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INSTRUCTIONS FOR THE PATIENTS FOR MULTI SLICE CT ALL FEMALE PATIENTS SHOULD MENTION THEIR L.M.P. ( DATE OF LAST MENSTRUAL PERIOD) PLEASE INFORM IF YOU ARE OR YOU THINK YOU ARE PREGNANT SO THAT PROPER PRECAUTION CAN BE TAKEN FOR THE STUDY . PLEASE INFORM IF YOU ARE LACTATING FOR ALL CONTRAST STUDIES IT IS ESSENTIAL TO HAVE RENAL FUNCTION STATUS – BLOOD UREA & SERUM CREATININE REPORTS . THIS IS SPECIALLY IMPORTANT FOR ALL DIABETIC , PATIENTS MORE THAN 50 YRS OR PATIENTS WITH HISTORY OF RENAL DYSFUNCTION PATIENT SHOULD BE FASTING FOR AT LEAST 4 HRS PRIOR TO THE EXAMINATION IF CONTRAST IS REQUIRED. HOWEVER NO NEED TO BE FASTING FOR PLAIN SCAN FOR ALL STUDIES SPECIALLY IN PEDIATRIC AGE GROUP WHERE SEDATION MAY BE REQUIRED FASTING HAS TO BE OF AT LEAST 6 HRS. PATIENTS MUST INFORM THE FRONT DESK/TECHNICIAN/DOCTOR ABOUT FOLLOWING o HISTORY OF ALLERGY TO ANY DRUGS / CONTRAST IN THE PAST o HISTORY OF ASTHMA / ATOPY /ANY OTHER HYPERSENSITIVITY etc. o HISTORY OF THYROID / RENAL DISORDER o HISTORY OF DIABETES MELLITUS – WHETHER ON METFORMIN o HISTORY OF MULTIPLE MYELOMA DETAILS OF PREVIOUS SURGERY AND OTHER INVESTIGATIONS TO BE PROVIDED TO THE RADIOLOGIST ON DAY OF EXAMINATION FOR THE ABDOMINAL / PELVIC EXAMINATION CONTRAST HAS TO BE TAKEN ORALLY ALSO FOR 2 HRS. FOR ALL ABDOMINAL AND PELVIC EXAMINATIONS PATIENT SHOULD BE PREPARED FOR A STAY IN THE DEPARTEMENT OF ABOUT 3 HRS. INSTRUCTIONS FOR THE PATIENTS FOR MRI NO NEED TO BE FASTING , EVEN FOR A CONTRAST SCAN, EXCEPT FOR MRI ABDOMEN WHERE FASTING OF 4 HRS IS REQUIRED. IF SEDATION IS REQUIRED PATIENT HAS TO BE FASTING FOR 6 HRS. SEDATION IS USUALLY REQUIRED FOR CHILDREN / UN COOPERATIVE PATIENTS ALL DIABETIC / PATIENTS WITH RENAL DISEASE OR PATIENTS MORE THAN 50 YEARS OF AGE TO HAVE BLOOD UREA & SREUM CREATININE REPORTS FOR CONTRAST SCANS PATIENTS WITH FOLLOWINGS CAN NOT BE TAKEN FOR MRI Cardiac pacemaker Metal Sharpnel Orbital Metalclips/Metallic fragments Aneurysm clips Hearing Aids Neuro-simulator (Tens-unit) Aortic clips Insulin pump Any other ferro-magnetic foreign body Programmed intracranial shunts PLEASE INFORM IF YOU HAVE ANY OF THE ABOVE WITH YOU PREGNANCY IS NOT AN ABSOLUTE CONTRAINDICATION, HOWEVER SHOULD BE AVOIDED IN FIRST TRIMESTER INFORM US IF YOU ARE OR THINK YOU ARE PREGNANT OR IF YOU ARE LACTATING CONTRAST MAY BE REQUIRED WHICH IS GIVEN INTRAVENOUSELY IF CONTRAST STUDY REQUIRED PLEASE INFORM ABOUT ANY HISTORY OF ALLERGY / DRUG REACTIONS PATIENT TO BRING ALL PREVIOUS REPORTS ON THE DAY OF EXAMINATION INSTRUCTIONS FOR THE PATIENTS FOR ULTRASOUND PATIENT TO BE FASTING FOR 6 HRS FOR ALL ABDOMINAL EXAMINATIONS NO NEED TO BE FASTING FOR PELVIC / SOFT PART ( EYES, THYROID, SCROTUM, BREAST, MUSCULOSKELTAL, CRANIAL ) ULTRASOUND FULL BLADDER REQUIRED FOR PELVIC ULTRASOUND, HOWEVER FOR TRANS VAGINAL OR TRANS RECTAL EXAMINATION BLAADER HAS TO EMPTY REMOVE ANY JEWELRY AROUND THE NECK FOR THYROID SCAN TO BRING ALL PREVIOUS RECORDS ON DAY OF EXAMINATION FOR FEMALE PATIENTS : REFERRAL SLIP FROM THE PHYSCIAN IS MUST IF USG IS FOR PREGNACY / PELVIS. USG WILL NOT BE PERFORMED FOR PELVIS IF YOU ARE OR THINK YOU ARE PREGNANT UNLESS YOU HAVE A REFERRAL SLIP FROM YOUR DOCTOR INSTRUCTIONS FOR THE PATIENTS FOR X RAYS / SPECIAL XRAY STUDIES ALL FEMALE PATIENTS SHOULD MENTION THEIR L.M.P (LAST MENSTRUAL PERIOD). PLEASE INFORM IF YOU ARE OR YOU THINK YOU ARE PREGNANT SO THAT PROPER PRECAUTION CAN BE TAKEN FOR THE STUDY . PLEASE INFORM US IF YOU ARE LACTATING YOU MAY NEED TO REMOVE CLOTHING WITH METAL PARTS, SNAPS OR ZIPPERS. YOU MAY ALSO NEED TO REMOVE JEWELRY OR EYEGLASSES DEPENDING UPON THE TYPE OF X RAYS. YOU MAY BE ASKED TO WEAR A HOSPITAL GOWN. MOST ROUTINE X-RAYS ONLY TAKE A FEW MINUTES. FOR ALL