Clinical outcomes and significance of postoperative ultrasound biomicroscopy in patients with Boston type 1 keratoprosthesis

ABSTRACT Purpose: To determine the clinical outcomes in patients after type 1 Boston keratoprosthesis surgery and the significance of ultrasound biomicroscopy imaging for postoperative follow-up. Methods: This retrospective analysis included 20 eyes of 19 patients who underwent corneal transplantation with type 1 Boston keratoprosthesis between April 2014 and December 2021. Data on patient demographics, preoperative diagnosis, visual acuity, and postoperative clinical findings were analyzed. Results: Type 1 Boston keratoprosthesis implantation resulted in intermediate- and long-term positive outcomes. However, blindness and other serious complications such as glaucoma, retroprosthetic membrane formation, endophthalmitis, or retinal detachment also occurred. The use of ultrasound biomicroscopy imaging allowed for better evaluation of the back of the titanium plate, anterior segment structures, and the relationship of the prosthesis with surrounding tissues, which provided valuable postoperative information. Conclusion: Regular lifetime monitoring and treatment are necessary in patients who undergo Boston type 1 keratoprosthesis implantation for high-risk corneal transplantation. ultrasound biomicroscopy imaging can be a valuable imaging technique for the evaluation of patients with Boston type 1 keratoprosthesis, providing important information on anterior segment anatomy and potential complications. Further studies and consensus on postoperative follow-up protocols are required to optimize the management of patients with Boston type 1 keratoprosthesis.

Unilateral acute cataract after facial aesthetic procedure: a case report

ABSTRACT Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound.

Lesiones subepiteliales del esófago. Revisión de la literatura / Subepithelial tumors of the esophagus. Literature review

Introducción. Las lesiones subepiteliales son masas que se originan en la pared de una víscera hueca, respetando la integralidad de la mucosa que las recubre. Se diferencian de las lesiones que comprometen la luz esofágica por compresión extrínseca de la pared, de origen mediastinal o cervical extraesofágico. El objetivo de este artículo fue hacer una revisión de las lesiones subepiteliales más frecuentes del esófago según su histología, sus manifestaciones clínicas y el manejo recomendado. Métodos. Se realizó una revisión de la información disponible en bases de datos, estableciendo las caracteristicas, los medios para el estudio y el tratamiento de las lesiones subepiteliales más frecuentes del esófago. Resultados. Las lesiones subepiteliales del tracto digestivo, en general, requieren del apoyo de la ecoendoscopia como el método diagnóstico más preciso para conocer las características propias de la lesión, además de permitir la toma de biopsias dirigidas, especialmente en lesiones mayores de 2 cm. Las técnicas de inmunohistoquímica son necesarias para lograr el diagnóstico que establezca el manejo más adecuado de las diferentes lesiones. Conclusión. El manejo de las lesiones subepiteliales del esófago requiere de un estudio temprano. Las técnicas endoscópicas, como la disección submucosa endoscópica y la disección del tercer espacio, han permitido un nuevo abordaje en el estudio y tratamiento de las lesiones subepiteliales.

Introduction. Subepithelial lesions are masses that originate in the wall of a hollow viscus, respecting the integrity of the mucosa that covers them. They are differentiated from lesions that compromise the esophageal lumen due to extrinsic compression of the wall, of mediastinal or estraesophageal cervical origin. The objective of this article was to review the most frequent subepithelial lesions of the esophagus according to their histology, clinical manifestations, and recommended management. Methods. A review of the information available in the databases was carried out, establishing the characteristics, means for the study, and treatment of the most frequent subepithelial lesions of the esophagus. Results. Subepithelial lesions of the digestive tract, in general, require the support of endoscopy as the most precise diagnostic method to understand the characteristics of the lesion, in addition to allowing targeted biopsies to be taken, especially in lesions larger than 2 cm. Immunohistochemical techniques are necessary to achieve the diagnosis that establishes the most appropriate management of the different lesions. Conclusion. The management of the subepithelial lesions of the esophagus requires early study. Endoscopic techniques, such as endoscopic submucosal dissection and third space dissection, have allowed a new approach in the study and treatment of subepithelial lesions.

