Objective: To compare the sonographic findings of atherosclerotic changes in carotid arteries of diabetic and non-diabetic individuals. Material & Methods: A cross-sectional study of 62 diabetic and non-diabetic individuals was conducted from 11 November 2021 to 20 March 2022 at the Radiology Department of District Head Quarter Hospital, Faisalabad, Pakistan. The ultrasound of carotid arteries with a TOSHIBA MX Doppler ultrasound machine, using a linear probe with transducer frequency of 5-12.5MHz was performed in both diabetic and non-diabetic participants. Results: The mean value of CIMT in diabetic patients was 0.6839 ± 0.29178mm while the mean value of CIMT in Non- diabetic patients was 0.8000 ± 0.08563mm. The mean value of peak systolic velocity (PSV) of CCA in diabetic patients was 41.4194 ± 6.60189mm and the mean value of PSV of CCA in Non- diabetic patients was 41.7742 ± 6.52538mm. The mean value of PSV of ICA in diabetic patients was 58.4839 ± 12.03293mm and in Non- diabetic patients was 59.0323 ±10.03489mm. Similarly, the mean value of ICA/CCA ratio in diabetic patients was 1.4097 ± 0.39442 while in non-diabetic patients was 1.4323 ± 0.30374. Conclusion: The diagnostic accuracy of ultrasonography of common carotid artery, and internal carotid artery is very high for atherosclerosis. The use of sonography for measurement of IMT and plaque area act as a vital tool for the detection of atherosclerosis changes due to diabetes. Keywords: carotid artery, diabetes mellitus, intima-media thickness

Acknowledgement: Knowledge of vascular hemodynamics of a particular region is essential to draw a fine line between normal and a pathological state. Face is highly vascular and little is known about normal blood flow characteristics of its superficial arteries. Thus there is a need to assess the normal blood flow characteristics of the face and to establish a normative database. This may later be helpful in planning of aesthetic procedures, face reconstruction following trauma or during surgery and in follow up examination of many skin diseases.To evaluate the blood flow of superficial arteries of face by Doppler ultrasound in young adults. Methods: A cross sectional descriptive study was conducted at University of Lahore Teaching Hospital and University Ultrasound Clinic Green Town, Lahore. Data was collected according to inclusion criteria. Sample size of 311 patients were included in this research comprising 112 (36%) females and 199(63.9%) were males. Data entry and analysis was done by using SPSS version-23. Results: Analysis of data showed that out of 311 patients 112 (36%) females and 199(63.9%) were males, According to the result analysis of the total number of 311 patients, facial artery had a mean diameter of 1.4 mm ( 0.14cm) and diameter of temporal artery at tragus  was calculated 1.5mm ( 0.15cm) with SD 0.2. Facial and temporal artery average PSV among individuals was 26.8 ± 5.3 and 35.2 ± 11.9 respectively.  Average RI value of facial artery was 0.81± 0.05 mm and for temporal was 1.0  ± 0.8 mm . Conclusion: The facial and temporal artery can be assessed on Doppler ultrasound for velocity and resistance parameters. No significant difference was seen in the parameters between males and females.

Objective: To evaluate diagnostic accuracy of ultrasound in renal masses taking computed Tomography as a gold standard. Methodology: A cross-sectional study of 198 study subjects with renal masses was conducted at District Head Quarter Hospital (DHQ) and Allied Hospital, Faisalabad. Patients of age 18 years and above and of both genders with complaints of hematuria and/or palpable mass in the flank region was included. Patients with nephrolithiasis, any other gross renal pathology and patients with any contraindication to the contrast agent, were excluded. Results: Ultrasound had the Sensitivity of 76.67%, Specificity of 100%, positive predictive value of 100%, negative predictive value of 80.56%, and the diagnostic accuracy of 88.14% respectively for the assessment of renal cell carcinoma. Conclusion: Ultrasound is a reliable tool for the differentiation of renal masses, and other renal pathologies such as simple cysts, complex cysts, and polycystic kidney disease.

Objectives: The objective was to determine the accuracy of Gray Scale versus Doppler Ultrasound to Detect Deep Venous Thrombosis in Lower Extremities. Study Design: Cross Sectional Analytical study.  Setting: The University of Lahore and Shalimar Hospital Lahore. Period: May to October 2020. Material & Methods: After a permission from the ethical committee and a written consent of the patients, on the basis of the clinical suspicions of deep vein thrombosis, A total of 140 patients of both the genders, aging from 20 to 90 years, were referred for Gray Scale & Doppler ultrasound examination. The convenient sampling technique and Statistical software for social sciences (SPSS version 22.0) were used for the analysis of data. Results: In 140 patients’ present study on Gray Scale ultrasound, 120 (85%) cases were observed  with significantly increased blood vessel size, intraluminal echogenicity and a loss of compressibility However, on Doppler ultrasound, 130 (92%) cases were detected possessing significantly increased blood vessel size, intraluminal echogenicity, absence of blood flow and negative augmentation effect. Conclusions: From the result of present study, it is concluded that Doppler may be used as gold standard to diagnose the DVT in the lower extremities. This study concludes also that DVT detection accuracy difference between Doppler and Gray Scale ultrasound is minor i.e. 1:1.08. This minor difference encourages the radiology practitioners of periphery to screen DVT in lower extremities through Gray Scale ultrasound, if Doppler ultrasound is unavailable there.

