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Hasan Rawashdeh,1,2 Aparna Ramachandran,1 Jenny M Yang,1 Gemma Blain,1 Jon Hyett1,3 1Department of Women and Babies, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; 2Department of Obstetrics and Gynaecology, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Obstetrics and Gynaecology, Western Sydney University, Sydney, NSW, AustraliaCorrespondence: Hasan Rawashdeh, Department of Obstetrics and Gynaecology, Jordan University of Science and Technology, Irbid, Jordan, Tel +00 962 7 9828 4038, Email hmrawashdeh@just.edu.joBackground: Preterm birth (PTB) is associated with significant neonatal mortality and morbidity. Universal measurement of cervical length has been proposed as a screening tool to direct intervention to prevent PTB.Aim: To assess the impact of the introduction of sonographic mid-trimester cervical length screening on the use of cervical cerclage and PTB.Material and Methods: A retrospective cohort study reviewed two groups of women who underwent cervical cerclage before and after the introduction of universal sonographic cervical length screening. Demographics and outcomes were compared using Student’s t test, Fisher’s Exact test and Kaplan–Meier analysis.Results: Following introduction of universal cervical length screening, the overall rate of cerclage increased from 2.5/1000 births to 6.0/1000 births (p < 0.01). There was a reduction in the proportion of sutures placed purely based on maternal history (50.0% to 30.4%; p < 0.001), while the proportion of sutures placed following ultrasound assessment increased in both high- (21.7 to 36.6%) and low-risk (11.7% to 30.4%) women (p < 0.001). The overall rate of PTB < 37 weeks in women has a cerclage was 25.7% and was highest in women undergoing rescue cerclage (64.3%; p < 0.01). There was no difference in the rate of PTB between high- and low-risk women undergoing history- or ultrasound-indicated cerclage. Mean pregnancy length was most prolonged in low-risk women undergoing ultrasound-indicated cerclage, extending gestation from 33.9 to 38.3 weeks (p < 0.01).Conclusion: Universal cervical length screening results in an increase in the use of cerclage, specifically on the basis of the ultrasound findings. Women who were at low risk but then underwent ultrasound-indicated cerclage experienced most prolongation of pregnancy. Women who were at high risk but had a suture on the basis of ultrasound findings-indicated cerclage represent an alternative method of management with no significant difference in the gestational age of delivery.Keywords: cerclage, premature birth, cervical length measurement, progesterone, ultrasonography

Background: The aim of this study was to find the difference between the liver function test (LFT) and hepatorenal index (HRI), before and after the administration of Prunus mume (PM) and choline i.e., to find the predictors of the non-alcoholic fatty liver disease (NAFLD) severity according its HRI, during the three-month follow-up period. Methods: LFT, glucose, and lipid tests were determined in 168 NAFLD patients, at baseline and after three-month drug treatment. HRI was calculated by Image J software analyzing the ultrasound images, and according its value, 3 groups of NAFLD were formed. Results: The HRI at baseline (1.3598±0.1744) and after 3 months therapy (1.3061±0.1923) differs significantly (p

Background: Foot posture is proposed as an important factor that may affect the lower limb alignment. Variations from the normal foot posture may contribute to musculoskeletal injuries of the lower extremity especially knee joint. Considering variations in foot posture and knee joint alignment, this study aimed to assess and compare pennation angles of the vastus medialis oblique (VMO), vastus medialis (VM) and vastus lateralis (VL) in women with pronated foot posture and normal ones. Methods: This observational, case-control study was carried out on 31 women with pronated foot posture (foot posture index: 6-12) and 31 women with normal foot posture (foot posture index: 0-5) in the age range of 18 to 35 years old. Participants were recruited from female students of university communities using Non-probability Sampling method. Sampling was carried out from September 2019 up to February 2020 at the biomechanics laboratory of rehabilitation faculty of Tehran University of Medical Sciences. The pennation angle of VMO, VM and VL muscles was measured by using two dimensional. B-mode ultrasound imaging (USI) .A 7.5MHz linear transducer with 50mm footprint was used for the measurements. The ultrasound images were analyzed using Image J software. Three longitudinal scans were captured for each muscle pennation angle while the probe removed between each scan. Results: The results of this study showed that there is no statistical significant difference between the pennation angles of VMO, VM and VL in women’s foot posture compare to the normal ones (P>0.05). However, the results of intraclass correlation coefficient (ICC) of USI measurements showed “good” intrarater reliability for VMO (ICC=0.88), VM (ICC=0.87) and VL (ICC= 0.77) pennation angles. Conclusion: Based on the results of this study, the pennation angle of knee extensor muscles (VMO, VM, and VL), which was measured in non-weight bearing, is not different in young women with pronated foot compared to the normal ones. In addition, USI demonstrated good reliability for measuring VMO, VM and VL pennation angles.

INTRODUCTION: The objective of the study was to retrospectively evaluate the feasibility of the magnetic resonance imaging (MRI)-ultrasonography (US) fusion system for the guidance of sacroiliac joint (SIJ) injections and the clinical results of patients who underwent intra-articular and peri-articular injections. METHODS: In this study, MRI-US fusion-guided SIJ injections in 10 patients with active sacroiliitis were evaluated retrospectively. Injections were made in the synovial part of the SIJ in 5 patients and in the ligamentous part in 5 patients. RESULTS: Injections were successful in treating pain in all patients. There was no significant difference in clinical responses (post-injection 2nd week and 3rd month) between synovial or ligamentous injection groups. DISCUSSION AND CONCLUSION: The MRI-US fusion method is an effective and reliable option for SIJ injection guidance. There is no difference in the effectiveness of corticosteroid injections into the synovial or ligamentous compartment in the management of sacroiliitis in spondyloarthritis patients.

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of the study was to carry out a comparative analysis of the linear size of the uterus in women during the frst period of adulthood and old age according to ultrasound examination data. Material and methods. The study was based on the results of ultrasound examination of 53 women with normal pelvic dimensions who were examined at the gynecology department of the Perm Krai Clinical Hospital during the period from 2021 to 2022. All the women consented to the examination, which was performed according to the indications in order to exclude probable pathology of the reproductive system. The ultrasound examination consisted of measuring the longitudinal (length), transverse (width) and anteroposterior (thickness) dimensions of the uterus using transvaginal access. Women were divided into two groups: the frst group consisted of 27 subjects of the frst period of mature age (22 to 35 years), the second group included 26 subjects of advanced age (75 to 88 years). Results. When comparing the indicators of uterine size, their statistically signifcant decrease from the frst period of adulthood to old age: uterine length decreased by 54.5 % (p < 0.001), width – by 57.8 % (p < 0.001), thickness – by 67.8 % (p < 0.001). We believe that this pattern can be substantiated by the onset of postmenopause and a decrease in estrogenic hormone content from reproductive age to senile age. Conclusions. The obtained results of the intravital comparative analysis of the uterus linear dimensions in women of the frst period of adulthood and old age expand the scientifc ideas about age-related features of this organ of the reproductive system, are the basis for further research and can be used by physicians of clinical specialties such as gynecology, gerontology, ultrasound diagnostics.

Zhirong Yan,1,&ast; Huifen Lin,2,&ast; Ying Yang,3 Jialin Yang,3 Xueshan Li,2 Yusheng Yao3,4 1Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Anesthesiology, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, People’s Republic of China; 3Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, People’s Republic of China; 4Fujian Provincial Key Laboratory of Critical Care Medicine, Fuzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yusheng Yao, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No.134 Dongjie Street, Fuzhou, People’s Republic of China, Tel +86-13559939629, Fax +86-591-88217841, Email fjslyys@126.comPurpose: This study aimed to examine the effectiveness of ultrasound-guided thoracic paravertebral block on postoperative quality of recovery in patients undergoing percutaneous nephrolithotomy.Patients and Methods: In this randomized, double-blind, placebo-controlled trial, we enrolled patients scheduled for unilateral percutaneous nephrolithotomy. Patients were randomly allocated to receive thoracic paravertebral block either with 20 mL of 0.5% ropivacaine (PVB group) or an equal volume of saline (control group). The primary outcome was the quality of patient recovery at 24 h postoperatively, assessed using the 15-item Quality of Recovery scale. The secondary outcomes included the area under the curve of pain scores over time, time to first rescue analgesia, and postoperative 24 h morphine consumption.Results: We analyzed the data of 70 recruited participants. The median Quality of Recovery-15 score at 24 h postoperatively was 127 (interquartile range, 117– 133) in the PVB group, which was significantly higher than 114 (interquartile range, 109– 122) in the control group, with a median difference of 10 points (95% confidence interval, 5– 14; P< 0.001). The area under the curve of pain scores over time was lower in patients receiving thoracic PVB than in those receiving saline block (P< 0.001). The median time to first rescue analgesia in the PVB group (10.8 h, interquartile range 7.1– 22.8 h) was longer than that in the control group (1.9 h, interquartile range 0.5– 4.3 h) (P< 0.001). Similarly, the median postoperative 24-hour morphine consumption was nearly half as low in the PVB group as in the control group (P< 0.001). The occurrence of postoperative nausea and vomiting, and pruritus were significantly higher in the control group (P=0.016 and P=0.023, respectively).Conclusion: Preoperative ultrasound-guided single injection of thoracic paravertebral block with ropivacaine improved the postoperative quality of recovery and analgesia in patients undergoing percutaneous nephrolithotomy.Keywords: pain management, quality of recovery, regional anesthesia, ultrasonography