A Case of Mediastinal Lymphoma that was Missed on EBUS-TBNA but Correctly Diagnosed after EBUS-TBCNB

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a breakthrough in diagnosing mediastinal diseases. However, it is less sensitive in diagnosing some mediastinal diseases, where diagnosis largely depends on a larger tissue sample with preserved tissue architecture, such as lymphoproliferative diseases of the mediastinum. Another newer approach, endobronchial ultrasound-guided transbronchial mediastinal cryonodal biopsy (EBUS-TBCNB), can overcome the limitations of EBUS-TBNA and provide larger samples with preserved tissue architecture. Here we present a case of an elderly female with multiple mediastinal lymphadenopathy who underwent EBUS-TBNA two times, despite adequate sampling, the diagnosis remains inconclusive. We were only able to make a diagnosis of mediastinal lymphoma after EBUS-TBCNB under conscious sedation. Endobronchial ultrasound-guided transbronchial mediastinal cryonodal biopsy is a safe and effective procedure that can be used in the successful diagnosis of mediastinal pathologies where EBUS-TBNA remained inconclusive, or it may be used as a combined procedure with EBUS-TBNA in cases of diagnostic uncertainty.

Comprehensive Study on Ultrasound-assisted Extraction (UAE) of Bioactive Compounds with Medicinal Properties from Date Processing Byproduct

The date palm (Phoenix dactylifera L.), originating from Mesopotamia, is a crucial fruit crop with significant economic value across the Middle East, South Asia, North Africa, and Central America. Although the edible flesh of dates is prized for its nutritional properties, substantial amounts of byproducts, such as seeds and press cake, are discarded during processing. These byproducts are rich in bioactive compounds, including phenolics, flavonoids, and antioxidants, which have potential health benefits. Conventional extraction methods for these compounds often involve toxic solvents and can degrade heat-sensitive substances. This study explores Ultrasound-Assisted Extraction (UAE) as a sustainable alternative for recovering bioactive compounds from date press cake (DPC). The efficacy of UAE was evaluated under various conditions to optimize the yield and quality of the extracted compounds. The study found that UAE significantly enhances the extraction of bioactive compounds, with optimal conditions identified as 15 minutes at 40癈 with a 60% ethanol solution. The optimized UAE conditions resulted in a yields of 121.73 mg GAE/g for TPC, 446.66 mg QE/g for TFC, and 67.76% for antioxidant activity. The extracted compounds demonstrated significant antioxidant activity, suggesting their potential application in food, pharmaceutical, and cosmetic industries. The findings indicate that DPC, typically considered waste, can be valorized as a rich source of natural antioxidants and bioactive compounds, offering a sustainable approach to utilizing agricultural byproducts.

A Tale of Grumpy Neighbours: Angina from Left Main Coronary Artery Compression in Severe Pulmonary Hypertension with Large ASD

This report presents a case of a 42-year-old patient diagnosed with ostium secundum atrial septal defect (ASD) with severe pulmonary arterial hypertension (PAH). The patient presented with progressive chest pain and dyspnea and was found to have a lesion in the left main coronary artery (LMCA) ostium by coronary angiography. Computed tomography (CT) imaging revealed a significant enlargement of the main pulmonary artery (MPA), which indicated possible compression of the LMCA by the pulmonary artery which was subsequently confirmed by coronary angiography and intravascular ultrasound (IVUS). Our patient underwent IVUS guided percutaneous coronary intervention by which a stent was deployed in the ostial LMCA, leading to near resolution of the patient's symptoms. Currently, the patient is under follow-up. This case highlights an often-overlooked cause of chest pain and dyspnea in patients with PAH. Although these patients often experience typical and atypical angina due to elevated right-sided pressures, the current report reveals that external compression of the LMCA by an enlarged pulomonarya artery(PA) can also cause coronary ischemia. Physicians should consider LMCA compression when assessing PAH patients with chest pain, as percutaneous coronary intervention and stenting can safely and effectively manage this condition.

