Objective: Keros classification based assessment of olfactory fossa depth in different age groups of both genders using computerized tomography (CT) Methodology: Cross sectional study done at Ziauddin university, Clifton, Karachi. Sample size was 270 adults including 160 males & 110 females. The assessment of depth of Olfactory fossa was carried out by measuring the height of lateral lamella of cribriform plate on CT images. Result: Olfactory fossa of 270 patients from both sides of both genders were classified according to Keros classification. We found Type II to be the most frequent on both sides in both genders. No significant difference in olfactory fossa depth was found when compared in different age groups. Conclusion: The present study shows that vast majority of the population comes under Keros type II & type III thus emphasizing the need of pre-operative radiological assessment. Association of right & left olfactory fossa depth in different age groups was found to be insignificant.

Objective: To find out the frequency of protrusion of Internal Carotid artery in sphenoid sinus and dehiscence of carotid canal in a subset of Karachi population.  Study design: This was a Cross-sectional study conducted at Radiology department of Ziauddin university.  Methodology:  We analyzed 270 head and neck CT scans 270 Head and neck CT scans (540 sides) were analyzed. CT was performed on a 16 slice Toshiba Alexion at Ziauddin Hospital, Karachi —removed for blind review---. SPSS version 20 was used for data analysis.  Results: Out of 270 CT scans analyzed, 28 (10.3) scans showed protrusion of ICA in sphenoid sinus. Out of 45 (16.6) of the subjects showed dehiscence of carotid canal. Out of total dehiscence present unilateral cases were more frequent as compared to bilateral. Unilateral protrusion was also more common as compared to bilateral protrusion of ICA.  Conclusion: Knowledge of dehiscence and protrusion related to ICA and sphenoid sinus anatomy is essential to avoid complications in endoscopic sinus surgery.

Objective: To correlate Uroflowmetry with Prostate volume and International Prostatic Symptom Score in BPH patients and healthy adults in a subset of Karachi Population. Study Design and Setting: This is a crossectional study carried out at Ziauddin Hospital, Karachi over a period of 6 months. Methodology: In this study 100 Samples were taken through non probability convenience sampling. Inclusion criteria includes 40years and above. Sample initially was taken on the basis of International Prostatic Symptom Score i.e., less than 8 and greater than 8 score. Ultrasonography was performed. 65 Individuals with International Prostatic Symptom Score > 8 and Prostate volume <25 and individuals having symptom index < 8 and Prostate volume > 25ml went for Uroflowmetry. Mean and standard deviation was taken out for quantitative variables. Univariate analysis and Multiple Linear Regression applied to assess relationship between Uroflowmetry with Prostate volume and International Prostatic Symptom Score. Result: Mean age of patients was found to be 58±6 years. Mean International Prostatic Symptom Score was 11±4. Mean Prostate Volume was 28ml±5, mean Qmax was 14ml/s ±4. The correlation between Qmax and International Prostatic symptom score was found to be negative (-0.78) and statistically significant. No correlation was found between Prostate volume and Qmax. Conclusion: Qmax and International Prostatic Symptom Score are reliable tool for assessing Benign Prostatic Hyperplasia patients concluding that as Symptom Score increases Qmax decreases. Qmax showed no correlation with Prostate volume. Prostate volume assessed on Ultrasonography is not an authentic parameter for diagnosing BPH patients

Objective: To assess the variations in  the  course  of  optic  nerve  (ON)  in  relation  to  sphenoid  sinus with the help of CT scan. Methodology: A cross-sectional study was carried out using  computed  tomographic  (CT)  paranasal  sinus scans of two hundred and seventy study participants between January 2017 and May 2017. Non-probability consecutive sampling technique was used and data was entered on SPSS version 23. Inclusion criteria comprised of adults coming for CT head and  brain  who  did  not  have  bony  abnor- mality of sphenoid and ethmoid sinuses or adjacent structures. However, individuals  with  sinonasal  tumors, chronic rhinosinusitis, prior sinus surgery, facial fracture, nasal polyposis and  congenital  craniofacial anomaly were excluded from this study. Analysis of optic nerve was carried out according to DeLano's classification. Results: Type 1 ON was found to be the most frequent type; 55.93%, followed by type 2 with a frequency of 26.85%. However, type 3 and type 4 appeared less frequently, that is 11.1% and 6.11%, re- spectively. When comparing right and left sides it was noted that the frequency of type 1 optic nerve was found to be higher on both right and left sides with a value of 56.30% and 55.5%, respectively. Type 2 showed a frequency of 26.67% on right side and 27% on left side. Type 3 was identified to be   11.4% and 10.7% on right and left sides, respectively. Type 4 optic nerve was found to be the least  common type in our study on both sides, i.e. 5.56% on the right side and 6.67% on the left side. Conclusion: The combined percentage of type II and type III ON that is 37.96% in our sample brings us to this conclusion that  fairly  high  percentage  of  our  population  is  exposed  to  increased  potential risk of iatrogenic optic nerve injury thus emphasising the need for careful evaluation of ON in relation to sphenoid sinus anatomy on CT scan prior to endoscopic sinus surgery.

Objective: To evaluate the immunohistochemical expression and scoring of HER2/neu in different variants of adenocarcinoma of prostate and to compared the association of HER2/neu expression with biological behavior and risk factors of prostate adenocarcinoma. Study Design and Setting: Cross sectional study in which all clinically suspected prostate adenocarcinoma cases received at the laboratory Saddar Karachi during the years 2015 and 2016 were evaluated for morphological features of adenocarcinoma. Methodology: This cross sectional study was carried out using prostate biopsies of clinically suspected prostate adenocarcinoma. The diagnosis of adenocarcinoma was confirmed and histological characterization was done by evaluating the morphological features. The tumors were graded according to the revised 2015 Gleason’s grouping. Immunohistochemical analysis for HER2/neu expression was performed in the most representative tumor block. SPSS version 22 was used for data analysis. Mean frequency and percentages were calculated for quantitative variables, whereas chi-square test and Fisher’s Exact Test were applied for qualitative variables. P-value of < 0.05 was considered as significant. Results: Out of 77 biopsies only one showed moderate HER2/neu expression. Positive HER2/neu was acinar variant. No significant statistical association was observed between expression of HER2/neu and prostate cancer variants. The positive case had age more than 60 years with moderately increased serum PSA levels and was aggressive in nature at the time of diagnosis. Conclusion: It was concluded from the study that HER2/neu was rarely expressed in prostate adenocarcinoma