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Full-Text Articles in Medicine and Health Sciences

Multipara With Utero-Vesical Fistula Following Repeat Cesarean Section: A Rare Iatrogenic Complication, Gulnaz Shafqat, Anam Khan, Salma Azam, Rehana Murad Oct 2021

Multipara With Utero-Vesical Fistula Following Repeat Cesarean Section: A Rare Iatrogenic Complication, Gulnaz Shafqat, Anam Khan, Salma Azam, Rehana Murad

Department of Radiology

Utero-Vesical fistulas are the rarest of all urogenital fistulas, with most cases occurring after cesarean section. Its prevalence is increasing worldwide because of the increasing indications of cesarean section. Patient usually presents with urine leak, amenorrhea and cyclic hematuria. Herein, we present a case of patient presenting with complain of severe urinary tract infection following cesarean section. Review and update of recent literature regarding the diagnostic imaging of this entity are described.


Hepatocellular Carcinoma With Extrahepatic Blood Supply From Right Renal Artery, Amir Humza Sohail, Ahmad Musa, Muhammad Salman Khan, Hassan Raza Hashmi, Basit Salam, Collin E M. Brathwaite Oct 2021

Hepatocellular Carcinoma With Extrahepatic Blood Supply From Right Renal Artery, Amir Humza Sohail, Ahmad Musa, Muhammad Salman Khan, Hassan Raza Hashmi, Basit Salam, Collin E M. Brathwaite

Department of Radiology

Extrahepatic blood supply is seen in around 17-27% of hepatocellular carcinoma lesions. Evidence suggests that this extrahepatic supply most commonly originates from a right intercostal artery (70-83%) followed by left intercostal, omental and right renal arteries. Thus a comprehensive knowledge of variations in standard vascular anatomy and cognisance of factors influencing or predicting extrahepatic blood supply in HCC is instrumental in ensuring the success of surgical and interventional procedures. We present the unusual case of a 66-year-old male with HCC in Segment I of the liver with aberrant blood supply from the right renal artery in the absence of any …


Hospital-Based Ultra-Sonographic Prevalence And Spectrum Of Thyroid Incidentalomas In Pakistani Population, Faheem Ullah Khan, Kiran Hilal, Iftikhar Ali, Mehreen Samad, Rabiya Tariq, Wiqar Ahmad, Muhammad Arif Saeed, Noman Khan Aug 2021

Hospital-Based Ultra-Sonographic Prevalence And Spectrum Of Thyroid Incidentalomas In Pakistani Population, Faheem Ullah Khan, Kiran Hilal, Iftikhar Ali, Mehreen Samad, Rabiya Tariq, Wiqar Ahmad, Muhammad Arif Saeed, Noman Khan

Department of Radiology

Introduction: Thyroid incidentalomas (TIs) are clinically asymptomatic nodules found accidentally during imaging studies ordered for some other reasons. Being easily accessible, non-invasive, and inexpensive, thyroid ultrasound (US) is a key investigation in the management of thyroid nodules.
Methods: This ultrasound-based cross-sectional study was performed in the radiology department of a major tertiary care hospital. Every second patient visiting the emergency department was a potential candidate for a thyroid ultrasound. Patients having ages greater than 20 years were included in the study.
Results: A total of 250 patients were included in the study. Out of these, 175 were female and 75 …


Value Of Periappendiceal Fat Sign On Ultrasound In Acute Appendicitis, Ayesha Walid, Muhammad Azeemuddin, Zainab Hussain Jul 2021

Value Of Periappendiceal Fat Sign On Ultrasound In Acute Appendicitis, Ayesha Walid, Muhammad Azeemuddin, Zainab Hussain

