Ultrasound Unit Research Articles

Burden of Congenital Defects Diagnosed through Ultrasonography in Soba Fetomaternal Unit, Khartoum, Sudan

Background: Congenital anomalies are among the leading causes of fetal loss, despite it can be identified prior to birth through advanced technology in expert hands. Our research aimed at estimating the prevalence of congenital anomalies in Sudan. Methods: A facility-based retrospective cross-sectional study combined with a community-based survey through a telephone interview was implemented on a purposive convenient sample of 138 participants. The data were computerized in Epi Info 7. Google Earth Pro enabled to collect the geographical coordinates for the residence of the participants. Descriptive statistics were performed through SPSS 23 and ArcGIS 10.3 was used to generate the geographical distribution map of congenital defects to visualize the catchment areas of Soba Ultrasonography Unit. Results: Of the 138 participants, the estimated prevalence of congenital defects was 2.2/10,000 live births. The ultrasonography screening revealed that neural tube defects were the most prevalent anomalies with 13.0% (18/138), which represented 47.4% (18/38) of all defects. Concerning children, a mortality rate of 23.2% (32/138) was reported. Conclusions: The child mortality rate post ultrasound screening of 23.2%, and the neural tube defects being the most common anomalies appealed to Sudan health authorities for focusing on more preventive antenatal practices to strengthen and promote maternal and child health.

Early noninvasive diagnosis of endometriosis: dysmenorrhea and specific ultrasound findings are important indicators in young women

To diagnose endometriosis in young patients ≤25y with severe dysmenorrhea through specific ultrasonographic examination findings and to correlate the symptoms to its different forms: ovarian, deep infiltrating endometriosis, and adenomyosis. A retrospective observational study. University Hospital. Women aged 12-25 years with severe dysmenorrhea and a visual analog scale score ≥7. This study included 371 women aged 12-25 years referred to our gynecological ultrasound (US) Unit between January 2016 and December 2021 with severe dysmenorrhea and a visual analog scale score ≥7. Two dimensional, 3 dimensional, and power Doppler US pelvic examinations (transvaginal or transrectal in presexually active girls) were performed on all patients. Medical history and symptoms were collected routinely for each patient before the scan. All possible locations of endometriosis, isolated or combined occurrence, were evaluated, and recorded using an US dedicated mapping sheet. Painful symptoms were evaluated by visual analog scale and correlated to the different endometriosis forms. At least one US endometriosis feature was identified in 131 (35.3%) patients, whereas the US findings of 170 (45.8%) were normal despite the referred dysmenorrhea. Of the 131 patients with endometriosis, ovarian endometrioma was found in 54 (41.2%), and 22 (16.8%) had an isolated endometrioma. Adenomyosis was detected in 67 (51.1%) patients, and 28 (21.4%) showed its isolated indications. Posterior deep infiltrating endometriosis was found in 70 (53.4%) patients, and uterosacral ligament (USL) fibrotic thickening was found in 63 (48.1%). In 23 patients, the USL lesion was completely isolated. The combined occurrence of dysmenorrhea with dyspareunia, bowel symptoms, and heavy menstrual bleeding increases the presence of endometriosis up to 59%, 63%, and 45%, respectively. In young patients with severe dysmenorrhea, the US-based detection rate of pelvic endometriosis was one-third. USL fibrotic thickening and mild adenomyosis are often the only findings, so an accurate pelvic US scan can provide an early diagnosis by identifying small endometriotic lesions. Young patients with dysmenorrhea should be referred to an expert sonographer to minimize the delay between the onset of symptoms and diagnosis.

