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Abstract Heat stress negatively impacts the reproductive performance of sheep including the efficiency of estrous synchronization regimens. This study aimed to investigate the potential effects of L-Carnitine (LC) administration on the efficacy of the OvSynch protocol in ewes under summer climatic conditions. Ewes were synchronized for estrus using the OvSynch protocol and a dose of LC (20 mg/kg body weight) was intravenously (IV) administered on the same day of PGF2α injection to one group (n = 8; LC group), while other ewes (n = 8; control group) received the same protocol without LC. Ultrasonographic evaluation (including B-mode, color, and pulsed Doppler) was used to assess the morphometrical and hemodynamic parameters of ovarian structures [number, size, and blood flow of follicles (GFs) and corpora lutea (CLs)] and uterus during the estrous phase (Day 0), and on Day 8 post ovulation (luteal phase). Uterine artery blood flow (MUA) was assessed by measuring the resistive index (RI) and pulsatility index (PI) at both stages. The serum samples were collected to measure the concentrations of estradiol (E2), progesterone (P4), and total antioxidant capacity (TAC) using commercial kits. Results revealed a significant (P

Background: Fetal growth restriction (FGR), a condition occurring due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth less than normal in light of the growth potential of that specific infant. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications are growth retardation and major and subtle neurodevelopmental handicaps. Adequate surveillance of fetal growth is a crucial factor. Objective: To correlate clinical and ultrasound diagnosis of fetal growth restriction .Methodology: This prospective study was conducted in the Department of Obstetrics and Gynaecology at NSCB medical college, Jabalpur during the period of March 2018 to August 2019. Total 288 cases were included in the study. Results: The prevalence of FGR was found to be 33.7%. 60.81% of cases were in the age group 20-25 years. 89% of women belonged to rural areas. 67.30% of women belonged to the upper-lower class. The sensitivity and specificity of clinical methods were found to be 70.7% and 74.2% respectively. The sensitivity of ultrasonography and Doppler was 80.5% and 90.2%, and specificity was found to be 87.7% and 95.1% respectively. Out of 126 clinically suspected IUGR cases, overall 82 cases (65.1%) were confirmed as IUGR at birth. 43(20.63%) were lost to follow-up. Conclusion: The Doppler study is the best available modality for diagnosing FGR due to its high specificity, however clinical assessment, being a cost-effective screening tool, is equally good in diagnosing FGR.

The median arcuate ligament syndrome (MALS) is a rare disease characterized by abdominal pain caused by the external compression of the celiac artery by the median arcuate ligament. Surgical treatment is indicated, but given the non-specific symptoms, these patients are often hospitalized in the Departments of Internal Medicine where the diagnosis may be unknown. We present a case of MALS admitted to our Internal Medicine Division. An abdominal ultrasound in a woman with longstanding abdominal pain showed elevated celiac artery velocities during forced expiration. Computed tomography angiography (CTA) of the abdomen showed stenosis of the origin of the celiac artery and confirmed the diagnosis of MALS. MALS is a syndrome that has to be considered, especially in young women with abdominal pain of unclear etiology; evaluated by color Doppler ultrasound, in the presence of elevated hepatic artery velocities during forced expiration, the confirmatory test is CTA.