Background: Prostate enlargement is a common issue amongst men, which causes significant side effects for aging men. Regarding the high prevalence of prostate enlargement and opium addiction and its derivatives, assessing the relationship between opium use with prostate enlargement may be an exciting issue. Methods: This was a cross-sectional study. There were two groups; the case group contained men with a history of at least one year of opium abuse. The control group was men in the same age range referred to university-affiliated hospitals for ultrasonography for other reasons except for prostate problems. The prostate size and demographic information of patients were recorded. The prostate volume of more than 20 ml was considered as an enlarged prostate. Results: 212 males participated in the study from December 2018 to March 2019 at Namazi Hospital of Shiraz University of Medical Sciences, including 78 drug abuse patients (mean age=39.08±6.52 years old) in the case group and 134 (mean age=40.69±6.28 years old) in the control group. The mean prostate size in the addict group was significantly higher than in the healthy group (P=0.005). There was a significant correlation between the size of the prostate and the age in both groups. However, there was no correlation between prostate size and body mass index. Conclusion: Due to a decrease in the sexual desire of addicted people, we first expected to face smaller prostates in addicted men; however, the study results proved the opposite. One explanation can be that the decreased libido increases the likelihood of fluid accumulation in the prostate, this might lead to chronic inflammatory reactions, hypertrophy, and prostate hyperplasia. Therefore, a more comprehensive study is needed to investigate the interaction between the drug and prostate tissue. Finally, it can be concluded that addiction to opium and its derivatives can increase the chance of prostate enlargement. Due to the lack of previous studies in this field, it seems necessary to conduct additional studies with larger sample sizes and control confounding factors.

Introduction: Metastatic spread of lung cancer to supraclavicular lymph nodes is considered distant metastasis for treatment purposes. Detection of supraclavicular lymph node metastasis in patients with lung cancer serves for tissue diagnosis by itself and also helps avoid more invasive biopsy from the primary lung mass itself. Ultrasonography of the lower neck can detect supraclavicular lymph nodes before they are palpable and can also be used for safe sampling of these lymph nodes. The aim of this study was to find out the prevalence of metastatic supraclavicular lymph nodes among patients with lung carcinoma in a tertiary care centre. Methods: A descriptive cross-sectional study done in a tertiary care center, carried out from 15 September 2019 to 14 September 2020. Ethical approval was obtained from the Institutional Review Committee (Reference number: 84(611)E2/076/077). The study was done among 92 patients with biopsy-proven lung cancer (lung mass or supraclavicular lymph node biopsy) who were referred for evaluation, and/or percutaneous transthoracic biopsy. Convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Among 92 patients with proven lung cancer, metastatic supraclavicular lymph nodes were seen in 13 patients (14.10%) (8.17- 19.73, 90% Confidence Interval). Among 13 patients with metastatic lymph nodes, 9 (69.23%) had palpable supraclavicular lymph nodes. The majority 11 (84.61%) had round-shaped lymph nodes. All metastatic lymph nodes showed loss of echogenic fatty hilum. A total of 12 (92.30%) metastatic lymph nodes showed a peripheral disorganized pattern of vascularity. Conclusions: The prevalence of metastatic supraclavicular lymph nodes was lower than in similar studies done in international settings.

Macrodystrophia lipomatosa (MDL) is a rare congenital disorder characterized by localized gigantism of one or several digits. It may involve the entire limb due to progressive overgrowth of all mesenchymal elements with an excessive increase in the fibro-adipose tissues. It occurs most commonly in the lower limbs. It comes to clinical attention for cosmetic reasons, mechanical problems secondary to degenerative joint disease, or the development of neurovascular compression. We report a case of MDL of the right foot with difficulty walking and wearing footwear. With a complete radio-clinical workup and history review, a provisional diagnosis of MDL was made, confirmed by histopathology and during surgery. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Objective: To evaluate the abdominal aorta diameter in asymptomatic Pakistani population to determine the associations between age, gender and BMI and abdominal aortic diameter measured by ultrasonography. Study Design: Case series. Place and Duration of Study: Department of Radiology, Combined Military Hospital, Lahore, Pakistan, from Jun to Dec 2021. Methodology: A total of ninety-four healthy asymptomatic subjects of both genders, between 18-80 years of age, were enrolled for the study. Aortic diameters were measured (inner to inner method) using electronic calipers on static images. The Anteroposterior and Transverse (TR) diameters were measured at three levels: the first at the aortic hiatus, which was directly below the abdominal aortic commencement, the second at the suprarenal (mid-point), and the third at the aortic bifurcation (lower level). Results: Males had significantly larger (p-value<0.001) anteroposterior and transverse abdominal aorta diameters than females, with abdominal aorta diameter values found to be significantly higher (p-value 0.001) in age group of greater than 40 years except anteroposterior distal abdominal aorta diameter. Similarly, a significant difference (p-value <0.001) was noted in abdominal aorta diameter among patients with different BMI groups other than distal abdominal aorta diameter. Conclusion: Abdominal aorta diameters vary greatly depending on age, gender and BMI. Clinicians must know the usual diameter of the abdominal aorta in order to recognize an aneurysm at an early stage. [ABSTRACT FROM AUTHOR]

Background: Crohn's disease (CD) is a complex autoimmune disease that results in chronic inflammation of the gastrointestinal tract. CD activity is determined through clinical, laboratory, endoscopic, and radiological evaluations. Studies that examine the data of radiological modalities of evaluation are lacking, particularly in Saudi Arabia. This study compares magnetic resonance enterography (MRE) and ultrasonography (US) findings among patients diagnosed with CD, to uncover a possible correlation between these techniques. Methods: All patients were assessed for disease activity using MRE and US. Results: A total of 376 patients with CD were recruited. The mean age was 14.9 ± 4.3 years (range, 8–27 years), and males constituted 64% (n = 239) of the cohort. Overall, a strong positive correlation was found between US and MRE evaluations of disease activity (r = 0.83, P < 0.001). US activity correlated positively with MRE findings of enlarged lymph nodes (P < 0.001), bowel wall enhancement (P < 0.001), distal jejunal thickness (P < 0.001), and distal ileal thickness (P < 0.001). The mean difference in wall thickness was significant based on gender (P < 0.001), age in proximal jejunal thickness (P < 0.001), and distal ileal thickness (P = 0.011). Conclusions: MRE and US correlate significantly as imaging techniques for the assessment of CD activity.

Idiopathic intracranial hypertension is characterised by increased intracranial pressure of unknown aetiology. It is usually seen among obese women who are of childbearing age. With an incidence of 0.9 per 100,000 in women of childbearing age, the incidence in obese women is as high as 19.3 per 100,000. Here, we represent the case of a 31-year-old, non-obese primigravida with hypothyroidism which was diagnosed as idiopathic intracranial hypertension during pregnancy. This patient, was managed with multi-disciplinary considerations so as to avoid complications in perioperative period.

Introduction: Access to ultrasound imaging services is limited in rural areas and point-of-care ultrasound (POCUS) has the potential to address this gap. We aimed to examine how POCUS is utilised by doctors in contemporary Australian rural general practice. Methods: A portable ultrasound machine and access to a training course were provided to four general practices in rural South Australia, and the type and frequency of POCUS scans were recorded, along with user information, between July 2020 and June 2021. Participating general practitioners (GPs) completed a survey at the commencement of the study regarding their previous experience and confidence in using POCUS for specific assessments and procedures. Results: Of the 472 scans recorded, most (95%) were for clinical indications, 3% for teaching activities and 2% for self-learning. Overall, 69% were obstetric scans, followed by abdominal (12%), gynaecological procedures (10%), other procedural (7%) and thoracic exams (1.5%). Users reported higher confidence for lower complexity POCUS. Conclusion: Although POCUS has diverse potential applications in rural practice, GPs reported limited confidence for certain scans and used POCUS predominantly for obstetric indications. Further studies should examine the barriers to POCUS utilisation, with particular attention to training requirements, reimbursement for use and access to machines.

