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Bloat is any abnormal gas swelling, or increase in diameter of the abdominal area. As a symptom, the patient feels a full and tight abdomen, which may cause abdominal pain and is sometimes accompanied by increased stomach growling, or more seriously, the total lack of it.

Pains that are due to bloating will feel sharp and cause the stomach to cramp. These pains may occur anywhere in the body and can change locations quickly.They are so painful that they are sometimes mistaken for heart pains when they develop on the upper left side of the chest. Pains on the right side are often confused with problems in the appendix or the gallbladder.

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White blood cells (leukocytes) orchestrate the host response to pathogens. Leukocytes are divided into myeloid (eosinophils, monocytes, neutrophils, basophils) and lymphoid (B cells, T cells, and natural killer (NK) cells) elements. Monocytes and neutrophils mediate innate immune defenses and present antigens to lymphocytes, the principal effectors of the adaptive immune system. Eosinophils and basophils defend against parasitic pathogens, play important roles in inflammation, and mediate allergic reactions.Monocytes and neutrophils, as part of innate immunity, phagocytose bacteria and debris, eliminate virus-infected cells, and destroy parasites and fungi. Phagocytosis is assisted by serum complement proteins, which adhere to pathogens and promote chemotaxis and opsonization. Monocytes mature in tissue to become macrophages, where they, along with dendritic cells and B cells, serve as antigen presenting cells (APCs) to the adaptive immune system.B and T cells, as part of adaptive immunity, confer long-term protection against pathogens, especially extracellular bacterial infections. Adaptive immunity orchestrates both antibody-mediated humoral immunity and T-cell mediated cellular cytotoxicity. B cells secrete neutralizing antigen-specific antibodies (i.e. humoral) upon stimulation by the macrophages, dendritic cells, and T cells. In contrast, T cells and NK cells, upon stimulation, can directly kill aberrant cells (i.e. cell-mediated). These aberrant cells include those infected with viruses, bacteria, and fungi, tumorigenic cells, and transplanted tissue.


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Colic is uncontrollable crying in an otherwise healthy baby. Your baby is considered colicky if he’s younger than 5 months old and cries for more than three hours in a row on three or more days a week for at least three weeks (phew!). Colic isn't a disease and won't cause your baby any long-term harm, but it's a tough thing to go through for babies and their parents.

If your baby is colicky, find more than 20 sanity-saving tips to help you deal with it in our article about coping with colic.

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X-linked agammaglobulinemia (XLA) is a condition that affects the immune system and occurs almost exclusively in males. People with XLA have very few B cells, which are specialized white blood cells that help protect the body against infection. B cells can mature into the cells that produce special proteins called antibodies or immunoglobulins. Antibodies attach to specific foreign particles and germs, marking them for destruction. Individuals with XLA are more susceptible to infections because their body makes very few antibodies.Children with XLA are usually healthy for the first 1 or 2 months of life because they are protected by antibodies acquired before birth from their mother. After this time, the maternal antibodies are cleared from the body, and the affected child begins to develop recurrent infections. In children with XLA, infections generally take longer to get better and then they come back again, even with antibiotic medications. The most common bacterial infections that occur in people with XLA are lung infections (pneumonia and bronchitis), ear infections (otitis), pink eye (conjunctivitis), and sinus infections (sinusitis). Infections that cause chronic diarrhea are also common. Recurrent infections can lead to organ damage. People with XLA can develop severe, life-threatening bacterial infections; however, affected individuals are not particularly vulnerable to infections caused by viruses. With treatment to replace antibodies, infections can usually be prevented, improving the quality of life for people with XLA.


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A double uterus is a rare congenital abnormality. In a female fetus, the uterus starts out as two small tubes. As the fetus develops, the tubes normally join to create one larger, hollow organ — the uterus.


Sometimes, however, the tubes don't join completely. Instead, each one develops into a separate structure. A double uterus may have one opening (cervix) into one vagina, or each uterine cavity may have a cervix. In many cases, a thin wall of tissue runs down the length of the vagina, dividing it into two separate openings.


Women who have a double uterus often have successful pregnancies. But the condition can increase the risk of miscarriage or premature birth.

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Earwax blockage occurs when earwax (cerumen) accumulates in your ear or becomes too hard to wash away naturally.

Earwax is a helpful and natural part of your body's defenses. It cleans, lubricates and protects your ear canal by trapping dirt and slowing the growth of bacteria.

If earwax blockage becomes a problem, you or your doctor can take simple steps to remove the wax safely.

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 Central nervous system (CNS) embryonal tumors form in embryonic cells that remain in the brain after birth. CNS embryonal tumors tend to spread through the cerebrospinal fluid (CSF) to other parts of the brain and spinal cord.

The tumors may be malignant (cancer) or benign (not cancer). Most CNS embryonal tumors in children are malignant. Malignant brain tumors are likely to grow quickly and spread into other parts of the brain. When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Benign brain tumors grow and press on nearby areas of the brain. They rarely spread to other parts of the brain. Both benign and malignant brain tumors can cause signs or symptoms and need treatment.

Although cancer is rare in children, brain tumors are the third most common type of childhood cancer, after leukemia and lymphoma. This summary is about the treatment of primary brain tumors (tumors that begin in the brain). The treatment of metastatic brain tumors, which begin in other parts of the body and spread to the brain, is not discussed in this summary. For information about the different types of brain and spinal cord tumors, see the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment Overview.

Brain tumors occur in both children and adults. Treatment for adults may be different from treatment for children. See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information on the treatment of adults.

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Some couples are almost desperate to conceive a baby of one particular gender. Fathers especially, can be eager to have a boy but there are also mothers who long for a son. Most couples however, are happy with either a boy or a girl baby, as long as it is healthy and strong. But if you are keen to try to sway the odds of having a boy then there is no harm in trying. Just remember that there are no guarantees and the odds of conceiving a boy or a girl are almost exactly the same for each and every pregnancy.

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Epidermolysis bullosa (ep-ih-dur-MOL-uh-sis buhl-LOE-sah) is a group of rare diseases that cause fragile, blistering skin. The blisters may appear in response to minor injury, even from heat, rubbing, scratching or adhesive tape. In severe cases, the blisters may occur inside the body, such as the lining of the mouth or the stomach.


Most types of epidermolysis bullosa are inherited. The condition usually shows up in infancy or early childhood. Some people don't develop signs and symptoms until adolescence or early adulthood.


Epidermolysis bullosa has no cure, though mild forms may improve with age. Treatment focuses on caring for blisters and preventing new ones.

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Esthesioneuroblastoma (es-THEE-zee-o-NOO-row-blas-TOE-muh) is a rare type of cancer that begins in the upper portion of the nasal cavity.


The area where esthesioneuroblastoma begins is separated from the brain by a bone that contains tiny holes that allow the nerves that control smell (olfactory nerves) to pass through. Esthesioneuroblastoma is also called olfactory neuroblastoma.


Esthesioneuroblastoma, which can occur at any age in adults, generally begins as a tumor in the nasal cavity and may grow or extend into the sinus, eyes and brain. People with esthesioneuroblastoma can lose their sense of smell, have frequent nosebleeds and experience difficulty breathing through their nostrils as the tumor grows.


Esthesioneuroblastoma can also spread to the lymph nodes in the neck and the parotid glands. In advanced cases, esthesioneuroblastoma can spread to other parts of the brain and other parts of the body, such as the lungs, liver and bones.


Esthesioneuroblastoma treatment usually includes surgery. Often, radiation and chemotherapy are recommended, as well.

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A febrile seizure is a convulsion in a child that may be caused by a spike in body temperature, often from an infection. Your child's having a febrile seizure can be alarming, and the few minutes it lasts can seem like an eternity.


Febrile seizures represent a unique response of a child's brain to fever, usually the first day of a fever. Fortunately, they're usually harmless and typically don't indicate an ongoing problem. You can help by keeping your child safe during a febrile seizure and by comforting him or her afterward.

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Fibroadenomas (fy-broe-ad-uh-NO-muhz) are solid, noncancerous breast lumps that occur most often in women between the ages of 15 and 35.


A fibroadenoma might feel firm, smooth, rubbery or hard and has a well-defined shape. Usually painless, it might feel like a marble in your breast, moving easily under your skin when examined. Fibroadenomas vary in size, and they can enlarge or shrink on their own.


Fibroadenomas are among the most common noncancerous (benign) breast lumps in young women. Treatment might include monitoring to detect changes in size or feel, a biopsy to evaluate the lump or surgery to remove it.

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Fibrocystic breasts are composed of tissue that feels lumpy or rope-like in texture. Doctors call this nodular or glandular breast tissue.


It's not at all uncommon to have fibrocystic breasts. More than half of women experience fibrocystic breast changes at some point in their lives. In fact, medical professionals have stopped using the term "fibrocystic breast disease" and now simply refer to "fibrocystic breasts" or "fibrocystic breast changes" because having fibrocystic breasts isn't really a disease. Breast changes categorized as fibrocystic are considered normal.


Although many women with fibrocystic breasts don't have symptoms, some women experience breast pain, tenderness and lumpiness — especially in the upper, outer area of the breasts. Breast symptoms tend to be most bothersome just before menstruation. Simple self-care measures can usually relieve discomfort associated with fibrocystic breasts.

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Fibromuscular dysplasia is a condition that causes narrowing (stenosis) and enlargement (aneurysm) of the medium-sized arteries in your body. Reduced blood flow from narrowed arteries to the organs can affect the function of the organs.


Fibromuscular dysplasia appears most commonly in the arteries leading to the kidneys. Fibromuscular dysplasia can also affect the arteries leading to your brain, heart, abdomen, arms and legs.


Fibromuscular dysplasia can cause a number of complications, such as high blood pressure or tears of the artery (arterial dissection), if left untreated. Arterial dissection, or spontaneous coronary artery dissection (SCAD), can limit blood flow to the organ supplied by the injured artery.

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Fibrous dysplasia is an uncommon bone disorder in which scar-like (fibrous) tissue develops in place of normal bone. This irregular tissue can weaken the affected bone and cause it to deform or fracture.


In most cases, fibrous dysplasia occurs at a single site in one bone, but can occur at multiple sites in multiple bones. Single bone involvement usually occurs in adolescents and young adults. People who have more than one affected bone typically develop symptoms before the age of 10.


Although fibrous dysplasia is a genetic disorder, it's caused by a gene mutation that's not passed from parent to child. There's no cure for the disorder. Treatment, which may include surgery, focuses on relieving pain and repairing or stabilizing bones.

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Frostbite occurs when the skin is exposed to extreme or prolonged cold. The skin freezes, as do tissues beneath the surface of the skin. In extreme cases, muscle, nerves, and blood vessels may also freeze.


Skin may freeze within minutes when exposed to temperatures that fall below freezing. Even if temperatures are above freezing, the skin is likely to freeze if it’s wet or exposed to severe wind chills.


Frostbite also occurs when your skin directly contacts very cold surfaces. This type of exposure may immediately freeze the skin that touches the frozen surface.

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Gallbladder cancer is cancer that begins in the gallbladder.


Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder stores bile, a digestive fluid produced by your liver.


Gallbladder cancer is uncommon. When gallbladder cancer is discovered at its earliest stages, the chance for a cure is very good. But most gallbladder cancers are discovered at a late stage, when the prognosis is often very poor.


Gallbladder cancer is difficult to diagnose because it often causes no specific signs or symptoms. Also, the relatively hidden nature of the gallbladder makes it easier for gallbladder cancer to grow without being detected.

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Gastrointestinal (GI) bleeding is a symptom of a disorder in your digestive tract. The blood often appears in stool or vomit but isn't always visible, though it may cause the stool to look black or tarry. The level of bleeding can range from mild to severe and life-threatening.


Bleeding in the stomach or colon can usually be easily identified, but finding the cause of bleeding that occurs in the small intestine can be difficult. But sophisticated imaging technology can usually locate the problem, and minimally invasive procedures often can fix it.

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Glioblastoma is an aggressive type of cancer that can occur in the brain or spinal cord. Glioblastoma forms from cells called astrocytes that support nerve cells.


Glioblastoma can occur at any age, but tends to occur more often in older adults. It can cause worsening headaches, nausea, vomiting and seizures.


Glioblastoma, also known as glioblastoma multiforme, can be very difficult to treat and a cure is often not possible. Treatments may slow progression of the cancer and reduce signs and symptoms.

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Golfers elbow or medial epicondylitis is an overuse injury similar to tennis elbow (on the outside of the arm) but causing pain on the inside of the elbow instead. It is sometimes known as throwers elbow or little league elbow. We explain the symptoms, causes and treatment to return you back to full fitness in the shortest time.

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Your hip is the joint where your thigh bone meets your pelvis. It is called a ball-and-socket joint, because the ball-like top of your thigh bone fits into a cup-like area within your pelvis, much like a baseball fits into a glove.


Hip


Normally, the ball glides smoothly within the socket, but a problem with the ball or socket rim can interfere with smooth motion. This problem can cause hip impingement or femoro acetabular impingement (FAI). It is believed to be a major cause of early osteoarthritis of the hip, particularly in those under age 40.

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High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication.


It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart.

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Digested food particles must travel through 25 feet or more of intestines as part of normal digestion. These digested wastes are constantly in motion. However, intestinal obstruction can put a stop to this. An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food.


If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage. If enough pressure builds up, your intestine can rupture, leaking harmful intestinal contents and bacteria into your abdominal cavity. This is a life-threatening complication.


There are many potential causes of intestinal obstruction. Often, this condition can’t be prevented. Early diagnosis and treatment are crucial. An untreated intestinal obstruction can be fatal.

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Invasive lobular carcinoma is a type of breast cancer that begins in the milk-producing glands (lobules) of the breast.


Invasive cancer means the cancer cells have broken out of the lobule where they began and have the potential to spread to the lymph nodes and other areas of the body.


Invasive lobular carcinoma makes up a small portion of all breast cancers. The most common type of breast cancer begins in the breast ducts (invasive ductal carcinoma).


Invasive lobular carcinoma typically doesn't form a lump, which is common in breast cancer. Instead, there is a change in the breast that feels like a thickening or fullness in one part of the breast and is different from the surrounding breast tissue.

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Juvenile-onset fibromyalgia (JFM) is a poorly understood chronic pain condition most commonly affecting adolescent girls. The condition is characterized by widespread musculoskeletal pain and other associated symptoms, including fatigue, nonrestorative sleep, headaches, irritable bowel symptoms, dysautonomia and mood disorders such as anxiety and/or depression. In the past few years, there has been a greater focus on understanding JFM in adolescents. Research studies have provided insight into the clinical characteristics of this condition and its effect on both short-term and long-term psychosocial and physical functioning. The importance of early and effective intervention is being recognized, as research has shown that symptoms of JFM tend to persist and do not resolve over time as was previously believed. Efforts to improve treatments for JFM are underway, and new evidence strongly points to the potential benefits of cognitive–behavioural therapy on improving mood and daily functioning. Research into pharmacotherapy and other nonpharmacological options is in progress. Advancements in the understanding of adult fibromyalgia have paved the way for future studies on diagnosis, assessment and management of JFM. This Review focuses on our current knowledge of the condition, provides an update of the latest research advances, and highlights areas for further study.

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A bursa is a closed, fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. Bursae is plural for bursa. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When a bursa becomes inflamed, the condition is known as bursitis. Most commonly, bursitis is caused by local soft-tissue trauma or strain injury, and there is no infection (aseptic bursitis). On rare occasions, particularly when the immune system is suppressed, the bursa can become infected with bacteria. This condition is called septic bursitis.

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Krabbe disease, also known as globoid cell leukodystrophy or galactosylceramide lipidosis, is an autosomal-recessive sphingolipidosis caused by deficient activity of the lysosomal hydrolase galactosylceramide beta-galactosidase (GALC). GALC degrades galactosylceramide, a major component of myelin, and other terminal beta-galactose–containing sphingolipids, including psychosine (galactosylsphingosine). Increased psychosine levels are believed to lead to widespread destruction of oligodendroglia in the CNS and to subsequent demyelination. [1, 2, 3]


Krabbe originally described a condition with infantile onset that was characterized by spasticity and a rapidly progressive neurologic degeneration leading to death. Since the original description, numerous cases have been documented that show a wide distribution in age of onset.

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Amblyopia, commonly known as lazy eye, is the eye condition noted by reduced vision not correctable by glasses or contact lenses and is not due to any eye disease. The brain, for some reason, does not fully acknowledge the images seen by the amblyopic eye. This almost always affects only one eye but may manifest with reduction of vision in both eyes. It is estimated that three percent of children under six have some form of amblyopia.

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Lewy body dementia (LBD) is a progressive brain disorder in which Lewy bodies (abnormal deposits of a protein called alpha-synuclein) build up in areas of the brain that regulate behavior, cognition, and movement.

 

A complex disease, LBD can present with a range of symptoms including problems with thinking, memory, moving, sleep and/or changes in behavior, to name a few of the physical, cognitive, and behavioral symptoms.

 

LBD also affects autonomic body functions, such as blood pressure control, temperature regulation, and bladder and bowel function. Progressively debilitating, LBD can also cause people to experience visual hallucinations or act out their dreams.

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Male breast cancer is a rare cancer that forms in the breast tissue of men. Though breast cancer is most commonly thought of as a woman's disease, male breast cancer does occur.Male breast cancer is most common in older men, though it can occur at any age.Men diagnosed with male breast cancerat an early stage have a good chance for a cure. Still, many men delay seeing their doctors if they notice one of the usual signs or symptoms, such as a breast lump. For this reason, many male breast cancers are diagnosed when the disease is more advanced.


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Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body.


Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas.


Although cystic fibrosis requires daily care, people with the condition are usually able to attend school and work, and often have a better quality of life than people with cystic fibrosis had in previous decades. Improvements in screening and treatments mean people with cystic fibrosis now may live into their mid- to late 30s, on average, and some are living into their 40s and 50s.

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MEdulloblastoma is a cancerous tumor—also called cerebellar primitive neuroectodermal tumor (PNET)—that starts in the region of the brain at the base of the skull, called the posterior fossa. These tumors tend to spread to other parts of the brain and to the spinal cord


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Membranous nephropathy (MEM-bruh-nus nuh-FROP-uh-thee) occurs when the small blood vessels in the kidney (glomeruli), which filter wastes from the blood, become damaged and thickened. As a result, proteins leak from the damaged blood vessels into the urine (proteinuria). For many, loss of these proteins eventually causes signs and symptoms known as nephrotic syndrome.In mild cases, membranous nephropathy may get better on its own, without any treatment. As protein leakage increases, so does the risk of long-term kidney damage. In many, the disease ultimately leads to kidney failure. There's no absolute cure for membranous nephropathy, but successful treatment can lead to remission of proteinuria and a good long-term outlook.


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Myelofibrosis is a serious bone marrow disorder that disrupts your body's normal production of blood cells. The result is extensive scarring in your bone marrow, leading to severe anemia, weakness, fatigue and often an enlarged spleen.Myelofibrosis is an uncommon type of chronic leukemia — a cancer that affects the blood-forming tissues in the body. Myelofibrosis belongs to a group of diseases called myeloproliferative disorders.Many people with myelofibrosis get progressively worse, and some may eventually develop a more serious form of leukemia. Yet it's also possible to have myelofibrosis and live symptom-free for years. Treatment for myelofibrosis, which focuses on relieving symptoms, can involve a variety of options.

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Myxofibrosarcoma is a common connective tissue neoplasm of malignant fibrocytes in a myxoid matrix favoring the extremities. Like many other tumors of connective tissue, soft tissue sarcoma exhibits high recurrence rates but is rarely known to metastasize. We present a patient with myxofibrosarcoma of the hand with metastases to the lungs, pleura, and mediastinum. The mediastinal metastasis presented clinically with gastrointestinal symptoms due to compression of the gastroesophageal junction. To our knowledge, this is the first report of metastatic myxofibrosarcoma of the hand and also the first report of metastatic myxofibrosarcoma to mediastinal lymph nodes at the level of the gastroesophageal junction. We also performed a comprehensive literature review of metastatic myxofibrosarcoma.

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Neurofibromatosis is a genetic disorder that causes tumors to form on nerve tissue. These tumors can develop anywhere in your nervous system, including your brain, spinal cord and nerves. Neurofibromatosis is usually diagnosed in childhood or early adulthood.The tumors are usually noncancerous (benign), but sometimes can become cancerous (malignant). Symptoms are often mild. However, complications of neurofibromatosis can include hearing loss, learning impairment, heart and blood vessel (cardiovascular) problems, loss of vision, and severe pain.Neurofibromatosis treatment aims to maximize healthy growth and development and to manage complications as soon as they arise. When neurofibromatosis causes large tumors or tumors that press on a nerve, surgery can help ease symptoms. Some people may benefit from other therapies, such as stereotactic radiosurgery or medications to control pain.

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Have you ever noticed how the skin on your elbows and knees is often darker than the rest of the skin on your arms and legs? It's a bit funny-looking, isn't it? Some people think it's the result of dirt (and sometimes it is), but you'd be surprised to find that dirt often has nothing to do with the dark spots on your elbows and knees.

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Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain or the tissue and structures that are near it. Many different types of pediatric brain tumors exist — some are noncancerous (benign) and some are cancerous (malignant).Treatment and chance of recovery (prognosis) depend on the type of tumor, its location within the brain, whether it has spread, and your child's age and general health. Because new treatments and technologies are continually being developed, several options may be available at different points in treatment.Treatment for brain tumors in children is typically quite different from treatment for adult brain tumors, so it's very important to enlist the expertise and experience of pediatric specialists in neurology and cancer.

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Pineoblastoma is one of several different types of tumors that arise in the area of the pineal gland, requiring different therapies. The exact diagnosis is critical for choosing the correct therapy. Pineal tumors typically present with hydrocephalus, a buildup of fluid pressure within the brain

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A placental abruption is a serious condition in which the placenta partially or completely separates from your uterus before your baby's born.The condition can deprive your baby of oxygen and nutrients, and cause severe bleeding that can be dangerous to you both. A placental abruption also increases the risk that your baby will have growth problems (if the abruption is small and goes unnoticed), be born prematurely, or be stillborn.Placental abruption happens in about one in 150 pregnancies. It's most common in the third trimester but can happen any time after 20 weeks.


