An Investigation of Exposure to the Eyes and Thyroid of Personnel Near to Patient in Abdominal Radiography: A Phantom Study

Abdominal radiography is beneficial in a variety of clinical situations. Prior to the introduction of multiplanar imaging, it was considered as the main examination for gastrointestinal pathology. However, the radiation dose received is considered high since it is equivalent to the dose of at least 75 chest radiographs. Personnel including staff or relatives may be required to assist patients in many conditions, increasing unnecessary radiation and the likelihood of radiation-induced cancer. The purpose of this study was to determine the radiation dose received by personnel when eyes and thyroid are exposed during abdominal radiography. The Rando and body phantoms were used to represent personnel and patients in this experimental approach. The dose was measured as entrance surface dose (ESD) by using TLD-100, which was positioned at the Rando phantom's eyes and thyroid. The study included a total of twenty exposures, five times at each of four distinct sites. The mean doses (eyes/thyroid in mGy) were (0.083/0.081), (0.090/0.087), (0.093/0.092), and (0.092/0.089), respectively, at locations 1, 2, 3, and 4. The results indicated that there was no correlation between organ and location affecting ESD measurement (p=0.960). There was no significant difference in dose between the two organs (p=0.355), with the mean difference in the eyes being 0.002 more than in the thyroid. The proximity of the eyes to the tube source contributed for the increased dose observed at the eyes. Though ESD was substantial for location pairings 1 vs. 3 (p=0.001) and 1 vs. 4 (p=0.015) owing to the anode-cathode phenomena. In conclusion, personnel should avoid the tube source and cathode region, since they give a greater dose of radiation, particularly when the personnel are closest to the patient and does not have eyes or thyroid protection.

Abdominal Imaging Utilization during the First COVID-19 Surge and Utility of Abdominal MRI

We sought to determine relative utilization of abdominal imaging modalities in coronavirus disease 2019 (COVID-19) patients at a single institution during the first surge and evaluate whether abdominal magnetic resonance imaging (MRI) changed diagnosis and management. 1107 COVID-19 patients who had abdominal imaging were analyzed for modality and imaging setting. Patients who underwent abdominal MRI were reviewed to determine impact on management. Of 2259 examinations, 80% were inpatient, 14% were emergency, and 6% were outpatient consisting of 55% radiograph (XR), 31% computed tomography (CT), 13% ultrasound (US), and 0.6% MRI. Among 1107 patients, abdominal MRI was performed in 12 within 100 days of positive SARS-CoV-2 PCR. Indications were unrelated to COVID-19 in 75% while MRI was performed for workup of acute liver dysfunction in 25%. In 1 of 12 patients, MRI resulted in change to management unrelated to COVID-19 diagnosis. During the first surge of COVID-19 at one institution, the most common abdominal imaging examinations were radiographs and CT followed by ultrasound with the majority being performed as inpatients. Future COVID-19 surges may place disproportionate demands on inpatient abdominal radiography and CT resources. Abdominal MRI was rarely performed and did not lead to change in diagnosis or management related to COVID-19 but needs higher patient numbers for accurate assessment of utility.

A case report: Characteristic plain radiographic findings of a displaced abomasum in a heifer

A 9-month-old Holstein heifer with a history of severely poor growth presented with diarrhoea. On physical examination, a metallic pinging sound was heard on the simultaneous percussion and auscultation of the left trunk. On the cranial abdominal radiography, the contour of a gas-filled balloon-like abomasum wall was delineated, which elevated to the dorsal abdomen. Radiopaque sand at the bottom of the abomasum had been pulled up caudodorsally by the gas-filled abomasum. After surgery, the gas-filled balloon-like appearance of the abomasum wall disappeared and the radiopaque sand was located in the normal position. To our knowledge, no reports on a displaced abomasum on plain radiographs are available. The radiographic findings described herein are characteristic imaging findings of a displaced abomasum. Abdominal radiography could be a new option as an auxiliary diagnostic approach for a displaced abomasum.

Necrotizing Enterocolitis in Preterm Infants Born to Mother with COVID-19

Background: The COVID-19 pandemic has had a wide impact on both pregnant women and their babies. Necrotizing enterocolitis (NEC) is a gastrointestinal emergency in neonates with high morbidity and mortality. Objective: This study aims to investigate the incidence of NEC in preterm infants born to mothers with confirmed COVID-19. Methods: This observational study was conducted in neonatal intensive care unit at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from May 2020 to April 2021. All preterm infants born to mothers with positive COVID-19 based on swab examination were included as study participants. PCR swab examination was performed within 48 hours after birth. The diagnosis of COVID-19 was defined as positive if the swab test result could detect the SARS-CoV-2 virus. The diagnosis of NEC was established by clinical symptoms and confirmed by abdominal radiography. Results: Out of 45 preterm infants included in this study, 6 infants experienced NEC. Factors that were significantly associated with the incidence of NEC included asphyxia and intubated mother. Positive PCR results from the infants alone did not significantly increase the risk of NEC. The combination of asphyxia and intubated mother (Odds Ratio [OR]=10.000, 95% Confidence Interval [CI]=1.056-94.677, P=0.020) and the combination of positive PCR result, asphyxia, and intubated mother (OR=2.438, 95% CI=1.673-3.551, P=0.007) were found to be significantly associated with the incidence of NEC Conclusion: Significant factors associated with the incidence of NEC in preterm infants born to mothers with COVID-19 included asphyxia and intubated mothers prior to delivery. A positive PCR result alone did not significantly increase the risk of NEC.

