A randomised controlled trial to assess the feasibility of utilising virtual reality to facilitate analgesia during external cephalic version.

External cephalic version (ECV) is associated with a moderate degree of pain. Virtual reality (VR) is a technology that has shown promise in offering procedural analgesia. We undertook a clinical pilot to assess the viability of VR to reduce pain during ECV.

Nuclear cardiology practices and radiation exposure in Africa: results from the IAEA Nuclear Cardiology Protocols Study (INCAPS).

Objective: While nuclear myocardial perfusion imaging (MPI) offers many benefits to patients with known or suspected cardiovascular disease, concerns exist regarding radiation-associated health effects. Little is known regarding MPI practice in Africa. We sought to characterise radiation doses and the use of MPI best practices that could minimise radiation in African nuclear cardiology laboratories, and compare these to practice worldwide.

Nuclear Cardiology Practice in Asia: Analysis of Radiation Exposure and Best Practice for Myocardial Perfusion Imaging - Results From the IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS).

Background: This paper examines the current status of radiation exposure to patients in myocardial perfusion imaging (MPI) in Asia.

Methods and results: Laboratories voluntarily provided information on MPI performed over a 1-week period. Eight best practice criteria regarding MPI were predefined by an expert panel.

Functional compared to anatomical imaging in the initial evaluation of patients with suspected coronary artery disease: An international, multi-center, randomized controlled trial (IAEA-SPECT/CTA study).

Objective: To test the hypothesis that, in the initial evaluation of patients with suspected coronary artery disease (CAD), stress myocardial perfusion imaging (MPI) would result in less downstream testing than coronary computed tomographic angiography (CCTA).

Methods: In this international, randomized trial, mildly symptomatic patients with an intermediate likelihood of having CAD, and asymptomatic patients at intermediate risk of cardiac events, underwent either initial stress-rest MPI or CCTA. The primary outcome was downstream noninvasive or invasive testing at 6 months.

Nuclear Cardiology Practices and Radiation Exposure in the Oceania Region: Results From the IAEA Nuclear Cardiology Protocols Study (INCAPS).

Background: There is concern about radiation exposure with radionuclide myocardial perfusion imaging (MPI). This sub-study of the International Atomic Energy Agency (IAEA) Nuclear Cardiology Protocols Study reports radiation doses from MPI, and use of dose-optimisation protocols in Australia and New Zealand (ANZ), and compares them with data from the rest of the world.

Methods: Data were collected from 7911 MPI studies performed in 308 laboratories worldwide in one week in 2013, including 439 MPI studies from 34 ANZ laboratories.

Opportunities for improvement on current nuclear cardiology practices and radiation exposure in Latin America: Findings from the 65-country IAEA Nuclear Cardiology Protocols cross-sectional Study (INCAPS).

Background: Comparison of Latin American (LA) nuclear cardiology (NC) practice with that in the rest of the world (RoW) will identify areas for improvement and lead to educational activities to reduce radiation exposure from NC.

Methods And Results: INCAPS collected data on all SPECT and PET procedures performed during a single week in March-April 2013 in 36 laboratories in 10 LA countries (n = 1139), and 272 laboratories in 55 countries in RoW (n = 6772). Eight "best practices" were identified a priori and a radiation-related Quality Index (QI) was devised indicating the number used.

Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries.

Purpose: Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis.

Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS).

Aims: To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing 'best practices' worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose.

Methods And Results: We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March-April 2013. Eight 'best practices' relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory.

Evaluation of a novel decorporation approach to prevent radioactivity uptake by using acidosis in experimental animals.

With an aim to devise a prophylactic and/or therapeutic approach for preventing internalization of radiothallium (201Tl), and more importantly by implication, its chemical analogue radiocesium (137Cs) during any nuclear emergency, different ex vivo and in vivo animal models were created to determine the role ofpH in absorption of 201Tl across jejunum/muscle tissue and whole body retention of 201Tl respectively. Movement of Tl+ under simulated pH conditions proved that pH had direct influence on its absorption. Oral intake of acidified water or parenteral administration of lactic acid was able to reduce the body burden of 201Tl by up to 12 and 50% respectively.

Hybrid imaging worldwide-challenges and opportunities for the developing world: a report of a Technical Meeting organized by IAEA.

The growth in nuclear medicine, in the past decade, is largely due to hybrid imaging, specifically single-photon emission tomography-computed tomography (SPECT-CT) and positron emission tomography-computed tomography (PET-CT). Introduction and use of hybrid imaging has been growing at a fast pace. This has led to many challenges and opportunities to the personnel dealing with it.