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Precocious puberty is when a child's body begins changing into that of an adult (puberty) too soon. Puberty that begins before age 8 in girls and before age 9 in boys is considered precocious puberty.


Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the body's ability to reproduce.


The cause of precocious puberty often can't be found. Rarely, certain conditions, such as infections, hormone disorders, tumors, brain abnormalities or injuries, may cause precocious puberty. Treatment for precocious puberty typically includes medication to delay further development.

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A premature baby is one who is born too early, before 37 weeks. Premature babies may have more health problems and may need to stay in the hospital longer than babies born later. 


They also may have long-term health problems that can affect their whole lives. About 1 in 10 babies is born prematurely each year in the United States. 


The earlier in pregnancy a baby is born, the more likely he is to have health problems. Some premature babies have to spend time in a hospital’s neonatal intensive care unit (also called NICU). This is the part of a hospital that takes care of sick newborns. But thanks to advances in medical care, even babies born very prematurely are more likely to survive today than ever before.

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Presbyopia is when your eyes gradually lose the ability to see things clearly up close. It is a normal part of aging. In fact, the word “presbyopia” means “old eye” in Greek. You may start to notice presbyopia shortly after age 40. You will probably find that you hold reading materials farther away in order to see them clearly.

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Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants.


Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who abuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines.

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Premature labor is also called preterm labor. It’s when your body starts getting ready for birth too early in your pregnancy. Labor is premature if it starts more than three weeks before your due date.

Premature labor can lead to an early birth. But the good news is that doctors can do a lot to delay an early delivery. The longer your baby gets to grow inside you -- right up to your due date -- the less likely he or she is to have problems after birth.


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Pseudobulbar affect (PBA) is a condition that’s characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.

If you have pseudobulbar affect you'll experience emotions normally, but you'll sometimes express them in an exaggerated or inappropriate way. As a result, the condition can be embarrassing and disruptive to your daily life.

Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication.

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Pseudomembranous colitis (PMC) is inflammation in your colon that happens when there's too much of certain bacteria in your system. The most common bacterium that causes PMC isClostridium difficile, or C. diff.

PMC is also called antibiotic-associated colitis or C. difficilecolitis. Most of the time, it's a side effect of taking antibiotics.

People in hospitals or nursing homes also can get PMC, especially if they've just had surgery or are receiving treatment for cancer.

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Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. The name means “false brain tumor” because its symptoms are similar to those caused by brain tumors. It’s also known as idiopathic intracranial hypertension. This condition is treatable, but it can return in some cases.

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Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (deep vein thrombosis).


Because the clots block blood flow to the lungs, pulmonary embolism can be life-threatening. However, prompt treatment greatly reduces the risk of death. Taking measures to prevent blood clots in your legs will help protect you against pulmonary embolism.


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Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel.


With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level.

More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.


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When the occasional headache strikes, most of us take an over-the-counter (OTC) analgesic, such as acetaminophen, ibuprofen, aspirin, or a pain-relief medication containing caffeine. While OTC analgesics can help relieve headache pain they must be taken correctly — or they could actually make your headaches worse. The overuse or misuse of analgesic drugs — exceeding labeling instructions (such as taking the medications three or more days per week) or not following your healthcare provider’s advice — can cause you to "rebound" into another headache. When the pain reliever wears off, you may experience a withdrawal reaction, prompting you to take more medication. This only leads to another headache and the desire to take yet more medication. So the cycle continues until you start to suffer from chronic daily headaches, with more frequent headaches and more severe pain.

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Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. To learn more about how cancers start and spread, see What Is Cancer? For information about the differences between childhood cancers and adult cancers, see Cancer in Children. Retinoblastoma is a cancer that starts in the retina, the very back part of the eye. It is the most common type of eye cancer in children. Rarely, children can have other kinds of eye cancer, such as medulloepithelioma, which is described briefly below, or melanoma.To understand retinoblastoma, it helps to know about the parts of the eye and how they work.


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Sarcomas are cancers that develop from connective tissues in the body, such as muscles, fat, bones, the linings of joints, or blood vessels. There are many types of sarcomas. Rhabdomyosarcoma (RMS) is a cancer made up of cells that normally develop into skeletal muscles. The body has 3 main types of muscles.


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Ringworm of the body is a fungal infection that develops on the top layer of your skin. It's characterized by a red circular rash with clearer skin in the middle. It may itch. Ringworm gets its name because of its appearance. No actual worm is involved. Also called tinea corporis, ringworm of the body is closely related to athlete's foot (tinea pedis), jock itch (tinea cruris) and ringworm of the scalp (tinea capitis). Ringworm often spreads by direct skin-to-skin contact with an infected person or animal. Mild ringworm often responds to antifungal medications that you apply to your skin. For more-severe infections, you may need to take antifungal pills for several weeks


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Rubella is an acute, contagious viral infection. While rubella virus infection usually causes a mild fever and rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or infants with congenital malformations, known as congenital rubella syndrome (CRS). The rubella virus is transmitted by airborne droplets when infected people sneeze or cough. Humans are the only known host.


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Sebaceous glands are part of epidermal appendages. Neoplasms of the sebaceous glands may be benign, such as sebaceous hyperplasia or sebaceous gland adenomas. The malignant sebaceous gland carcinoma most commonly arises in the periocular area. Fewer than 120 cases of sebaceous cell carcinoma have been reported at extraocular sites. The most common site of origin is the meibomian glands of the eyelids, leading to the term meibomian gland carcinoma. However, this neoplasm can occur in other sebaceous glands, such as in the caruncle, the glands of Zeis, and in the eyebrow. Sebaceous cell carcinoma is a lethal eyelid malignancy and can masquerade as benign conditions. Error or delay in diagnosis is common, and this tumor carries a significant mortality rate with metastasis.


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Seborrheic (seb-o-REE-ik) dermatitis is a common skin condition that mainly affects your scalp. It causes scaly patches, red skin and stubborn dandruff. Seborrheic dermatitis can also affect oily areas of the body, such as the face, sides of the nose, eyebrows, ears, eyelids and chest. Seborrheic dermatitis may go away without treatment. Or you may need many repeated treatments before the symptoms go away. And they may return later. Daily cleansing with a gentle soap and shampoo can help reduce oiliness and dead skin buildup.Seborrheic dermatitis is also called dandruff, seborrheic eczema and seborrheic psoriasis. For infants, the condition is known as cradle cap and causes crusty, scaly patches on the scalp.


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Seborrheic keratosis (seb-o-REE-ik ker-uh-TOE-sis) is one of the most common noncancerous skin growths in older adults.A seborrheic keratosis usually appears as a brown, black or light tan growth on the face, chest, shoulders or back. The growth has a waxy, scaly, slightly elevated appearance. Seborrheic keratoses don't become cancerous and aren't thought to be related to sun exposure, but they can look like skin cancer. Seborrheic keratoses are normally painless and require no treatment. You may decide to have them removed if they become irritated by clothing or for cosmetic reasons.

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Your bowels are made up of two parts -- the large intestine, also called the colon, and the small intestine. Short bowel syndrome usually affects people who’ve had a lot of their small intestine removed. Without this part, your body can’t get enough nutrients and water from the food you eat. This causes bowel troubles, like diarrhea, which can be dangerous if you go without treatment.If you learn you have short bowel syndrome, know that doctors can do a lot of things to ease your symptoms and make sure you get the right nutrition. People who have the disease can lead active lives.Over time, your body may adjust to having a shorter small intestine, and you may be able to take fewer medicines. The key is to stick to your treatment plan and get the support you need.


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Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep.There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring. Treatments for obstructive sleep apnea are available. One treatment involves using a device that keep your airway open while you sleep. Another option is a mouthpiece to thrust your jaw forward during sleep. In more severe cases, surgery may be an option too


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The small bowel makes up most of the digestive tract. Cancers of the small bowel are rare. Cancers that have spread to the small bowel from another part of the body, are called secondary cancers. Look at the information about where the cancer started (the primary cancer) because the treatment is the same. 


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Solitary fibrous tumors are rare growths of soft tissue cells that can form nearly anywhere in the body.Solitary fibrous tumors most often occur in the lining around the outside of the lungs (pleural solitary fibrous tumors). Solitary fibrous tumors have also been found in the head and neck, breast, kidney, prostate, spinal cord, and other sites.Most solitary fibrous tumors are noncancerous (benign), but in rare cases, solitary fibrous tumors can be cancerous (malignant). Solitary fibrous tumors tend to grow slowly and may not cause signs and symptoms until they become very large.

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Concern or fear about certain situations, activities, animals or objects is not uncommon. Many people feel anxious when faced with a snake or spider, heights, or travelling by plane. Fear is a rational response to situations that can pose a threat to our safety.However, some people react to objects, activities or situations (the phobic stimulus) by imagining or irrationally exaggerating the danger. Their feelings of panic, fear or terror are completely out of proportion to the actual threat. Sometimes the mere thought of the phobic stimulus, or the sight of it on TV, is enough to cause a reaction. These types of excessive reactions may be indicative of a specific phobia.People with specific phobias are often well aware that their fears are exaggerated or irrational, but feel that their anxious reaction is automatic or uncontrollable. Specific phobias are often associated with panic attacks, during which the person experiences overwhelming physical sensations that may include a pounding heart, choking, nausea, faintness, dizziness, chest pain, hot or cold flushes and perspiration.

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A fold of fat that some people have under their chin and that looks like a second chin

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Spider bites are quite rare. Spiders are not bloodsucking creatures and do not feed on humans.In fact, many species' fangs cannot pierce human skin.The only reason a spider would bite a human is defense. Spiders will bite when they are surprised or feel trapped.Quickly putting a hand or foot into a place where a spider lives, like a shoe or box, may surprise the spider and cause it to attack.A spider may also attack if it is trapped, such as in a jacket that has been hanging in the closet for some time.

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Spina bifida means open spine. The spine (backbone) protects the spinal cord, a bundle of nerves that runs down the middle of your back. The spinal cord carries signals back and forth between your body and your brain. Spina bifida happens when the bones in the spine don’t form correctly, or when the spinal cord doesn’t form correctly, leaving a gap or opening. Spina bifida can happen anywhere along the spine.Spina bifida is the most common kind of neural tube defect (also called NTD). NTDs are birth defects of the brain and spinal cord. Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, in how the body develops or in how the body works.A baby’s neural tube normally develops into the brain and spinal cord. It starts out as a tiny, flat ribbon that turns into a tube by the end of the first month of pregnancy. NTDs happen if the tube doesn’t close completely. About 1,500 to 2,000 babies are born with spina bifida each year in the United States.

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The subarachnoid space is the area between the brain and the skull. It is normally filled with cerebrospinal fluid (CSF), which acts as a floating cushion to protect the brain (see Anatomy of the Brain When blood is released into the subarachnoid space, it irritates the lining of the brain, increases pressure on the brain, and damages brain cells. At the same time, the area of brain that previously received oxygen-rich blood from the affected artery is now deprived of blood, resulting in a stroke. SAH is frequently a sign of a ruptured aneurysm


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Takotsubo cardiomyopathy is a weakening of the left ventricle, the heart's main pumping chamber, usually as the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, a serious accident, or a natural disaster such as an earthquake. (For additional examples, see "Stressors associated with takotsubo cardiomyopathy.") That's why the condition is also called stress-induced cardiomyopathy, or broken-heart syndrome. The main symptoms are chest pain and shortness of breath.

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The features of seizures beginning in the temporal lobe can be extremely varied, but certain patterns are common. There may be a mixture of different feelings, emotions, thoughts, and experiences, which may be familiar or completely foreign. In some cases, a series of old memories resurfaces. In others, the person may feel as if everything – including home and family – appears strange. Hallucinations of voices, music, people, smells, or tastes may occur. These features are called “auras” or “warnings.” They may last for just a few seconds or may continue as long as a minute or two.Experiences during temporal lobe seizures vary in intensity and quality. Sometimes the seizures are so mild that the person barely notices. In other cases, the person may be consumed with fright, intellectual fascination, or even pleasure.The experiences and sensations that accompany these seizures are often impossible to describe, even for the most eloquent adult. And of course it is even more difficult to get an accurate picture of what people are feeling.

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The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw to open and close, enabling you to speak and eat.This abbreviation is also used to refer to a group of health problems related to your jaw. These disorders can cause tenderness at the joint, facial pain, and difficulty moving the joint. According to the National Institute of Dental and Craniofacial Research, as many as 10 million Americans suffer from TMJ. TMJ is more common among women than men. These disorders are treatable, but there are many different possible causes. This can make diagnosis difficult.Keep reading to learn more about TMJ. You should discuss any concerns with your doctor.

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Transient global amnesia is a sudden, temporary episode of memory loss that can't be attributed to a more common neurological condition, such as epilepsy or stroke.During an episode of transient global amnesia, your recall of recent events simply vanishes, so you can't remember where you are or how you got there. In addition, you may not remember anything about what's happening in the here and now. Consequently, you may keep repeating the same questions because you don't remember the answers you've just been given. You may also draw a blank when asked to remember things that happened a day, a month or even a year ago.With transient global amnesia, you do remember who you are, and recognize the people you know well. But that doesn't make your memory loss less disturbing.Fortunately, transient global amnesia is rare, seemingly harmless and unlikely to happen again. Episodes are usually short-lived, and afterward your memory is fine.

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Thromboangiitis obliterans (TAO), an inflammatory vasculopathy also known as Buerger disease, is characterized by an inflammatory endarteritis that causes a prothrombotic state and subsequent vaso-occlusive phenomena. The inflammatory process is initiated within the tunica intima. It characteristically affects small and medium-sized arteries as well as veins of the upper and lower extremities. The condition is strongly associated with heavy tobacco use, and disease progression is closely linked to continued use. (See Pathophysiology and Etiology.)Patients often present with moderate-to-severe claudication that can quickly progress to critical limb ischemia featuring rest pain or tissue loss. Features of acute limb ischemia (eg, pain, paresthesia, palor, mottling, poikilothermia, paresis, and pulselessness) are common signs and symptoms encountered in the emergency setting. [1, 2, 3, 4] (See Presentation.)Pharmacologic therapy is generally ineffective; abstinence from tobacco is the only measure known to prevent disease progression. (See Treatment.) Given the arteritis of the small and medium-sized vessels, surgical or endovascular revascularization may not be possible, because of the absence of a distal target for revascularization. As the disease evolves, amputation may be the only viable option.


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Thrombocytopenia is a condition in which you have a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that help blood clot. Platelets stop bleeding by clumping and forming plugs in blood vessel injuries.Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system problem. Or it can be a side effect of taking certain medications. It affects both children and adults.Thrombocytopenia may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

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Thrombocytosis is a disorder in which your body produces too many platelets (thrombocytes), which play an important role in blood clotting. The disorder is called reactive thrombocytosis or secondary thrombocythemia when it's caused by an underlying condition, such as an infection.Thrombocytosis (throm-boe-sie-TOE-sis) may also, less commonly, be caused by a blood and bone marrow disease. When caused by a bone marrow disorder, thrombocytosis is called autonomous, primary or essential thrombocytosis, or essential thrombocythemia.Your doctor may detect thrombocytosis in routine blood test results that show a high platelet level. If your blood test indicates thrombocytosis, it's important to determine whether it's reactive thrombocytosis or if you have essential thrombocythemia, which is more likely to cause blood clots.


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Thrombophlebitis is inflammation of a vein caused by a blood clot. It typically occurs in the legs. A blood clot is a solid formation of blood cells that clump together. Blood clots can interfere with normal blood flow throughout your body, and are considered dangerous. Thrombophlebitis can occur in veins near the surface of your skin or deeper, down in between your muscle layers.


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A joint is where bones connect and move.  Arthritis is thinning of the cartilage, which is the smooth covering of the joint.  The body reacts to loss of the joint surface by forming bone spurs (osteophytes) Thumb arthritis is a genetic predisposition: like graying and thinning of the hair, it comes with age and it shows up earlier in some families.  Unlike thinning of the hair, women tend to get thumb arthritis sooner than men do.


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Tinea Barbae which is common term known as Beard Fungus or Barber's Itch is a fungal infection of the skin in the area of the face where there is growth of beard meaning that it affects mainly the bottom area of the face and some part of the neck. As the name suggest, Tinea Barbae is solely limited to males and does not affect females in any way. It is usually found in adolescents or young adults. Tinea Barbae has now become quite rare due to the modern hygiene practices which prevent any fungal infections especially in the facial area.


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Tuberous sclerosis complex (TSC) is a genetic disorder affecting cellular differentiation, proliferation, and migration early in development, resulting in a variety of hamartomatous lesions that may affect virtually every organ system of the body.The best-known cutaneous manifestation of TSC is adenoma sebaceum, which often does not appear until late childhood or early adolescence. This lesion is an angiofibroma (ie, cutaneous hamartoma) and is not related to excessive sebum or acne. Flat, reddish macular lesions develop first, which can be mistaken for freckles early on. See the image below.

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Traumatic brain injury (TBI) is a complex injury with a broad spectrum of symptoms and disabilities. The impact on a person and his or her family can be devastating. The purpose of this site is to educate and empower caregivers and survivors of traumatic brain injuries. This site aims to ease the transition from shock and despair at the time of a brain injury to coping and problem solving. Bookmark this site for the latest medical breakthroughs and brain research, the highest quality treatment for brain damage, the symptoms of brain injuries and the nation's best traumatic brain injury rehabilitation centers and resource information.


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Uterine fibroids are benign tumors that originate in the uterus (womb). Although they are composed of the same smooth muscle fibers as the uterine wall (myometrium), they are much denser than normal myometrium. Uterine fibroids are usually round.Uterine fibroids are often described based upon their location within the uterus. Subserosal fibroids are located beneath the serosa (the lining membrane on the outside of the uterus). These often appear localized on the outside surface of the uterus or may be attached to the outside surface by a pedicle. Submucosal (submucous) fibroids are located inside the uterine cavity beneath the inner lining of the uterus. Intramural fibroids are located within the muscular wall of the uterus.

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An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back.Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort.

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Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which also includes ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). [1, 2] Unstable angina is considered to be an ACS in which there is myocardial ischemia without detectable myocardial necrosis (ie, cardiac biomarkers of myocardial necrosis —such as creatine kinase MB isozyme, troponin, myoglobin—are not released into the circulation). See the image below.

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Ureteral obstructions are blockages in your urinary tract, which includes your kidneys, bladder, the tubes that carry urine from your kidneys to your bladder (ureters), and the tube that connects your bladder to the outside of your body (urethra). Blockages can develop for many reasons, including gastrointestinal problems. Ureteral obstructions are more common in men, especially as they get older and their prostate gland enlarges.Obstructions can be cured with surgery, but they need to be treated promptly. If they’re not, they can lead to severe illness, kidney damage and life-threatening infections.

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Imagine that you're exercising. You're working up a sweat, you're breathing hard, your heart is thumping, blood is coursing through your vessels to deliver oxygen to the muscles to keep you moving, and you sustain the activity for more than just a few minutes. That's aerobic exercise (also known as "cardio" in gym lingo), which is any activity that you can sustain for more than just a few minutes while your heart, lungs, and muscles work overtime. In this article, I'll discuss the mechanisms of aerobic exercise: oxygen transport and consumption, the role of the heart and the muscles, the proven benefits of aerobic exercise, how much you need to do to reap the benefits, and more.


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Zumba is an exercise fitness program created by Colombian dancer and cyclist/choreographer Alberto "Beto" "Power Pedal" Perez during the 1990s.[1] Zumba is a trademark owned by Zumba Fitness, LLC. The Brazilian pop singer Claudia Leitte has become the international ambassador to Zumba Fitness. Zumba involves dance and aerobic movements performed to energetic music. The choreography incorporates hip-hop, soca, samba, salsa, merengue and mambo. Squats and lunges are also included.[3] Zumba Fitness, the owner of the Zumba program, does not charge licensing fees to gyms or fitness centers.[4] Approximately 15 million people take weekly Zumba classes in over 200,000 locations across 180 countries


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Those who are looking to feel the burn, baby! Looking to strengthen and tone your legs and glutes? Step right up.We combine the awesome toning and strengthening power of Step aerobics, with the fun fitness-party that only Zumba® brings to the dance-floor.Zumba® Step increase cardio and calorie burning, while adding moves that define and sculpt your core and legs.


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Step aerobics is a classic cardio workout. It's lasted for decades for a simple reason: It delivers results.The "step" is a 4-inch to 12-inch raised platform. You step up, around, and down from the platform in different patterns to boost your heart rate and breathing, and strengthen your muscles.Step aerobics moves range from simple to advanced. The most basic is a step-up, step-down. Once you get more experienced, you do moves that take you over the top and around the step forwards, sideways, and backwards.Most people take step aerobics classes at a gym, with an instructor showing you each move. The instructor and the upbeat music motivate you to keep going.Your class will start with a warm-up, followed by choreographed routines on the step, and a cooldown at the end. In some classes, you'll use hand weights for strength-training moves off the step.


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An exercise ball, also known as a Swiss Ball, is a ball constructed of soft elastic with a diameter of approximately 35 to 85 centimeters (14 to 34 inches) and filled with air. The air pressure is changed by removing a valve stem and either filling with air or letting the ball deflate. It is most often used in physical therapy, athletic training and exercise. It can also be used for weight training. The ball, while often referred to as a Swiss ball, is also known by a number of different names, including balance ball, birth ball, body ball, ball, fitness ball, gym ball, gymnastic ball, physio ball, pilates ball, Pezzi ball, stability ball, Swedish ball, therapy ball, or yoga ball


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If you are bored of lifting heavy weights, doing yoga and other regular stretching exercises then AEROBICS is the right option for you. You will not only enjoy doing it but also reap several health benefits out of it. Aerobics is a kind of cardio workout that causes you to breathe harder, makes you sweat and gets your heart pumping faster than at rest. Dance moves you perform in this, makes the heart and lungs work harder as the body’s need for oxygen is increased. So, get your heart pumping with Bong beauty Bipasha Basu, performing aerobics dance workout.


