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Abstract Background Smart phone technology including different instant messaging applications like, WhatsApp, can be used for the development of radiological skills, reporting, and performance. To determine the utility, attitude, and outcome of WhatsApp for augmenting education in FCPS radiology residency program. To assess the opinion of radiology residents regarding WhatsApp as a tool to enhance postgraduate training. Methodology A mixed method (qualitative and quantitative) was conducted at Dow Institute of Radiology, Karachi, Pakistan. All FCPS Radiology residents were given a radiological case by principal investigator followed by residents’ response in 24 h. Key findings were shared by the mentor. Before and after the intervention of WhatsApp, all residents were evaluated with written and radiological imaging reporting exam. For quantitative analysis, a closed ended questionnaire was used containing information about total number of messages, images, webpage links shared, level of contribution (active/non-active), and utility (contribution in education related topic only). A feedback form with Likert scale was also got filled by all residents. For qualitative research, semi structured interviews (SSIs) were conducted. Results Median number of total images shared were 293 (IQR 1002 images), messages shared 110 (IQR), webpages shared were 54 webpages (61 webpages) and total contents shared by participants was 243 (544 contents). Active contributors showed better performance in utility, competency of contents and attitude towards using social media as a medium for learning. Comparison of written and OSCE results showed better performance after the intervention. Feedback form with Likert scale revealed that students responded positively regarding the shared learning content. Thematic analysis showed 52 codes and 16 themes. Conclusion In this research we have observed that WhatsApp is highly efficient and productive academic tool which can amplify postgraduate radiology education. Student’s narrative reflects that residents have found the missing link which can take them to radiological professional excellence through targeted high-profile learning outside lecture hall in time and place convenient motivational environment. Once it will be blended with existing teaching strategy, it can prove to be a game changer.

As deepfake technology gains traction, the need for reliable detection systems is crucial. Recent research has introduced various deep learning-based detection systems, yet they exhibit limitations in generalising effectively across diverse data distributions that differ from the training data. Our study focuses on understanding the generalisation challenge by exploring different aspects such as deep learning model architectures, pre-training strategies and datasets. Through a comprehensive comparative analysis, we evaluate multiple supervised and self-supervised deep learning models for deepfake detection. Specifically, we evaluate eight supervised deep learning architectures and two transformer-based models pre-trained using self-supervised strategies (DINO, CLIP) on four different deepfake detection benchmarks (FakeAVCeleb, CelebDF-V2, DFDC and FaceForensics++). Our analysis encompasses both intra-dataset and inter-dataset evaluations, with the objective of identifying the top-performing models, datasets that equip trained models with optimal generalisation capabilities, and assessing the influence of image augmentations on model performance. We also investigate the trade-off between model size, efficiency and performance. Our main goal is to provide insights into the effectiveness of different deep learning architectures (transformers, CNNs), training strategies (supervised, self-supervised) and deepfake detection benchmarks. Following an extensive empirical analysis, we conclude that Transformer models surpass CNN models in deepfake detection. Furthermore, we show that FaceForensics++ and DFDC datasets equip models with comparably better generalisation capabilities, as compared to FakeAVCeleb and CelebDF-V2 datasets. Our analysis also demonstrates that image augmentations can be beneficial in achieving improved performance, particularly for Transformer models.

Objectives: To compare the perception of dental students and faculty members regarding the attributes of effective clinical teachers. Method: The cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from August 2021 to November 2021, and comprised third and final year dental students and associated clinical faculty members from in three dental colleges in the city. Data was collected using the modified version of a pre-validated questionnaire. Data was analysed using SPSS 25. Results: Of the 200 students approached, 169(84.5%) responded; 135(79.9%) females and 34(20.1%) males with mean age 21.78±1.099 years (range: 19-26 years). Of the 59 teachers approached, 49(83%) responded; 33(67.3%) females and 16(32.7%) males with mean age 31.59±5.041 years (range: 23-49 years). The students found record-keeping a tiresome task (42%), while teachers regarded it essential for clinical development. Unlike teachers, the students were unable to identify the relevance of clinical objectives and they also did not appreciate teachers’ involvement in clinical procedures. For other domains regarding personal traits, teaching methods and clinical skills, both groups had similar responses. Conclusion: There was generally a similarity of opinions among students and teachers regarding the essential qualities of effective dental clinical teaching. Key Words: Dental education, Clinical teaching, Competent clinical teacher.

