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Background: Presurgical staging and characterization of renal masses can be accomplished with magnetic resonance imaging (MRI). Objective: Present study aims to determine the diagnostic accuracy of magnetic resonance imaging in detecting clear renal cell carcinoma, taking histopathology as gold standard. Study design: Descriptive, cross-sectional study. Study duration and settings: Study was conducted at department of Diagnostic Radiology, Jinnah Hospital, Lahore from 4th June 2018 to 3rd December 2018. Material and methods: A total of 133 patients with clear renal cell carcinoma on ultrasonography having age 20-60 years of either genders were enrolled. Patients with pregnancy, previous nephrectomy and contraindicated for MR studies were excluded. MRI abdomen was performed in every patient using the 1.5 Tesla MR system with gradient strength of 33mT/m. MRI findings were correlated with histopathology findings. Results: MRI of abdomen pelvis was performed in all patients and there were 68 True Positive and six False Positive results observed . Among 59 patients whose MRI was negative, 06 patients (False Negative) found clear renal cell carcinoma on histopathology, but True Negative patients had no clear RCC (p=0.0001).Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of diagnostic accuracy of magnetic resonance imaging in detecting clear renal cell carcinoma was 91.89%, 89.83%, 91.89%, 89.83% and 90.98% respectively Conclusion: This study concluded that magnetic resonance imaging is a highly sensitive and accurate non-invasive modality for diagnosing clear cell renal cell carcinoma.. Keywords: Renal cell carcinoma, magnetic resonance imaging, sensitivity

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Valvular heart diseases affects millions of patients worldwide, and the burden is rising as the population ages. Severe valvular heart disease is associated with significant morbidity and mortality, claiming over 50,000 lives annually in the USA [1]. Coumadin (generic name: warfarin) is an anticoagulant, which stops the formation of blood clots and makes blood thinner (less viscous). As for Vitamin K, it helps the process of blood clotting. In other words, warfarin has the opposite effect to Vitamin K. Warfarin is a widely used and cheap drug which decreases the risk of thrombosis or embolism in patients with diseases such as atrial fibrillation (AF), venous thrombo-embolism, and mechanical heart valve surgeries. Treatment with warfarin requires close monitoring with regular tests of PT-INR for better outcome of patients [2]. The purpose of the study is to shorten and simplify the process for the testing and prescription of warfarin by introducing point of care analysis (POC). The aim was also to evaluate changes in time and cost related to the new processes. Effective management of warfarin therapy is frequently challenged by its difficult pharmacology and adverse effects. One strategy to ensure safe warfarin use is provision of comprehensive warfarin education to patients regarding self-testing and self-management of accurate dose according to INR value. Point of care INR monitoring has shown beneficial impacts on the risk of thromboembolic events, anticoagulation control, patient satisfaction, and quality of life [3].

Objective: The objective of this study is to assess asymptomatic bacteriuria during pregnancy and its antimicrobial resistance to the common bacterial isolates in the urine. Study Design and Setting: The cross-sectional study was carried out in the Antenatal Clinic, Obstetrics and Gynaecology Unit of Avicenna Medical and Dental Hospital, Lahore, Pakistan. Methodology: This descriptive, cross-sectional study lasted for nine months and information was collected with the help of a self-designed questionnaire using non-probability random sampling. The frequency distribution of socio-economic and demographic factors of 167 pregnant women was observed while the cultural examination was performed on urine samples of diagnosed cases of asymptomatic bacteriuria through microscopy to find out antimicrobial resistance against bacterial isolates. Results: The prevalence rate of asymptomatic bacteriuria was 13.2%. The most common pathogen was E. coli followed by Klebsiella Pneumoniae and Staphylococci. Resistance of urine pathogens was observed against Ampicillin, Amoxiclav, Norfloxacin, and Piperacillin/Tazobactam. Conclusion: E. coli was identified as the most predominant pathogen that showed higher resistance to Cefotaxime. History of renal stone, trimester, parity, education and low-socio-economic status were the significant factors for ASB