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An ECG (electrocardiogram) records the electrical activity of your heart at rest. It provides information about your heart rate and rhythm, and shows if there is enlargement of the heart due to high blood pressure (hypertension) or evidence of a previous heart attack (myocardial infarction). However, it does not show whether you have asymptomatic blockages in your heart arteries or predict your risk of a future heart attack. The resting ECG is different from a stress or exercise ECG or cardiac imaging test. You may need an ECG test if you have risk factors for heart disease such as high blood pressure, or symptoms such as palpitations or chest pain. Or you may need it if you already have heart disease. But in other cases, you may think twice about having this test.

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An echocardiogram (echo) is a graphic outline of the heart's movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

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Fetal echocardiography is a test similar to an ultrasound. This exam allows your doctor to better see the structure and function of your unborn child’s heart. It’s typically done in the second trimester, between weeks 18 to 24.


The exam uses sound waves that “echo” off of the structures of the fetus’ heart. A machine analyzes these sound waves and creates a picture, or echocardiogram, of their heart’s interior. This image provides information on how your baby’s heart has formed and whether it’s working properly.


It also allows your doctor to see the blood flow through their heart. This in-depth look allows your doctor to find any defects or abnormalities in the baby’s blood flow or heartbeat.

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The child will lie down tilted slightly on his / her side on a hospital bed in our child-friendly examination room, not an operating room. Many exam rooms are equipped with a television to keep a child entertained and alleviate boredom. The child must be undressed from the waist up and can choose to wear a short gown.


To improve the quality of the pictures, a colorless, warm gel is applied to the skin on the area of the chest where the heart is located. A transducer, a small microphone-like device, is placed on top of the gel and against the skin. The transducer uses sound waves, which bounce off the different parts of a child's heart, creating a picture.


The transducer is moved over the chest, abdominal area, and neck in order to obtain the images.


The sounds you may hear from the echo machine are the sounds of the blood flowing from one chamber to another and the valves opening or closing as the blood moves through the heart.


The colors you see on the screen are not the colors of the blood. The colors tell us what direction the blood is flowing. The red color shows the blood is flowing towards the transducer and the blue color shows blood is flowing away. A child may feel some discomfort from the pressure of the transducer. Pediatric echosonographers are trained to complete scans in as pain-free and patient-sensitive manner as possible. 


A computer interprets the information from the transducer to make an image of the heart appear on the screen. This image is recorded into a digital storage system for the cardiologist to measure and review. 

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A stress echocardiography, also called an echocardiography stress test or stress echo, is a procedure that determines how well your heart and blood vessels are working.


During a stress echocardiography, you’ll exercise on a treadmill or stationary bike while your doctor monitors your blood pressure and heart rhythm. When your heart rate reaches peak levels, your doctor will take ultrasound images of your heart to determine whether your heart muscles are getting enough blood and oxygen while you exercise.


Your doctor may order a stress echocardiography test if you have chest pain that they think is due to coronary artery disease or a myocardial infarction, which is a heart attack. This test also determines how much exercise you can safely tolerate if you’re in cardiac rehabilitation. The test can also tell your doctor how well treatments such as bypass grafting, angioplasty, and anti-anginal or antiarrhythmic medications are working.

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This test is the same as a treadmill exercise test. This test checks the function of the heart during and after physical activity. In addition, an IV will be started and, at the peak of exercise, the patient will be injected with a mild isotope. The patient will then be escorted to the scanning room adjacent to the stress lab for approximately 30 minutes. From there, the patient will be free to leave and will return 3 hours later for a repeat scan.


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TMT Laboratories (a.k.a. Tension Member Technology or simply TMT) is primarily a large-scale mechanical test facility. Our 24,000-square-foot laboratory houses several large test machines with load frames, cylinders, and load cells that range in capacity from a few pounds to several million. These machines and their auxiliary equipment can be configured in various combinations to simulate a wide variety of mechanical service situations. To compliment the mechanical testing, TMT also keeps a large suite of electrical and optical test equipment that can be used to monitor various test parameters during mechanical or stand-alone tests. Since we opened our doors in 1976, we have worked with the oil & gas, telecommunication, military & defense, space & aviation, oceanographic, shipping, automotive, construction, and recreation industries. During this time, we have developed world-renowned expertise in the testing and optimizing of rope and cable systems. Despite our attraction to ropes and cables, we are always looking for new areas to apply our resources. Our test machines, diverse instrumentation, data acquisition equipment, and experienced engineers are ready to tackle a wide range of testing needs.


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A brainstem auditory evoked response (BAER) test measures how your brain processes the sounds you hear. The BAER test records your brainwaves in response to clicks or other audio tones that are played for you. The test is also called a brainstem auditory evoked potentials (BAEP) or auditory brainstem response (ABR) test.


A BAER test can help to diagnose hearing loss and nervous system disorders, especially in newborns, young children, and others who may not be able to participate in a standard hearing test.


BAER tests are often administered to canines and are the only scientifically reliable way to test a dog’s ability to hear with one or both ears.

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An electromyogram (EMG) measures the electrical activity of muscles when they're at rest and when they're being used. Nerve conduction studies measure how well and how fast the nerves can send electrical signals.


Nerves control the muscles in the body with electrical signals called impulses. These impulses make the muscles react in certain ways. Nerve and muscle problems cause the muscles to react in ways that aren't normal.


If you have leg pain or numbness, you may have these tests to find out which nerves are being affected and how much they are affected. These tests check how well your spinal nerves are working. They also check the nerves in your arms and legs.

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We reviewed the records of 52 amyotrophic lateral sclerosis (ALS) patients examined between 1995 and 2000 who had needle electromyography (EMG) of their respiratory muscles, including the diaphragm, at or near the time of their diagnosis. With respiratory function testing, patients with abnormal diaphragmatic EMG at diagnosis (Group 1, n=23) had significantly lower forced vital capacity (FVC), lower daytime arterial PO(2) and higher PCO(2) measurements (p<0.05) than patients with normal diaphragmatic EMG (Group 2, n=29). Twenty-eight percent of the patients without symptoms or signs of respiratory insufficiency at the time they were examined had an abnormal diaphragm EMG. Mean survival of Groups 1 and 2 were similar. However, sub-analysis of patients within each group, comparing those treated with non-invasive positive pressure ventilation (NIPPV) with those not treated, showed that treated patients in Group 1 (abnormal diaphragm EMG) survived significantly longer (p<0.05) than untreated patients. They also started NIPPV earlier than treated patients in Group 2. We conclude that respiratory muscle EMG was simply and safely performed on ALS patients at or around the time of diagnosis. The procedure can detect sub-clinical respiratory muscle dysfunction. The technique used for EMG of the respiratory muscles, its pitfalls and contraindications are also reviewed.

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Electromyography (EMG) is a diagnostic procedure that evaluates the health condition of muscles and the nerve cells that control them. These nerve cells are known as motor neurons. They transmit electrical signals that cause muscles to contract and relax. An EMG translates these signals into graphs or numbers, helping doctors to make a diagnosis.


A doctor will usually order an EMG when someone is showing symptoms of a muscle or nerve disorder. These symptoms may include tingling, numbness, or unexplained weakness in the limbs. EMG results can help the doctor diagnose muscle disorders, nerve disorders, and disorders affecting the connection between nerves and muscles.


There are two components to an EMG test: the nerve conduction study and needle EMG. The nerve conduction study is the first part of the procedure. It involves placing small sensors called surface electrodes on the skin to assess the ability of the motor neurons to send electrical signals. The second part of the EMG procedure, known as needle EMG, also uses sensors to evaluate electrical signals. The sensors are called needle electrodes, and they are directly inserted into muscle tissue to evaluate muscle activity when at rest and when contracted.


During each part of the EMG procedure, one electrode releases a very mild electrical signal while the other electrodes measure how long it takes for the signal to reach them. This mimics the natural electrical signals sent by the nerves to the muscles. The distance between the electrodes and time it takes for a signal to reach them is used to determine the speed at which the nerves are able to send and receive signals. An abnormal speed usually indicates a muscle or nerve disorder.

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This course shows you videos of the commonly studied muscles in the upper extremity, insertional activity and muscle activation and motor unit analysis techniques to help you gain a working understanding of the technical skills you need to perform needle EMG examinations. The video will focus on muscle localization and needle insertion techniques, what results you should expect, how to study the shape, amplitude and duration of motor unit waveforms, pitfalls and common errors you should watch for. Muscles studied include the First Dorsal Interosseous (FDI), the Abductor Pollicis Brevis (APB), the Flexor Carpi Radialis (FCR) the Brachio-Radialis (BR), the Triceps (TRI), the Deltoid (DEL) and the Cervical Paraspinals.

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This test measures the integrity of nerve tracts which conduct the electric impulses. It is used to assess the nature, severity and duration of the nerve lesion and in combination with EMG helps in predicting the chances of recovery after a nerve lesion.The nerves of interest are stimulated with a very low voltage electric current which causes mild tingling over the area stimulated. The test takes 20 min to 1 hour depending upon the number of nerves to be tested. It is very useful, in cases of carpal tunnel syndrome, diabetic neuropathy, traumatic neuropathy, plexopathy, varius vitamin deficiencies.

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This test is used to test the nerves and muscles in your entire lower extremity. Your doctor will usually order this test when he suspects that there may be some type of problem with the nerve supply to your foot and leg. Commonly the EMG/NCV test is used to diagnosis one of the following: Tarsal Tunnel Syndrome, Peripheral Neuropathy, Neuromuscular disorders, Nerve palsy or Paralysis, and Radioculopathy. Your doctor typically will refer you to either a hospital or a neurologist to have the test preformed.

The EMG portion of the test is used to record the electrical activity in your muscles. It can diagnose diseases of the nerves and muscles. It can detect conditions such as tarsal tunnel syndrome, inflamed muscles and pinched nerves. A tiny needle, called an electrode, is inserted directly into a specific muscle belly. The electrode then records the activity during the insertion, while the muscle is at rest, and while the muscle contracts. Nerve and muscle diseases alter the pattern of electrical activity in these muscles, which is record both audibly and on a computer screen. After the first muscle is tested, the electrode may be inserted into another muscle. Muscles chosen for the testing vary with the patient's symptoms and may be modified, depending on the results from the first muscles tested. Total testing time may range from just a few minutes to more than an hour, depending upon how many muscles are tested. After the exam, you may feel tenderness in the tested muscles. There is a slight risk of minor, localized inflammation in muscles during the test. This usually lasts only a few hours. Other common patient complaints are pain with insertion of the electrode.

Most of the time the Nerve Conduction Velocity Test will accompany the EMG Test. The NCV evaluates the health of the peripheral nerve by recording how fast electrical impulse travels through it. A peripheral nerve transmits information between the spinal cord and the muscles. You will be resting on a cart or bed and electrodes will be taped to your skin. A stimulator will be held against your skin, which sends out a small electrical charge along the nerve. You may feel a tingle or your muscles may twitch but this shock is not harmful. Each test will take only a few minutes. After the exam the electrodes will be removed and your skin cleaned. The time between the stimulation and response will be recorded to determine how quickly and thoroughly that the impulse is sent. A number of nervous system diseases may reduce the speed of this impulse. Each nerve test takes just a few minutes to an hour, depending upon how many nerves are being tested.

While the hospital or neurologist's office will give you instructions for the day of the examination, a few general preparations will help. Eat normally and take medication as you usually would. If you are taking a blood thinner, make sure you inform the testing facility and ask the ordering physician about the use of the medication and the timing of the test. Bath or shower the morning of the examination. Avoid bath oils or any skin lotions or emollients the day of the examination.


A typical EMG/NCV of the lower extremity takes approximately 45 minutes. This test is an important tool for diagnosing diseases of the nervous system, you can help ensure the best results if you relax and cooperate with the technicians. Make sure that you ask any questions that you have about the test before it is performed. Your physician will discuss the results with you. If you have any further questions regarding why this test was ordered for you, please ask your physician.



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A nerve conduction study (NCS) involves activating nerves electrically with small safe pulses over several points on the skin, usually on the limbs, and measuring the responses obtained. Usually, the response or signal is measured from the nerve itself or from a muscle supplied by the nerve being activated. This gives information about the state of health of the nerve, muscle and neuromuscular junction (the portion responsible for communication between the nerve and muscle). A commercial device is normally employed to measure the signals.

Electromyography (also known as needle EMG) involves the measuring of electrical activity within muscles by way of a needle electrode. It is rather similar to having an electrical microphone at the tip of the needle. Muscles are electrically active organs, and the signals and patterns of signals can lend additional information regarding the state of the muscle as well as the nerve supplying it.

In Australia, the person responsible for these tests is a neurologist, who frequently has had further training in the subspecialty of clinical neurophysiology.
A doctor may recommend that you undergo this test. There are a wide variety of conditions that are assessed with this technique. Quite frequently, the examination is requested because the patient is experiencing symptoms that suggest some problem with the nerves (numbness, tingling, weakness or pain) or muscles (weakness or pain), even though the physical examination is normal. Indeed, in many cases, there is no abnormality seen and the test can then be reassuring, but it cannot detect all conditions. In general terms, the test is useful for detecting if there is a significant abnormality, but this is also often easier when there is a definite clinical abnormality. In such cases, the test can help clarify what the problem is, although usually, unless the nerve problem is a common entrapment (site of compression), other tests may be required to ascertain the exact nature of the problem.
There are several types of nerves but generally speaking, the two major types are motor and sensory nerves. Motor nerves carry signals from the brain to the muscle to enable contraction and movement, and sensory nerves relay information to the brain. When the nerve is stimulated with metal electrodes (metallic patch/es that can conduct signals), a response can be measured by surface (on the skin) electrodes some distance away in sensory nerves overlying the nerve itself. For the motor nerves, the response is usually detected over the muscle that is activated by that nerve. In this fashion, results can reveal information about the size and speed of the electrically conducted impulse. The size usually reveals the number of nerve fibres present and the speed, the integrity of the myelin (insulating membrane around the nerve ‘axon’ or cable). This is why the word ‘conduction’ is used.
You will be given instructions on how to prepare for the test. You should not use creams or emollients on your hands and feet (the most common sites of your nerve tests) on the day of the test, and preferably since your last shower or bath. Generally speaking, there are no other preparations of note.

Please advise the neurologist performing the test if you have a pacemaker or other similar devices. If you are taking warfarin, heparin or some other medication to thin your blood, and if you are having a needle EMG test, you should advise both your GP and the neurologist. A measurement of how thin your blood is may be important before that test can be performed.
The NCS procedure is usually very safe and is non-invasive. Firstly, you will be told how to position yourself and the skin area will be prepared. Then some electrodes will be attached to your skin and you will be forewarned when to expect the stimulation. Many people are understandably anxious about the intensities of the small safe electrical pulses that are passed via the skin, but usually relax quickly when they know what to expect. It is faily important that you remain relaxed for the recordings to minimise the ‘noise’ (interference) in the recordings from excessive muscular activity.
Here, a small needle is inserted through the skin into a muscle belly. Sterilisation of the skin and a local anaesthetic is not generally required. Usually the consultation and procedure takes about 30-45 minutes in all. More complicated assessments may demand more time.
Following the test, you will be allowed to put on your garments and shoes. It should be noted that the final interpretation of the clinical meaning of the test rests with the clinician who ordered the test. This is because they can put together the whole picture. For this reason, the neurologist performing the test can only give you limited information about the meaning of the results, and may not even be able to provide any information on the next step or any possible treatments because they are unaware of all the other clinical information.


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Proximal conduction studies by F-wave technique, with conventional distal motor and sensory conduction were performed along the ulnar nerves of 20 patients each with cervical spondylotic radiculopathy and/or myelopathy and with classical motor neurone disease (MND). Such F-wave parameters as shortest F-latency, F-conduction velocity, conduction time and F-ratio were calculated. Twenty-five age- and sex-matched healthy volunteers acted as controls. Proximal slowing associated with sensory conduction abnormalities and normal distal motor conduction favored cervical spondylosis (CS). Distal slowing with a normal proximal motor and sensory conduction was associated with motor neurone disease.


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A nerve conduction velocity (NCV) test is used to assess nerve damage and dysfunction. Also known as a nerve conduction study, the procedure measures how quickly electrical signals move through your peripheral nerves.Your peripheral nerves are located outside of your brain and along your spinal cord. These nerves help you control your muscles and experience the senses. Healthy nerves send electrical signals more quickly and with greater strength than damaged nerves.The NVC test helps your doctor differentiate between an injury to the nerve fiber and an injury to the myelin sheath, the protective covering surrounding the nerve. It can also help your doctor tell the difference between a nerve disorder and a condition where a nerve injury has affected the muscles.Making these distinctions is important for proper diagnosis and determining your course of treatment.

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A nerve conduction velocity test (NCV) is an electrical test that is used to determine the adequacy of the conduction of the nerve impulse as it courses down a nerve. This test is used to detect signs of nerve injury. In this test, the nerve is electrically stimulated, and the electrical impulse 'down stream' from the stimulus is measured. This is usually done with surface patch electrodes (they are similar to those used for an electrocardiogram) that are placed on the skin over the nerve at various locations. One electrode stimulates the nerve with a very mild electrical impulse. The resulting electrical activity is recorded by the other electrodes. The distance between electrodes and the time it takes for electrical impulses to travel between electrodes are used to calculate the speed of impulse transmission (nerve conduction velocity). A decreased speed of transmission indicates nerve disease or abnormal pressure on the nerve. A nerve conduction velocity test is often done at the same time as an electromyogram (EMG). An EMG is carried out in order to exclude or detect muscle conditions which may be present due to muscular or neurologic disease.


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The facial nerve conduction velocity was measured in 30 healthy subjects (60 sides) and in 51 patients with a unilateral Bell's palsy. The normal value was 47.8 +/- 5.1 m/s. Incomplete recovery was common in Bell's palsy when the velocity was below 30 m/s. Mild synkinesis was observed in only one patient when the nerve conduction velocity was above 30 m/s. When the degree of degeneration revealed by electroneuroneography did not exceed 60%, the conduction velocity was in the normal range. For degrees of degeneration in excess of this, the conduction velocity decreased in parallel with the increase in the degree of degeneration.


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A somatosensory evoked potential (SSEP) is an evoked potential caused by a physical stimulus (usually a small electric pulse). Electrodes positioned over particular areas of the body record responses of the SSEP, these are then observed as a reading on an electroencephalogram (EEG).  A SSEP can most commonly involve stimulation of the median nerve at the wrist, or the posterior tibial nerve at the ankle. This investigation therefore tests the pathway of the sensory nerves to the sensory areas of the brain, even though the stimuli are non-physiological.


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Somatosensory Evoked Potentials (SSEPs) are electric signals recorded from the scalp or spine following stimulation to the peripheral nerves. They are time-locked responses, representing the function of the ascending sensory pathways. Early in the 1960s Larson et al introduced the use of somatosensory evoked potentials to monitor neural structure during neurosurgical procedures. It was utilized as a supplement to the wake-up test during correctional spinal surgeries for spinal deformities such as scoliosis to provide warning of compromised spinal cord function to the spine surgeons, as reported by McCallum et al and Nash et al in the 1970s. Since then SSEP has become one of the earliest and primary tools for intraoperative neurophysiological monitoring.


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Somatosensory Evoked Potentials (SSEPs) are electrical responses recorded from the nervous system following electrical stimulation of a peripheral nerve.  For example, stimulation of the median nerve at the wrist produces electrical activity that travels along the sensory pathway on its way to the brain. This activity can be recorded with electrodes positioned along that pathway.


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Visual Evoked Potential/ Response (VEP/VER) measures the electrical signal generated at visual cortex in response to visual stimulation. The visual cortex is primarily activated by the central visual field and there is a large presentation of the macula at occipital cortex. VEP depends on integrity of visual pathway including eye, optic nerve, chiasma, optic tract, optic radiation and cerebral cortex. Standard International Society for Clinical Electrophysiology of Vision (ISCEV) protocols[1] assess the anterior visual pathway (eye, optic nerve anterior to the optic chiasma). For dysfunctions of posterior visual pathway extended multi-channel protocols are needed.


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3D movies, 3D books, 3D printing and now 3D dental scans? Do I have to wear those funny looking glasses? Will I get motion sickness or up close and personal with all sorts of creatures? Don’t get yourself into dental distress! 3D dental scans are the newest advancement in technology that your dentist can use to get a good idea of what’s really going on with your chompers — no silly glasses needed.

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A barium enema is a type of X-ray imaging test that allows doctors to examine your lower intestinal tract. It involves delivering a contrast solution that contains the metallic element barium into your rectum while a technician takes X-ray images of the area. The barium solution will be delivered using an enema — a process in which your doctor pushes a liquid into your rectum through your anus.


The barium solution helps to improve the quality of the X-ray images by highlighting certain areas of tissue. The X-ray used in this procedure is known as fluoroscopy. It allows the radiologist to see your internal organs in motion by tracking the flow of the barium solution through your intestinal tract.


The test doesn’t require painkillers or sedation, but there may be moments of slight discomfort.

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Barium tests are used to help see the outline of the upper parts of the gut (gastrointestinal tract) such as the gullet (oesophagus), stomach and upper gut (small intestines). The gut (gastrointestinal tract) does not show up very well on ordinary X-ray pictures. However, if you drink a white liquid that contains a chemical called barium sulfate, the outline of the upper parts of the gut (oesophagus, stomach and small intestines) shows up clearly on X-ray pictures. This is because X-rays do not pass through barium.

Depending on what part of your gut is being looked at, you may have one or more of the tests listed below. In each test, the barium coats the lining of the gut being tested. Therefore, abnormalities in the lining or structure of the gut can be seen on the X-ray pictures. In each of the following tests, several X-ray pictures are taken using low-dose X-rays. The total amount of radiation for each test is quite small and thought to be safe. The X-ray machine is usually linked to a TV monitor. Still pictures, or a video recording of X-ray pictures taken in quick succession, can be taken if necessary.

In this test you drink some barium liquid. The barium liquid is often fruit-flavoured so it is pleasant to drink. You stand in front of an X-ray machine whilst X-ray pictures are taken as you swallow. This test aims to look for problems in the gullet (oesophagus). These include a narrowing (stricture), hiatus hernias, tumours, reflux from the stomach, disorders of swallowing, etc. You will usually be asked not to eat or drink for a few hours before this test. A barium swallow test takes about 10 minutes.