Department of Radiology

Introduction: Acute right lower quadrant abdominal pain is one of the most common surgical presentations to the emergency department with acute appendicitis being the topmost differential diagnosis. Although computed tomography (CT) is the gold standard in diagnosing appendicitis, in our setup ultrasound is often the initial imaging modality available in urgent care settings especially for children and pregnant females. On ultrasound, an inflamed appendix has a diameter of 6 mm or more and is non-compressible. Increased periappendiceal fat echogenicity is an important ancillary sign of acute appendicitis that supports the sonographic diagnosis of acute appendicitis. To determine the association of …


Morel-Lavallée Lesion In A 35-Year Female, Amir Humza Sohail, Muhammad Talha Liaquat, Mohammed Sachal Sohail, Muhammad Salman Khan, Hazim Hakmi Mar 2021

Morel-Lavallée Lesion In A 35-Year Female, Amir Humza Sohail, Muhammad Talha Liaquat, Mohammed Sachal Sohail, Muhammad Salman Khan, Hazim Hakmi

Department of Radiology

Morel-Lavallée lesion is a post-traumatic degloving cyst, usually filled with blood, lymph or necrotic tissue, which mostly develops in the area around greater trochanter. Early diagnosis and prompt treatment is essential to prevent further complications, such as compression of surrounding structures. X-rays have limited use and magnetic resonance imaging (MRI) is the modality of choice in diagnosing the lesion. We report a case of a 35-year female presenting with left thigh pain after a fall from motorcycle almost 21/2 years ago. Ultrasound and MRI confirmed the presence of Morel-Lavallée lesion involving the left pelvis and upper thigh. Given the chronicity …


Angioembolisation For The Treatment Of Pseudo-Aneurysm Of Internal Maxillary Artery, Muhammad Azeemuddin, Anosha Khan, Atif Hafeez Siddiqui, Asad Shakil, Basit Salam, Raza Sayani Mar 2021

Angioembolisation For The Treatment Of Pseudo-Aneurysm Of Internal Maxillary Artery, Muhammad Azeemuddin, Anosha Khan, Atif Hafeez Siddiqui, Asad Shakil, Basit Salam, Raza Sayani

Department of Radiology

Pseudo-aneurysm of internal maxillary artery, following a road traffic accident, is a rare clinical scenario. The consequence of pseudo-aneurysm may be spontaneous rupture of the arterial wall, which may eventually lead to life-threatening hemorrhage. We report a case of a 20-year male who presented with recurrent epistaxis. CT scan was performed, which revealed a pseudo-aneurysm of the internal maxillary artery; this was successfully treated by angioembolisation. Similar cases of traumatic pseudo-aneurysms have been reported, however, none presented with recurrent epistaxis after management of pan-facial fractures. Key Words: Epistaxis, Pseudo-aneurysm, Angioembolisation, Pan-facial fracture.


Endovascular Coil Embolization Of Ruptured And Unruptured Intracranial Aneurysms: Review Of A 15 Year Single Center Experience In Pakistan, Misha Khalid Khan, Muhammad Danish Barakzai, Mustafa Belal Hafeez Chaudhry, Tanveer Ul Haq, Muhammad Ehsan Bari, Raza Sayani Feb 2021

Endovascular Coil Embolization Of Ruptured And Unruptured Intracranial Aneurysms: Review Of A 15 Year Single Center Experience In Pakistan, Misha Khalid Khan, Muhammad Danish Barakzai, Mustafa Belal Hafeez Chaudhry, Tanveer Ul Haq, Muhammad Ehsan Bari, Raza Sayani

Department of Radiology

Objective: To assess the outcome of endovascular treatment of intracranial aneurysm over 15 years.
Methods: The retrospective study was conducted at the at Radiology Department of Aga Khan University Hospital, Karachi, and comprised medical records from April 2003 to April 2018 of patients who received endovascular treatment for intracranial aneurysm. Multiple variables reviewed included demographics, clinical presentation, aneurysm morphology, technique used, technique outcome and clinical outcome. Data was analysed using SPSS 22.
Results: Of the 242 patients, 111(45.8%) were males and 131(54.1%) were female. The overall mean age was 46.3+/-13.543 years (range: 9-78years). Aneurysm size was <5mm in 95(40.4%) patients, 5-10mm in 98(41.7%) and >10mm in 42(17.9%) patients. …


