USG B scan is a noninvasive imaging technique used to assess ocular structures. It works by emitting high frequency sound waves into the eye, which are reflected back to a probe and converted into an image. Key principles include sound traveling faster in solids than liquids, stronger reflections occurring at interfaces of different densities, and perpendicular angle of incidence providing best images. Clinical applications include evaluating conditions that prevent normal examination like corneal scarring or dense cataracts. It can differentiate pathologies like vitreous hemorrhage from asteroid hyalosis.
OCT is a great technology,Many ophthalmologist find very difficult to understand it ,SO I have tired to simplify it as much as possible .Hope everyone can understand now onwards the basic about OCT .
Every feedback s most welcomed sothat i can improve further in coming days
Please email your feedback to me in the following address
yourgyanu@gmail.com
OCT is a great technology,Many ophthalmologist find very difficult to understand it ,SO I have tired to simplify it as much as possible .Hope everyone can understand now onwards the basic about OCT .
Every feedback s most welcomed sothat i can improve further in coming days
Please email your feedback to me in the following address
yourgyanu@gmail.com
Ocular Ultrasound is an ultrasound for eyes that uses high frequency sound waves to get detailed pictures of your eye and it's orbit. This procedure is usually done by Ophthalmologists.
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Ocular Ultrasonography (Ocular USG/ Ophthalmic USG), ophthalmic ultrasound/ ophthalmic ultrasonography/ ocular ultrasound/ Ultrasound of eye and orbit
PRESENTATION LAYOUT
Introduction
History
Physics
Principles & instrumentation
Terminologies
Indications & contraindications
Methods - A-Scan - B-Scan
Interpretation
Definition
Ultrasound Waves are acoustic waves that have frequencies greater than 20 KHz
The human ear can respond to an audible frequency range, roughly 20 Hz - 20 kHz
......................
For Further Reading
Clinical Procedures in Optometry by J. D. Barlett, J. B. Eskridge & J. F. Amos
Ophthalmic Ultrasound: A Diagnostic Atlas by C. W. DiBernardo & E. F. Greenberg Internet
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
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www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
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Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
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Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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The prostate is an exocrine gland of the male mammalian reproductive system
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1. USG B SCAN
Dr.Gyanendra Lamichhanae
Vitreo retinal Fellow, Gunma University ,JAPAN
Lumbini Eye Institute, Bhairahawa
2. What is ultrasound
• sound pressure with a frequency greater than the upper limit of
human hearing.
• Although this limit varies from person to person, it is approximately
20 kilohertz (20,000 hertz) in healthy, young adults
2
4. • B-scan ultrasonography is an important
noninvasive technique for the clinical
assessment of various ocular and orbital
diseases
4
5. HISTORY
• 1793: Lazzaro Spallanzani (Italy) discovered that bats orient
themselves with the help of sound whistles while flying in
darkness. This was the basis of modern ultrasound application
Bats use ultrasounds to navigate in the
darkness
5
6. History contd…….
• World war II: a device based on piezoelectric effect developed
by Paul Langevin (France) ,able of emitting & receiving ultrasound
under water used as sonar.
• 1956: first documented use of ocular USG, Mundt and
Hughes used A scan technique to detect intraocular tumour.
• 1972: First use of hand held B scan by Bronston &
workers ,which was applied directly to the closed lid without a
water bath
6
7. • Principles of ultrasound:
• By definition, an ultrasound wave has a frequency greater than 20
kHz (20,000 oscillations/ second)
• As the frequency of USG increases, the wavelength decreases
and wavelength of an ultrasound determines its depth of tissue
penetration and resolution
Wavelength α Depth of penetration of the ultrasound
• So, Larger is the frequency of US = shorter is its wavelength =
shallower is its penetration = better is the resolution of resultant
echo graph.
7
8. • That’s why USG probes used for Ocular USG are of higher
frequency(10MHz)as it needs much less tissue penetration (an
eye is 23.5 mm long on average) & higher resolution.
• In contrast, ultrasound probes used for purposes such as
obstetrics, use lower frequencies (1-5Hz) for deeper
penetration into the body, and, because the structures being
imaged are larger, they do not require the same degree of resolution
8
9. Ultrasound Principles and Physics
Ophthalmic ultrasonography uses high-frequency sound waves,
transmitted from a probe into the eye.
As the sound waves strike intraocular structures,
they are reflected back to the probe and converted into an electric
signal.
The signal is subsequently reconstructed as an image on a monitor,
9
10. Velocity
• The velocity of the sound wave is dependent on the density of the
medium through which the sound travels.
• Sound travels faster through solids than liquids, an important
principle to understand since the eye is composed of both.
• There are known velocities of different components of the eye, with
sound traveling through both aqueous and vitreous at a speed of
1,532 meters/second (m/s) and through the cornea and lens at
an average speed of 1,641 m/s
10
11. Reflectivity
• When sound travels from one medium to another medium of
different density, part of the sound is reflected from the interface
between those media back into the probe.
• This is known as an echo; the greater the density difference at that
interface, the stronger the echo, or the higher the reflectivity
• In A-scan ultrasonography, a thin, parallel sound beam is emitted,
which passes through the eye and images one small axis of
tissue; the echoes of which are represented as spikes arising
from a baseline. The stronger the echo, the higher the spike
11
13. • In B-scan ultrasonography, an oscillating sound beam is
emitted, passing through the eye and imaging a slice of tissue;
the echoes of which are represented as a multitude of dots that
together form an image on the screen.