This is similar to a barium swallow (above). However, it aims to look for problems in the stomach and the first part of the gut (small intestine), known as the duodenum. These problems may include ulcers, small fleshy lumps (polyps), tumours, etc. You drink some barium liquid but you then lie on a couch whilst X-ray pictures are taken over your tummy (abdomen). It may take a little longer to do than a barium swallow.

So that the barium coats all around the lining of the stomach, the doctor doing the test (radiologist) may do one or more of the following:

Ask you to swallow some bicarbonate powder and citric acid before swallowing the barium. These 'fizz up' when they mix in the stomach and make some gas. (You may have to resist the urge to burp.) The gas expands the stomach and duodenum and also pushes the barium to coat the lining of the stomach and duodenum. This makes the X-ray pictures much clearer. It is the shape and contours of the lining of the stomach and duodenum which need to be seen most clearly on the pictures.

Ask you to turn over on to your stomach on the couch. Various X-ray pictures may be taken whilst you are in different positions. You may be given an injection of a drug that makes the muscles in the stomach and gut relax.You will usually be asked not to eat anything for several hours before this test. (Food particles in the gut can make it difficult to interpret the X-rays.) However, you may be allowed sips of water up to two hours before the test.


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A barium meal is a diagnostic test used to detect abnormalities of the esophagus, stomach and small bowel using X-ray imaging. X-rays can only highlight bone and other radio-opaque tissues and would not usually enable visualization of soft tissue. However, infusion of the contrast medium barium sulfate, a radioopaque salt, coats the lining of the digestive tract, allowing accurate X-ray imaging of this part of the abdomen.

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Have your dinners planned for the week within seconds!  As a Scramble member, each week you receive a suggested meal plan with:


Five family-friendly dinners complete with main course and one to two easy, healthy side dishes

Meals feature seasonal fruits and vegetables for great flavors and savings

All meals have full nutritional information by meal and by individual dish

An organized shopping list with items listed by grocery store section


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A barium swallow is an imaging test that uses X-rays to look at your upper gastrointestinal (GI) tract. Your upper GI tract includes the back of your mouth and throat (pharynx) and your esophagus.


You may have just a barium swallow. Or this test may be done as part of an upper GI series. This series looks at your esophagus, stomach, and the first part of the small intestine (duodenum).


X-rays use a small amount of radiation to create images of your bones and internal organs. X-rays are most often used to find bone or joint problems, or to check the heart and lungs. A barium swallow is one type of X-ray.


Fluoroscopy is often used during a barium swallow. Fluoroscopy is a kind of X-ray “movie.”


The test also uses barium. Barium is a substance that makes certain area of the body show up more clearly on an X-ray. The radiologist will be able to see size and shape of the pharynx and esophagus. He or she will also be able see how you swallow. These details might not be seen on a standard X-ray. Barium is used only for imaging tests for the GI tract.

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A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. NOF recommends a bone density test of the hip and spine by a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry.


You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone density test. Some people also call it a bone mass measurement test. This test uses a machine to measure your bone density. It estimates the amount of bone in your hip, spine and sometimes other bones. Your test result will help your healthcare provider make recommendations to help you protect your bones.


Are you a postmenopausal woman or man age 50 and older? Have you recently broken a bone? If you answered “yes” to both questions, you should talk to your doctor or other healthcare provider about getting a bone density test if you’ve never had one.

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A carotid Doppler test is generally an outpatient procedure, states Johns Hopkins Medicine. During the test, the patient must lie on his back with his neck bent back slightly. A technician applies a gel to the skin, presses a device called a transducer against the neck, and moves it around the area of the carotid artery. The technician then repeats the process on the other side of the neck. Carotid Doppler tests do not expose patients to radiation, and they usually do not cause any discomfort.


Patients who have carotid artery blockage or narrowing sometimes experience symptoms such as dizziness, confusion, drowsiness or headache that prompt a doctor to perform a carotid Doppler test, states Johns Hopkins Medicine. Other symptoms that may indicate problems with blood flow in the carotid arteries include momentary blindness in one eye or temporary problems speaking or moving. Carotid Doppler is sometimes performed as part of an evaluation prior to major cardiac surgery.

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A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. A regular ultrasound uses sound waves to produce images, but can't show blood flow.


A Doppler ultrasound may help diagnose many conditions, including:


Blood clots

Poorly functioning valves in your leg veins, which can cause blood or other fluids to pool in your legs (venous insufficiency)

Heart valve defects and congenital heart disease

A blocked artery (arterial occlusion)

Decreased blood circulation into your legs (peripheral artery disease)

Bulging arteries (aneurysms)

Narrowing of an artery, such as in your neck (carotid artery stenosis)

A Doppler ultrasound can estimate how fast blood flows by measuring the rate of change in its pitch (frequency). During a Doppler ultrasound, a technician trained in ultrasound imaging (sonographer) presses a small hand-held device (transducer), about the size of a bar of soap, against your skin over the area of your body being examined, moving from one area to another as necessary.


This test may be done as an alternative to more-invasive procedures, such as angiography, which involves injecting dye into the blood vessels so that they show up clearly on X-ray images.


A Doppler ultrasound test may also help your doctor check for injuries to your arteries or to monitor certain treatments to your veins and arteries.

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Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations.

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This study aimed to evaluate the vascular pattern of solid breast lesions using power Doppler ultrasonography (PDUS) and assess whether the presence of intratumoural penetrating vessels can predict breast cancer malignancy.

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Carotid ultrasound uses sound waves to produce pictures of the carotid arteries in the neck which carry blood from the heart to the brain. A Doppler ultrasound study – a technique that evaluates blood flow through a blood vessel – is usually part of this exam. It’s most frequently used to screen patients for blockage or narrowing of the carotid arteries, a condition called stenosis which may increase the risk of stroke.


Little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. A loose-fitting, open necked shirt or blouse is ideal.

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The use of Doppler ultrasound to assess both the changing haemodynamics of the neonatal circulation and the perfusion of the brain is reviewed. The brain is particularly susceptible to both ischaemic and haemorrhagic injury in preterm and asphyxiated infants. However, the unique characteristics of the transitional neonatal circulation, and of the cerebral vasculature, pose considerable problems in the interpretation of Doppler signals from intracranial arteries. A volumetric Doppler method which eliminates some of those problems is discussed. The same method allows full assessment of the cardiovascular status of the newborn infant, including estimation of ductal shunting and left ventricular output. Doppler ultrasound, if used with a full understanding of the inherant assumptions and limitations of the particular methodology, is likely to prove invaluable in investigating pathological cerebral and cardiac vascular events in the newborn.

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With the most advanced Echo-cardiography ultrasound and color Doppler system from Philips which uses a X- Matrix Probe (>9000 piezoelectric crystals) and break-through pure wave single crystal technology deliver high wualty images.


This is the only diagnostic centre in city doing ultrasound contrast study. 

Some of the features are unique in the machine and not available elsewhere. The machine gives extreme resolution for excellent 2D and LIVE 3D (4D) images. It has extreme color sensitivity. 3D images in cross sectional view (all three planes). VOCAL ( Volumetric organ calculation), Multislice CT like images. PANORAMIC images to include a wide area in single image. Dynamic MR to give maximum resolution, Broad band frequency compounding, harmonic imaging etc.

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A recent estimate of the number of men in the United States suffering with complete erectile dysfunction is 10 to 20 million. When partial erectile dysfunction is included, the estimate jumps to 30 million.1 Age-specific prevalence is estimated to be 5% at age 40, increasing to 15% to 25% by age 65. In clinical series, the ratio of organic to psychologic male sexual dysfunction also varies with age: 70% of patients under 35 years of age have a psychogenic cause, and 85% of patients over 50 years of age have organic impotence.2 Patient accounts of coital frequency similarly vary with age: 75% of men in their seventh decade report having coitus once monthly, and 37% of patients 60 to 69 years old describe having weekly coitus.

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Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

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A Doppler ultrasound is a test that uses high-frequency sound waves to measure the amount of blood flow through your arteries and veins, usually those that supply blood to your arms and legs.


Vascular flow studies, also known as blood flow studies, can detect abnormal flow within an artery or blood vessel. This can help to diagnose and treat a variety of conditions, including blood clots and poor circulation. A Doppler ultrasound can be used as part of a blood flow study.


A Doppler ultrasound is a risk-free and pain-free procedure that requires little preparation. The test provides your doctor with important information about the flow of blood through your major arteries and veins. It can also reveal blocked or reduced blood flow through narrowed areas in the arteries, which could eventually lead to a stroke.

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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus. 

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A prospective study comparing colour Doppler ultrasound (US) with the 'gold standard' of intra-arterial digital subtraction angiography in the evaluation of renal transplant artery stenosis was performed. Both the intrarenal vessels and the transplant renal artery were examined by Doppler US. Diagnostic arteriography was performed only if, on Doppler, the peak systolic velocity in the transplant renal artery exceeded 1.5 ms-1. Of 109 patients, the transplant artery could not be visualized using colour Doppler US in three, and these were omitted from statistical analysis. Of the remaining 106 patients, 31 had a peak systolic velocity greater than 1.5 ms-1 in the transplant renal artery and were referred for DSA. Of the multiple renal Doppler indices recorded, the peak systolic velocity in the transplant artery was the best discriminating measurement for the detection of renal artery stenosis. A peak systolic velocity of > or = 2.5 ms-1 in the transplant renal artery had a sensitivity of 100% and a specificity of 95% for the detection of renal artery stenosis ( > 50% diameter reduction). Although a significant difference in Pulsatility Index, Resistive Index, Acceleration Index and Acceleration Time was recorded from the intrarenal vessels in the angiographically normal and stenosed groups with Doppler, these measurements were less useful as discriminating diagnostic tests. In conclusion, the peak systolic velocity in the transplant renal artery is the most sensitive Doppler criterion for renal artery stenosis and is sensitive and specific enough to be used as a screening test. The intrarenal acceleration time and index should not be used in isolation.

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A device called a transducer is passed over the scrotum, directing high-frequency sound waves (ultrasound) at the structures within, including the testicle, epididymis (the tube that transports sperm from the testicle), and blood vessels. The sound waves are reflected back to the transducer and electronically converted into real-time images displayed on a viewing monitor. These images are then saved on film or video and reviewed for abnormalities.

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Color Doppler is an ultrasound-based diagnostic imaging technique used to visualize subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible Pathology or Lesions. Colour Doppler is also used for the following applications:-

Carotid Colour Doppler to detect risk of stroke and paralysis by   evaluating the vessels   in the neck that supply blood to the brain.  Peripherial Arterial Colour Doppler.

Peripherial Venous Colour Doppler for detection of Deep Vein Thrombosis (DVT).

Renal Doppler (especially for hypertensive patients and diabetics).

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Color Doppler ultrasound is a medical imaging technique which is used to provide visualization of the bloodflow, using color processing to add color to the image so that a doctor or care provider can clearly see what is happening inside the body. This technique requires the use of an ultrasound machine which is capable of color Doppler ultrasound, and can be performed in a hospital or clinic as an outpatient procedure. Having this imaging study performed is not usually painful, and the patient does not require sedatives. 

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Venous ultrasound uses sound waves to produce images of the veins in the body. It is commonly used to search for blood clots, especially in the veins of the leg – a condition often referred to as deep vein thrombosis. Ultrasound does not use ionizing radiation and has no known harmful effects.


On occasion, you may be asked not to eat or drink anything but water for six to eight hours beforehand. Otherwise, little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus.

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You will lie on a narrow table that slides into the center of the CT scanner. Most often, you will lie on your back with your arms raised above your head.

Once you are inside the scanner, the machine's x-ray beam rotates around you. Modern "spiral" scanners can perform the exam without stopping.

A computer creates separate images of the belly area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the belly area can be made by stacking the slices together.

You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.

The scan should take less than 30 minutes.

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An angiogram of the head and neck is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the blood vessels of the head and neck camera.gif. An angiogram of the neck (carotid angiogram) can be used to look at the large arteries in the neck that lead to the brain. An angiogram of the head (cerebral angiogram) can be used to look at the veins or the four arteries (four-vessel study) carrying blood to the brain.


During an angiogram, a thin, soft tube called a catheter is placed camera.gif into a blood vessel in the groin (femoral artery or vein) or just above the elbow (brachial artery or vein). The catheter is guided to the head and neck area. Then an iodine dye (contrast material) is injected into the vessel to make the area show clearly on the X-ray pictures. The angiogram pictures can be made into regular X-ray films or stored as digital pictures in a computer.


An angiogram can find a bulge in a blood vessel (aneurysm). It can also show narrowing or a blockage in a blood vessel that slows or stops blood flow. An abnormal pattern of blood vessels (arteriovenous [AV] malformation) or abnormal vessels near a tumor can be seen.


A magnetic resonance angiogram (MRA) or computed tomography angiogram (CTA) may be an option instead of a standard angiogram. Each of these tests is less invasive than an angiogram. Some MRA tests and all CTA tests require an injection of dye. A CTA also involves radiation exposure.


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This is a procedure used to evaluate the blood flow of the arteries in the arms or legs. Using image-guidance, doctors can determine if there is damage to or a blockage of blood flow in an artery. This is helpful in diagnosing certain conditions such as atherosclerosis (hardening of the blood vessel) or damage caused by trauma. This helps doctors in planning for future interventions, including vascular procedures (such as stent placement) or surgery.

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You will be asked to lie on a narrow table that slides into the center of the CT scanner.


While inside the scanner, the machine's x-ray beam rotates around you.


A computer creates many separate images of the body area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the head and neck area can be created by stacking the slices together.


You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.


Complete scans usually take only a few seconds. The newest scanners can image your entire body, head to toe, in less than 30 seconds.

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A computerized tomography (CT) coronary angiogram is an imaging test that looks at the arteries that supply blood to your heart. It might be used to diagnose the cause of chest pain or other symptoms.


A CT coronary angiogram relies on a powerful X-ray machine to produce images of your heart and its blood vessels. These tests are noninvasive and don't require recovery time. Coronary CT angiograms are increasingly an option for people with a variety of heart conditions.


A traditional (not CT-based) coronary angiogram requires that a flexible tube (catheter) be threaded through your groin or arm to your heart or coronary arteries. If you have known coronary artery disease, your doctor might recommend a traditional coronary angiogram because you can also receive treatment during that procedure.

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The first reported case of the use of computed tomography (CT) to guide biopsy was published in 1975 (1). By 1976, CT was heralded as the single most accurate method for guiding biopsy (2). With the increasing availability of CT and the development of percutaneous techniques, this statement has proved true: CT is now the imaging modality of choice for guiding percutaneous procedures. Over the following 20 years, CT-guided procedures were performed by obtaining a planning image of the region of interest and using cutaneous markers to specify a percutaneous access point. Needle advancement was documented by leaving the scanning room and obtaining one to three contiguous images at the level of the needle plane and repeating the process with each subsequent manipulation of the needle. The advent of CT fluoroscopy in the early 1990s allowed the needle to be visualized in real time, expediting the procedure and markedly reducing its overall length, partly because participants did not leave the scanning room (3). However, the use of real-time CT fluoroscopy potentially increased patient radiation dose and, for the first time, exposed physicians, nurses, and technologists to radiation.


Because CT fluoroscopy–guided procedures have become more common, they account for an important portion of the radiation dose delivered to our patient population. It has been shown that radiation dose may be significantly reduced in diagnostic CT examinations with no loss of diagnostic image quality (4). Likewise, dose should be taken into account when planning interventional procedures, and the radiation dose used should be as low as reasonably achievable to complete the procedure successfully. In this article, we discuss how patient dose is estimated and how knowledge of how a radiation dose is distributed over the course of a procedure is essential in developing low-dose protocols. If certain straightforward steps are followed, it is possible to significantly reduce radiation exposure for both patients and physicians

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Bronchoscopy is a procedure that looks inside the lung airways. It involves inserting a bronchoscope tube, with its light and small camera, through your nose or mouth, down your throat into your trachea, or windpipe, and to the bronchi and bronchioles of your lungs. This procedure is used to find the cause of a lung problem. It can detect tumors, signs of infection, excess mucus in the airways, bleeding, or blockages in the lungs. It also can allow your doctor to take samples of mucus or tissue for other laboratory tests, as well as to insert airway stents, or small tubes, to keep your airway open to treat some lung problems.


The procedure is performed using a flexible bronchoscope or a rigid bronchoscope. Flexible bronchoscopy is more common than rigid bronchoscopy, and flexible bronchoscopy usually does not require general anesthesia. Before the procedure, you will be given medicine to relax you. A liquid medicine also will be given to numb your nose and throat. If you have low blood oxygen levels during the procedure, you will be treated with oxygen therapy. If you have a lot of bleeding in your lungs or a large object is stuck in your airway, you may require rigid bronchoscopy in a hospital operating room under general anesthesia.


After the procedure, you will be monitored to make sure you don’t have complications. You may experience a sore throat, cough, or hoarseness that will go away with time. If you had the procedure as an outpatient, you likely will be able to go home after a few hours, but you will need a ride home because of the medicines or anesthesia you received. You will need to follow up with your doctor after the procedure to get your results.


Bronchoscopy is usually safe, but there is a small risk for fever, minor bleeding, or pneumonia. Pneumothorax, or collapsed lung, is a rare but serious side effect that can be treated. Your doctor may do a chest x ray after the procedure to check for lung problems.

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Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of the body.


The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or transferred to a CD or DVD.


CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels.


A cardiac CT scan for coronary calcium is a non-invasive way of obtaining information about the presence, location and extent of calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart muscle. Calcified plaque results when there is a build-up of fat and other substances under the inner layer of the artery. This material can calcify which signals the presence of atherosclerosis, a disease of the vessel wall, also called coronary artery disease (CAD). People with this disease have an increased risk for heart attacks. In addition, over time, progression of plaque build up (CAD) can narrow the arteries or even close off blood flow to the heart. The result may be chest pain, sometimes called "angina," or a heart attack.


Because calcium is a marker of CAD, the amount of calcium detected on a cardiac CT scan is a helpful prognostic tool. The findings on cardiac CT are expressed as a calcium score. Another name for this test is coronary artery calcium scoring.

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Computed Tomography or CT Scan is one of the advanced X-ray procedures. Different from the usual X-ray, CT scan employs multiple X-ray beams and creates a detailed, 3D-like image of the body parts. CT scan of chest—also CT scan thorax—focuses on lungs and is designed for identification of various lung-related disorders. Because CT scan chest gives elaborated images of lungs, it detects and predicts the presence of lung cancer at early stages. A CT scan of abdomen provides the details of the blood vessels, bones and organs in the abdominal cavity.

Let your physician know if you have particular allergies, are pregnant, have diabetes or weigh

more than 135 kg because CT scanners have a weight limit.

Your physician may ask you to do the following prior to the scan:

1. fast for 2–4 hours,

2. stop taking particular medicines,

3. drink a large glass of oral contrast (chemicals to get better images) wait for 60–90

minutes,

4. wear a loose clothing that is comfortable and

5. remove items like dentures, jewellery, hair clips, hearing aids, eyeglasses, etc.

Depending on the type of CT scan – chest/upper abdomen, the contrast may be:

1. delivered through a vein in your forearm or hand,

2. given via the rectum using an enema or

3. taken orally in a liquid form.

CT scan is done for the following: Chest: analysing the abnormalities in the chest; detecting lung cancers or tumours and blood clots or internal injuries; monitoring the effect of lung cancer drugs on cancer; etc. Abdomen: detecting pain or a mass in the abdomen; locating kidney stones; diagnosing cancers, appendicitis, or Crohn’s disease; etc.



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Virtual colonoscopy is a minimally invasive exam to screen for cancer of the large intestine (colon cancer). Virtual colonoscopy is also known as a screening CT colonography.


Unlike traditional colonoscopy, which requires a scope to be inserted into your rectum and advanced through your colon, virtual colonoscopy uses a CT scan to produce hundreds of cross-sectional images of your abdominal organs. The images are combined and digitally manipulated to provide a detailed view of the inside of the colon and rectum.


Virtual colonoscopy is one option used to screen for colon cancer. Discuss your colon cancer screening options with your doctor to determine whether virtual colonoscopy is the right option for you.

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The spinal cord is made up of three bones: lumbar, dorsal, and cervical. The dorsal spine, the middle portion of the cord, comprises 12 vertebrae and forms the largest portion. A CT scan with a Virtualscopy test of the dorsal spine gives a 3D scanned image of the spine. It is useful in getting a clear picture of the condition of the bones and helps in detecting any abnormalities in the same. Back pain and multiple sclerosis are the most common symptoms that call for a CT scan test of the dorsal spine. It is a relatively painless procedure.

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noninvasive X-ray test that is used to diagnose a variety of medical conditions.


It provides detailed cross sectional images of the body part in question to provide more clarity and detailed images than traditional X-rays.


A CT scan of the facial area produces images of a patient’s sinus cavity.

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A CT of the head is an exam which takes thin slice images of the brain, brain stem and skull. This is very useful to diagnose stroke, trauma, congenital defects, bleeding and possible masses. A CT of the orbit is an exam which takes thin slice images of the eye and orbital socket at three different angles. This helps in the diagnosis of things such as injury, diseases and congenital effects.

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Triphasic spiral liver Computed Tomography (CT) is a standardized procedure for the detection and characterization of a large variety of benign and malignant liver lesions. This helps in the decline of mortality and morbidity rates among patients with liver disease. Spiral computed tomography has gained acceptance as the preferred computed tomography technique for routine liver evaluation because it provides image acquisition at peak enhancement of liver parenchyma during a single breath hold. In addition fast data acquisition allows successive scanning of the entire liver at different intervals after injection of the iodinated contrast material, thus creating the possibility of multiphase liver computed tomography.

Triphasic CT scan is a good non-invasive tool and can be used as first line imaging modality for differentiating benign and malignant focal liver lesions. Benign lesions like haemangioma can be reliably differentiated from malignant liver lesion; therefore unnecessary biopsies can be avoided. It is also particularly useful for hypervascular lesions which can be easily missed on routine CT scanning.



