Background: Characterization of ovarian masses is essentially required and inevitable for optimization of clinical decision making, patient care and management. The diagnosis of ovarian masses is a frequent dilemma in clinical work. Ultrasonography remains the modality of choice in the early investigation of suspected adnexal masses because of its availability and being a safe modality. Aim: To review the current literature on different patterns of manifestation of ovarian masses on ultrasound and its various modes, helping in differential diagnosis on the basis of morphologic, vascular and other characteristics as seen on ultrasound. Methods: Electronic database was searched (PubMed, Google Scholar, Science direct) with data ranging from year 2000 to 2021. Most relevant studies, relating to sonographic appearances of ovarian masses were selected. Results: Twenty five most relevant articles were found: 8 articles were regarding gray-scale ultrasound, 3 articles regarding three dimensional ultrasonography, 2 articles regarding contrast enhanced ultrasonography, 2 regarding elastography and rest were regarding combined use of gray-scale and Doppler ultrasound including color and power Doppler ultrasonography for the assessment of ovarian masses. Our results show that conventional 2D sonography, in conjunction with latest advancements helps improving the diagnosis based on typical sonographic appearances of masses. Screening for ovarian cancer also proves to be helpful for early diagnosis and improvement in survival rate. Conclusion: Ultrasonoraphy and its different modalities such as 3DUS, CEUS, elastography along with conventional 2D and Doppler studies accurately identifies morphologic, structural and vascular featuresof the adnexal masses and differential diagnosis by escapingunnecessary surgeries and improving the survival rate. Keywords: Ultrasonography, Ovarian masses, malignant ovarian masses, contrast enhanced ultrasound,

Background: Ovarian dysfunction is a condition in which ovaries stop working and menstrual periods stops before age 40. This can cause fertility problems. There are several causes of ovarian dysfunction causing infertility such as endometriosis, ovarian torsion etc. Aim: To revise the current literature about causes of ovarian dysfunction and its sonographic findings in infertile women. Methods: Electronic data base search was performed (PubMed, Science direct, Google Scholar) with data range from 2000 to 2019. All the data is available online in English. Results: Seventeen articles were found regarding different causes of ovarian dysfunction and their sonographic appearance. Also our results show that ultrasound can be used as a reliable tool for detection of ovarian pathologies. Conclusion: This study supports a temporal association between various causes of ovarian dysfunction and infertility risk. Gray-scale in addition to color Doppler ultrasound serves an important role in detection of different causes of ovarian dysfunction and their sonographic appearances. Keywords: Ultrasound exam, ovarian dysfunction, ovarian volume, ovarian masses

Background: Burn is an injury which affects approximately all systems of body and is very common among accidental injuries which causes burden on hospitals. A lot of treatment interventions are introduced until now for the management of burn to lessen complications and increase quality of life in survivors. Methodology: Forty-eight patients who complete selection criteria were included in this study. Written informed consent was obtained from every participant in this study before starting any physical examination. Participants was allocated into two groups randomly. On 1stday range of motion at involved joints was assessed using goniometry. Group A is treated with stretching techniques, while group B is treated with Range of Motion exercises. Conventional treatment for both groups’ participants includes isometrics exercise and anti-contracture positioning. Treatment frequency was 3 times a week. Results: Comparison of all upper extremityjoint movements at baseline and 4th week has shown that there was a significant difference between post treatment range of motion with p value of less than 0.05 showing that group A is more effective in improving shoulder flexion after burn injury.Comparison of mean of all measured range of motions in group A and B was 57.08 degree ±28.29 and 59.25 degree±33.52 in pre-treatment and 96.66 degree ±36.35 and 81.49 degree ±33.10 post-treatment. Conclusion: Stretching techniques are more effective in the prevention of post burn contractures than Range of Motion exercises, as more improvement was noted in range of motion at joints of upper limb in patients after stretching. Keywords: ROM (Range of motion), RCT (randomized controlled trail)

Carotid Arterial Intima Media Thickness (CA-IMT) is taken as an important indicator of atherosclerosis with increasing age and long-term exposure to particulate air pollution associated diseases like hypertension, diabetes, obesity, cigarette smoking, alcohol usage, drugs, deranged lipid profile and high cholesterol, high salt and fatty diet Objective: To evaluate the Doppler ultrasonography indices of common and internal carotid arteries on both sides in normal individuals. Methods: A prospective comparative cross sectional study was conducted at Imperial Diagnostic and Research Centre, Imperial College of Business Studies, Lahore, Pakistan for a period of four months after the approval of synopsis. Convenient sampling technique was used and all patients visiting us during study interval of and fulfilling the inclusion criteria were included. A total of 50 participants age range from15 to 68 years, were included. Aloka Prosound α 5 SV, equipped with linear array probe with frequency of 6-9MHz, was used. All the participants, who were normal volunteers, were subjected to B-mode imaging and color-coded Doppler ultrasonography of their common carotid arteries and internal carotid artery in supine position. Baseline investigation was taken for blood pressure (BP) during resting phase. Participant’s age, weight and height were also assessed and recorded on questionnaire forms. MedCalc was then used to apply relevant tests for statistical analysis. Repeated Measures ANOVA was performed to see the difference between the values taken during supine and standing position on each side. Results: The IMT showed significant positive correlation with the age in both right and left CCA and ICAs. EDV values of right CCA showed significant positive correlation and RI and PI showed significant negative correlation with age. PSV and SD values of left CCA and PSV of right ICA showed significant negative correlation with age. Left ICA diameter and PSV showed the significant positive correlation with age. Conclusion: The study provides the information about normal Doppler indices which might be useful in the evaluation of cases of carotid artery diseases. These figures can be used to gain a better understanding of the aetiology of ischemic strokes in the brain.