Background: Diabetic peripheral neuropathy (DPN) is the prevalent microvascular complication of diabetes mellitus (DM). 30-50% of diabetics are likely to be affected by DPN. It significantly impacts the skeletal muscles, resulting in an accelerated loss of muscle mass. The objective of this systematic review was to evaluate the ankle and foot muscle changes in diabetic peripheral neuropathy using ultrasound., Method: A comprehensive search was conducted in Scopus, Embase, and PubMed databases, which yielded 64 studies, out of which 5 studies are included in this meta-analysis., Result: The meta-analysis shows that the thickness and cross-section area of the extensor digitorum brevis muscle are reduced in DPN as compared to the control group with p-value<0.004 and p-value<0.001, respectively. The thickness of MIL muscle was also smaller in DPN p-value=0.02. Similarly, the thickness and CSA of AH muscle are also reduced in DPN patients compared to the control group, with p-values of 0.21 and 0.14., Conclusion: Meta-analysis reveals that diabetic peripheral neuropathy (DPN) patients have reduced foot muscle thickness and cross-sectional area (CSA) compared to controls without neuropathy. This highlights the importance of ultrasound in detecting muscle atrophy early in diabetic patients since it provides objective measures beyond traditional screening with its real-time and non-invasive nature., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The most common adrenal lesion is an adrenal adenoma in adults. Adrenal adenomas can have a variety of imaging features due to their widespread prevalence. As a result, distinguishing between typical and atypical imaging features of adrenal adenomas is critical, as is distinguishing atypical adrenal adenomas from potentially malignant lesions. Here, we present a case of adrenal adenoma with atypical imaging findings presenting as Cushing’s syndrome.

Copyright of Kocatepe Veterinary Journal / Kocatepe Veteriner Dergisi is the property of Afyon Kocatepe University, Faculty of Veterinary Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: In our study, we aimed to examine the effect of Lung ultrasonography on prognostic factors (parapneumonic effusion, empyema development, etc.) in patients with a diagnosis of pneumonia who were followed up in the Chest Diseases Clinic and Anesthesia Intensive Care Unit. METHODS: Fifty patients with a pre-diagnosis of pneumonia and / or pleural effusion were included in our study between 01.01.2017 - 01.06.2018 in the Chest Diseases Department of Van Yüzüncü Yıl University Medical Faculty and in the Anesthesia Intensive Care Unit. The patients were followed up with lung ultrasonography and the factors affecting the prognosis of these cases were examined. RESULTS: Of the patients included in the study, 16 were female (32%), 34 were male (78%); Their mean age was 60.4 +- 19.4 (15-87). Pleural effusion was detected in 56% of the cases. 28.57% of 28 cases were evaluated as transudate and 71.42% as exudate. Tube thoracoscopy was performed in 4 cases and decortication in 1 case, no patient required fibrinolytic. The mean hospitalization period of the patients was 7.78 +- 5.44 days (min. 2-Max 22). DISCUSSION AND CONCLUSION: As a result of the data obtained in our study, we are of the opinion that lung ultrasonography supports the need for more frequent use in current practice due to its advantages such as high success in interventional procedures, low complication rate, and most importantly, the opportunity to operate at the bedside, especially in intensive care.

Wen Li,1,2 Qing Song,2 Yu Lan,2 Jie Li,3 Ying Zhang,2 Lin Yan,2 Yingying Li,2 Yan Zhang,2 Yukun Luo2 1Department of Ultrasound, Medical School of Chinese PLA, Beijing, People’s Republic of China; 2Department of Ultrasound, The First Medical Center Chinese PLA General Hospital, Beijing, People’s Republic of China; 3Department of Pathology, The First Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of ChinaCorrespondence: Yukun Luo; Yan Zhang No. 28 Fuxing Road, Haidian District, Beijing, 100853, People’s Republic of ChinaTel +8613311373556; +8613581937501Fax +8601055499255Email luoyk301@126.com; zhangyaner301@126.comPurpose: Differentiation between follicular thyroid carcinomas (FTCs) and follicular thyroid adenomas (FTAs) is difficult and the sonographic features of FTC are not yet fully established. The purpose of this study is to explore the sonographic features of FTC and the value of sonography in differentiating FTCs from FTAs.Patients and Methods: A total of 28 pathologically proven FTCs and 53 FTAs in 78 patients who were performed thyroid surgery were included in this retrospective study. The sonographic features of each tumor including an interrupted halo, satellite nodule(s) with or without halo ring, local irregularity of margin and cluster of grapes sign were evaluated. A mode image of FTC halo was built up in our study. The frequencies of the sonographic features were compared by chi-square test or Fisher exact test between FTCs and FTAs. The relative risk of malignancy was assessed by logistic regression analysis.Results: Logistic regression analysis showed that a thick, irregular and/or interrupted halo with or without satellite nodule(s), hypoechoic or marked hypoechoic echogenicity, a predominantly solid pattern, cluster of grapes sign, micro-or macro-calcifications, rim calcifications correlated with significant increases in relative risk for FTCs (odds ratio 11.48 (1.37– 96.56), 6.74 (1.05– 43.30), 17.51 (1.78– 172.53), 9.55 (1.44– 63.46), 9.36 (1.25– 70.15) and 17.45 (1.04– 292.65), respectively, p< 0.05). Two new sonographic features, an interrupted halo and satellite nodule(s) with or without halo ring, can only be found in FTCs.Conclusion: An interrupted halo and satellite nodule(s) with or without halo ring are specific sonographic features for FTCs. Sonography could play a role in differentiating follicular thyroid carcinoma from adenoma.Keywords: follicular thyroid carcinoma, follicular thyroid adenoma, ultrasonography

The present paper is a bibliographical research on canine hip dysplasia using imaging and molecular genetics techniques. Ever since the first description in 1935 made by Schnelle, canine hip dysplasia has remained one of the most diagnosed orthopedic conditions present in the dog breeds. The gold standard method of diagnosis of hip dysplasia is the radiological examination in hip-extended position. While the radiological examination focuses mainly on the individual for the diagnosis of this condition, methods of diagnosis of an entire population are sought, and these methods are represented by molecular genetics techniques. Naming the etiology of canine hip dysplasia and finding out the latest methods of genetically and radiologically diagnosis of canine hip dysplasia and the best alternatives of treatment for this disease. Canine hip dysplasia continues to be a major problem for owners, breeders and veterinarians. Currently, there are five standardized systems worldwide that deal with the grading of canine hip dysplasia. In addition to digital radiology, CT and ultrasonographic examination are feasible diagnosis methods. Even if the standard method of diagnosis remains the radiological examination in the present, the near future provides to be of the molecular genetic techniques.

B-mode and Doppler ultrasonography in ruminants, as a technique has allowed establishing new concepts on the reproductive physiology of females, through the study of follicular dynamics and morphometry of the corpus luteum, therefore, the objective was to characterize by means of B-mode and Doppler ultrasonography the corpus luteum in recipient llamas. Thirty-seven recipient llamas were used (27 for B-mode ultrasonography and 10 Doppler) that were synchronized by applying buserelin acetate 0.0096 mg, nine days later 0.048 mg of prostaglandin F2α analog was applied two days later, the second dose of buserelin acetate was applied at the same dose to guarantee ovulation and subsequent formation of the corpus luteum, the evaluation in mode B of the morphometry consisted of observing the echotexture, area, diameter and volume of the corpus luteum with the use of a SonoStar SS-8® ultrasonograph at 6.5 MHz frequency and 6 cm depth equipped with a transrectal linear transducer; using the same technique with a Draminski 4Vet® Doppler equipment, the percentage of luteal area of vascularization (% AVL) was determined. The data were subjected to a descriptive analysis being 0.119±0.032 cm2 of area, 12.7±1.7 mm of diameter and 0.84±0.32 cm3 of CL volume, to determine the relationship between metric measures the Pearson correlation was used observing a positive relationship between area/diameter of 0.7506, area/volume of 0.9289 and diameter/volume of 0.6602, observing a high positive correlation between area and volume, finally the % AVL characteristics was 34.97 for the CL of recipient llamas. In conclusion, the morphometric characteristics evaluated in mode B (area, diameter and volume) have a positive correlation and the % AVL could be applied as a tool in the efficient reproductive management for the selection of recipients in camelids, understanding that it is one of the first reports of these characteristics in llamas.