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The advent of high-resolution computed tomography (CT) scanning in the 1980s has revolutionized diagnostic imaging of the temporal bone. CT scanning offers the greatest structural definition of any currently available imaging modality. [1, 2] The purpose of this article is to familiarize the reader with the normal anatomy of the temporal bone depicted by CT scanning. The article reviews the anatomy of the middle ear space and surrounding bone and presents radiographic imaging in both axial and coronal views, with labeled salient features and relevant text.


An axial view through the superior portion of the temporal bone can be seen below.


A study by Visvanathan and Morrissey used high-resolution CT scanning to determine that temporal bone variations are not uncommon. Evaluating 339 temporal bones, the investigators found that the incidences of deep sinus tympani, anteriorly located sigmoid sinus, high dehiscent jugular bulb, enlarged internal auditory meatus, and enlarged cochlear aqueduct were 5.01%, 2.94%, 2.76%, 1.76%, and 0.58%, respectively.

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A doctor or physician may order a CT scan of the leg to make detailed pictures and analyze the internal structure. Computerized tomography (CT) scanning is useful to get a very detailed 3D image of certain parts of legs.


The process begins by taking many different X-ray views at various different angles, which are then combined with the use of computer processing to create cross-sectional images of the bones and soft tissue inside of your body, including tissues inside of solid organ. Ordinary X-ray testing does not show clear images of soft tissue, so doctors often request CT scanning to get a good image of soft tissue including organs, muscles, blood vessels, nerves, and the brain. Sometimes a contrast dye is used as it shows up clearer on the screen.


A quality CT scan of the leg will use multiple x-rays to make cross sectional pictures of the leg.

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Computed tomography (CT) of the abdomen and pelvis is a diagnostic imaging test used to help detect diseases of the small bowel, colon and other internal organs and is often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.


Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking, and allergies. You will be instructed not to eat or drink anything for a few hours beforehand. If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. These medications must be taken 12 hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A CT scan, commonly referred to as a CAT scan, is a type of X-ray that produces cross-sectional images of a specific part of the body. In the case of a lumbar spine CT scan, your doctor can see a cross-section of your lower back. The scanning machine circles the body and sends images to a computer monitor, where they are reviewed by a technician.


The lumbar portion of the spine is a common area where back problems occur. The lumbar spine is the lowest portion of your spine. It’s made up of five vertebral bones. Below the lumbar spine is the sacrum and below the sacrum is the coccyx (tailbone). Large blood vessels, nerves, tendons, ligaments, and cartilage are also part of the lumbar spine.

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CT scanning-sometimes called CAT scanning-is a noninvasive medical test that helps physicians diagnose and treat medical conditions.


CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.


CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.


Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders.

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Direct examination via endoscopy remains the criterion standard for evaluation of laryngotracheobronchial pathologic conditions. Endoscopy allows for easy visualization and accurate diagnosis of mucosal and superficial submucosal lesions. However, the evaluation of deeper structures is capable only through CT imaging or MRI. CT imaging has become the most commonly used technique for general laryngeal imaging. It is readily available at most hospitals and even at some outpatient centers. The acquisition time for a CT image is extremely short (within a matter of seconds), which is quite useful for the laryngeal examination, as patients are generally required to hold their breath to reduce movement. [1, 2]


Nevertheless, small lesions may still be difficult to visualize. In these cases, active techniques such as the Valsalva maneuver and phonation can better delineate masses of the hypoglottis and vocal cords, respectively.


MRI has also become more widely available in the past decade, although it has not surpassed CT scanning for conventional laryngeal imaging. Both techniques have advantages and disadvantages. For example, CT and MRI appear to be comparable in efficacy for defining the site and extent of disease in fat and muscle. MRI, however, is more sensitive for detecting pathologic involvement of cartilage (Glastonbury). CT imaging is best for evaluation of occult fractures and dislocations during laryngeal trauma. Furthermore, MRI seems to be the optimal method for examining cooperative patients, especially for preoperative larynx evaluation when partial laryngectomy is considered. CT imaging is more useful in patients who cannot lie still for the study (eg, inebriated, combative). The imaging study performed usually depends on the experience of the radiologist. Additionally, MRI avoids radiation exposure. For more information, please see the Medscape Reference articleMR Imaging of the Larynx.

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A computed tomography (CT) scan of the orbit is an imaging method. It uses x-rays to create detailed pictures of the eye sockets (orbits), eyes and surrounding bones.

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Computed tomography (CT) perfusion of the head uses special x-ray equipment to show which areas of the brain are adequately supplied with blood (perfused) and provides detailed information about blood flow to the brain. CT perfusion is fast, painless, noninvasive and accurate. It’s a useful technique for measuring blood flow to the brain, which may be important for treating stroke, brain blood vessel disease and brain tumors.

Computed tomography (CT) perfusion imaging shows which areas of the brain are adequately supplied or perfused with blood and provides detailed information on delivery of blood or blood flow to the brain.

CT perfusion scanning is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.

CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.

In many ways CT scanning works very much like other x-ray examinations. Different body parts absorb the x-rays in varying degrees. It is this crucial difference in absorption that allows the body parts to be distinguished from one another on an x-ray film or CT electronic image.

In a conventional x-ray exam, a small amount of radiation is aimed at and passes through the part of the body being examined, recording an image on a special electronic image recording plate. Bones appear white on the x-ray; soft tissue, such as organs like the heart or liver, shows up in shades of gray, and air appears black.With CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate around you, measuring the amount of radiation being absorbed throughout your body. Sometimes, the examination table will move during the scan, so that the x-ray beam follows a spiral path. A special computer program processes this large volume of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the image slices are reassembled by computer software, the result is a very detailed multidimensional view of the body's interior.

Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, allow thinner slices to be obtained in a shorter period of time, resulting in more detail and additional view capabilities.


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PNS is the full form of Para Nasal Sinuses. A Computed Tomography (CT) Scan of the PNS is an imaging test of sinuses which uses X-Rays to bring out in-depth images of air-filled spaces within the bones of the face, surrounding the nasal cavity. It usually includes the upper area of the throat, behind the nose. Some doctors refer to CT Scan PNS as Sinus CT Scan also. 

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A CT scan uses X-rays to make detailed pictures camera.gif of the spine and vertebrae camera.gif.


During the test, you will lie on a table that is attached to the CT scanner, which is a large doughnut-shaped machine. The CT scanner sends X-rays through the body. Each rotation of the scanner takes a second and provides a picture of a thin slice of the organ or area being studied. One part of the scanning machine can tilt to follow the curve of your spine. All of the pictures are saved as a group on a computer. They also can be printed.


In some cases, a dye called contrast material may be put in a vein (IV) in your arm or into the spinal canal. The dye makes structures and organs easier to see on the CT pictures. The dye may be used to check blood flow and look for tumors, areas of inflammation, or nerve damage.

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Abdominal and Pelvic CT scan shows the abdominal and pelvic organs of our body (such as the pancreas, liver, kidneys, spleen, and adrenal glands) and the gastrointestinal tract. A doctor usually orders this test to check for a cause of abnormal pain and sometimes to follow-up on an abnormality seen on another test such as an ultrasound.

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A CT (computed tomography) scan, which is also called a CAT scan, is a type of specialized X-ray. The scan can show cross-sectional images of a specific area of the body. With a CT scan, the machine circles the body and sends the images to a computer, where they’re viewed by a technician.


An abdominal CT scan helps your doctor see the organs, blood vessels, and bones in your abdominal cavity. The multiple images provided give your doctor many different views of your body.


Keep reading to learn why your doctor may order an abdominal CT scan, how to prepare for your procedure, and any possible risks and complications.

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Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of the body.


The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or transferred to a CD or DVD.


CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels.


Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancer, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders.

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X-ray imaging, also called radiography, is a fast and easy way to identify and diagnose bone injuries and disorders such as arthritis, cancer, osteoporosis, fractures and infections. It is also used in conjunction with orthopedic surgery to ensure that a fracture or other injury has been properly aligned, and it can aid in the detection and diagnosis of abnormalities in the chest organs, including the heart and lungs. X-rays may be followed up with MRI, PET, CT, or ultrasound imaging if further testing is needed.

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A fistulogram is a special x-ray procedure. It uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to produce images of an abnormal passage within the body called a fistula. It looks at the blood flow in your fistula or graft (dialysis access). This procedure can check to see if it is blocked or if there is any narrowing (stenosis).

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Fluoroscopy is a study of moving body structures. It’s much like an X-ray "movie" and is often done while a contrast dye moves through the part of the body being examined. A continuous X-ray beam is passed through the body part and sent to a video monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, allows healthcare providers to look at many body systems, including the skeletal, digestive, urinary, cardiovascular, respiratory, and reproductive systems.


Fluoroscopy may be used to evaluate specific areas of the body. These include the bones, bowel, muscles, heart vessels, and joints.

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Hysterosalpingography is a procedure where x rays are taken of a woman's reproductive tract after a dye is injected.Hystero means uterus and salpingo means tubes, so hysterosalpingography literally means to take pictures of the uterusand fallopian tubes. This procedure may also be called hysterography (or HSG).As with other types of pelvic examinations, the woman will lie on her back on an examination table with her legssometimes raised in stirrups. The x-ray equipment is placed above the abdomen.A speculum is inserted into the vagina and a catheter (a thin tube) is inserted into the uterus through the cervix (theopening to the uterus). A small balloon in the catheter is inflated to hold it in place. A liquid water-based or oil-based dyeis then injected through the catheter into the uterus. This process can cause cramping, pain, and uterine spasms.As the dye spreads through the reproductive tract, the doctor may watch for blockages or abnormalities on an x-raymonitor. Several x rays will also be taken. The procedure takes approximately 15-30 minutes. The x rays will bedeveloped while the patient waits, but the final reading and interpretation of the x rays by a radiologist (a doctor whospecializes in x rays) may not be available for a few days.Interestingly, sometimes the hysterosalpingography procedure itself can be considered a treatment. The dye used cansometimes open up small blockages in the fallopian tubes. The need for additional test procedures or surgical treatmentsto deal with infertility should be discussed with the doctor.


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Intravenous pyelogram (IVP) is an x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder and help diagnose blood in the urine or pain in your side or lower back. An IVP may provide enough information to allow your doctor to treat you with medication and avoid surgery.Inform your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to iodine-based contrast materials. Your doctor may instruct you to take a mild laxative the evening before the exam and to not eat or drink anything after midnight. Wear loose, comfortable clothing and leave jewelry at home. You may be asked to wear a gown.


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Mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer early – before women experience symptoms – when it is most treatable. Tell your doctor about any breast symptoms or problems, prior surgeries, hormone use, whether you have a family or personal history of breast cancer, and if there’s a possibility you are pregnant. If possible, obtain copies of your prior mammograms and make them available to your radiologist on the day of your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. Don’t wear deodorant, talcum powder or lotion under your arms or on your breasts as these may appear on the mammogram and interfere with correct diagnosis.

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Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.


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A micturating cysto-urethrogram (or MCU) is a study using X-rays that shows the bladder and urethra (the tube that carries urine from the bladder and out of the body) while passing urine (see children’s X-ray examination). The test is performed to find out if the urine goes from the bladder back up to the kidneys instead of out through the urethra, known as vesico-ureteric reflux (VUR). This can be the cause of recurrent urinary tract (in the bladder or kidneys) infection and kidney damage. The test also shows how the bladder empties and what the urethra looks like.This test is most commonly performed on children under six months of age, but can be used less commonly as an investigation for older children and adults with multiple recurrent urinary tract infections.


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MR angiography (MRA) uses a powerful magnetic field, radio waves and a computer to evaluate blood vessels and help identify abnormalities or diagnose atherosclerotic (plaque) disease. This exam does not use ionizing radiation and may require an injection of a contrast material called gadolinium, which is less likely to cause an allergic reaction than iodinated contrast material. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. In some instances, your doctor will provide you with a card that includes information about your implant to give to the technologist. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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Constipation has a high prevalence in the general population and is a cause for significant morbidity. It has been estimated that approximately 10% of the Indian population suffers from constipation. [1] Chronic constipation leads to approximately 2.5 million visits to the physicians in the United States annually. [2] Various definitions have been used for chronic constipation. However, recently, the Rome II criteria were developed to promote consistency in the diagnosis. [3] Constipation may be primary or secondary. Primary constipation may be due to slow transit disorder or anorectal expulsion disorder (obstructive defecation) or a combination of these. According to the National Institute for health and Clinical Excellence (NICE) guidelines issued in 2010, obstructed defecation syndrome (ODS) is characterized by the urge to defecate but an impaired ability to expel the fecal bolus. Symptoms include unsuccessful fecal evacuation attempts, excessive straining, pain, bleeding after defecation, and a sense of incomplete fecal evacuation. [4] Patients may also resort to digital rectal evacuation. Evaluation and treatment of these patients has been difficult. Magnetic resonance defecography (MRD) has been shown to demonstrate the structural abnormalities associated with ODS, and patients with significant structural abnormalities may benefit from surgical interventions like stapled transanal resection of rectum (STARR). Patients who do not demonstrate significant structural abnormalities can be referred for biofeedback techniques. We present our experience in a large series of patients with suspected ODS who underwent MRD at our tertiary care center.


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Mammography is a screening tool for breast cancer. At NM Medical we employ advanced digital imaging technology for the dual benefits of optimum diagnostic quality and maximum patient comfort. Mammography is important because in its earliest stages breast cancer may not be palpable; it may be too small to feel as a lump or tissue change. Mammography can help detect these changes two years or more before you would feel them. Physical examination is also important because pre-menopausal breast tissue is often dense and fibrous, which may decrease the reliability of mammography for young women.

  

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You can have peace of mind that we place you first with a focus on giving you comprehensive benefits, value for money and services to improve the quality of care available to you. As a Discovery Health Medical Scheme member you have access to the broadest and best level of healthcare cover in the market based on your medical condition needs. Depending on your medical aid plan, we cover for in- and out-hospital tests and screening, including investigations, radiology and blood tests, vaccinations for adults and children and blood tests


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MR spectroscopy (MRS) allows tissue to be interrogated for the presence and concentration of various metabolites. Grossman and Yousem said "If you need this to help you, go back to page 1; everything except Canavan has low NAA, high Choline". This is perhaps a little harsh, however it is fair to say that MRS often does not add a great deal to an overall MR study but does increase specificity, and may help in improving our ability to predict histological grade.


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Diffusion tensor imaging tractography, or DTI tractography, is an MRI (magnetic resonance imaging) technique that measures the rate of water diffusion between cells to understand and create a map of the body’s internal structures; it is most commonly used to provide imaging of the brain. This advanced imaging technique, which provides much more detailed images of the brain than a conventional MRI, may also be used in the diagnosis of stroke, acute ischemia, brain tumors and multiple sclerosis, as well as pre-operative planning.  Using MRI technology, DTI tractography is non-invasive and uses radio waves and a magnetic field to produce images of the brain, tissues and skull. MRI technology provides detailed images showing small changes in body tissue and blood flow, which makes it an extremely reliable tool for the detection of disease, injury, bleeding and swelling.  Loyola offers state-of-the-art imaging and diagnostic techniques in order to provide timely and accurate diagnosis for our patients. Our expert radiologists are recognized nationally for clinical excellence, innovative diagnostic and therapeutic methods and skilled use of the latest technology. Our experienced technologists provide testing in a caring and compassionate environment where we want you to feel comfortable asking any questions you may have about your test or procedure. 


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Magnetic resonance cholangiopancreatography or MRCP uses a powerful magnetic field, radio waves and a computer to evaluate the liver, gallbladder, bile ducts, pancreas and pancreatic duct for disease. It is noninvasive and does not use ionizing radiation. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam


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A magnetic resonance angiogram (MRA) is a type of magnetic resonance imaging (MRI) scan that uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. In many cases MRA can provide information that can't be obtained from an X-ray, ultrasound, or computed tomography (CT) scan. MRA can find problems with the blood vessels that may be causing reduced blood flow. With MRA, both the blood flow and the condition of the blood vessel walls can be seen. The test is often used to look at the blood vessels that go to the brain, kidneys, and legs. Information from an MRA can be saved and stored on a computer for further study. Photographs of selected views can also be made.During MRA, the area of the body being studied is placed inside an MRI machine. Contrast material is often used during MRA to make blood vessels show up more clearly.


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Ankle pain and ankle injuries are common. Physicians must carefully eliminate other conditions before making an ankle arthritis diagnosis. Physicians use a comprehensive approach that is verified by diagnostic imaging to arrive at a clinical diagnosis.Below is a description of the process physicians use to determine if a patient’s symptoms are caused by ankle osteoarthritis.

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Magnetic resonance (MR) imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The exquisite soft-tissue contrast resolution, noninvasive nature, and multiplanar capabilities of MR imaging make it especially valuable for the detection and assessment of a variety of soft-tissue disorders of the ligaments (eg, sprain), tendons (tendinosis, peritendinosis, tenosynovitis, entrapment, rupture, dislocation), and other soft-tissue structures (eg, anterolateral impingement syndrome, sinus tarsi syndrome, compressive neuropathies [eg, tarsal tunnel syndrome, Morton neuroma], synovial disorders). MR imaging has also been shown to be highly sensitive in the detection and staging of a number of musculoskeletal infections including cellulitis, soft-tissue abscesses, and osteomyelitis. In addition, MR imaging is excellent for the early detection and assessment of a number of osseous abnormalities such as bone contusions, stress and insufficiency fractures, osteochondral fractures, osteonecrosis, and transient bone marrow edema. MR imaging is increasingly being recognized as the modality of choice for assessment of pathologic conditions of the ankle and foot.


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Magnetic resonance imaging (MRI) of the brain is a safe and painless test that uses a magnetic field and radio waves to produce detailed images of the brain and the brain stem. An MRI differs from a CAT scan (also called a CT scan or a computed axial tomography scan) because it does not use radiation. An MRI scanner consists of a large doughnut-shaped magnet that often has a tunnel in the center. Patients are placed on a table that slides into the tunnel. Some centers have open MRI machines that have larger openings and are helpful for patients with claustrophobia. MRI machines are located in hospitals and radiology centers. During the exam, radio waves manipulate the magnetic position of the atoms of the body, which are picked up by a powerful antenna and sent to a computer. The computer performs millions of calculations, resulting in clear, cross-sectional black and white images of the body. These images can be converted into three-dimensional (3-D) pictures of the scanned area. This helps pinpoint problems in the brain and the brain stem when the scan focuses on those areas.


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Magnetic Resonance Imaging is a highly advanced imaging modality. Epilepsy Protocol MRI involves obtaining images of brain slices through MRI scanning in epileptic patients. This scanning enables the doctor in obtaining evidences of abnormalities or injuries in brain. Underlying pathologies inside of brain like infections or tumors cannot be seen externally. Such occurrences can be investigated through an MRI Epilepsy Protocol. As a result, MRI becomes the most accurate mode for planning line of treatment.


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HE  MRI technician should be informed if you have any inner ear implants, artificial joints, a defibrillator or pacemaker, particular types of heart valves, vascular stents, brain aneurysm clips.

The staff will ask you to remove anything that contains metal, including jewelry, sunglasses or any electronic gadgets. All these interferes with the MRI machine’s ability to produce a clear image. Braces and dental fillings will typically not pose a problem, but pens, pins, and certain dental appliances can interfere. 

In the case of implants and pacemakers, those items can stop working properly due to an MRI’s magnetic field.

You will be asked to wear a hospital gown or clothing that doesn’t contain metal fasteners. 

Lastly if you’re pregnant , kindly inform the staff, the doctor may postponed the test if required.

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Magnetic resonance imaging (MRI) of the chest uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the chest. It is primarily used to assess abnormal masses such as cancer and determine the size, extent and degree of its spread to adjacent structures. It’s also used to assess the anatomy and function of the heart and its blood flow. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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CSF flow studies are performed using a variety of MRI techniques and are able to qualitatively assess and quantify pulsatile CSF flow. The most common technique used is time resolved 2D phase contrast MRI with velocity encoding. Note, when referring to CSF flow in the setting on imaging we are referring to pulsatile to-and-fro flow due to vascular pulsations rather than bulk transport of CSF (the mechanism by which produced CSF is absorbed, via absorption at arachnoid granulations and via the glymphatic pathway). The latter is too slow to be easily assessed clinically. 


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The anatomy of the craniovertebral junction, although complex, may be well visualized by routine MR imaging. This essay discusses the anatomy of the complex articulations of the craniovertebral junction. Representative MR images and gross anatomic photographs are presented to illustrate the intricate ligamentous and articular anatomy. Knowledge of the normal anatomy of the occipitoatlantoaxial region is necessary in order to understand the common disorders that affect this area. The most common disorders are trauma and arthropathies, but also include congenital abnormalities and neoplasm. The resultant abnormal mechanics may lead to neurologic sequelae or pain

 

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 Magnetic Resonance Imaging (MRI) of the dorsal spine is a non invasive process used to scan the dorsal section of your spinal cord. It uses radio waves and high intensity magnetic fields to learn about the internal tissue structures of the dorsal spine. This scanning technique is used for various diagnostic as well as treatment purposes


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Magnetic Resonance Imaging (MRI) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. MR imaging uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. The images can then be examined on a computer monitor, transmitted electronically, printed or copied to a CD. MRI does not use ionizing radiation (X-rays). Detailed MR images allow physicians to better evaluate various parts of the body and determine the presence of certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning)


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The right hip pain diagnosis is essential to obtaining the right care. Specialization and unmatched experience are the hallmarks of the Center for Hip Preservation’s medical staff. The advanced hip pain tests available at our center assist our specialists in making the right diagnosis and pursuing the right treatment. Both a physical examination and radiological examinations are conducted to diagnose hip joint pain. Without an official reading by an experienced radiologist, subtle X-ray findings (e.g., tears, infections, systematic diseases, tumors, etc.) may remain undetected until such time as an abnormality has progressed to the point where a non-imaging specialist may identify it. Delays in diagnosis add to medical cost and may considerably effect treatment and ultimate patient outcome. The skilled staff members at the Center for Hip Preservation help patients and families understand their hip pain and all of the treatment options available.