Evaluación del aporte ecográfico en estética: hallazgos faciales que inciden en la terapéutica / Evaluation of the ultrasound contribution in aesthetics: facial findings that have an impact on therap

Resumen Introducción: La radiología, especialmente la ecografía, está ganando importancia en el campo de la medicina estética, facilitando la evaluación anatómica de los pacientes antes de procedimientos inyectables, ayudando en el diagnóstico de complicaciones y en la identificación de materiales de relleno. Existen variantes anatómicas que pueden aumentar el riesgo de complicaciones, además muchos pacientes no recuerdan qué materiales han sido inyectados previamente. Este trabajo busca evaluar la utilidad de la ecografía en la toma de decisiones terapéuticas y compartir la experiencia de los autores con pacientes entre 2021 y 2023. Objetivo: Describir los hallazgos ecográficos de una serie de pacientes que se realizaron ecografía facial Doppler por indicación de su médico estético y evaluar cómo incide en la toma de decisión terapéutica. Método: Este trabajo fue aprobado por el Comité de Ética. Estudio prospectivo descriptivo analítico de una cohorte de pacientes atendidos entre 2021 y 2023. Se incluyeron pacientes que se realizaron ecografía facial antes o después de un procedimiento inyectable. Se determinó cómo incidió la ecografía en la selección del tratamiento estético. Datos y variables se analizaron mediante Stata Statistical Software Release14 (College Station, TX: StataCorpLP). Resultados: Se estudiaron 83 pacientes, 53 se realizaron ecografía para planificar un procedimiento (grupo 1) y 30 por complicaciones (grupo 2). Del grupo 1, 24 (45,2%) no presentaban rellenos previos, 15 (28,3%) ácido hialurónico y 14 (26,4%) rellenos permanentes. Doce presentaron variantes anatómicas. Del grupo 2, 14 sufrieron complicaciones agudas y 16 crónicas. El informe ecográfico condicionó un cambio en la terapéutica del médico estético en el 74% de los pacientes. Conclusión: La ecografía facial otorgó información fundamental para la planificación de los tratamientos estéticos y condicionó un cambio en la conducta terapéutica en la mayor parte de la población estudiada.

Abstract Introduction: Radiology, especially ultrasound, is gaining importance in the field of aesthetic medicine, facilitating the anatomical evaluation of patients prior to injectable procedures, assisting in the diagnosis of complications, and identifying filler materials. There are anatomical variations that can increase the risk of complications, and many patients do not remember which materials have been injected previously. This work aims to evaluate the utility of ultrasound in therapeutic decision-making and to share the authors' experience with patients between 2021 and 2023. Objective: To describe ultrasound findings in patients that had a facial Doppler ultrasound study referred by an aesthetic physician and to evaluate how it influenced the therapeutic decision. Method: This study was approved by the institutional Ethics medical Committee. It is a prospective, descriptive, analytical study of a patient cohort assessed between 2021 and 2023. The study includes patients who had a facial ultrasound referred by their aesthetic physician, either before or after injectable treatments. The influence of ultrasound findings on treatment selections was considered. Data were analyzed using Stata Statistical Software Release 14 (College Station, TX: StataCorp LP). Results: A total of 83 patients were studied. Fifty-three patients underwent a facial ultrasound before planning an injectable treatment (group 1), while 30 patients underwent facial ultrasound due to complications related to injectables (group 2). In group 1, 24 patients (45.2%) had no previous fillers, 15 (28.3%) had hyaluronic acid fillers, and 14 (26.4%) had permanent fillers. Twelve patients (22.6%) presented anatomical variations. In group 2, 14 patients (46.6%) had acute complications and 16 (53.3%) had chronic complications. Based on these results, ultrasound findings changed the therapeutic decision in 74% of the cases (62 patients). Conclusion: Facial ultrasound provided crucial information for aesthetic treatment planning and altered the treatment approach in the majority of the patients studied.

