Hifu
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This document discusses using MRI to follow up on uterine fibroids treated with HIFU. It explains that HIFU induces coagulative necrosis in tumor tissue by rapidly raising the temperature. An MRI study assessed percentage of intralesional necrosis by measuring ADC values and contrast enhancement pre and post-treatment. The study found increased ADC values reflected liquefactive necrosis, while contrast enhancement decreased after treatment. Both dynamic contrast MRI and DWI can effectively assess the treatment response and reduction in tumor size and enhancement due to coagulative necrosis.
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Journal Club : Article by Kim YS, Rhim H, Choi MJ, Lim HK, Choi D. High-intensity focused ultrasound therapy: an overview for radiologists. Korean journal of radiology. 2008 Aug 1;9(4):291-302.
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This document discusses the history and uses of electro surgery in gynecology. It begins with the early history of heat therapy and progresses to modern developments. Key points covered include the basics of electricity used, types of currents and waveforms, effects on tissue, and specific applications in gynecology like treating cervical lesions, tubal sterilization, endometriosis, and fibroids. Proper use and safety precautions are also emphasized.
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This document discusses uterine artery embolization (UAE) as a treatment for uterine fibroids. UAE involves blocking the uterine arteries using small particles, which cuts off the blood supply to the fibroids. The document outlines the procedure and evidence from clinical trials and registries showing that UAE improves symptoms in 85-95% of patients and decreases fibroid volume by 30-48%. While complications occur in 6.9-20.7% of patients, UAE has been shown to be an effective alternative to hysterectomy and myomectomy in treating uterine fibroids.
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High intensity focused ultrasound (HIFU) is an early stage medical technology that is in various stages of development worldwide to treat a range of disorders. The mechanism is similar to using a magnifying glass to focus sunlight. Focused ultrasound uses an acoustic lens to concentrate multiple intersecting beams of ultrasound on a target. Each individual beam passes through tissue with little effect but at the focal point where the beams converge, the energy can have useful thermal or mechanical effects. HIFU is typically performed with real-time imaging via ultrasound or MRI to enable treatment targeting and monitoring (including thermal tracking with MRI).
HIFU in the Management of Uterine Fibroids .pptx
HIFU is a non-invasive technique using focused ultrasound to ablate uterine fibroids. It was developed in the 1950s and first used commercially in Europe in 1994. HIFU kills fibroids through coagulative necrosis, leading to shrinkage and symptom relief. Studies show HIFU can shrink fibroids by 32.5-52.5% within 6 months. HIFU has advantages over other treatments as it is non-invasive, spares the uterus, allows for future pregnancies, and has a faster recovery time of 1-2 days. Initial evidence also suggests HIFU does not negatively impact fertility or ovarian reserve. Larger clinical trials are still needed to further evaluate HIFU's effects on
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This document discusses electro-surgery and its use in laparoscopic surgery. It describes the basic electro-surgical circuit and how high current density at the active electrode creates heat to cut or coagulate tissue. It discusses different wave forms and their effects. Safety issues are also covered, including ensuring proper placement of the patient return electrode to avoid burns and understanding how capacitive coupling through instruments can lead to thermal injuries during laparoscopic procedures.
Sonosalpingography. Dr. Sharda Jain, Dr. Jyoti Agarwal
Evaluation of fallopian tubes forms an essential part of evaluation
Tubal pathology is a cause of infertility in 30- 35% of infertile patients
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Fallopian tubes can be assessed by:
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Laparoscopy & CHROMOTUBATION
Recommended
HIFU
Journal Club : Article by Kim YS, Rhim H, Choi MJ, Lim HK, Choi D. High-intensity focused ultrasound therapy: an overview for radiologists. Korean journal of radiology. 2008 Aug 1;9(4):291-302.
electro surgery
This document discusses the history and uses of electro surgery in gynecology. It begins with the early history of heat therapy and progresses to modern developments. Key points covered include the basics of electricity used, types of currents and waveforms, effects on tissue, and specific applications in gynecology like treating cervical lesions, tubal sterilization, endometriosis, and fibroids. Proper use and safety precautions are also emphasized.
