Institute of Ultrasound Imaging
Karachi - Pakistan
The Institute of Ultrasound Imaging was founded in 1984 by Dr. Musarrat Hasan and Dr. Seema Musarrat .

Dr. Musarrat Hasan was appointed as the Director of the Institute and Dr. Seema as the Educational Coordinator. Dr. & Mrs.  
Musarrat Hasan conceived the idea of this Institute on the basis of the increasing demand of Doctor for Ultrasound training.

Our Institute is located at Clifton, which is a posh locality of Karachi; the covered area is about 3600sq.ft.
It comprises of:

* Three scanning rooms
* One lecture Hall
* One common room
* Audio visual room
* Library Hall
* Patients visiting Hall

The Library is equipped with all latest books on ultrasound, journals, CDs, Multi-format cases & Video cassettes.

The Institute carries out scanning of over 120 patients daily. Training on patients is done on referrals from various charitable  
organization, government and semi-government hospitals.

To date we have trained over 5850 doctors who are serving in the field of ultrasound as hard working and brilliant sonologists.

The time period of our course is six weeks; at the end of which an official certificate distribution ceremony is held at five  
start hotels in which an honorable chief guest is invited to give away the certificates.

Following respected personalities have already honored this occasion & visited our institute.

Hakim M. Said Esq, Governor of Sindh and Chancellor Hamdard University.
Mr. Salik Nazeer, Health Secretary Government of Sindh
Mr. Abdul Hannan Deputy High Commissioner Republic of Bangladash Karachi.
Prof. Syed Irtifaq Ali, Vice Chancellor, Karachi University.
Prof. S.M. Rab, President - College of Physicians and surgeons of Pakistan.
Prof. M. Shafi Quraishy Health Secreatry. Government of Sindh and Principal, Dow Medical College.
Prof Ali Mohammad Ansari, Dean Faculty of Medicine, Karachi University.
Prof. Azhar Hussain, Registrar, College of Physicians and Surgeons.
Prof Razia Ansari, Chairperson. Academic Council, Jinnah Post-Graduate Medical Center.
Prof Sadiqa N. Jaffery, Head of Department OB/GYN - Ziauddin Hospital.
Prof. Khurshid Noorani, Head of Department OB/GYN, Jinnah Post - Graduate Medical Center.
Prof. Hasan Fatima Jaffery, Head of Department OB/GYN - JPMC.
Prof. Salma Akram, Department of Pathology, Civil Hospital, Karachi.
Prof. Mohammad Akram, Department of Pathology, Civil Hospital, Karachi
Prof.  Haji Haroon, Consultant Radiologist, Karachi X-Rays & Ultrasound.
Prof. Jehan Ara Pal, Head of Department OB/GYN - Agha Khan University Hospital.
Prof. Tasneem Ahsan Head of Department of Medicine & Director JPMC.
Prof. Mashoor Alam Shah. Head of Department of Medicine & Director JPMC.
Prof. Hiroki Watanabe. President WFUMB World Federation of Ultrasound in Medicine & Biology.
Prof. Naeem Jaffery, Vice Chancellor, Ziauddin Medical University.
Prof M. Jaleesi, Dean Faculty of Medicine, Karachi University.
Prof. F.U. Baqai, Chancellor, Baqai Medical University.
Prof. Zahida Baqai, Department of OB/GYN, Baqai Medical Univeristy
Prof. Syed Hamid Shafqat, Director, Jinnah Post Graduate Medical Centre
Prof. Mansoor Darr CEO Karachi Lab & Diagnostic Center, President Pakistan Society of Pathalogy.
Prof. Faruq Abbas CEO Karachi Lab & Diagnostic Center.
Prof. Razia Kurajo Department of OBGYN JPMC (Jinnah Post Graduate Medical Center) Karachi.
Prof. Haider Ali G. Kazi. Head of Deaprtment of psychiatry Civil Hospital Hyderabad.
Prof. Nasira G. Kazi. Head of Deaprtment of Anatomny Liaquat Medical College Jamshoro.
Prof. Nargis Soomro Professor & Head of Department of OBGYN Civil Hospital Karachi.
Prof. Roger Sanders Director & CEO of Institute of Ultrasound Baltimore Marry Land USA.
Prof. Masood Hameed Vice Chancellor Dow University of Health Science
Prof. Zaman Shaikh Head of Department of Medicine Civil Hospital Karachi
Prof. Saeeda Malik Minister Womens Development Government of Pakistan
Prof. Majeed Memon Head of Department of OB/GYM Hamdard University Karachi.
Prof. Sultana Tayyab. Head of Department of OB/GYN Civil Hospital Karachi.
Prof. Shireen Bhutta Head of Department of OB/GYN & Chairman Academic Council JPMC Karachi.
Prof. Kittipong Vairojanavong. President AFSUMB (Asian Federation of Societies for Ultrasound in Medicine and Biology).