The Value of CEUS LI-RADS combined with AFP in early diagnosis of hepatocellular carcinoma in low- and high-risk patients

Background: We found that the occurrence of hepatocellular carcinoma (HCC) has increased significantly in non?cirrhotic individuals, with HCC being frequently overlooked or misdiagnosed. Contrast?enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI?RADS) is known to have a high diagnostic quality in high?risk HCC patients. Therefore, we aimed to compare the detection accuracy of CEUS LI?RADS for HCC between low? and high?risk individuals, to confirm its value in low?risk patients at increased risk of HCC, but not yet included in the high?risk groups of LI?RADS. In addition, since CEUS LR?4 and LR?M categories contain a relatively high proportion of HCC, and serum alpha?fetoprotein (AFP) is the most commonly used biomarker for HCC, and the clinically valid, we attempted to further improve the early diagnostic capability of CEUS LI?RADS for HCC in the low?risk and high?risk patients by combining CEUS LR?4 and LR?M categories with AFP. Methods: We defined high?risk groups (HR)?included in the high?risk patients of LI?RADS, low?risk groups (LR)?not included in the high?risk patients of LI?RADS and enrolled 189 HCC patients with LR and HR settings in a retrospective study. All lesions were confirmed histopathologically. The CEUS LI?RADS accuracy for detecting HCC in these two patients was compared. In addition, the diagnostic algorithm in our study was proposed (for CEUS LR?4 and LR?M patients with AFP>20 ng/ml). we analyzed the ability of CEUS LI?RADS as a valid method of establishing the early diagnosis of HCC in LR and HR patients by combining LR?4 and LR?M categories with AFP. Results: Through comparative analysis, the specificity of the CEUS LR?5 category for HCC in the HR group was 78.4%, whereas in the LR group, it was 94.2%. Meanwhile, the sensitivity (63.2% vs. 63.0%) and positive predictive value (PPV) (75.0% vs. 88.7%) did not differ between the LR and HR groups (P = 0.990, P = 0.299). It is noteworthy that there were the high proportion of HCC in CEUS LR?4 and LR?M categories in our cases and when we combined CEUS LR?4 and LR?M categories with AFP significantly improved the sensitivity by 21.0% (84.2%) in the LR group, and by 16.0% (79.0%) in the HR group, with statistically difference in sensitivity after combination in the HR group (P = 0.014). Conclusions: The CEUS LR?5 category has real meaningful utility in the diagnosis of HCC in both LR and HR patients. The early detection power of the CEUS LI?RADS category for HCC patients was further increased when the CEUS LR?4 and LR?M categories were combined with elevated AFP.

Indications for Cervical Cerclage in Pregnant Women: Obstetric and Perinatal Outcomes in a Tertiary Public Hospital

Aims: This study aims to assess the impact of cervical cerclage on gestational and perinatal outcomes at a tertiary hospital, considering various surgical indications. Preterm labor (PTL) is a major cause of neonatal and perinatal morbidity and mortality, affecting about 15 million newborns globally each year. Cervical insufficiency (CI) contributes significantly to PTL, particularly in women with a history of spontaneous preterm births or second-trimester losses. This research examines how cervical cerclage, a standard treatment for CI, influences these outcomes. Study Design: This is an observational, analytical, retrospective cohort study based on documentary research. Place and Duration of Study: The study was conducted at a tertiary public hospital in Cascavel, Paraná, Brazil, from January 1, 2020, to March 20, 2024. Methodology: A database review was performed for pregnant women who received cervical cerclage using the McDonald technique. Participants were divided into three groups based on the indication for the procedure: obstetric history only, ultrasound only, and both. The study analyzed gestational and perinatal outcomes. Comparisons were made using ANOVA, Kruskal-Wallis, and Chi-square tests, with P < 0.05 considered significant. Results: Out of 41 women studied, 19 (46.3%) had cervical cerclage based solely on obstetric history, 16 (39.0%) based on a combination of obstetric history and ultrasound, and 6 (14.6%) based only on ultrasound. Significant differences were noted in maternal age, history of premature births and miscarriages, cervical length, and nulliparity. Despite these differences, no statistically significant variations were observed in obstetric and perinatal outcomes, including gestational age at cerclage removal and delivery, delivery type, neonatal weight, APGAR score, NICU admission, and neonatal morbidity and mortality. Notably, 76.3% of births occurred at term (> 37 weeks), and the average pregnancy length post-cerclage was 21 weeks (IQR: 5.00). Additionally, 90.3% of neonatal outcomes were favorable. Conclusion: All three indications for cervical cerclage were associated with extended gestation, increased rates of full-term births, and favorable neonatal outcomes.

