Shared by Dr. Mustafa Taha(@مصطفى محمود السيد from Facebook)
I am so happy to provide you a number of videos of multiple interested in medical cases that were done by my EagleView probe.
This 40- year male patient presented to ER with acute confusion rapidly admitted to ICU.
On ICU ,the patient was in deep coma Glasgow coma scale was 5 and blood pressure was 80/50, JVP was raised and radial pulse was rapid and irregularly irregular, cardiac auscultation showed pan systolic murmur, spleen hugely enlarged and there are peripheral signs of infective endocarditis(Janeway lesion Osler nodules splinter hemorrhages and finger ulcerations), investigations are done and CT of brain show ischemic CVA.
I provide rapid bedside echo by EagleView, and the result was big mitral valve vegetations with rapid heart rate due to atrial fibrillation.
The case was diagnosed as Infective endocarditis with splenic and brain ischemic infarction due to vegetation emboli.
This 50 year male pt come with SOB and cough with lower limbs swelling, pt admitted to ICU and mechanically ventilated,on examination pt was in respiratory distress,Bp 90/50 ,JVP elevated.
The shape of chest wall showed pectus excavatum with thoracic scoliosis with coarse crepitations on auscultation, bedside echo was done by EagleView US and show hugely dilated right atrium together with right ventricle with evidence of D shape interventricular septum provides severe pulmonary hypertension with severe tricuspid regurge, inferior vena cava was congested and poorly collapsed which give hint about elevated pressure in the right atrium, case diagnosed later as core pneumonia due to chest wall deformity complicated by a chest infection.
Always at High Level of Blood Pressure? Do You Snore When You Sleep?
During sleep, the muscles of the whole body relax, and so do the muscles of the throat. The waves of “hoo – hoo – hooooo” sound is called snore. That’s because when you are breathing, the air in and out of the respiratory tract cause vibration.
In a thundering snore, some people repeatedly stop and start breathing while you sleep. The whole night in between “snoring – stop breathing – snoring again” loop is called sleep apnea hypopnea syndrome by the doctor.
Maybe you feel snoring during sleep is not a big problem, but as a matter of fact, it might be one of causes of your poor hypertension control!
What are the consequences of sleep apnea?
Hypoxemia, an abnormally low concentration of oxygen in the blood, is the result of “apnea” and “hypoventilation” during sleep. Thus although you seem to sleep for long time, your sleep is not of high quality. When getting up in the morning, you may feel dizzy, headache and dull. When working in the daytime, you may be easily tired and sleepy. Overtime, you may be accompanied by memory loss, aniety and irritability.
In addition, long-term hypoxemia can also cause vascular lesions. 45% to 48% of patients with sleep apnea have high blood pressure. There are studies showing that treating sleep apnea is helpful to take control of hypertension.
Moreover, obesity, diabetes and hyperlipidemia can also be caused by hypoxemia. The risk of coronary heart disease, cerebrovascular accident is much higher.
So who needs to be very careful about snoring? To put it simply, patients who are overweight, especially those with high blood pressure who have a stubby neck and no chin.
Obesity and snoring are a dangerous pair. Snoring can lead to obesity; obesity will aggravate snoring. There could be a vicious cycle. Then hypertension, diabetes, high blood lipid problems come out.
How to improving breathing and snoring?
The most important thing is to lose weight.
Keep a balanced diet. Don’t eat too much at each meal.
Maintain a certain amount of exercise. Half an hour of jogging, aerobics, swimming and other aerobic exercise every day. You can undertake the strength training of low intensity under the guidance of professional fitness coach. Although the strength training in low intensity cannot burns much fat, it is helpful to improve body shapeand control high blood pressure.
Keep a good sleep habit.
You may be prone to snoring during sleep when you feel tired or if you sleep after drinking. Therefore, avoid excessive fatigue in the daytime, and don’t drink alcohol before going to bed. Additionally, taking the position of sleeping on your side is also effective.