Assessment of diaphragmatic role in dyspneic patients with pleural effusion

BackgroundDyspnea that is caused by pleural effusion and affects patients’ quality of life may not be resolved after lung expansion following pleural tapping. This study aims to investigate the role that changes in the diaphragmatic shape and movement play in the development of dyspnea in those patients.MethodsThirty patients with pleural effusions and dyspnea were evaluated before and at 24 h after therapeutic thoracentesis. The primary outcomes are to investigate changes in diaphragmatic shape and movement before and after thoracentesis by chest ultrasound to evaluate factors causing effusion-related dyspnoea, while the secondary outcomes are firstly to investigate the effect of pleural effusion on the cardiorespiratory, functional, and diaphragmatic variables in causing dyspnea and secondly to detect the percentages and demographics of patients who experience post-drainage dyspnea improvement.ResultsThirty patients with age >18 years old who had moderate to massive pleural effusion (either of benign or malignant etiology), with breathlessness were recruited from the Chest Department, Ultrasonography Unit, Ain-Shams University Hospitals. Almost all (96.7%) of the studied patients experienced shortness of breath with a mean modified Borg Score of 5.13 ± 1.78, tapping of varying amounts of pleural fluid ranging from 1000 to 2000 ml.There is a highly significant improvement in the diaphragmatic excursion, with non-significant improvement in diaphragmatic shape, although nonsignificant correlation between diaphragmatic excursion and functional parameters (M. Borg score, spirometry, and 6MWD: 6-min walk distance), but a significant negative correlation between diaphragmatic excursion and amount of drained effusion (P value 0.045 and 95% CI for OR 1.041–36.779). 63.3% of patients experienced dyspnea improvement after thoracocentesis, and they showed highly significant improvements in M. Borg dyspnea score, spirometry, pulse rate, respiratory rate, 6MWD, and blood oxygen saturation.ConclusionIn this study, we conclude that the improvement of the diaphragmatic excursion was negatively correlated with the amount of drained effusion, but no significant correlation was detected with the functional parameters and effusion-related indices that may be caused by the small sample size of the study.

Peripheral Nerve Stimulation in Painful Conditions of the Upper Extremity-An Overview.

Our objective is to present a brief history of the evolution of peripheral nerve stimulation, the current understanding of peripheral nerve stimulation mechanisms in chronic pain, peripheral nerve stimulation applications in upper extremity chronic pain conditions, and complications of peripheral nerve stimulation. The evolution of peripheral nerve stimulation from the early ages to the current status has been facilitated by discoveries in neurobehavioral mechanisms of pain, advances in technology and percutaneous lead development, and the availability of high-quality portable ultrasound units. Peripheral nerve stimulation application in managing upper extremity pain of amputated limbs, post-stroke shoulder pain, complex regional pain syndrome (CRPS), and median, ulnar, and radial neuropathies are discussed. Finally, we describe complications of peripheral nerve stimulation. The availability of ultrasound-guided peripheral nerve stimulation techniques and superior peripheral nerve stimulation technology have opened up new and minimally invasive treatment options for chronic intractable neuropathic pain of the upper extremity. Additionally, the ability to place peripheral nerve stimulation leads percutaneously without open peripheral nerve surgery expands the pool of implanting physicians, while simultaneously decreasing the risks and complications that are associated with open surgery.

Contribution of Ultrasonography in the Etiological Diagnosis of First Trimester Bleeding at the Nianankoro Fomba Hospital of Segou, Mali

Bleeding in early pregnancy is common. Approximately 20-25% of pregnant women may experience bleeding in early pregnancy. Half of the women who experience vaginal bleeding in the first trimester of pregnancy will carry their pregnancy to term. About 50% of first trimester bleeding will result in miscarriage. Given these factors, we evaluated the role of ultrasonography in the diagnosis of the first trimester bleeding. This prospective observational study took place from January 1 to December 31, 2019 at the ultrasonography unit of the Nianakoro Fomba Hospital of Segou. It involved pregnant women with first trimester bleeding who met the inclusion criteria of our study. Data were collected using a form and analyzed using EPIINFO version 7 software. The mean ± standard deviation of the age of the pregnant women was 26 ± 3.9 years with an age range of 15 to 43 years. On ultrasonography, out of 103 cases, 52.43% were abortions, 35.92% as threatened abortion and 8.74% as ectopic pregnancy. Ovarian detachment (29.13%) and interrupted pregnancy (22.33%) were the predominant ultrasonographic abnormalities. Ultrasonography remains an essential exam in the etiological diagnosis of first trimester bleeding.

