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  • 0 Ectopic Pregnancy

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    Ectopic Pregnancy   Ectopic pregnancy, is one of the more serious complications of pregnancy. Ectopic pregnancy happens when the products of fertilization implants and develops beyond the confines of the uterus. Ectopic pregnancy is almost always not viable, except for very few instances. This condition can bring bleeding within the abdominal cavity which can be fatal for the mother. The most common form of ectopic pregnancy is one that takes places within the fallopian tubes, which is also called tubal pregnancies. Other locations of ectopic pregnancy are the ovaries, cervix, and the abdomen. As has been mentioned, this condition can bring  bleeding and death, and as such should be treated as an emergency. The course of a normal uterine pregnancy starts when the uterus receives the newly fertilized egg. The egg implants itself in the nutrient-rich uterine lining where it will eventually develop. On the other hand, in ectopic pregnancy, this process does not take place in the uterus: 98% of the time it happens in the Fallopian tubes. With the current advances in diagnostic tools and procedures such as the early pregancy scan, ectopic pregnancy can be detected and addressed earlier. However, in spite of the diagnostic advances, this condition is still the main cause of morbidity and mortality among mothers all over the world. An increase in the incidence of ectopic pregnancy can be found in countries with substandard prenatal imaging and care. Ectopic pregnancy takes place when the fertilized egg implants into the lining of the Fallopian tube. The egg eventually erodes into the surrounding blood vessels, bringing about bleeding. The bleeding that takes places within the Fallopian tube will push the egg out of the tube, ending up in what is called a tubal abortion. The Fallopian tube does not undergo inflammation in this case, and the pain is brought about by the prostaglandins present at the actual area of implantation and the irritation due to the presence of blood in the peritoneum. When bleeding becomes more profuse, it can bring about threat to the mother. While the common cause of increase in bleeding is the delay in the diagnosis of ectopic pregnancy, some bleedings take place a little faster. This is especially true when the implantation takes place in the proximal area of the Fallopian tube. In this case, the egg may eventually erode into the Sampson artery located in close proximity to the tube. In 50% of cases, ectopic pregnancies resolve by itself, without intervention. This is especially true with tubal abortions. Currently, the need to perform surgery has been drastically reduced with the introduction of methotrexate in the treatment of ectopic pregnancy. It should be remembered, though, that surgery will still have to be performed when the Fallopian tubes is near rupture or have already ruptured. Surgery may entail a limited incision via a laparascopic method, or a larger incision may be used, in which case it is called a laparatomy.   Ectopic Pregnancy Signs and Symptoms The early signs and symptoms of ectopic pregnancy are usually so subtle, if they are even present, which is why it is quite difficult to make an early diagnosis. The average time for the signs and symptoms of ectopic pregnancy to present themselves is about 7.2 weeks following the last menstruation, and the range is from 5 to 8 weeks. Diagnosis may come in even later for areas where facilities are insufficient.   The following are the early presentations of ectopic pregnancy: Hypogastric pain accompanied by a sensation of swelling. The pain may be perceived as an intense stomach pain, but the pain may also occur in the form of a strong cramping sensation.Dysuria, or pain when urinatingA vague abdominal discomfort which is similar to symptoms brought about by the presence of corpus luteum in the ovaryMild vaginal bleeding. This is a form of withdrawal bleeding, a phenomemnon that occurs when progesterone levels go down. This symptom may also be noted during the early stage of pregnancy (also called “implantation bleed”), or during miscarriage.Abdominal pain during bowel movement.Later on, ectopic pregnancy presents itself as pain and bleeding, which may be vaginal or abdominal, or both. The causes of bleeding are as follows: Hormonal trigger, i.e., a drop in the level of progesterone•  Peritoneal bleeding secondary to rupture of the Fallopian tube Some of the differential diagnoses are miscarriage and normal pregnancy in its early stage. Pelvic inflammatory disease, or PID, is the most common faulty diagnosis for ectopic pregnancy. To rule out the presence of PID, a pregnancy test can be performed. A positive pregnancy test essentially rules out PID because a pregnancy that is concurrent with an active pelvic infection is very rare. When bleeding becomes more profuse, the following symptoms may occur: •  Pain which may be located at the lower back, abdomen, and pelvis •  Shoulder pain. This is regarded as a dangerous sign, because it indicates irritation of the diaphragm secondary to blood that is filling up the abdomen. •  Unilateral pelvic tenderness and cramping sensation •  The pain is comparatively acute as opposed to other more chronic pelvic pain, which worsens with time. Ectopic pregnancy should also be differentiated from other conditions like pelvic inflammatory disease, appendicitis, and other gynecological, gastrointestinal, and urinary problems.   Ectopic Pregnancy Causes While a number of risk factors for ectopic pregnancy have been identified in previous studies, no particular risk factor can be singled out in 30 to 50 percent of cases. Infertility, smoking, endometriosis, a previous history of pelvic inflammatory disease, prior use of DES, a history of D & C or other uterine surgeries, tubal surgery, use of an IUD or intrauterine device, tubal ligation, and a history of ectopic pregnancy are just some of the risk factors enumerated.   Ectopic Pregnancy Treatment Medical Methotrexate has been used for the nonsurgical treatment of ectopic pregnancy since 1993. Methotrexate can halt the growth of the embryo, inducing either an abortion or a resorption of the embryologic tissue or the passage of the products of conception during the woman's regular menstrual period. If administered early enough, methotrexate is effective in terminating ectopic pregnancy.   Surgical   Surgical treatment may have to be initiated once bleeding has set in. In a patient with only little bleeding seen on ultrasound, however, the decision to perform surgery turns into a dilemma. Studies to back this up will have to be identified. Two surgical procedures, laparoscopy and laparotomy, can be used by the surgeons. Both approaches can provide visualization of the pelvis and the affected Fallopian tube. The tube can then be incised either by taking out only the portion where the embryo has implated (slaphingostomy) of by taking out the entire tube (salphingectomy). Robert Lawson Tait is credited for doing the first successful surgery for an ectopic pregnancy, which took place in 1883.