Background: Crohn's disease (CD) is a complex autoimmune disease that results in chronic inflammation of the gastrointestinal tract. CD activity is determined through clinical, laboratory, endoscopic, and radiological evaluations. Studies that examine the data of radiological modalities of evaluation are lacking, particularly in Saudi Arabia. This study compares magnetic resonance enterography (MRE) and ultrasonography (US) findings among patients diagnosed with CD, to uncover a possible correlation between these techniques. Methods: All patients were assessed for disease activity using MRE and US. Results: A total of 376 patients with CD were recruited. The mean age was 14.9 ± 4.3 years (range, 8–27 years), and males constituted 64% (n = 239) of the cohort. Overall, a strong positive correlation was found between US and MRE evaluations of disease activity (r = 0.83, P < 0.001). US activity correlated positively with MRE findings of enlarged lymph nodes (P < 0.001), bowel wall enhancement (P < 0.001), distal jejunal thickness (P < 0.001), and distal ileal thickness (P < 0.001). The mean difference in wall thickness was significant based on gender (P < 0.001), age in proximal jejunal thickness (P < 0.001), and distal ileal thickness (P = 0.011). Conclusions: MRE and US correlate significantly as imaging techniques for the assessment of CD activity. [ABSTRACT FROM AUTHOR]

Background: The purpose of the current study was to evaluate the ability of three protocols to triage women presenting with pregnancy of unknown location (PUL). Methods: Women with pregnancy of unknown location were recruited from Aziz Medical Centre from 1st August, 2018 to 31st July, 2020. The criterion of progesterone, human chorionic gonadotrophin (hCG) ratio, and M4 algorithm were used to predict risk of adverse pregnancy outcomes and classify women. Finally, 3 groups were established including ectopic pregnancy, failed pregnancy of unknown location, and intrauterine pregnancy (IUP). The primary outcome was to assign women to ectopic pregnancy group using these protocols. The secondary outcome was to compare the sensitivity and specificity of the three protocols relative to the final outcome. Results: Of the 288 women, 66 (22.9%) had ectopic pregnancy, 144 (50.0%) had intrauterine pregnancy, and 78 (27.1%) had failed pregnancy of unknown location. The criterion of progesterone had a sensitivity of 81.8%, specificity of 27%, negative predictive value (NPV) of 83.3%, and positive predictive value (PPV) of 25% for high risk result (ectopic pregnancy).The hCG ratio had sensitivity of 72%, specificity of 73%, NPV of 90%, and PPV of 44% for high risk result (ectopic pregnancy). However, model M4 had sensitivity of 86.4%, specificity of 91.9%, NPV of 95.8%, and PPV of 76% for high risk result. Conclusion: Based on the findings of the study, it was revealed that prediction model of M4 had the highest sensitivity, specificity, negative predictive value and positive predictive value for high risk result (ectopic pregnancy). [ABSTRACT FROM AUTHOR]

Background: The application of mesenchymal stem cells in the healing of chronic wounds is one of the most challenging issues in cell therapy. The present study investigated the efficacy of intradermal injection of umbilical cord Whartonchr('39')s Jelly-derived mesenchymal stem cells in diabetic wound healing using ultrasound imaging in an animal model. Methods: During this experimental laboratory study that was performed in the Skin and Stem Cell Research Center, Tehran University of Medical Sciences between October 2017 and October 2016, mesenchymal stem cells were isolated from umbilical cord Whartonchr('39')s jelly of 10 neonates. The cells were passage. The differentiation potential of cells to osteocyte and adipose cells was evaluated. The expression of specific markers of mesenchymal stem cells was evaluated using flow cytometry. The viability and quality of cells were evaluated before transplantation. The diabetes model was developed by intraperitoneal injection of streptozotocin in 42 male Wistar rats. The animals were randomly divided into two groups: normal saline injection (control) and cell injection. Cell transplantation was performed intradermally. Skin thickness and density were assessed using ultrasound imaging on days 7, 14 and 21. Finally, the data were analyzed using a t-test and analysis of variance. Results: Injection of mesenchymal stem cells caused faster closing of the wound. The results of biometric measurement of wound skin in rats showed that skin thickness and density on days 7, 14 and 21 in the Wharton jelly mesenchymal stem cell injection group had a significant increase compared to the control group. Conclusion: The results of cell analysis showed that the isolated cells are the same as mesenchymal stem cells. The cells were of the required health and quality. Intradermal injection of mesenchymal stem cells in diabetic wound area caused faster healing in diabetic rats, according to which, such stem cells can be considered in cell therapy, especially in the field of chronic wound healing.

Background: Surgery and accurate removal of the brain tumor in the operating room and after opening the scalp is one of the major challenges for neurosurgeons due to the removal of skull pressure and displacement and deformation of the brain tissue. This displacement of the brain changes the location of the tumor relative to the MR image taken preoperatively. Methods: This study, which is done from March to December 2019 in Tehran, is evaluated on the available database of RetroSpective Evaluation of Cerebral Tumors (RESECT) including pre-operative MR images, and intra-operative ultrasound from 22 patients with low-grade gliomas who underwent surgeries at St. Olavs University Hospital. This study is used for image registration of preoperative MR imaging and ultrasound imaging after resection of the skull to compensate for brain changes. By this method, we obtained a third image that resembles preoperative MR imaging but has the geometry of the brain shape changes. We used a combination of the two transformations named Affine and non-rigid Free Form Deformation (FFD) for hierarchically moving the pixels to compensate for global variations, and also nonlinear local and small variations. Also, by applying the mutual information function, we consider the entropy value as the criterion of similarity due to the non-similarity of the nature of the images. Also, Limited Broyden-Fletcher-Goldfarb-Shannon method is used for optimization. Results: The results of the proposed method were presented on the available database of RetroSpective Evaluation of Cerebral Tumors (RESECT) including images of 22 patients with glioma type 2 tumors and evaluated based on 15 landmarks per patient and also mutual information criteria. The mean target registration error for affine, FFD and the proposed method are 46.19, 42.85 and 38.01, respectively. It was shown that the proposed method achieved high accuracy by combining the two transformations of affine and FFD compared to the separate use of each of the two models. Conclusion: In image registration of preoperative MR and ultrasound images for compensation of brain shift, the combination of affine and FFD transformations had better results than the individual use of each of the transformations.

Background and purpose: Acute scrotum syndrome is one of the complaints in emergency departments which has several causes. This study was performed to determine the causes and symptoms of acute scrotal pain in patients attending emergency departments in Mazandaran province, Iran. Materials and methods: A cross-sectional study was done in all patients with acute scrotum syndrome in emergency departments affiliated to Mazandaran University of Medical Sciences, 2011- 2016. Patients’ medical records (clinical and paraclinical information, and diagnostic and therapeutic procedures) were investigated. Data analysis was done applying Chi- square test and t-test. Results: The study included 205 patients with a mean age of 34.10±17.34. Patients were diagnosed with testicular torsion (n=60, 29.3%), epididymo-orchitis (n= 63, 30.7%), inguinal hernia (n= 69, 33.7%), varicocele (n=11, 5.4%), and testicular torsion (n=2, 2.1%). In testicular torsion, the pain was most sudden (23.9%) and the duration of symptoms onset and arrival at emergency department was 3.62±4.38 hours. The definitive diagnoses were consistent with ultrasound findings in 91.7% of the cases with testicular torsion, 96.8% of those with epididymis orchitis, 95.7% of patients with hernia, and in 54.5% of cases with varicocele. Conclusion: Younger age, duration of pain, sudden pain, and cremaster reflex are helpful in differentiating testicular torsion from other causes of acute scrotum syndrome. Ultrasonography of the testis should be immediately performed as the main diagnostic measure for acute scrotum syndrome.