Uterine artery embolisation
This document discusses uterine artery embolization (UAE) as a treatment for uterine fibroids. UAE involves blocking the uterine arteries using small particles, which cuts off the blood supply to the fibroids. The document outlines the procedure and evidence from clinical trials and registries showing that UAE improves symptoms in 85-95% of patients and decreases fibroid volume by 30-48%. While complications occur in 6.9-20.7% of patients, UAE has been shown to be an effective alternative to hysterectomy and myomectomy in treating uterine fibroids.
Adhesion prevention
Adhesions are an important yet often neglected cause of impaired fertility
The use of adhesion prevention agents should be considered in laparoscopic surgeries as well as Open Surgeries, where adhesion formation is expected
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High intensity focused ultrasound (HIFU) is an early stage medical technology that is in various stages of development worldwide to treat a range of disorders. The mechanism is similar to using a magnifying glass to focus sunlight. Focused ultrasound uses an acoustic lens to concentrate multiple intersecting beams of ultrasound on a target. Each individual beam passes through tissue with little effect but at the focal point where the beams converge, the energy can have useful thermal or mechanical effects. HIFU is typically performed with real-time imaging via ultrasound or MRI to enable treatment targeting and monitoring (including thermal tracking with MRI).
HIFU in the Management of Uterine Fibroids .pptx
HIFU is a non-invasive technique using focused ultrasound to ablate uterine fibroids. It was developed in the 1950s and first used commercially in Europe in 1994. HIFU kills fibroids through coagulative necrosis, leading to shrinkage and symptom relief. Studies show HIFU can shrink fibroids by 32.5-52.5% within 6 months. HIFU has advantages over other treatments as it is non-invasive, spares the uterus, allows for future pregnancies, and has a faster recovery time of 1-2 days. Initial evidence also suggests HIFU does not negatively impact fertility or ovarian reserve. Larger clinical trials are still needed to further evaluate HIFU's effects on
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This document discusses electro-surgery and its use in laparoscopic surgery. It describes the basic electro-surgical circuit and how high current density at the active electrode creates heat to cut or coagulate tissue. It discusses different wave forms and their effects. Safety issues are also covered, including ensuring proper placement of the patient return electrode to avoid burns and understanding how capacitive coupling through instruments can lead to thermal injuries during laparoscopic procedures.
Sonosalpingography. Dr. Sharda Jain, Dr. Jyoti Agarwal
Evaluation of fallopian tubes forms an essential part of evaluation
Tubal pathology is a cause of infertility in 30- 35% of infertile patients
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Fallopian tubes can be assessed by:
Hysterosalpingography
Hysterosalpingo-contrast-sonography (HycoSy)
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1. The document discusses new uses of lasers in gynecology as outlined in 2019 guidelines from the International Society for the Study of Vulvovaginal Disease and International Continence Society.
2. Lasers have been used for over 40 years for procedures like genital wart removal, laser laparoscopy, and laser hysteroscopy. More recently, transvaginal or vulvar lasers have been used to treat conditions like lichen sclerosus, vulvodynia, vaginal laxity, overactive bladder, and pelvic organ prolapse.
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Laparoscopy is a minimally invasive surgical procedure that involves inserting a narrow telescope through a small incision in the abdomen to visualize internal organs. It can be used both diagnostically to investigate issues like infertility, masses, or suspected abnormalities, and therapeutically to treat conditions like endometriosis, myomas, ectopic pregnancies, and more. Potential risks include injuries to internal organs from trocar insertion or diathermy, bleeding, infection, and port site complications. Careful patient selection and surgical technique can help reduce risks.
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3D and 4D ultrasound provide several advantages over traditional 2D ultrasound for assessing female pelvic anatomy and pathology. Multiplanar views allow for more accurate diagnosis of uterine anomalies by visualizing the coronal and true midline planes. Intracavitary lesions can be precisely localized. Ovarian volumes and antral follicle counts are more accurately determined. Endometrial receptivity markers like vascular indices are measurable. Doppler of uterine arteries provides additional information on receptivity. Overall, 3D/4D ultrasound improves evaluation of female pelvic structures and fertility-related conditions.
