[en] The national radiological conference was held at Peshawar, Pakistan. This book gives the conference information and abstracts of papers presented in the conference. There are about 37 abstracts submitted for the conference and related nature of the materials. Out of these 37 papers 17 are of nuclear oriented which are presented here separately. (A.B.)

[en] Bone tumors present problems which vary from simple to impossible. While benign and innocuous lesions such as fibrous cortical defects are common, primary malignant tumors of bone are relatively rare. The majority of bone tumors are ^silent^. Pain is the main clinical symptom, but it occurs only in a small percentage of lesions and usually not until bone destruction is quite advanced. Although various laboratory studies are usually performed to screen for bone metastases, all are insensitive and usually not positive until later in the course of the disease. Before attempting to interpret the radiological features of a bone tumor, consider the age of patient and other relevant information. The main basis of diagnosis is plain X-ray films, supplemented as necessary by computed tomography, scintigraphy, angiography and magnetic imaging. In this presentation radiological manifestations of benign and malignant bone tumors will be discussed. (author)

[en] Radiologists and Para Medical Staff in hospitals receive varying amounts of radiation doses as a part of their occupation. PINSTECH Health Physics Division provides radiation dosimetry services through out the country to all radiologists and Para Medical Staff through its National Film Badge Service. This helps to comply with relevant safe limits recommended by ICRP (20 mSv per year) and adopted by PNRB. Kodak Personnel Monitoring Film Type-II is used to record the dose on monthly basis. Results of annual average dose as received by the Radiologists and para Medical Staff in Pakistan have been presented. The preliminary results indicate that there have been very few cases of over exposure wherein relevant limit(s) have been exceeded. However there is concern about the proper usage of film badges. (author)

[en] It is established that immunosuppressed allograft recipients are at increased risk of developing certain types of cancers. The incidence of malignancies varies from 1% to 16% with an average of 6%. The variation of incidence may indicate differences in the intensity of immunosuppressive therapy given at various centers. The incidence also varies in different geographical regions. Kaposi's Sarcoma is more common in Arabs, Blacks Italian Jewish and Greeks. In our study of 630 patients, 12 had developed different malignancies. Six patients had Kaposi's Sarcoma, 4 had lymphoma and 2 were miscellaneous tumors, one each for adenocarcinoma of pancreas and testicular teratoma. (author)

[en] Simple radiographs remain the cornerstone in the investigation of skeletal trauma and the most common skeletal lesion seen by the radiologist is a fractured borne. While there are many fractures which are difficult to recognize. It is essential to use all information on the films and not to let any available data to go waste. In addition to missing pathology out of the primary field of view, it is difficult to identity. Subtle lesions / injuries / abnormalities. Ancillary signs, which are then useful, include soft tissue signs, joint effusions and minimal changes in bony contour. The basic principle of obtaining two views of a traumatised region at right angles to each other applies. Oblique views and horizontal beam film are useful aids. A number of illustrate cases are presented to strengthen these points. (author)

[en] It is fact that some errors are always in dose-volume prescription, management of radiation beam, derivation of exposure, planning the treatment and finally the treatment of the patient ( a three dimensional subject). This paper highlights all the sources of error and relevant methods to decrease or eliminate them, thus improving the over-all therapeutic efficiency and accuracy. It is a comprehensive teamwork of the radiotherapist, medical radiation physicist, medical technologist and the patient. All the links, in the whole chain of radiotherapy, are equally important and duly considered in the paper. The decision for Palliative or Radical treatment is based on the nature and extent disease, site, stage, grade, length of the history of condition and biopsy reports etc. This may entail certain uncertainties in Volume of tumor, quality and quantity of radiation and dose fractionation etc, which may be under or over-estimated. An effort has been made to guide the radiotherapist in avoiding the pitfalls in the arena of radiotherapy. (author)

[en] This study is related with non-small cell lung cancer. The series includes 50 patients of both sexes with histologically proven non-small cell carcinoma of lung in whom done in two arms. In arm 'A' only radiotherapy was used and in arm 'B' chemotherapy and radiotherapy were used. The results of toxicities in both arms were observed and it was conducted that by adding the chemotherapy to radiotherapy the relief of symptoms is almost same as with radiotherapy alone, but toxicity is much more increased. Cancer of lung is cause of cancer mortality in both sexes. About 95% patients die of this disease and is a real community problem. Majority of cases in both sexes are seen in age range of 35 to 75 years, with peak at age of 55 to 65 years. Smoking is said to be the major contributing factor to the development of lung cancer. (orig./A.B.)