Background: Bleeding incidents during percutaneous dilatational tracheostomy are concerning, and most cases occur in patients with unrecognized and unanticipated anatomical variations in the vascular anatomy. However, the extent of this variation remains unclear. To address this knowledge gap, our study aimed to comprehensively map laryngeal vascular anatomy in a cohort of adult patients., Methods: Ultrasound assessments of the soft tissue in the neck were performed, spanning from the thyroid cartilage to the third tracheal ring and extending 2 cm laterally on both sidesperformed. We subdivided this area into 12 zones comprising four medial and eight lateral sections. A pre-planned form was used to document the presence of arteries or veins in each zone. The results are reported as odds ratios, 95% CIs, and corresponding P values., Results: Five-hundred patients were enrolled from August 14, 2023, to November 13, 2023, at the University Hospital of Padua. Arteries and veins were identified in all investigated zones (varying from a minimum of 1.0%-46.4%). The presence of invessels progressively increased from the cricothyroid membrane to the third tracheal ring and from the midline to the paramedian laryngeal area., Conclusions: Given the prevalence of arteries and veins, particularly in areas where tracheostomies are commonly performed, we strongly advocate for routine ultrasound assessments before such procedures are performed.

Purpose: We aimed to explore the predictive value of an ultrasound-based radiomics model for the central lymph node metastasis of papillary thyroid carcinoma. Methods: A total of 126 patients with papillary thyroid carcinoma treated between February 2021 and February 2023 were retrospectively enrolled and assigned into metastasis group (n=59, with cervical central lymph node metastasis) or non-metastasis group (n=67, without metastasis) based on surgical and pathological findings. Intergroup comparisons were conducted on the results of contrast-enhanced ultrasonography, preoperative conventional ultrasonography, as well as real-time shear wave elastography. Results: The maximum lesion diameter, echo, margin, capsule invasion, calcification, average elasticity modulus (Eavg), rising time (RT), and peak intensity (PI) had diagnostic value for papillary thyroid carcinoma, and their combination exhibited higher diagnostic value (area under the curve: 0.817). The logistic regression model was built, and the maximum lesion diameter, hypoechoic/extremely hypoechoic, lobulated or irregular margin (95% confidence interval: 1.451-6.755), capsule invasion, microcalcification/macrocalcification or peripheral calcification, high-level Eavg, low-level RT and high-level PI served as risk elements affecting papillary thyroid carcinoma from the aspect of central lymph node metastasis (odds ratio>1, P<0.05). According to the logistic regression model, the model was reliable and stable (area under the curve: 0.889, P<0.05). Conclusion: The established ultrasound-based radiomics model can be utilized for early identifying the central lymph node metastasis of papillary thyroid carcinoma., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Introduction: Correct and prompt diagnosis is essential for the appropriate management of patients. Often, children and their caretakers cannot provide a reliable history to allow clinicians to determine the cause of the pain. This study's objective was to find out the prevalence of abnormal ultrasonographic findings among referred patients with pain abdomen in the radiology department of a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among patients in the out-patient and emergency department with complaints of abdominal pain from 2021 April 5 to August 30 in a tertiary care hospital. Ethical clearance was taken from IRC (registration no: 423/2021). The convenience sampling method was used. Written informed consent was taken from each study participant. Collected data were entered and analyzed on Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 250 patients with pain abdomen referred to the department of radiology, 169 (67.6%) (61.80-73.40 at 95% Confidence Interval) had abnormal ultrasonographic findings. Mean age of the patients was 39.4±17.9 years. Initial clinical diagnosis was in agreement with the abdominal ultrasound diagnosis in 57 (22.8%) patients. For the remaining 193 patients, the diagnosis obtained from abdominal ultrasound differed from the initial clinical diagnosis. Conclusions: Most of the cases of pain abdomen showed abnormalities in ultrasound. Clinical evaluation should be used together with ultrasound abdomen in order to arrive at a correct diagnosis.

Objective: To determine the correlation of renal ultrasonographic parameters with serum creatinine levels in patients with chronic kidney disease. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi Pakistan, from Sep 2020 to April 2021. Methodology: One hundred thirteen patients with chronic kidney disease (Stages 1 to 4) were enrolled in a cross-sectional study. Detailed history and examination were carried out. Serum creatinine levels were carried out, and findings were noted. All patients underwent renal ultrasonography evaluation, kidney parameters were assessed, findings were noted, and statistical analysis was performed. Results: The mean age of the patients was 42.96±12.71 years, the duration of Chronic kidney disease was 30.38±14.59 months, the length of the kidneys was 7.15±1.84 cm, the volume of the kidneys was 59.4±12.7 ml, the thickness of the renal cortex was 3.78±1.41 cm, thickness of renal parenchyma was 8.33±1.71 mm and serum creatinine levels were 5.36±2.63. Renal ultrasound parameters negatively correlated {for length of kidneys r=-0.187 (p=0.047), for volume r=-0.133 (p=0.161), for cortical thickness r=-0.285 (p=0.002) and parenchymal thickness r=-0.083 (0.382)} with serum creatinine level and only cortical thickness and length of kidneys had significant correlation with it. Conclusion: Ultrasound assessment is an easy and reliable tool. Measurement of cortical thickness and length of kidneys must be routinely incorporated in the ultrasonographical assessment of patients with Chronic kidney disease. [ABSTRACT FROM AUTHOR]

INTRODUCTION[|]In the present study, in thorax ultrasonography (USG) Doppler images obtained from cases with occult pneumothorax, we investigated the status of pulsatile pleural sounds over the pleural line and called these as the pleural sound sign (PSS). The purpose of the present study was to identify the efficacy of the proposed PSS in diagnosing pneumothorax and to compare it with the other USG findings including the sliding lung sign (SLS) and seashore sign (SSS). [¤]METHODS[|]The present study included 66 consecutive patients who were referred to the emergency unit with a blunt trauma from October 2009 to January 2010 at a tertiary university hospital. [¤]RESULTS[|]Of the 66 patients, 34 were in the patient group, and 32 were in the control group. Males accounted for 66.7% (n=44) of the study population. In predicting pneumothorax, the areas under receiver operating characteristic (ROC) curves of PSSmax and PSSdifference were 0.989 and 0.990, respectively. While the sensitivity of the SLS was 88% and the sensitivity of the SSS was 56%, the specificities of the SLS and SSS were 100%. Based on our findings, accuracy ranking was as follows: PSSmax = PSSdifference > SLS > SSS. [¤]DISCUSSION AND CONCLUSION[|]New applications of thorax USG are rapidly growing. Our findings have to be confirmed in a large patient series. PSS is not a novel method, but it enhanced the importance of USG in the diagnosis of pneumothorax. We can stipulate that it can replace thorax computed tomography imaging particularly for the diagnosis of occult pneumothoraxes. [¤]

Objective: To identify the anatomical landmarks of tibial motor nerve branches to the gastrocnemii, soleus and tibialis posterior muscles for selective motor nerve blocks in the management of spastic equinovarus foot. Design: Observational study. Patients: Twenty-five chronic stroke patients with spastic equinovarus foot. Methods: Motor nerve branches to the gastrocnemii, soleus and tibialis posterior muscles were tracked in the affected leg, using ultrasonography, and located in the space (vertical, horizontal and deep) according to the position of the fibular head (proximal/distal) and a virtual line from the middle of the popliteal fossa to the Achilles tendon insertion (medial/lateral). Results: Mean coordinates for the gastrocnemius medialis motor branch were: 1.5 cm (standard deviation (SD) 2.7) vertical (proximal), 1.7 cm (SD 1.3) horizontal (medial), 1.1 cm (SD 0.4) deep; for the gastrocnemius lateralis motor branch: 0.9 cm (SD 2.2) vertical (proximal), 1.8 cm (SD 1.7) horizontal (lateral), 1.0 cm (SD 0.3) deep; for the soleus motor branch: 1.4 cm (SD 1.1) vertical (distal), 1.6 cm (SD 0.7) horizontal (lateral), 2.8 cm (SD 0.7) deep; and for the tibialis posterior motor branch: 4.3 cm (SD 1.5) vertical (distal), 1.9 cm (SD 0.9) horizontal (lateral), 4.2 cm (SD 0.8) deep. Conclusion: These findings may help in the identification of tibial motor nerve branches to the gastrocnemii, soleus and tibialis posterior muscles for selective motor nerve blocks in the management of spastic equinovarus foot.