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Endometriosis is known to have a remarkably negative effect on the Quality of Life of the women. Surgery is considered when medical therapy is unsuccessful or in the setting of infertility. A high recurrence rate is reported in advanced stages of endometriosis. Thus, Complete excision and prevention of recurrence is particularly important.
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This document summarizes a presentation given by Dr. Rajni Singh on vaginal hysterectomy techniques. Key points include:
- Vaginal hysterectomy is the safest and most cost-effective surgical route for conditions like fibroids and abnormal bleeding, with less complications and faster recovery compared to abdominal hysterectomy.
- Evaluation of pelvic support and anatomy is important prior to the surgery.
- Techniques like bladder dissection, use of curved scissors and hemostatic systems like Ligasure can aid in performing a bloodless procedure.
- Post-operative care includes catheter removal after 12 hours and discharge usually within 24-36 hours. Potential complications include vault hematoma, infections and urinary tract injuries
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This document discusses the basic principles of laparoscopy. It describes the key differences between laparoscopic and open surgery for both patients and surgeons. For patients, laparoscopic surgery results in less pain, faster recovery times, and quicker return to normal activities due to smaller incisions. For surgeons, laparoscopy provides a magnified view but with altered tactile response and two-dimensional images. The document outlines the typical laparoscopic setup including the endoscope, light source, camera, monitor, insufflator, trocars and various instruments. It also lists some common laparoscopic procedures that can be used for diagnostic and operative purposes.
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Not all women with breast cancer are candidates for BCS. However, speak to a doctor to find out whether BCS is an option for you.
BCS might be a good option for the below reason:
1. If the tumor is small and localized.
2. If you are eligible for radiation therapy
3. Do not have inflammatory breast cancer
4. Are not pregnant or, if pregnant, will not need radiation therapy immediately.
5. Do not have a mutation linked to breast cancer.
6. Do not have serious connective tissue diseases such as scleroderma or lupus.
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Hysteroscopic procedures are getting refined and with the advent of miniature scopes , doing these procedures in he office is getting better and more comfortable.
Ashermans and hysteroscopic adhesion preventions
This document provides information about Prof. Narendra Malhotra, including his professional qualifications and positions held. It lists that he is a practicing obstetrician gynecologist in Agra with special interests in high risk obstetrics, ultrasound, laparoscopy, infertility and genetics. It also provides information about Malhotra Nursing & Maternity Home Pvt. Ltd. and Global Rainbow Health Care in Agra.
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Seminar discussing the evolution of laparoscopy over the years and the importance of ergonomics for better standard of healthcare.
Safety measures in operative hysteroscopy
Operative hysteroscopy has a low complication rate of around 0.22% according to a large multicenter study. The most common complications are uterine perforation, fluid overload, hemorrhage, and bladder or bowel injury. Several safety measures can help minimize risks, including proper patient selection, an experienced surgeon, good instrumentation, clear visualization, and concurrent laparoscopy or ultrasound guidance when needed. Careful management of distending media is also important to prevent fluid overload issues.
Lavh 1
This document discusses laparoscopic assisted vaginal hysterectomy (LAVH). It begins with a brief history of laparoscopic hysterectomy and incidence rates of different hysterectomy methods from various studies. It then describes the classification, indications, procedure, complications, and comparison of LAVH, vaginal hysterectomy, and abdominal hysterectomy. While laparoscopic hysterectomy may be preferred for its minimal invasiveness, the document emphasizes that vaginal hysterectomy should be performed when possible to avoid unnecessary procedures. In conclusion, it states that the main goal of LAVH is to reduce abdominal hysterectomy rates by utilizing it where vaginal hysterectomy is contraindicated.
Cesarean scar endometriosis
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Endometriose der Bauchwand nach Kaiserschnitt [Presentation in English].
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The document discusses cervical histology and screening for cervical cancer. It describes the squamocolumnar junction (SCJ) and transformation zone of the cervix. The location of the SCJ changes with age due to regenerative changes. Screening guidelines from ACOG and WHO are provided regarding what ages to screen and what tests to use. Screening methods like Pap smear, HPV testing, visual inspection with acetic acid are outlined. Management of abnormal screening results including follow up testing and treatment options like cryotherapy, LEEP, and hysterectomy are summarized.
