Aim: To explore data on non alcoholic fatty liver disease. For this systematic review, our major purpose is to compare grading of fatty liver disease diagnosed on ultrasound with cholesterol level and liver enzymes. Methodology: For this study, total 25 studies were included which follow the Preferred Reporting Items guideline for conducting this systematic review analysis (PRISMA). We search electronic articles from year 2008 to from year 2020 on PUB Med, online Willey library, and ScienceDirect site by using keywords related to sonographic imaging for fatty liver disease. Results: These case studies shows that increasing grades of fatty liver disease are significantly associated with increasing value of total cholesterol levels and liver enzymes.Comparing the heterogeneity level of studies we observed that AST studies have 85% heterogeneity whereas 77% ALT data and 76% GGT data were similar to each other. On the other hand, we observed complete study 12 studies provide information related to TG, TC, HDL, and LDL respectively. Conclusion: Our meta-analysis concluded that the severe cases of liver diseases need biopsies and histopathological examination. Though ultrasonography provides a complete liver picture with 84.8% sensitivity and 93.6% specificity which may help in many cases still the majority of the studies failed to observe steatosis, NAS score. Keywords: Non alcoholic fatty liver disease(NAFLD),ultra sonography,lipid profile ,liver enzymes.

Objective: To study the correlation of resistive index of main renal artery and inter-lobar artery with degree of hydronephrosis. For the purpose of this study data collection was carried through different research works conducted previously regarding hydronephrosis and its effects on the resistivity index of renal arteries. Study Design: Systemic Review. Setting: Radiology Research Section, University of Lahore. Period: September 2018 to May 2020. Material & Methods: Research was conducted with the help of keywords. One hundred and three articles were found at initial stage. A table was designed for data collection purpose including the information such as author of article, year of research, type of hydronephrosis, number of patients, and the resistive index of renal arteries. The data included both male and female patients of any age suffering from hydronephrosis of any origin and no area or time limitation was applied. Results: Pooling results of this systematic review depicts that the researchers conducted various researches addressing the cause of hydronephrosis, the effect of type of hydronephrosis on the resistive index, difference between resistivity index of obstructive and non-obstructive hydronephrosis, level of obstruction and its effect on RI of the renal artery, factors that influence RI other than renal in origin but not a single research conducted on human subject represents the correlation of different grades or degrees of hydronephrosis with either main renal artery or inter-lobar arteries. Out of 17 articles, 8 (47%) articles discuss the resistive index for both obstructive and non-obstructive hydronephrosis while remaining 9 (53%) articles discuss only the mean resistive index for the obstructed kidney. Conclusion: Although renal resistive index is the parameter which is influenced by a variety of other factors such as age of patient, plasma renin level, and the simultaneous presence of certain diseases like hypertension, cardiac diseases, diabetes mellitus, and renal disorders. The presence of any of these factors may rise the RI values even if there is no renal obstruction. Yet different research mainly shows that the values of RI are high i.e. >0.70 in case of obstructed kidney while generally the values of RI are <0.70 in case of none obstructed kidney.

We evaluated 50 patients who had renal transplants and were sent for Doppler Ultrasound for complications, after the transplant procedure. Ages of the patients ranged from 20 to 65 years, 39 were male and 11 were female. In inclusions only first month post op patients were included and only those patients were considered who had some sort of complications on ultrasound at some stage of the follow up.Following complications were noticed: Diminished corticomedullary demarcations, increased echogenicity with raised R I (20 pt). Perinephric collections other than haematoma (13 pt). Perinephric haematoma (06 pt). Obstructed transplanted kidney ( 05 pt). Diminished arterial vascularity of the kidney (04 pt) Renal vein thrombosis (02 pt). RI was found to be raised in increased echogenicity, obstructed hydronephrotic kidney, diminished arterial supply and was disturbed in RVT.

Aim: To determine the diagnostic accuracy and epidemiology of placenta accreta spectrum (PAS) in patients of placenta previa. Design: Systematic review. Methods: PubMed, Google Scholar, ClinicalTrials.gov and MEDLINE were searched between January1992 and December 2020. Studies on placenta previa complicated by PAS diagnosed in a defined obstetric population. This research was carried out using standard methods and protocols and keeping in view Newcastle-Ottawa scale for observation and assessment of case study along with the difference approved by consensus. The overall diagnostic accuracy of ultrasonographic findings is the main outcome of this study, whereas the prevalence of placenta accreta in patients of placenta previa and its incidence among different countries all over the world is also described. Results: In this review study, about 300 articles were evaluated. More over about 15 prospective and 14 retrospective case studies incorporated for assessment having complication with placenta previa and PAS. According to the meta-analysis, a significant (p<0.001) heterogeneity was found between case research that evaluate PAS prevalence and incidence in the placenta previa cohort. The median prevalence in case of placenta previa along with PAS came out to be 0.113% (IQR 0.048–0.17).Whereas incidence in females having placenta previa along with complication of PAS came out to be 11.3% (IQR 7.3–20.0). The overall median sensitivity of the ultrasound to find cases of placenta accreta spectrum in patients of placenta previa is 83.33 %( IQR 77.0-94.34) and specificity is 95.9 %( IQR 88.0-98.4). Conclusions: The high level of diversity observed in results obtained by diagnostic and qualitative data showed strong emphasis should be made on implementation of standard methods and protocols for assessment and diagnosis of pregnancy complication like placenta previa, its type and PAS. However, transvaginal and transabdominal ultrasound remains the gold standard diagnostic tool for placenta previa and placenta accreta spectrum. Keywords: Placenta accrete, placenta previa, sonography

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