Evaluation of posterior segment ocular disorders using B-scan ultrasonography in patients attending a tertiary care teaching hospital Telangana India

Background: Ultrasonography is one of the most useful non-invasive techniques for evaluation of the Posterior segment of the eye. Objectives: to evaluate the posterior segment and identify any posterior segment disorders, using diagnostic B - scan ultrasonography in patients presenting with opaque ocular media. Methodology: Patients with opaque media were subjected for evaluation of the Posterior segment using a standard Ultrasound unit - MARVEL B-scan, consisting of diagnostic B scan and A scan biometry. Ultrasound probe was placed over the globe of the closed eye after applying coupling gel over the probe. The globe was scanned thoroughly using transverse, longitudinal, oblique and axial scans.Ultrasound image was analysed for any abnormalities both in real time and after freezing the image and findings were documented Results: Almost ¾ th of the patients with ocular trauma were found to have detectable posterior segment pathologies on b scan. Retinal detachment combined with vitreous hemorrhage was most common b scan finding in patients with ocular trauma.Posterior vitreous detachment was commonly observed pathology in 10 eyes followed by vitreous hemorrhage in 7 patients. Conclusion: B-scan ultrasonography is useful in the assessment of ocular traumatic and non – traumatic lesions and supplements clinical examination with valuable information.

233 Comparison of Intramuscular fat Deposition in Different Muscles of Beef Cattle

Abstract Two groups (light = 740 lbs and heavy = 942 lbs) of Akaushi cross steers (n = 20), were ultrasounded for carcass traits by an Ultrasound Guidelines Council Certified Technician every 28 days to quantify differences in intramuscular fat deposition occurring in three distinct muscles (longissimus dorsi, biceps femoris and semitendinosus). Cattle were fed at the West Texas A&M University Research Feedlot and scanned with an Aloka 500 ultrasound unit using Beef Image Analysis (BIA) Feedlot software from Designer Genes Technologies, Inc. (Harrison, AR). Carcass ultrasound measurements included 12-13th rib ribeye area (REAU), subcutaneous fat thickness (FTU), intramuscular fat percentage along the longissimus dorsi (IMFULD), rump fat thickness (RFU) as well as intramuscular fat percentage of the biceps femoris (IMFUBF) and semitendinosus (IMFUST). A difference was detected in IMFULD for the duration of the study (P < 0.05). However, no differences occurred from day 0 to day 56 (P = 0.34), or from day 84 to day 140 (P = 0.17) for IMFULD. There was a slight numerical decrease (0.1505%) in IMFUBF from day 0 to day 56, with an increased difference from day 56 to day 84 (P < 0.05). There was a positive change from 4.113% to 5.728% in the heavy group (P = 0.08) and a change from 4.113% to 4.456% in the light group (P = 0.42) for IMFUBF. There was a significant change in IMFUST from day 56 to 84 (P < 0.05). Of note, there was a decrease in IMFULD, IMFUBF and IMFST from day 140 to day 168 which could be associated with adverse winter weather events. The data present a positive increase throughout all muscles studied for beef cattle while on feed, though weather events have the possibility to negatively affect gains more rapidly than progressive effects associated with feed and growth.

PSII-A-7 Evaluation of Technician Skill Level Effect on Ultrasonic Estimates of Body Composition in Feedlot Heifers

Abstract The objective of this study was to evaluate technician skill level on ultrasonic estimates of body composition in feedlot heifers (n = 31) across different days. One unexperienced technician (UT1) and one experienced technician (UT2) took measurements of 12-13th rib fat thickness (FTU), longissimus muscle area (REAU) and intramuscular fat thickness (IMFU) on Day 1 (98 days preharvest), Day 2 (42 days preharvest) and Day 3 (48h preharvest) with an IBEX EVO II ultrasound unit equipped with 3.5-MHz, 172-mm scanning width, linear-array transducer. Carcass fat thickness (FTC), longissimus muscle area (REAC) and Marbling Score (MS) were measured 24 h postmortem. Significant differences were observed between FTC and FTU for UT1 (p< .01) and REAC and REAU for UT1 (p< .01) on Day 3. No differences were detected between FTC, FTU, REAC and REAU for UT2 on Day 3. No differences existed for REAU between technicians on Day 1 (p = 0.4547) or Day 2 (p = 0.4937). Significant differences between technicians were observed on Day 3 (p< .05) for REAU. Pearson correlation coefficients (p< .01) were .79 and .59 between REAU and REAC for UT1 and UT2, respectively. No significant differences were observed between technicians on Day 1 (p = 0.6175), Day 2 (p = 1.0) or Day 3 (p = 0.0625) for FTU. Pearson correlation coefficients (p< .01) were .79 and .76 between FTU and FTC for UT1 and UT2, respectively. No significant differences were observed between technicians on Day 1 (p = 0.1716) or Day 2 (p = 0.0595) but were significant on Day 3 (p < 0.05) for IMFU. Pearson correlation coefficients (p< .01) were .69 and .68 between IMFU and MS for UT1 and UT2, respectively. These results indicate dependence of ultrasound image collection on technician skill and years of experience to achieve accurate predictions for carcass endpoints in beef cattle.