BARIUM EXAMINATION - FASTING FOR 6 HRS. FOR BARIUM ENEMA – LAXATIVE TO BE TAKEN BY THE PATIENT NIGHT BEFORE , BOWEL SHOULD BE FULLY EVACUATED BEFORE EXAMINATION FOR IVP AND OTHER EXAMINATION REQUIRING IODINATED CONTRAST o IT IS ESSENTIAL TO HAVE RENAL FUNCTION STATUS – BLLOD UREA & SERUM CREATININE REPORTS . THIS IS SPECIALLY IMPORTANT FOR ALL DIABETIC PATIENTS o PATIENT SHOULD BE FASTING FOR 4- 6HRS PRIOR TO THE EXAMINATION . PATIENTS MUST INFORM THE FRONTDESK/TECHNICIAN ABOUT FOLLOWING o HISTORY OF ALLERGY TO ANY DRUGS / CONTRAST IN THE PAST o HISTORY OF ASTHMA / ATOPY /ANY OTHER HYPERSENSITIVITY etc. o HISTORY OF THYROID / RENAL DISORDER o HISTORY OF DIABETES MELLITUS – WHETHER ON METFORMIN o HISTORY OF MULTIPLE MYELOMA TO BRING ALL PREVIOUS RECORDS ON DAY OF EXAMINATION INSTRUCTIONS FOR THE PATIENTS FOR MAMMOGRAPHY PLEASE INFORM IF YOU ARE OR YOU THINK YOU ARE PREGNANT SO THAT PROPER PRECAUTION CAN BE TAKEN FOR THE STUDY . BEST TIME FOR MAMMOGRAPHY IS ONE WEEK FOLLOWING PERIOD – ASK FOR L.M.P. NO DEODORANT, TALCUM POWDER OR LOTION UNDER ARMPIT ON THE DAY OF MAMMOGRAM BRING PREVIOUS STUDIES , IF ANY INSTRUCTIONS FOR THE PATIENTS FOR STRESS ECHO CARDIOGRAM DO NOT EAT OR SMOKE FOR 3 HOURS BEFORE THE TEST. YOU MAY DRINK WATER. DO TAKE YOUR USUAL MEDICATIONS WITH WATER, UNLESS INSTRUCTED OTHERWISE BY YOUR DOCTOR OR NURSE. DIABETICS WHO USE INSULIN OR GLUCOSE LOWERING AGENTS MAY NEED TO ADJUST THEIR DOSAGE. PLEASE CHECK WITH YOUR PHYSICIAN IF YOU ARE NOT SURE. DO WEAR LOOSE FITTING CLOTHING THAT ALLOWS EASY ACCESS TO THE CHEST, AND COMFORTABLE WALKING SHOES. COMPUTED TOMOGRAPHY (CT) ABOUT THE STUDY CT Scan also called CAT SCAN is an imaging technique using X-Ray and computers to visualize the internal structure of the human body with great precision and detail. It is one of the best tools to study chest and abdomen and the effect of trauma. This institute is equipped with state of the art multi slice CT . The procedure is performed in the CT Scan room. The Patient will be asked to lie down on the table which is designed to slide. Patients are requested not to move during the scan. In most cases intravenous contrast injection is required. Where ever contrast is to be injected the patient has to be on empty stomach for 4-6 hours. CT examination causes no pain. The multislice CT has very short scan time and most of the scans are over in one breathhold. Contrast : Contrast injection is given in a vein during the procedure to enhance the blood vessels so that the doctor can visualize the lesion more clearly and accurately and assess the vascularity of abnormal lesion. The institute uses the best available non ionic contrast medial still rarely the contrast can cause a reaction in few patients, the probability of which is more in patients who are having allergic disorders. In case of any reaction due to contrast the centre is well equipped and is backed by the specialists to take care of these reactions if they occur. For abdominal / pelvic studies oral and rarely rectal contrast may be required. The common type of reactions are: Minor : Itching, nausea and redness and swelling at the site of injection or along the length of the vein. Severe : These include shortness of breath, irregular heart beat, kidney failure and unconsciousness. Rarely an Anaphylaxis fatal reaction may occur. Oral contrast given for abdominal / pelvic scans is harmless and usually causes no side effects. However in very few cases patients may develop loose motions which is usually self limiting , however patient must drink lot of fluid and remain well hydrated if it happens. Two types of Contrast are available : (1) Ionic and Non Ionic. Ionic contrasts are cheaper but the chances of reactions occurring are high (0.1%). (2) Non