NEW USES OF LASER IN GYNECOLOGY
1. The document discusses new uses of lasers in gynecology as outlined in 2019 guidelines from the International Society for the Study of Vulvovaginal Disease and International Continence Society.
2. Lasers have been used for over 40 years for procedures like genital wart removal, laser laparoscopy, and laser hysteroscopy. More recently, transvaginal or vulvar lasers have been used to treat conditions like lichen sclerosus, vulvodynia, vaginal laxity, overactive bladder, and pelvic organ prolapse.
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Laparoscopy is a minimally invasive surgical procedure that involves inserting a narrow telescope through a small incision in the abdomen to visualize internal organs. It can be used both diagnostically to investigate issues like infertility, masses, or suspected abnormalities, and therapeutically to treat conditions like endometriosis, myomas, ectopic pregnancies, and more. Potential risks include injuries to internal organs from trocar insertion or diathermy, bleeding, infection, and port site complications. Careful patient selection and surgical technique can help reduce risks.
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3D and 4D ultrasound provide several advantages over traditional 2D ultrasound for assessing female pelvic anatomy and pathology. Multiplanar views allow for more accurate diagnosis of uterine anomalies by visualizing the coronal and true midline planes. Intracavitary lesions can be precisely localized. Ovarian volumes and antral follicle counts are more accurately determined. Endometrial receptivity markers like vascular indices are measurable. Doppler of uterine arteries provides additional information on receptivity. Overall, 3D/4D ultrasound improves evaluation of female pelvic structures and fertility-related conditions.
Step wise pelvic devascularisation
Systematic pelvic devascularisation is an effective and uterus conserving surgical method to control PPH.
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Endometriosis is known to have a remarkably negative effect on the Quality of Life of the women. Surgery is considered when medical therapy is unsuccessful or in the setting of infertility. A high recurrence rate is reported in advanced stages of endometriosis. Thus, Complete excision and prevention of recurrence is particularly important.
Non descent vaginal hysterectomy
This document summarizes a presentation given by Dr. Rajni Singh on vaginal hysterectomy techniques. Key points include:
- Vaginal hysterectomy is the safest and most cost-effective surgical route for conditions like fibroids and abnormal bleeding, with less complications and faster recovery compared to abdominal hysterectomy.
- Evaluation of pelvic support and anatomy is important prior to the surgery.
- Techniques like bladder dissection, use of curved scissors and hemostatic systems like Ligasure can aid in performing a bloodless procedure.
- Post-operative care includes catheter removal after 12 hours and discharge usually within 24-36 hours. Potential complications include vault hematoma, infections and urinary tract injuries
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This document discusses the basic principles of laparoscopy. It describes the key differences between laparoscopic and open surgery for both patients and surgeons. For patients, laparoscopic surgery results in less pain, faster recovery times, and quicker return to normal activities due to smaller incisions. For surgeons, laparoscopy provides a magnified view but with altered tactile response and two-dimensional images. The document outlines the typical laparoscopic setup including the endoscope, light source, camera, monitor, insufflator, trocars and various instruments. It also lists some common laparoscopic procedures that can be used for diagnostic and operative purposes.
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Breast-conserving Surgery is also known as lumpectomy or partial lumpectomy, it is a procedure to remove the cancer from the breast and some normal tissue. BCS involves only the part of the breast that has cancer to be removed. BCS is a good option for many women with early-stage cancers. Usually after BCS, radiation therapy is given to destroy cancer cells that may not have been removed during surgery. In some cases, chemotherapy and radiation are both given after BCS.
Who is BCS recommended for?
Not all women with breast cancer are candidates for BCS. However, speak to a doctor to find out whether BCS is an option for you.
BCS might be a good option for the below reason:
1. If the tumor is small and localized.
2. If you are eligible for radiation therapy
3. Do not have inflammatory breast cancer
4. Are not pregnant or, if pregnant, will not need radiation therapy immediately.
5. Do not have a mutation linked to breast cancer.
6. Do not have serious connective tissue diseases such as scleroderma or lupus.
FOGSI FOCUS Medicolegal Issues in Obstetrics and Gynecology Practice
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Radical hysterectomy
Radical hysterectomy is a surgical procedure for treating cervical cancer. It involves removing the uterus, cervix, part of the vagina, and nearby lymph nodes and tissue. There are different classifications of radical hysterectomy based on the extent of tissue removed. Complications can include bleeding, infection, injury to nearby organs like the bladder or ureters. Radical hysterectomy is indicated for early stage cervical cancer and may provide better survival outcomes than radiation alone for some patients.