Evaluation of Technical Efficiency of Hospitals during COVID-19 Crisis: A Case Study of Kohgiloyeh and Boyer-Ahmad Hospitals

Background: Hospitals are the most important executive part of healthcare systems. During COVID-19 crisis, they faced a sudden demand, and spent the hospital resources and equipment in order to provide treatment services to COVID-19 patients. Considering that the provision of services was focused on these patients, the efficiency of hospitals during this crisis was not clear. The purpose of the current research is to investigate the efficiency of hospitals affiliated with Kohgiluyeh and Boyer Ahmad University of medical sciences, as well as the imaging units as the most important diagnostic department in the time of this pandemic.
 Methods: This was a quantitative and retrospective study which examining technical efficiency of 6 hospitals affiliated with Kohgiluyeh and Boyer Ahmad University of medical sciences. In addition, the technical efficiency of the imaging units (CT scan, radiology and ultrasound) in these hospitals was evaluated. Technical efficiency was calculated and compared through different scenarios based on different inputs and outputs during the pandemic. The model used in this research was multi-stage DEA. To analyze the data, the output maximization model and variable returns to scale were used. Relevant data were collected for a one-year period, from October 2020 to October 2021. Technical efficiency was calculated using Deap 2.1.
 Results: The average technical efficiency of the hospitals affiliated with Kohgiluyeh and Boyer Ahmad University of medical sciences during COVID-19 pandemic was 0.80 which was satisfactory. The average efficiency of CT scan, ultrasound and radiology units in the studied hospitals and based on the defined scenarios was 0.67, 0.44 and 0.40, respectively. This shows that the ultrasound and radiology units are far from efficient.
 Conclusion: The hospitals under study as well as CT scan units were efficient during COVID-19 crisis. Examining the efficiency of the returns compared to the scale showed that increasing the number of beds as well as the equipment would not increase efficiency. Paying attention to the needs of population under study and financing them accordingly, would lead to the financial efficiency of the hospitals.

Relationship Between Wrist Flexor Muscle Thickness, Grip Strength, And Sonographic Characteristics Of The Ucl

Medial elbow joint complex injuries have been reported in competitive and recreational athletes. Ultrasound imaging (USI) is a common method for assessing the morphology of the ulnar collateral ligament (UCL). Previous research has indicated that the long wrist flexor muscle group may also function secondarily as an active stabilizer of the medial elbow joint complex. It is surmised that the relative strength of this muscle group may reduce the load placed on the UCL, thereby potentially altering the morphology of the UCL and displacement of the medial elbow joint space (MJS) as determined through sonography. PURPOSE: The purpose of this preliminary study was to examine the relationship of UCL thickness, MJS displacement, and wrist flexor muscle thickness as measured by musculoskeletal ultrasound to grip strength in college-aged recreational athletes. METHODS: Twenty-eight asymptomatic collegiate recreational athletes (age 22.3 ± 1.5yrs) participated. Participants were placed supine with the elbow joint complex position at 30 degrees of flexion with a wedge placed underneath the humerus creating a gravity-induced valgus force on the MJS. Thickness of the UCL at mid- substance (mm), MJS width (mm), and wrist flexor group thickness (mm) was measured using a GE LOGIQ E ultrasound unit. Grip strength was assessed with a Jamar hydraulic hand dynamometer measured in pounds. The Pearson product moment correlation coefficient was used to determine the relationship among each of the variables. Significance was accepted at P < 0.05. RESULTS: A moderate significant relationship between grip strength and UCL ligament thickness was observed (r= .43, p< .05). No other statistically significant relationships were found among the variables. CONCLUSIONS: This preliminary investigation found a moderate relationship between grip strength and UCL ligament thickness. Suggesting that the greater ones grip strength the greater the stabilizing force the wrist flexors may have against a valgus load absorbed by the UCL at the elbow joint complex. No relationships were found among grip strength, muscle thickness, and MJS width. Further research is needed to further understand these potential relationships, particularly in symptomatic, competitive overhead-sport athletic populations.