Ionic contrasts are expensive but are associated with a much lower reaction rate (0.017%). At this institute only Non ionic contrast is used for all intravenous contrast injections. Option is available for a lesser nephrotoxic contrast but that is relatively more expensive MRI ( MAGNETIC RESONANCE IMAGING ) ABOUT THE STUDY WHAT IS MRI? Magnetic Resonance Imaging (MRI) is the latest imaging technique that utilizes a strong magnetic field and radio waves to visualize the internal structure of the human body with great precision and details. The region of interest can be imaged in any plane at any angle without moving the patient. It involves no X-ray exposure and is harmless. The technique has no known side effects of significance. Tesla is the unit of magnetic strength, higher the tesla , the stronger the MRI system resulting in better images quality. This institute is equipped with state of art 3.0Tesla unit – the maximum permissible for human use internationally. PREPARATION No preparation is required for MR examination. If sedation is required (as in small and in uncooperative patients), patient should be empty stomach for 2 hours before the examination. CAN YOU BE TAKEN FOR MRI STUDY? You cannot be taken for MRI, if you have any of the following medical devices: Cardiac pacemaker Metal Sharpnel Orbital Metal clips/metallic fragments Programmable VP shunts Hearing Aids Neuro-stimulator (Tens-unit) Aortic Clips Insulin pump Any other ferro-magnetic foreign body. Please inform if you have any of the above medical devices / surgery in the past Pregnancy is not an absolute contraindication for MRI, however the procedure should be avoided in the first 3 months. MRI is safe after 6 weeks of cardiac / vascular stenting ABOUT THE PROCEDURE After you have been examined and checked by the technologist / attendant you will be taken up for the examination. The actual procedure is performed in MRI room. The MRI system has a large magnet and a padded examination table. You will be asked to lie flat on the table which is designed to slide into the centre of the magnet. You are requested not to move during the scan. There are no X ray radiations. During the study you will hear intermittent humming and thumping sounds. In about 20% of the cases contrast injection (Gadolinium) may be required. If you have renal impairment please inform if contrast is required for your study. HOW LONG WILL THE STUDY TAKE? The length of your stay in the magnet is about 5-20 minutes depending upon the type of study and the part being imaged. During this entire period you will be in contact with the technologist/doctor by a two way intercom system. ABOUT THE STUDY WHAT IS A STRESS ECHOCARDIOGRAM? AN ECHOCARDIOGRAM IS A PAINLESS, HARMLESS TEST THAT USES HIGH FREQUENCY SOUND WAVES (ULTRASOUND) TO EXAMINE THE HEART’S ANATOMY AND FUNCTION. A TREADMILL STRESS TEST EVALUATES YOUR HEART’S RESPONSE TO PHYSICAL ACTIVITY THROUGH THE MONITORING OF YOUR HEART RATE, BLOOD PRESSURE, AND ELECTROCARDIOGRAMS WHILE YOU EXERCISE ON A TREADMILL. WHEN THE TWO TESTS ARE COMBINED, AN ASSESSMENT CAN BE MADE OF THE STATUS OF YOUR HEART AT REST, AS WELL AS DURING AND IMMEDIATELY FOLLOWING STRESS. THIS CAN PROVIDE YOUR DOCTOR WITH INFORMATION REGARDING WHETHER OR NOT YOU HAVE SIGNIFICANT BLOCKAGES IN YOUR HEART ARTERIES. OTHER INFORMATION OBTAINED INCLUDES AN ASSESSMENT OF THE PUMPING FUNCTION OF YOUR HEART AND THE STATUS OF YOUR HEART VALVES. COMMON REASONS TO HAVE A STRESS ECHOCARDIOGRAM TO DETERMINE IF CORONARY ARTERY DISEASE IS PRESENT AND IF FURTHER STUDIES AND /OR TREATMENT ARE REQUIRED. TO EVALUATE PROGRESS FOLLOWING A MAJOR CARDIAC EVENT (HEART ATTACK, HEART SURGERY, ETC.). TO INVESTIGATE THE EFFORT OF EXERCISE ON HEART VALVE FUNCTION.