Acute vertebral compression fracture: differentiation of malignant and benign causes by diffusion weighted magnetic resonance imaging

OBJECTIVE: To evaluate the sensitivity, specificity and accuracy of diffusion weighted (DWI) magnetic resonance imaging (MRI) in the diagnosis and differentiation between benign (osteoporotic/infectious) and malignant vertebral compression fractures in comparison with histology findings and clinical follow up. METHODS: The study was conducted at the Radiology Department, Aga Khan University Hospital (AKUH) Karachi. It was a one year cross-sectional study from 01/01/2009 to 01/01/2010. Forty patients with sixty three vertebral compression fractures were included. Diffusion-weighted sequences and apparent diffusion coefficient (ADC) images on a 1.5 T MR scanner were obtained in all patients to identify the vertebral compression fracture along with benign and malignant causes. Imaging findings were compared with histopathologic results and clinical follow-up. RESULTS: Diffusion-weighted MR imaging found to have, 92% sensitivity, 90% specificity and accuracy of 85% in differentiation of benign and malignant vertebral compression fracture while PPV and NPV were 78 % and 90% respectively. CONCLUSION: Diffusion weighted magnetic resonance imaging offers a safe, accurate and non invasive modality to differentiate between the benign and malignant vertebral compression fracture

Abstracts from the 7th annual neurology research day, shifa international hospital, islamabad

:It\u27s a cross sectional study conducted at CP clinic of Armed Forces institute of Rehabilitation medicine Rawalpindi from Jan 2012 to Jan 2013. All cerebral palsy children above 2 years of age and both genders were included in study. SPSS version 17 was used for data analysis

Willingness to Pay for Community-Based Healthcare Insurance Schemes in Developing Countries: A Case of Lahore, Pakistan

BACKGROUND: Healthcare costs and poverty are significant barriers to achieving universal access to healthcare. Thus, Community-Based Health Insurance Schemes (CBHIS) are regarded as an influential instrument for providing access to healthcare. For this purpose, this study was carried out in order to assess the community’s Willingness to Pay (WTP) for CBHIS and its determinants among the residents of Lahore City.METHODS: A cross-sectional study was adopted during the period of May 2018 to August 2018 to conduct a standardized questionnaire survey among targeted population of Lahore. A total of 250 households from lower, middle and upper-middle-class areas were approached randomly from which 200 participated in the survey, rendering a response rate of 90.9%. Sample size was determined by using single population proportion formula assuming 5% margin of error and 95% Confidence Interval (CI). Moreover, multiple regression analysis, Pearson’s correlation and t-test were employed to determine relationships between different variables affecting WTP.RESULTS: Sixty-four percent of the respondents were willing to pay for CBHIS. Among the remaining thirty-six% of unwilling the community, income level (p< 0.05, CI=0.34 to 1.11) and education level (p< 0.05, CI=0.52-1.37) were significant predictors of WTP. Moreover, strong positive relation (p<0.05) between people’s awareness and WTP for CBHIS was witnessed. The findings further suggested that the larger population of the willing community was not willing to pay more than 5000 Rs annually.CONCLUSION: Henceawareness level of the community regarding the benefits of CBHIS is a major hindrance. The key policy priority is to increase the community’s awareness regarding the benefits of CBHIS and to increase willingness to pay rate among public.&nbsp

Empyema thoracic presenting as low back ache

AbstractA 24 years old female was presented with a 2 weeks history of fever (high grade), cough, fatigue, shortness of breath, chest pain right side and low back ache. Patient prefers to lie towards right side. CECT thorax reveals empyema thoracic with paravertebral extension. Patient was put on IV antibiotic according to culture and sensitivity. Clinical and Radiological improvement was evident after 1 week

Morphometric analysis of glenoid cavity of dry scapulae and its role in shoulder prosthesis

