Introduction:Rhabdomyolysis (RM) is a condition where there is injury to striated muscle fibers causing release of myoglobin, creatine phosphokinase (CPK), and other intracellular contents into the circulation. High myoglobin levels cause acute kidney injury (AKI). Trauma is the most common cause of RM and development of complications related to the degree of myoglobin released. Currently, the degree of RM is assessed and treatment is instituted based on serum CPK. As myoglobin is the direct cause of AKI, we set out to determine if serum myoglobin is a more reliable predictor than CPK for the development of AKI in traumatic RM.Methodology:A prospective observational study of 90 patients was admitted to the surgical Intensive Care Unit/high dependency unit of a tertiary hospital with traumatic RM whose serum CPK >5000 U/L. Along with standard treatment including intravascular volume optimization and hemodynamic stabilization, they were treated with “crush protocol.” Daily/twice a day, serum CPK and myoglobin were estimated. Categorical data are expressed as frequency and percentage, and the continuous variables are presented as mean (standard deviation) or median (interquartile range) based on normality. Other statistical analyses were done using the Chi-square test, independent t-test, and rank sum test based on normality.Results:Fourteen out of 90 patients developed AKI and one patient required renal replacement therapy. CPK value of >12,000 U/l was identified to have 64% sensitivity and 56% specificity for developing AKI whereas serum myoglobin value of >5000 ng/ml was identified to have 78% sensitivity and 77% specificity for developing AKI.Conclusion:Following traumatic RM, in patients on “crush protocol,” serum myoglobin is a more sensitive and specific test than serum CPK, for predicting AKI.

Background: Pleural effusion is due to excessive accumulation of pleural fluid in the pleural space that exceeds the physiological amount. Pleura effusion imaging technique will play important role in diagnosis and subsequent management of the disease. Ultra sound (US) is a non radiation technique and it can be used in immediate application at the point of care. Methods: A Prospective study. Study, containing 60 pleural effusion cases. Demographic data was collected followed by history regarding current health status, history of medication, alcoholism and Active smoking. In all the subjects, chest radiography posteroanterior data was obtained. Conventional CT of the chest was performed and ultrasound scan was recorded for each participant. Results: In the present study encysted effusions, pleural thicknees, pleural mass and consolidation are less diagnosed by chest x-ray compared with ultrasound. The number of pleural effusions, encysted effusions, pleural thicknees, pleural mass and consolidation are equally diagnosed by ultrasound and computed tomography. The number of unilateral and bilateral are equally diagnosed by ultrasound and computed tomography. Conclusion:Present study finding suggested that ultrasound is an easy accessible method for detection of pleural effusion and it is very helpful in detection of encysted effusions, pleural thickness, pleural mass and pleural nodules. Ultrasound will not only helpful in diagnosis of pleural effusion it will also useful in the management of pleural effusions.

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Lymphangioma is a rare benign congenital malformation of lymphatic system. We present a case of 32 year old male with rare retroperitoneal lymphangioma extending to mediastinum.

Background: AUB (Abnormal Uterine Bleeding) is any bleeding outside normal frequency, regularity, duration, and volume. Abnormal bleeding in menstruation is depicted using terms such as oligomenorrhea, Polymenorrhea, Metorrhagia, and menorrhagia. Objectives: The present clinical study was conducted to assess the efficacy of histopathological findings and TVS/TAS in subjects with AUB. Methods: In the present prospective clinical study, 102 subjects within the age of 21-85 years with abnormal uterine bleeding. All subjects underwent hysteroscopy and premenstrual dilatation and curettage despite sonography findings and baseline investigations. The obtained endometrial tissue was assessed via histopathological examination.