INFERIOR THYROID ARTERY DOPPLER: A NEW TOOL IN DIFFERENTIATION OF GRAVE'S DISEASE AND HASHIMOTO'S THYROIDITIS. A NOVEL RADIOLOGICAL-PATHOLOGICAL CORRELATION STUDY

Background: Autoimmune thyroid diseases are characterized by diffuse involvement of thyroid gland with hypoechogenicity and altered echotexture at gray scale ultrasound being a characteristic feature. An overlap of this pattern in patients affected by Graves' disease or Hashimoto's thyroiditis. Differentiation between causes of thyrotoxicosis at time of diagnosis, either hyperthyroidism due to Graves' disease or destructive thyrotoxicosis due to thyroiditis, is very important as management of each is completely different. Comparison of Doppler indices Aims and Objectives: in patients of Diffuse thyroid disease ( Graves' and Hashimoto's) on ultrasound with normal study population. Participants w Material &amp; Methods ere recruited in the ultrasound unit at the Victoria hospital, Bangalore medical college and research institute. We conducted a prospective study on a group of 20 Normal individuals and 40 patients with Diffuse thyroid disease on Ultrasonography (20 cases of Hashimoto's thyroiditis and 20 cases of Graves disease). The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-ow Doppler ultrasonography of the thyroid tissue was performed and spectral ow analysis of both inferior thyroid arteries was assessed. Inferior thyroid artery Doppler parameters were calculated in all patients. Mean PSV of normal indivi Results duals was 16.4. Hashimoto's patients who had their mean PSV was 36.2 and Graves patients who had their mean PSV 86.4. On applying unpaired t test, the two tailed p value was less than 0.05 (0.001 and 0.0001 respectively), which found statistically highly signicant. The comparison of Doppler indices of Hashimotos disease and Graves diseases - On applying unpaired t test, the two tailed p value was less than 0.05 (0.0001) which was found statistically highly signicant. Blood Conclusion ow is a useful marker in initial diagnosis of diffuse thyroid. The high correlation between Doppler indices with pathological diagnosis establishes this modality as an acceptable alternative to Nuclear imaging. Its role in pregnancy and lactation where nuclear imaging is contraindicated needs to be emphasised.

Abstract 104: Kisspeptin Signaling And Pregnancy Outcomes Are Ameliorated In The Preeclamptic-like BPH/5 Mouse After Synchronization Of Sex Steroid Hormones

Kisspeptins (KP), encoded by Kiss1 , are reported to play a role in early-onset preeclampsia (ePE), a life-threatening hypertensive disorder of pregnancy. KP is higher in term ePE placentae than in normal pregnancies. However, the role of KP in PE has not been confirmed. The Blood Pressure High Subline 5 (BPH/5) mouse model spontaneously develops the main features of ePE, including impaired placental expansion and maternal hypertension. We have shown that Kiss1 is higher at the BPH/5 maternal-fetal interface on embryonic days (e) 4.5 and 7.5. BPH/5 females have abnormal circulating sex steroid hormones (SSH) during early gestation (e2.5), with lower estradiol-17ß (E2) and higher progesterone (P4). Since E2 and P4 may modulate uterine Kiss1 , we aimed to investigate the effects of artificial synchronization of SSH (AS-SSH) in BPH/5 uteroplacental KP signaling and placental development. We hypothesized that AS-SSH would prevent BPH/5 uteroplacental Kiss1 upregulation and normalize KP downstream expression of tissue inhibitor of metalloproteinase (TIMP) 2 and placental defects. AS-SSH was performed after ovariectomy of pregnant BPH/5 and C57 females (n = 8/strain) at e2.5 with one dose of E2 (25 ng/mouse, subcutaneously), and daily subcutaneous injections of P4 (1ng/mouse) until embryonic implantation sites (eIS) were collected 3 days post-surgery (n = 8/group). Contrary to natural (Nat) BPH/5 pregnancies, eIS Kiss1 and TIMP2 expression was not different between AS-SSH BPH/5 and C57 (p &gt; 0.05). Nat and AS-SSH pregnant mice were anesthetized at e12.5 to assess umbilical cord blood flow via ultrasound and uteroplacental units were harvested for placental morphometry (n = 4-6/group). Placental expansion into the maternal decidua was measured and expressed as the ratio of the placenta depth in relation to the placenta + decidua. Nat BPH/5 had lower placental expansion and umbilical blood flow than Nat C57, whereas AS-SSH BPH/5 had higher placental expansion and umbilical blood flow than Nat BPH/5 (p &lt; 0.05). In conclusion, synchronization of the E2 and P4 profile in the BPH/5 mouse early gestation mitigated Kiss1 and TIMP2 upregulation at the maternal-fetal interface and ameliorated the placental defects previously reported in this model.