Background: Diabetic nephropathy affects 40 percent of patients with type I diabetes mellitus. It carries a poor prognosis when fully developed, where the estimated death rate is approximately 40-100 times that of nondiabetics. Vascular resistivity evaluation at multiple points of renal parenchyma can indicate structural or functional changes within the kidneys and can provide useful diagnostic and prognostic information. Objective: The goal of the research was to use renal artery Doppler to evaluate the mean renal resistivity index in patients with Diabetes Mellitus. Methodology: The research was initiated with the approval of the University of Lahore Ethical Committee. In this study, all the patients were registered after signing the informed consent form. Toshiba Xario was used with a convex probe of frequency of 3-5 MHz. Renal Resistive Index (RRI) was evaluated and sonographic data was kept in the ultrasound unit. The Statistical package for Social Sciencies version 24 was used for analysing the data. Results: Among 97 patients, there were 66 females and 31 males of which 50 patients were with Diabetes and 47 were normal. In the result of our study it was seen that renal resistive index significantly increases in patients with Diabetes Mellitus. Conclusion: In conclusion, renal resistive index (RRI) levels were high in patients with Diabetes Mellitus showing positive correlation of RRI values

Objective: To compare the diagnostic accuracy of color Doppler ultrasound with computed tomography angiography in patients with lower limb ischemia and to assess the severity of stenosis. Study Design: Cross Sectional Analytical study. Setting: Shalamar Hospital, Lahore. Period: May 2020 to October 2020. Material & Methods: Data were collected according to the Age, Height, Weight, BMI, Duration of diabetes, Total Cholesterol, LDL, HDL, Triglyceride, Gender, Socioeconomic status, Diabetes, Hypertension, Stenosis, Collateral, calcification. Sample size of46 patients were included in this research comprising 32 males (69.6%) and 14 females (30.4%).Data entry and analysis will be done by using SPSS version-23. Results: Total numbers of 46 patients were included in this research comprising 32 males (69.6%) and 14 females (30.4%). According to the result analysis 34 patients had shown peripheral arterial disease at color Doppler and 12 patients had not shown peripheral arterial disease at color doppler. 38 patients had shown peripheral arterial disease at CTA and 8 patients had not shown peripheral arterial disease at CTA. Conclusion: This study concludes that computed tomography angiography for detection of peripheral arterial disease as the gold standard, MDCT angiography shows higher sensitivity (82.6%) than color-coded Doppler ultrasonography (73.9%) in the assessment of peripheral arterial disease.

Background: Hypertensive disorders are an important medical problem of gestation. Hypertensive disorders of pregnancy (HDP) are a significant cause for maternal and fetal morbidity as well as mortality. Intrauterine growth retardation (IUGR) commonly describes the condition of fetus whose size or growth is subnormal. IUGR fetus is frequently described as symmetrical and asymmetrical IUGR in term of their body proportions. Asymmetric growth retardation is typically linked to uteroplacental inadequacy. Hypertension is one of the maternal causes of placental insufficiency. Aim: To compare head circumference and abdominal circumference ratio in normotensive and patients with pregnancy induced hypertensive disorders after 28 weeks of gestation. Methodology: A cross sectional analytical study was carried on 113 pregnant females in which 57 women were normotensive and 56 women were hypertensive. All individuals were scanned by two- dimensional ultrasound following 28 weeks of pregnancy to evaluate sonographic parameters HC and AC. The HC/AC ratio was estimated by dividing head circumference with abdominal circumference. Results: Out of 57 normotensive patients 27 (36.48%) fetuses were diagnosed with IUGR having HC/AC ratio more than 1, while 30 had normal HC/AC ratio. In 56 hypertensive patients 47(63.51%) fetuses were diagnosed with IUGR having HC/AC ratio greater than 1, however 9(23.07%) fetuses had HC/AC ratio within normal range. So out of total 113 patients, 74 fetuses were found with IUGR while 39 fetuses had HC/AC ratio within normal ranges. Our study found that a cut off value of ≥ 1.0974 for HC/AC ratio could be used as diagnostic parameter in predicting IUGR. Conclusion: HC/AC ratio is a useful parameter for the detection of IUGR. Keywords: Head Circumference, Abdominal Circumference, Intra Uterine Growth Retardation

Failure of conception in women after frequent unprotected intercourse for one year is known as infertility. Ultrasound examination can detect certain pathologies that may result in primary or secondary infertility. Objective: To describe the various transvaginal ultrasonographic findings of infertile females in population of Lahore. Methods: The study was started after the consent of ethical committee of the University of Lahore. All the patients were registered in this study after signing the informed consent form. Toshiba Xario with transvaginal transducer frequency ranging from 9-12 MHz was used. Pathologies were evaluated through transvaginal scanning and sonographic data was kept in the ultrasound machine. A consecutive sampling technique was used and data was further evaluated with the help of Statistical Package for the Social Sciences version 24. Results: Among 138 females, PCOS was seen in 40.6% of the subjects. The second most common pathology was ovarian cyst which was seen in 10.9% of subjects. And the incidence of multiple fibroids was 5.1% as third most common pathology in both primary and secondary infertility cases. Most ovarian pathologies were found to be bilateral. 12.3% subjects had no findings on ultrasound. Conclusion: PCOS was the utmost common pathology connected with primary and secondary infertility. The second and third most common pathologies were ovarian cyst and multiple fibroids respectively.