Applications of ir in obstetrics and gynecology2
Uterine artery embolization and interventional radiology techniques like pre-operative balloon occlusion of the aorta or internal iliac arteries can help manage invasive placenta and reduce obstetric hemorrhage. These minimally invasive IR procedures are alternatives or adjuncts to traditional cesarean hysterectomy for invasive placenta and can decrease blood loss, increase time for surgical control of bleeding, and allow for potential uterine-sparing treatments. Close collaboration between obstetrics and interventional radiology can help lower rates of hysterectomy and transfusion requirements for patients experiencing obstetric hemorrhage.
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PHYS459_Thesis
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This document discusses brachytherapy for breast cancer, including indications and treatment modalities. It notes that brachytherapy allows higher doses to be delivered to smaller target volumes, shortening treatment time and reducing tumor repopulation. Prospective randomized trials show lumpectomy with radiation improves local control over lumpectomy alone. Accelerated partial breast irradiation (APBI) delivers radiation to a limited region after breast-conserving surgery in 4-5 days instead of 3-7 weeks for whole breast irradiation (WBI), improving quality of life. Patient selection criteria for APBI are discussed. Brachytherapy is the most conformal radiation option, minimizing dose to normal tissues. Boost radiation after WBI improves local control and cos
Thyroid surgery under local anesthesia in selected group of patient
The document discusses thyroid surgery under local anesthesia in selected patients. It notes that historically thyroid surgery was often performed under local anesthesia. The advantages of local anesthesia include avoiding side effects of general anesthesia, providing postoperative analgesia, and facilitating day surgery cases. Thyroid surgery can be safely performed under local anesthesia in properly selected patients, with benefits including reduced costs, operating time, and burden on anesthesia resources compared to general anesthesia. Complications were low when local anesthesia was used.
Radiotherapy
Radiotherapy uses ionizing radiation to treat cancer cells, especially for breast cancer. It works by damaging the DNA of cancer cells, either directly or through free radicals. Radiotherapy is often used as adjuvant therapy after breast surgery to reduce the risk of local recurrence from 10-40% to under 5%. It is also used for palliative treatment of metastases. While side effects like skin irritation are common, newer techniques reduce toxicity. Ongoing research aims to optimize radiotherapy schedules and techniques.
Urology gynecology mri staging for ca cervix
This document discusses the use of MRI in staging cervical cancer according to the FIGO staging system. It provides details on the MRI protocol, what areas to evaluate for tumor extension, and the accuracy of MRI findings. Key areas MRI can evaluate include parametrial invasion, vaginal involvement, pelvic sidewall extension, hydronephrosis, and lymph node status. Accuracy is high for staging tumor extension locally and detecting lymph node metastases.
Cyberknife An expertise state of art Technology to execute Stereotactic Robot...
ALARA Informative Page | NewsLetter Publication |
Cyberknife
The CyberKnife is a frameless robotic radiosurgery system used to treat both benign and malignant tumors. It was invented in the 1990s and is manufactured by Accuray. It uses a compact linear accelerator mounted on a robotic arm to deliver radiation from many angles and can track tumor motion using X-ray imaging and respiratory tracking sensors. Treatment planning involves defining target volumes and constructing a correspondence model between internal fiducial markers and external sensors to track tumor position in real-time during delivery. The CyberKnife provides an alternative to frame-based radiosurgery and can fractionate treatment over multiple days.
ICRU 83
This seminar is presented as a part of weekly journal club and seminar presented in Apollo Hospital,Kolkata Department of Radiation Oncology.This seminar is moderated by Dr Tanweer Shahid.
Summary of embrace protocol
The EMBRACE protocol involves a prospective multicenter study evaluating image-guided radiotherapy for cervical cancer, with a focus on improving outcomes. Key aspects of the protocol include:
1. Retrospective studies identified the benefits of MRI-based adaptive brachytherapy and established guidelines for parameters to evaluate.