  • 0 Ovarian Cancer Symptoms

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    Ovarian cancer is one of the most widely diagnosed forms of cancer in women today. It is not only a fatal cancer form, but also very difficult to diagnose and this is the basic reason that most women diagnosed with ovarian cancer lose their life in the battle. Understanding ovarian cancer, learning about the ovarian cancer symptoms and the possible treatments is very essential today, especially if you wish to live a long and healthy life with your loved ones. Here is a brief about ovarian cancer and its symptoms that you should keep a check on, for your healthy life.   Ovaries Ovaries are the most essential part of the female reproductive system. Size of an almond, they release the female hormones namely, estrogen and progesterone. Also, the ovaries release eggs that travel away through the fallopian tube and settle in the uterus of a woman. These eggs when get fertilized with a sperm, they form a fetus which grows into a baby. W hen a woman passes through her menopause, the ovaries stop producing the eggs and decrease the release of the female hormones and slowly shrink.   Ovarian Cancer Ovarian cancer is the cancer of ovaries. It develops in the ovaries and remains undetected for a long time period until it spreads into the pelvis and also the abdomen of the patient. Once the cancer spreads into the pelvis and the abdomen, it is termed as the last stage of ovarian cancer and treating it in such a critical condition is nearly impossible. Thus, it is extremely vital to understand the ovarian cancer symptoms and detect them within the right time to fight against ovarian cancer. Ovarian cancer symptoms The early symptoms of ovarian cancer are not very specific to the disease. They are similar to other health conditions mostly related with urinary bladder problems and the digestive system. As a result, detecting ovarian cancer is extremely tricky. When a patient suffers from ovarian cancer, the ovarian cancer symptoms remain persistent and worsen with the passing time. These symptoms include: Swelling or bloating in stomach Abdominal pressure and feeling of fullness without eating much Persistent indigestion Digestion problems such as gas and nausea Change in your bowel habits, particularly constipation Problems with your urinary bladder, need to urinate frequently Loss of appetite and feeling full Persistent lack of energy Lower back pain Weight increase only in your abdominal area. Clothes fitting tighter to your waist. Pain in your pelvis or abdomen   If you suffer from any one or more of these ovarian cancer symptoms at least 2 times in a week, it is important that you call your doctor and undergo a checkup soon. However, these symptoms are very common in women and they do not usually indicate ovarian cancer. They may feel the same symptoms during menstrual cycles as well. But, if these ovarian cancer symptoms follow a specific pattern, such as mentioned below, it is time you take the symptoms seriously and visit a doctor: They commence suddenly They are not similar to the cramps or pain you suffer during menstruation or digestive problems They occur nearly every day and don’t seem to fade away Other less common ovarian cancer symptoms: Indigestion Fatigue Pain during intercourse Back pain Change in the menstrual cycle Constipation These above mentioned symptoms are common in most women, but they do not always indicate that you have ovarian cancer. However, if you suffer from any of these symptoms, it is essential that you get yourself checked for ovarian cancer. The same symptoms also indicate other health problems, so don’t get stresses and simply visit your doctor with your queries. Also, usually these symptoms of the ovarian cancer  do not seem very serious for a woman to visit a doctor or undergo medical tests. But, avoiding check-ups may also delay your treatment if you are seriously suffering from ovarian cancer. Once you visit your doctor, you will be put on a watchful waiting period. During this time, both you and your doctor will observe the symptoms that you suffer and whether they direct to ovarian cancer.  Whom to see for ovarian cancer? In order to confirm about your condition, you may visit any medical professional. For instance, you may visit the following: Medical nurse Physician Internist Gynecologist Family physician Obstetrician Arrange a private ultrasound scan Diagnosis Based on the ovarian cancer symptoms, the diagnosis can be done through a couple of tests such as physical examination, pelvic exam, blood tests, ultrasound, and biopsy. Based on these test results and the ovarian cancer symptoms you suffer from, ovarian cacner can be diagnosed easily in a patient. Once diagnosed with ovarian cancer, you will be treated by Gynecologist oncologist and a medical oncologist. Your condition can improve when you are treated regularly by an experienced gynecologist oncologist. They can help you get the best treatment and also cure the disease with an initial surgery. Treatment Local therapy (surgery and radiation treatment for removing ovarian cancer), intraperitoneal chemotherapy (chemotherapy only for abdomen and pelvis) and systemic chemotherapy (chemotherapy injected through mouth or vein to destroy cancer cells in the body) are some of the treatment methods that are followed for treating ovarian cancer.   Can Ultrasound Diagnose Ovarian Cancer? A pelvic ultrasound scan will be one of the primary tests in the diagnosis and monitoring of ovarian cancer. Ovarian cancer can be clearly seen in a transabdominal or transvaginal ultrasound scan.

  • 0 URINARY TRACT INFECTION IN WOMEN – CAUSES, SYMPTOMS, TREATMENT & PREVENTION

    • by Administrator
    • 06-11-2019
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    Urinary  Tract  Infection  ( UTI ) is  defined  as  the  infection  of  any  part  of  the  Urinary  system  i.e  the  Urethra, Urinary  bladder, Ureters  or  the  Kidneys. These  infections  are  quite  common  in  women  because  of  the  short  length of  the  urethra  &  the  proximity  of  the  urethral  opening  to  vagina &  anal  opening.   How does Urinary Tract Infection develop ?   Causes of UTI : UTI  develops  when  infective  organisms  invade  the  various  parts  of  the  Urinary  tract . To  begin  with, they  may  affect  the  urethra, and  if  the  infection  remains  uncontrolled,  they  may  ascend  upwards  to  invade  the  Urinary  bladder,  ureters  or  even  the  Kidneys.  The  factors  which  aggravate  the  risk  of  UTI’s  in  women  include: Female anatomy–  As discussed above,  the close  association between  the  female  urethra,  vagina  &  anal  region  increases  the  likelihood  of  spread  of  bacteria from  vaginal  or  gastro-intestinal  tract  to  the  urinary  Moreover, the  short  urethra in  women  decreases  the  distance  that  the  bacteria  need  to  travel  in  order  to  reach  the  urinary  bladder . Thus,  the  incidence  of  UTI’s  is  more  in  women  as  compared  to  men. Sexual activity –  Sexual  activity  increases  the  chances  of  UTI  especially,  if  there  are  multiple  sexual  Women  are  more  prone  to  sexually  transmitted  infections  &  the  organisms  may  be  transmitted  from  the  genital  region  to  the  urethra  by  the  contact  with  fingers/genitals/other  devices. Certain contraceptive measures –   Certain  birth  control  measures  such  as  using  the  Diaphragm  or  spermicidal  agents  can  increase  the  chances  of Pregnancy- UTI’s  are  common  in  pregnancy,  the  risk  begins  at  6  weeks   &  peaks  at  about  22-24  weeks  of    The  reason  is  the  relaxation  of  smooth  muscles  in  response  to  pregnancy  hormones  and  the  resultant  increase  in  volume of urinary  bladder,  accompanied  by  urinary stasis (  decreased  urinary  flow rate ).  This  also  leads  to  increased  episodes  of  urinary  reflux  i.e  backward  flow  of  urine  from  the  bladder   into  the  ureters  or  even  kidneys  occasionally. All  these  factors  increase  the  chances  of  development  of  UTI  in  pregnancy. Menopause- After  menopause,  the  circulating  levels  of  Oestrogen  in  the  body  decrease  and  this  leads  to  changes  in  the  mucosal  lining  of  the  urinary  &  genital  tract  that  increases  the  chances  of infections. Obstruction to  urinary  flow –  This  maybe  due  to  certain  abnormalities  of  the  urinary  tract  or  presence  of  stones  ( calculus) in  urinary  tract,  which  may  prevent  smooth  forward  flow  of  urine  and  may  predispose  to Low Immunity  –  A decreased  immunity,  for  eg  in  women  with  Diabetes  or  HIV  infection,  increases  the  chances  of Recent Urinary  / Genital  procedure-  Any  surgical or  interventional  procedure  involving  the  urinary  tract  or  sometimes  the  genital  tract  also  may  increase  the  possibility  of  UTI Others- Other  causes  like  a neurological  condition  ,  history  of  previous  urinary  infections    may  also  increase  a  woman’s  chances  of  developing  UTI.     How do I know if I have UTI ?   Symptoms of Urinary Tract Infections : Urinary  tract  infections  may  sometimes  cause  no  symptoms   but  mostly,  a  woman  gets  one  or  more  of  the  following  signs/symptoms : Urgency- There  may  be  a  strong  urge  to  urinate,  which  may  sometimes  be uncontrollable Frequency- You  may  soon feel  the  need  to  urinate  again  even  though  you  have  passed  urine Dysuria- There  may  be  pain  in  urethral  region  or  pelvis  while  urinating Odour- The  urine  may  be  foul  smelling Colour- Sometimes,  the  urine  may   appear  cloudy  or  maybe  blood    Consult  your  doctor  if  the  urine  appears  blood  stained. Pelvic pain-  When  the  infection  reaches  the  bladder,  it  may  lead  to  pelvic  pain  or  pain  felt  in  the  lower  part  of  the Flank pain-  Pain  in  the  upper  back  &  sides  may  be  a  sign  of  infection  in  the  kidneys  and  it  maybe  accompanied  by  fever,  chills,    Consult  your  doctor  immediately  if  you  develop  any  of  these. The  gold  standard  for  diagnosing  a  Urinary  Tract  Infection  is  a Urine  test  for  routine  microscopy  and  a  Culture/Sensitivity test  to  check  for  the  presence  of  specific  infective  organisms  and  their  sensitivity  to  various  antibiotics.  A  culture/sensitivity  test  guides your  doctor  to  prescribe  the  most  effective  antibiotic  for  the  organism  causing  your  UTI.     How can UTI be treated ?   Urinary Tract Infection Treatment : The  best  cure  for  a  urinary  tract  infection  is  to  take  relevant  antibiotics  for  the  prescribed  period  of  time  as  advised  by  your  doctor. However,  there  are  other  supportive  measures  that  need  to  be  followed  in  order  to  facilitate  relief  of  symptoms  &  complete  cure . Antibiotics  usually  lead  to  a  quick  relief  of  symptoms,  however,  you  must  continue  the  medications  for  the  complete  prescribed  duration  or  else  it  may  lead  to  incomplete  cure  of  UTI  which  may  then  flare  up  again  after  a  few  days  and  thus  may  lead  to  recurrent , resistant infections . You  can  also  take  certain  supportive  measures  to  ease  your  discomfort  when you  have  UTI  : Drink plenty  of  water :  Drink  at  least  8-10  glasses  of  water  in  a    Water  helps  to  dilute  the  urine  and  hence  decreases  the  irritation  &  pain  in  the  urinart  tract.  It  also  helps  to  flush  out  the  toxins &  organisms  causing  the  UTI. Avoid Coffee/  tea  or  other  liquids  that  may  irritate  your Urinary alkalinisers may  sometimes  be  prescribed  by  your  doctor  &  help  decrease  the Avoid sexual  activity when  you  have  active Cranberry juice,  Barley  water,  etc  help  ease  the  discomfort  but  the exact  benefit  afforded  by  these  is  still Use warm  heating  pads  on  lower  abdomen  &  back  to  relieve  the    However,  make  sure  that  the  pads  are  not  excessively  hot.     What are the complications of UTI ?   Usually,  if  treated  properly,  UTI  does  not  cause  any  long  term  complications.  However, if  treated  incompletely,  or  in  a  person with  compromised  immunity ,  it  may  lead  to  the  following  complications: Recurrent infections-  Recurrent  UTI  is  defined  as  the  occurrence  of  UTI  3 times  or  more  in  a  year  .  Partially  treated  infections  or  in  cases  where  the  cause  for  the  primary  infection  persists  &  is  not  eradicated,  may  lead  to  recurrent Kidney damage- Persistent  infection  or  a  very  acute  &  severe episode  of  UTI  may  sometimes  lead  to  permanent  kidney  damage  which  may  necessitate  a  prolonged  course  of Preterm birth  –  Untreated  UTI  may  lead  to  onset  of  preterm  labour  &  delivery  leading  to  low  birth  weight  &  compromised  baby  who  may  need  Nursery  care  or  admission  to Sepsis- Spread  of  infection  all  over  the  body  may  lead  to  serious  complications  &  sepsis  which  may  require hospital/ICU  admission  .     How  can  UTI  be  prevented  ?   Prevention of Urinary Tract Infection :   UTI  can  be  prevented  by  following  measures  : Drink plenty  of  liquids –  at  least  8-10  glasses  a  day After urinating  or  passing  stools,  wipe  from  front  to  back,  to  prevent  spread  of  organisms  from  anal  region  towards Avoid use  of  spermicidal  jellies  or  diaphragms  for Avoid multiple  sexual  partners Ensure that  you  take  a  complete  treatment  for  the first  episode  of    UTI  as  prescribed  by  your    What is the role of ultrasound in management of urinary tract infections?   Urinary tract ultrasound imaging is being used in cases of confirm UTI to evaluate the urinary tract anatomy and exclude any undrlying pathology such kidney stones, tumours and bladder problems. In cases of chronic complications ultrasound will evaluate any damaged caused to the kidneys from recurremt infections such as renal scaring or hydronephrosis. Your doctor will probably refer you to your loal hospital to have a kidney ultrasound scan but as the ultrasound NHS waiting times are along you can opt to have a private ultrasound instead. You can find more about the private urinary tract scans we offer at the exam page informaltion.  