Faculty:
* Dr. Musarrat Hasan
* Dr. Seema Musarrat
* Dr. Ambreen Sohaib
* Dr. M. Saulat Nawaz
* Dr. Ghousia Khan
* Dr. Rida Pervaiz

Manager & Administrator:
* Mr. Raffat Hasan

Three Ultrasound courses are conducted every year that are approximately 4 months apart. At the end of the course, there is  
an exam conducted by the Institute on behalf of Thomas Jefferson University and those conditions who are among the first 4  
are offered a 3 months attachment period as trainees of our clinic which is followed by the selection of 3 candidates out of  
three successive courses for fellowship program.

Syllabus for Five Weeks course in Ultrasound
* Time period Five weeks
* Working days Six days per week
* Time per day Five hours daily

Time distribution per day:
* 1hour - 30minutes scanning on patients.
* Scanning time in six on patients.
* Scanning time per doctor
* 15min per day
* 75min per week
* 4 hours 50mins in six weeks

Lecture Time
* 1hour 45min per day
* 8hour 75min per week
* 54hours per six weeks

Multi format review class
* 30min per day
* 2hour 75min per week
* 15 hours per six weeks

Tea break daily for 15min

Lecture format for each week

First week
1st Day Introductory lecture and demonstration on Equipment
2nd Day Physics and Instrumentation
3rd Day A look into the female pelvis
4th Day Foetal Well Being - 1st trimester
5th Day Foetal Well Being - 2nd & 3rd trimester
6th Day Video Lectures

Second week
1st Day Fetal Well Being 2nd & 3rd trimester
2nd Day Demonstration on Patients
3rd Day Method of Writing the Reports
4th Day The Placenta
5th Day Foetal abnormalities I (head and body)
6th Day Video Lectures

Third week
1st Day Fetal abnormalities (limbs & Miscellaneous)
2nd Day “IUGR” Intra Uterine Growth Restricted and “BPP”
3rd Day “Ectopic Pregnancy”
4th Day “Uterine Masses”
5th Day “Overian Masses”
6th Day  Video Lectures

Fourth week
1st Day Evaluation of Liver
2nd Day Focal masses in the Liver
3rd Day Diffuse liver disease
4th Day Gall Bladder
5th Day Evaluation of CBD
6th Day Video Lectures

Fifth week
1st Day Pancreas and Spleen
2nd Day Urinary Tract
3rd Day Diffuse Renal problems and acute pain in the Lumber region
4th Day Focal masses of the kidneys
5th Day Retro peritoneal masses
6th Day Video Lectures

Time period:
4 hours

Time Distribution
1hour 30min Test on different multi format slides
15min Break for tea
2hour 15min Theory

History Taking
History is also a very essential part of scanning students are encouraged to take a good history of the patient. They are  
encouraged to develop a friendly talk with the patients and to ask them all relevant questions like.

Self-Scanning
A self scanning class is held in the last week, when all the students are encouraged to scan each other for a period of 40 min  
each in this way, they get a better idea about the scanning technique and the handling of the probe as it is being done on  
themselves.

Reports
Students are encouraged to write reports at the end of each scanning session every day. They are explained the various  
formats of reporting.

Students get a chance to present their report in front of the class and then it discussed and dealt with thoroughly.

Protocols for Six months attachment

The institute of Ultrasound Imaging has undergone remarkable metamorphosis over the year. Besides imparting Ultrasound  
training to doctor for a period of 6 weeks, 6 months clinical attachment and one year Visiting Fellowship program has also been  
introduced by the clinic.

Attachment Policy:
6 months attachment is only offered to the first 4 position holders of the post course exam.

Functioning:
The clinical education and practical experience is imparted at the Diagnostic Ultrasound Center, which is a well-
equipped clinic state of art machines.

Teaching Experience:
Trainee doctors are encouraged during their period of attachment to participate in the teaching sessions of the courses  
that are held at the institute.

Morning sessions at the clinic:
At the start of each day a 30 mins morning clinical session is held at the consultant's desk. Interesting cases are  
discussed and short presentations are made during this session. Senior doctors also deliver short lectures on basics of  
color Doppler scanning once a week.

Theoretical and Practical hands on Experience:
The Theoretical and Practical Protocols for 6months attachment is as follows;

1.  Patients Scheduling.
The first step in learning and practicing ultrasound starts from patient's availability. Hence a lot of emphasis is put on  
scheduling the patients. Which means not only to make the patients available to them for scanning at the clinic timings but  
also to look for patient's convenience. Rescheduling of the patients is some time required for certain procedures, for which  
they are given prior appointment. Preparation required for the test and brief protocol is explained to the patient about  
how the test will be done.

2. Mechanical and Technical know how.
At the start of the day all the trainee doctors are advised to switch on the machines and to check the calibrations and pre-
set manual of the machines to avoid any error during practical sessions. To check all the probes are plugged in. Connection  
of the machine with printer and VCR are checked and appropriate setting is done. All probes are cleaned with aseptic  
solution.

