Search

Supplemental material, sj-docx-1-tra-10.1177_14604086231184505 for Can we predict failure of non-operative management of blunt splenic injuries on arrival? A comparison of predictors of immediate splenectomy versus splenectomy secondary to non-operative management failure by Asad Naveed, Robert Christopher Adams-McGavin, Andrew Beckett, Errol Colak, Joao Rezende-Neto, Najma Ahmed and David Gomez in Trauma

Aim: To investigate the reference values of Doppler indices for umbilical artery and Middle Cerebral Artery as well as Cerebro-placental Ratio and specifically, to evaluate the quality of methodology used on which these reference values are grounded, with the help of already established quality standards for research design, statistical analysis as well as methods of results reporting. Methodology: The methodological quality of the full-text versions of eligible studies was assessed independently by the same reviewers and a medical statistician (E.S.U.). Disagreements were resolved by consensus or consultation with two other reviewers (A.T.P. and E.F.). Quality criteria for evaluation methodologies of the published articles was developed which was based on the already available research publication25,36,37. The methodology evaluation criteria was segregated into two levels, one is study design and the other one is statistics used as well as its reporting methods. Total no. of criteria of quality were 24 to be evaluated. Results: Generally, methodological quality score was parallel for the research articles designed to evaluate umbilical artery range (median 42%; range 13.8–63.8%). For the studies focusing on middle cerebral artery range showed a median of 48% with a Class interval of 22.1–72.1% whereas the median score of cerebroplacental ratio was 47.1% with a Class interval of 34.6–55.5%. Conclusion: Rigorous methodology of this review study is the major strength, which is consisted of a standard and well developed methodology of scoring the quality of studies according to their methodology selection as well as the statistical analysis and the level of its interpretation. Keywords: Umbilical artery, Middle Cerebral Artery, Cerebro-placental Ratio, Doppler indices

Background: Ventriculomegaly is most common indicator of many of neural tube anomalies of intrauterine fetus. Presence of which has alarming sign for sonologist to have careful evaluation of fetus for other cranial and extra cranial anomalies. Aim: To evaluate the sonographic difference of fetal ventricle dilatation and neural tube anomalies. Study design: Cross Sectional study. Methodology: Female patients (n=1492) were enrolled in present study held at University Ultrasound Clinic, Green Town, University of Lahore as a reference placement for 6 months. Informed consent was taken from all of them. In this study, pregnant women who underwent ultrasound scanning between 18 and 40 weeks of gestational age were reviewed according to normal size of ventricles and dilatation of ventricles by per abdominal ultrasound having convex transducer with 3.5MHZ frequency. Results: A total of 1492 cases of pregnant women between gestational ages of 18-40 weeks were examined. Normal cases were 1485/1492(99.5%).Total 7-cases were found to have ventricle dilatation. Fetus with mild ventricular dilatation 1/7, with moderate ventricle dilatation were 4/7, 2/4 having moderate ventricle dilatation were associated with neural tube anomalies, severe ventricle dilatation was noted in 2/7, both these fetuses had neural tube anomalies. Conclusion: This study concluded that level of degree of dilatation increases the chances of abnormalities. Early detection provide better counseling opportunity for family to make decisions regarding their fetuses. Keywords: Neural tube defects, Ventriculomegaly, Gestation age and Ultrasonography.

