splenic Dimensions in Healthy Pregnant and Non-Pregnant Women

Objective: To compare the ultrasonographic findings of splenic dimension in healthy pregnant and non-pregnant women. Methods: This analytical cross-sectional study was conducted at University Ultrasound Clinic, Lahore from August 2022 to February 2023. A total of 200 females (100 non-pregnant and 100 pregnant) were examined. Mindray and Toshiba Ultrasound Machines were used to perform the ultrasonography. The measurements of splenic length, width, and thickness were recorded. The length of the spleen was measured in a longitudinal view. The width of the spleen was measured in a transverse view. The anteroposterior diameter (thickness) of the spleen was also measured. Results: The overall mean age was 29.0 ± 7.8 years. The mean difference of splenic width, thickness, and volume were significantly higher in pregnant women as compared to non-pregnant women i.e., 5.58 ± 1.44 cm vs. 5.15 ± 1.42 cm (p-value 0.033), 6.37 ± 2.56 cm vs. 4.46 ± 1.10 cm (p-value <0.001), and 178.2 ± 97.90 cm³ vs. 118.8 ± 47.57 cm³ (p-value <0.001) respectively. A significant difference of splenic width (p-value <0.001) and thickness (p-value <0.001) were observed with respect to gestational age of the individuals. Moreover, mean difference of splenic width was significantly increased in age group 15-30 years as compared to 31-51 years i.e., 5.68 ± 2.25 cm vs. 4.94 ± 2.00 cm (p-value 0.022) respectively. Conclusion: In pregnancy, the splenic thickness and splenic volume is seen to be increased when compared to non-pregnant women.

COMPARISON OF HIGH-RESOLUTION SONOGRAPHY AND COLOUR DOPPLER FLOW IMAGING IN PATIENTS PRESENTING WITH ACUTE SCROTUM

Introduction: One of the most common urological emergency conditions is acute scrotum. Scrotal pain is commonly seen in early adults in the emergency departments with an association of different pathologies. The aim of this study was to determine the comparison of high-resolution sonography and colour Doppler flow imaging in patients presenting with acute scrotum. Material & Methods: A descriptive study was conducted at the Department of Radiology, Lady Reading Hospital, Peshawar, Pakistan. This study enrolled a purposive sample of emergency department patients presenting with acute scrotal pain. The pattern of blood flow, peak systolic velocity, resistive index, pulsatility index, mean and standard deviation were calculated for the continuous variables. Descriptive analyses were performed to investigate the distribution of data. Results: A total of 72 patients were enrolled in our study. The mean age of patients was recorded 36.33±11.66 years. The most common scrotal pathologies that associated with scrotal pain was hydrocele 31(38.8%), followed by varicocele 22(27.5%), testicular torsion 9(11.3%), cyst 8(10.0%), epididymo-orchitis 7(8.8%), pyocele 6(7.5%), orchitis 4(5.0%), increase scrotal wall thickness 3(3.8%), undescended testis 3(3.8%), inguinoscrotal hernia 1(1.3%), testicular atrophy 1(1.3%), rete testis 1(1.3%), hemangioma 1(1.3%), hematoma 1(1.3%), scrotal mass 1(1.3%), testicular microlithiasis 1(1.3%), and normal scrotal sonography 4(5.0%) of cases respectively. Conclusion: High-resolution ultrasonography along with colour and power Doppler should be used as 1st line imaging modality in patients presenting with acute scrotal pain

Comparison of Sonographic Quantitative Assessment of Splenomegaly in Thalassemia Patients Receiving Whole Blood and Packed Red Cell Transfusions

Objective: An observational cross-sectional study to assess sonographic splenomegaly quantitatively in thalassemia patients grouped with respect to transfusion given whole blood vs packed red cells. Methods: A study was conducted among 330 patients equally divided into two groups, undergoing an abdominal ultrasound examination with a transducer frequency ranging from 3-5 MHz during the period December 2021 to August 2022. An independent t-test was applied to compare the splenic volume in thalassemia patients given whole blood transfusions versus packed red cells transfusions, and Cohen's d was used to indicate the standardized difference between two ultrasound splenic volume means. Results: The mean splenic volume of the patients who received whole blood cells was 320.62 ± 219.05 cm3, which is greater than the patients who received packed red cells, whose mean was 60.72 ± 58.72 cm3, The splenomegaly was quantitatively assessed in six age groups ranging from 1 to 3 years, 4 to 6 years, 7 to 9 years, 10 to 12 years, 13 to 15 years, and 16-18 years and mean splenic volume in each age group was compared to those receiving whole blood or packed red cells transfusion. there is a statistically significant difference between both transfusion receiving groups, having a larger Cohen’s d size effect of 1.62. Conclusion: Ultrasound is a reliable imaging modality for assessing splenic volume and linear parameters of the spleen with greater splenomegaly in thalassemia patients with whole blood transfusions than those with packed red cells when quantitatively assessed according to relevant age groups. Thalassemia patients should be transfused packed red cells to delay splenomegaly, that should be assessed sonographically

Understanding the Common Misconceptions of Temperature (ΔT) and Heat (Q) for PSP and Non-PSP Teachers

This study investigates the comprehension of temperature (ΔT) and heat (Q) in elementary school physics. This research uses a case study technique involving one instance of temperature (ΔT) and heat (Q). Five hundred forty-seven prospective teachers participated in the research during the 2022-2023 school year. This study employs observation, interviews, and document analysis for data collection. This study, which included pre-service physics teachers (Psp) and in-service physics teachers (Non-Psp), was conducted in a classroom setting. In qualitative analysis, the participants\u27 methods of determining temperature change (ΔT) and heat (Q) were examined using descriptive-analytic approaches. Data collected from participants is analyzed based on prepared topics and direct quotations from the issues in which the results are consolidated. Research analysis indicates that participants struggle to differentiate between temperature (ΔT) and heat (Q) due to the reliance on rote teaching methods and students\u27 preconceived notions about nature that may not align with scientific concepts. When compared to scientific principles. Teachers lack understanding of the origin of temperature change (ΔT) and heat (Q). Studying temperature change (ΔT) and heat transfer (Q) involves practical applying issues and physics concepts. Both PSP and non-PSP teachers lack understanding of the ideas underpinning kinematics, which they are expected to teach in the classroom. Poor comprehension of essential concepts by teachers will hinder students\u27 learning outcomes. Teachers can define temperature. If he lacks an understanding of temperature concepts like Celsius, Kelvin, Reamur, and Fahrenheit, as well as the concept of heat connected to conduction, convection, and radiation, then... Under those circumstances, the teacher will struggle to educate efficiently