2. The prospective EMBRACE I study involved over 1400 patients treated with chemoradiation followed by MRI-guided brachytherapy at 23 centers. Early results showed high local control rates and the benefits of combined intracavitary/interstitial brachytherapy in reducing morbidity.
3. The ongoing EMBRACE II study aims to further improve outcomes through
Salivary gland tumors
Most salivary gland tumors are benign, with pleomorphic adenoma being the most common benign tumor of the parotid gland in children. Malignancy is more common in smaller salivary glands. Surgery is the primary treatment and includes superficial parotidectomy for tumors of the superficial lobe or total conservative parotidectomy for tumors involving the deep lobe or with high risk of metastasis. Postoperative radiotherapy improves local control for T3/T4 tumors, close or positive margins, lymph node metastasis, adenoid cystic carcinoma, or high/intermediate grade tumors. Elective nodal radiotherapy is recommended for high grade tumors but not usually for adenoid cystic or acinic cell tumors due to their low
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Radiotherapy planning in carcinoma cervix dr rekha
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Thyroid surgery under local anesthesia in selected group of patient
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Female imaging.pptx
The document discusses various gynecological imaging signs and findings including the Koala bear sign seen with pelvic inflammatory disease, the Pokémon sign seen with ovarian dermoid cysts, and the floating balls sign seen with ovarian dermoid cysts characterized by floating spheres of lipid material. It also discusses Canal of Nuck hernia where the left ovary herniates into the Canal of Nuck requiring surgery due to the high risk of ovarian torsion.
Genitourinary signs.pptx
This document discusses various radiological signs seen in genitourinary conditions. It describes the "Bear's paw sign" seen in xanthogranulomatous pyelonephritis, the "Onion ring appearance" seen in testicular epidermoid tumors, and the "Koala bear sign" seen with pelvic inflammatory disease and tubo-ovarian abscesses. It also mentions signs seen in pelvic endometriosis, deep pelvic endometriosis, and peritoneal inclusion cysts/pseudocysts. Finally, it describes different types of prostatic cysts and the "Erased charcoal sign" seen with transitional cell tumors.
CT Angiography.pptx
This document discusses CT angiography and venography procedures. It provides normal measurements for parts of the aorta and describes variants of the aortic arch branches. It also discusses aneurysms, stents, leakage types, and bypass grafts. Terms used in angiography are defined. Anatomy of the lower limbs and indications for angiography are covered. Techniques for deep vein thrombosis evaluation are explained. Examples of acute DVT and May-Thurner syndrome findings are shown.
Genitourinary signs
This document discusses various genitourinary signs seen on imaging studies. It describes the "Bear's paw sign" seen with xanthogranulomatous pyelonephritis and the "Onion ring appearance" seen with testicular epidermoid tumors. It also mentions the "Koala bear sign" seen with pelvic inflammatory disease and tubo-ovarian abscesses, as well as kissing ovaries seen with pelvic endometriosis. Deep pelvic endometriosis and locations of utricle cysts and Mullerian duct cysts are also outlined.
Otosclerosis
Otosclerosis is a metabolic bone disease that causes conductive or mixed hearing loss. It involves the replacement of normal bone in the otic capsule with spongy, vascular bone. There are two phases: initially the normal bone is absorbed and replaced with spongy bone (otospongiosis), which is later replaced with dense sclerotic bone. It typically presents in the second to fourth decades of life. CT imaging is useful for assessing the stapes footplate, oval and round windows. Treatment involves stapedectomy and prosthesis insertion for fenestral otosclerosis or medications/cochlear implants for retrofenestral otosclerosis. Post-operative complications can include prosthesis displacement, fixation, ob
Cochlear implant
This document discusses cochlear implants, including:
- Indications for cochlear implants are profound to severe bilateral sensorineural hearing impairment.
- The implant converts sound into electrical signals that stimulate the auditory nerve.
- Preoperative imaging assesses anatomy like the cochlear nerve and ducts for patient selection.
- Postoperative imaging evaluates electrode placement depth and angle, and identifies any complications like infections.