Correlation between plantar acceleration time and Doppler ultrasound with the ankle-brachial index in patients with peripheral arterial disease

Background: Due to the inaccuracy of the ankle-brachial index, especially in diabetic patients, different alternative strategies have been considered to evaluate patients with peripheral arterial disease, such as the measurement of plantar acceleration time with Doppler ultrasound. The use of plantar acceleration time was described, which consists of measuring the morphology of the wave produced by the time elapsed from the beginning of systole until reaching the maximum systolic peak, as represented on Doppler ultrasound. A morphological change in the wave could indicate some interaction due to the presence of resistance to flow and arterial ductility. Methods: Sixty-five inframalleolar ultrasound studies were performed in patients with peripheral arterial disease. The acceleration time was calculated, and statistical analysis was conducted using linear regression and analysis of variance. The patients were correlated with the ankle-brachial index and among the studied inframalleolar arteries. Results: Correlations were calculated with a non-parametric method: Spearman's correlation coefficient and it was identified that the plantar acceleration time was not significantly correlated with the ankle-brachial index. Probably due to the presence of non-compressible ankle-brachial indices, a significant correlation was found between the inframalleolar arteries studied. Conclusions: The plantar acceleration time is a necessary complementary study for evaluating patients with peripheral arterial disease. It is essential to perform more inframalleolar ultrasound studies in patients for whom the ankle-brachial index is compressible and assessable, to establish a significant correlation within our population.

A comparative study between conventional and ultrasound-guided supraclavicular brachial plexus block in upper limb surgeries

Background: The well-researched method of brachial plexus blocking is used in upper limb procedures. The blind paresthesia methodology used in the conventional approach has a greater failure rate and may cause damage to the tissues that surround and nerves. Peripheral nerve stimulators and ultrasound methods were used to better localise the nerve/plexus in order to prevent certain of these issues. Methods: A total of 50 patients were included in this prospective randomized trial and randomly assigned to two groups: US (Group US) and LM (Group LM) after receiving clearance from the institutional ethics committee and consent from the patients. Each of the two groups got 0.5% bupivacaine. The injection of local anaesthetic (bupivacaine, 2 mg/kg) did not exceed the hazardous dosage since the amount was determined based on body weight. Result: The demographic information for both groups was similar. When compared to ultrasound, the mean time required for the method to provide a block via inducing paraesthesia was much shorter. There was no statistically significant difference in the meantime of motor block start, sensory blockade, or the length of both types of blockades. The ultrasonic group had a higher block success rate than the traditional group, although this difference didn't prove clinically important. Conclusions: The most secure and effective approach to perform a supraclavicular brachial plexus block is using ultrasound guidance. Because ultrasonography allows for the transmission of local anaesthetic and instantaneous imaging of underlying structures, the incidence of problems is lower.

Prognostic significance of cerebro-placental ratio in predicting perinatal

Background: Cerebro-placental ratio (CPR), measured by Ultrasound Doppler velocimetry in pregnancy, has gained much attention in recent years as an important tool in predicting perinatal outcomes. The study aimed to calculate the cerebro-placental ratio and correlateit with perinatal outcome in terms of intrapartum fetal heart variation, meconium staining of liquor, mode of delivery, Apgar score at birth, and NICU admissions.Methods: It was hospital-based prospective cross-sectional study on 119 pregnant women with high-risk pregnancies. All women had doppler velocimetry ultrasound, and cerebro-placental ration was calculated. Perinatal outcome was noted in terms of FHR variability in labor, Meconium staining of liquor, Apgar score and need for NICU admission.Results: Out of the total of 119 women, 88 women had CPR >1.08 and 31 women had CPR of <1.08. Meconium staining of liquor, low Apgar score, and NICU admission was mound in significantly more babies with low CPR.Conclusions: CPR has a good prognostic value in predicting many adverse perinatal outcomes.