Home CPAP therapy.
Usually, CPAP (Continuous Positive Airway Pressure) machine is used to treat sleep apnea. It can produce a certain amount of pressure, initiatively “blow” the air into the patient’s respiratory tract in the inhalation. It is good to improve the situation of hypoxemia during sleep.
The control of blood pressure is a problem. It cannot just rely on antihypertensive drugs.
If you have a problem with snoring during sleep and your blood pressure is monitored to be over high, it is recommended to take a sleep study in the hospital or to monitor your blood oxygen levels by using sleep apnea monitors at home.
Heart health is a prerequisite for good health. A healthy heart pumps fresh blood and carries oxygen to nourish organs and tissues.
Heart disease in our life will do harm to human body. It is mainly due to a result of some bad habits formed long time in daily life.
People of all ages should take care of their heart and maintain a healthy lifestyle, so as to reduce the risk of heart desease.
So how to take care of your heart at your age?
(1) 20-30 years old：Build good habits
People in their 20s are busy at work or school, sometimes sitting for a whole day with little time for exercise. Sitting for long periods of time lowers HDL cholesterol levels and fails to clear arterial plaque. So sit less and move more. Take the stairs instead of taking the elevator, or run or bike instead of driving the car.
Don’t smoke and avoid secondhand smoke. Smoking will increase the risk of heart disease.
Don’t ingnore your body health even though you are at an early age. The body mass index, heart rate, blood pressure and belly circumference should be tested regularly every year to adjust your lifestyle and diet. You can take a smart scale to manage your body health at home.
(2) 30-40 years old: Stay strong
People at this age is very easy to induce the occurrence of various diseases. So you should attach importance to more outdoor activities and a healthy diet.
Doing aerobic exercise to keep your heart rate and weight at normal level.
At the same time, follow the dietary principle of low salt, low sugar and low oil, eat at least 500 grams of vegetables and 200 grams of fruit every day, of which dark vegetables account for more than half. Staple food should be diversified. Increase the proportion of coarse grain in staple food.
Learn to release stress of work and life and keep a good state of mind. Prolonged stress can raise blood pressure, speed up the heart rate, damage the endothelial cells in the blood vessels. You can relieve stress by meditation, listening to soft music and exercising.
Remember to learn your family genetic history and regularly do physical examination.
👇 Wellue recommend a device to monitor your heart rate during exercising.
Always focusing on your health and fitness, it will continuously monitor your heart rate during exercising and can vibrate to tell ireeugular heartbeats.
(3) 40-50 years old: Home monitoring
People aged 40-50 should actively monitor blood pressure, blood sugar, blood lipids, body weight and other indicators. Deal with sleep apnea early. In particular, blood sugar should be checked every three years after the age of 45, and once a year for those at high risk for hyperglycemia, diabetes and being overweight.
Wellue recommend this Wi-Fi blood pressure monitor to measure your average blood pressure and track ECG instantly when you feel discomfort. Its AI-ECG platform will tell you what the ECG means. 👇
Guard your heart all day long. AI-ECG platform will detect abnormal ECG events. No worry about identifying ECG waveforms.
Cardiovascular disease is becoming more and more common in younger people, so people of any age should pay attention to protecting their heart by adjusting their diet and avoiding foods high in salt, sugar and fat. Eat plenty of fresh fruits and vegetables, exercise moderately, and actively control your weight. Pay more attention to your heart. If unexplained chest pain or discomfort occurs, seek medical advice as soon as possible.
A number of companies are looking beyond the wrist at the next frontier in wearable technology. Few people know that the finger can provide a useful snapshot of a person’s overall health. This is because it contains arteries that can be sensed by finger-worn devices to capture physiological data such as your heart rate and blood oxygen.
Slim and sleek, smart rings are generating lots of interest. Particularly amongst people who are after something that is useful, as well as lightweight and fashionable. The big brands, such as Apple, Fitbit, and Garmin, are yet to enter this area. But there are a few other players with interesting offerings.