- Proper electrode positioning and monitoring for complications are important aspects of postoperative imaging reports.
Neuro signs
This document provides descriptions and images related to various neuroimaging signs seen in neuroradiology. It discusses signs seen in conditions such as multiple sclerosis, CADASIL, ischemic and hemorrhagic strokes, infections like abscesses, tumors, and other pathologies. Specific signs described include the boomerang sign, butterfly medulla sign, onion rings sign, trident sign, and others. Imaging features of various diseases and abnormalities are also outlined.
Intervention signs
1. The document discusses various vascular signs and conditions seen on angiography related to neurofibromatosis, adventitial cystic disease, aneurysms, and endovascular repair of abdominal aortic aneurysms.
2. Key signs discussed include the string of beads sign seen in fibromuscular dysplasia, adventitial cystic disease affecting the popliteal artery, and various types of endoleaks seen after endovascular aneurysm repair.
3. Different types of vascular malformations are also summarized, including arteriovenous malformations, fistulas, venous malformations, and sinus pericarnii.
Head and neck
This document summarizes key anatomical variations of the sphenoid sinus that can impact trans-sphenoid pituitary surgery. It describes variations in pneumatization degree, type of pneumatization, sellar bulge prominence, septation, and intercarotid distance that are evaluated on preoperative CT and MRI to assess surgical complexity. Examples of imaging findings of each variation are also provided.
Pediatrics signs
This document provides information on various pediatric signs and diseases that can be identified on imaging studies. It lists different basal ganglia and striatal involvements that can be seen with various genetic diseases and conditions like CO poisoning. It also lists nasal masses, hip dysplasia, skull lesions, vertebral abnormalities, and heart and lung signs that can indicate different diseases. Common pediatric radiological findings are described that can help diagnose conditions such as mucopolysaccharidosis, sickle cell anemia, neuroblastoma, osteopetrosis, achondroplasia, and others. Respiratory signs seen in conditions like meconium aspiration, bronchopulmonary dysplasia, and HMD are also detailed.
Msk signs edited
This document contains medical images and descriptions of various musculoskeletal signs and pathologies. It discusses imaging findings and classifications for conditions like:
- Adhesive capsulitis showing thickened ligaments.
- SLAC and SNAC wrist classifications.
- Femoroacetabular impingement presentations.
- Charcot neuroarthropathy acute and chronic stages.
- Various tendon injuries and ligamentous injuries patterns.
It provides comparisons of imaging findings between similar conditions like fibrous dysplasia and osteofibrous dysplasia. Assessment techniques for foot deformities like clubfoot and flatfoot are also outlined.
Vascular malformations of the head and neck
This document discusses soft tissue vascular lesions of the head and neck. It defines different types of vascular lesions including hemangiomas, arterial malformations, venous malformations, lymphatic malformations, and mixed malformations. For each type, the document provides descriptions, classifications where relevant, examples of MRI appearances, and treatment approaches. Key differences highlighted include hemangiomas having a sizable parenchymal component unlike vascular malformations, and distinguishing high flow from low flow lesions based on the presence or absence of flow voids on MRI sequences.
Infrapatellar fat pad abnormalities
This document provides a classification of abnormalities that can occur in the infrapatellar fat pad, including benign tumors, cysts, ganglia, recesses, bursae, and overuse/impingement syndromes. Specific conditions mentioned include para-articular chondroma, localized villonodular synovitis, synovial hemangioma, parameniscal cysts, Hoffa's recesses, Hoffa's ganglion, infrapatellar bursitis, Hoffa's fat pad impingement, and cyclops lesions. The document also provides brief descriptions and imaging characteristics of some of these conditions.
Chest signs
This document lists and describes various chest signs seen on imaging that can indicate different medical conditions. Some examples provided are the polo mint sign indicating acute pulmonary embolism, the gloved finger sign seen in allergic bronchopulmonary aspergillosis, and the tree in bud appearance commonly seen with tuberculosis infections. Different patterns such as reticulation, cysts, nodules and crazy paving are described along with the conditions they may suggest such as fibrosis, sarcoidosis or pneumonia. Specific signs for conditions like silicosis, round atelectasis, and congenital heart defects are also defined.
