Objective To determine the diagnostic accuracy of echo-planar diffusion-weighted imaging (DWI) in the diagnosis of intra-cerebral abscesses by taking histopathological findings as the gold standard. Subject and methods A retrospective cross-sectional study was performed from July 2014 to June 2015 at a tertiary care hospital in Karachi. A total of 462 patients, who were referred for magnetic resonance imaging (MRI) brain, presenting with clinical suspicion of an intra-cerebral abscess on the basis of clinical signs and symptoms, were included in this study. MR imaging was performed. All patients subsequently underwent surgery. The histopathological findings of these patients were collected and compared with echo-planar diffusion-weighted MRI findings. A proforma was used to record the findings. Results The mean age of the patients was 47.39±13.54 years. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of echo-planar diffusion-weighted MRI in the diagnosis of intra-cerebral abscesses was 85.64%, 95.88%, 93.82%, 90.14%, and 91.56%, respectively. Conclusion Brain abscesses and necrotic tumors are, most of the time, difficult to differentiate on routine conventional imaging, and prompt diagnosis is important, as an untreated brain abscess could be lethal. Diffusion imaging can aid in the diagnosis and further management plan so as to help in improved patient care. Although this sequence has high sensitivity and specificity, it should be used in addition to conventional imaging and not as a replacement of histopathology.

INTRODUCTION: Acute pancreatitis is a protean disease with varying clinical findings from mild to severe. CT is the imaging modality of choice to help stage the severity of inflammatory processes, detect pancreatic necrosis and depict local complications. Objectives of this study was to evaluate the role of MDCT in diagnosis and staging of acute pancreatitis and to identify the complications of acute pancreatitis on CT scanning. MATERIAL AND METHODS: This was a descriptive study done from 26th September 2016 to 25th March 2017. 45 patients of age range 17-85 years (29 Male and 16 Female) were included in study. CT scans were assessed for pancreatic necrosis and its complications. Computed tomography severity index (CTSI) was calculated by Balthazar's grading + degree of necrosis points into mild, moderate and severe CTSI. RESULTS: 14 patients had mild, 14 had moderate and 17 patients had severe acute pancreatitis CTSI. Of 31 patients with pancreatic necrosis 26 (83.8%) patients showed complications and 5 (16.12%) patients were without complications. Of 14 patients without pancreatic necrosis only 5 (35.7%) patients were with complications and 9 (64%) were without complications. CONCLUSION: CT scan should be the investigation of choice if clinical diagnosis is acute pancreatitis and to assess the severity of disease to predict its course.

Objective: To compare the diagnostic accuracy of appendicitis inflammatory response score and Alvarado score in diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: It is a Cross Sectional Study Study setting and Duration: This study conducted at the Department of General Surgery, Abbasi Shaheed Hospital, Karachi from September 2018 To March 2019. Methods: Alvarado and Appendicitis inflammatory response scores were used to evaluate all patients. For the Alvarado scoring system, a score of 7 or more was considered a high chance of acute appendicitis, while the AIR scoring system required a score of 9 or higher. The findings of the histopathology lab were compared to the test results. Both tests' results were analysed to determine their sensitivity, specificity, and diagnostic accuracy. Results: For Alvarado score Sensitivity (80.1%), Specificity (92.3%) and accuracy was 81.7%. For AIR score Sensitivity (72.6%), Specificity (94.2%), and accuracy was 75.5%. There were 66.9% male and 33.1% female patients. Right iliac fossa pain was 76.8%, pain migration to right iliac fossa was 63.5%, anorexia was 90.9%. Conclusion: Higher sensitivity and specificity of the Appendicitis inflammatory response score and the Alvarado score were found to outperform the histological findings in appendicitis. Keywords: Appendicitis, Appendicitis Inflammatory Response Score, Diagnostic Accuracy, Acute Appendicitis, Histopathology, Alvarado Score,

Objective: To determine diagnostic accuracy of increased mean platelet volume as inflammatory marker in diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: Cross Sectional Study. Setting: Department of Surgery, Abbasi Shaheed Hospital, Karachi. Duration: From 28th October 2016 To 27thApril 2017. Material and Methods: Total 229patients suffered from acute appendicitis were included. Venous blood (<20 ml) for complete blood count was sent to lab before surgery. MPV >11fl was taken as increased value. Post-appendicectomy appendix was sent for histopathology. Sensitivity, specificity, positive and negative predictive values were calculated. Stratification was done. Chi-square test was applied post stratification and p-value ≤0.05 was considered as significant. Results: There were 128 male and 101 female. Mean age was 34.09±6.63 years. Mean duration of symptoms was 28.97±11.89 hours. 107 patients were observed with total leukocyte count >10X103µL. Mean platelets volume was more than 11 fl in 47.2% patients. Sensitivity, Specificity, PPV, NPV and accuracy were 74.6%, 91.6%, 92.5%, 71.9%, and 81.6% respectively. Conclusion: In conclusion in patients with temporary diagnosis of acute appendicitis, high MPV “≥ 11fl” can assist in the identification of acute appendicitis hence negative rate of appendectomy can be decreased.. Keywords: Diagnostic Accuracy, Increased Mean Platelet Volume, Acute Appendicitis, Histopathology