Efficacy of Doppler Ultrasound in Detection of Ovarian Malignancy

Objective: To evaluate the accuracy of colour Doppler USG and b-mode USG preoperatively in detection of ovarian malignancy using histopathological diagnosis as gold standard Methodology: This cross-sectional study was conducted at Fauji Foundation hospital Rawalpindi from June, 2017 to Jan, 2020 after seeking the ethical approval from the hospital ethical committee A total of 96 female patients having adnexal masses on ultrasound were included in study. Enrollment in the study was subjected to written informed consent. Patients having adnexal mass of non-ovarian origin, patients not fit for surgery and lost to follow up were excluded from study. History taking and examination was followed by ultrasound and color-doppler of each patient. Color Doppler sonography was carried out with real-time ultrasound and Doppler scanner unit. All the included patients were undergone laparotomy after pre op workup. Histopathologies of all patients were traced. To avoid observer error, a designated trained operator performed doppler ultrasound from hospital own resource by using Toshiba Xario colour Doppler .Histopathology was also performed by hospital pathology laboratoty by trained histopathologist. All the included patients were undergone laparotomy after pre op workup. Histopathologies of all patients were traced .All the relevant findings were recorded in the pre-designed proforma. Data was entered and analysed in SPSS Version-26. Result: The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler with grayscale USG in detecting ovarian malignancy were calculated. The specificity was found to be 90.3% and sensitivity was 79.2%. Positive and negative predicative values were 92.9% and 73.1% respectively. Conclusion: Based upon the study findings, the Doppler USG’s reliability can be established for detection of ovarian malignancies. Keywords: Adnexal mass, Doppler, Ultrasonography, Ovarian malignancy

Telemedicine and natural disasters: various services, requirements, challenges, and general framework

Providing early health care services in natural disaster is one of the essential applications of telemedicine. This narrative review aims to investigate the applications, advantages and challenges of telemedicine in natural disaster-stricken areas. Medline (through PubMed), Web of Science (WOS), and Scopus databases were searched for related articles published from beginning to 2022. The keywords used for the search included "telemedicine" and "natural disaster." After removing duplicate papers, irrelevant review articles and letters to editors, 44 relevant papers were selected and reviewed. Information sharing through audio, visual, and data-oriented services is among critical approaches that telemedicine services mainly use. Teleconsultation, tele-education, remote interpretation, tele-psychiatry, and tele-surgery are among measures that can be implemented in emergencies like earthquakes, fires, floods, storms, and drought. The fundamental requirements of a telemedicine-oriented system for providing emergency services in natural disasters include wireless scales, conversation tools, blood pressure monitor, respiratory rate monitor, spo2 sensor, glucometer, portable ultrasound unit, wearable thermometers, virtual stethoscopes, portable three leads electrocardiograph monitor, and digital otoscopes. Simple telemedicine systems can have many advantages in the natural disasters. However, the main challenge in this regard is to adapt the necessary communication systems to a telemedicine paradigm. Another critical challenge is to interpret and apply the summary of acquired information and the inevitable interaction outcomes at the required time and place.