3. History and Consent
As soon as the patient comes to the clinic and hands over the ultrasound request at the reception desk, one of the trainee  
doctors is immediately assigned to take a short clinical history of the patient with reference to the request. If consent is  
required then that is also taken during this time. Details of the scanning procedure are explained to the patient. Major  
question are asked from the patients like what is the complaints? Any previous X-rays, ultrasounds & lab investigations  
done? Any history of operations? In addition to this all OB/GYN patients are asked about the menstrual history.

4. Patient Handling
Almost all ultrasound procedures require some degree of preparation, which is explained to the patient before taking him to  
the examination couch. Patient's comfort and privacy are given top priority. After positioning the patient uncovering and  
draping the areas for scanning, patient ID is fed into the machine. Other relevant data for e.g. LMP or EDD is also  
recorded. Bed is cleaned after every examination to this any special handling if required is provided to the patient, e.g.  
wheel chair or any personal support.

5. Scanning
The clinic is equipped with state of art machine with various probes of multi frequency. Trainee doctors are made aware of  
the probe selection according to the area required to scan for eg. 3.5MHz probe us used for scanning OB/GYN, 7.5Mhz  
for small parts and endocavitary 6Mhz probes for vaginal and rectal scans. They are required to obtain the images on  
paper printer of area scan and label them on screen.  They are required to measure various parameters and probe is  
cleaned with aseptic solution after every patient.

6. Ultrasound Reports
Preliminary reports with provisional diagnosis are prepared trainee doctors, these reports are then checked by senior  
consultants where by confirming the diagnosis. Trainees are once again required to check the report for any typing error.

7. Special Procedures
Procedures like hystero salpingo sonography , diagnostic as well as prognostic aspirations (abscess, cysts and pleural  
effusions) are also carried out at the clinic by the trainee doctors under the supervision of senior consultants under all  
aseptic measures.

8. Clinical Log Book
A clinical record of all the cases seen daily for the period of 6months by the trainee and all the procedures performed is  
maintained in the form of a log book. Special and teaching cases for the purpose of follow-up are recorded on DVD.

The above mentioned protocols are carried out by all the trainees for a period of six months during which their  
performance and skill is assessed on a regular basis.

One-year clinical visiting fellowship program

The Institute of Ultrasound Imaging Karachi an affiliate center of Jefferson ultrasound Research and Education Institute  
Philadelphia, Pennsylvania USA, offers one year Visiting Fellowship program in the field of clinical and diagnostic  
ultrasound.

Fellowship program offers clinical as well as theoritical  learning facilities for the doctors.

Three fellows are selected from list of those doctors who have already completed 6 months attachment at the Institute.

Around 12 doctors manage to complete a period of six months attachment program, out of which 3 outstanding candidates  
are selected for one-year fellowship.

Protocols
Visiting fellowship protocols are an extension and elaboration of clinical and theoretical learning provided during 6 months  
period of attachment.

Scanning and Log Book
The fellows on patients do daily scanning for a period of 6hour.
A variety of cases are seen by them including OB/GYN, abdomen and small parts (breast, thyroid, eye and peripheral  
Doppler scans).
Interesting and unusual cases are followed up for further procedure and outcome.
Invasive procedures like Hyesterosalpingosonograpy and aspiration of cysts and obcess are also carried out by the fellows  
independently.

All the doctors are advised to maintain a record of the cases seen by them date wise.

At the end of the year this record is logged in the form of a booklet named the log book.

Yearly log book is also helpful in assessing the performance of each doctor.

Teaching Sessions
Visiting Fellowship doctors are incorporated into teaching and administrative work during the 6 week course at the  
institute.

Short lectures, scanning instructions, reporting format and multi format teaching session are given to the doctors on  
rotational basis to enhance their knowledge and clinical experience.

Research and Presentations
Various clinical topics are given to the doctors on a monthly basis for collecting data and research material for compiling  
and presenting papers in the conferences during their fellowship period.

Pre-presentation workshops are also arranged at the clinic to help and guide the doctors about paper presentations.

A full time library service is also available at the institute, which provides latest books on ultrasound, journals and  
research papers by doctors from all over the world.
Membership of Professional Societies.

Participants of the course encouraged to become member of various professional ultrasound societies locally as well as  
foreign e.g. Ultrasound Society of Pakistan, American Institute of Ultrasound in Medicine, Australian Society of  
Ultrasound in Medicine AFSUMB & WFUMB.

Morning Lectures and Meetings
Daily morning sessions of 20mins for case discussions and short presentation are a routine at the clinic.

Short lectures on practical points are delivered by senior consultant once a week during morning sessions.

Courses Revision
During 1year fellowship session all the doctors get the opportunity to revise the 6weeks course at least twice, which  
includes revision of lectures, multi formats and video cassettes by foreign speakers.

Doctors are encouraged to participate and help their senior in arranging conference and clinical meeting through out the  
year. They are assigned tasks to handle independently.

At the end of one-year program the clinical research work done by the fellows is assessed and sent to the Jefferson  
University, Philadelphia, PA. United States of American.

Job recommendations are also provided to out standing candidates.

A certificate of commendation is also awarded.
About The Institute