The Association Of Chest Radiographic Findings And Severity Scoring With Clinical Outcomes In Patients With Covid-19 Presenting To The Emergency Department Of A Tertiary Care Hospital In Pakistan, Raima Kaleemi, Kiran Hilal, Ainan Arshad, Russell S. Martins, Avinash Nankani, Tanveer Ul Haq, Sundas Basharat, Zeeshan Ansar Jan 2021

The Association Of Chest Radiographic Findings And Severity Scoring With Clinical Outcomes In Patients With Covid-19 Presenting To The Emergency Department Of A Tertiary Care Hospital In Pakistan, Raima Kaleemi, Kiran Hilal, Ainan Arshad, Russell S. Martins, Avinash Nankani, Tanveer Ul Haq, Sundas Basharat, Zeeshan Ansar

Department of Radiology

Introduction: While chest x-rays (CXRs) represent a cost-effective imaging modality for developing countries like Pakistan, their utility for the prognostication of COVID-19 has been minimally explored. Thus, we describe the frequency and distribution of CXR findings, and their association with clinical outcomes of patients with COVID-19.
Methods: All adult (≥ 18 years) patients presenting between 28th February-31st May to the emergency department of a tertiary care hospital in Pakistan, who were COVID-19 positive on RT-PCR with CXR done on presentation, were included. A CXR Severity Score (CXR-SS) of 0-8 was used to quantify the extent of pulmonary infection on CXR, …


Imaging Patterns Of Encephalopathy In Patients With Covid-19, Kumail Khandwala, Fatima Mubarak, Nadeem Ahmad Jan 2021

Imaging Patterns Of Encephalopathy In Patients With Covid-19, Kumail Khandwala, Fatima Mubarak, Nadeem Ahmad

Department of Radiology

The aim of this retrospective observational study was to describe the neuroimaging manifestations of patients with COVID-19. This study was conducted at Aga Khan University Hospital, Karachi, Pakistan from March to July 2020. COVID-19 patients with neurological symptoms and positive neuroimaging were included after confirmation of COVID-19 by polymerase chain reaction test (PCR). In the 12 included patients, seizures and altered mentation were predominant neurological manifestations. Three cases had acute watershed infarcts (25%), two cases had posterior cerebral artery territorial infarcts (16.7%), two cases had periventricular corona radiata infarcts (16.7%), three cases had hypoxic ischemic encephalopathy (25%), two cases had …


To Determine The Efficacy Of Bilateral Inferior Petrosal Sinus Sampling In Differentiating Cushing Disease From Ectopic Cushing Syndrome, Muhammad Azeemuddin, Tanveer Ul Haq, Shahmeer Khan, Raza Sayani, Ayesha Shoukat Hussain, Rumaisa Khan Jan 2021

To Determine The Efficacy Of Bilateral Inferior Petrosal Sinus Sampling In Differentiating Cushing Disease From Ectopic Cushing Syndrome, Muhammad Azeemuddin, Tanveer Ul Haq, Shahmeer Khan, Raza Sayani, Ayesha Shoukat Hussain, Rumaisa Khan

Department of Radiology

Management of endogenous Cushing syndrome is based on its aetiology. Increased Adrenocorticotropic Hormone (ACTH) levels are the most common cause of this disorder and, therefore, it is critical to determine the source of ACTH before further management. Dynamic post contrast MRI is currently the most common investigation implied to diagnose pituitary adenoma; however, it comes with the drawback of low specificity and high false positive results. Inferior petrosal sinus sampling (IPSS) is an established invasive procedure performed to differentiate central versus peripheral source of ACTH which, in turn, results in hypercortesolaemia. This is a series of 14 patients who underwent …