  • 0 PELVIC INFECTIONS: CAUSES AND PREVENTION

    • by Administrator
    • 06-11-2019
    0.00 of 0 votes

    Pelvic Infections or Pelvic Inflammatory Disease (PID), is a term used for infection of Pelvic organs i.e the Uterus, Fallopian tubes & Ovaries in a woman. These are commonly transmitted sexually but may, sometimes, be attributed to other causes. According to WHO, about 448 million new cases of Sexually Transmitted Infections (STI) are diagnosed annually and it is among the top 5 disease categories for which an individual seeks medical care. Signs and Symptoms – Many women having PID may not have any obvious symptoms, but usually an episode of PID or Pelvic infections may present with the following symptoms:   Lower abdominal pain Pain during intercourse Bleeding after intercourse Irregular/ abnormal periods or spotting in between two periods. Excessive or foul smelling vaginal discharge Vaginal or Perineal itching Frequent or painful/burning urination Occasionally, in advanced cases, there may be fever, vomiting, severe pain or even fainting episodes.   Complications – Pelvic infections and PID can be a cause of significant morbidity and may have long lasting outcomes including: It is the leading cause of infertility, about 1 in 8 women having a history of PID can have difficulty in getting pregnant. It may lead to chronic pelvic pain in about 25% women. They may have pain related to menstrual cycles or may have persistent lower abdominal pain. PID leads to formation of adhesions i.e scar tissue in or around fallopian tubes which significantly increases the chances of Ectopic pregnancy ( pregnancy implanted outside the cavity of uterus that can lead to serious life-threatening complications) In the long-term, recurrent pelvic infection, especially with HPV, can be a precursor of cervical cancer. Causes and Risk factors – PID is generally considered to be a polymicrobial infection, i.e it is caused by multiple micro-organisms. These generally include bacterial pathogens like Chlamydia and Neisseria along with a number of other pathogens like Gardnerella, Mycoplasma, Trichomonas, Herpes Simplex Virus-2 and various anaerobic bacteria that may be transmitted by sexual contact and are found in the vagina. Hence, it comes as no surprise that PID results primarily from unprotected sexual intercourse in most cases. However, there may be other causes for the development of the infection and the following factors may increase the risk of a woman suffering from PID: Unprotected sexual activity i.e intercourse without using a condom. Having multiple sexual partners or having intercourse with a person who has multiple sexual partners. Onset of sexual activity before the age of 25 years. A history of prior sexually transmitted disease which has been incompletely treated in the woman or the sexual partner. A history of sexual abuse Any history of Gynaecological interventional procedure for eg. Endometrial biopsy, IUCD insertion, Hysteroscopy etc. Vaginal douching has been paradoxically associated with development of vaginal infection as it alters the normal vaginal balance of useful versus harmful bacteria. However, some studies have failed to demonstrate a clear association between the two. Apart from these, certain genetic factors have been studied which are found to predispose to pelvic infection. Any decrease in generalized body immunity may also cause a flare-up of an underlying infection for eg – in prolonged illness, HIV infection or any immune compromised state such as pregnancy. Pelvic Infection Treatment and Prevention – PID or Pelvic Infection treatment is usually by an antibiotic course along with other medications lasting for about 2 weeks. Depending upon your symptoms, this maybe either an oral medication or sometimes, in severe cases, a woman may need to be hospitalised for injectible medications or surgical intervention as required. It is important for the sexual partner to be treated simultaneously to prevent re-infection. However, PID and sexually transmitted infections are better prevented than treated. Hence, anyone who is at a risk of pelvic infections should take the following precautions: Practice safe sex i.e always use a condom at the time of intercourse ( unless of course, you are actually trying for pregnancy) Avoid indulging in indiscriminate sexual activity with multiple partners or with a partner who is in a sexual relationship with multiple persons. Avoid indulging in sexual activity at a very young age. Consult a doctor at the first sign of an infection & take proper treatment. Practice good perineal hygiene and avoid vaginal douching. It helps to wipe from the front backwards after passing urine/stools rather than wiping from back to front. Consume a variety of fruits, probiotics and a healthy, well balanced diet to boost your immunity.    