الملخص: أهداف البحث: لتحديد دور الأشعة السينية المحمولة التسلسلية في التشخيص والتقدير الكمي لمرضى كوفيد-19 المؤكدين المنومين في مستشفى الرعاية الثالثية. طرق البحث: تم إجراء دراسة استعادية في معهد داو للأشعة، جامعة داو للعلوم الصحية. تمت دراسة الحالات الإيجابية المؤكدة لكوفيد-19 من نوفمبر 2020 إلى يناير 2021 بدراسة استعادية. تم استرداد معلومات البيانات حول التركيبة السكانية للمرضى والخصائص السريرية ونتائج الأشعة السينية على الصدر والنتائج من خلال السجل الطبي الإلكتروني. تمت مقارنة خط الأساس ونتائج الأشعة السينية للصدر للمتابعة باستخدام درجة شدة الأشعة السينية على الصدر. تم استخدام الانحدار اللوجستي متعدد المتغيرات لتقييم العلاقة بين خصائص المرضى ونتائج المرضى. النتائج: اشتملت الدراسة على 329 مريضا بمتوسط عمر 56.43 ± 13.10 سنة (المدى 16-85 سنة). كان الدمج المحيطي وعتامة الزجاج الأرضي (89.4٪) أكثر نتائج الأشعة السينية شيوعا تليها مشاركة الرئة الثنائية (79.0٪) والاندماج المحيط/عتامة الزجاج الأرضي (69.9٪). من بين المرضى الذين تم إدخالهم، خرج 61.4 ٪ من المرضى، و 49.5 ٪ من المرضى لديهم مدة إقامة مطولة ≥10 أيام، وتوفي 37.7 ٪ من المرضى. بعد تعديل خصائص جميع المرضى، أظهر النموذج متعدد المتغيرات عدم وجود فرق كبير في درجة شدة الأشعة السينية للصدر فيما يتعلق بنتائج المريض. ارتبط المرضى الذين تم إدخالهم في وحدة العناية المركزة، ودعم العلاج بالأكسجين، وضغط إيجابي ثنائي المستوى في المسالك الهوائية، وجهاز التنفس الصناعي بشكل كبير بنتيجة الخروج من المستشفى، والإقامة المطولة في المستشفى، والوفاة. الاستنتاجات: كان الاستصحاف المحيطي وعتامة الزجاج الأرضي أكثر اكتشافات الأشعة السينية للصدر شيوعا في مرضى كوفيد-19 المقبولين. لم يلاحظ أي اختلاف كبير في درجة شدة الأشعة السينية للصدر في النتيجة الأولية للخروج، والإقامة المطولة في المستشفى، والوفاة. ليس هناك حاجة لإجراء أشعة سينية يومية للصدر في المرضى في المستشفى حتى يتم طلبها في حالة تفاقم الأعراض أو التدخل الهام مثل التنبيب الرغامي. Abstract: Objective: To determine the role of the serial portable chest X-ray in the diagnosis and quantification of patients with confirmed COVID-19 admitted to a tertiary care hospital. Methods: A retrospective study was conducted at Dow Institute of Radiology, Dow University of Health Sciences. Confirmed positive cases of COVID-19 from November 2020 to January 2021 were retrospectively studied. Patients' demographics and clinical characteristics, chest X-ray findings, and outcomes were retrieved through electronic medical records. Baseline and final follow-up chest X-rays findings were compared by using chest X-ray severity score. Multivariable logistic regression was used to evaluate the relationship between patients’ characteristics and patient outcomes. Results: The study included 329 patients with a mean age of 56.43 ± 13.10 years (range 16–85 years). Peripheral consolidation and ground glass opacities (89.4%) were the most common X-ray findings followed by bilateral lung involvement (79.0%) and perihilar consolidation/ground glass opacities (69.9%). Among the patients who were admitted, 61.4% were discharged, 49.5% had prolonged length of stay ≥10 days, and 37.7% died. After adjustment of all patients' characteristics, the multivariate model showed no significant difference in chest X-ray severity score in relation to the patient's outcome. Patients who were admitted to the intensive care unit, and received oxygen support, bilevel positive airway pressure, and a ventilator were significantly associated with the outcome of being discharged, prolonged hospital stay, and death. Conclusion: Peripheral consolidation and ground glass opacities were the most common chest X-ray findings in admitted COVID-19 patients. No significant difference in chest X-ray severity score was noted in the primary outcome of being discharged, prolonged hospital stay, and death. There is no requirement for daily chest X-rays in hospitalized patients until required in the condition of worsening symptoms or significant intervention such as endotracheal intubation.