One of these is Wellue. Their FDA-registered O2Ring continuously monitors your blood oxygen (SpO2), heart rate, and movement with clinical-grade accuracy. Slip it onto your thumb or index finger and it will do the rest. You can view data in real-time on the device itself, or sync the ring with the app or the accompanying PC/Mac software for detailed analysis and reports on trends.
Typically retailing for $169 on getwellue.com , the O2Ring is more expensive than a typical fingertip blood oxygen monitor. Is it worth the extra price? I set out over the past week to find out.
Wellue O2Ring review: Design & hardware
Feels solidly built – rubberised design
More about functionality than fashion
Large, easy to read display
12-16 day battery life
Look & feel
Despite the name, the Wellue O2ring is not a ring in the classical sense. The device is made of soft silicone that has a rubberized feel to it. It is also larger than a typical ring so is more about function than style. But it is smaller and much less cumbersome than fingertip blood oxygen monitors which it is meant to replace.
The actual size of the device comes in at 4 x 3 x 3.5cm (L x W x H) and weight at 15 grams. It fits fingers that measure between 50 and 82mm. The rubberized band stretches so can expand for those with large fingers.
While it is not fancy, the whole thing does feel solidly built. A large screen sits on top which is easy to read thanks to its size.
On one side of the display is a touch key that you can use to wake up the screen and cycle through time, heart rate/oxygen level readings. There’s no power button. As soon as you slip on the ring it will turn on the sensor and the screen will spring to life. When you remove the ring, it will switch off automatically after a few seconds. I really liked this, as most of my other devices require powering on and off. The touch key is also very responsive.
You are meant to wear the O2Ring on your thumb finger. If that feels too tight, the other option is to use the index finger. I found the band approach to be much more comfortable than fingertip alternatives as it does not get in the way of anything. You can type and do pretty much anything you want while wearing the ring.
To properly test it out, for a week I wore the Wellue O2Ring every night during sleep. With all the typical tossing and turning it stayed in place and never felt in danger of slipping off. The rounded corners on the device mean that it does not snag on the bed sheets or pillows. In fact, the ring is so comfortable, I would wake up in the morning forgetting it is even on.
The only part of the design I am a bit cautious about is the flexible tip at the end of the silicon band. It seems a bit flimsy. I am not sure if it might break at some point with long-term use.
Unlike some other smart rings, this device is primarily meant for use at home or in healthcare facilities. The bulkiness of O2Ring means it is something you would probably not want to wear in outdoor environments anyway. You could if you wanted to. But blood oxygen readings are best taken while at rest or sleep so there would be little point in taking measurements in those conditions.
Wellue says the device is designed to give medically accurate readings during sleep when you are sitting somewhere or walking slowly. Some of their customers are professional pilots. They use the O2Ring to monitor their blood oxygen when flying planes.
The device has an IP24 rating for dust and water resistance. So you should not take a shower or bath with it, but you’ll probably be ok to wear it in the rain.
Under the hood
The technology that is used by Wellue O2ring is something called transmissive oximetry. This is trusted and used in hospitals and clinics. Smartwatches use reflective technology which is not seen as accurate.
With transmissive oximetry, a device passes two wavelengths of light through a thin part of the body to a photodetector. It then measures the changing absorbance at each of the wavelengths. Fingertips are perfect for such measurements as they have higher blood flow rates than other tissues. Hence the accuracy of the O2Ring and traditional clip-on fingertip oximeters.
The O2ring has built-in memory which enables it to work independently without a phone. There are 4 small memory cards built-in. Each can store about 10 hours of data.
This means you do need to sync with the app from time to time. So if you track sleep each night, after four or five nights you’ll need to fire up the app. If you don’t, the oldest recording will be deleted when the memory is full. Async is done automatically when connected via Bluetooth 4.0 to the smartphone app or computer software.