  • 0 Uterine Fibroids

    • by Administrator
    • 06-11-2019
    5.00 of 1 votes

    What are fibroids Fibroids are benign ( Non cancerous ) growths that develop from the muscle tissue of the uterus. Although their cause is unknown, they are known to be hormone dependant  tumors & estrogen stimulates their growth. They may be present inside the cavity of uterus, within its wall, on its outer surface or attached to it by a stem like structure.   Who is most likely to have fibroids ? They are more common in women aged between 30-40 yrs but may actually occur at any age.  Commonly associated with familial predisposition & early onset of periods, these tumors are found more frequently in African- American women & Caucasians.   How does a woman suspect she may have fibroids ? Most of the fibroids may not cause any symptoms at all and diagnosed on a routine pelvic ultrasound scan during a gynaecological check up.  When symptomatic , the Fibroids may cause the following symptoms : Changes in menstruation- Longer, more frequent or heavy menstrual periods.   Painful periods or vaginal bleeding at times other than menstruation. Pain- Often dull, heavy & aching pain in the lower back or abdomen Pressure symptoms-  Difficulty in urination or frequent urination; constipation/ rectal pain or difficult bowel movements Large lump in abdomen Infertility or miscarriages and commonly diagnosed during early pregnancy scans and follicular tracking scans   How are fibroids diagnosed ? The fibroids may present with above symptoms or be detected on routine pelvic ultrasound examination. Once clinically suspected, the diagnosis may be confirmed by: Ultrasonography- Uses sound waves to create a picture of uterus & other pelvic organs Hysteroscopy- Uses a camera mounted on slender long device to see the inside of the uterus Hysterosalpingography-  Special X- ray test  used to detect changes in shape & size of Uterine cavity and fallopian tubes. Laparoscopy- Uses a camera on a slender long device to see the inside of abdominal cavity MRI- Uses magnetic waves to produce exact images of body tissues   Do all fibroids need to be treated ? No, fibroids that do not cause symptoms, are small or occur in a woman nearing menopause often may not require treatment. However, certain signs & symptoms  may signal the need for treatment: Heavy or painful periods Bleeding in-between periods Rapid increase in size Infertility Pressure symptoms, Difficulty in urination or defaecation Pelvic pain or lump abdomen   Can medications be used to treat fibroids ? Medications can be used to decrease the heavy bleeding or pelvic pain caused due to fibroids , but they do not prevent the growth of the fibroids  nor do they make the fibroids disappear. Some medications that can be used  are the painkillers eg. Paracetamol &  Brufen, Oral contraceptive pills,  Progesterone pills or IUCD  & Gn RH agonists.   What surgeries may be used to treat fibroids ? Myomectomy is the surgical removal of fibroids while leaving the uterus intact. It  may be done by laparoscopy/ hysteroscopy or by giving a cut on the abdomen in conventional manner. Hysterectomy  is the surgical removal of the uterus with the fibroids. The ovaries may or may not be removed. This also may be done by Laparoscopy or abdominally or vaginally. Hysterectomy is done when other treatments have failed or the fibroids are too large & childbearing function of uterus has been completed. Other treatments modalities include Uterine artery embolisation or HIFU (High intensity focused Ultrasound ).   Pelvic ultrasound Scan   The pelvic ultrasound scan is the first line of investigation when fibroids or other gynaecological problems are suspected are suspected.  Your doctor will probably refer you to your loal hospital to have a transvaginal ultrasound scan but as the ultrasound NHS waiting times are along you can opt to have a private ultrasound instead. You can find more about the transabdominal and transvaginal scans we offer at the exam page informaltion.  

  • 0 What is a Private Scan

    • by Administrator
    • 05-11-2019
    0.00 of 0 votes

     What is a Private Scan?  A private scan is a medical imaging examination undertaken by a private healthcare provider where the cost of the examination is undertaken by the patient. There is a large number of private diagnostic imaging providers that offer various scans including private ultrasounds, CT and MRI.   What is a Scan? A medical scan is a diagnostic imaging investigation employed to diagnose any internal abnormality that explains any symptoms you might be experiencing.   Different types of scans There are various kinds of diagnostic scans but the most common are:   Ultrasoudn Scan The ultrasound scan, mostly ascociated with pregnancy ultrasounds, is using sound wanes to obtain internal images of your organs. Uses no radiation and it is not known to be harmful to adults and most important unborn babies. You can find more information about ultrasound scans.   CT Scan   Unlike the ultrasound scan the CT scan uses radiation to obtaing images of the internal organs and be used in cases where ultrasound offer suboptimal imaging information. Due to radiation risk CT scans are limited to patients where the diagnosis outweights the radiation risks from the scan.   MRI Scan   The MRI scanner used magnetic fields to obtain the required diagnostic information.   Can i pay for an scan? Yes, you can pay to have a private scan but CT and MRI investigations will require a doctor's request. The majority of the ultrasound scan clinics do not require a doctors referral.   How much an ultrasound Scan cost? Ultrasound scan prices vary quite significantly throughout the UK and mostly in London.  The average price is however between £100 and £200. Private hospitals will charge significant more than a private ultrasound clinic run by NHS sonographers. Sometimes more than 3 times. You also need to be aware of any hidden costs. A few clinics offer significantly discounted examination, raising concerns not only about the quality of service but also diagnostic accuracy of the results.     Why should I have a private ultrasound scan? The main reason patients choose to have a private ultrasound scan instead of one provided for free by the NHS is that the waiting times can be very long. Most NHS providers aim to offer an ultrasound within 6 weeks. It is unfortunately very common these days to hear stories of patients waiting for more than 6 weeks waiting. This can have significant impact on patients' health management. Another reason is convenience. Although NHS is slowly changing, most imaging departments operate between 9 to 5 which is not always suitable with our fast and busy lifestyles.      How to choose a private ultrasound clinic?   There are so many ultrasound clinics in London offering scans and mainly private ultrasounds that makes it very difficult to choose the best.   What should you look for when you choosing an ultrasound clinic? Care Qualiy Commision registration  Independent reviews to find out what users think about the service they received. If the sonographers or radiologists are experienced and knowledgable.  How long they have been offering ultrasound services?  

