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Background: Gliomas represent the most prevalent type of primary brain tumor and are associated with a significant mortality rate. The utilization of MR cerebral perfusion proves effective in distinguishing between low-grade and high-grade gliomas, surpassing the capabilities of routine MRI. This distinction allows for the timely initiation of surgical intervention. We aimed to document the diagnostic accuracy of MR cerebral perfusion against the gold standard of lab-based histopathology. Methods: We conducted this cross-sectional validation study over a duration of six months in the outpatient radiology department of a major public sector hospital of Rawalpindi, Pakistan. All patients had MR cerebral perfusion Scan of brain in order to differentiate low grade and high grade glioma. Quantitative rCBV analysis was carried out adopting a threshold value of 3, above this value the lesion was considered at a high grade. The results were written on specially designed proforma. Results: A total 230 patients were included in the study with mean age of 50.68+16.36 and there were 135 (58.7%) male and 95 (41.3%) were female. There were 122 (53.0%) patients presented with low grade glioma and 108 (47.0%) patients presented with high grade glioma. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of MR cerebral perfusion to differentiate between low grade and high grade gliomas was 85.71%, 70.97%, 88.89%, 64.71% and 81.74% respectively. Conclusion: This study concludes that the MR perfusion reliably identifies higher-grade features in a tumor that otherwise may not appear on standard MRI scan. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between home chaos and Self-regulation (effortful control) among young children including other dimensions of temperament (Surgency and Negative affect). Place and Duration of the Study: The study was conducted from January 2015 to September 2016 in Rawalpindi. Materials and Methods: This is a descriptive correlational study. The sample consisted of 100 children (3-7 years) and their mothers. The sample was selected from different private and government schools. For children who were less than 4 years, the mothers were contacted at their homes directly. A purposive sampling technique was used to collect data. To assess temperament and home chaos Children's Behavior Questionnaire Very Short Form (CBQ) and Confusion, Hubbub, and Order Scale (CHAOS)-Urdu Version were used respectively. To collect demographic information for sample selection according to sampling criteria the forms were sent to parents through children. Results: The results showed significant negative association between home chaos and children's effortful control ( = -.21*, p<.05), non-significant positive association between home chaos, negative affect( = .06, p>.05) and surgency ( = -.16, p>.05). Home chaos was also found to be a significant predictor of effort among children. In addition, it was found that gender moderated the relation between home chaos and effortful control. Boys get affected more than girls and show poor effortful control in chaotic homes [t (96) = 2.39, p<.05]. Conclusion: Home chaos is a significant predictor of effortful control, one dimension of temperament among young children. Boys showed fewer self-regulation skills in chaotic homes as compared to their counterparts. [ABSTRACT FROM AUTHOR]

Objective: To evaluate interobserver variability in core breast biopsies of category B3 and B4 at a tertiary care centre Study Design: Retrospective, observational, cross-sectional study. Place and Duration of Study: Histopathology Department, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from Mar 2017 to Jun 2018. Methodology: A total of thirty cases of histologically confirmed lesions of category B3 and B4 on core breast biopsies from March 2017 to June 2018 were retrieved from archive of Histopathology department, AFIP Rawalpindi. Patients' age, histologic diagnosis and reporting B category were noted. The selected cases were anonymized and distributed among 3 pathologists for independent review. The participating pathologists were kept unaware of the findings given by fellow participants and previously agreed reference diagnoses. Study cases were reviewed by the participating pathologists. The results were analyzed and overall concordance rate, discordance rate, over interpretation rate and under interpretation rate were calculated. Results: A total of 30 (n=30) patients were enrolled of which 22 were assigned category B3 (73%) and 8 were assigned category B4 (27%) on initial microscopic evaluation (original opinion). The ages of the study patients ranged from 25 to 85 years. The average concordance rate of morphologic findings of study pathologists compared to the reference diagnosis was 63% (19/30). Among these the average concordance rate compared to reference diagnosis among category B3 lesions was 73% (16/22) and among category B4 lesions was 37.5% (3/8). The average rate of disagreement of morphologic findings of study pathologists compared with the reference diagnosis was 37% (11/30). Among these the average rate of disagreement compared to reference diagnosis among category B3 lesions 27% (6/22) and among category B4 lesions was 62.5% (5/8). The overall over interpretation rate was 44% and overall under interpretation rate was 56%. The overall rate of unanimous agreement of independent diagnoses among the three panel consultants was 50% (15/30). Among these 15 cases 12 were assigned category B3 and 3 were assigned category B4. The overall rate of disagreement of independent diagnoses among the three panel consultants was 50% (15/30). Conclusion: In our study the opinion was established by interpretation of a single slide. Average concordance rate among the participating pathologists' findings and the previously agreed upon final diagnoses was 63% and disagreement was 37%, the rate of agreement being higher in the category B3 and lower in the category B4 lesions. However effect of these results on the therapy and prognosis of patients still needs to be evaluated. [ABSTRACT FROM AUTHOR]