Apart from accuracy, what distinguishes the O2Ring from other such devices is the sampling rate. Oxygen levels, pulse rate, and motion data are captured at 1-second intervals. For those with medical conditions such as sleep apnea, the high sampling rate will be very important.
As far as the all-important battery life, the oxygen ring has an advertised running time of between 12 and 16 hours on a single charge. Wellue says this is enough for two nights. In practice, though, I found that it was best to charge it after a full night’s sleep. I tend to sleep at least 8 hours per night and it definitely wouldn’t last me a full two nights.
Charging is done via a micro-USB cord. Unfortunately, there is no progress bar or percent charged on the display, so you will need to leave it on until the display turns off. It can take more than an hour to go from zero to full so it is not that quick.
The battery inside the Wellue O2Ring is similar to a coin cell for watches. So theoretically, you could replace it yourself if needed, or ask a repairman to do it. But the battery should last a few years so there probably wouldn’t be any need for that.
Wellue O2Ring review: Functionality
Clinical-grade data, FDA registered for accuracy
Choice of smartphone app or PC/Mac software
Abnormal SpO2 and heart rate alerts
Export high-resolution oxymetry reports to share with doctor
Setup and first use
For me, a highlight of this product is that it is incredibly easy to set up and just as easy to use. Start off by downloading the ViHealth app to your iPhone or Android device. Open it and create an account.
Slip your finger in O2Ring (or plug it into the charger) to switch it on and the app will find it and ask if you want to pair. Click on the picture of the ring and you’re done. From that point on it will link up automatically whenever the ring is switched on and the app is open. You can also use the app in offline mode to review data when the ring is off.
At this point, you might want to tweak a few options. Go to the “Settings” tab in the app where you will have the option to connect with Apple Health and where you’ll be able to turn on the heart rate and oxygenation alarms. This will also allow you to set up the high and low thresholds for each.
The O2Ring vibrates to alert the wearer if he or she has approached the preset limits. The idea is that this will warn you of heart abnormalities or hypoxic events so that you can take a break to recover. So, for example, if your oxygen level dips below the configured threshold during sleep, the vibration will wake you up so that you can adjust your sleep position.
For those that suffer from sleep apnea, this is a feature that cheap oxygen monitors simply do not have. So this feature alone justifies the higher price point of the Wellue O2Ring as compared to such devices.
The discreet vibration also helps your partner sleep better. Think of it as a vibrating smartphone. Something like this is great for meetings and noisy environments. Mind you, there’s no built-in speaker in the ring. However, the mobile app can sound audio alarms if that is your preference. You can even use both at the same time, the vibration alarm on the ring and the sound alarm on the phone.
I do feel, though, there is a missed opportunity that could be fixed with a firmware update. Considering the vibration functionality is already there along with a clock, it would be nice if the O2Ring could act as a morning wake-up alarm.
Lots of informative data in the smartphone app
You can use the ring itself for real-time blood oxygen and heart rate readings. Once you slip the device on it will automatically start to capture the measurements for a minute or so before shutting off the display so you can sleep. Dead simple. The real-time data can also be seen in the dashboard of the app.
I found the Perfusion Index (PI) to be a nice feature. Similar to an indication of the strength of a cell phone signal, it quantifies the quality of the pulse reading. This can vary depending on lots of factors such as the way you wear the ring, physiological conditions, skin temperature, and more. You can use it to assess whether you are wearing the device correctly. As long as PI is green you are good to go.
In the morning, you take off the ring, and the display will briefly turn on and start a count-down from 10 to 0 and then a “SAVING” and “END” message. After that, you can turn on your phone, open the app and allow it to sync.
Blood oxygen measurements appear to be accurate when compared with a traditional oximeter. That’s to be expected considering Wellue has secured FDA approval for the device. Plus measurements are captured each second and displayed in four-second intervals in the app. Much more useful than Apple Health which only shows SpO2 data in 10-minute intervals.