Over the past few years, social media has become an indispensable part of the news generation and dissemination cycle on the global stage. These digital channels along with the easy-to-use editing tools have unfortunately created a medium for spreading mis-/disinformation containing visual content. Media practitioners and fact-checkers continue to struggle with scrutinising and debunking visual user-generated content (UGC) quickly and thoroughly as verification of visual content requires a high level of expertise and could be exceedingly complex amid the existing computational tools employed in newsrooms. The aim of this study is to present a forward-looking perspective on how visual UGC verification in journalism can be transformed by multimedia forensics research. We elaborate on a comprehensive overview of the five elements of the UGC verification and propose multimedia forensics as the sixth element. In addition, different types of visual content forgeries and detection approaches proposed by the computer science research community are explained. Finally, a mapping of the available verification tools media practitioners rely on is created along with their limitations and future research directions to gain the confidence of media professionals in using multimedia forensics tools in their day-to-day routine.

Objectives: To determine the positive predictive value of Breast Imaging Reporting and Data System category IV lesions, and to evaluate interobserver agreement among radiologists in interpreting the subcategories. Method: The cross-sectional study was conducted at the Dow Institute of Radiology, Dow University of Health Sciences, Karachi, from September 2018 to February 2019, and comprised adult females aged 30-60 years diagnosed with Breast Imaging Reporting and Data System IV. Already diagnosed breast carcinoma patients were excluded. The positive predictive value of Breast Imaging Reporting and Data System category IV was calculated using histopathology findings as the gold standard. Data was analysed using SPSS 22. Results: There were 191 patients with a mean age of 49.01±11.79 years. Positive family history of breast cancer was found in 33(17.3%) subjects. Category IV-A was noted in 53(28.0%) subjects, IV-B in 45(23.6%) and IV-C in 93(48.7%). The overall positive predictive value of category IV was 151(79.1%), IV-A 27(50.9%), IV-B 35(77.7%) and IV-C 89(95.6%). Malignant disease was significantly associated with architectural distortion and suspicious microcalcifications (p

OBJECTIVE: To determine the accuracy of limited protocol Magnetic resonance imaging of lumbar spine in determination of lumbar disc herniation, nerve root compression and annular tear taking findings of routine MRI as a reference standard. METHODOLOGY: A descriptive cross-sectional study was conducted from August 2016 to February 2017 at Dow Institute of Radiology (DIR), Dow University of Health Sciences (DUHS). All patients of either gender aged 20 years or more presenting for MRI with low back pain were included. Routine complete protocol included T1W spin echo (SE) images on the sagittal plane, fat suppression sequence on the sagittal plane and T2W fast spin echo (FSE) images on the sagittal and axial planes, while limited protocol included T2W fast spin echo images on the sagittal and axial planes. Statistical analysis for social sciences (SPSS version 24), Inc, USA was used for the purpose of statistical analysis. RESULTS: The sensitivity and specificity of limited protocol of disc herniation, nerve root compression, and AT were found to be 100% taking full protocol for disc herniation, nerve root compression, and AT as a gold standard. A significant difference of disc herniation was observed with age (p-value:

Since the coronavirus disease (COVID-19) outbreak in December 2019, studies have been addressing diverse aspects in relation to COVID-19 and Variant of Concern 202012/01 (VOC 202012/01) such as potential symptoms and predictive tools. However, limited work has been performed towards the modelling of complex associations between the combined demographic attributes and varying nature of the COVID-19 infections across the globe. This study presents an intelligent approach to investigate the multi-dimensional associations between demographic attributes and COVID-19 global variations. We gather multiple demographic attributes and COVID-19 infection data (by 8 January 2021) from reliable sources, which are then processed by intelligent algorithms to identify the significant associations and patterns within the data. Statistical results and experts' reports indicate strong associations between COVID-19 severity levels across the globe and certain demographic attributes, e.g. female smokers, when combined together with other attributes. The outcomes will aid the understanding of the dynamics of disease spread and its progression, which in turn may support policy makers, medical specialists and society, in better understanding and effective management of the disease.

Study DesignDescriptive cross-sectional study.PurposeTo determine the frequency of lumbosacral transitional vertebrae (LSTV) in patients with low back pain (LBP) and the role of iliolumbar ligament (ILL) origin from L5 in LSTV cases.Overview of LiteratureTransitional vertebrae are developmental variants of the spine. LSTV is a common congenital abnormality, and failure to recognize this anomaly may result in serious consequences during surgery.MethodsAll patients aged 11–90 years of either gender with LBP for any duration, who presented for X-ray and magnetic resonance imaging (MRI) of the lumbosacral spine, were included. X-rays of the lumbosacral spine in anteroposterior and lateral views were acquired. In addition, T1- and T2-weighted sagittal and axial MRI was performed. Images were evaluated on a workstation.ResultsOf 504 patients, transitional vertebrae were observed in 75 patients (15%). Among them, 39 (52%) patients had Castellvi type III and 36 (48%) patients had Castellvi type II. However, on MRI, 42 (56%) patients had O'Driscoll type II, 18 (24%) patients had O'Driscoll type IV, and 15 patients (20%) had O'Driscoll type III. ILL origin from L5 was significantly higher (n=429, 100%) among patients with a normal lumbosacral junction than among patients with a transitional lumbosacral junction (n=22, 29.3%) (p

Study DesignDescriptive cross-sectional study.PurposeTo determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography.Overview of LiteratureThere is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries.MethodsA retrospective study was conducted on abdominopelvic computed tomography (CT) scans performed between January 1st 2015 and December 31st 2015 for various clinical indications. Patients with lower back pain, with a history of trauma or road traffic accident, or referred from orthopedic or neurosurgery departments were excluded to avoid any bias. CT scans were reviewed in axial, sagittal, and coronal planes using bone window settings for evaluating spondylolysis and spondylolisthesis.ResultsOf 4,348 patients recruited, spondylolysis and spondylolisthesis were identified in 266 (6.1%) and 142 (3.3%) patients, respectively. Age was significantly higher in both spondylolysis and spondylolisthesis patients than in those without spondylolysis and spondylolisthesis (47.19±15.45 vs. 42.5±15.96, p60 years old, both spondylolysis (p=0.018) and spondylolisthesis (p=0.025) were significantly more prevalent in females.ConclusionsThe prevalence of pars interarticularis fracture observed higher with gradual increase in the prevalence with advancing age. In particular, preponderance was significantly higher among older females.