  • 0 Pregnancy & Ultrasound

    • by Administrator
    • 16-07-2019
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    Ultrasound in Pregnany Ultrasound is a ubiquitous technology in all areas of medicine but many people are either ignorant of the nature of the technology or have a misguided notion of it. It is not unusual to find people putting it in the same bracket as an x-ray. This misguided impression can quite understandably evoke significant anxiety, especially where pregnancy is concerned. Let’s start by stating a simple but important fact. Ultrasound does not involve ionising radiation.Ultrasound is a form of sound waves generated at very high frequency. This will be in the range of 3.5 to 7 million cycles per second (Megahertz). Normal sound waves audible to the ear are at a much lower frequency of fewer than 20 thousand cycles per second.  How Ultrasound Works The sound waves are produced by a crystal built in the probe used for the test. The waves are then reflected from the various structures they encounter as they travel through the body. The data produced by the reflected waves is then processed by the computer in the scanning machine to produce an image on the screen representative of the reflecting structures. That is how the detailed image of the pregnant uterus and baby within, complete with movements, is produced and seen in real-time. The conventional position for an obstetric ultrasound is on your back, usually propped up comfortably to allow you a clear view of the monitor screen. A clear, water-based conducting gel is applied to the abdomen. The gel helps transmit the sound waves. A hand-held probe is then moved over the area in a systematic way. Alternatively, the ultrasound scan is performed with the probe placed in the vagina (transvaginal ultrasound scanning). This technique often complements conventional transabdominal ultrasound techniques by providing better detail especially in the very early phase of pregnancy such as in the early pregnancy scan. A woman will normally be advised accordingly if this is deemed to be the more appropriate route or sometimes as an additional measure if the abdominal route has not provided all the required information.   Preparation A full bladder is necessary to get a good picture. Therefore, the person due to being scanned will be asked to drink a few glasses of water (or similar) an hour or so before the test and to refrain from urinating before the procedure. A full bladder is, however, not necessary for the transvaginal Ultrasound. There may be some slight discomfort from pressure on the full bladder otherwise the procedure is perfectly painless. The conducting gel may feel slightly cold and wet. There is no perception of the sound waves and of-course you cannot hear them. When to have a Scan Scans may be performed in the First Trimester to: Confirm a normal pregnancy Confirm viability Assess the baby's age (gestation) Assess potential problems such as threatened miscarriage, ectopic pregnancy etc. Assess the baby's heartbeat Confirm the number of embryos/fetuses Identify any abnormalities of the placenta, uterus, and other pelvic structures The main early trimester scans are the early pregnancy scan and the dating scan. In the Second Trimester (after 13 weeks) Assess the baby's age, growth, position, and sometimes gender. A detailed look at the baby’s vital organs and limbs to identify or rule out any possible congenital problems. Identify any developmental (growth) problems Rule out multiple pregnancies Evaluate the placenta, amniotic fluid, and other pelvic organs. In the Third Trimester (after 26 weeks):Scans not normally required at this stage except when monitoring pregnancy development and fetal wellbeing in special situations: these may include: Multiple pregnancies Suspected fetal growth problems Chronic medical conditions such as diabetes, hypertension, epilepsy etc. Pre-eclampsiaOther situations where a scan may be called for are when there is a need to: Detect cervical changes that might predict preterm labour. Verify breech presentation or other uncommon fetal or cord position before delivery. Get valuable information leading to treatment of any conditions arising in the course of a pregnancy in a bid to improve a woman’s chances of having a healthy baby.  Scan Aided Tests and Procedures Pregnancy ultrasound plays a crucial role in antenatal care. Some tests which are routinely done for diagnostic purposes are directly ultrasound-guided. Such tests include: Amniocentesis: This is the most well-known and commonest invasive test used to make a diagnosis of any condition that may be affecting the fetus. It is commonly performed in the early second trimester (15 – 16 weeks) and is now routinely ultrasound guided. An amniocentesis is a test in which the cells that are floating in the fluid surrounding the fetus are examined for the chromosomal pattern of the fetus. The operator will have the ultrasound probe on the abdomen and will guide the fine needle used under direct ultrasound guidance into the womb. Once the tip is seen to be inside a pool of amniotic fluid, a sample will be drawn for the test. Normally this takes a few short minutes and in the vast majority, only one attempt is sufficient.Amniocentesis results are usually available two to three weeks after the test. Amniocentesis carries a risk of losing the pregnancy of about 0.5 - 1% (1 in 100-200). Age is probably the commonest indication for requesting amniocentesis usually for the diagnosis of Down’s Syndrome. This is because, all other factors being normal, the older the mother, the higher the risk of Down’s and other chromosomal disorders. A 21 year old mother has a 1:1700 risk of having a baby with Down’s Syndrome, a 30 year old 1:950, at 40 the risk is almost 1:100 and by 45 years of age it is 1:30.As mentioned earlier while these statistics refer to the most recognized chromosomal anomaly, there are other anomalies, some of them incompatible with life. It is therefore important for any prospective mother to be aware that the overall risk of all chromosomal anomalies is significantly higher than that of Down’s alone at any stage of life. A 201 year old will therefore have an overall chromosomal abnormalities risk (for her baby) of about 1:500 and at 40 the risk would have risen to 1:66.CVS: This stands for Chorionic Villus Sampling which simply means taking a biopsy from the developing placenta. It is also ultrasound guided. The procedure is also performed under direct ultrasound guidance. It differs from amniocentesis in three major aspects: It can and is usually performed earlier in the pregnancy. This is towards the end of the first trimester. Results are available much more rapidly with a normal turnaround of 48 – 72 hours. It has a significantly higher procedure associated miscarriage rate which could be as much as twice that of amniocentesis. Fetal Echocardiography: Congenital heart defects occur in about 1% of live births. Causes are multiple and sometimes cannot be identified. Whilst a routine detailed ultrasound scan performed at 18-20 weeks will focus on the heart among other major organs, not all defects will be detected. It is also sometimes necessary to perform a much more detailed study of the baby’s heart. This specialised structural study using ultrasound is called echocardiography or popularly just shortened as ‘echo’. Situations, where this may be recommended, include: A family history of congenital heart disease An abnormal fetal heart rhythm detected during a routine examination. Fetal heart abnormalities detected during a routine pregnancy ultrasound scan Abnormality of another major organ system such as the gut or lungs. Insulin-dependent (type 1) diabetes Exposure to some drugs in very early pregnancy. For example, some anticonvulsants used to treat epilepsy can damage the developing heart. If the mother has abused alcohol or drugs during pregnancy If a mother has diabetes, phenylketonuria, or a connective tissue disease such as lupus If the mother has had rubella during pregnancy Diagnosis of some chromosomal abnormalities   Cordocentesis Sometimes it becomes necessary to obtain a sample of blood from the umbilical cord of the unborn baby, usually for diagnostic purposes. This requires direct ultrasound visualization. This would simply not be feasible without the aid of ultrasound. In some condition, transfusion of blood into the unborn baby is performed. Again, this is directly dependent on ultrasound.There are many other areas where ultrasound in pregnancy is not only useful but indispensable. These include localization of the placenta which could help determine the safest mode and timing of delivery, checking pattern of blood flow in the cord, a useful feature in monitoring fetal well-being in at risk fetuses, estimating fetal weight which could be useful in making important decisions and many more.   Biophysical ProfileSometimes there is concern about the unborn baby’s wellbeing. This may be because the baby is not moving well, growth is unsatisfactory or the pregnant mother is suffering from such conditions as pre-eclampsia, diabetes etc. It may, in such circumstances, be deemed necessary to monitor the baby closely and one of the strategies sometimes adopted is to perform what is known as a biophysical profile > With this one checks the baby’s movements, general muscle tone, breathing movements and fetal heart pattern. Apart from the latter, the rest are all done by using ultrasound.   Trans-vaginal Ultrasound scanning   The idea of having the scan performed vaginally can and does provoke anxiety for some women. It is important to say that this is a safe procedure and does not in any way pose a risk to either mother or baby.In very early pregnancy, this may be the preferable method of scanning as it produces sharper details and may give crucial information otherwise unobtainable (using trans-abdominal scanning). It is also the case that a transvaginal scan does not require a full bladder, not the most comfortable of requirement especially for an expectant mother struggling with perpetual nausea. A vaginal scan also circumvents the difficulties with obtaining a good view of the embryo/fetus in early pregnancy for women who are overweight or obese.   