Search

Lefort I osteotomy is a versatile procedure which is used to correct maxillary deformities. It can be performed solitarily or with other mandibular orthognathic procedures like BSSO to correct dentofacial deformities. Diverse complications are often met post orthognathic surgeries. We report rare complication of pseudoaneurysm in three such patients who presented with different symptoms. Although different treatment options are available for pseudoaneurysms, endovascular embolization is reported to be the superior one. Pre-embolization angiograms in all three patients demonstrated internal maxillary artery pseudoaneurysms. Successful embolization was performed using coils in all these patients with additional use of PVA particles. No further bleeding episodes occurred. [ABSTRACT FROM AUTHOR]

Management of renal emergencies has revolutionized over the past years and in that domain intervention radiology has gained an emerging role as the minimally invasive procedures aid at salvaging renal function and minimizing morbidity and mortality. Aim of this study is to highlight emerging importance of newer transcatheter therapies available to intervention radiologists in managing renal emergencies,attending in detail the techniques and clinical outcomes of interventional procedures. METHOD: We compiled few of the procedures performed at Shifa international hospital, Islamabad from January 2017- January 2023. These include: Management of fibromuscular dysplasia. Renal angiomyolipoma embolization. Renal artery giant aneurysm coiling/ embolization. Management of post renal biopsy bleed. Post partial nephrectomy bleed management. Embolization of renal cell carcinoma metastasis to stomach and small bowel. Renal cyst alcohol ablation. CONCLUSION: Knowledge about the disease, procedures of intervention developed for their management and their clinico-therapeutic outcomes can help efficiently treat the patients with renal illnesses. [ABSTRACT FROM AUTHOR]

We report case of 27 years old male of a rare complication of epidermoid cyst with malignant transformation into squamous cell. Patient underwent surgery 4 months back for resection of epidermoid cyst. The patient presented post-operatively to our setup when he started having pain and swelling at surgical site which was growing progressively. Initial investigations of CT and MRI were done which showed imaging features similar to epidermoid cyst. Re-exploration surgery and histopathology confirmed keratin pearls which are seen in epidermoid cyst. On follow-up, the imaging not only showed post-surgical complications but also interval development of nodular and enhancing masses in the surgical bed. Patient underwent surgery again for postoperative complications. Biopsy was taken from tumor site. Histopathological slides of squamous cells with keratin pearls correlated with our findings of squamous cell carcinoma on imaging. Fewer cases of epidermoid cyst's complication into malignancy are reported in literature. Our purpose is to highlight one of such cases. [ABSTRACT FROM AUTHOR]

Neuroradiology remains the most fascinating dimension of radiology; encompassing a variety of interesting radiological signs manifested in the brain with particular neurological disease. Interestingly most of these signs resemble different animals, birds or insects in the brain. Understanding and recognizing these signs aids in successful interpretation of the scans and aids in establishing appropriate diagnosis. The aim of this study is to illustrate these typical neuro-radiological signs resembling various animals and to briefly outline the underlying pathogenesis. METHOD: We compiled all these cases with interesting neuro-radiological signs manifested on MRI brain performed at Shifa international hospital, Islamabad from January 2016-December 2019. These include:. 1. Hallervorden Spatz disease; Eye of tiger sign 2. Wilson disease; Face of the giant Panda sign 3. Central pontine myelinolysis; Owl eye appearance 4. Glioma; Butterfly sign 5. Joubert syndrome; Bat wing fourth ventricle 6. Metachromicleukodystrophy; Tigroid pattern 7. Dysplastic cerebellar gangliocytoma; Tigroid or leopard skin pattern 8. Meningioma: Tail sign 9. Corpus callosum agenesis; Steer horn ventricles 10. Penguin sign; Progressive supranuclear palsy 11. Caput medusa; DVA. CONCLUSION: Knowledge of these easily decipherable animal based signs in brain is important as it helps in narrowing down the elaborate list of differentials and also facilitates in making imaging based diagnosis. [ABSTRACT FROM AUTHOR]

PURPOSE: COVID pneumonia, emerged as a pandemic, is a highly communicable viral infection, pathogen being novel corona virus. Though the definitive diagnosis is established by a positive RT-PCR throat swab; radiological imaging may also provide an important adjunct towards the diagnosis of novel corona virus infection. The first line imaging modalities being radiograph and computed tomography (CT) chest. Purpose of the study wasto document the common imaging appearances of emerging novel corona virus disease on CT scan. MATERIALS AND METHODS: All the consecutive patients presenting to Shifa International hospital (SIH), Islamabad from February 2020, to May 2020, having RT-PCR positive COVID- 19 infection were enrolled retrospectively with CT chest performed at admission. These imaging scans were evaluated by two independent Consultant Radiologists. Data was analyzed on SPSS v21 and displayed as frequency percentages. RESULTS: 150 patients (115 (76.7%) men, 35 (23.3%) women; mean age 57.39 ±13.5 standard deviation) were included in the study. The characteristic CT features of COVID 19 pneumonia included ground-glass opacities (GGOs) in 138 patients (92%) which were bilateral, multifocal and multilobar. Among these 138 patients with bilateral and multifocal ground-glass opacities (GGOs) with concomitant consolidations were present in 41 (29.7%) and crazy paving was seen in 105/138 scans (76%). 5 out of 150 patients lacked these GGOs and showed consolidations without GGOs. Other imaging features included subpleural lines in 10 patients (6%), vascular dilatation in 22 patients (14.6%) and air bronchograms in 30 patients (20%). Pleural effusion in 3 scans (2%). None of the initial cases showed enlarged lymph nodes. 7 out of 150 scans (4.6%) had no positive findings. Predominantly peripheral and bilateral distribution in 146 of 150 scans (97.3%). CONCLUSION: According to our initial experience, the imaging appearances of COVID 19 infection on CT chest compromises of predominantly bilateral, multilobar and multifocal GGOs. Crazing paving and concomitant consolidations may or may not be seen. Other commonly reported features were subpleural lines, vascular dilatation and air bronchograms with pleural effusions being the least common. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the survival rate and main reasons of failure of tunneled central venous catheters (Groshong). STUDY DESIGN: Retrospective cross-sectional analysis. PLACE OF STUDY: Department of Interventional Radiology, Shifa International Hospital, Islamabad. DURATION OF STUDY: Two years (January 2010 to December 2011) MATERIALS AND METHODS: A retrospective analysis was carried out on 72 patients in whom Groshong catheters were placed and then followed from January 2010 to December 2011. The data was collected from hospital information system (HIS) and patients medical record, and was analysed for different indicators such as catheter survival and main reasons of its failure. RESULTS: Of 72 patients, half of patients were lost to follow. Among the remaining half, 19 (52.7%) catheters achieved their desired function. Among remaining 17 catheters, 5 were removed due to blockage and 12 due to infection with infection rate of 0.46 per 1000 catheter days. The catheter survival rates according to Kaplan Meier analysis at 1, 3 and 6 month were 82%, 47% and 42% respectively. CONCLUSION: Groshong catheters can be used as vascular access for longer duration especially in oncology patients. Infection is commonest reason of their premature removal. [ABSTRACT FROM AUTHOR]