Clinical and forensic aspect’s of the cocaine body packer in senegal

This study aims to describe the clinical and forensic features of the cocaine body packer in Senegal.This research work is a retrospective and descriptive study. It was conducted based on 19 suspect cases attended for medical care at the Hospital of tambacounda. Suspects were exclusively male subjects, aged 24 to 33 years and Nigerian citizens. All of them were asymptomatic. Pelvic touch was positive in 42.1% of cases. Abdominal radiography pointed out that all the suspects presented with damage (100%). The average number of drug pellets carried per person was 43+/- 20 units. Body drug packing is a reality in Senegal. Narcotic drug policies should invest in capacity building by financing effective diagnostic tools.

Clinical, Diagnostic, and Treatment Features of Body Packing in Brazil: Drugs, Cell Phones and Beyond

Introduction: Body packing is the smuggling of drugs and other contents inside the human body. However, non-narcotic contents studies are limited to rare case reports in literature. Thus, the objective of this study was to investigate cases of body packers in Brazil considering narcotic and non-narcotic contents. Methods: Retrospective study analyzing the medical records of body packers admitted from January 2015 to December 2019 at one of the main tertiary hospitals in central Brazil. Results: Ten cases of body packing were observed. Only 50% of the patients carried drugs, while surprisingly, 70% carried non-content, especially cell phones and accessories. All the patients were male, prisoners and young adults. In 60%, there were gastrointestinal obstruction and in 30%, there was acute narcotic intoxication. Abdominal radiography was enough for diagnosis in 80% of the cases. In 90% of the cases, emergency laparotomy was required, but all the patients successfully recovered. Conclusions: There was a higher prevalence of body packing of non-narcotic content; however, clinical and radiological presentations were similar to those of narcotic content. Emergency surgery proved to be effective for both content types. This study highlights the concerning high prevalence of body packing of cell phones and accessories in addition to drugs.

Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

Comparison of Kidney-Ureter-Bladder Radiography with Computed Tomography Scout Film for the Diagnosis of Renal Calculi Taking Axial Computed Tomography as Gold Standard

Background: Nephrolithiasis is a widespread disease with an incidence of 17-13 in North American, 5-9% in Europe, and 1-5% in the Asian continent. Plain abdominal radiography is used to visualize renal stones, but the cysteine stones are often poorly visible, uric acid and mixed stones are not visible at all. The second diagnostic tool for the diagnosis of renal calculus is computed tomography. The CT scout film is often overlooked and did not use for the diagnostic purpose. Objective: To compare Kidney-ureter-bladder radiography with computed tomography scout film for the diagnosis of renal calculi taking axial computed tomography as a gold standard. Materials and Methods: It was a cross-sectional analytical study design conducted on 57 patients presenting with acute flank pain in Faisal Hospital Faisalabad. Patients having ages between 18-60 were included in the study. Pregnant patients and patients with lndinavir therapy were excluded from the study. Results: The sensitivity recorded for CT scout film was 66.7% and for the plain abdominal radiography was 80.7%. The calculus carrying Hounse field unit less than 200 HU were not visualized on both the modalities x-ray and plain abdominal radiography. However, the calculus greater than 5mm in size has a sensitivity of 73% on CT scout film. Conclusion: The sensitivity recorded for CT scout film was 66.7% and for the plain abdominal radiography was 80.7%. The calculus carrying Hounse field unit less than 200 HU were not visualized on both the modalities x-ray and plain abdominal radiography. However, the calculus greater than 5mm in size has a sensitivity of 73% on CT scout film.

Pseudohermaphroditism in a female French Bulldog

Pseudohermaphroditism is a sexual anomaly, rare in dogs, in which the individual has both male and female characteristics; normally ambiguous external genitalia and male or female gonads. This report concerns a 5-month-old female French Bulldog, where the principal concern was the presence of a structure in the internal region of the genitalia with evolution of approximately 2 months. Upon clinical examination, it was found that the patient had a characteristically female phenotype and a vagina with no apparent changes, despite the presence of a hypertrophied structure inside, similar to a clitoris and a probable penile bone. A right lateral abdominal radiography revealed the presence of a probable atrophied penile bone located inside the vulva. An ultrasound examination showed the presence of two oval, coarse and hypoechogenic structures in the inguinal (subcutaneous) region, suggesting ectopic testicles; ovaries and uterus were not observed. However, during laparotomy the absence of ovaries and the presence of uterus and testicles in the subcutaneous tissue were observed.