Diagnostic efficacy of sonography for diagnosis of ovarian torsion

Objectives: Misdiagnosing ovarian torsion is now suggested as an important issue in clinical setting. The aim of this study was to determine the diagnostic accuracy of sonography for ovarian torsion. Methods: In this study 323 women with acute pelvic pain with highly suspected ovarian torsion signs and symptoms attending Imam Reza Medical Center in Kermanshah between 2011 through 2012 were included and underwent a transabdominal sonography (2-5 MHz probes). Then findings of sonography were compared with laparatomy. Results: The ultrasound correctly diagnosed 72.1% of ovarian torsion and missed 27.9% of them (false negatives). However, one free subject (0.4%) was misclassified as ovarian torsion (false positive). There was a strong correlation between sonography and laparatomy with a kappa value of 84.0%. The sensitivity and specificity of sonography were 72.1% and 99.6%, respectively. Sonography had a positive predictive value of 96.9%, a negative predictive value of 95.9%, and a total accuracy of 96.0% for detection of ovarian torsion. Conclusion: Sonography appears to be an excellent method to evaluate patients with suspected ovarian torsion. Abnormal blood flow detected by sonography is highly predictive of ovarian torsion and is therefore useful in the diagnosis of this phenomenon

Decreased endogenous progesterone and ratio of progesterone to estrogen in stroke ischemia

Progesterone and estrogen are two steroid hormones whose exposure may decrease the risk and delay the onset of ischemic stroke. The main objective of this study was to determine the plasma level of progesterone, estrogen and ratio of progesterone/estrogen in ischemic stroke patients. The plasma levels of progesterone, estrogen and ratio of  progesterone/estrogen in 30 patients (15 men and 15 women) with acute ischemic stroke was determined within 12 h of the onset of the attack as well as in 30 control subjects (15 men and 15 women) of comparable age. There were significant differences between the progesterone and ratio of progesterone/estrogen of stroke and control group (p = 0.022 and p = 0.001, respectively). Compared with control, stroke patients had lower levels of progesterone and ratio of progesterone/estrogen. There were not significant differences between levels of estradiol in stroke and control groups. The results showed ischemic stroke is accompanied by reduction ofprogesterone and ratio of progesterone/estradiol. These reductions might be involved in the decreased protection of brain to ischemic injury