Background: The lateral angle of scapula becomes truncated and broadened and form the glenoid cavity which shows variable morphology. There is a notch present on its anterosuperior part which gives its different shape. When this glenoid notch is indistinct its shape is piriform, when it is distinct it looks like inverted comma shape and when it is absent its oval shape. The shoulder joint is one among the most commonly dislocated joints in the body. The fracture of glenoid with dislocations is very common in the trauma. The detail knowledge about variation in anatomy of glenoid cavity like different shape, size and dimensions are important during designing and fitting of glenoid component for total shoulder arthroplasty. The objective of present study was to obtain anthropometric data of scapulae and the glenoid cavity specifically the diameters and various shape of glenoid belongs to population of Bihar and compare it to findings from other races of the world.Methods: The present study was a cross sectional study which has been carried out on 228 undamaged dry adult human scapulae in which 126 belongs to right side and 102 belongs to left side. The age and gender of the bones used in the study was not predetermined.Results: The most common shape of glenoid cavity recorded in the present study was pear shape (50.44%) followed by inverted comma shape (35.96%). The least common shape was oval (13.6%). The mean length of scapula was observed as 135.07±14.23mm, the mean breadth of scapula was 97.55±9.63 mm, the mean supero inferior glenoid diameter was 35.80±3.14mm, the mean antero posterior glenoid diameter 1 was 23.63±2.50mm, and the mean antero posterior glenoid diameter 2 was 16.17±2.24mm and mean glenoid cavity index was 66.40±8.14%. In all the above measurements bilateral differences was not statistically significant.Conclusions: The knowledge about the different shape and dimensions of glenoid are very important during designing and fitting of glenoid component for total shoulder arthroplasty. It is also helpful during evaluation of different pathological conditions like rotator cuff disease, osteochondral defects and Bankart lesion. Since the present study is conducted on a limited number of scapulae further cadaveric, radiological and clinical studies are indicated.

Role of Biraderism in Democratization in Punjab, Pakistan; a Conceptual Framework

Pakistan has been in pursuit for stable democratic system since its creation. The patronclient relationship is shaping and defining the general politics and the biraderi politics of Pakistan. These links also legitimize the politically dynamic biraderies‘ clench on means and resources as well as the transfer of these resources as a bequest to coming generations of biraderies. The process of democratization is directly correlated and undermined due to biraderism that makes its pace very sluggish and inactive. It has been considered irresistible for non-democratic forces. It is generally argued the prehistoric group identities like family, kinship and caste, or biraderi membership, played a more important role in determining voting behaviour than the individual‘s political rational preferences. This phenomenon is overwhelmingly rule in the life of an individual in a society which is still in the transitional phase of democracy. The settlement policies of social engineering of the British had worked very well in the central region Punjab specifically. This is a theoretical and analytical study that presents a conceptual framework between biraderism and democratization process. The process of democratization is a dependent variable and the dynamics of biraderism work as an independent variable

Duplication of hypoglossal canal in North Indian human skulls

Background: The hypoglossal canal is one among the permanent components of occipital bone of both human being and animal skull, which transmits the twelfth cranial nerve, meningeal branch of ascending pharyngeal artery and emissary veins. This is commonly known as anterior condylar canal. In some cases, this canal is divided by a bony spicule leading to a variant known as double hypoglossal canal. Such partition of hypoglossal canal predisposes the roots of twelfth cranial nerve to entrapment in the occipital bone during ossification which subsequently may leads to an alteration in the tongue movement as well as speech. The objectives of the present study were to obtain the incidence of the variant of double hypoglossal canal in north Indian population especially in Bihar and compare the incidence of such type of variation in skull of different parts of our country as well as various races of the world.Methods: The present study was carried out on 110 undamaged dry adult human crania of unknown age and sex for any variations in the hypoglossal canal or incidence of double hypoglossal canal.Results: We observed 15 cases (13.63%) of double hypoglossal canal in which 8 (7.27%) specimens had unilateral while 7 (6.36%) specimens had bilateral double hypoglossal canal. Double hypoglossal canal was more common in right side. In 5 cases (4.54%) unilateral bony spicules were seen.Conclusions: The study about the hypoglossal canal and its different variation is very important to clinicians, anatomist, forensic experts as well as anthropologists too. The knowledge about the different dimensions of hypoglossal canal is also very essential for neurosurgeons and radiologist for the planning of the surgeries around the posterior cranial fossa for tumors like schwannoma of hypoglossal nerve and treatment of sleep apnea syndrome. Hence the detailed morphometric study of hypoglossal canal will be helpful for the planning of surgical intervention around the base of skull becomes easier and safer

