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We interpret a case, manifesting Magnetic Resonance (MR) imaging features in relation with Metronidazole (Flagyl) toxicity. MRI brain exhibited an abnormal signal intensity comprising symmetrically bilateral dentate nuclei of cerebellum. The metronidazole toxicity was identified on MR imaging characteristics and reinforced on a clinical basis. In the hospital, metronidazole was stop. Patient recovered clinically with cessation of metronidazole. Follow-up MR imaging was not performed. In this report, we present a case establishing a characteristic finding in MR images within the dentate nuclei of cerebellum. Patient was treated for liver abscess and presented with slurring of speech, generalized weakness, and dysarthia.

Background: Hepatosplenic sizes of children vary with age .There are many diseases which affect the sizes of the liver and spleen ranging from acute liver disease to other hepatosplenic disorders . Ultrasound is a quick and reliable method .Unfortunately there is lack of sufficient data in our population therefore my study would be beneficial in determining various disease processes. Objective: To establish normative data of Hepato-Splenic sizes in Pakistani pediatric population using ultrasonography. Methods: The study was conducted at the Ziauddin University Hospital, a tertiary care teaching facility in Karachi. The cross sectional prospective hospital based study was conducted with 150 patients aged 1 month to 14 years. Ultrasonographic evaluation for the assessment of liver, spleen and portal vein size was performed. These were correlated with the age, sex, height/length and weight of the children. Results: Normal liver and spleen length and its ranges with portal vein diameter were obtained. The liver, spleen length and portal vein significantly correlated highly with the height/length (r=0.7,0.7,0.6 )respectively and weight of the subjects (r=0.7,0.7,0.4 respectively). Conclusion: The study provides the normal values of liver and spleen size by ultrasonography in healthy Pakistani pediatric population. Key Words: Hepatosplenic Size, Ultrasound, Liver Transplant, Chronic Liver Disease.

Background: Multiple renal pathogenesis manifested as unilateral or bilateral size changes, therefore there should be normative reference data for proper comparison. Our goal is to determine normal standard value ranges for renal dimensions in pediatric population in Karachi. Sonographically renal length in 150 children were measured and correlate with age, gender, body height, weight and BMI. Objective: Sonographic Measurement of Normal Renal Size and Correlation with Somatic Variables in Subset of Karachi Pediatric Population. Methods: A six month cross sectional hospital based assessment of kidney size (length, width) was evaluated with the help of sonography. XarioTM 200 Toshiba with convex 3.5 frequency transducer will be used. The mean renal dimensions with standard deviation (SD) were estimated for every group of age. The renal length and width were determined and corresponded with different somatic variables. Descriptive statistics with Regression analysis was done. Results: The normal length and the width of kidneys and its ranges were obtained. Right kidney length moderately and significantly correlated with height and weight (r=0.651, r=0.654) and age (r=0.538) respectively. However, moderately insignificant with BMI (0.129). Lefts kidney moderately and significantly correlated with height and weight (r=0.665 r=0.705), negative insignificant with age (0.564) and moderately weak insignificant relationship with BMI (0.174). Conclusion: The research presents the normal range parameters of renal size and measurements by sonography in healthy pediatric population in Karachi. Guideline measurements of kidneys represent a statistically important and comprehensive interaction with specifications of growth which allows us to easily calculate the renal size by derived regression analysis. Key Words: Renal Size, Sonography, Children, Chronic Renal Disease.

Abstract: Oral submucous fibrosis (OSMF) is a chronic, irreversibly progressive and precancerous disease that effects oral, oropharyngeal and oesophageal mucosa. OSMF is characterised by the inflamation and progressive fibrosis of lamina propria that leads to difficulty in mastication, speech, swallowing and causes limited mouth opening. Arecoline (major alkaloid) in areca nut is the main aeitiological factor in causing the disease. Prevalance of OSMF ranges from 0.2 % to 0.5% in South India. The malignant rate of transformation over 17-year period was 7.6%. Trace elements (part of metalloenzymes) are recognised as versatile biomarkers which may be helpful in early detection, prognosis and can reduce the incidence of cancer. Copper, Iron, Zinc, Selenium, Cadmium, antioxidants (Superoxide Dimutase, Vitamin A, Vitamin C, Vitamin E), immunoglobulins and alternation in oncosupressor genes and other genes have been emphasized as biochemical parameters that play an important role in its pathogenesis. These parameters can also serve as important biomarkers in early detection of a premalignant condition and cancer progression. Key Words: Oral submucous fibrosis, trace elements, biomarkers, antioxidants, oncosuppressor genes