Comparison of ultrasound and computed tomography in the diagnosis of malignant ovarian tumours at tertiary care center

Background: Accurate diagnosis of ovarian tumours is a diagnostic challenge. Multiple modes are used for the early detection of ovarian tumours. Early detection provides a survival advantage. Ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI) are important imaging modalities in this regard. This study aims to compare the diagnostic accuracy of USG and CT imaging in the detection of malignant ovarian tumours.Materials: An observational cross-sectional study is conducted in the department of radiodiagnosis of Narayan medical college and hospital, Bihar over a period of 18 months from August 2021 to March 2024. Fifty-three patients with suspected ovarian malignancy who were not pregnant or had contraindications for administration of contrast media were included in the study. USG, CT and histopathology reports were compared for diagnostic accuracy with respect to different components.Results: Mean age of the patients was seen to be 49.6�.8 years. Abdominal pain was the most common presentation Majority of the patients had vascular lesions with a well-differentiated margin, heterogenous enhancement and septations. USG and CT agree almost perfectly in, identifying septations, calcification, and in differentiating margin of the tumours and very poorly for the identification of lymphadenopathy. CT had better sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) when compared to USG for diagnosis of ovarian malignanciesConclusions: CT has superior diagnostic accuracy compared to USG for diagnosis of ovarian tumours. However, USG provides similar diagnostic accuracy for identifying septations, calcification, and in differentiating margins of tumours.

Malformaciones congénitas diagnosticadas en el servicio de medicina materno fetal de la Maternidad Concepción Palacios / Congenital malformations diagnosed in the maternal fetal medicine service of the Maternidad Concepción Palacios

Objetivo: Identificar y clasificar las diferentes anomalías del desarrollo diagnosticadas en la unidad de ecografía del servicio de medicina materno fetal de la Maternidad Concepción Palacios entre enero y diciembre de 2023. Métodos: Estudio retrospectivo, descriptivo, transversal que incluyó la evaluación de los 4225 reportes de ultrasonido obstétrico realizados en 2023. Se excluyeron los estudios sin diagnóstico morfológico. Las variables evaluadas fueron características clínicas de las gestantes, prevalencia según tipo de anomalía del desarrollo y según el aparato o sistema afectado. Resultados: Se diagnosticaron anomalías del desarrollo en 282 pacientes, para una frecuencia de 6,7 %. Las anomalías fueron únicas en 187 casos (66,3 %) y múltiples en 95 pacientes (33,7 %). El total de malformaciones fue 360 (8,5 %). El mínimo de lesiones detectadas fue una y el máximo fue tres. El sistema afectado con mayor frecuencia fue el sistema nervioso central, con 104 casos (28,9 %); le siguen, en orden de frecuencia, los marcadores aislados, vistos en 92 pacientes (25,6 %) y las anomalías cardiovasculares, en 49 fetos (13,6 %). Conclusión: La frecuencia de malformaciones congénitas diagnosticadas en el año 2023 fue de 6,7 % de las ecografías realizadas en la unidad de ecografía del servicio de medicina materno fetal de la Maternidad Concepción Palacios; en las dos terceras partes de los casos fueron únicas y el tercio restante fueron múltiples. En orden de frecuencia, los sistemas afectados fueron sistema nervioso central, marcadores aislados de aneuploidías y anomalías cardiovasculares(AU)

Objective: To identify and classify the different developmental anomalies diagnosed in the ultrasound unit of the maternal-fetal medicine service of the Concepción Palacios Maternity Hospital between January and December 2023. Methods: Retrospective, descriptive, cross-sectional study that included the evaluation of the 4225 obstetric ultrasound reports performed in 2023. Studies without morphological diagnosis were excluded. The variables evaluated were clinical characteristics of the pregnant women, prevalence according to type of developmental anomaly and according to the affected apparatus or system. Results: Developmental abnormalities were diagnosed in 282 patients, with a frequency of 6.7%. The anomalies were single in 187 cases (66.3%) and multiple in 95 patients (33.7%). The total number of malformations was 360 (8.5%). The minimum number of injuries detected was one and the maximum was three. The most frequently affected system was the central nervous system, with 104 cases (28.9%); This is followed by isolated markers, seen in 92 patients (25.6%), and cardiovascular anomalies, in 49 fetuses (13.6%). Conclusion: The frequency of congenital malformations diagnosed in 2023 was 6.7% of the ultrasound scans performed in the ultrasound unit of the maternal-fetal medicine service of the Concepción Palacios Maternity Hospital; Two-thirds of the cases were singles and the remaining third were multiples. In order of frequency, the affected systems were central nervous system, isolated markers of aneuploidies, and cardiac anomalies(AU)

