Microvascular Changes in Patients with Psoriatic Arthritis as Shown in Nail Fold Capillaroscopy

P-value less than 0.05 was considered statistically significant.Participants had a mean age of 44.2

Nail fold Capillaroscopic Findings in Iranian Patients with Systemic Lupus Erythematosus

Background: Systemic Lupus Erythematosus is a progressive autoimmune disease with a wide range of morphological and functional changes in microscopic examination of small blood vessels. Identification of vascular diseases at early stage, plays an essential role in the prevention of its’ vascular complications. Nailfold capillaroscopy (NFC) is a non-invasive, easy, painless, and accurate method for evaluation of microcirculation and could be used for this purpose. The vast majority of studies on capillaroscopy in lupus patients have shown that changes are not specified to lupus –unlike Systemic Sclerosis- and are more likely to overlap with other diseases. Therefore, it was decided to check capillaroscopic changes and evaluate morphological changes and capillary structure in terms of quality and quantity in lupus patients.Materials and Methods: Nail fold capillaroscopic findings of 114 patients aged 19-75 years old were reviewed in this study. The results were categorized as: a) normal, b) non-specific morphological abnormalities, and c) Scleroderma-like pattern.  Results were analyzed qualitatively and quantitatively using SPSS 21 software. "Chi square" test was used to analyze the relationships between variables (P<0.05 was considered significant).Results: Our results show that Lupus –independent of any other microvascular risk factor can significantly affect the morphology and structure of blood circulation and these changes are shown with detail by nail fold capillaroscopy.Conclusion: Most of the findings are in line with similar studies performed by other investigators in this field. However, no specific pattern was recognized and microbleeding was higher in our patients with scleroderma-like pattern of involvement

Petersen’s Hernia as a Complication of Bariatric Surgery: A Case Report

Background: Bowel obstruction due to Petersen hernia is a known but rare late complication of a R-Y surgery that can be a life threatening condition.  Delayed intervention may result in a high morbidity and even mortality. The clinical findings are not specific, In this context, imaging exams have an important part in the early detection and surgery of this condition. Cases Report: We describe the case of a 46-year old man presenting with acute abdominal pain and a history of gastric bypass five years previously. Abdominal Ultrasound did not reveal any significant findings. Indeed, through the use of multi slice computed tomography with IV and oral contrast , diagnosis of internal hernia was made and confirmed by laparotomy. Conclusion:Internal hernias are rare and difficult to diagnose, but they should be included in the differential diagnosis in intestinal obstruction cases and a history of abdominal surgery to reduce the high morbidity and mortality rates; surgical intervention shouldn’t be delayed

Metformin and Intravascular Contrast Media: What to do in Patients Receiving Both: a Narrative Review

Metformin-associated lactic acidosis (M-ALA) is considered to be one of the complications caused by intravascular contrast media (CM) administration in diabetics especially those with coexisting renal or cardiac impairment. We focused on the necessity and duration of metformin suspension in diabetics with normal or impaired renal function scheduled for CT scan with IV contrast. Searching PubMed, Web of Science, and Scopus databases, we reviewed the latest relevant guidelines as well as articles published from 1994 to 2015. There is no global consensus among different guidelines on the duration of the Metformin suspension before CT scan with IV contrast. Also, lack of substantial evidence supporting M-ALA encourages specialists to take a less conservative approach.It is safe to continue Metformin in patients with normal renal function who have no co-morbidities. In cases of equivocal renal function (30<GFR<60 mL/min/1.73 m2) and also in patients with normal renal function and other co-morbidities, the decision should be made based on the patient’s clinical status. In case of severe renal failure, the use of metformin should be reassessed. Due to the probability of contrast associated nephropathy, laboratory follow up seems to be necessary for all patients

Automatic colorization of non-enhanced brain CT images for clinical diagnosis

Background: The frequent use of brain computed tomography (CT) scans in emergency settings necessitates accurate reporting of CT results as quickly as possible. Conventional CT scans produce grayscale images, requiring window width and center level changes, resulting in a need for time-consuming interpretation by experienced radiologists. This study aimed to design a novel software application for automatic smart colorization of conventional brain CT images and to evaluate the diagnostic accuracy, visual quality, ease of diagnosis, and reporting time for color CT images compared to conventional grayscale CT images. Materials and Methods: First, we designed an application that converted non-enhanced grayscale brain CT images into color images according to the Hounsfield unit value of different tissues (e.g., brain, fat, bone, fluid, air) with minimal noise so that all brain tissues could be evaluated using one window level. This process took less than one second, without the need for high-end systems. Next, 75 printed images (25 unprocessed grayscale CT, 25 processed color CT, and 25 magnetic resonance imaging [MRI]) from 25 patients with hemorrhagic or ischemic stroke were read by two experienced radiologists. The radiologists scored the CT images from each patient (unprocessed grayscale and processed color) on a ten-point scale for visual quality and ease of diagnosis compared to the MRI image. Results: The mean visual quality score was 18% higher and the mean ease of diagnosis score was 23% higher for colorized images than for grayscale images (both P < 0.001). Statistically, there were no significant differences in the diagnostic accuracy or reporting time between color and grayscale images. Conclusion: This is the first study to report automatic smart colorization of non-enhanced brain CT images, producing high-quality colorized images with better visual quality and ease of diagnosis compared to grayscale CT. This low-cost solution can be widely applied in clinical settings, regardless of minimal facility or resource availability. &nbsp