Quality management in nuclear medicine for better patient care: the IAEA program.

The International Atomic Energy Agency promotes the practice of nuclear medicine among its Member States with a focus on quality and safety. It considers quality culture as a part of the educational process and as a tool to reduce heterogeneity in the practice of nuclear medicine, and in turn, patient care. Sensitization about quality is incorporated in all its delivery mechanisms.

IAEA programs in empowering the nuclear medicine profession through online educational resources.

The International Atomic Energy Agency's (IAEA) programme in human health aims to enhance the capabilities in Member States to address needs related to the prevention, diagnosis, and treatment of diseases through the application of nuclear techniques. It has the specific mission of fostering the application of nuclear medicine techniques as part of the clinical management of certain types of diseases. Attuned to the continuous evolution of this specialty as well as to the advancement and diversity of methods in delivering capacity building efforts in this digital age, the section of nuclear medicine of the IAEA has enhanced its program by incorporating online educational resources for nuclear medicine professionals into its repertoire of projects to further its commitment in addressing the needs of its Member States in the field of nuclear medicine.

Trends in nuclear medicine in developing countries.

This article describes trends in nuclear medicine in the developing world as noted by nuclear medicine professionals at the International Atomic Energy Agency (IAEA). The trends identified are based on data gathered from several sources, including information gathered through a database maintained by the IAEA; evaluation of country program frameworks of various IAEA Member States; personal interactions with representatives in the nuclear medicine field from different regions of the world; official proceedings and meeting reports of the IAEA; participation in numerous national, regional, and international conferences; discussions with the leadership of major professional societies; and relevant literature. The information presented in this article relied on both objective and subjective observations.

Use of technetium(99m)-ciprofloxacin scan in Pott's spine to assess the disease activity.

Purpose: The World Health Organisation has declared tuberculosis (TB) a global emergency and spinal tuberculosis is one of the most common forms. There is still controversy regarding optimum duration of treatment in osteoarticular tuberculosis due to the lack of well-defined criteria for the end point of treatment. Emergence of multi drug resistant tuberculosis, primarily due to use of poor drug regimens, further illustrates the need of newer and more effective diagnostic methods, particularly in developing countries.

Evaluation of adequacy of short-course chemotherapy for extraspinal osteoarticular tuberculosis using 99mTc ciprofloxacin scan.

In the evidence-based medicine era, objective treatment guidelines have been laid down for pulmonary tuberculosis, but the same is not true for osteoarticular tuberculosis. This has led to demands for standardising the treatment protocol and to a lack of consensus between doctors regarding the composition and duration of treatment. Twenty-five patients with extraspinal osteoarticular tuberculosis were evaluated prospectively.

Development of atropine sulphate nasal drops and its pharmacokinetic and safety evaluation in healthy human volunteers.

Introduction: The increased use of organophosphate (OP) insecticides and the ever increasing possibility of terror groups using nerve agents underscore the need to develop effective and safe antidotes against OP poisoning. While intramuscular administration of nerve gas antidotes like atropine sulphate has certain lacunae, intravenous route is neither practical nor feasible in the field conditions for mass casualties. The objective was to develop a novel atropine sulphate nasal drop formulation, evaluate and characterize it using scintigraphy and to carry out safety-efficacy study in human volunteers with a view to obtain early pharmacological effects in comparison to the existing options, particularly the conventional intramuscular route.

Role of 99mTc-Tetrofosmin delayed scintigraphy and color Doppler sonography in characterization of solitary thyroid nodules.

Objectives: A study was undertaken to evaluate the diagnostic efficiency of Tc-Tetrofosmin scan and color Doppler in the characterization of benign and malignant solitary thyroid nodules.

Methods: Fifty-two patients found to have a cold solitary thyroid nodule on Tc-pertechnetate scintigraphy were included in this study. All patients underwent a single-injection dual-phase (30 min and 120 min) Tc-Tetrofosmin scan.

Tc-99m ciprofloxacin scans for detection of tubercular bone infection.

Tc-99m MDP and Tc-99m ciprofloxacin scans were performed in 14 patients with suspected tubercular bone disease and in 2 cases of nontubercular bone infection. In 5 patients the findings were true negative. There were no false positives and 1 was false negative.

Anti-inflammatory activity of Seabuckthorn (Hippophae rhamnoides) leaves.

Immunomodulatory activity of Seabuckthorn (SBT) leaf extract was evaluated in adjuvant induced arthritis (AIA) rat model. Inflammation was induced by injecting Complete Freund's Adjuvant (CFA) in the right hind paw of rats. SBT extract was administered intraperitoneally to treat the inflammation.