Association of NS1 Antigen, IgM, IgG Antibodies and RT-PCR in the Diagnosis of Dengue Virus Infection

Background: To determine the association of ELISA based serological markersNS1 antigen, IgM, IgG antibodies and RT-PCR in the diagnosis of dengue virus infection Methods: In this descriptive cross sectional study 420 serum samples from patients with suspicion of dengue fever were tested for detection of dengue by NS1 antigen ELISA, IgG, IgM ELISA. RT-PCR for dengue was carried out in all NS1 antigen ELISA positive cases for confirmation of dengue. Results: Out of 420 cases , 249 cases were positive for either one of the three markers NS1, IgM,IgG. Males constituted 71.66%.Two hundred and two (48.09%) were positive for NS1 only,13 (3.09%) were positive for NS1 and IgG, 07 (1.66%) were NS1, IgM and IgG positive,16 (3.80%) were positive for IgG only ,11 (2.61%) were positive for NS1 and IgM whereas 171 (40.17%) samples were reported negative for NS1, IgM and IgG.RT-PCR was conducted on 233 NS1 positive cases out of which 80.06% cases turned out positive. Maximum number of cases belonged to DEN-2 genotype. Conclusion: Early diagnosis helps in improved patient care, suitable treatment, prevents severe complications and helps limit the spread of the disease. RT PCR is  a reliable test for the  diagnosis of acute dengue fever

A new species of cucullanus (Nematoda: Cucullanidae) from marine edible fish Otolithus ruber (sciaenidae) based on light and Scanning Electron Micrscopy.

Based on light and scanning electron microscopical observations, a new species of Cucullanus Müller, 1777 (Nematoda: Cucullanidae) is described from the intestine of marine edible fishes Otolithus ruber (Schneider, 1801), were collected ( February 2006 to July 2007) from fresh landing of Karachi coast, Pakistan. Detailed light and scanning electron microscopy revealed some important taxonomical features like, Broader anteriorly, posterior end pointed, provided with small bifurcated spike at the tip of the tail. Lateral alae absent. Oral opening dorsoventrally elongate, surrounded by narrow membranous flange or collarette supported by row of numerous teeth. Three submedian cephalic papillae and a pair of prominent lateral amphids are present. Pseudobuccal capsule or esophastome wider than posterior part of esophagus. Deirids simple, just anterior to esophagus and intestinal junction. Tail broadly conical, bifurcated at the tip

Staging of endometrial carcinoma by magnetic resonance imaging: correlation with surgery and histopathology

OBJECTIVE: To evaluate the accuracy of MRI in staging of endometrial carcinoma, and comparison with surgery and histopathological findings. METHODS: A one year prospective cross-sectional study was conducted from 10/3/2005 to 31/5/2006, at the Radiology department, Aga Khan University Hospital (AKUH) Karachi. Fifty two patients with diagnosis of endometrial carcinoma, referred to radiology department for preoperative staging by MRI and had undergone surgery were included. RESULTS: MRI was found to be 79% sensitive, 85% specific and 80% accurate for staging endometrial carcinoma while PPV and NPV were 97% and 66% respectively. CONCLUSION: Magnetic resonance imaging is a good, safe, accurate and non invasive imaging modality in staging of endometrial carcinoma. It can be used as a first line radiological investigation in patients with endometrial carcinoma for treatment planning