ABSTRACT
Background: The international commission on radiation protection (ICRP) publican 135 recommends that Diagnostic Reference Levels (DRLs) should be tied to defined technical and patient parameters for the imaging task. Whereas for computed tomography (CT) examinations, DRLs are defined in terms of two established technical parameters namely, Volume-based Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP), a debate has ensued as to whether patient size, age and weight or clinical indication should be used as patient parameters. The objective of diagnostic reference levels (DRLs) is to assist in the optimisation of radiation dose to the patients while maintaining diagnostic image quality. It is generally accepted that each country requires having national DRLs to guide the practice of radiography regarding dose optimization as a prerequisite to good radiation protection practice. Objective: This review aimed to establish commonly used approaches to establishing national diagnostic reference levels for computed tomography. Methods: A systematic literature search in databases containing leading journals in radiography, radiology and medical physics was performed aided by the use of carefully selected search terms that relate to CT and DRLs. The literature search was achieved by the use of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) flow chart. A total of 109 studies were screened out of which 54 were excluded and 55 sought for retrieval. After further assessment for quality, 20 studies were included in this study for review. Key Findings: 95% of the studies in this review used CTDIvol and DLP as technical parameters indicating dose. 70% of the studies reviewed used patient size, age and weight while 30% used clinical indication as patient parameters. 30% of the reviewed articles did indicate that the surveys to establish NDRLs employed a retrospective approach, while 35% employed a prospective approach and 35% did ..

ABSTRACT
We conducted a retrospective and prospective study. In our study, we collected 35 cases of MAR, including 21 boys and 14 girls, over a period of 4 years, from January 2017 to December 2020. We recorded an average of 8.7 cases of ADR per year. They are more frequent in boys, with a sex ratio of 1.5. The majority of our patients came from the Mopti region and were of Dogon ethnicity. Most of the malformations were discovered by the parents, given that 54.3% of the mothers had given birth in a health centre and the malformed children were most often seen in a state of intestinal obstruction or sub-occlusion requiring an emergency colostomy. The diagnosis was made during the systematic examination of the newborn in the delivery room in 8.57% of our patients. Low forms were more frequent (48.6%). Invertograms were performed in 15 patients (42.9%). Abnormalities associated with MAR were dominated by spinal malformations in 4 cases (11.4%). In terms of treatment, the operative techniques used, in order of frequency, were: ASARP 8 cases (30.8%); Pena PSARP 15 cases (57.7%), YV Proctoplasty 2 cases (7.7%) and PENA PSARP plus MOLLARD AP 1 case (3.8%). Average follow-up was 12 months. Four (4) patients (15.4%) were lost to follow-up. Post-operative follow-up was favourable in 17 patients (65.4%); 4 cases of death and 1 case of anal stenosis.

ABSTRACT
Background: X-ray systems in the cardiac catheterization laboratory are essential to helping and treating patients best. However, they come at the cost of harming the patients and health workers through unnecessary high exposure to radiation particles. Aim: The study aimed to evaluate and compare the effectiveness and the radiation doses of the recent Philips imaging systems Azurion Hybrid OR and the older Philips systems Allura Xper FD 10 and Allura clarity FD 10 in the cardiac catheterization laboratories. Method: A descriptive, comparative research design was utilized, 480 procedures were assessed retrospectively, and all met predetermined inclusion criteria from January 2014 until May 2023. Dose area product, Air Kerma, and Fluoroscopy time (Fluro time) were compared between the three Philips systems, which are Allura Xper FD10/10 R 7.2 and Allura Clarity FD10 R8.2 (old system) and Hybrid Azurion new Philips system. Result: Allura clarity FD 10 and Azurion Hybrid OR were superior to Allura Xper FD 10 in Dose Area Product and Air Kerma (p<0.5). However, fluro time was statistically non-significant among the systems. Conclusion: The latest X-ray imaging systems significantly manage Dose Area Product and Air Kerma levels during medical procedures. Employing these advanced technologies in a cardiac catheterization lab can yield optimal outcomes while minimizing radiation exposure for patients and healthcare personnel.