Introduction: Ulcerative colitis is a chronic inflammatory disease of indefinite etiology having relapsing and remitting course. Assessing inflammatory activity via different scoring systems along with clinical correlation plays an important role in the diagnosis and surveillance of ulcerative colitis patients. Histopathological findings should be correlated with the clinical, endoscopic and radiological findings to exclude other causes with similar symptomatology, hence improving the management of patients with UC. Aims and objective: To determine the clinical features and histological features in relapsed patients of ulcerative colitis. Place and duration of study: Department of Pathology, Histopathology section, Sheikh Zayed hospital Lahore, from 25th February, 2016 to 25th February, 2017. Materials and methods: One hundred and ninety cases underwent endoscopic colonic biopsies from the three sites proximal colon, distal colon and rectum. Results: Out of one hundred ninety patients majority patients presented with vague abdominal pain 105(55.3%) followed by bleeding per rectum 74(38.9%). Most commonly seen histological feature is cryptitis 189(99.5%) succeeding chronic inflammation 188 (98.9%). Conclusion: Relapsed patients predominantly presents with vague abdominal pain. Cryptitis is most commonly seen histological feature in relapsed patients of ulcerative colitis. Keywords: Inflammatory bowel disease, Ulcerative colitis , Crohn’s disease

Background: Wilms tumor is the most common pediatric renal neoplasm. Following preoperative therapy, various histological subtypes, risks and clinical stages are determined. A survival outcome of different subtypes is excellent depending upon the stage of patient. In developed countries, overall survival and disease free survival is excellent due to early presentation and closer follow up. Methods: A retrospective study conducted at the Pediatric Hematology/Oncology department, Children Hospital, Lahore. All diagnosed WT cases from 1st January 2014 who completed their treatment before 31st December 2018 were included. Entire management was based on SIOP 2001. Patients presenting before nephrectomy received four cycles of pre-operative chemotherapy depending upon the clinical stage. After nephrectomy, postoperative chemotherapy regimen was based on stage, risk stratification and metastatic status of the patient. Survival outcome of different histopathological subtypes and stages was determined via Kaplan-Meier survival analysis and p-value was calculated via log rank test. Results The mean age of 93 children was 44.4 months with predominance of males (55.9%) and more commonly found in right sided kidney (55.9%). Majority patients completed the entire course of treatment (77.4%). The overall survival of all histological subtypes and stages was 77.4% and 77.1% and disease free survival was 88.2% and 89.4% respectively, at 48 months follow up. Our study showed that febrile neutropenia is major culprit affecting treatment outcome. Conclusions The advanced stage presentation is quite typical in developing nations and contributes towards decreased OS and DFS seen in different histological subtypes and stages. In our study OS significantly dropped from 45.3% in stage III to 12.9% in stage IV disease (P < 0.001). Despite belonging to low middle income class country and uneducated background, majority patients completed the entire course of treatment and relapse was fairly less. The perks of current study are that our hospital is the only pediatric tertiary care centre in Lahore, which have investigated a variety of parameters influencing the course of WT treatment over four-year time period.

Background: Ascaris lumbricoides (A. lumbricoides) is one of the most common nematodes (roundworms) affecting humans more frequently. It generally infests the gastrointestinal tract. However, unusual sites may rarely be affected. Sinusitis is a quite common clinical complaint seen in ENT departments. However, A. lumbricoides as a cause of sinusitis is fairly uncommon. The rarity of the disease, vague clinical complaints, and nonspecific radiological findings may end in delayed diagnosis, leading to severe complications. Clinicians should keep in mind this rare diagnosis, especially in underdeveloped countries. Case presentation: A 3-year-old girl with a low socioeconomic background presented in the Department of ENT, Ch. Mohammad Akram Teaching & Research Hospital, Lahore, with a 15-day history of unilateral nasal blockage, and foul-smelling nasal discharge (blood stained on and off) from the right nostril. On examination, there was vague swelling on the right lateral wall of the nose that was firm to hard. The right maxillary sinus area and infra-orbital region were also vaguely enlarged. A radiographic examination of the head and neck revealed haziness in the right maxillary sinus; however, the rest of the paranasal sinuses were unremarkable. The right nasal cavity was filled with pale yellow/necrotic secretions. A thick pus-like collection was noted coming out from the maxillary ostium. Surgeons suspected some foreign bodies; however, no viable or dead cord-like structures were found during surgical manipulation. Discussion: Ascariasis is a worldwide common helminthic infection that is especially endemic in tropical/subtropical regions because of the suboptimal sanitary conditions. People are also unaware of their hygiene and how to dispose of their excreta, which is a major issue in the rural populations of developing countries. The major route of transmitting infection is ingesting embryonated eggs in the form of contaminated food/water or using raw vegetables/fruits without proper washing.