Muscle Function Obtained with Motion Mode Ultrasound and Surface Electromyography during Core Endurance Exercise

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured between fascial borders at a given time point during an exercise. This selected time point produces a one-dimensional image resulting in real-time, live observation of anatomy. Ultrasound used during functional movement can be referred to as dynamic ultrasound; this is feasible and reliable with the use of a linear transducer, elastic belt, and foam block to secure consistent transducer placement. The lateral abdominal wall is commonly investigated using ultrasound due to the overlapping nature of the muscles. Surface electromyography (sEMG) can complement M-mode ultrasound imaging because it measures the electrical representation of muscle activation. There is minimal evidence using M-mode ultrasound and sEMG simultaneously during core exercise. Exercises that challenge the core musculature involve both isometric holds (e.g., side plank), as well as oscillatory extremity movements (e.g., dead bug). In this study, both instruments will be used simultaneously to measure core muscle function during exercise. Ultrasound measurements will be obtained using a linear transducer and ultrasound unit, and sEMG measurements will be acquired from a wireless sEMG system. To make comparisons between participants and exercises, normalization methods using static, exercise starting positions for both instruments will be used. An activation ratio will be used for ultrasound and calculated by dividing the contracted thickness (thickness during a time point of exercise) by the rested (starting position) thickness. Muscle thickness will be measured in centimeters from the superior inferior fascial border to inferior superior fascial border. These methods aim to offer an innovative and practical measurement of muscle function with M-mode ultrasound and sEMG during core endurance exercises.

The effect of cigarette smoking on first-trimester crown-rump length.

Does cigarette smoking impact the embryonic growth rate in the first trimester? This is a retrospective multicentre observational study of 2912 pregnancies. Women who presented to the early pregnancy and perinatal ultrasound units between 2010 and 2019 were included in the study. The data collected included the following: smoking status, the crown-rump length (CRL) of the pregnancy at the first ultrasound that showed an embryonic heart rate, the gestation in days and the CRL at another ultrasound up to the nuchal translucency scan and the gestation in days. Additional demographic data included the following: age, weight, height, parity and mode of delivery.Of the 2912, complete smoking and demographic data were available for 657 pregnancies. One hundred and thirty-seven (26.3%) were smokers, and 520 (73.7%) were not. The rate of change of smokers vs non-smokers between two CRLs and two different days of gestation was calculated. The Wilcoxon rank sum test with continuity correction was used for statistical analysis. This gives a value of W = 31,940 and a P-value = 0.06. There is a slight shift in location for the smokers; however, it is not statistically significant. The insignificance may be due to the general large variance in growth rate. The impact of cigarette smoking on embryonic growth rate detected by CRL in the first trimester is statistically insignificant.

Case presentation of oral soft tissue lesions by using ultrasound, terahertz and histopathology

<h3>Background</h3> In recent years, there has been an intense interest in biomedical imaging applications based on terahertz (THz) wavelengths due to its advantages such as non-invasiveness and non-ionizing radiation. <h3>Case Presentation and Differential Diagnosis</h3> A total of 10 intraoral lesions were evaluated by using an ACUSON S 2000 (Siemens, Munchen, Germany) color Doppler ultrasonography unit with a 15 MHz intraoperative probe. The borders of the lesion, vascular supply, and internal structure were evaluated. After ultrasonography, excision of lesions was performed under local anesthesia and histopathological examination and spectroscopy by using Terahertz Attenuated Total Reflection (ATR) in the light were performed. On ultrasonographic examination, 6 of the lesions showed a heterogeneous hyperechogenicity with well-defined margins and posterior acoustic shadow with no vascularity. The lesions were diagnosed histopathologically as fibroma with hyperkeratosis, hyperplasia of epidermis, proliferation of fibroblasts, and hyaline degeneration in partially hyperplastic collagen. Three of these lesions were hypoechoic with well-defined hyperechoic borders, with some isoechoic areas indicating internal vascularization. These lesions were histopathologically diagnosed as peripheral giant cell granuloma showing epithelioid cells and macrophages. One lesion showed a heterogeneous echogenic internal structure with clear hyperechoic borders without vascularization on ultrasonographic evaluation. This was histopathologically diagnosed as oral focal mucinosis, appearing as well-circumscribed but non-encapsulated myxomatous connective tissue. Imaging characteristics of the 10 lesions were shown by using the terahertz method with our laboratory settings. <h3>Conclusion</h3> Terahertz images were found to be promising in terms of assessing intraoral soft tissue lesions. <b>Statement of Ethical Review</b> Written consent and permission was obtained from the patients