Hallazgos imagenológicos torácicos en seguimiento de pacientes con síndrome PostCovid-19 / Thoracic imagenological findings in follow-up of patients with Post-Covid-19 syndrome

Objetivo: Describir los hallazgos imagenológicos en radiografías de tórax y ecografías pulmonares de pacientes con síndrome post-COVID-19. Métodos: estudio descriptivo, prospectivo y transversal que incluyó pacientes con síndrome post-COVID-19, sometidos a radiografías de tórax y ecografías pulmonares en el Servicio de Neumonología Clínica del Hospital Dr. José Ignacio Baldo, entre enero y octubre de 2022, con la finalidad de establecer su evolución imagenológica pulmonar. Se utilizó estadística descriptiva, chi-cuadrado de Pearson y prueba kappa de concordancia, considerando significativo un valor de p < 0,05. Resultados: La muestra consistió en 58 pacientes con una edad media de 55 ± 13 años, predominando el sexo femenino (58,6%). El 60,3% mostró alteraciones en la radiografía de tórax; un 74,3% con patrón intersticial bilateral y un 25,7% con patrón intersticial unilateral. La ecografía reveló patrón intersticial en el 43,1% de los casos y se observaron dos microconsolidaciones subpleurales. Conclusiones: Las radiografías de tórax y las ecografías pulmonares son herramientas imagenológicas eficaces, accesibles y económicas para detectar alteraciones en pacientes con síndrome post-COVID-19. (AU)

Objective: To describe imaging findings in chest radiographs and lung ultrasounds of patients with post-COVID-19 syndrome. Methods: A descriptive, prospective, and cross-sectional study was carried out that included patients with post-COVID-19 syndrome, who underwent chest radiographs and lung ultrasounds at the Clinical Pneumonology Service of Dr. José Ignacio Baldo Hospital, between January and October 2022. Descriptive statistics, Pearson's chi-square, and kappa concordance test were used, considering a p-value < 0.05 significant. Results: The sample consisted of 58 patients with an average age of 55 ± 13 years, with a predominance of females (58.6%). 60.3% showed alterations in the chest radiograph; 74.3% with a bilateral interstitial pattern and 25.7% with a unilateral interstitial pattern. The ultrasound revealed an interstitial pattern in 43.1% of the cases and two subpleural microconsolidations were observed. Conclusions: Chest radiographs and lung ultrasounds are effective, accessible, and economical imaging tools to detect alterations in patients with post-COVID-19 syndrome. (AU)

Comparison of Transesophageal Echocardiography Probe as Surface Probe with Vascular Probe During Right Internal Jugular Vein Catheterization in Cardiac Surgeries

Transesophageal echocardiography (TEE) has become an essential monitor for the management of most patients undergoing cardiothoracic surgery. TEE and central venous catheter placement are often used during cardiac surgeries. Here we conducted a study comparing TEE 3D probe as a surface probe with the ultrasound?guided (USG) vascular probe for guiding right internal jugular vein (IJV) catheterization. Context: USG vascular probe and TEE probe can help during central venous catheterization (CVC) and can confirm the location of guide wire in the neck vessels. We proposed this study, as there are only few studies comparing between TEE probe as surface probe and USG vascular probe for right IJV cannulation. Aims: To compare the TEE probe as a surface probe and USG vascular probe during right IJV catheterization in cardiac surgeries. Settings and Design: Prospective, comparative study. Methods and Material: One twenty?four patients of either sex posted for major elective cardiac surgery were included in this study. Patients were divided into two groups (TEE group and USG group) of 62 by assigning the study participants alternatively to each group. The goal of this study was to compare the puncture time, visualization of IJV to first successful puncture, quality of the imaging with needle tip positioning, and catheter positioning using both TEE probe and vascular probe. The primary outcome was comparison of time from visualization of the IJV to successful puncture using both TEE probe as a surface probe and vascular probe. Secondary outcome was to compare the quality of image with respect to needle tip positioning and compare quality of image with respect to catheter position using both probes. Statistical Analysis Used: Statistical analyses were performed by using a statistical software package SPSS, version 20.0. Results: The observation and results of our study clearly show the feasibility of TEE as surface probe for guiding central venous catheter in right IJV just like the vascular linear probe. There was no significant difference between the two groups ( P > 0.05). No statistical differences were found in the puncture time, image quality, needle tip positioning, wire positioning, and catheter positioning between the two groups. All the P values were greater than 0.05. Conclusions: The TEE probe can be used as an alternative method to guide IJV puncturing and catheterization when the vascular probe is not available. It is feasible especially in cardiac surgeries where the TEE monitoring machine is a must in modern anesthesia and readily available than an ultrasound machine.