Abstract: Annually hundreds of crab-eating foxes (Cerdocyon thous) are referred to rehabilitation centers and zoos in Brazil. The ultrasonographic study of wildlife species is an important tool for a non-invasive and accurate anatomical description and provides important information for wildlife veterinary care. The aim of the present study was to determine the characteristics of the main abdominal organs as well as the vascular indexes of the abdominal aorta and renal arteries of crab-eating foxes (Cerdocyon thous) using mode B ultrasonography and Doppler ultrasonography, respectively. Ultrasonographic features of the main abdominal organs were described and slight differences were noticed between ultrasound imaging of abdominal organs of crab-eating foxes and other species. The bladder presented wall thickness of 12±0.01mm, with three defined layers. Both, the right and left kidneys presented corticomedullary ratio of 1:1 and similarly to the adrenals and the liver, they were homogeneous and hypoechoic compared to the spleen. The spleen was homogeneous and hyperechoic compared to the kidneys. The stomach presented 3 to 5 peristaltic movements per minute, wall thickness of 39±0.05mm and lumen and mucosa with hyperechoic and hypoechoic features, respectively. Small and large intestines presented 2 to 3 peristaltic movements per minute, wall thickness of 34±0.03mm and three defined layers with hyperechogenic (submucosa and serosa) and hypoechogenic (muscular) features. Ovaries of the female crab-eating fox were hypoechoic compared to the spleen and with heterogeneous parenchyma due to the presence of 2x2mm ovarian follicles. Prostates of the six males were regular and with a well defined boundary, with a homogeneous and hyperechoic parenchyma compared to the spleen. Vascular indexes of the abdominal aorta (PSV: 25.60±0.32cm/s; EDV: 6.96±1.68cm/s; PI: 1.15±0.07 e RI: 0.73±0.07) and right (PSV: 23.08±3.34cm/s; EDV: 9.33±2.36cm/s; PI: 1.01±0.65 e RI: 0.65±0.16) and left renal arteries (PSV: 23.74±3.94cm/s; EDV: 9.07±3.02cm/s; PI: 1.04±0.31 e RI: 0.64±0.10) were determined. Thus, conventional and Doppler ultrasonographic imaging provides basic information that can be used as reference for the species as well for other wild canids and it is a precise and non-invasive method that can be safely used to evaluate and diagnose abdominal injuries in these patients.

The paper analyzes the performance of extracranial hemodynamics — volumetric and linear blood flow velocity, the state of peripheral vascular resistance and vascular reactivity at ultrasound Doppler examination of the internal carotid and vertebral arteries of 66 children with bronchial asthma and and 22 healthy children. Development of regional hypoperfusion in vertebrobasilar zone, disorders of the carotid system are proven, but these changes have not led to a decrease in the volumetric blood flow velocity in both internal carotid arteries and the total volume of cerebral blood flow, indicating the compensation of hemodynamic disturbances due to the influence of constant rates in volumetric blood flow in the carotid system. Changes in parameters of extracranial hemodynamics in children with bronchial asthma should be considered as predictor of cerebrovascular complications in this group of patients.

A 73-year-old female patient underwent transradial coronary angiography with stable angina and signs of significant myocardial ischemia revealed by exercise stress test. After insertion of a 6F radial sheath into the right radial artery and intra-arterial administration of heparin plus verapamil, the hydrophilic guidewire could not be advanced under fluoroscopic guidance. Immediately afterwards, radial angiography was performed, which displayed a radial artery perforation with significant contrast extravasation. The perforated segment was crossed meticulously with the same guidewire after additional vasodilator drug administration. Afterwards, a 5F TIG catheter was advanced to the axillary artery and held in place for 20 minutes with application of external compression with a sphygmomanometer cuff at the level of systolic blood pressure. The same maneuver was again performed following cuff deflation and completion of coronary angiography with the 5F catheter. Final angiography displayed complete sealing of the perforation without a need for neutralization of heparin. External compression was continued for two hours, and after documentation of normal triphasic radial artery flow by Doppler ultrasound (DUS), the radial sheath was removed. The patient was discharged the following day with no evidence of hand ischemia and wellpalpable radial artery pulse. DUS demonstrated normal radial artery flow one month later. This unusual complication was managed successfully with a simple and easily applicable technique that can be performed in such cases.

Systemic atherosclerosis is a condition which progresses with age, decreases quality of life, and life expectancy. Lower extremity peripheral arterial disease (PAD) is a common manifestation of systemic atherosclerosis in the elderly. These individuals have a 2 to 4 fold higher risk of coronary heart disease and stroke. In addition, systemic atherosclerosis causes overall functional disability including restricted lower extremity movements. When used alone for diagnostic purposes, claudication is an unreliable sign of PAD in all age groups especially the elderly. Moreover, claudication is difficult to define due to the advancing age and degenerative changes in lumbar and peripheral joints. Doppler ultrasonography (US) is an easily available and noninvasive means of arterial visualization in the lower extremities. In this review, supporting evidence for the use of Doppler US in the diagnosis of PAD will be discussed. Past and present recommendations regarding Doppler US in the current PAD guidelines will be overviewed.