The stronger the echo, the brighter the dot.
example, the dots that form the posterior vitreous hyaloid membrane
are not as bright as the dots that form the retinal membrane.
This is very useful in differentiating a posterior vitreous detachment (a
benign condition) from a more highly reflective retinal
detachment (a blinding condition) because retina is more dense
than vitreous.
13
14. Angle of incidence
• The angle of incidence of the probe is critical for both A-scan and B-
scan ultrasonography.
• When the probe is held perpendicular to the area of interest,
more of the echo is reflected directly back into the probe tip
and sent to the display screen.
• When held oblique to the area imaged, part of the echo is
reflected away from the probe tip and less is sent to the display
screen.
• The more oblique the probe is held from the area of interest, the
weaker the returning echo and, thus, the more compromised the
displayed image.
.
14
15. • On A-scan, the greater the perpendicularity, the more steeply
rising the spike is from baseline and the higher the spike.
• On B-scan, the greater the perpendicularity, the brighter the dots
on the surface of the area of interest
15
16. • Because various parts of the eye and various pathologies are
different in size and shape, understanding this concept and
anticipating the best possible display for that eye are important.
• Perpendicularity to the area of interest should be maintained to
achieve the strongest echo possible for that structure
16
17. Absorption
• Ultrasound is absorbed by every medium through which it
passes.
• The more dense the medium, the greater the amount of
absorption.
• This means that the density of the solid lid structure results in
absorption of part of the sound wave when B-scan is
performed through the closed eye, thereby compromising the
image of the posterior segment
17
18. • Therefore, B-scan should be performed on the open eye unless the
patient is a small child or has an open wound .
• Likewise, when performing an ultrasound through a dense cataract
as opposed to the normal crystalline lens, more of the sound is
absorbed by the dense cataractous lens and less is able to pass
through to the next medium, resulting in weaker echoes and images
on both A-scan and B-scan. For this reason, the best images of
the posterior segment are obtained when the probe is in
contact with the sclera rather than the corneal surface,
bypassing the crystalline lens or intraocular lens implant .
18
19. Instrumentation
• Ophthalmic ultrasound instruments use what is known as a pulse-
echo system, which consists of a series of emitted pulses of sound,
each followed by a brief pause (microseconds) for the receiving of
echoes and processing to the display screen.
• The amplification of the display can be altered by adjusting the gain,
which is measured in decibels (dB). Adjusting the gain in no way
changes the frequency or velocity of the sound wave but acts to
change the sensitivity of the instrument's display screen.
• When the gain is high, weaker signals are displayed, such as
vitreous opacities and posterior vitreous detachments.
• When the gain is low, the weaker signals disappear, and only
the stronger echoes, such as the retina, remain on the screen.
19
20. • Typically, all examinations begin on highest gain so that no
weak signals are missed; then, the gain is reduced as necessary
for good resolution of the stronger signals
20
21. • The probe face is usually oval in shape and when placed on the
globe is represented by the initial white line on the left side of the
display screen. The vitreous cavity is displayed in the center of
the echogram, and the posterior pole is displayed on the right side
of the echogram
21
22. Indications
• when direct visualization of intraocular structures is difficult or
impossible.
• Situations that prevent normal examination
lid problems (eg, severe edema, partial or total tarsorrhaphy),
corneal opacities (eg, scars, severe edema),
hyphema, hypopyon,
miosis, pupillary membranes
dense cataracts
vitreous opacities (eg, hemorrhage, inflammatory debris).
22
24. Clinical Applications
Differentiation between VH & asteroid Hyalosis:
• AH is highly ecogenic,they are still visible when the gain setting is
reduced upto 60dB whereas VH which usually disappears by 60 dB
24
26. Vitreous Inflammation
USG is very helpful in assessing the severity and extent of intraocular
inflammation in a patient suspected of having endophthalmitis.
VITRITIS appears in B-scan as scattered particle or large
aggregates.
sometimes in absence of external inflammatory signs, it is important
to differentiate between endophthalmitis and vitreous
hemorrhage. VH is generally associated with PVD and layering
of blood in inferior portion of the eye to produce sheet-like
echoes
26
28. PVD
• In PVD with normal eye, the reflectivity is very low, high
gain(90dB) setting is required the reflectivity disappears
lowering the sensitivity,under 70 dB.
• It should be kept in mind that PVD with hemorrhage shows
extremely high reflectivity .
• Kinetic echography typically shows a very undulating movement
that continue after the eye movements stops, which
differentiates PVD from less mobile retinal and choroidal
detachments
28
29. RD vs PVD
In presence of opaque media,the differentiation between PVD and RD is
challenging. Few points are-
1) RD is usually uniformly high reflective and of even thickness whereas
tilting of probe in different direction may reveal uneven thickness &
reflectivity of membranes in PVD,
2) The image of PVD will disappear from the screen at higher gain setting
(70dB) than a RD(40-50dB)
4) PVD may appear as a line with multiple discontinuities or may be
completely detached from ON.Rhegmatogenous RD:appear as a mobile
membrane attached anterior to the ora serrata and posterior to the ON
head
. 29
30. 4) On kinetic Echography,a PVD has much more after
movements when compared to RD.
The mobility of RD depends on
duration of the detachment. Recent bullous RD may be highly
mobile,whereas chronic RD with proliferative Vitreoretinopathy
appear stiff.
30
33. • Choroidal Detachment: CD appear as smooth, convex elevations
from the posterior eye wall. In massive CD, choroids from opposite
fundus areas may touch in the middle of the vitreous cavity-“Kissing
Choroid”
33