Objectives: The Dutch Radiological Society developed CO-RADS classification, a system for the classification of CT scan chest findings among suspected COVID-19 patients. However due to some important issues it was modified by authors and then applied on our study population. The objective was to study the spectrum of lungs involvement as concluded by HRCT scan chest finding and classifying it using the “Modified CO-RADS classification” Methods: This cross-sectional study was conducted jointly by the departments of Medicine and Radiology, JPMC from January 16, 2021 to April 30, 2021. This study includes suspected cases of COVID-19 patients aged between 18-80 years who came for HRCT chest. Their data variables were recorded. HRCT findings were classified using “Modified CO-RADS classification”. Patients’ results of real time PCR for COVID-19 were also followed. Results: A total of 78 patients presented to the study department during this study period. Of them 85.8% were male (n=67) and 14.2% were female (n=11). Out of the 78 patients, 58 were tested positive for COVID-19 on first RT-PCR on follow up. Among positive two patients (3.4%) had CO-RADS-1, 4 patients (7%) had CO-RADS-2, 19 patients (32.75%) had CO-RADS-3, 21 patients (36.2%) had CO-RADS-4 while 12 patients (20.7%) had CO-RADS-5 category. (CO-RAD-6 category was omitted). Of the patient who had negative results on RT-PCR, five patients had CO-RADS-4 while three patients had CO-RADS-5. On repeat RT-PCR all (8/8) patients of category IV and V proved Covid-19 positive. Conclusion: HRCT scan chest can be used for quicker diagnosis of COVID-19 patients in patients with respiratory complaints in whom prompt diagnosis is required and when RT-PCR investigation process would be taking prolonged time due to over burden during pandemic situation. “CO-RADS classification after modification” proved more effective communicative tool to label and understand the severity of lung involvement in Covid-19 disease. doi: https://doi.org/10.12669/pjms.38.4.4687 How to cite this:Tabassum S, Haider S, Shaukat S. Spectrum of HRCT Scan Chest Findings in COVID-19 Patients as Categorized by Modified CO-RADS Classification. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4687 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective:To determine frequencies of different MRI patterns of tuberculous spondylitisin a public sector hospital in Karachi.Methods:This descriptive multidisciplinary case series study was done from October 25, 2011 to May 28, 2012 in Radiology Department and Department of Medicine in the Jinnah Postgraduate Medical Center Karachi. MRI scans (dorsal / lumbosacral spine) of the Patients presenting with backache in Medical OPD, were performed in Radiology Department. Axial and sagittal images of T1 weighted, T2 weighted and STIR sequences of the affected region were taken. A total of 140 patients who were diagnosed as having tuberculous spondylitis were further evaluated and analyzed for having different patterns of involvement of the spine and compared with similar studies.Results:Among frequencies of different MRI pattern of tuberculous spondylitis, contiguous vertebral involvement was 100%, discal involvement 98.6%, paravertebral abscess 92.1% cases, epidural abscess 91.4%, spinal cord / thecal sac compression 89.3%, vertebral collapse 72.9%, gibbus deformity 42.9% and psoas abscess 36.4%.Conclusion:Contiguous vertebral involvement was commonest MRI pattern, followed by disk involvement, paravertebral & epidural abscesses, thecal sac compression and vertebral collapse.
Objective:To estimate the effect of portal pressure lowering drug ‘octreotide’, by observing the Doppler waveform before and after the administration of intravenous bolus of octreotide and thus to assess indirectly its efficacy to lower the portal pressure.Methods:This quassi experimental study was carried out in Medical Department in collaboration with Radiology Department of Jinnah Postgraduate Medical Center Karachi Pakistan from September 10, 2015 to February 5, 2016. Cases were selected from patients admitted in Medical Wards and those attending Medical OPD. Diagnosis of cirrhosis was confirmed by Clinical Examination and Lab & Imaging investigation in Medical Department. Doppler waveform study was done by experienced radiologist in Radiology Department before and after administration of octreotide. Doppler signals were obtained from the right hepatic vein. Waveform tracings were recorded for five seconds and categorized as ‘monophasic’, ‘biphasic’ and ‘triphasic’. Waveform changes from one waveform to other were noted and analyzed.Results:Significant change i.e. from ‘monophasic’ to ‘biphasic’ or ‘biphasic’ to ‘triphasic’ was seen in 56% cases while ‘monophasic’ to ‘triphasic’ was seen in 20% cases. No change was seen in 24% cases. Improvement in waveform reflects lowering of portal vein pressure.Conclusion:Non invasive Hepatic vein Doppler waveform study showed improvement in Doppler waveform after administration of octreotide in 76% cases. Doppler waveform study has the potential of becoming non invasive ‘follow up tool’ of choice for assessing portal pressure in patients having variceal bleed due to portal hypertension.
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