The predominant salivary glands are parotid, submandibular, and sublingual glands. Innumerous small salivary glands are present in the buccal cavity, pharynx, and the larynx, which are not identified on usual radiologic studies. Frequently used radiology imaging comprise of plain radiography and conventional sialography. Nowadays, high-resolution ultrasonography (HRUS) is being progressively used for the salivary gland imaging. Hence, the significance of cross-sectional studies like computed tomography (CT) and magnetic resonance imaging (MRI) have transformed the imaging of the salivary glands. Different changes in radiologic studies have led to increase sensitivity in the detection of disorders that include the significant salivary glands. Ultrasonography, plain radiographs, sialogram, magnetic resonance imaging (MRI), computed tomography (CT), and nuclear scintigraphy /positron emission tomography (PET) all considered as involving in the programming of future treatment, surgical or otherwise. We reevaluate the techniques applied for the chief salivary glands imaging, and its application. An exploration of literature search was determined utilizing the electronic databases of Pub Med, Google scholar, Elsevier from 1970 to 2015 for English-language articles. The search terms utilized were salivary gland imaging. The titles and abstract of articles were evaluated. Entire text and reviews were appraised when the abstracts meet to the inclusion criterion. This review included all articles that were used for the advancement of information about salivary gland imaging. Key Words: Salivary glands; Parotid, Submandibular, Sublingual glands

A lump in the breast in any age group of women leads to the great anxiety. High frequency, high-resolution USG helps in its evaluation. However, it could be difficult to distinguish all benign from all malignant solid breast masses using USG criteria. Short-interval follow-up can be suggested. Ultrasound breast can also identified unsuspected occult masses in mammographicaly heterogeneous parenchyma breast. Various studies in past had discussed differentiating features b/w benign and malignant breast lesion. The American College of Radiology classified the breast masses in BIRADS-US classification. An exploration of literature search was determined utilizing the electronic databases of Pub Med, Google scholar, Elsevier from 200 to 2016 for English-language articles. The search terms utilized were breast masses. The titles and abstract of articles were evaluated Entire text and reviews were appraised when the abstracts meet to the inclusion criterion. This review included all articles that were used for the advancement of information about breast masses. Key Words: Breast ultrasound, Breast mass, ACR BIRADS-US criteria

Abstract Background The rationale behind this study was to find out the frequency of dysplasia and colorectal cancer (CRC) in young patients with ulcerative colitis (UC) using histopathological examination. This facilitated early detection of dysplasia and CRC by regular endoscopic biopsies and also guided physicians on appropriate surveillance and management, thus improved outcome. Methods It was a prospective cross-sectional study conducted at the Department of Pathology, PIMS, Islamabad. Seventy-six biopsies of already diagnosed cases of UC of young patients aged between 15 and 40 years of either gender were included. Specimens were fixed in 10% buffer formalin, paraffin embedded followed by cutting, slide preparation, and staining with hematoxylin and eosin (H&E) stain, and examined under light microscope. Statistical package for social sciences (SPSS 21) was used for data compilation and analysis. Mean and standard deviation were calculated for quantitative variables. Frequency and percentage were calculated for qualitative variables. Results There were 13 (17.2%) patients who were diagnosed with colorectal dysplasia, 3 (4.0%) with indefinite for dysplasia, 8 (10.5%) with low-grade dysplasia, and 2 (2.6%) with high-grade dysplasia. There were three (3.9%) patients who were diagnosed for colorectal carcinoma, one (1.3%) with grade 1, one (1.3%) with grade 2, and one (1.3%) with grade 3 CRC. Conclusion Routine biopsies can identify dysplastic epithelium, which is an established sign for synchronized carcinoma with ulcerative colitis, and give the rationale for surveillance of the patients.