Objective To determine the frequency of carotid plaques on Doppler USG and associated presenting symptoms at Tertiary Care Centre, Lahore Methods A cross-sectional study of 366 individuals was conducted from January 2020 to November 2020 at the Radiology Department of Shiekh Zayed Hospital, Lahore, Pakistan. A consultant radiologist scanned both sides of extra-cranial carotid artery tree. The DUS of carotid arteries was done with a GE Voluson Expert 730 Doppler ultrasound machine, using a linear probe with transducer frequency of 6-12.5MHz. Results A total of 366 patients underwent bilateral carotid Doppler ultrasound examinations. Our findings showed carotid plagues in 156 (42.62%) patients and majority were males 105(67.53). Mean age recorded was 61.17 ± 9.54 years and mean body mass index was 25.43 ± 3.40 Kg/m2. Highest number of plaques were noted in the left carotid artery 64 (41.03%), main location was common carotid artery 88 (56.41%) and majority were homogenous plagues 88 (56.41%).Majority patients presented with headache 177 (48.36%). Associated comorbidities were diabetes mellitus, hypertension and dyslipidemia. Conclusion The accuracy of diagnosing Carotid artery plagues has greatly increased over time due to radiological innovation. Carotid doppler ultrasound is a cheap noninvasive modality to detect carotid artery plagues due to its sensitivity, precision, and reliability. Since there is a high frequency of carotid plagues noted in middle age male adults, appropriate screening with prophylactic management can save a lot of disease burden from a lower middle income class country.

Background: Abnormal uterine bleeding (AUB) is one of the major problems requiring gynecological consultation. Biopsy proved to be gold standard for the accurate diagnosis of abnormal bleeding. It is more frequently observed in perimenopausal females. Aim: To determine morphological spectrum of endometrium in patients of pre and post-menopausal age groups with abnormal uterine bleeding. Study Design: Descriptive-cross-sectional study Place and duration of study: Department of Histopathology, K. E. Medical University Lahore from 31-07-2018 31-01-2019 Methodology: Three hundred and eighty four patients undergoing diagnostic dilatation and curettage or hysterectomy for abnormal uterine bleeding were included. Their demographic features i-e age and address were noted. The biopsies received in Pathology Department were formalin fixed, after tissue processing and cutting the slides were prepared and stained with haematoxylin and eosin stains. Results: There were 311(80.99%) patients between 25-50 years of age whereas 73(19.01%) between 51-60 years of age. Morphological spectrum of endometrium in patients of pre and post-menopausal age groups with abnormal uterine bleeding shows that 71(18.49%) had proliferative morphology, 58(15.10%) had secretary, 37(9.64%) had simple hyperplasia, 56(14.58%) had complex hyperplasia, 17(4.43%) had atrophic endometrium and 145(37.76%) had other type of morphology (may include mechanical causes such as intrauterine contraceptive device and malignancy). Conclusion: Morphological spectrum of endometrium in patients of pre and postmenopausal age groups with abnormal uterine bleeding shows proliferative morphology as the common morphology followed by secretary, simple hyperplasia, and complex hyperplasia. Key words: Abnormal uterine bleeding, Morphological spectrum of endometrium, Proliferative