Incremental value of 2-dimensional longitudinal radial and circumferential speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography

Background: DSE is considered one of the good options in clinical practice but due to some limitations new promising modalities like speckle tracking echocardiography [STE] was introduced. STE is a new imaging technique that allows evaluation of global and regional myocardial function independently from the angle of acquisition and from cardiac translational movements

Objectives: Determine optimal cutoff values for longitudinal, radial and circumferential strains at peak DSE for detection of significant stenosis on CA. Also investigate incremental value of combining strain measurements to wall motion analysis. Methods: The study population comprised 100 patients [age 50 +/- 9 years] underwent high dose DSE, STE followed by CA. DSE and STE results were compared and added to each other and finally compared to CA result

Results: GLS cutoff points [-16.75%] showed significantly higher accuracy when compared to GCS and GRS, with highest balanced sensitivity and specificity to predict CAD. GLS, GRS and GCS reduced the DSE false positivity by 83%, 72.2% and 66.6% respectively. STE also showed better Agreement with CA than DSE in detecting coronary territorial affection especially LAD [Kappa= 0.775]

Conclusions: STE is feasible during DSE, it helps increasing the diagnostic accuracy of DSE and decreasing its false positivity. Both global and segmental longitudinal strain can offer accurate, feasible and non invasive assessment of CAD

sialographic study of the secretory function of the parotid gland in diabetic patients

Secretory sialography was done for the parotid gl and using an oily contrast medium in five diabetic patients as well as five control subjects. A derangement in the secretory function of the parotid gl and with a resultant retardation of evacuation was observed in the diabetic patients. The contrast medium was found to persist in the ductal and acinar system up to two weeks in the diabetic patients. On the other h and, the gl and was completely emptied within one day in the normal subjects

study on contrast and resolution of a submandibular sialolith using the appropriate exposure factors

Ten male patients with sialoliths in the subm and ibular salivary gl and s and /or their ducts were investigated in this study. Various technical exposure factors were utilized in order to obtain cross sectional m and ibular occlusal films with the best contrast and resolution. It has been found that the best contrast and resolution of sialoliths were achieved by the lower range limits of killovoltage and the shortened exposure times