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Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Lateral hip pain occurs with greater trochanteric pain syndrome. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses; however, a rational approach to the hip examination can be used. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance arthrography is the diagnostic test of choice for labral tears.


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Magnetic resonance imaging (MRI) of the knee uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the knee joint. It is typically used to help diagnose or evaluate pain, weakness, swelling or bleeding in and around the joint. Knee MRI does not use ionizing radiation, and it can help determine whether you require surgery. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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 Magnetic resonance imaging (MRI) is a test done with a large machine that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the belly. In many cases MRI gives information about structures in the body that cannot be seen as well with an X-ray, ultrasound, or CT scan. For an MRI test, you are placed inside the magnet so that your belly is inside the strong magnetic field. MRI can find changes in the structure of organs or other tissues. It also can find tissue damage or disease, such as infection or a tumor. Pictures from an MRI scan are digital images that can be saved and stored on a computer for further study. The images also can be reviewed remotely, such as in a clinic or an operating room. Photographs or films of selected pictures can also be made.In some cases, contrast material may be used during the MRI scan to show certain structures more clearly in the pictures. The contrast material may be used to check blood flow, find some types of tumors, and show areas of inflammation or infection.


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 An MRI scan uses magnets and radio waves to capture images inside your body without making a surgical incision. The scan allows your doctor to see the soft tissue of your body, like muscles and organs, in addition to your bones. An MRI can be performed on any part of your body. A lumbar MRI specifically examines the lumbar section of your spine — the region where back problems commonly originate.The lumbosacral spine is made up of the five lumbar vertebral bones (L1 thru L5), the sacrum (the bony “shield” at the bottom of your spine), and the coccyx (tailbone). The lumbosacral spine also consists of large blood vessels, nerves, tendons, ligaments, and cartilage.


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Myelography uses a real-time form of x-ray called fluoroscopy and an injection of contrast material to evaluate the spinal cord, nerve roots and spinal lining (meninges). It is particularly useful for assessing the spine following surgery and for assessing disc abnormalities in patients who cannot undergo MRI. You will be instructed on how to prepare. Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to iodinated contrast materials. You may be advised to stop taking blood thinners or other medications several days prior to your exam. You also may be told to avoid solid food and increase your fluid intake beforehand. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.


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Neoplastic disease of the nose, paranasal sinuses, the nasopharynx and the parapharyngeal space requires thorough assessment of location and extent in order to plan appropriate treatment. CT allows the deep soft tissue planes to be evaluated and provides a complement to the physical examination. It is especially helpful in regions involving thin bony structures (paranasal sinuses, orbita); here CT performs better than MRI. MRI possesses many advantages over other imaging modalities caused by its excellent tissue contrast. In evaluating regions involving predominantly soft tissue structures (ec nasopharynx and parapharyngeal space) MRI is superior to CT. The possibility to obtain strictly consecutive volume data sets with spiral CT or 3D MRI offer excellent perspectives to visualize the data via 2D or 3D postprocessing. Because head and neck tumors reside in a complex area, having a 3D model of the anatomical features may assist in the delineation of pathology. Data sets may be transferred directly into computer systems and thus be used in computer assisted surgery.


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Head and neck MRI uses a strong magnetic field combined with radiofrequency waves to create highly detailed, cross-sectional images of internal structures in the head and neck area; these scans are examined for abnormalities. For certain studies, an MRI contrast dye such as gadolinium may be injected to provide better definition of soft tissues and blood vessels and thus enhance the images. Head and neck MRI is used to detect abnormalities outside of the skull.


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Orbit/Face MRI is a painless radiology exam which may be performed to help visualize the face area in a non-invasive manner. It aids doctors in visualizing tumors, infection, inflammation, and any neck disorders that a patient might have.


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A pelvis MRI (magnetic resonance imaging) scan is an imaging test that uses a machine with powerful magnets and radio waves to create pictures of the area between the hip bones. This part of the body is called the pelvic area. Structures inside and near the pelvis include the bladder, prostate and other male reproductive organs, female reproductive organs, lymph nodes, large bowel, small bowel, and pelvic bones. An MRI does not use radiation. Single MRI images are called slices. The images are stored on a computer or printed on film. One exam produces dozens or sometimes hundreds of images.


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Pituitary gland plays a central role in body growth, metabolism, and reproductive function. A number of diseases that affect the pituitary-hypothalamic axis can have profound clinical, endocrinological as well as neurological consequences. These conditions can be classified as neoplastic, infectious, inflammatory, posttraumatic, congenital/developmental, and physiological. Various neoplastic conditions include pituitary adenoma/apoplexy, hypothalamic glioma, craniopharyngioma, rathke cleft cyst, germinoma, teratoma, metastasis, leukemic infiltration, lymphoma, and Langerhans cell histiocytosis. Infectious and inflammatory causes include tubercular/lymphocytic hypophysitis, sarcoidosis, and Wegener's granulomatosis. Traumatic causes include postoperative sella or transection of the pituitary stalk. Accurate diagnostic differentiation of these lesions is essential for both safe and effective disease management. Recent advances in neuroimaging helps the radiologists and endocrinologists to study the pituitary region in greater detail. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating hypothalamic-pituitary-related endocrine diseases.

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Magnetic resonance imaging (MRI) of the shoulder uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the bones, tendons, muscles and blood vessels within the shoulder joint. It is primarily used to assess injuries. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers, so that other findings may be required to help make the diagnosis. These findings include thickening of an attachment of the lateral pterygoid muscle, rupture of retrodiskal layers, and joint effusion and can serve as indirect early signs of TMJ dysfunction. It is important for the radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its final stage, an advanced and irreversible phase that is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further studies conducted with the latest MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms.


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The purpose of this study was to correlate disc position and the type of disc displacement, intra-capsular effusion and degenerative changes of the condyle as demonstrated in MRI studies. In this study, 126 temporomandibular joints (TMJs) of 63 patients with TMJ disorders were investigated using clinical examination and MRI. One hundred and twelve TMJs were found to have internal derangement as disc displacement. The angle between the posterior margin of the disc and the vertical line drawn through the centre of the condyle was measured on MRI for each TMJ. The positions of the discs were normal, 0 degrees-10 degrees, in 11.11%; slightly displaced, 11 degrees-30 degrees, in 37.30%; mildly displaced 31 degrees-50 degrees, in 15.08%; moderately displaced, 51 degrees-80 degrees, in 7.14% of the TMJs with anterior displacement with reduction (ADDR). The disc position was severely displaced anteriorly, as over 80 degrees, in all TMJs with anterior disc displacement without reduction (ADD), constituting 27.78% of all cases. We found that the smaller the degree of disc displacement the milder the internal derangement and that the intra-capsular effusion was more frequently associated with TMJ with ADDR. The degenerative condylar changes were more severe with an increased degree of anterior disc displacement.


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Magnetic resonance cholangiopancreatography (MRCP) is a special type of magnetic resonance imaging (MRI) exam that produces detailed images of the hepatobiliary and pancreatic systems, including the liver, gallbladder, bile ducts, pancreas and pancreatic duct. Magnetic resonance imaging (MRI) is a non-invasive medical test that physicians use to diagnose and treat medical conditions.MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various parts of the body and determine the presence of certain diseases.

Doctors use MRCP to examine diseases of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. These may include tumours, stones, inflammation or infection evaluate patients with pancreatitis to detect the underlying cause. In patients with pancreatitis, an MRCP may be performed using a medication called Secretin to assess for long term scarring and to determine the amount of healthy pancreatic function and secretions help to diagnose unexplained abdominal pain and provide a less invasive alternative to endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a diagnostic procedure that combines endoscopy, which uses an illuminated optical instrument to examine inside the body, with iodinated contrast injection and x-ray images. You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary. Usually, you will be instructed not to eat or drink anything for several hours before your procedure.Jewellery and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. In general, metal objects used in orthopaedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect and identify any metal objects.


You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centres allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment.  A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you.


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Magnetic resonance imaging (MRI) is an advanced medical imaging technique that does not use x-rays or radiation. Instead it uses a strong magnetic field, radio waves, and a computer. This creates very clear pictures of internal body structures. An MRI is used to examine soft tissues like organs, muscles, tendons, & blood vessels in many parts of the body. This includes areas of the brain, spine, abdomen, chest, pelvis, and joints (like knees and shoulders). The MRI image offers unique information to help your doctor better plan your treatment and care.


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A Whole Spine MRI Scan is an imaging test done to access the spinal anatomy and investigate the causes of a patient's back pain. The MRI can find changes in the spine and other tissues. MRI scans are needed when other imaging tests like X-ray, and CT scan fails to obtain any critical information and conservative treatment has stopped working or responding well. A Whole Spine MRI Scan is recommended to better diagnose the problems with your spine and provide an alternative treatment. The MRI Scan can also find problems such as infection or a tumour.


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Pulmonary function tests are a broad range of tests that measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood. Spirometry measures how well the lungs exhale. The information gathered during this test is useful in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases (especially asthma and chronic obstructive pulmonary disease, COPD). Lung volume measurement detects restrictive lung diseases. In this set of diseases, a person cannot inhale a normal volume of air. Restrictive lung diseases may be caused by inflammation or scarring of the lung tissue (interstitial lung disease) or by abnormalities of the muscles or skeleton of the chest wall. Testing the diffusion capacity (also called the DLCO) permits an estimate of how efficiently the lungs transfer oxygen from the air into the bloodstream.


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A retrograde urethrogram is a routine radiologic procedure (most typically in males) used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. The procedure involves the insertion of a Foley catheter into the distal urethra and minimally inflating it. This is followed by instillation of 30mL of water-soluble contrast and a plain radiograph is obtained; leakage of the contrast suggests urethral injury (usually secondary to pelvic trauma) and is an indication for surgical intervention.It is used when there is suspicion of urethral trauma, such as a history of trauma to the area followed by pain, inability to void urine, or the presence of blood at the urethral meatus, a scrotal hematoma, or free-floating prostate on rectal examination. If a urethral injury is suspected, a retrograde urethrogram should be performed before attempting to place a Foley catheter into the bladder. If there is a urethral disruption, a suprapubic catheter should be placed.

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A fistulogram uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to produce images of an abnormal passage within the body called a fistula. Similarly, a sinogram assesses an abnormal passage called a sinus that originates or ends in one opening, often on the skin. Both examinations are used to assess and diagnose the size and shape of fistulas and sinuses and any related abscess and/or infection. You will be instructed on how to prepare. You may be asked to refrain from eating or drinking anything for several hours before the examination, but you should be allowed to take medications with small amounts of clear fluid up to two hours prior. Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to contrast materials. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown


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Ultrasound imaging also called as sonography uses a transducer or probe to generate sound waves and produce pictures of the body's internal structures. It is often used to help diagnose unexplained pain, swelling or infection. It is used to see internal body structures such as tendons, muscles, joints, vessels and internal organs. It may also be used to provide imaging guidance to needle biopsies or to see and evaluate conditions related to blood flow. It is also the preferred imaging method for monitoring a pregnant woman and her unborn child. It does not use ionizing radiation, has no known harmful effects, and provides a clear picture of soft tissues that don't show up well on x-ray images.Most of these level II ultrasounds should be done in the second trimester of pregnancy usually between 18 and 22 weeks. It uses sound waves to produce pictures of a baby (embryo or fetus) within a pregnant woman, as well as the mother's uterus and ovaries. It does not use ionizing radiation, has no known harmful effects, and is the preferred method for monitoring pregnant women and their unborn babies. A Doppler ultrasound study – a technique that evaluates blood flow in the umbilical cord, fetus or placenta – may be part of this exam. It is a totally painless and safe procedure. It is useful test to establish the presence of fetus, estimate the age of pregnancy, diagnose congenital abnormalities of the fetus, assess fetal growth and well being etc. Preparation - No special preparation is needed.


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Your doctor has requested an ultrasound-guided biopsy. The goal of a biopsy is to remove a sample of tissue for testing in a laboratory. A biopsy can help diagnose abnormalities such as infection, inflammation or malignancy. During your biopsy, an imaging physician will use an ultrasound scanner to accurately guide a needle to the site of the biopsy. The needle will then be used to remove a tissue sample. At the S. Mark Taper Foundation Imaging Center, a highly trained medical team will oversee your procedure. This team will include an imaging physician, a diagnostic medical sonographer and a registered nurse.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.

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A biophysical profile (BPP) test measures the health of your baby (fetus) during pregnancy. A BPP test may include a non stress test with electronic fetal heart monitoring and a fetal ultrasound. The BPP measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby. A BPP is commonly done in the last trimester of pregnancy. If there is a chance that your baby may have problems during your pregnancy (high-risk pregnancy), a BPP may be done by 32 to 34 weeks or earlier. Some women with high-risk pregnancies may have a BPP test every week or twice a week in the third trimester. It is usually done to keep track of your baby’s health. 

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A breast ultrasound uses sound waves to make a picture of the tissues inside the breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other potentially harmful types of radiation. A breast ultrasound is used to see whether a breast lump is filled with fluid (a cyst) or if it is a solid lump. An ultrasound does not replace the need for a mammogram, but it is often used to check abnormal results from a mammogram


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Ultrasound imaging of the breast uses sound waves to produce pictures of the internal structures of the breast. It’s primarily used to help diagnose breast lumps or other abnormalities your doctor may have found during a physical exam, mammogram or breast MRI. Ultrasound is safe, noninvasive and does not use ionizing radiation.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You will be asked to undress from the waist up and to wear a gown during the procedure.

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 Ultrasound imaging of the head uses sound waves to produce pictures of the brain and cerebrospinal fluid. It is most commonly performed on infants, whose skulls have not completely formed. A transcranial Doppler ultrasound evaluates blood flow in the brain’s major arteries. Ultrasound is safe, noninvasive, and does not use ionizing radiation.This procedure requires little to no special preparation. Your doctor will instruct you on how to prepare, including whether adults undergoing the exam should refrain from using nicotine-based products that may cause blood vessels to constrict. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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 B-scan ultrasonography is an important adjuvant for the clinical assessment of various ocular and orbital diseases. With understanding of the indications for ultrasonography and proper examination technique, one can gather a vast amount of information not possible with clinical examination alone. This article is designed to describe the principles, techniques, and indications for echographic examination, as well as to provide a general understanding of echographic characteristics of various ocular pathologies. 

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USG scan for Follicular Monitoring is done to study ovarian follicles that are used to identify ovulation of egg. For couples planning for pregnancy, ovulation period is the important period to try on, for conception to happen. Out of many ways available, the most reliable way to understand the ovulation is Follicular monitoring. It’s an endovaginal scan carried to study the ovaries, uterus and uterus lining. Looking at ovaries, the growth of follicles inside ovaries can be assessed giving a chance to predict the ovulation and also look if the womb is getting ready for pregnancy.

With follicular monitoring, you will get to know the growth of follicles, the approximate rupture period of follicles and hence can predict the ovulation period thereby have an intercourse happen at the right time for conception to take place. The womb if not yet ready for pregnancy can be treated by some supplements prescribed by the doctors.

This scan is carried out in a slightly dark examination room. You will have to undress down from your waist while you get covered by a sheet. Now you will be asked to position yourself lying down on your back on a special bed with your knees bent. Once you position yourself comfortably; the transducer, a sterile lubricated covered electronic device, is gently inserted into your vagina to look at the uterus and ovaries. Depending on how relaxed the patient is, the test takes up to 15 minutes.


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 X-ray beams are passed through the abdomen, producing images of the kidneys, ureters, and bladder on a special type of film. KUB radiography is often used as a first step in diagnosing problems of the urinary system, and is usually done in conjunction with intravenous pyelography.

 

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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.

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Thyroid ultrasound uses sound waves to produce pictures of the thyroid gland within the neck. It does not use ionizing radiation and is commonly used to evaluate lumps or nodules found during a routine physical or other imaging exam.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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Ultrasound  is safe and paUltrasoundinless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.


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Ultrasound is a high-frequency sound that you cannot hear but it travels through fluid and soft tissues. However, it bounces back, or echoes, when it hits a more solid, dense surface such as a valve or bile in the gallbladder etc. So, when ultrasound 'hits' structures of different densities in our bodies, it echoes differently with each hit. 


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Ultrasound imaging of the scrotum uses sound waves to produce pictures of a man’s testicles and surrounding tissues. It is the primary method used to help evaluate disorders of the testicles, epididymis (a tube immediately next to a testicle that collects sperm) and scrotum. Ultrasound is safe, noninvasive, and does not use ionizing radiation.

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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels





 

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Thyroid ultrasound uses sound waves to produce pictures of the thyroid gland within the neck. It does not use ionizing radiation and is commonly used to evaluate lumps or nodules found during a routine physical or other imaging exam.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A transrectal ultrasound (TRUS) may also be called prostate sonogram or endorectal ultrasound. It is used to look at the prostate and tissues around it. An ultrasound transducer (also called a probe) sends sound waves through the wall of the rectum and into the prostate and surrounding tissue. A computer analyzes the wave patterns (called echoes) as they bounce off the organs and converts them into an image that doctors view on a video screen.

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An ultrasound test uses high-frequency sound waves to create images of your internal organs. Imaging tests can identify abnormalities and help doctors diagnose conditions. A transvaginal ultrasound, also called an endovaginal ultrasound, is a type of pelvic ultrasound used by doctors to examine female reproductive organs. This includes the uterus, fallopian tubes, ovaries, cervix, and vagina.

“Transvaginal” means “through the vagina.” This is an internal examination. Unlike a regular abdominal or pelvic ultrasound, where the ultrasound wand, or transducer, rests on the outside of the pelvis, this procedure involves your doctor or a technician inserting an ultrasound probe about two or three inches into your vaginal canal.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.


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Ultrasound imaging also called as sonography uses a transducer or a probe to generate sound waves and produce pictures of the body's internal structures. It is often used to help diagnose unexplained pain, swelling or infection. It is also used to see internal body structures such as tendons, muscles, joints, vessels and internal organs. Ultrasound abdomen is primarily used for evaluating the kidneys, liver, pancreas, gall bladder etc.It may also be used to provide imaging guidance to needle biopsies or to see and evaluate conditions related to blood flow. It does not use ionizing radiation, has no known harmful effects, and provides a clear picture of soft tissues that don't show up well on x-ray images. It is a painless, safe and non invasive procedure.
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As an ancillary test for congenital adrenal hyperplasia (CAH), particularly in situations in which a diagnosis of 21-hydroxylase and 11-hydroxylase deficiency have been ruled out


Confirming a diagnosis of 3-beta-hydroxy dehydrogenase (3-beta-HSD) deficiency


Analysis for 17-hydroxypregnenolone is also useful as part of a battery of tests to evaluate females with hirsutism or infertility; both can result from adult-onset CAH

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17-ketosteroids are substances that form when the body breaks down male steroid sex hormones called androgens and other hormones released by the adrenal glands in males and females, and by the testes in males.

A 24-hour urine sample is needed. You will need to collect your urine over 24 hours. Your health care provider will tell you how to do this. Follow instructions exactly to ensure accurate results.

Your provider will ask you to temporarily stop any medicines that may affect the test results. Be sure to tell your provider about all the medicines you take. These include:

1.Antibiotics

2.Aspirin (if you are on long-term aspirin)

3.Birth control pills

4.Diuretics (water pills)

5.Estrogen..


Increased levels of 17-ketosteroids may be due to:

1.Adrenal gland problems such as tumor, Cushing syndrome

2.Imbalance of sex hormones in females (polycystic ovary syndrome)

3.Ovarian cancer

4.Testicular cancer


Decreased levels of 17-ketosteroids may be due to:

1.Adrenal glands not making enough of their hormones (Addison disease)

2.Kidney damage

3.Pituitary gland not making enough of its hormones (hypopituitarism)

4.Removal of the testicles (castration)

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The hormone 17-hydroxyprogesterone is a building block for producing the hormone cortisol. Cortisol is produced mainly by the adrenal cortex (the outer part of the two adrenal glands, located above the kidneys). Cortisol is called the "stress hormone" because it's secreted in larger amounts as part of the body's response to physical or emotional stress.


Cortisol levels normally vary throughout the day. They're highest in the morning, just before waking up, and lowest at night.


Some people, however, can't make enough cortisol because they lack an enzyme in the adrenal glands that's needed to make it. They'll have a buildup of 17-hydroxyprogesterone in the blood because it's not being converted to cortisol.


In kids, the most common cause of cortisol deficiency, and consequently high levels of 17-hydroxyprogesterone, is one of the forms of the genetic disorder congenital adrenal hyperplasia (CAH).


CAH can affect both boys and girls. It causes the adrenal glands to make excess androgens (male steroid hormones) and, in some cases, not enough of the hormones that regulate the body's salt balance.


Though treatable, undetected CAH can sometimes lead to more serious symptoms such as dehydration and shock in infants.

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Primary aldosteronism should be suspected whenever a patient has the triad of hypertension, hypokalemia, and inappropriate renal potassium wasting. The biggest challenge is the differential diagnosis between the more common adrenal adenoma and bilateral hyperplasia. Because adrenal adenomas increase the circulating levels of 18-hydroxycorticosterone (18-OH B), serum levels of 18-OH B may be useful to differentiate them from bilateral adrenal hyperplasia. The cutoff point appears to be about 50 ng/dL of serum. Most values are around 100 ng/dL. The higher the level of this precursor, the greater the possibility that an adrenal adenoma is present. J Clin Endocrinol Metab.

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There are different types of cortisol tests that may be performed, including blood, saliva, and urine tests. The urine test is done over a period of 24 hours.

The cortisol urine test tends to be more comprehensive than the other types of cortisol tests. It measures the total amount of cortisol excreted into the urine over a 24-hour period. Blood tests or saliva tests, however, only measure cortisol levels at a particular time of day. Some people also find blood tests to be stressful, and since the body releases more cortisol during times of stress, the results may not be as precise. In some cases, your doctor may order both a cortisol urine test and another type of cortisol test to obtain more accurate results.