Unveiling the elusive: a case of missed hydrops fetalis

Hydrops fetalis, characterized by abnormal fluid accumulation in fetal tissues, poses diagnostic challenges often leading to adverse outcomes. We present a case of a 26-year-old multigravida diagnosed with hydrops fetalis at 26 weeks, despite unremarkable antenatal visits. Detailed ultrasound revealed characteristic signs, prompting urgent intervention. Despite aggressive measures, the neonate succumbed shortly after birth. This case highlights the complexities of diagnosing and managing hydrops fetalis, emphasizing the need for heightened clinical awareness. Diagnostic steps, including fetal ultrasound and genetic testing, are pivotal for confirming diagnosis and guiding management, underlining the critical role of comprehensive prenatal care in improving outcomes.

Three-dimensional follicular assessment: a review of technique and indications

Follicular maturity assessment and tracking are employed to ascertain mature oocytes� presence and assess the response to ovarian stimulation. This step is crucial to ensure successful outcomes during assisted reproductive techniques. Currently, two-dimensional (2-D) transvaginal ultrasound is performed to monitor follicle growth and determine the optimal time for administration of human chorionic gonadotropin (hCG) hormone. However, the accurate follicle size, count, and multi-follicle maturity assessment require significant expertise and negligible inter-observer variations to maintain the reliability and validity of the measurements. 2-D ultrasound allows only an approximation of the actual follicular volume; therefore, it cannot be used to define standards for follicular maturity assessment. With the improvement of ultrasonography imaging technologies and the supporting software, it is now possible to acquire three-dimensional data sets and perform precise estimation of absolute dimensions, volumes, and mean dimensions of even complex structured follicles. This paper aimed to provide an in-depth review of the use of 3D ultrasound (3D-US) in reproductive medicine and combines an overview of the technique of performing a 3D-US for a fast, valid, objective, and reliable follicular assessment.

Ultrasonographic Evaluation In Achilles Tendon Rupture

The emergency department (ED) commonly sees patients with acute Achilles tendon injuries from sportsrelated activities. Signicant patient morbidity may arise from an Achilles tendon rupture that is missed or misdiagnosed. Nevertheless, clinically diagnosing an Achilles tendon rupture is not always straightforward. Pain and soft tissue swelling may make it difcult to do physical examination exercises to rule out a tendon injury. It has been demonstrated that ultrasound is highly sensitive in identifying Achilles tendon ruptures. This case report describes a case of a fty-year-old male who complained of excruciating bilateral leg and ankle discomfort, hampering with a proper and thorough physical evaluation. However, a quick and precise diagnosis of acute Achilles tendon rupture was made possible by an ultrasound scan. This case illustrates the importance of ultrasound as a diagnostic technique in patients with suspected Achilles tendon rupture, especially if there is limited physical examination.

Ultrasound guided aspiration versus incision and drainage in the management of breast abscess

Background: The aim of this study is to compare the results of ultrasound guided aspiration and incision and drainage in the management of breast abscess. Methods: This is a comparative study of between ultrasound guided aspiration and incision and drainage, consist of 50 patients with breast abscess who underwent both the treatment alternatively in our institution Sri. Siddhartha Institute of Medical Sciences and Research Begur during 2021 to 2023. 7th and 14th day following aspiration, patients should be assessed both clinically and by USG breast. Results were tabulated and analyzed. Results: 4 patients developed complications following Incision and drainage. 3 milk fistula and wound gaping, 1 recurrence and 3 patients developed complications following USG guided aspiration All 3 cases were recurrence. Conclusions: USG guided aspiration is simple, painless, day care procedure and effective alternative method of treatment to incision and drainage in properly selected patient and with timely support by sonologist with early postoperative recovery and good patient satisfaction.