How popular is X-ray hysterosalpingography in the investigation of infertility by radiographers and radiologists in Nigeria?

Background: Nigeria has an infertility rate of 4% to 48.1%. This health condition is the most frequently investigated in radiology departments across the country. Although ultrasound is used as first line investigation, its limited sensitivity to tubal patency has made hysterosalpingography (HSG), despite its radiation risks, as the procedure of choice. Objective: To determine the throughput of all special investigations in the study locations with a view to ascertaining if the use of hysterosalpingography is declining or flourishing. Methods: A retrospective extraction of data about special investigations from physical archives in the radiology department of two tertiary hospitals. Concluded special investigations between 2012 – 2014 and 2017 – 2019 were enlisted. The physical film jackets in both centers were consecutively scrutinized and the type and date of special investigation was noted. Results: A total of one hundred and forty-eight thousand, three hundred and twenty-two (148,322) patients aged 2 days to 95 years (mean: 34.85 ± 16.61 years) passed through the radiology departments between 2012 – 2014, and 2017 – 2019. Those for special radiological investigations numbered 4,806 (3.24 %). Hysterosalpingography (n = 2.148; 44.7%) and lateral invertogram (n = 39; 0.8%) were the special investigations with the highest and least throughputs, respectively. There were five specific HSG findings and fibroid had the highest frequency (n = 683; 31.80%). Conclusions: Hysterosalpingography is the most common special radiological procedure for investigating infertility by radiographers and radiologists in Nigeria.

Injection propofol and ketamine in pediatric and adult patients undergoing diagnostic radiological procedure (magnetic resonance imaging and computed tomography scan)

Background: The purpose of this study was to evaluate the effect of propofol and ketamine in pediatric and adult patients undergoing diagnostic radiological procedure (magnetic resonance imaging (MRI) and computed tomography (CT) scan). Methods: A comparative observation study conducted at Sri Aurobindo Medical College and PG Institute, Indore, Department of Anesthesiology after approval from Institutional ethical committee. The duration of this study was April 2019 to May 2020. Group KP: Inj. combination of ketamine and propofol (ketofol) with bolus dose of 0.50 mg/kg and 0.75 mg/kg respectively in initial 10 min followed by infusion at the rate of 0.05 ml/kg/hr till the completion of imaging.Results: The mean age was 11.55±2.80 in children and 31.34±2.43 in adult. Mean weight of patients were 30.54±8.86 in children and 60.21±10.45 in adult. Gender distribution (male:female) were 24/16 and 26/14 children group and adult group. Conclusions: We found that the combination of ketamine (ketofol) and propofol to be safe and well tolerated in pediatric patients and adult patients undergoing diagnostic radiological procedure (MRI and CT scan).

La ecografía como método simple y rápido para evaluar la correcta colocación de sondas de alimentación enteral en pacientes críticos con ventilación mecánica

La radiografía (Rx) abdominal, el método diagnóstico utilizado para verificar la posición de la sonda de alimentación enteral (SAE), es una fuente de irradiación y de potenciales efectos adversos para los pacientes. Hay pocos estudios sobre colocación de SAE y ecografía. Los autores estudiaron 41 pacientes con inserción de SAE y mantenimiento de la guía hasta la comprobación de su correcta colocación con ecografía, detectando una correcta colocación en 38 pacientes frente a 3 pacientes con una inadecuada posición de la SAE, con una sensibilidad del 97% (IC 95%: 84.9-99.8%) y una especificidad del 100% (IC 95%: 19.7-100%). La evaluación de la posición de la SAE a través del abdomen mediante ecografía es práctica y segura, asociándose con resultados diagnósticos satisfactorios. ABSTRACT Abdominal X-rays (AXRs) is the classic radiological procedure used to assess placement of a nasoenteric tube (NET). As a disadvantage, AXRs expose the patient to a dose of ionizing radiation and can cause potential adverse effects in the future. There are few studies about NET placement and ultrasound (US) assessment. Authors studied 41 patients undergoing NET placement keeping the wire until correct placement US assessment. Correct placement occurred in 38 patients, with a 97% sensitivity (confidence interval, 95%: 84.9-99.8%) and a 100% specificity (CI 95%: 19.7-100%). NET placement evaluation with abdominal US is a safe and practical procedure, associated with accurate diagnostic outcomes.

Fallopian Tube Recanalization (F.T.R): application of Interventional Radiology (I.R) post hysterosalpingography in management of female infertility at rural hospital

Background: Infertility is defined as inability to conceive even after 1 year of unprotected intercourse. Tubal blockage is one of the common causes of primary as well as secondary infertility in females. Fallopian tube recanalization (FTR) an interventional radiological procedure is one of the most promising, effective, minimally invasive and cost-effective technique in patients having infertility owing to tubal blockage. The aim is to study the cause, hysterosalpingography findings, and outcome of fallopian tube recanalization by interventional radiological procedure in patients with tubal-blockage presenting with infertility.Methods: This was a prospective observational study of women with primary or secondary infertility presenting to interventional radiology department. The patients either had already undergone hysterosalpingography (HSG) or came for HSG. Fallopian tube recanalization was done as per institutional protocol. Hysterosalpingography abnormalities, outcome and complications of fallopian tube recanalization procedure were studied.Results: In this study of 87 patients unilateral or bilateral tubal blockages were seen in 16 and 24 patients respectively. Majority of the patients had Segment I proximal block. Bilateral recanalization could be successfully done in 12 patients (24 tubes) with bilateral Proximal Tubal Blockage (PTO). Unilateral recanalization was possible in 12 patients (tubes) with unilateral proximal block and 8 tubes with bilateral proximal tubal block. 10 tubes with PTO could not be recanalized. 5 cases diagnosed with bilateral Distal Tubal Block (DTO), recanalization was not attempted and were referred for appropriate gynecological management. Minor complications were noted in 8 patients while no major procedure related complications were observed.Conclusions: Fallopian tube recanalization (by interventional radiology procedure) in patients with fallopian tube blockage diagnosed on HSG is found to be cost effective, minimally invasive and have low complication rate. It is associated with excellent outcome in terms of technical success and improved conception rate.