We present a case report of a rheumatoid arthritis patient, who underwent a PET scan, which revealed inflammation of multiple joints, which was missed by both physical and ultrasound examinations. A 55-year old woman with a long-term rheumatoid arthritis, who had undergone arthroplasty of the left knee in the past, consulted with the rheumatologist for pain in the left knee. The physical examination revealed signs of inflammation in the left knee and right elbow. The inflammatory parameters were high. Ultrasound showed intraarticular effusion without signs of active synovitis in the left knee. The ultrasound assessment of the other joints (hands, wrists and feet) was also negative for active synovitis, while positron-emission tomography (PET) revealed increased glucose metabolism at the level of the medial side of the left knee, left radio-ulno-carpal joint, I-II-III metacarpo-phalangeal joints bilaterally, right II metatarso-phalangeal joint, and left II-III metatarso-phalangeal joints. This case report demonstrates that PET might be more sensitive than ultrasound in detecting subclinical joint inflammation.

Introduction: Emergency care delivery to patients in remote and rural areas is limited by diagnostic restrictions and long transport times to major centres of care. People with suspected acute stroke living long distances from a hospital are unlikely to receive time-critical reperfusion therapy for these reasons. Basic brain imaging assessing blood flow in the major intracranial arteries could facilitate such care in remote settings. A 3-hour training package for novice transcranial ultrasound users has been piloted on a small group of volunteers to investigate whether they could acquire transcranial ultrasound images and video clips to potentially allow remote interpretation and optimise pre-hospital management of acute stroke. Methods: A pilot training project was set up in a university setting in Inverness, Scotland. Volunteer clinicians and students of nursing or medicine with no practical experience in transcranial ultrasound were recruited. Participants received three 1-hour training sessions combining theoretical aspects and hands-on practice on healthy volunteers provided by a qualified neurologist with more than 2 years of experience in transcranial ultrasound. Transcranial greyscale and colour-coded duplex sonography was performed to visualise midline structures and major intracranial vessels, and to measure blood flow velocity in the middle cerebral artery, followed by an unsupervised assessment. Qualitative analysis of the anonymised feedback from participants on the training experience and its potential application was also performed. Results: A total of 11 volunteers were recruited in the current pilot study. The average time to complete transcranial ultrasound assessment was approximately 40 minutes. The brain midline and cerebral peduncles were correctly labelled by 64% (7/11) and 91% (10/11) of volunteers, respectively. Participants demonstrated a good performance in detecting major intracranial vessels. The correct labelling rate for the middle cerebral artery was 73% (8/11), and 64% (7/11) for the anterior and posterior cerebral arteries. There was agreement between the trainer and the participants on rating the quality of scans as assessed using a visual analogue scale. All participants gave positive feedback on the provided training and time allocated for each session. Generally, volunteers thought that operating the ultrasound machine and the probe simultaneously was difficult. It was also suggested that further follow-up training, with possible supervision, would be useful to retain the acquired skills. Conclusions: Transcranial ultrasound scans of a quality to allow expert interpretation can be acquired by inexperienced transcranial ultrasound operators after receiving a brief training. This could potentially be used by medical staff working in remote and rural areas to facilitate acute care for stroke patients, but further work with a larger sample is needed.

Background: Open inguinal hernia repair (OIHR) surgery is a common surgical procedure, and ultrasound guided interfascial plane blocks can also be included in current approaches to postoperative multimodal analgesia regimens. This study aimed to compare the postoperative analgesic efficacy of the erector spinae plane block (ESPB) and transversalis fascia plane block (TFPB) in patients undergoing OIHR., Methods: This prospective, randomized, assessor-blinded comparative study was conducted in the postoperative recovery room and ward of a tertiary hospital. A total of 80 patients with American Society of Anesthesiologists physical status I-III were enrolled and allocated equally to either the ESPB or TFPB group. The patients received standard multimodal analgesia in addition to an ultrasound-guided ESPB or TFPB. During the first 24 h postoperatively, tramadol consumption was assessed and pain levels at rest and during movement were compared using numeric rating scale (NRS) scores at 1, 3, 6, 9, 12, 18, and 24 h postoperatively., Results: The results showed no difference in NRS scores at any time point between the groups, except for NRS at rest in the third hour. However, tramadol consumption was lower in the TFPB group than in the ESPB group overall (88 ± 75.2 vs. 131 ± 93.7 mg, respectively; P = 0.027, mean difference: -43, 95% CI [-80.82, -5.18])., Conclusions: The TFPB leads to lower tramadol requirements in the first 24 h postoperatively than the ESPB in patients undergoing OIHR.

Objectives: The study aimed to evaluate the role of ultrasonographic assessment of enthesitis in patients with spondyloarthritis (SpA) in terms of disease activity, functionality, and quality of life., Patients and Methods: Ninety SpA patients (57 males, 33 females; mean age: 37.5±9.7 years; range, 18 to 60 years) were included in cross-sectional study between November 2016 and January 2017. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI), Short Form-12 (SF-12), and Ankylosing Spondylitis Quality of Life (ASQoL) were utilized for clinical evaluation. The clinical evaluation of enthesitis was performed with the Spondyloarthritis Research Consortium of Canada (SPARCC) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) via an algometer calibrated to 4 kg/cm 2 of pressure. Ultrasound evaluation was performed according to Madrid Sonographic Enthesitis Index (MASEI). A total of 2,610 entheseal sites were examined clinically, and 1,080 were assessed ultrasonographically., Results: A significant proportion of enthesitis (463/1,080) was detected on ultrasonographic evaluation but not with clinical enthesitis score (MASES and SPARCC). Although ultrasonographic entheseal evaluation detected enthesitis in at least one enthesis of all patients, 35 of the patients had no enthesitis with clinical examination. The sites most frequently involved in the entheses were the proximal patellar tendon and Achilles tendon. The MASEI score did not correlate with the MASES, SPARCC, BASDAI, SF-12, and ASQoL but moderately correlated with the C-reactive protein (CRP) level (r=0.348), ASDAS-CRP (r=0.294), and BASFI score (r=0.244)., Conclusion: The association of ultrasonography scores with CRP levels and ASDAS-CRP indicates that ultrasonography is effective in detecting inflammation. The MASEI score weakly correlates with functionality but not with quality of life. Ultrasonographic evaluation is invaluable and merits to be incorporated into SpA disease scoring system., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish League Against Rheumatism.)

Lymphoma with cardiac involvement is rare; however, there can be very serious consequences. It is usually revealed in autopsy studies. Cardiac invasion by lymphoma may occur through retrograde lymphatic flow, hematogenous spread, or direct invasion from neighboring structures. Direct invasion is the most common, and has the most destructive results. The clinical signs and symptoms are nonspecific. Presently described is the case of a patient who was initially examined in a cardiology polyclinic due to exertional dyspnea and cardiomegaly seen in a chest X-ray. Echocardiographic examination revealed a suspected mass and the patient was referred to our clinic. A mass lesion filling the mediastinum and invading the right ventricle was detected in a computed tomography image of the chest. On the same day, a tru-cut biopsy with thoracic ultrasound guidance was performed by the pulmonologist. Three days after the biopsy, the patient was referred to the hematology clinic for treatment of pathological lymphoma. This case was presented to draw attention to the importance of prompt diagnosis and treatment of thoracic and mediastinal mass lesions with a multidisciplinary approach and to emphasize that a biopsy can be performed quickly and safely in patients with a mediastinal mass with the guidance of ultrasound, even when there is cardiac involvement.

