Objective: To evaluate the diagnostic accuracy of Magnetic Resonance spectroscopy (MRS) in distinguishing neoplastic from non-neoplastic ring enhancing brain lesions taking histopathological findings as gold standard. Study Design and Setting: The cross sectional study was conducted at Radiology department of Jinnah Postgraduate Medical Centre. Methodology: Total 102 patients with ring enhancing lesions detected on MRI brain contrast studies were selected for this study. Cases were referred from Outpatient Department of Neurology Clinics who were suspected of having space occupying lesions in brain. Full history, clinical examination and laboratory investigations (Complete Blood Count and ESR) were carried out. The patients having claustrophobia, metallic implants, cardiac pacemaker and having metallic foreign body in situ were excluded from the study. Informed consent was taken from the research and MRS was performed. On MRS, lesion was categorized and final diagnosis was taken based on histopathology results. All the information was recorded into predesigned proforma. Patients Data was scrutinized by using Statistical Package for Social Sciences (SPSS 21.0). Mean + SD was calculated for age, gender, duration of symptoms and size of the lesion. Results: The average age of the patients was 35.45±10.36 years. Sensitivity, specificity, PPV, NPV and accuracy of MRS was 87.5%, 93.3%, 95.5%, 89.7% and 92.1% respectively. Conclusion: Magnetic resonance spectroscopy can be effective in discerning neoplastic from non-neoplastic ring enhancing cerebral lesions, thus avoiding an invasive procedure like brain biopsy

Objectives: To correlate severity of thrombocytopenia with different grades of esophageal varices in chronic liver disease patients undergoing EGD in a tertiary care hospital. Study Design: Cross sectional study. Setting: Gastroenterology & Hepatology Department at Liaquat National. Period: Six months from Jan to June 2016. Material and Methods: Seventy six subjects of chronic liver disease were recruited and studied for correlation between platelet count and esophageal varices by gastroscopy while the data was analyzed in SPSS version 17. Period: From July 2016 to Dec 2016. Results: There were 55 (72.4%) males and 21 (27.6%) females. The mean age was 45.6 ± 14.7 years. 10 (13.2%) had Hepatitis B, 58 (76.3%) Hepatitis C, 01 (1.3%) Wilson’s disease, 03 (3.9%) Autoimmune disease and 04 (5.3%) Alcoholic liver disease. 09 (11.8%) had Child-Pugh Class A, 41 (53.9%) Class B and 26 (34.2%) had Class C. The mean platelet count was 85/µl ± 40.2/µl. Out of 76 patients 70 (92.1%) had esophageal varices. 23 (30.3%) had grade III varices, 19 (25%) had grade II, 14 (18.4%) each had grade I & IV and 06 (7.9%) had grade 0 varices. Conclusion: thrombocytopenia can predict the occurrence of esophageal varices in cirrhotic population while gastroscopy has high yield for varices.

Objectives: To evaluate the frequency of renal impairment after spontaneous bacterial peritonitis (SBP) in cirrhotic population. Study Design: The study was conducted as Descriptive Cross-Sectional. Setting: Liaquat National Hospital Karachi. Period: For six months (October 01, 2015 to March 31, 2016). Methodology: The subjects with liver cirrhosis spontaneous bacterial peritonitis (SBP) were evaluated for serum creatinine and serum blood urea nitrogen (BUN) for evaluation of renal impairment while the patient's information was recorded on proforma and analyzed in SPSS-15.0. Results: The mean ±SD of age, BUN and serum creatinine for whole population was 50.69±10.69 years, 22.4197±11.64742 and 1.2207±0.92535. Renal impairment was detected in 40 (27.2%) individuals while it is normal in 107 (72.8%) subjects. Conclusion: The renal impairment after SBP in cirrhotic population is higher in present study.

Objectives: To evaluate the frequency of H. pylori stool antigen in individuals with dyspepsia. Study Design: Cross sectional study. Setting: Liaquat National Hospital, Karachi. Period: July-2017 to 31st December-2017). Patients and Methods: The individuals with dyspeptic symptoms for ≥3 months durations were included and explored for H. Pylori infection by H. Pylori stool antigen while the result were analyzed and frequencies and percentages were calculated. Results: The mean ± SD for overall population was 36.29±8.57 years while the frequency of H. pylori was recorded as 38.57% (54/140) patients respectively. Conclusion: H. pylori infection usually observed in dyspeptic individuals and should be screened for eradication therapy.

Objectives: To determine the frequency & severity of liver involvement in dengue infection among adults at tertiary care hospital. Period: Six months (9th May 2016 to 9th Nov 2016). Study Design:  Cross-sectional study. Setting: Department of Gastroenterology and Department of Medicine Liaquat National Hospital, Karachi. Patients and Methods: Results: A total of 343 patients with Dengue fever were selected to conduct this study with mean age of 34.67±9.09 years. Mean duration of the fever was 7.31±1.62 days. Mean duration of hospital stay of the patients came out to be 3.50+0.82 days. Severity of liver enzymes derangement was mild in 80 patients (23%), moderate in 246 (72%) & severe in 17(5%). Mortality was seen in 14% (47 patients) & 100% mortality was seen in dengue fever patients with severely deranged Liver enzymes. Conclusion: Dengue fever patients with deranged liver enzymes had statistically worse outcome thus can lead to early recognition of high risk cases.