Increased Great Saphenous Vein Diameter at the Level of Knee among Patients with Varicose Veins in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Colour Doppler ultrasonography plays an important role in determining the morphological and hemodynamic information of the venous system. This study aimed to find out the prevalence of increased great saphenous vein diameter at the level of the knee among patients with varicose veins in a tertiary care centre. A descriptive cross-sectional study was carried out in the Department of Radiology at a tertiary care centre from 30 October 2021 to 31 March 2022 after taking ethical approval from the Institutional Review Committee (Reference number: 028-077/078). A convenience sampling technique was used for the study. The study group consisted of patients over 18 years, coming for ultrasonography examination of the lower limb with the clinical symptoms and signs of varicose veins. The great saphenous vein diameter was measured at the level of the medial femoral condyle of the knee using the software in the ultrasonography unit. B mode, colour Doppler and spectral analysis were done. A cut-off value of 5 mm for the diameter of the great saphenous vein was taken to indicate the presence or absence of varicosity and saphenofemoral reflux. Point estimate and 90% Confidence Interval were calculated. Among 72 patients with varicose veins, the diameter of the great saphenous vein was increased in 59 (81.94%) (74.50-89.38, 90% Confidence Interval) patients. The mean diameter of the great saphenous vein in our study was similar when compared to other studies conducted in similar settings. saphenous vein; ultrasonography; varicose veins.

REGIONAL SCLERAL THICKNESS AS A RISK FACTOR FOR CENTRAL SEROUS CHORIORETINOPATHY.

To evaluate regional sclera thicknesses as possible risk factors for central serous chorioretinopathy (CSC). Patients with CSC and controls were evaluated with contact B-scan ultrasonography using a 20 Mhz concentric phased array ultrasound unit and enhanced depth imaging optical coherence tomography to measure the scleral thickness at the equator and posterior pole. The resultant data were evaluated using univariate analysis and generalized estimating equations. There were 40 patients with CSC with a mean age of 58 years and 23 controls with a mean age of 60.7 years (P = 0.31). The mean subfoveal scleral thicknesses were 1.3 mm in the CSC group and 0.86 mm in the control group (P < 0.001). The mean equatorial scleral thickness was 0.61 mm in the CSC group and 0.42 mm in the control group (P < 0.001). Using generalized estimating equations, the equatorial scleral thickness (P = 0.001), posterior scleral thickness (P < 0.001), and subfoveal choroidal thickness (P = 0.032) were independent predictors of CSC. Once these variables were entered into the equation, neither sex nor age were significant predictors. Generalized estimating equation analysis showed that equatorial, but not posterior, scleral thickness was a significant predictor of subfoveal choroidal thickness. Scleral thicknesses of the posterior and equatorial portions of the eye were found to be significant predictors of CSC, consistent with what was proposed in the theory of venous overload choroidopathy. Direct measurement by high resolution ultrasonography provides independent information about specific regions of the sclera and also avoids making speculative assumptions derived from anterior segment measurements.

Evaluation of Timing and Workmetry of Service Delivery in the Imaging Ward of Shahid Rahnemoun Hospital, in Yazd, in 2021

Background: The importance of timing lies on providing services, identifying the current status of service delivery, and determining the workload to improve productivity of the organization and the level of satisfaction of service providers and recipients. The aim of this study is to investigate the timing of patient's workflow, in order to identify the current state of service delivery, and determine the workload in the imaging ward of Shahid Rahnemoun hospital in Yazd.&#x0D; Methods: The present study was descriptive-analytical and cross-sectional-observational, which was conducted in 2021. The sample included 1287 images or graphs from the imaging ward of Shahid Rahnemoun Hospital, during a period of 3 months and during different shifts (morning, evening and night). They were selected using the Krejcie-Morgan method. Frequency, percentage, means, and standard deviation were used to evaluate descriptive statistics.&#x0D; Results: Results of the study showed that the maximum and minimum mean time calculated for each service was related to the service of hospitalized patients in the radiology unit (22:50 minutes) and operating room patients (2:16 minutes), respectively. Also, the maximum and minimum working hours spent for all services obtained were related to the inpatients in the radiology unit (67747 minutes) and outpatients in the ultrasound unit (243 minutes), respectively.&#x0D; Conclusion: The timing and workmetry of the activities performed in the hospital's imaging ward, gave the authors a view of the current situation of the workforce and the amount of work done by the imaging ward.