[en] Twenty-two (22) patients having radiologically non-functioning and unilaterally obstructed kidneys with normal kidneys on other side on IVU were studied. Age range was 19 to 60 years (mean 38.4) with 18 males and four females. The kidneys were divided into the groups, according to urinary pH of obstructed kidney at operation. Group 1 (pH < 6.0) Group 2 (pH 6.1 - 7.0); Group 3 (pH > 7.1). The obstruction was corrected in all patients despite the preoperative radiological findings and morphological appearance at operation. Radiological recovery was assessed 2 months post-operatively on IVU and was found to be good (concentration of dye in 7-25 minutes), in all patients in Group-1 (10/22) in Group 2 (8/22) recovery was good in 2 patients, moderate (concentration in 25 to 24 hours), in 4 and absent (no concentration after 2 hours) in 2 patients in group II (4/22) there was no evidence of radiological recovery in either patient. (author)

[en] A total of 25 consecutive, confirmed or highly suspected, cases of PBM were imaged at Nuclear Medicine Department (NMD) Institute of Radiotherapy and Nuclear Medicine (IRNUM) Peshawar, Pakistan. Randomly selected twenty-five patients (21 male and 4 female) referred to NMD out of patients' section for pre-surgical and /or pre-radiotherapy evaluation were inducted in the study. Blood flow, blood pool and intensity, pattern, size, shape and soft tissue uptake of delayed images in various histopathological types of PBM were carried out. All the tumors had increased blood flow and pool activity except four of the five cases of chondrosarcoma (CS). On delayed images all the cases had intensity greater than the normal and irregular or hot foci on homogeneous background in nearly all of the tumors. Almost all the cases had larger sizes disrupting the normal bone outline. Increased soft tissue uptake (STU) was noted in four of the nine cases of Osteogenic sarcoma (OS) and one histiocytoma. CS shows characteristically reduced blood flow and blood pool on 3PBS, STU was seen in 44% of the cases of OS and one histiocytoma. Intensity, pattern, size and shape offered no additional information in the characterization of PBM. 3PBM can be used as an adjunct to conventional radiology in the characterization of PBM. (orig./A.B.)

[en] Diarrhoea is seen with many tumors and following several chemotherapy regimen esp. those containing 5-fluorouracil and high dose folinic acid it causes debility even death, delays cancer treatment, reduces compliance increases cost. It causes dehydration, renal failure volume depletion. Quality of life is worsened and hospitalization may be needed in multifactorial, with secretion; absorption imbalance due to mucosal damage, necrosis or inflammation. Local infection is set up by opportunistic organism and cell necrosis. The large volume of fluid and electrolytes overwhelms colonic absorptive capacity. Agent usually used for treatment is opioids (such as Diphenoxylate / Loperamide]. Bismuth (for inflammatory diarrhea). NSAIDs or alpha 2-agonists. For optimal management, the cause and severity should be assessed and treatment planned. Advice is given about certain dietary restraints and avoidance of some drugs. Fever, infection, dehydration and electrolyte losses are treated, pain relieved. Diphenoxylate / Loperamide (later is more effective; 4 mg, STAT, then 2mg every 4 hours or even 2 hourly) may be used. It is moderately effective in CID. Octreotide is useful in carcinoid. VIPoma, AIDS idiopathic secretary diarrhea, ileostomy, dumping syndrome. It acts directly on epithelial cells to reduce secretin, motilin pancreatic polypeptide. It slows transit time, reduces fluid and electrolyte secretin, increases absorption of electrolytes. It is effective in 5 FU and high dose chemotherapy with a 90% response rates seen after 3 days treatment. High Dose Chemotherapy and total body irradiation - induced diarrhea usually resolves within 72 hours. (author)