Amniotic FluidUltrasound scanning is quite useful in estimating the amniotic fluid volume. This is easy to do and in most cases, this will be normal. However, where the volume is found to be reduced or increased, it could be a very important gauge of the baby’s wellbeing. It may also be the first warning that something is not quite right with the baby and could trigger further, more specific, tests. Serial ultrasound scan monitoring of fluid volume is sometimes used to monitor the progress of a pregnancy and together with other tests could be used to make a decision on the timing and/or mode of delivery. Placental locationIt is not possible through a physical examination to tell the exact location of a placenta in the womb. For the majority of pregnant women, this is really of no importance. However, about 1 in 50 mothers (2%) will have placenta praevia (low-lying placenta) at term. This is a potentially dangerous condition for both mother and baby and most of those affected will need close antenatal observation and delivery by caesarean section. Ultrasound scanning does accurately locate the placenta and aid in making these crucial decisions.It is important to stress that almost one in five women will be found to have a ‘low-lying’ placenta at their 20 weeks pregnancy scan. This is no cause for panic as for the vast majority of them, the placenta will be normally located by the time they get to the third trimester. Many units offer a repeat ultrasound scan at around 32-34 weeks as a form of reassurance. Placental abruptionPlacenta praevia (above) is not to be confused with Placental abruption (abruption placenta). The two conditions are not related even though for both the main concern is severe haemorrhage that is associated with them. In placental abruption, the placenta gets partly or wholly detached from the womb. That will cause bleeding and in most cases, pain. The extent of the bleeding and therefore its effect on the baby will depend on the degree of placental detachment. Ultrasound scanning has a limited role in placental abruption. The diagnosis is mainly secured on a clinical presentation rather than ultrasound findings. Twins and ultrasound scanningIn days gone by, it was not unusual for twins and rarely other forms of multiple pregnancies not to be discovered until the time of delivery. Ultrasound changed all that. It is exceedingly unusual for that to happen in modern times in most developed countries. Over 95% of mothers in the United Kingdom have antenatal ultrasound scans and the figure is just over 70% in the USA. Even in those countries where ultrasound scans are not offered as a matter of course, the obstetrician or midwife looking after the pregnant woman will suspect the presence of multiple pregnancies in the course of examining her abdomen. This will usually trigger a recommendation for an ultrasound scan. Confirming the number of fetuses is then, in most cases, a straightforward affair. Identical or not?Many prospective mothers carrying twins are anxious to know whether the babies are identical or not. In many (but not all) cases it is possible to tell whether they are or not using ultrasound scanning.If the twins are sharing the same gestation sac or even if they are in different sacs but sharing the same placenta, they are then definitely identical. This is, however, not that common (and a good thing too).Most twins have separate placentas and sacs. These could be identical or non-identical. It is sometimes possible to tell with a fair degree of confidence whether such twins are identical or not depending on the timing of the ultrasound scan. Of-course if the twins are of different sex, that is confirmatory that they are non-identical. However, it is only possible to tell the gender of a fetus after about 16-17 weeks. The babies have also got to be in a favourable position to be able to do this.Sharing a sac or placenta not good?This is not the best form for twins as there are significant potential complications unique to this type of twins. Some of these complications can be life-threatening for the one or both babies. The subject is discussed further in the section on multiple pregnancies. Doppler UltrasoundWhen there are problems or suspected complications, this special type of ultrasound may be employed to try to get important information which may aid in decision making. It takes its name from the 19th-century Austrian physicist Christian Doppler who was the first to describe the phenomenon. So, what is it?Doppler ultrasound is a form of ultrasound that can detect and measure blood flow. Doppler ultrasound depends on the Doppler effect, a change in the frequency of a wave resulting here from the motion of a reflector, in this case, the red blood cells.If you are keen to know what the various types of Doppler Ultrasound are, here we will attempt to explain. It is not a walk in the park. Don’t say you haven’t been warned. Colour Doppler -- This technique estimates the average velocity of flow within a vessel by colour coding the information. The direction of blood flow is assigned the colour red or blue, indicating flow toward or away from the ultrasound probe (transducer). Pulsed Doppler -- This method allows a sampling volume or "gate" to be positioned in a vessel visualized on the grey-scale image, and displays a graph of the full range of blood velocities within the gate versus time. The amplitude of the signal is approximately proportional to the number of red blood cells and is indicated, not in colour, but simply as a shade of grey. Power Doppler -- This device depicts the amplitude, or power, of Doppler signals rather than the frequency shift. This allows detection of a larger range of Doppler shifts and thus better visualisation of small vessels, but at the expense of directional and velocity information.  Color Doppler depicts blood flow in a region and is used as a guide for the placement of the pulsed Doppler gate for more detailed analysis at a particular site.Doppler ultrasound has many applications including, for example, the detection and measurement of decreased or obstructed blood flow to the legs as in suspected DVT. Colour Doppler ultrasound is done first to evaluate vessels rapidly for abnormalities and to guide placement of the pulsed Doppler to gain sample volume for detailed analysis of velocities. The bottom line:It is very difficult to imagine modern obstetrics without ultrasound. It is an integral part of the care of the pregnant mother and her unborn baby and there is no doubt at all that millions of people across the globe arguably owe their lives to this technology which is now taken as a matter of course. Twins and other forms of multiple pregnancies FrequencyAbout 1% of spontaneous conceptions among the Caucasian population will be twins or other less common forms of multiple pregnancies. The rate is slightly higher for those of black African ancestry and somewhat lower for Japanese and others of oriental ancestry. The rate of multiple pregnancies in assisted conception such as IVF is significantly higher. For any individual woman, family history is a significant factor. If a woman is a twin herself, she has a much higher chance than average of having twins herself. The same applies to a woman who has first-degree twin relatives i.e. siblings or parents. The rate of identical twins is however constant and is not influenced by age, race, family history or any other factors. Monozygotic twins is another term to describe identical twins. The rate is roughly 4 per 1,000 births. Twin IssuesTwins may be exciting but these pregnancies also have their own specific challenges. It is important to stress up-front that the majority of twin pregnancies, upwards of 85%, have a completely successful outcome and dispel the impression that twin pregnancy is automatically bad news.That done, let's turn to the common saying, which happens to be largely true, that doctors and midwives like repeating when speaking about twin pregnancies. The saying goes “all pregnancy complications are commoner in twins apart from prolonged pregnancy”. That is an important and honest starting point. So, when you talk of prematurity, pre-eclampsia, placental abruption, growth restriction, antepartum haemorrhage, postpartum haemorrhage, it is a true general statement that the risk of any of these is higher, the bigger the number of babies a woman is carrying. Unique Twin Issues: Increased risk of pregnancy complications is not the only issue that needs to be dealt with. There are problems that are unique to twin pregnancy. The most important one of these is a twin-to-twin transfusion. This condition occurs only in identical (monozygotic twins) and specifically those who share a placenta. The medical term for a common placenta in twins is monochorionic. It is true that twins that share a placenta have got multiple blood vessel communications within that placenta. These communications are not always a problem and in many if not most cases there is no problem as there is physiological equilibration of the blood flow in both. However, for some, these communications are a problem which is sometimes lethal for one or both. This is brought about by an imbalance in the blood flow whereby one ends up as a ‘donor’ and the other a ‘recipient’. It means there is a net flow of blood to the recipient and this is the one at greatest risk as he/she gets overloaded. Can anything be done? When twin-to-twin transfusion is suspected or diagnosed, the care becomes a specialist issue. There will be serial ultrasound scanning to track the progress of the condition of the twins. Other tests will also be done to keep a close eye on the babies. Sometimes intervention is required to try to reduce the severity of the condition. In most cases, delivery is early to try to prevent further deterioration. Not all cases of twin-to-twin transfusion are that severe. Some are mild enough not to require any intervention. Vanishing twin It is true but probably not widely recognised that twin pregnancies in the second and third trimester represent at most two-third of pregnancies that start as such. What does this mean? Basically, it means, a lot more pregnancies start as twins. For a variety of reasons some embryos in twin pregnancies do not make it beyond the first few weeks and these pregnancies continue as singleton pregnancies. Some of these women would have had early ultrasound scans say at 6 or 7 weeks. Presence of twins would have been identified then and a repeat scan a few weeks down the line a repeat scan shows, not two, but one fetus. The other twin has ‘vanished’.As mentioned earlier, this phenomenon is estimated to affect up to a third of all twins that start as such. Mercifully, this vanishing occurs fairly early before the first scan for most affected mothers and therefore these will be oblivious of the fact that they started off with twins. The loss of the one twin is usually accompanied by very mild or no noticeable symptoms.  