Nonspecific chronic low back pain (NCLBP) is a major public health and global socioeconomic burden with a variety of symptoms, such as fear-avoidance behaviors. This study aimed to evaluate the effect of cognitive behavioral therapy (CBT) associated with stabilization exercise (SE) on thickness of transverse abdominis (TrA) muscle in patients with NCLBP. Forty patients with NCLBP were randomly assigned into experimental CBT associated with SE (n = 20) and control groups without SE (n = 20). Transverse abdominis muscle thickness was assessed during abdominal drawing in maneuver (ADIM) and active straight leg raise (ASLR) of the right lower limb using ultrasound imaging. Fear-avoidance belief and disability were evaluated using a fear-avoidance belief questionnaire (FABQ) and a Roland-Morris disability questionnaire (RMDQ) before and after intervention. Mixed-model analysis of variance indicated that the effect of time was significant for the right and left TrA contraction thickness during ADIM and left TrA contraction thickness during ASLR (P <.05). However, the experimental group exhibited higher right and left TrA muscle thickness compared with the control group during ADIM (P =.001). Moreover, there were no significant differences between groups in the thickness of TrA muscle during ASLR (P >.05). The effect of time was significant for FABQ (P =.02) and RMDQ (P =.01); however, the effect of group was significant for the FABQ after intervention (P =.04). Stabilization exercise associated with CBT is more effective than SE alone in improving fear avoidance belief and in increasing the thickness of the TrA muscle during ADIM task. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of lung ultrasound (LUS) in the diagnosis of pneumonia in children using chest x-ray as the gold standard. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Radiology, Combined Military Hospital, Sialkot Pakistan, from Feb to Aug 2021 Methodology: All patients underwent clinical examination, chest radiograph (anterior-posterior view), lung ultrasound and blood sample analysis in the first 24 hours after admission. A pre-specified hospital radiologist carried out a lung ultrasound. The examination was performed with the patient sitting upright or supine. The presence of pneumonia on x-ray and USG were recorded. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of lung ultrasound in the diagnosis of pneumonia by taking chest x-ray as the gold standard was calculated in all the study participants. Results: In this study, 262 patients with clinical features of pneumonia were enrolled. The mean age of the study participants was 3.27±2.344 years. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), accuracy and frequency of lung ultrasonography (US) vs chest radiography (CR) in diagnosing pneumonia was 95.28%, 87.5%, 99.59%, 36.84%, 95.04% and 96.95% respectively. Conclusion: Lung ultrasound emerged as a sensitive diagnostic tool to diagnose pneumonia in children. Sensitivity, specificity, positive predictive value, and negative predictive value all favoured the use of this modality to diagnose pneumonia in paediatric patients. [ABSTRACT FROM AUTHOR]

Sarcomatoid carcinoma of the lung is a rare, poorly differentiated, low-grade carcinoma in the non-small cell lung cancer (NSCLC) group. It is a very aggressive tumor; the 5-year survival rate in patients with sarcomatoid carcinoma does not exceed 20%. There are a limited number of retrospective screenings of sarcomatoid carcinoma cases and case reports in the literature. The diagnosis, treatment, and prognostic features of sarcomatoid carcinoma are not well known compared with other NSCLCs. However, studies of sarcomatoid carcinoma have demonstrated that the prognosis is poor and response to standard chemotherapy treatment is not as good as seen with other NSCLCs. Presently described is a rare case diagnosed by thoracic ultrasonography-guided transthoracic biopsy.

INTRODUCTION[|]The aim of the present study was to determine diagnostic success of thoracic ultrasonography (US)-guided transthoracic fine needle aspiration biopsy (TTFNAB) performed by chest physicians for anterior mediastinal lesions.[¤]METHODS[|]Patients with anterior mediastinal lesions observed with US-guided TTFNAB performed in our clinic between December 2010 and January 2016, were included in the study. Details of clinical, demographic, and radiographic findings of the patients, sonographic appearance and size of the lesions, diagnosis based on US-guided TTFNAB results, final diagnosis, method of final diagnosis, and complications were recorded. Thoracic US was performed by an experienced chest physician using Logiq 7 system (GE Healthcare, Inc. Chicago, IL, USA) with 3.5 MHz convex transducer in abdominal mode.[¤]RESULTS[|]Fourteen patients with mean age of 47.5+-13 years were included in the study. Twelve cases (85.7%) were diagnosed with US-guided TTFNAB. Remaining 2 (14.3%) cases could not be diagnosed with this method. The final diagnosis in those 2 cases was squamous cell carcinoma and lymphoma. Lesions in study were both malignant (n=12; 85.7%) and benign (n= 2; 14.3%). Sensitivity and specificity of US-guided TTFNAB were calculated as 85.7% and 100%, respectively. Pneumothorax was observed in only 1 case.[¤]DISCUSSION AND CONCLUSION[|]US- guided TTFNAB is an easy, accessible, and inexpensive diagnostic method with high diagnostic efficiency, low complication rate, and no radiation exposure.[¤]

Introduction: For several years, ultrasonography has played a major role as a diagnostic and therapeutic tool in various medical fields. Only recently has it been used for maxillofacial imaging. Aims and Objectives: To evaluate the reliability of ultrasonography as an alternative tool in the diagnosis of swellings in the orofacial region. Materials and Methods: Ultrasonographic examination of 30 patients of both the sexes aged between 8 and 70 years with swelling in the orofacial region was conducted. Doppler investigation was done in some cases to evaluate the vascularity. The following six sonographic parameters were recorded: shape, boundary echo, internal echo, distribution of internal echoes, posterior wall echoes, and vascularity. Following the clinical and ultrasonographic diagnosis, the lesion was subjected to histopathological examination and a final diagnosis was made. The ultrasonographic diagnosis was correlated with the clinical and histopathological diagnosis. Results: A significant association was observed between both clinical and histopathological diagnosis and ultrasonographic diagnosis (contingency = 0.888, P value = 0.000). Conclusion: Along with clinical and histopathological examinations, ultrasonography works out as a valuable adjunct in the diagnosis of orofacial swellings as it provides several advantages like it is non-invasive, easily reproducible, widely available, rapid, and inexpensive.

Objectives: This study aims to investigate the effects of trunk stabilization exercises (TSEs) in addition to conventional exercises in patients with stroke on balance, functionality and abdominal muscle thickness as measured by ultrasonography (USG) and to compare the patients' non-paretic side abdominal muscle thickness with healthy population., Patients and Methods: Between April 2019 and June 2019, a total of 26 hemiparesis/hemiplegic patients with stroke (15 males, 11 females; mean age: 62.3±7.8 years; range, 52 to 71 years) confirmed by neurological examination or computed tomography (CT) / magnetic resonance imaging (MRI) and 20 age-matched healthy volunteers (12 males, 8 females; mean age: 62.3±7.2 years; range, 53 to 70 years) were included in the study. The patients were randomized into two groups. In the first group (n=13), TSE were performed in addition to conventional neurorehabilitation program, five times/week for a total of four weeks. The second group (n=13) was given conventional neurorehabilitation program, five times/week for a total of four weeks. Also, healthy volunteers as the third group were compared with the patient population. The evaluations were made at the beginning and end of the treatment. The Berg Balance Scale (BBS), Barthel Index (BI), Postural Assessment Scale for Stroke Patients (PASS), and Functional Reach Test (FRT) were used. Abdominal muscle thickness at rest and contraction were evaluated using USG., Results: Ten patients in Group 1 and 10 patients in Group 2 completed study. A significant improvement was observed in all abdominal muscles in both groups (p<0.05), indicating no significant difference between the groups (p>0.05). There was a statistically significant improvement for BBS and FRT in both groups. The PASS and BI scores showed a significant improvement only in TSE group., Conclusion: Both the TSE and conventional neurorehabilitation program provided significant improvements in abdominal muscle thickness, balance and trunk control. For postural control and functionality, additional TSE seems to be more effective., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish Society of Physical Medicine and Rehabilitation.)

Objectives: This study aimed to clinically and ultrasonographically evaluate enthesitis in patients with spondyloarthritis (SpA) and to determine enthesitis response to anti-tumor necrosis factor (TNF) treatment., Patients and Methods: Thirty-one SpA patients (22 males, 9 females; mean age: 39.4±10.9 years; range, 22 to 60 years) who started anti-TNF treatment due to their high disease activity were included in the cross-sectional prospective study between May 2017 and January 2018. Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Quality of Life Questionnaire, Bath Ankylosing Spondylitis Functional Index, and Bath Ankylosing Spondylitis Metrology Index were recorded. Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Score were utilized for clinical enthesitis evaluation. Patients were ultrasonographically evaluated in accordance with the Madrid Sonographic Enthesitis Index (MASEI) by a blinded sonographer. Patients were clinically and ultrasonographically assessed at baseline and in the third month after the treatment., Results: In the initial evaluation, 24 (77.42%) of the patients had clinical enthesitis, and 30 (96.77%) of the patients had ultrasonographic enthesitis. After anti-TNF treatment, MASES, SPARCC, MASEI-structure, MASEI-thickness, MASEI-bursitis, MASEI-Doppler, MASEI-inflammatory, and MASEI-total scores significantly decreased (p<0.05). There was no significant change in MASEI-damage, MASEI-erosion, and MASEI-calcification scores following the therapy (p>0.05)., Conclusion: Anti-TNF treatment may improve clinical and ultrasonographic enthesitis, particularly inflammatory changes. Erosions and calcifications may not ameliorate after three months of anti-TNF treatment., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish Society of Physical Medicine and Rehabilitation.)