Git signs
This document provides a list of over 50 gastrointestinal signs seen on imaging with brief descriptions. Some of the signs included are:
- Windsock sign which indicates intraluminal duodenal diverticulum.
- Cobblestone sign seen in Crohn's disease which is characterized by a granular mucosa.
- String sign seen in Crohn's disease presenting as longitudinal ulcers.
- Pearl necklace sign seen with adenomyomatosis of the gallbladder appearing as dilated biliary radicles.
- Hourglass or collar sign indicating a diaphragmatic hernia.
The document serves as a reference for various imaging findings or "signs" seen in gastrointestinal diseases and
Pet ct technique
PET-CT combines functional PET imaging with anatomical CT imaging. A PET-CT scan involves fasting for 4-6 hours before injection of 18F-FDG tracer, followed by a whole body scan 40-60 minutes later lasting 13-17 minutes. Standardized uptake values (SUVs) are used to measure tracer uptake in tissues, with values over 2.5 suggesting malignancy. Dual time scanning one hour later can identify if SUV increases by 10% indicating malignancy or remains the same/decreases indicating benignity. Reference tissues like blood pools and livers are used to compare lesion uptake values to determine if they are higher, suggesting malignancy, or equal/lower, suggesting benignity.
Csf flowmetry
This document describes the process and parameters analyzed in quantitative cerebrospinal fluid (CSF) flow studies using phase contrast MRI. CSF flow is analyzed both qualitatively and quantitatively by measuring flow velocities and calculating stroke volume in the cerebral aqueduct. Elevated stroke volume is indicative of normal pressure hydrocephalus, while reduced values suggest cerebral atrophy. Key parameters including peak systolic and diastolic velocities, mean systolic flow, duration of CSF systole, and aqueduct stroke volume are calculated to differentiate normal, hyperdynamic, and hypodynamic CSF circulation.
Deformity correction
This document discusses methods for measuring alignment in the lower limbs, including the knee and hip joints. It outlines several key anatomical lines used as references, such as the mechanical axis of the femur and tibia. Joint orientation lines and angles are important for assessing malalignment. Measuring these lines and angles helps evaluate deformities and plan corrective procedures like osteotomies, which are performed at the center of rotation angle.
Arfi
Acoustic radiation force impulse (ARFI) is a sonographic technique that uses acoustic beams to mechanically excite tissue and monitor the displacement response to assess tissue stiffness without external compression. It provides qualitative images (Virtual Touch Tissue Imaging) and quantitative stiffness measurements (Virtual Touch Tissue Quantification) by tracking tissue displacement over time. Stiffer tissues like malignancies display as darker on images and have higher shear wave velocities measured in m/s. ARFI can help characterize and differentiate liver masses, breast and thyroid nodules, prostate cancer, and more.
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Identification and nursing management of congenital malformations The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Physiology of Chemical Sensation of smell.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Non-respiratory Functions of the Lungs.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Hifu
- 1. HIFU The follow-up of uterine fibroids treated with HIFU: role of DWI and Dynamic contrast-study MRI
- 2. Mechanism of action • Tissue temperature within the local region is instantly raised to 65- 100°C during first second of HIFU exposure; coagulation necrosis is therefore immediately induced in the tumor. • The real benefit of this technique is to strike the target tissue with precision while sparing the normal surrounding structures.
- 3. Aim of MRI study •Assessment of the percentage of intralesional necrosis:- • ADC value. • Percentage of contrast enhancement. • pre and post-treatment data were compared.
- 4. ADC value` • The increase of ADC after treatment reflects the liquefactive necrosis, and low cellularity.
- 5. Contrast enhancement Marked contrast enhancement before HIFU treatment. Central core of non enhancing necrotic area after treatment.
- 6. Size reduction and signal alteration after treatment. Leiomyoma before and after HIFU treatment
- 7. Conclusion • HIFU ablation is an effective and safe treatment in reducing uterine fibroids volume. • • Both dynamic study and DWI may serve as imaging tools to assess treatment response. • • There is reduction in the tumor volume and contrast enhancement with elevation in the ADC values (related to intralesional coagulative necrosis).