Cushing’s syndrome is a collection of symptoms associated with high cortisol levels. The most common symptoms include:


1.Increased urination

2.Increased thirst

3.Fatty tissue deposits, especially in the midsection and upper back

4.Pink or purple stretch marks on the skin

5.Weight gain

6.Fatigue

7.Muscle weakness

8.Thinning skin that bruises easily

9.Women may have irregular periods and excess facial and chest hair. Children may show delayed physical or cognitive development.


The symptoms of low cortisol levels often emerge slowly. At first, they may only appear during times of extreme stress, but they’ll gradually increase in intensity over several months. Potential symptoms include:


1.Weight loss

2.Fatigue

3.Dizziness

4.Fainting

5.Muscle weakness

6.Abdominal pain

7.Diarrhea

8.Constipation


When cortisol levels abruptly drop to life-threatening levels, an acute adrenal crisis may occur. The symptoms of an acute adrenal crisis include:


1.Darkening of the skin

2.Extreme weakness

3.Vomiting

4.Diarrhea

5.Fainting

6.Chills

7.Loss of appetite

8.Sudden onset of severe pain in the lower back, abdomen, or legs.


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Albumin commonly exists in the blood and is filtered by the kidneys. The presence or absence of albumin determines the functionality of the kidneys. It is said that small quantities of albumin leak into the urine when the kidneys do not function properly. This condition is known as microalbuminuria. A microalbumin test diagnosis urine for the presence of albumin.

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Testosterone plays a central role in male development and health. Likewise, androgen deficiency, or hypogonadism, is associated with a variety of symptoms including decreased energy, diminished libido and erectile dysfunction, among others. Male androgen levels steadily decline with age, and, in a subset of symptomatic older men, can result in late-onset hypogonadism (LOH). Over the last decade, increased awareness of hypogonadism among patients and providers has led to a significant rise in the use of testosterone replacement therapy (TRT) for hypogonadism, and especially in LOH. Accompanying the rise in TRT are concerns of potential adverse effects, including cardiovascular risks and the promotion of prostate cancer. The ‘androgen hypothesis’ asserts that prostate cancer development and progression is driven by androgens, and thus TRT has the theoretical potential to drive prostate cancer development and progression. In this review, we examine existing data surrounding testosterone and prostate cancer. There is significant evidence that androgens promote prostate cancer in experimental systems. However, there is no clear evidence that elevations in endogenous testosterone levels promote the development of prostate cancer in humans. As a result of experimental and historical data on the progression of prostate cancer following TRT, there has been widespread belief that TRT will promote disease progression in prostate cancer patients. Despite these fears, there are a growing number of studies demonstrating no increase in prostate cancer incidence among men on TRT. Furthermore, in studies involving a small number of patients, there has been no discernable increase in disease progression in prostate cancer patients on TRT. While data from large, prospective, randomized, controlled trials are absent, TRT in select prostate cancer patients is likely safe. In the end, the use of TRT in prostate cancer patients is still considered experimental and should only be offered after well-informed shared decision making and with close monitoring.

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This test finds out how much 5-hydroxyindoleacetic acid (5-HIAA) is in your urine.


Your liver breaks down the hormone serotonin into 5-HIAA. This waste product is normally sent from your body in your urine. Tumors called functioning carcinoids secrete serotonin. Carcinoid tumors are found in the intestinal tract, lungs, appendix, and other body tissues. Because serotonin in the blood is broken down very quickly, the amount of 5-hydroxyindoleacetic acid collected in the urine over a full day more accurately reflects the rate at which serotonin is being made than the blood level at one particular time. 

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Acid- Fast Bacilli (AFB) smear and culture are two separate tests always performed together at the MSPHL, Tuberculosis (TB) Unit. AFB smear refers to the microscopic examination of a fluorochrome stain of a clinical specimen. The AFB culture is the inoculation of a clinical specimen onto culture media Becton-Dickinson Mycobacteria Growth Indicator Tube (B-D MGIT broth) and Lowenstein-Jensen (L-J) media slant, incubation at 37°C for up to six (6) weeks and detection of growth or no growth during this incubation period. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have the disease cough, sneeze, or spit. The other widely used tests used in the diagnosis & screening of Tuberculosis infection are:AFB, smear examinationCulture, Mycobacterium TuberculosisMantoux test (Tuberculin skin test)Mycobacterium antibody panel (TB-IgG, IgM, IgA)Mycobacterium Tuberculosis by RT-PCRQuantiferon TB Gold.

The Acid Fast Bacilli - Sputum is done for routine health screenings, to identify the acid-fast bacilli in sputum, fluid or tissue specimen and to manage the medication of mycobacterial infections such as tuberculosis. It may also be used when an atypical mycobacterial infection is suspected.

The Acid Fast Bacilli is generally ordered on suspicion of tuberculosis. The most common symptom of tuberculosis is a chronic cough that produces mucus and sometimes contains blood streaks. Other symptoms of tuberculosis include chest pain, weakness, chills, fever and unexplained weight loss.


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White blood cells are an important part of your body’s immune system. They’re vital to protecting you from invading bacteria, viruses, and parasites. Your bone marrow produces all five of the different kinds of white blood cells in the body.


Each white blood cell lives anywhere from several hours to several days in the blood stream. An eosinophil is a type of white blood cell. Eosinophils are stored in tissues throughout the body, surviving for up to several weeks. The bone marrow continually replenishes the body’s white blood cell supply.


The number and type of each white blood cell in your body can give doctors a better understanding of your health. Elevated levels of white blood cells in your blood can be an indicator that you have an illness or infection. Elevated levels often mean your body is sending more and more white blood cells to fight off infections.


An eosinophil count is a blood test that measures the quantity of eosinophils in your body. Abnormal eosinophil levels are often discovered as part of a routine complete blood count (CBC) test.


Ongoing research continues to uncover an expanding list of roles performed by eosinophils. It appears now that nearly every system of the body relies on eosinophils in some way. Two important functions are within your immune system. Eosinophils destroy invading germs like viruses, bacteria, or parasites such as hookworms. They also have a role in the inflammatory response, especially if an allergy is involved.


Inflammation is neither good nor bad. It helps isolate and control the immune response at the site of an infection, but a side effect is tissue damage around it. Allergies are immune responses that often involve chronic inflammation. Eosinophils play a significant role in the inflammation related to allergies, eczema, and asthma.

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The number of neutrophils in the blood is expressed as absolute neutrophil count (ANC) and it measures the percentage of neutrophils in the differential WBC count. The ANC of a healthy individual falls in the range of 2,500 to 6,000 per microliter.

A total blood count gives the levels of the three types of blood cells - white blood cells, red blood cells, and platelets. Neutrophils are present in two forms – polys and bands. Polys are also known as segmented neutrophils and are the most abundant of the WBCs. Bands are also called stabs and are immature polys. Both polys and bands destroy invaders (i.e. microbes) in the body.

The ANC is calculated by multiplying the number of WBCs in blood by the percentage of total neutrophils.  For example, for a WBC count of 7000 per microliter, if neutrophils constitute 40% of the WBCs, the ANC in this case will be 7000 × 0.40 = 2800 per microliter.

An ANC below 1,000 per microliter is called neutropenia. ANCs less than 500 per microliter significantly increase the risk of infection. In cancer patients, frequent blood tests are performed to assess WBC count and ANC to monitor the body’s response to cancer treatment.

Neutrophils constitute nearly 55 to 70% of the total WBC count. Acute infections or trauma are the main triggers for production of neutrophils leading to elevated WBC count also known as neutrophilia or neutrophil leukocytosis.

In cancer patients, ANC is a reflection of the immunologic status of the patient in response to chemotherapy. This therapy suppresses production of WBC and hence neutrophils, thus increasing infection risks. Hence, a low ANC or neutropenia can be an indication of the need for reducing chemotherapy dosage or delaying the next sessions of chemotherapy. ANC also allows prediction of neutropenia-related events including fever after chemo­therapy sessions. It thus offers a clear picture of the patient’s immunologic status.

ANC helps determine the need for antibiotics or other measures along with therapy to decrease complications related to neutro­penia. While for an in-patient, a low ANC may be an indicator of the need to isolate the patient so as to protect him or her from exposure to infectious agents, in case of an out-patient, it can highlight the need to keep away from crowds or people having flu or colds. ANC is thus a powerful monitoring tool in cancer patients who are prone to bone marrow suppression due to radiation, chemotherapy, or bone marrow transplant.



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Most of the time blood is drawn from a vein on the inside of the elbow or the back of the hand. The site is cleaned with an antiseptic. The health care provider wraps an elastic band around your upper arm to make the vein swell with blood.


Next, the provider gently inserts a needle into the vein. The blood collects into an airtight tube attached to the needle. The elastic band is removed from your arm. The needle is then removed and the site is covered to stop bleeding.


In infants or young children, a sharp tool called a lancet may be used to prick the skin. The blood collects in a small glass tube, or onto a slide or test strip. A bandage is put on the spot to stop bleeding.


In the lab, the blood is placed on a microscope slide. A stain is added to the sample. This causes eosinophils to show up as orange-red granules. The technician then counts how many eosinophils are present per 100 cells. The percentage of eosinophils is multiplied by the white blood cell count to give the absolute eosinophil count.

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When ketones accumulate in the blood, the body enters ketosis. For some people, ketosis is normal. Low-carbohydrate diets can induce this state. This is sometimes called nutritional ketosis.


If you have type 1 diabetes, you may be at risk for diabetic ketoacidosis (DKA), which is a life-threatening complication in which your blood becomes too acidic. It can lead to a diabetic coma or death.


Contact your doctor immediately if you have diabetes and have a moderate or high reading for ketones. Some newer blood glucose meters will test blood ketone levels. Otherwise, you can use urine ketone strips to measure your urine ketone level. DKA can develop within 24 hours and can lead to life-threatening conditions if left untreated.

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Acetylcholine receptor (AChR) antibodies are autoantibodies produced by the immune system that mistakenly target proteins called acetylcholine receptors that are located on skeletal muscle fibers. This test detects and measures AChR antibodies in the blood.

Acetylcholine receptors function as "docking stations" for acetylcholine, a chemical substance (neurotransmitter) that transmits messages between nerve cells. Muscle movement starts when an impulse is sent down a nerve to the nerve ending, where it stimulates the release of acetylcholine. Acetylcholine travels across a microscopic gap between the nerve ending and a muscle fiber at the "neuromuscular junction." When it reaches the muscle fiber, it binds to one of many acetylcholine receptors and activates it, initiating muscle contraction.

AChR antibodies impede communication between nerves and skeletal muscles, inhibit muscle contraction, and cause rapid muscle fatigue by preventing activation of the acetylcholine receptors. They do this in three major ways:


1.Binding antibodies attach to the receptors on nerve cells and may initiate an inflammatory reaction that destroys the receptors.

2.Blocking antibodies may sit on the receptors, preventing acetylcholine from binding.

3.Modulating antibodies may cross-link the receptors, causing them to be taken up into the muscle cell and removed from the neuromuscular junction.


The end result of this interference is the development of myasthenia gravis (MG), a chronic autoimmune disorder associated with the presence of these antibodies and with their effects on muscle control.

AChR antibodies may be detected in different ways to determine which mechanism may be the problem in a particular individual, and the antibodies may be referred to as "binding," "blocking," or "modulating." However, the technique that measures "binding" is the most commonly performed and, generally speaking, it is rare for the other two tests to be positive without the "binding" test being positive as well. These other approaches may be useful when a healthcare practitioner strongly suspects myasthenia gravis and the "binding" test is negative.

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Approximately 90% of patients with myasthenia gravis MG) express antibodies to the acetylcholine receptor (aChR), which can be divided into binding, blocking, and modulating antibody. Binding antibody can activate complement and lead to loss of aChR. Blocking antibody may impair aChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of aChR expression, which correlates most closely with clinical severity of disease. Approximately 10% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibody. Myasthenia gravis (MG) is an autoimmune disease in which an acetylcholine receptor (AChR) is the antibody target. The AChR in the motor end-plate of skeletal muscle is an integral membrane protein consisting of five subunits (a pentamer). The alpha chain carries both the binding site for cholinergic ligands (binding site for acetylcholine and bungarotoxin) and the main immunogenic region, a region against which a majority of the antibodies of MG patients are directed. In MG, acetylcholine-dependent neuromuscular transmission is impaired by a loss of signal transduction. The final result is that threshold potential in the cell is never reached and the muscle cannot contract. The patient experiences voluntary muscle weakness and fatigue characteristic of the disease, as well as difficulty in swallowing, diplopia, ptosis (in ocular MG), and, in severe cases, death. Individuals who manifest AChR antibodies generally do not express a single, monoclonal antibody population. The antibody population is divided into three classes: • Binding • Blocking • Modulating Binding antibodies are those that are epitopically directed toward the large hydrophilic domain of the receptor. This class of antibodies can activate the complement cascade, resulting in tissue damage and receptor loss. The AChR binding antibody radioimmunoassay detects a wide population of autoantibodies. The use of soluble receptor measures not only antibody directed against the extracellular region of the receptor, presumably the portion involved in the pathophysiology of the disease, but intracellular determinants of the receptor not normally exposed to immunoglobulins. The assay is incapable of differentiating general binding antibodies from the more specific modulating population. Moreover, the binding assay does not easily measure a blocking population. Blocking autoantibodies prevent the binding of acetylcholine to the receptor. They may act by direct steric interference or by an allosteric mechanism. The pathology associated with this type of antibody will result in the most rapid loss of receptor function. Modulating antibodies as a class accelerate endocytosis, resulting in loss of receptors. It is largely this class of antibodies to which clinical severity has been most closely associated. In fifty-three percent of samples with any measurable autoantibody, all three antibody populations were present. Addition of blocking and modulating antibody assays to the binding assay increased the number of samples that tested positive by approximately 10 percent. Studies show that the presence of modulating antibody generally compares more closely to disease severity than either binding or blocking classes. Drachman et al showed that the blocking population has a disease severity correlation nearly as high as that of modulating antibodies (88% vs. 91%). Approximately 90 percent of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibody. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10 percent of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibody.


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Approximately 85-90% of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibodies. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10-15% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibodies. This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.


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Prostatic acid phosphatase (PAP) is an enzyme that is found in the prostate gland and semen of men. If the prostate isn’t working properly, then PAP is released into the blood. PAP determination in conjunction with PSA measurements is useful in assessing the prognosis of prostate cancer.1,2 Measurement of two markers allows identification of prostate cancer patients who have an elevation of PAP but not of PSA, and thus help monitoring the course of disease and response to treatment.

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Adrenocorticotropic hormone (ACTH) is a hormone produced in the anterior, or front, pituitary gland in the brain. The function of ACTH is to regulate levels of the steroid hormone cortisol, which released from the adrenal gland.


ACTH is also known as:

adrenocorticotropic hormone

serum adrenocorticotropic hormone

highly-sensitive ACTH

corticotropin

cosyntropin, which is a drug form of ACTH

An ACTH test measures the levels of both ACTH and cortisol in the blood and helps your doctor detect diseases that are associated with too much or too little cortisol in the body. Possible causes of these diseases include:

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Your pituitary gland is a pea-sized gland located at the base of your brain. It produces many types of hormones, including the adrenocorticotropic hormone (ACTH).


ACTH stimulates the adrenal glands, which sit atop the kidneys, to release two hormones: cortisol and adrenaline (also known as epinephrine). These hormones help you respond to stress in a healthy way and support your immune system. Cortisol is a steroid hormone that affects many different systems in the body, including your:


circulatory system

immune system

nervous system

bone metabolism

metabolism of nutrients such as carbohydrates, fats, and protein

Adrenaline, or epinephrine, is a hormone responsible for maintaining normal nervous system and circulatory function. This hormone, along with another hormone called norepinephrine, are responsible for your protective fight-or-flight response when you face a stressful situation.


Your healthcare provider might have you take an ACTH (cosyntropin) test if they suspect your adrenal glands aren’t functioning properly. This test requires you to receive an injection of cosyntropin, a synthetic portion of ACTH. You will also have two blood samples drawn — one before the injection and one after the injection. These samples measure the level of cortisol in your blood.


This ACTH stimulation test measures how your adrenal glands react to the ACTH in your blood. It does this by measuring your body’s cortisol levels. It’s important not to confuse this test with an ACTH test, which simply measures the ACTH levels in your blood.

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Protein C, a part of the natural anticoagulant system, is a vitamin K-dependent protein zymogen (molecular weight=62,000 da) that is synthesized in the liver and circulates at a plasma concentration of approximately 5 mcg/mL. Protein C is activated to activated protein C (APC) via proteolytic cleavage by thrombin bound to thrombomodulin, an endothelial cell surface membrane protein. APC downregulates the procoagulant system by proteolytically inactivating procoagulant factors Va and VIIIa. Protein S, another vitamin K-dependent coagulation protein, catalyzes APC inactivation of factors Va and VIIIa. APC interacts with and proteolyses factors V/Va and VIII/VIIIa at specific APC binding and cleavage sites, respectively. Resistance to activated protein C (APC resistance) is a term used to describe abnormal resistance of human plasma to the anticoagulant effects of human APC. APC resistance is characterized by a reduced anticoagulant response of patient plasma after adding a standard amount of APC. For this assay, the activated partial thromboplastin time clotting test fails to prolong significantly after the addition of APC.

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Adenosine deaminase (ADA) is a protein that is produced by cells throughout the body and is associated with the activation of lymphocytes, a type of white blood cell that plays a role in the immune response to infections. Conditions that trigger the immune system, such as an infection by Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB), may cause increased amounts of ADA to be produced in the areas where the bacteria are present. This test measures the amount of adenosine deaminase present in pleural fluid in order to help diagnose a tuberculosis infection of the pleurae.


Pleurae are membranes that cover the chest cavity and the outside of each lung. Small amounts of pleural fluid are continuously produced to lubricate the movement of the lungs against these membranes and the membranes against each other during inhalation and exhalation. A variety of conditions and diseases, including infection, can cause inflammation of the pleurae (pleurisy or pleuritis) and can lead to excessive pleural fluid accumulation (pleural effusion).


Tuberculosis can spread into the lungs and pleurae, causing symptoms such as chest pain, chronic cough, and shortness of breath. Since these symptoms may also be seen with a variety of other conditions, it is important to determine the cause as rapidly as possible in order to properly treat the affected person. Detecting mycobacteria in pleural fluid can be difficult because there may be a large volume of fluid and very low numbers of bacteria present. Though the ADA test is not specific and does not replace the culture for diagnosing TB, it may be positive even when numbers of bacteria are very low and can be used as an adjunct test to help determine whether tuberculosis is the likely source of a person's symptoms.



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Investing laboratories and new rapid tools to diagnose tuberculosis20140521_105740 Suzanne Zambia


To be able to halt the tuberculosis (TB) epidemic, one of the first and most essential breakthroughs we need to realize is universal access to laboratories that provide quality-assured diagnostic tests for TB. Each year an estimated 3 million people are either not diagnosed or not treated for TB. To be able to identify all persons with TB disease in need of treatment, laboratory facilities and laboratory networks urgently need to be upgraded and expanded in many countries. Laboratory work is also becoming progressively complex, following the increased use of quality-assured diagnostics and the introduction of new laboratory tools.


Countries often lack appropriately qualified technicians and well-trained managers, and laboratory services are facing challenges ranging from poor infrastructure, unreliable basic utilities (water, electricity), to interruptions of essential supplies.

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Alpha-fetoprotein (AFP) is a single polypeptide chain glycoprotein with a molecular weight of approximately 70,000 daltons. Synthesis of AFP occurs primarily in the liver and yolk sac of the fetus. It is secreted in fetal serum, reaching a peak at approximately 13 weeks gestation, after which it rapidly declines until about 22 weeks gestation and then gradually declines until term. Transfer of AFP into maternal circulation is accomplished primarily through diffusion across the placenta. Maternal serum AFP levels rise from the normal nonpregnancy level of 0.20 ng/mL to about 250 ng/mL at 32 weeks gestation.


If the fetus has an open neural tube defect, AFP is thought to leak directly into the amniotic fluid causing unexpectedly high concentrations of AFP. Other fetal abnormalities such as omphalocele, gastroschisis, congenital renal disease, and esophageal atresia; and other fetal distress situations such as threatened abortion, prematurity, and fetal demise, may also show AFP elevations. Decreased amniotic fluid AFP values may be seen when gestational age has been overestimated.

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Alpha-fetoprotein (AFP) is a protein produced in the liver of a developing fetus. During a baby's development, some AFP passes through the placenta and into the mother's blood. An AFP test measures the level of AFP in pregnant women during the second trimester of pregnancy. Too much or too little AFP in a mother's blood may be sign of a birth defect or other condition. These include:


A neural tube defect, a serious condition that causes abnormal development of a developing baby's brain and/or spine

Down syndrome, a genetic disorder that causes intellectual disabilities and developmental delays

Twins or multiple births, because more than one baby is producing AFP

Miscalculation of due date, because AFP levels change during pregnancy

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Alpha-fetoprotein (AFP) is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis (eg, yolk sac and embryonal carcinoma). Most studies report elevated AFP concentrations in approximately 70% of patients with hepatocellular carcinoma. Elevated AFP concentrations are found in 50% to 70% of patients with nonseminomatous testicular tumors.(1)


AFP is elevated during pregnancy. Persistence of AFP in the mother following birth is a rare hereditary condition.(2) Neonates have markedly elevated AFP levels (>100,000 ng/mL) that rapidly fall to below 100 ng/mL by 150 days and gradually return to normal over their first year.(2)


Concentrations of AFP above the reference range also have been found in serum of patients with benign liver disease (eg, viral hepatitis, cirrhosis), gastrointestinal tract tumors and, along with carcinoembryonic antigen in ataxia telangiectasia.

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Your liver’s in charge of making most of the proteins that are in your blood. They are important for good health.


Two of the key ones are:

Albumin. This carries medicines and hormones throughout your body. It also helps with tissue growth and healing.

Globulin. This is a group of proteins. Some of them are made by your liver. Others are made by your immune system. They help fight infection and transport nutrients.


The total serum protein test measures all the proteins in your blood. It can also check the amount of albumin you have compared to globulin, or what’s called your “A/G ratio.”


