ULTRASOUND

Ultrasound (US) is often used to guide various interventional procedures in the genitourinary (GU) tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

Exercise Tolerance Test (ETT)

Exercise Tolerance Test (ETT) assesses the response of your heart to increased workload and demand for blood. This is achieved by recording the ECG whilst you are walking on a treadmill machine.

Once you start walking on the treadmill, your blood pressure, heart rate, general condition and ECG will be monitored continuously. After every 3 minutes the speed and incline of the treadmill will be increased. You will be encouraged to exercise for as long as you can and the test will be continued until you reach a desired heart rate and/or cannot exercise any more (usually 10 to 15 minutes). After the test, you will be asked to rest while your ECG and blood pressure are recorded and until your recordings reach the normal baseline heart rate. All the recordings will be analysed by a cardiologist (doctor with special training to treat heart related diseases)

How to prepare for the test?

• An advance appointment must be made. 

• Bring your doctor’s prescription to the appointment. 

• You may be asked to stop certain medications a day before the test. Please confirm this with your doctor.

• Do not eat or drink anything for at least 4 hours before the test, on the day of the test,.

• Do not apply skin lotions on the day of the test.  

• Wear loose clothing and comfortable flat shoes to walk in. Do not wear open toe sandals, flip-flops or slippers. 

• It may be necessary for men to shave their chest before the test.

• If you are suffering from fever or any other illness, please inform the doctor or the technologist.

Cardiac Cathlab / Angiography / Angioplasty

The Heart, Lungs and Vascular Service Line at the Naimat Begum Hamdard University Hospital offers the most advanced and comprehensive cardiac, pulmonary and vascular care across the country.

Our team of Cardiologists, Cardiac Surgeons, Cardiothoracic Surgeons, Vascular Surgeons, Cardiac Nurses and Imaging Technicians, work together to deliver specialized and individualized care for our patients suffering from heart disease and disorders. Our cardiac services offer a full range of primary prevention, diagnostic (laboratory testing, clinical imaging, cardiopulmonary) to interventional (angiograph, angiogram), surgical (coronary artery bypass graft, also known as CABG) and rehabilitation options. This is the largest centre of its kind in the region, helping in the better diagnosis and treatment of cardiac diseases.

Our Pulmonary and Critical Care Services are equipped with the state-of-the-art diagnostic and treatment facilities for patients with pulmonary diseases and those who need critical care. Patients can rely on our highly qualified pulmonary and critical care doctors, surgeons, nurses and technicians to manage simple to complex cases. These include, but are not limited to, asthma, allergies, bronchitis, tuberculosis, pneumonia and cancer.

The Naimat Begum Hamdard University Hospital has multiple specialties all under one roof. This enables our doctors in the Heart, Lungs and Vascular service line to work closely with doctors from other service lines in the hospital and ensure our patients receive a holistic health treatment approach. 

MRI

Magnetic resonance imaging uses a powerful magnetic field and a series of radio wave energy pulses to produce detailed images of the organs and structures within the body. An MRI does not use x-rays or radiation. 

The MRI scan produces cross sectional images of the body called slices. These help in examining the internal parts of the body to assess for any medical conditions or diseases. MRIs are very useful for examining the brain and spinal cord.

Preparations for the Test:

• You will need to fast for 4 to 6 hours before you arrive for the test.
• You may be allowed to take your medications (if any), unless informed otherwise by your doctor.
• Please arrive 30 minutes before your exam to allow sufficient preparation time for the test.
• Please bring your test referral form (letter from the doctor) when you come for the exam.
• Please remove metal objects, including jewellery, dentures, spectacles and hearing aids before coming for the test. Metallic objects may interfere with producing accurate results.
• If you get anxious in closed spaces (experience claustrophobia), please inform your doctor or technologist. He or she may suggest medications to help you relax.
• Please inform your doctor or technologist if you have any allergies or experience any adverse reactions to medications. Please also let us know if you have any recent health problems or have had any recent surgeries.
• Please inform the doctor or technologist if you have medical or electronic devices in your body.

Echocardiogram (ECHO)

Doppler echocardiography is a procedure that uses high frequency sound waves (ultrasound) to take images and measurements of different parts of the heart.  The images are recorded in digital format and analysed using a specialized software (EchoPAC) program by a cardiologist (doctor trained to treat heart problems). No radiation (X-ray) is involved.

The test is performed by a specially trained echo-technologist. A doctor may assist the technologist if there is a need. The test is used in the diagnosis of cardiovascular diseases. 

How to prepare for the test?

• An advance appointment must be made. 

• Bring your doctor’s prescription to the appointment. 

• You can eat and drink as usual and should continue to take any prescribed medications. No special preparation is required.

• Wear clothing you can easily change in and out of, as you will be asked to change into a hospital gown when you come for the test.

Electrocardiogram (ECG)

An electrocardiogram measures and records the changes in your heart’s electrical activity.

Resting Electrocardiogram

Resting Electrocardiogram (ECG) is a simple test which is commonly used for basic evaluation of heart status. It records intrinsic electrical activity of the heart to provide useful information regarding previous damage to the heart muscles, enlargement of the heart chambers and abnormalities in the electrical system of the heart. The ECG results are valuable for the diagnosis and initial management of an sudden (acute) heart attack. In the case of an extended monitoring period, more specialized equipment known as an Event Recorder may be used. This mode of monitoring is particularly useful for patients who have very infrequent symptoms.