Purpose: In patients with erectile dysfunction, it is important to differentiate psychogenic from organic causes. Penile Doppler ultrasonography is a relatively inexpensive and minimally invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfunction in an adult male population, using penile Doppler ultrasonography. Materials and Methods: A retrospective study was conducted in a single center. All patients who presented with complaints of erectile dysfunction and underwent penile Doppler ultrasonography between July 2014 and June 2016 were included in this study. All examinations were performed using GE Voluson S6 and GE Logiq P5 devices. Following baseline scans, an intracavernosal injection of 20 μg of prostaglandin E1 was given. Peak systolic and end diastolic velocities were measured in each cavernosal artery. Patients with a peak systolic velocity of ＜25 cm/s were considered to have arterial insufficiency, while an end diastolic velocity of ＞5 cm/s was considered to indicate venous incompetence. Results: Out of 97 patients (mean age, 37.09±11.59 years; range, 19∼69 years), 50 patients (51.5%) had normal findings, 24 patients (24.7%) had arterial insufficiency, 15 patients (15.5%) had a venous leak, and 8 patients (8.2%) patients had arterial insufficiency with a venous leak. Psychogenic erectile dysfunction was significantly higher among patients aged ≤40 years, while arterial insufficiency with or without a venous leak was significantly higher among patients aged ＞40 years (p=0.022). Conclusions: A majority of the studied individuals demonstrated no organic cause of erectile dysfunction, thus confirming a high prevalence of the psychogenic etiology, particularly in relatively young individuals.

Introduction: Bilateral orbital meningocele is a rare congenital abnormality. In our review, no case was reported from Southeast Asia which has reported bilateral orbital meningocele with frontoethmoidal meningocephalocele. Frontoethmoidal meningocephalocele has many extracranial manifestations out of which orbital meningocele are one of them. In this study, we are reporting a case of a 4 years old male child presenting with bilateral exophthalmos and gradual loss of vision bilaterally. He underwent CT and MRI that showed bilateral intraorbital, extraconal mass lesions displacing the orbit. Cribriform plate was low lying with herniation of brain parenchyma in frontal region anteriorly. These findings were later proved to be similar post operatively.

Introduction: Bilateral orbital meningocele is a rare congenital abnormality. In our review, no case was reported from Southeast Asia which has reported bilateral orbital meningocele with frontoethmoidal meningocephalocele. Frontoethmoidal meningocephalocele has many extracranial manifestations out of which orbital meningocele are one of them. In this study, we are reporting a case of a 4 years old male child presenting with bilateral exophthalmos and gradual loss of vision bilaterally. He underwent CT and MRI that showed bilateral intraorbital, extraconal mass lesions displacing the orbit. Cribriform plate was low lying with herniation of brain parenchyma in frontal region anteriorly. These findings were later proved to be similar post operatively. Keywords: Orbital meningoencephalocele, cephalocele, meningocele.

Background & Objective: Radiology has played a significant role in the diagnosis and quantifying the severity of COVID 19 pulmonary disease. This study was conducted to assess patterns and severity of COVID-19 pulmonary disease based on radiological imaging., Methods: A prospective observational study was conducted in a large tertiary care public sector teaching hospital of Karachi, Pakistan from June 2020 till August 2020. All confirmed and suspected COVID-19 patients referred for chest X-rays and computed tomography (CT) scans were evaluated along with RT-PCR results. Suspected patients were followed for RT-PCR. Radiological features and severity of imaging studies were determined., Results: Of 533 patients in whom X-rays were performed, majority had severe/critical findings, i.e., 304 (57.03%). Of 97 patients in whom CT scan was performed, mild/moderate findings were observed in 63 (64.94%) patients. Of 472 patients with abnormal X-rays, majority presented with alveolar pattern 459 (97.2%), bilateral lung involvement 453 (89.6%), and consolidation 356 (75.4%). Moreover, lobar predominance showed lower zone preponderance in 446 (94.5%) patients. Of 88 patients with abnormal CT findings, ground-glass opacity (GGO) 87 (98.9%) and crazy paving 69 (78.4%) were the most common findings. An insignificantly higher association of PCR positive cases was observed with severe/critical X-rays (p-value 0.076) and CT scan findings (p-value 0.431)., Conclusion: Most common patterns on CT scans were GGO and crazy paving. While on chest radiographs, bilateral lung involvement with alveolar pattern and consolidation were most common findings. On X-rays, majority had severe/critical whereas CT scan had mild/moderate findings., Competing Interests: Conflict of Interest: The authors have no conflicts of interest., (Copyright: © Pakistan Journal of Medical Sciences.)