Day 2 :
- Ultrasound
Session Introduction
Musarrat Hasan
Institute of Ultrasound Imaging Karachi -Pakisatn
Title: Experience with Gaseous Spring Water as Contrast Agent in Tubal Patency Assessment
Biography:
Director & CEO Institute of Ultrasound Imaging since 1984, which is affiliated with JUREI at Thomas Jefferson University Hospital, Philadelphia PA, USA. Visiting Fellowship in Ultrasound from Thomas Jefferson University Hospital, Philadelphia USA 1982. Founder member & past President Ultrasound Society of Pakistan. Chairman History and Archiving AFSUMB. Fellow member, A I U M and recipient of 2001 Award for contributing & promoting Ultrasound. Has delivered more than 26000 hours of lectures / talks /scientific papers in ultrasound during last 33 years. Discovered New Contrast Agent for Tubal Patency.
Abstract:
The purpose of the study was to introduce new contrast agent ie gaseous spring water for the evaluation of Tubal Patency as an alternate to existing available contrast agents based on galactose matrix air bubbles, which are expensive and not easily available in third world countries. The technique used is same as used in other methods ie insertion of HSS catheter in the uterine cavity, instilling fluid/contrast agent and with the help of endovaginal probe visualizing the movement of echoes into the tubes and observation of fluid in the pouch of douglas . 4600 patients were examined from Jan 2006 to March 2016. Average of 7cc of gaseous spring water per patient was used. 80% were found to have patent tubes. 12% had unilateral blocked tubes and 8% had bilateral blocked tubes. Mean time spent on the procedure was 7 minutes. It is recommended that gaseous spring water be used as a first line of choice for assessing Tubal Patency as it is cost effective, safe easily available and does not require radiology suite. Paper will highlight the procedure and spill will be shown in video recording. Use of B-flow to minimize the procedure time will also be shown.
- Diagnostic Medical Sonography
Session Introduction
TRAN THI BICH THUY
ULTRASOUND DEPARTMENT ROUTINE CHECK ANNUALLY DEPARTMENT
Title: ACHALASIA
Biography:
Abstract:
Case report:His main complaints are choked swallowing, reflux. Ultrasound transverse sections of his right neck The diameters of upper , middle and lower of Esophagus in the neck are 12, 9 -17,5 – 22,7 mm respectively. Sagital section of the atrium is normal. Ultrasonographic diagnosis was dilated esophagus from the middle neck Atrium This patent’s Barium swallow images demonstrating the bird-beak appearance of the lower esophagus, dilatation of the esophagus.
Related internet information:Practice Essentials: Achalasia is a primary esophageal motility disorder characterized by the absence of esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) in response to swallowing. The LES is hypertensive in about 50% of patients. These abnormalities cause a functional obstruction at the gastroesophageal junction (GEJ). Signs and symptoms: Dysphagia (most common), Regurgitation, Chest pain, Heartburn, Weight loss, Physical examination is noncontributory.
Diagnosis: Barium swallow: Bird’s beak appearance, esophageal dilatation (see the image below) Barium swallow demonstrating the birdbeak appearance of the lower esophagus, dilatation of the esophagus, and stasis of barium in the esophagus. Barium swallow demonstrating the birdbeak appearance of the lower esophagus, dilatation of the esophagus, and stasis of barium in the esophagus. A dilatation of the distal esophagus with regular thickening of the esophagogastric junction (EGJ) with a "bird's beak appearance" in a patient with achalasia. (B) An elongated pseudokidney pattern without dilatation in a healthy subject.
Conclusion: Achalasia is a very rare disease. It is usually diagnosed by clinical, barium swallow, esophageal manometry, etc. Ultrasonography is also useful. A very few ultrasound images about achalasia was reported, which are two signs : Bird’s peak appearance and pseudokidney in atrium However, in case of this patient, we see an another sign is dilated esophagus in the neck.
- Ultrasound Physics and Instrumentation
Session Introduction
Musarrat Hasan
Institute of Ultrasound Imaging Karachi -Pakisatn
Title: Colour Doppler Misoprostol Response Study(CDMRS): an evaluation tool for patients awaiting myomectomy.
Biography:
Director & CEO Institute of Ultrasound Imaging since 1984, which is affiliated with JUREI at Thomas Jefferson University Hospital, Philadelphia PA, USA. Visiting Fellowship in Ultrasound from Thomas Jefferson University Hospital, Philadelphia USA 1982. Founder member & past President Ultrasound Society of Pakistan. Chairman History and Archiving AFSUMB. Has delivered more than 26000 hours of lectures / talks /scientific papers in ultrasound during last 33 years. Discovered New Contrast Agent for Tubal Patency.
Abstract:
Uterine myomas( fibroids) are benign tumors of the uterus. Myomectomy ,the surgical removal of myoma, is an important treatment option. The major problem with myomectomy is excessive bleeding. Many interventions have been used to reduce bleeding during myomectomy. Misoprostol produces uterine contraction thereby reducing blood supply to the myometrium and in the myoma, it can be used as an alternative to uterine artery occlusion or paracervical tourniquet to reduce blood flow during myomectomy.
Baseline study of all the patients was done before insertion of misoprostol or placebo and the largest selected fibroid in the patients with uterine fibroids was evaluated for its volume, contour, degenerative changes and perfusion by Ultrasound Doppler.
Resistive index (RI) was measured pre and post tablet insertion, after 20 minutes, and again reevaluated 40 minutes post insertion
In conclusion, we suggest that all patients who are planned for myomectomy should have prior CDMRS to evaluate the degree of vascularity and to assess if they have an appropriate response to misoprostol administered rectally, so that there is minimal or no blood loss during surgery. This preoperative assessment will decrease physician apprehension, with lesser intraoperative blood loss and morbidity.