How to prepare for the test?

• Do not apply oily or greasy creams on your skin on the day of your test.
• In this test, the ECG is continuously monitors the heart status for 24 to 48 hours or more. The signals are captured on a special recorder that is worn by the patient. This prolonged monitoring records transient rhythms or abnormalities. This test is especially useful for patients with palpitations, giddiness or fainting spells. It can also help in assessing responses to drug therapy.

Ambulatory EGGHow to prepare for the test?

• An advance appointment must be made. 

• Bring your doctor’s prescription to the appointment. 

• You can eat and drink as usual and should continue to take any prescribed medications. 

• Wear loose-fitting clothing when coming to the hospital and during the monitoring period.

• In the Holter hook-up room, surface electrodes will be placed on the upper chest. The electrodes will be connected to the recorder that will be strapped around your waist. You will need to wear it continuously for 24 to 48 hours as requested by your doctor. Please do not remove the electrodes on your own.

• You will be advised to return to the hospital at a given time to have the recorder removed for analysis.

Interventional Radiology

A significant number of conditions that once required open surgery can now be treated by interventional radiology using minimally invasive, image-guided techniques through incisions as small as 2mm. The benefits for patients include less pain and significantly reduced recovery time in hospital.

The section closely works with the oncology team, general surgeons, urologists and ICU/critical care teams in providing diagnostic and therapeutic interventional radiology services. We have a dedicated ultrasound room for ultrasound guided procedures, and access to the CT scanner for CT guided procedures.

PET-CT Scan

We offer the latest in screening equipment with the PET-CT, which is an advanced nuclear imaging technique. The PET-CT is used commonly for the diagnosis and monitoring of cancer (oncology) patients, although can also be used in the diagnosis of several other conditions.

Positron Emission Tomography or PET scan is a diagnostic test that detects radiation by the accumulation and non-accumulation of radiotracers (injected intravenously before the scan) into the body to analyse the functioning of the body organs and tissues.   

A Computerised Tomography or CT Scan produces a series of x-rays. A computer then arranges these pictures in a series that give detailed, cross-sectional pictures of the body, from different angles.

A Pet-CT Scan combines the information relayed by both the scans. This helps in detecting the structural changes in the body at a tissue and cellular level.

X-rays (x-radiation) are a type of radiation known as electromagnetic waves. When directed towards the body, the waves are able to produce black and white images of the body based on absorption.  Bones absorb the most radiation and appear white in an x-ray image, while fat and soft tissues absorb less and appear grey. Hollow structures, like the lungs, appear black on an x-ray image because they contain air. 

People think of x-rays when checking for broken bones although x-rays are also used to detect but not limited to, breast cancer, pneumonia and tuberculosis.

Mammogram

A mammogram is an x-ray of either one or both the breasts to help in the screening for breast cancer in women.

Preparations for the test:

• Please bring your test referral form (letter from the doctor) when you come for the exam.
• Schedule an appointment for the test for when your breasts are least likely to be tender. If you haven’t reached menopause, this is usually the week after your menstrual cycle.
• Please remove metal objects, including jewellery, dentures, spectacles and hearing aids before coming for the test. Metallic objects may interfere with producing accurate results.
• Please inform the doctor or technologist if you are pregnant or think you maybe pregnant.

Bone mineral

The bone mineral density test is an x-ray of the bones to measure the amount of calcium and other minerals in the bones. Bone mineral density test helps in the diagnosis of osteoporosis and assess the probability of bone fractures.

Preparations for the test:

• • Please bring your test referral form (letter from the doctor) when you come for the exam.

  • Please remove metal objects, including jewellery, dentures, spectacles and hearing aids before coming for the test. Metallic objects may interfere with producing accurate results.

  • Please inform your doctor or technologist if you have recently had a CT scan, nuclear medicine test or a barium exam. The contrast materials used in these tests may interfere with the results of the bone mineral density test. 

  • Please inform the doctor or technologist if you are pregnant.

These are special x-ray techniques that provide images of the teeth and jaw.

An OPG (orthopantomogram) gives a panoramic image of the mouth, giving information on the teeth and the bones of the upper and lower jaw.

A CEPH (cephalometry) is used to obtain measurements and determine relationships of the structures of the lower face e.g. for plastic surgery, orthodontics. 

Preparations for the test:

The NBHUH provides one of the most sophisticated radiology facilities. Our Radiology Department offers a comprehensive range of imaging services, including both routine and specialized procedures.

We have a cutting-edge picture archiving and communication system (PACS). This system allows digital images to be viewed immediately upon completion of an examination, which significantly reduces reporting turnaround times.
With each new improvement to the diagnostic and treatment processes at NBHUH, we aim to distinguish ourselves as a premiere health care provider in the South Asian region.

Electroencephalography (EEG) is a technique used to track the electrical activity of the brain through the placement of electrodes on the scalp. Clinically, EEG are often used to identify seizures, but this same technology can also be used by researchers to reveal a various brain functions and how those functions relate to human cognition and behavior. Unlike the tES techniques described above, the scalp electrodes employed during EEG are only used to record the brain’s natural electrical activity; they do not deliver electrical energy to the brain. Consequently, there are no major risks associated with this entirely noninvasive brain monitoring technique.