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For several decades, nonspecific methods, which depend upon raised globulin levels, have been used in the diagnosis of VL. Some of the tests used for detecting these nonspecific immunoglobulins are Napier's formol gel or aldehyde test and the Chopra antimony test. Since these tests depend upon raised globulin levels, results can be positive in a host of conditions (13, 14). Lack of specificity, as well as varying sensitivities, renders them highly unreliable.


Several immunodiagnostic methods which are more sensitive and specific have been developed. They are useful in identifying specific cases and can be used for community surveillance. The human body makes an attempt to fight against VL by producing some of the highest levels of antibodies found in response to any disease, all to no avail. This is due to polyclonal activation of the B cells, resulting in marked elevation of levels (in serum) of immunoglobulin G (IgG) and IgM against various nonspecific proteins and haptens (23). The consistent presence of high levels of antibodies against parasite antigens can simplify diagnosis of VL. Several serological techniques are based on detection of these antibodies. The specificity of the antibody depends upon the antigen or epitope used in the test, as the parasite stimulates production of a wide array of antibodies, including group-, genus-, and species-specific antibodies. Therefore, the sensitivity may depend upon the test and its methodology, but the specificity will depend on the antigen rather than the serological procedure used. In most serological tests, the sensitivity and specificity data are compared against demonstration of parasites in various tissues.


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Your body converts a form of sugar called glucose into energy. This process requires a number of different steps. One important component in the process is an enzyme known as aldolase. Aldolase can be found throughout the body, but concentrations are highest in skeletal muscle and liver.


Although there’s not a direct correlation, high blood aldolase levels can occur if there is damage to your liver or muscles.

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An aldosterone (ALD) test measures the amount of ALD in your blood. It’s also called a serum aldosterone test. ALD is a hormone made by the adrenal glands. The adrenal glands are found on top of your kidneys and are responsible for producing several important hormones. ALD affects blood pressure and also regulates sodium (salt) and potassium in your blood, among other functions.


Too much ALD can contribute to high blood pressure and low potassium levels. It’s known as hyperaldosteronism when your body makes too much ALD. Primary hyperaldosteronism could be caused by an adrenal tumor (usually benign, or noncancerous). Meanwhile, secondary hyperaldosteronism could be caused by a variety of conditions. These include:


congestive heart failure

cirrhosis

some kidney diseases (e.g., nephrotic syndrome)

excess potassium

low sodium

toxemia from pregnancy


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Bone Specific Alkaline Phosphatase is one of the isoenzymes of Alkaline Phosphatase.

Bone Specific Alkaline Phosphataseit is associated with osteoblast cell function and thought to have a role in bone mineralization.

The measurement of Bone Specific Alkaline Phosphatase provides information useful in the evaluation and treatment of people with Paget’s disease, osteoporosis, and metastases to bone.

Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. A glycoprotein that is found on the surface of osteoblasts, BAP reflects the biosynthetic activity of these bone-forming cells. BAP has been shown to be a sensitive and reliable indicator of bone metabolism.(1)

Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. This process is necessary for maintaining bone health. If the process becomes uncoupled and the rate of resorption exceeds the rate of formation, the resulting bone loss can lead to osteoporosis and, consequently, a higher susceptibility to fractures.

Osteoporosis is a metabolic bone disease characterized by low bone mass and abnormal bone microarchitecture. It can result from a number of clinical conditions including states of high bone turnover, endocrine disorders (primary and secondary hyperparathyroidism and thyrotoxicosis), osteomalacia, renal failure, gastrointestinal diseases, long-term corticosteroid therapy, multiple myeloma, and cancer metastatic to the bones.

Paget disease is another common metabolic bone disease caused by excessive rates of bone remodeling resulting in local lesions of abnormal bone matrix. These lesions can result in fractures or neurological involvement. Antiresorptive therapies are used to restore the normal bone structure.



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The skin of the inner forearm is the usual test site for allergy testing using the Skin Prick Test method. One can also take a blood sample for allergy testing and measure Total Immunoglobulin E (IgE) which is the marker antibody for allergy sensitisation. Then there are the Phadiatop inhalant screen, Food Allergy screens and over 450 individual RAST or ImmunoCAP tests available.


We can quantify allergy severity with another cellular marker, this is the Eosinophil cell in the blood stream. Eosinophils are also found in the allergy sufferer’s phlegm, gullet secretions and nasal mucous. Lung function tests are important in asthma diagnosis, and tests include Peak Flow (PF), Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC). Measurement of Nitric Oxide (NO) in exhaled air is another measure of allergic inflammation and indicates poor control or ineffective treatment

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An alpha-fetoprotein (AFP) blood test checks the level of AFP in a pregnant woman's blood. AFP is a substance made in the liver of an unborn baby (fetus). The amount of AFP in the blood of a pregnant woman can help see whether the baby may have such problems as spina bifida and anencephaly. An AFP test can also be done as part of a screening test to find other chromosomal problems, such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18). An AFP test can help find an omphalocele, a congenital problem in which some of the baby's intestines stick out through the belly wall.


Normally, low levels of AFP can be found in the blood of a pregnant woman. No AFP (or only a very low level) is generally found in the blood of healthy men or healthy, nonpregnant women.


The level of AFP in the blood is used in a maternal serum triple or quadruple screening test. Generally done between 15 and 20 weeks, these tests check the levels of three or four substances in a pregnant woman's blood. The triple screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type of estrogen (unconjugated estriol, or uE3). The quad screen checks these substances and the level of the hormone inhibin A. The levels of these substances-along with a woman's age and other factors-help the doctor estimate the chance that the baby may have certain problems or birth defects.

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To determine whether the presence of circulating desialylated glycoproteins reflect the existence and/or the severity of liver disease, 73 patients were evaluated with liver biopsies, conventional liver function tests, and the measurement of the degree of desialylation of two glycoproteins alpha 1-acid glycoprotein (alpha 1-AGP) and alpha 1-antitrypsin (alpha 1-AT). A combination of two immunological methods, available as routine laboratory tests, was used for the determination of the desialylation of alpha 1-AGP and alpha 1-AT. The severity of liver disease was assessed by a clinical classification depending upon the presence or absence of four complications (jaundice, ascites, hepatic encephalopathy, and weight loss). The presence of serum desialylated alpha 1-AGP did not allow detection of mild liver disease, but asialo alpha 1-AGP (and to a lesser extent of asialo-alpha 1-(AT) correlated with the severity of liver disease. The sensitivity of desialylated alpha 1-AGP in detection of severe liver disease was 65%, and its specificity was 80%.

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Alpha-1-antitrypsin (A1A) is the most abundant serum protease inhibitor and inhibits trypsin and elastin, as well as several other proteases. The release of proteolytic enzymes from plasma onto organ surfaces and into tissue spaces results in tissue damage unless inhibitors are present. Congenital deficiency of A1A is associated with the development of emphysema at an unusually early age and with an increased incidence of neonatal hepatitis, usually progressing to cirrhosis.

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Alpha-2-macroglobulin is a protease inhibitor and is 1 of the largest plasma proteins. It transports hormones and enzymes, exhibits effector and inhibitor functions in the development of the lymphatic system, and inhibits components of the complement system and hemostasis system.


Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when other lower molecular weight proteins are lost and alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.


Patients with acute pancreatitis exhibit low serum concentrations which correlate with the severity of the disease. In hyperfibrinolytic states, after major surgery, in septicemia and severe hepatic insufficiency, the measured levels of alpha-2-macroglobulin are often low. Acute myocardial infarction patients with low alpha-2-macroglobulin have been reported to have a significantly better prognosis with regard to the >1 year survival time.

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Under normal physiologic conditions, the usual daily dietary intake of aluminum (5-10 mg) is completely eliminated. Excretion is accomplished by avid filtration of aluminum from the blood by the glomeruli of the kidney. Patients in renal failure (RF) lose the ability to clear aluminum and are candidates for aluminum toxicity. Many factors increase the incidence of aluminum toxicity in patients in RF:


-Aluminum-laden dialysis water can expose dialysis patients to aluminum.


-Aluminum-laden albumin can expose patients to an aluminum burden they cannot eliminate.


-The dialysis process is not highly effective at eliminating aluminum.


-Aluminum-based phosphate binder gels are administered orally to minimize phosphate accumulation; a small fraction of this aluminum may be absorbed and accumulated.


If it is not removed by renal filtration, aluminum accumulates in the blood where it binds to proteins such as albumin and is rapidly distributed through the body. Aluminum overload leads to accumulation of aluminum at 2 sites: brain and bone. Brain deposition has been implicated as a cause of dialysis dementia. In bone, aluminum replaces calcium at the mineralization front, disrupting normal osteoid formation.


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Primary aminoacidopathies are typically autosomal recessive or X-linked inherited disorders resulting from a deficient enzyme or transport protein. Over 30 aminoacidopathies have been described in the literature. Symptoms range from relatively benign to severe and may include, but are not limited to, growth and mental retardation, developmental delay, learning disabilities, seizures, lethargy, coma, vomiting, metabolic acidosis or alkalosis, sudden infant death syndrome (SIDS), osteomalacia, and osteoporosis. Depending on the natural history of the disorder, symptoms may be minimized or prevented by early diagnosis and treatment. Treatment may be based on dietary restrictions and/or supplementation with cofactors (eg, riboflavin or cobalamin) or conjugating agents (eg, carnitine or sodium benzoate)

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This test checks the level of ammonia in your blood. The test helps find out why you may have changes in consciousness and also helps diagnose a liver disease called hepatic encephalopathy. This disease affects how your brain works, because of excess toxins, or poisons, in your body.


Your liver may not work properly if you have high levels of ammonia in your blood. Ammonia is a chemical made by bacteria in your intestines and your body's cells while you process protein. Your body treats ammonia as a waste product. It turns it into an amino acid called glutamine and a chemical compound called urea. Your bloodstream moves the urea to your kidneys, where it is eliminated in your urine.


But ammonia will build up in your body if you can't get rid of urea. This can sometimes happen if you have kidney or liver failure. It can also happen if you have a urea cycle disorder, a genetic disorder that means your body is missing one of the enzymes that remove ammonia from the blood. The ammonia blood test is the gold standard for diagnosing urea cycle disorders.


Too much ammonia in your body can cause psychological problems like confusion, tiredness, and possibly coma or death.


A child's reaction to too much ammonia can include seizures, breathing difficulties, and potentially death.

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A noninvasive diagnostic test for amebic liver abscess is needed, because amebic and bacterial abscesses appear identical on ultrasound or computer tomography and because it is rarely possible to identify Entamoeba histolytica in stool specimens from patients with amebic liver abscess. Here we report a method of detection in serum of circulating E. histolytica Gal/GalNAc lectin to diagnose amebic liver abscess, which was used in patients from Dhaka, Bangladesh. The TechLab E. histolytica II test (which differentiates the true pathogen E. histolytica from Entamoeba dispar) detected Gal/GalNAc lectin in the sera of 22 of 23 (96%) amebic liver abscess patients tested prior to treatment with the antiamebic drug metronidazole and 0 of 70 (0%) controls. After 1 week of treatment with metronidazole, 9 of 11 (82%) patients became serum lectin antigen negative. The sensitivity of the E. histolytica II antigen detection test for intestinal infection was also evaluated. Antigen detection identified E. histolytica infection in 50 samples from 1,164 asymptomatic preschool children aged 2 to 5 years, including 16 of 16 (100%) culture-positive specimens. PCR analysis of stool specimens was used to confirm that most antigen-positive but culture-negative specimens were true-positive: PCR identified parasite DNA in 27 of 34 (79%) of the antigen-positive, culture-negative stool specimens. Antigen detection was a more sensitive test for infection than antilectin antibodies, which were detected in only 76 of 98 (78%) amebic liver abscess patients and in 26 of 50 (52%) patients with intestinal infection. We conclude that the TechLab E. histolytica II kit is a sensitive means to diagnose hepatic and intestinal amebiasis prior to the institution of metronidazole treatment.

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Diagnosis and differential diagnosis of hyperandrogenism (in conjunction with measurements of other sex-steroids). An initial workup in adults might also include total and bioavailable testosterone (TTBS / Testosterone, Total and Bioavailable, Serum) measurements. Depending on results, this may be supplemented with measurements of sex hormone-binding globulin (SHBG / Sex Hormone Binding Globulin [SHBG], Serum) and other androgenic steroids (eg, dehydroepiandrosterone sulfate [DHEA-S]).


Diagnosis of congenital adrenal hyperplasia (CAH), in conjunction with measurement of other androgenic precursors, particularly, 17-alpha-hydroxyprogesterone (OHPG) (OHPG / 17-Hydroxyprogesterone, Serum), 17 alpha-hydroxypregnenolone, DHEA-S (DHES / Dehydroepiandrosterone Sulfate [DHEA-S], Serum), and cortisol (CORT / Cortisol, Serum).


Monitoring CAH treatment, in conjunction with testosterone (TTST / Testosterone, Total, Serum), OHPG (OHPG / 17-Hydroxyprogesterone, Serum), DHEA-S (DHES / Dehydroepiandrosterone Sulfate [DHEA-S], Serum), and DHEA (DHEA_ / Dehydroepiandrosterone [DHEA], Serum).


Diagnosis of premature adrenarche, in conjunction with gonadotropins (FSH / Follicle-Stimulating Hormone [FSH], Serum; LH / Luteinizing Hormone [LH], Serum) and other adrenal and gonadal sex-steroids and their precursors (TTBS / Testosterone, Total and Bioavailable, Serum or TGRP / Testosterone, Total and Free, Serum; EEST / Estradiol, Serum; DHES / Dehydroepiandrosterone Sulfate [DHEA-S], Serum; DHEA_ / Dehydroepiandrosterone [DHEA], Serum; SHBG / Sex Hormone Binding Globulin [SHBG], Serum; OHPG / 17-Hydroxyprogesterone, Serum).

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Culture and Sensitivity Anaerobic test is performed on a sample of blood to measure the level of Culture of the pathogenic organism in the blood.It is performed to confirm Infection and also during the treatment and after the treatment of Infection.

Also known as

C/S Anaerobic Blood, C/S Anaerobic, Culture and Sensitivity Anaerobic

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The immune system makes an abundance of proteins called antibodies. Antibodies are made by white blood cells (B cells). The antibodies recognize and combat infectious organisms (germs) in the body. Antibodies develop in our immune system to help the body fight infectious organisms. When an antibody recognizes the foreign proteins of an infectious organism, it recruits other proteins and cells to fight off the infection. This cascade of attack is called inflammation.


Sometimes these antibodies make a mistake, identifying normal, naturally-occurring proteins in our bodies as being “foreign” and dangerous. When these antibodies make incorrect calls, identifying a naturally-occurring protein (or self protein) as foreign, they are called autoantibodies. Autoantibodies start the cascade of inflammation, causing the body to attack itself. The antibodies that target “normal” proteins within the nucleus of a cell are called antinuclear antibodies (ANA). Most of us have autoantibodies, but typically in small amounts. The presence of large amount of autoantibodies or ANAs can indicate an autoimmune disease. ANAs could signal the body to begin attacking itself which can lead to autoimmune diseases, including lupus, scleroderma, Sjögren’s syndrome, polymyositis/dermatomyositis, mixed connective tissue disease, drug-induced lupus, and autoimmune hepatitis. A positive ANA can also be seen in juvenile arthritis.

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Angiotensin converting enzyme (ACE) participates in the renin cascade in response to hypovolemia. Its peptidase action on the decapeptide angiotensinogen I results in the hydrolysis of a terminal histidyl leucine dipeptide and the formation of the octapeptide angiotensin II, a potent vasoconstrictor that increases blood pressure.


The primary source of ACE is the endothelium of the lung. ACE activity is increased in sarcoidosis, a systemic granulomatous disease that commonly affects the lungs. In sarcoidosis, ACE is thought to be produced by epithelioid cells and macrophages of the granuloma.


Currently, it appears that ACE activity reflects the severity of sarcoidosis: 68% positivity in those with stage I sarcoidosis, 86% in stage II sarcoidosis, and 91% in stage III sarcoidosis. Serum ACE also appears to reflect the activity of the disease; there is a dramatic decrease in enzyme activity in some patients receiving prednisone.


Other conditions such as Gaucher disease, leprosy, untreated hyperthyroidism, psoriasis, premature infants with respiratory distress syndrome, adults with amyloidosis, and histoplasmosis have been associated with increased levels of ACE.

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Angiotensin II is the primary regulator of renal aldosterone secretion and a potent vasoconstrictor. It is generated through the renin angiotensin system (RAS): circulating angiotensinogen is cleaved by renin to form angiotensin I, which is then converted to angiotensin II via angiotensin converting enzyme (ACE). The rate-limiting step in the RAS is renin secretion by the renal juxtaglomerular cells, modulated by renal blood flow. Low renal blood flow and low perfusion pressure increases renin secretion, stimulating angiotensin II and aldosterone production with a resulting increase in blood pressure and renal sodium retention. These changes then produce inhibition of renin secretion and complete the feedback control loop.

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The antistreptolysin O (ASO) titer test is a blood test that checks for a strep infection. When you come into contact with harmful bacteria, your body produces antibodies to defend itself against these bacteria. Your body produces antibodies specific to the bacteria they fight.


The ASO titer test measures antibodies produced by your body in response to a toxin known as streptolysin O. Streptolysin O is a toxin produced by group A Streptococcus (GAS) bacteria. Your body makes the antistreptolysin O antibodies when you have a strep infection caused by GAS bacteria.


Usually, when you have a strep infection like strep throat, you receive antibiotics that kill the strep bacteria. But some people don’t have any symptoms during a strep infection and may not know they need treatment. When this happens, an untreated infection can lead to future complications. These complications are known as post-streptococcal complications.


The ASO titer test can help your doctor determine if you recently had a strep infection by measuring the presence of antistreptolysin antibodies in your blood.

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Anti B Titre test is performed on a sample of blood to measure the level of Anti B Titre in the blood.It is performed to confirm ABO Incompatibility and also during the treatment and after the treatment of ABO Incompatibility.

Also known as

Anti B Titre Tube Agglutination


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Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly systemic lupus erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

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Double-stranded (ds, native) DNA (dsDNA) antibodies of the IgG class are an accepted criterion (American College of Rheumatology) for the diagnosis of systemic lupus erythematosus (SLE).(1-3) dsDNA antibodies are detectable in approximately 85% of patients with untreated SLE, and are rarely detectable in other connective tissue diseases. Weakly-positive results caused by low-avidity antibodies to dsDNA are not specific for SLE and can occur in a variety of diseases.


Testing for IgG antibodies to dsDNA is indicated in patients who have a positive test for antinuclear antibodies (ANA) along with signs and symptoms that are compatible with the diagnosis of SLE. If the ANA test is negative, there is no reason to test for antibodies to dsDNA.(2)


The levels of IgG antibodies to dsDNA in serum are known to fluctuate with disease activity in lupus erythematosus, often increasing prior to an increase in inflammation and decreasing in response to therapy.

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The test system widely used currently for the determination of anti-HCV permits the detection of anti-HCV IgG alone. The data recently published by T. G. Wreghitt et al. confirm the probability of the presence of anti-HCV of both IgG and IgM classes in sera from hepatitis C patients. Anti-HCV IgM was detected by Ortho test with some modifications using an anti-M conjugate in the last stage of the experiment. Anti-HCV IgG were detected by regular Ortho test. A total of 46 patients with different forms of HCV infection and a control group were examined. According to the preliminary data, 18 patients were positive in the routine anti-HCV Ortho test. Among 18 anti-HCV-positive patients, nine had chronic HCV infection and the other 9 acute HCV infection. The distribution of IgM and IgG anti-HCV in the acute patients was as follows: 4 patients (44.5%) had approximately equal titres of IgG and IgM, 3 (33.5%) had predominantly IgG, 2 (22.2%) mainly IgM. A similar pattern was observed in the group with chronic HCV infection. Thus, 5 subjects (55.6%) showed approximately equal ratio of IgM and IgG anti-HCV, 2 (22.2%) had mostly IgM and the rest 2 mainly IgG. No anti-HCV in the control group was found. The control group consisted of 18 patients with chronic liver diseases without markers of HBV or HDV infection, 3 with HAV infection, 2 with HBV infection and 5 healthy subjects. The specificity of anti-HCV IgM test was confirmed by Chiron Western blot analysis using the same modification.(ABSTRACT TRUNCATED AT 250 WORDS).

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Hepatitis E virus (HEV) is the major etiologic agent of enterically transmiited non-A, non-B hepatitis worldwide and has a high case-fatality rate in pregnant women. Both IgM and IgG antibody to HEV (anti-HEV) are produced following infection. The titer of IgM anti-HEV declines rapidly during early convalescence; IgG anti-HEV persists and appears to provide at least short-term protection against disease.

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Hepatitis A virus (HAV) is endemic throughout the world, occurring most commonly, however, in areas of poor hygiene and low socioeconomic conditions. The virus is transmitted primarily by the fecal-oral route, and it is spread by close person-to-person contact and by food- and water-borne epidemics. Outbreaks frequently occur in overcrowded situations and in high-density institutions and centers, such as prisons and health care or day care centers. Viral spread by parenteral routes (eg, exposure to blood) is possible but rare, because infected individuals are viremic for a short period of time (usually <3 weeks). There is little or no evidence of transplacental transmission from mother to fetus or transmission to newborn during delivery.


Serological diagnosis of acute viral hepatitis A depends on the detection of specific anti-HAV IgM. Its presence in the patient's serum indicates a recent exposure to HAV. HAV-specific IgM antibody level becomes detectable in the blood by 4 weeks after infection, persisting at elevated levels for about 2 months before declining to undetectable levels by 6 months. They rarely persist beyond 12 months after infection.

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Antineutrophil cytoplasmic antibodies (ANCA) can occur in patients with autoimmune vasculitis including Wegener's granulomatosis (WG), microscopic polyangiitis (MPA), or organ-limited variants thereof such as pauci-immune necrotizing glomerulonephritis.(1) Detection of ANCA is a well-established diagnostic test for the evaluation of patients suspected of having autoimmune vasculitis. ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G. Antibodies to PR3 occur in patients with WG (both classical WG and WG with limited end-organ involvement) and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cANCA pattern. Antibodies to MPO occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the pANCA pattern.