Objective: To evaluate the diagnostic accuracy of Magnetic Resonance spectroscopy (MRS) in distinguishing neoplastic from non-neoplastic ring enhancing brain lesions taking histopathological findings as gold standard. Study Design and Setting: The cross sectional study was conducted at Radiology department of Jinnah Postgraduate Medical Centre. Methodology: Total 102 patients with ring enhancing lesions detected on MRI brain contrast studies were selected for this study. Cases were referred from Outpatient Department of Neurology Clinics who were suspected of having space occupying lesions in brain. Full history, clinical examination and laboratory investigations (Complete Blood Count and ESR) were carried out. The patients having claustrophobia, metallic implants, cardiac pacemaker and having metallic foreign body in situ were excluded from the study. Informed consent was taken from the research and MRS was performed. On MRS, lesion was categorized and final diagnosis was taken based on histopathology results. All the information was recorded into predesigned proforma. Patients Data was scrutinized by using Statistical Package for Social Sciences (SPSS 21.0). Mean + SD was calculated for age, gender, duration of symptoms and size of the lesion. Results: The average age of the patients was 35.45±10.36 years. Sensitivity, specificity, PPV, NPV and accuracy of MRS was 87.5%, 93.3%, 95.5%, 89.7% and 92.1% respectively. Conclusion: Magnetic resonance spectroscopy can be effective in discerning neoplastic from non-neoplastic ring enhancing cerebral lesions, thus avoiding an invasive procedure like brain biopsy

Objective: To evaluate the diagnostic accuracy of Strain Elastography in differentiating benign from malignant thyroid nodules taking fine needle aspiration cytology as gold standard. Study Design and Setting: It was a cross sectional study conducted at Radiology department of Jinnah Postgraduate Medical Centre, Karachi from May 2019 to June 2020 Methodology: Total 586 patients with complaints of swelling in region of thyroid gland were enrolled in study on which Strain Elastography was performed using linear transducer with ultrasound frequency of 7.5 MHz. The results of strain Elastography were compared with histopathology. All the information was recorded into predesigned proforma. Chi-square test was used for comparison among categorical variables and when it has not worked then imitation of Monte Carlos was applied and to see agreement among various categorical variables Kappa statistics were performed. Level of statistical significance was accepted as P < 0.05. Results: The sensitivity of 100%, specificity of 80.2%, positive predictive value of 61.7%, negative predictive value of 100%, and diagnostic accuracy of 85% of elastography was calculated in differentiation among benign from malignant thyroid nodules. Conclusion: Strain elastography is noninvasive technique which can be used to characterize thyroid nodules and helps in differentiating benign from malignant thyroid nodules and can limit the utilization of invasive technique like FNAC and helps in selection of patients which needs surgery.

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A neurodegenerative disorder which is fatal, rapidly progressive and has no effective treatment till date is amyotrophic lateral sclerosis. Almost 90% of all cases occur in the sporadic form, with the rest occurring in the familial form. It is a devastating disease leading to death within 3-5 years in most cases. The diagnosis of AML is difficult to made in spite of acknowledgment for 140 years. It is diagnosed by clinical presentation which is a combination of upper and lower motor neuron signs and electro diagnostic studies which gives information about diffuse motor axonal injury. This neurodegenerative disorder results in degeneration of corticospinal tracts and anterior horn cells and involving motor neurons of the cerebral cortex, brainstem, and spinal cord. There are a variable signs and symptoms of this disease, so the diagnosis is very important for the management and better outcome of the patients. Cause of death in these patients is usually respiratory failure

Eagles syndrome or stylohyoid syndrome is a rare condition where slender elongated temporal styloid process or ossified stylohyoid ligament manifest a wide range of symptoms including otalgia, dysphagia, foreign body sensation in throat, pain in retrogonia or along anterolateral neck. It occurs mostly unilaterally however bilateral cases are also reported. Multislice computed tomography with maximum intensity projections reconstructions is used for diagnosis and management purposes. It also aids to see its compressive effect on adjacent anatomical structures