Objective: To evaluate the temporal changes on serial chest radiographs (CXRs)of hospitalised COVID-19 positive patients till their outcome(discharge/death); to determine the severity of CXR score and its correlation with clinical outcome (hospital stay, chest intubation and mortality). Study Design: Descriptive study. Place and Duration of Study: Shifa International Hospital (SIH), Islamabad from March to June 2020. Methodology: After IRB approval, 112 patients were consecutively enrolled, having laboratory-confirmed SARS-CoV-2 and hospitalised in SIH. Patients' demographics and clinical data were retrieved from Radiology Information System (RIS). Chest radiographs (CXR) were retrieved from picture archive and communication system (PACS). CXR severity scoring was determined by three radiologists, and results were analysed. Results: Lung opacities (98.2%), involvement of both lungs (96.4%), both peripheral and central region involvement (62.5%) and upper/mid/lower zone distribution (61.6%) were the most frequent findings. Males affected more than females with a mean age of 58.9 ± 13.1 years. Zonal involvement, density and extent of opacities peaked on 10-13 th day of illness. In the last CXR, opacities showed decrease in extent as well as density, reduction in zonal involvement, and few having mixed interstitial thickening/fibrosis. One hundred and five out of 112 (93.8%) patients had residual radiographic abnormalities on discharge. Conclusion: Serial chest radiography can be used to monitor disease progression and temporal changes after initial HRCT. Patients who have CXR severity score of 4 or more at the time of admission, is a red flag for prolonged hospital stay and possible intubation. Severity of CXR findings peaked at 10-13 days. It is recommended to repeat CXRs every 3-4 th day during hospital stay. Majority of the patients has residual radiographic abnormality on discharge.
An ectopically located gallbladder is a rare entity. Here, we present a case of an ectopic gallbladder with left hepatic lobe agenesis. In this study, we describe the case of a 56-year-old male who was a known diabetic patient. He presented with abdominal pain, which started two weeks prior. Computed tomography (CT) abdomen with contrast was advised by the primary team, which showed an incidental ectopic gallbladder along the right posterior-inferior margins of the liver. Associated with it, there was complete agenesis of the left hepatic lobe, including absent segments II, III, and IV. Most of the commonly encountered ectopic positions include intrahepatic, transverse, retrohepatic, retroperitoneal, suprahepatic, falciform ligament, or under the left liver lobe. Ectopic gallbladders have clinical significance as they alter the clinical presentation of cholecystitis. They create technical challenges during cholecystectomy and other biliary operations and cause misdiagnosis in imaging. A thorough inspection of the biliary tract in patients undergoing surgery is suggested before electrocoagulation. A radiologist must always inform the clinician about the existence of an aberrant gallbladder.
Introduction The prevalence of deafness is high in Pakistan. Knowledge regarding the clinical features of patients with profound hearing loss will not only help identify the cause but will also help in the strategic planning for public health interventions. Objective The present study was conducted to cover in detail the clinical aspects of children with hearing loss, that is, age at presentation, associated deficits and disorders, possible cause of the disease, associated family history, and role of consanguineous marriage. Methods The present study was performed from November 2016 to September 2018. All of the patients under 6 years of age with profound bilateral hearing loss who would benefit from cochlear implantation were included in the study. Detailed history was taken. The developmental skills were assessed for all areas, and the patients were scored regarding their motor, manipulative, visual, language, social and self-care skills according to the Schedule of Growing Skills II. Detailed family history was taken from the parents of the affected children. The Statistical Package for the Social Sciences (SPSS) software, version 20.0, was used for the statistical analysis. Results The mean age of the children to be treated was 3.2 ± 1.25 years. Most patients (51.5%) had a positive family history of disease. Consanguineous marriage was common; the parents of 76.9% of the patients were first-degree relatives. Most patients (90.8%) had associated language impediments. In total, four (Ł3.07%) patients had global developmental delay. Conclusion Consanguineous marriage pattern plays an important role in diseases running in families. Development in these children is strongly linked to their age at the consultation.
Sexual harassment of females is a pervasive problem in academia that affects women's career prospects and overall well-being. The present study aimed to analyze female teachers' experiences regarding sexual harassment (SH) at Higher Education Institutions. The quantitative research design was employed for the current study. The study's sample included eighty (80) female teachers selected by using the technique of convenient sampling. For the purpose of data collection, the SEQ Sexual Experiences Questionnaire, designed by Fitzgerald et al. (1995) was employed. The findings revealed that the most typical forms of sexual harassment experienced by female instructors were gender harassment and unwanted sexual pursuits. The results of this study suggested that institutions need to adopt a zero-tolerance approach towards sexual harassment and are required to take proactive measures to prevent harassment to ensure a safe and respectful culture for females in the workplace.
Objective: To analyze the diagnostic accuracy of ultrasound in small bowel obstruction in the paediatric population and compare it with surgical findings. Study Design: Cross-sectional study. Place and Duration of Study: Radiology Department, Pakistan Institute of Medical Sciences, Islamabad Pakistan from Jun 2018 to Jun 2019. Methodology: This study enrolled 84 paediatric small bowel obstruction cases who underwent exploratory laparotomy at the Pakistan institute of medical sciences from Jun 2018 to Jun 2019. The clinically suspected cases of small bowel obstruction were referred by paediatric surgery to the Radiology department, where an ultrasound abdomen was performed by a senior resident, exclusively targeting the bowel. The clinical, sonological, and per-operative findings were recorded on a proforma. Results: The mean age in our study was 3.5±2.7 years. A male gender predominance was noted. The most consistent greyscale feature favouring bowel obstruction was dilated bowel loops, found among 98.7% (76 out of 77) of surgically confirmed cases of bowel obstruction. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound were 98.7%, 71.4%, 97.4%, 83.4% and 94.6% respectively. The sonological cause of obstruction was readily demonstrated among 51 (67%) out of 76 true positive cases. The most common site of obstruction was the distal ileum, with intussusception being the leading cause found among 32% of true positive cases. Conclusion: The overall diagnostic accuracy of ultrasound in revealing small bowel obstruction is high among the paediatric population.
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