  • 0 Abdominal Ultrasound Scan. Gallstones: Risk Factors and Causes

    • by Administrator
    • 21-01-2019
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        The private abdominal scan is one of our most popular examinations. Upper abdominal pains that can be caused by calculi within the gallbladder, are very common. Cholelithiasis is  the medical term for Gallstone disease. Cholelithiasis is one of the most common and costly of all digestive system diseases. This post outlines some of the associated risk factors and the more common causes of gallstone formation with some additional details about their classification. According to the NHS gallstones are thought to be caused by an imbalance in the chemical make up of the bile within the gallbladder. These chemical imbalances cause tiny crystals to form within the bile that can gradually increase in size from tiny grains of sand to the size of a pebble over a period of time.   Risk Factors The risk factors identified by Wang and Afdhal (2016) for gallstones in the gallbladder (cholelithiasis) include:- diet, age, gender, oestrogen therapy, obesity, fasting, diabetes, family history, rapid weight loss, some medications including those that reduce cholesterol or Lipids or an antibiotic called Cerfriaxone, disease of the ilium or it’s resection and spinal cord injuries. Stockley (2001) states that gallstones are not exclusive to fair, fat, flatulent, fertile over 40 years old females as was previously thought but are also found in young and old alike and have even been detected on fetal ultrasound scanning in the womb. According to Nathanson (2014) it has been estimated from autopsy studies that 12% of men and 24% of women of all ages have gallstone disease present and that 10-30% of them become symptomatic. There are over 40,000 operations to remove the gallbladder and its gallstones (cholecystectomy) performed annually in the UK. Stockley (2001) states that gallstones are formed in several ways: Cholesterol stones which are hard are formed due to an increase in the concentration of cholesterol in the blood (hypercholesterolaemia). An increase in bilirubin in the blood (hyperbilirubinaemia) found in patients with haemolytic anaemia which form irregularly shaped soft, small brown pigment gallstones. Biliary stasis caused by a faulty, malformed, non-emptying gallbladder or obstructed cystic duct leading to stagnant bile. This creates high concentrations of cholesterol and bile pigments following excessive water absorption. This leads to the formation of mixed cholesterol and bile pigment stones, the most common type of gallstone.    Gallstone Classification There are differing methods used for gallstone classification, namely their chemical composition location Wang and Afdhal (2016) classify gallstones into 3 types based on their chemical composition and macroscopic appearance: cholesterol, pigment and rare stones. 75% of gallstones in the Western world are cholesterol stones consisting mainly of cholesterol monohydrate crystals and precipitates of amorphous calcium bilirubinate. These stones are further sub-classified as either pure cholesterol or mixed stones that contain at least 50% of cholesterol by weight. The remainder of gallstones are classified as pigmented stones that contain mostly calcium hydrogen bilirubinate and they can be further sub-classified into two groups: black pigment (20%) and brown pigment stones (4.5%). Rare gallstones account for 0.5% and include calcium carbonate stones and fatty acid-calcium stones.   Wang and Afdhal (2016) classify gallstones by their location as Intrahepatic stones which are predominantly brown pigment stones Gallbladder stones which are mainly cholesterol stones with a small group of black pigment stones. Bile duct stones (choledocholithiasis) which are composed mostly of mixed cholesterol stones.   Gallstone Diagnosis The abdominal ultrasound scan is the first line of investigation in the diagnosis of gallstones. This ultrasound scan is performed on a fasted patient.  The reason for fasting is that the gallbladder is like a balloon. When we eat something fatty, the gallbladder will excrete the bile into the gut to break down the fat and therefore the gallbladder collapses and it is not possible therefore to see if there are any stones within the lumen.  International Ultrasound Services offers private ultrasound scans  to evaluate your gallbladder for any signs of gallstones, thickening of the gallbladder wall and the existence of any pericholecystic fluid. We will also check your liver, your pancreas, your kidneys and the spleen at the same time. You can book an ultrasound scan in London by visiting our ultrasound scan appointments booking page. You can find more information about the upper abdominal scan here.     References: NHS Choices (2016) Gallstones causes. Available at: http://www.nhs.uk/Conditions/gallstones/Pages/causes.aspx [Accessed 17/10/2016] Wang, D., Afdhal, N. (2016). Gallstone Disease In: Feldman, M., Friedman, L., Brandt,L.(eds) Sleisanger and Fordtran’s Gastrointestinal and Liver Disease Pathophysiology / Diagnosis / Management. Volume 1. 10th Edition. Philadelphia, Saunders Elsevier. pp -1100 - 1108 Stockley, M (2001) Abdominal Ultrasound. 1st edition. Greenwich Medical Media Nathanson, L. (2014) Gallstones, In: Garden, O., Parks, R. (eds.) Hepatobilary and Pancreatic Surgery. A Companion to Specialist Surgical Practice. 5th edition. Edinburgh. Saunders Elsevier. p 174. Bibiliograph: http://www.webmd.com/digestive-disorders/gallstones#1What Are Gallstones? [Accessed 17/10/2016] http://www.livescience.com/34726-gallstones-symptoms-treatment.html. [Accessed 18/10/2016] Mayo Clinic (2013) Gallstones causes. Available at: http://www.mayoclinic.org/diseases-conditions/gallstones/basics/causes/con-20020461. [Accessed 18/10/2016]      

  • 0 Private scans

    • by Administrator
    • 21-01-2019
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    Welcome to our new private scan blog. Our private scan clinic in Notting Hill Gate offers a wide range of private scans for men and women as well as pregnancy private scans. We are conveniently located a few minutes walk from Notting Hill Gate tube station and we offer a range of out of hour private scan appointments, including emergency/on-call private scans to suit your lifestyle. You can find the whole range of our private scans and costs here.         Who interprets the results of the private scan and how do I get them? Our Sonographer, a Health Care Professional specifically trained to perform and understand the ultrasound scan images, will do your private scan and provide you with a written report that you can take it your doctor.  Our sonographers will also discuss the results with you during and after your ultrasound scan examination. It is very common that sometimes when you leave you to remember of a question that you forgot to ask, so please don't hesitate to contact us either via phone or e-mail and we will do our best to answer your question.   What are the benefits and risks of the ultrasound scan examination? Benefits Ultrasound scanning is noninvasive. An ultrasound scan exam may be occasionally, temporarily uncomfortable, but it should not be painful. Ultrasound is widely available, easy-to-use and less expensive than other imaging modalities. Ultrasound imaging is extremely safe and does not use any ionizing radiation. Ultrasound scanning gives a clear picture of soft tissues such as liver that do not show up well on x-rays. Risks There are no known harmful effects on humans related to ultrasound scan examinations.   What are the limitations of Ultrasound Scan Imaging?  Ultrasound waves do not travel well in bowel or gas so you can not fully evaluate abdominal organs such as stomach and bowel or organs obscured by the bowel. It can also be hard to fully visualise the internal anatomy of large patients as the sound has further to travel and therefore the returning echoes are weaker.   Why choose us for your private scan? We are conveniently located in the heart of London, just a few minutes’ walks from Notting Hill Gate station, in a cobbled cul-de-sac off Kensington Mall in the Royal Borough of Kensington and Chelsea. We offer same day and emergency after hours and weekend appointments in a clean and caring environment, to suit your needs. Unlike some of our competitors, we provide you with a private scan report at the same day to fast track any potential treatment.  We have years of experience in medical ultrasound scanning. Experience gained working for flagship NHS trusts alongside leaders in the field of diagnostic medical imaging including general ultrasound, urology, musculoskeletal, gynaecology, pelvis, testicular and vascular scan examinations. You can, therefore be assured that your health is in good hands. Our range of private scan examinations includes the abdomen, pelvis, kidneys, bladder, prostate, ovary, testicle, scrotal, knee, shoulder, groin, ankle, wrist to name a few. We are also experts in pregnancy ultrasound and we regularly rotate through our hospital EPU that mainly deals with recurrent miscarriage. Our full range of private scans can be viewed via the site menu. Our competitively priced private scan services and personalised service is second to none and this is the reason our clients recommend us to friends and family.    About Ultrasound Scans Diagnostic Medical ultrasound scan or medical sonography as otherwise known is a painless imaging technique utilising sound waves to produce internal images of the body.It is called ultrasound as the sound frequency being used is at the region of 1 to 20MHz. The human ear can't hear these frequencies.The sound waves are produced by the transducer or the probe as most commonly known. As they travel through the body they bounce back to the transducer due to various sound transmissions differences in tissues. The returning echoes are picked up by the probe and a powerful computer analyses the echoes and creates the 2d image on the screen.There are various kinds of ultrasound scans that can be performed and each looks at different organs of the body such as tendons, muscles, joints, blood vessels, liver, kidneys, uterus and ovaries to confirm or exclude possible pathology.Unlike Ct and MRI, ultrasound does not use radiation and therefore is pregnancy friendly. It is also live and is ideal for musculoskeletal exams to evaluate moving joints.   Looking for a private scan in London? IUS London specialises in diagnostic private ultrasound scans to provide you with quick diagnosis and the much-needed reassurance about your health, within a convenient location. The cost of a private ultrasound scan shouldn’t be prohibited when it comes to someone’s wellbeing. This is why our prices are competitive and affordable with no compromise to the level of care. The price you see is the price you pay with no hidden extras. We have hundreds of happy clients including GP’s, consultants, radiologists and midwives to name a few. Some of our clients choose us when large, well-established ultrasound scanning companies failed them in diagnostic accuracy and especially aftercare. We offer ultrasound scan appointments via our online booking system or on the phone. We do not charge a deposit or a cancellation fee as we care more about our clients and we respect their decision to decide what is best for them without concern about the ultrasound scan deposit they already paid.     