Objective: Hypertensive and diabetic patients are at higher risk of developing ocular complications. Color and spectral Doppler, as a noninvasive technique, can be used to monitor and access the ophthalmic artery (OA) and its hemodynamic characteristics. The aim of this study was to investigate the hemodynamics of OA in diabetes and hypertension. Materials and Methods: This cross-sectional study was conducted at the University of Lahore sonography clinic. The patients were investigated using Toshiba Xario with 5 to 7.5 MHz linear transducer and the scanning was completed with closed eyelids. Those included in the study were hypertensive and diabetic patients. Exclusions were made based on a patient’s history of eye surgeries, trauma, inflammation, glaucoma, cataract, and pregnancy. Results: There were 200 patients recruited and of which, 41 were hypertensive and diabetic, whereas 159 were normal subjects. In this cohort, 41 patients (20%) were positive for hypertension and diabetes. There were 159 patients (79%) were negative for diabetes and hypertension. The resistive index (RI) of right OA was 0.783 ± 0.114 with 0.029. When considering the OA hemodynamics recorded, the pulsatility index (PI), the systolic/diastolic (S/D) ratio, RI, and end diastolic velocity (EDV) were significantly correlated among those with hypertension and diabetes. In the normal subjects, all hemodynamic measurements were seen as normal, when compared to those with hypertension and diabetic. Conclusion: This cohort study may suggest that there is a pathological increase in vascular resistance, PI, S/D ratio, and decreased blood flow velocities, in ophthalmic artery, for those hypertensive and diabetic patients.

Diabetic and hypertensive patients are at increased risk of vascular complications. Carotid Doppler ultrasonography serves as a non-invasive gold standard technique/tool to access and monitor carotids hemodynamics and morphology. There is a need to predict difference in carotid artery hemodynamics among hypertensive and diabetic patients.Aim: Aim of this study is to find out the hemodynamics of carotid artery in diabetic and hypertensive patients. Method: Cross sectional study conducted at University Ultrasound Clinic Green Town. All patients were investigated with Toshiba Xario XG with 5-7.5MHz linear probe. Study included diabetic and hypertensive individuals, whereas patients with history of carotid endarterectomy, carotid stenting and co-morbidity were excluded. Total 200 participants were recruited, 41 were diabetic and hypertensive, while 159 were normal subjects. Statistical analysis was performed using SPSS version 21. Results: From 200 participants were recruited, out of them 41 patients with 20.5% were positive with diabetes and hypertension and 159 patients with 79.5% were negative with diabetes and hypertension. Right common carotid artery intima media thickness (IMT) mean ± S.D was 0.659±0.114mm with p-value (0.022). Left common carotid end diastolic velocity mean ± S.D was 16.719±6.303cm/s with p-value (0.002). Conclusion: The study highlighted that common carotid artery intima media thickness (IMT) and common carotid artery end diastolic velocity were significantly correlated with hypertension and diabetes. Our findings revealed that common carotid artery IMT and EDV were significant in hypertensive and diabetic patients. Indeed, hypertension and diabetes are mainly associated with vascular complications.

Infertility in women is caused by a variety of hereditary and acquired uterine problems. Ultrasound has been found to be a good, quick, safe, and cost-effective way to assess the size, quantity, and location of abnormalities and to measure endometrial thickness in different phases of menstrual cycle.Objective: The main objective of this study wasto evaluate roleof ultrasound in assessment of endometrial thickness in infertile females of secretory phase. Methods: This is a descriptive study, including eighty two females age 24 to 46 years from University ultrasound clinic, Lahore after the approval of ethical committee of Allied health sciences, University of Lahore. Informed consent was taken before including the subjects in the study. Data was collected according to data collection sheets. Results: The results showed that primary infertility (54.9%) is more in females than secondary infertility (45.1%). There were 10(47.6%) females in primary infertility with 9-12mm endometrial thickness and 11(52.4%) in secondary infertility. 24(57.1%) females in primary infertility with 13-16mm endometrial thickness and 18(42.9%) in secondary infertility. 11(68.8%) females in primary infertility with 17-20mm endometrial thickness and 5(31.3%) in secondary infertility. 3(100%) females in secondary infertility with 21-24mm endometrial thickness.Conclusion: Female patients who initially taking infertility treatment had less endometrial thickness in proliferative phase; their endometrial thickness maybe increased in early secretory phase or at 21st day of their menstrual cycle but they had lost their chance to conceive the pregnancy in proliferative phase due to less endometrial thickness. The females should know the normal endometrial thickness in different phases of their menstrual cycle to conceive the pregnancy. This study shows ultrasound plays a vital role in detecting endometrial thickness in infertility treatment.

We compared children who were positive for Ebola virus disease (EVD) with those who were negative to derive a pediatric EVD predictor (PEP) score. We collected data on all children