Introduction: Meniscal tears are among the most common indications for knee arthroscopy. Artificial polyurethane scaffolds have demonstrated efficacy in reducing pain and promoting the growth of normal meniscal tissue, with high absorption rates facilitating full tissue regeneration., Aims: This study aimed to evaluate the remodeling of polyurethane meniscal implants post-reconstruction using ultrasonography. This imaging technique not only assesses changes in implant properties, such as echogenicity, but also the shape changes during functional examination., Methods: The assessment of meniscal extrusion, comparing size at rest and under weight-bearing, is an indirect parameter that provides insight into the physical properties of the remodeling implant, with greater extrusion indicating reduced stiffness and inferior physical properties of the meniscus. Ultrasonography has the valuable advantage of allowing for assessment of the blood supply to the meniscus through Power Doppler imaging., Results: The presence of vessels within the meniscal implants serves as evidence of ongoing remodeling. The study included 35 patients (13 female, 22 male; mean age 41.6 years, range 18-66) who underwent arthroscopic meniscal reconstruction with polyurethane implants, with an average time from surgery of 2.8 years (range 0.3-4.5 years). Results showed complete (29.7%), significant (45.9%), or moderate (16.2%) remodeling into natural meniscal tissue in 91.8% of the implants., Conclusion: The mean values of extrusion in the supine position and during 90-degree flexion were significantly greater in the operated limb (2.603) compared to the contralateral limb (1.978; t(35) = 2.442; P < 0.05). No significant differences in extrusion were found between the limbs in a standing position, indicating favorable physical properties of the polyurethane meniscal implants. Further ultrasonography studies of meniscal scaffolds are deemed relevant., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

INTRODUCTION[|]Pectoralis minor syndrome (PMS) is a neurovascular disorder affecting the upper extremity. In the present study, the demographic and clinical features of patients diagnosed as PMS were examined, as well as cases of concomitant subacromial impingement syndrome (SIS).[¤]METHODS[|]A retrospective trial was conducted with 12 patients with the diagnosis of PMS according to a pectoralis minor muscle (PMM) block test. The PMM block was performed under the guidance of ultrasonography.[¤]RESULTS[|]Of the 12 PMS patients evaluated, 83% had a complaint of pain, 58.3% had paresthesia, and 16.6% had swelling of the hand. A physical examination revealed that 58.3% of the patients had tenderness at the biceps tendon, 16.6% had subacromial tenderness, and 16.6% had tenderness at the acromioclavicular joint. In 66.6% patients, subacromial impingement tests were positive, and 33.3% of them had a positive subacromial injection test (SIT).[¤]DISCUSSION AND CONCLUSION[|]PMS can be overlooked and may also be confused with other disorders, such as SIS. Furthermore, SIS may also accompany PMS. Therefore, in such painful pathologies, injection tests such as SIT and PMM block should be used as the reference test for the diagnosis and it should be kept in mind that these 2 clinical disorders can be observed together.[¤]

Background: Laparoscopic cholecystectomy is the gold standard in the treatment of gallstones. It has proved to be an effective and safe procedure both in elective and emergency conditions; however, conversion to open surgery is inevitable in some cases. Hence the present study was carried out to identify various factors which can predict the difficult laparoscopic cholecystectomy so that an early conversion to open cholecystectomy can be considered. Material and Methods: A prospective st st study was conducted from 1 February 2011 to 31 January 2012 that included 63 patients of all age groups and both sexes who were found to have symptomatic gallstones and were scheduled for laparoscopic cholecystectomy at Nepalgunj Medical College and Teaching Hospital, Nepal. Age, sex, body mass index, previous abdominal surgery and past history of acute attack of cholecystitis of the patients were recorded. A pre-operative ultrasound was performed just prior to surgery, and three ultrasonographic parameters were analyzed, namely gall bladder wall thickness, number of stones and stone impacted in Hartmann's pouch. Intra-operative causes for difficult laparoscopic cholecystectomy like adhesions in Calot's triangle and gall bladder perforation with bile leak were also evaluated. Results: Total number of patients in this study was 63; out of which difficult laparoscopic cholecystectomy was seen in 25(39.7) patients and 7(11.1) patients required conversion to open cholecystectomy. Ultrasonography was good at predicting difficulty in each component with exception of gall bladder wall thickness which was not statistically significant. Conclusion: BMI, ultrasonographic finding of presence of multiple stone or stones impacted in Hartmann's pouch, adhesion in Calot's triangle and gall bladder perforations are predictors of difficult laparoscopic cholecystectomy.

Background: The costoclavicular brachial plexus block (CCB) is a recently established technique that uses the infraclavicular approach and is performed just below the clavicle. This meta-analysis aimed to determine whether CCB can reduce the incidence of hemidiaphragmatic paralysis (HDP), which is a major adverse event related to brachial plexus block (BPB), while yielding comparable block performance as other BPB techniques., Methods: We searched electronic databases to identify relevant studies that compared the incidence of HDP between CCB and other BPB techniques. The primary outcome was the incidence of HDP following CCB and other BPB techniques. The secondary outcomes were pulmonary function test results, other adverse events, and block performance parameters such as onset and performance time., Results: We included six randomized controlled trials that included 414 patients. Compared with the other BPB group, the CCB group had a significantly lower incidence of HDP (relative ratio: 0.21, 95% CI [0.12, 0.36], P < 0.001) and higher peak expiratory flow rate (mean difference: 0.68 L/s, 95% CI [0.13, 1.23], P = 0.015). There were no significant between-group differences with respect to other adverse events and block performance parameters., Conclusions: Compared with other BPB techniques, CCB involves a lower incidence of HDP with comparable onset and performance time.

Objective: To determine the diagnostic accuracy of polyhydramnios for detecting fetal anomalies on ultrasound in singleton pregnancies. Study Design: Cross-sectional study. Place and Duration: Armed Forces Institute of Radiology and Imaging, Military Hospital, Rawalpindi Pakistan, from Oct 2018 to Apr 2019. Methodology: A total of 145 pregnant females coming for antenatal/anomaly scans, aged 18 to 45 years, were included. All scans were obtained with a 3.5-5 MHz curvilinear transducer and obstetric settings of the ultrasound machine. AFI was calculated as the sum of the deepest, unobstructed, vertical length of each pocket of fluid measured in cm in all four quadra nts and then added to the others. The radiologist observed fetal structural anomalies. Results: Polyhydramnios was present in 15(10.34%) patients. The congenital fetal anomaly on ultrasound was present in 6(4.14%) cases. In polyhydramnios-positive patients, 05(3.4%) had a congenital fetal anomaly, and 10(6.8%) had no congenital fetal anomaly. Among 130 polyhydramnios-negative patients, 01(0.7%) had a congenital fetal anomaly, whereas 129(88.9%) had no congenital fetal anomaly. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of polyhydramnios for detecting fetal anomalies on ultrasound were 83.33%, 91.41%, 29.4%, 99.23% and 92.41%, respectively. Conclusion: This study concluded that the diagnostic accuracy of polyhydramnios¸, significantly moderate to severe forms, is relatively high for detecting fetal anomalies on ultrasound. [ABSTRACT FROM AUTHOR]

Background and aim: Liver abscesses in feedlot cattle have a major economic impact in the beef industry because of liver condemnation and reduced animal performance and carcass yield. The aim of this study was to document the clinico-pathological and ultrasonographic findings in cattle and buffaloes with hepatic abscess. Materials and Methods: Three male feedlot cattle and 5 buffaloes suffered from liver abscesses were investigated. Clinical, hemato-biochemical and Ultrasonographic were performed. Liver abscesses were confirmed through centesis and aspiration under ultrasonographic guidance which yield purulent material. Necropsy and histopathological studies were applied on 3 of them, where ultrasonographic diagnosis was confirmed. Results: Altered appetite, loss of body weight, dull demeanor and decreased ruminal motility were recorded in all eight animals. Systemic disturbance and feces abnormalities were appeared with variable degrees. Icterus and abdominal pain were observed only in one cattle. Leucocytosis, hypoalbuminaemia and hyperglobulinaemia were reported in all animals while liver enzymes were mildly elevated only in 3 cattle and one buffalo. Abscess appeared by ultrasonography as hypoechoic to echogenic circumscribed mass, pinpoint to 10 cm in diameter, with or without echogenic wall, located in the right lobe 7th to 12th intercostal spaces. Abscesses were located intra-hepatic in 7 (3 cattle and 4 buffaloes) animals and peri-hepatic (between liver and reticulum) in one buffalo. Conclusions: Ultrasonographic results were of considerable value for ante-mortem diagnosis of hepatic abscesses.