  • 0 Private Pregnancy scans and Scanxiety

    • by Administrator
    • 21-01-2019
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    Scan Anxiety- Scanxiety and the truth   There have been lots of talks lately on the newspapers and online about scanxiety - someone created a fancy word to describe anxiety before diagnostic scans such as CT and MRI. The term quickly included private ultrasound scans mainly private pregnancy scans in a newspaper attempt to grab the reader’s attention.  The Guardian headline reads:"Scanxiety: why private baby scans are on the riseMany pregnant women are paying for extra ultrasounds, for reassurance or for ‘souvenir scans’. But does multiple scanning pose a risk to the unborn child?" The MailOnline article reads:Pregnant women with 'scanxiety' are told to avoid private ultrasounds as firms offer multiple scans to assuage their fears Study found almost a third of mothers-to-be pay for extra scans while pregnant Many do so due to anxiety, despite NHS offering scans at 12 weeks and 20 weeks Parent site ChannelMum.com says ‘pop-up’ firms target women with 'scanxiety' Another article on MailOnline reads:The rise of 'scanxiety': Pregnant women are risking their babies' health by paying for unnecessary scans UK and US guidelines advise getting two scans: one at 12 weeks, one at 20 weeks A new study shows a third of mothers-to-be pay for extra private ultrasounds Too many high-intensity scans may cause harm to the foetus, experts warn  Anxiety over the baby's health may be doing more harm than good, they say     Going through these articles as a qualified sonographer with more than 15 years experience, i found out that they were full of inaccuracies, misinformation and scaremongering. Ultrasound is used in pregnancy since the late 70s. There were a few research publications suggesting that ultrasound might affect the growth of the unborn baby but with no conclusive evidence and consequent studies failed to duplicate the results. The medical community, therefore, is suggesting that ultrasound should be used where clinically indicated. NICE recommends 2 scans at 12 and 20 weeks as sufficient during the pregnancy. A new study in England, however, shows that almost a third of expectant mothers are paying for additional private scans.  So NICE knows better than the pregnant mothers or is it because NICE has to take into account the lack of NHS sonographers and midwives and try to alleviate the stress on the NHS? If two ultrasound scans are enough in the UK, why they are not enough in the USA, Australia and most other European countries? So would you say to an expectant mother and her partner who had a miscarriage and sometimes, unfortunately, multiple ones, who are in the waiting room shaking waiting to find out if their baby has a heartbeat that is overreacting and suffering from scanxiety? Do you think that the ultrasound scan is clinically indicated? I would say yes as the ultrasound scan will either reassure them, that their baby is alive or at the worst case scenario will confirm their fear but at least they will know and they will be able to deal with it. In very anxious patients, sometimes a quick scan is the best option for alleviating stress which is helpful in so many other ways. In our London ultrasound clinic, we do not just do pregnancy scans such the early pregnancy/reassurance scan but we do a variety of other ultrasonic examinations such as abdominal, pelvic and musculoskeletal examinations. We have clients from all walks of life including health care professionals who are not willing to wait 6+ weeks to have a scan on the NHS as they want to find out if there is something wrong with them and treat it ASAP. We assume that these clients are suffering from scanxiety too but all these articles concentrated on expecting mothers as a soft target. Never the less anxiety associated with the results of a scan either ultrasound, CT or MRI between cancer patients is well documented. Some concerns on these articles arise from the intensity of the ultrasound beam and the length of ultrasound scanning. The intensity of the ultrasound beam is significantly higher on 4D scans than 2D scans as is the scanning time. In our London ultrasound clinic we do not offer 4D ultrasound scans but most of the ultrasound clinics that do offer them, they offer them later in pregnancy at 20+ weeks, when the baby is well developed and the effects of ultrasound intensity are minimal.  The most valid point of these articles is the use of untrained/unqualified sonographers. I am not aware of any ultrasound clinics in the UK that uses unqualified sonographers and as far as I know, most of the ultrasound clinics are registered with CQC. Never the less the DailyMail has compiled a list with tips on finding a reputable scanning clinic:   TIPS ON FINDING A REPUTABLE SCANNING CLINIC  ·  Check that your ultrasound clinic is registered with the Care Quality Commission, to ensure it meets professional standards.·  Look online for clinic reviews and check how long the company has been established.·  Ask the clinic about staff qualifications and experience. Any reputable firm will be happy to help. Your sonographer should be HCPC qualified.·  Some clinics do offer discounts to make the treatment affordable for everyone. However if you are being pressured to buy more packages than you need or can afford, consider going elsewhere. It's your body, your baby and your choice.·  If you feel overly anxious, speak with your midwife. Your ultrasound clinic will work with him or her. If you have any questions please feel free to contact us.       What can be seen on ultrasound during the early Pregnancy Scan Pregnancy or baby ultrasound scans are a routine part of prenatal care. Ultrasound scans are completely painless, have no known side effects on mothers or babies, and can be carried out at any stage of pregnancy: in early pregnancy, ultrasound is being used to confirm the baby's heartbeat and exclude any early stage abnormalities; later in pregnancy ultrasound is being used to evaluate the baby's overall health. It may be worth noting that spotting is common in pregnancy. Usually, it's nothing to worry about, but it's always best to double check with your doctor or midwife.What can be seen during the early scan: At 5 weeks gestation (i.e 3 weeks after conception) a small gestation sac might be visible. At 6 weeks, the yolk sac, the embryo (foetal pole) and the heartbeat might be visible. At 7 weeks the embryo will be around 10mm with a fast heartbeat. At 8 weeks, the embryo will be around 16mm and the body and the head might be distinguishable. The embryonic movement might also be seen. At 9 weeks, the embryo is now a foetus and head, body and limbs start to form.    

 

 

 

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