Background: Deep vein thrombosis is a multi causal disease and its one of most common venous disorder, but only one quarter of the patients who have signs and symptoms of a clot in the vein actually have thrombosis and need treatment .The disease can be difficult to diagnose. Venous ultrasound in combination with clinical finding is accurate for venous thromboembolism, its costly because a large number of patients with suspicious signs and symptoms. Venography still the gold standard for venous thromboembolism but it is invasive. The D-dimer increasingly is being seen as valuable tool rolling out venous thromboembolism and sparing low risk patients for further workup.Objectives: this study has designed the role of D-dimer to confirm diagnosis of deep vein thrombosis for patients with positive Doppler and those show no features of thrombosis in Doppler using more accurate and sensitive instrument measuring the concentration of D- dimer.Methods: Thirty patients with deep vein thrombosis diagnosed by Doppler and clinical signs and symptoms (for those with negative Doppler) assessed for D- dimer by automachine cormy accent 200 based on immunoassay which more sensitive than the ordinary methods.Results: Twenty-eight patients out of thirty shows a significant elevation of D-dimer compared to control group which show no elevation in D- dimer level. On other side higher level of D- dimer found in those with negative Doppler as same as level to the patients with positive Doppler.Conclusion: Patients with clinical sign and symptoms of deep vein thrombosis and negative Doppler should be assessed for D- dimer using more sensitive technique based on immunological assay.Key words: deep vein thrombosis (DVT) pulmonary embolism (PE), Doppler

Se estudiaron 18 pacientes con diagnóstico de insuficiencia mitral a quienes se les realizó una ventriculografía nuclear (basal y luego de 5 mg de nisoldipina oral) y un ecocadiograma Doppler con el propósito de validar un método radioisotópico para calcular el índice de regurgitación usando el análisis factorial. Mientras que la frecuencia cardíaca, el volumen telediastólico y el volumen sistólico no cambiaron significativamente posnisoldipina, la presión sanguínea, así como la fracción de eyección ventricular izquierda, el volumen telesistólico y el índice de regurgitación, disminuyeron significativamente (p < 0,05). Hubo una buena concordancia (78 %; Kappa = 0,66) entre la valoración de la severidad de la insuficiencia mitral por ventriculografía nuclear y por eco Doppler, mientras que al comparar los resultados de la evaluación clínica con la ventriculografía nuclear, la concordancia fue moderada (67 %; kappa = 0,48). Se concluye que el cálculo del índice de regurgitación por análisis factorial en una ventriculografía nuclear, constituye un método no invasivo adecuado para la evaluación semicuantitativa de la severidad de la insuficiencia mitral.SUMMARY18 patients with diagnosis of mitral insuficiency that underwent nuclear ventriculography (basal and after 5 mg of oral nisoldipina) and a Doppler echocardiogram aimed at validating a radioisotopic method to calculate the regurgitation index by using the multifactorial analysis qere studied. Heart rate, the telediastolic volume and the systolic volume did not change significantly after the administration of nisoldipine, However, blood preasure, the left ventricular ejection fraction, the telesystolic volume and the regurgitation index decreased notably (p < 0.05), There was a good concordances (78 %; Kappa = 0.66) between the assessment of the severity of mitral insuficiency by nuclear ventriculography and by Doppler echocardiogram. On comparing the results of the clinical evaluation with nuclear ventricugraphy it was observed a moderate concordance (67 %, Kappa = 0.48). It was concluded that the calculation of the regurgitation index by factorial analysis in a nuclear ventriculography is a noninvasive method suitable for the semicuantitative evaluation of mitral insuficiency severity.