Nailfold Capillaroscopy in 430 patients with Rheumatoid Arthritis

Background: Microvascular changes are one of the first obvious steps in numerous inflammatory diseases such as rheumatoid arthritis (RA). Nailfold video capillaroscopy (NFC) is an easy, reliable and safe method for evaluating peripheral microangiopathy. The objective of this study was to examine nailfold microcirculation in RA patients, assess morphological and structural changes quantitatively and qualitatively, and recognize useful changes. Methods: A total of 430 patients diagnosed with RA were examined in a period of 4 years. NFC was performed on all fingers of both hands in each patient. Different parameters indicating microvascular changes were detected and analyzed; such as microvascular architecture, capillary distribution disturbances, capillary morphology, capillary density, efferent/afferent limb ratio, subpapillary venular plexus and morphological abnormalities. The obtained results were categorized into normal pattern, nonspecific morphological abnormality and scleroderma pattern. Results: The mean age of participants was 51.03&plusmn;14.54 (19-87 years) that consisted of 359 females and 71 males. Based on the findings, angiogenesis (74.7%) was the most pathological condition observed after tortuosity (99.5%). 7.2% and 20.9% of patients were categorized into normal and scleroderma pattern group, respectively. Among morphological abnormalities, angiogenesis, isolated enlarged loop, irregular enlarged loop and architectural derangement were significantly more frequent in scleroderma than normal pattern (p<0.001). Conclusion: NFC may play an important role in monitoring RA disease and patients&rsquo; follow-up. Therefore, in our opinion it could be considered in the course and follow-up of rheumatoid arthritis

Comparison of Nutritional Behaviors and Body Mass Index in Patients with and without Non-Alcoholic Fatty Liver Diseases

AbstractBackground and Objective: The prevalence of non-alcoholic fatty liver Disease (NAFLD) and its complications in adults are increasing. Nutritional habits and its consequent obesity are major risk factors for developing the disease. The aim of this study was comparing nutritional habits and body mass index in two groups of participants with and without NAFLD.Materials and Methods: This case control study was performed with participation of 170 people aged 20-55, who referred to the department of sonography in the Taleghani teaching hospital of Tehran. The sampling method was convenience sampling. Data collected by interview with the individuals. Socio-demographic characteristics, reason for referring, and nutritional habits were determined. Anthropometric measurements and liver ultrasound were also performed. Data were analyzed by using t-test for comparing the means between 2 groups and chi-square test for determining the relationship between the variables. P-values of 0.05 or less were considered statistically significant.Results: The group with the disease significantly consumed more high-fat dairy products than the group without the disease (42% vs. 23%) (P=0.013). The mean (SD) for weekly consumption of fruits in the group with the disease was significantly higher than that in the group without the disease 11.6(6.7) vs. 8.2(5.5) unit (P=0.001). The mean (SD) for BMI of the group with the disease was higher than that of the group without the disease 32.8(6.6) vs. 24.4(3) respectively (P&lt;0.001).  Unexpectedly, the mean (SD) for weekly consumption of fast foods in the group without fatty liver with 0.8(0.9) was two times more than that in the affected group with 0.4(0.8) (P=0.012).              Conclusion: The prevalence of obesity and some unhealthy eating habits in patients with NAFLD and those at risk, requires designing and implementing educational interventions for increasing individuals’ awareness and improving their attitude towards healthy eating behaviors. </p

Comparison of Physical Activity and Body Mass Index in Patients with and without Non-Alcoholic Fatty Liver Disease

Background and Objective: The prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD), as one of the health problems, and its complications are increasing. Inadequate physical activity and obesity are the determinants of the incidence of NAFLD. This study aimed to compare physical activity and Body Mass Index (BMI) in both groups of patients with and without NAFLD in Tehran.Materials and Methods: In this cross-sectional study, 170 outpatients aged 20 to 55 who referred to Taleghani Hospital of Tehran for sonography participated. They were selected using convenience sampling method. Using completing the questionnaires through systematic interviews with individuals, socio-demographic characteristics, complain and the level of  physical activity were assessed. Anthropometric measurements and ultrasound were also performed. Data were analyzed using descriptive methods for descriptive data analysis, T-test and Chi-square tests to compare of the means between groups and to determine the relationship between variables.Results: Most patients with NAFLD (60%) had intense level of physical activity and only a small percentage of them (11.3%) had low level of physical activity. While in the group of patients with NAFLD, most people (36.7%) had moderate level of physical activity and 28.9% had low level physical activity. The difference between the level of physical activity in the two groups was significant (p=0.001). The mean (SD) BMI of patients with NAFLD was higher than patients without NAFLD (32.8(6.6) vs. 24.4(3)) (p&lt;0.001).Conclusion: Considering the prevalence of obesity and inadequate physical activity in patients with NAFLD, life style change recommended through designing and implementation of educational interventions to increase their knowledge and improve attitude, also physical activity interventions as option with diet to improve clinical statu