The “History” tab in the app shows you a timeline of all your measurements. What I didn’t like is that each time you remove the ring, it saves the session as a separate one. So if you take the ring off in the middle of the night and put it back on, two data sets will be created. So in that sense, it can get a bit messy.
Each individual session shows a wealth of data. There is a handy O2 score bar that quantifies your oxygen shortage during sleep. It combines frequency, duration, and depth of oxygen drops. In my case, I was typically at 9.8 and 9.9 which is considered to be excellent. If the Score turns yellow or red, Wellue suggests you speak to your doctor for advice. To make this easier, the O2Ring can create a SpO2 report in PDF format that you can email to your doctor.
Other data shows your average pulse rate for the session, average SpO2, the number of drops over 4%, lowest SpO2, and more. All very useful stuff that goes into more detail as far as blood oxygen than any other device I’ve come across. Nothing really out there allows you to create four-second interval, high-resolution oximetry reports that can be shared at the click of a button.
There’s also a PC, MAC app that you can optionally use
I also liked the fact that you have the option of installing PC or Mac software called O2 Insight Pro. Simply download it from the Wellue website.
It works exactly the same way as the smartphone app but everything is displayed on the large screen format that is easier to read. You’ll have no trouble detecting in detail the hourly graphs – it is comparable to an actual sleep study report.
Wellue O2Ring review: The bottom line, is it worth it?
The Wellue O2Ring is a very useful product. But it is not for everyone. The device is primarily designed for people who need to track their oxygen levels in detail, especially those who have or suspect they have sleep apnea or another medical problem. If you’ve recently tested positive for Covid-19 this ring might give you peace of mind.
The device predominantly does one thing and it does it well – it tracks your blood oxygen in one-second intervals with medical-grade accuracy. Other stats that you’ll get are heart rate and body movement. The thing will also buzz you into alertness if you are experiencing low oxygen levels or irregular heart rates. For those that suffer from sleep conditions, it could be a lifesaver. Shift your position and the buzzing will stop.
The ring is quite big in size so it is not something you would want to wear around the clock. But for measurements at home, in the office, or overnight it is quite useful. The device is also well made and comfortable to wear, in my case on my thumb.
Typically retailing for $169 on getwellue.com, the O2Ring is expensive if all you need are ad-hoc blood oxygen and heart rate readings. A typical fingertip pulse oximeter is a much cheaper option. But if you need overnight monitoring with alarms and long-term tracking then it is probably the best option out there. For some, it might become their most important piece of jewelry.
Gallbladder Polyps – are present in 4 to 6 percent of the population.4,5 An estimated 90% are benign cholesterol polyps, less than 10 mm in size and are incidental findings. The remaining 10% are adenomatous polyps that have malignant potential.
Most polyps are spherical (attached by a pedicle to the gallbladder wall). Less common are the broad based (sessile) polyps.
Sonographically a polyp appears as a hyperechoic nodule (more echogenic than the surrounding bile) attached to the gallbladder wall. The polyp is nonmobile and remains in a fixed position regardless of changes in patient position. The polyp is non-shadowing.
We have 36years old man sent to our clinic complain of right upper quadrant pain for an abdominal ultrasound, the study done using a handheld ultrasound devise from EagleView and gallbladder wall shows multiple immobile polypoid ingrowths into gallbladder lumen with no vascularity at color doppler which denotes gallbladder polyp.
image (1) sagittal view of the gallbladder demonstrated non-shadowing polypoid ingrowth into gallbladder lumen by the white arrow. gallbladder wall demonstrated by the black arrow.
image (2) transverse view of the gallbladder demonstrated non-shadowing polypoid ingrowth into gallbladder lumen by the white arrow. gallbladder lumen demonstrated by the black arrow.
image (3) color doppler over the gallbladder polyp (white arrow) demonstrated no color flow.