Can indirect magnetic resonance arthrography be a good alternative to magnetic resonance imaging in diagnosing glenoid labrum lesions?: a prospective study

Background This study was designed to evaluate and compare the diagnostic value of magnetic resonance imaging (MRI) and indirect magnetic resonance arthrography (I-MRA) imaging with those of arthroscopy and each other. Methods This descriptive-analytical study was conducted in 2020. All patients who tested positive for labrum lesions during that year were included in the study. The patients underwent conservative treatment for 6 weeks. In the event of no response to conservative treatment, MRI and I-MRA imaging were conducted, and the patients underwent arthroscopy to determine their ultimate diagnosis and treatment plan. Imaging results were assessed at a 1-week interval by an experienced musculoskeletal radiologist. Image interpretation results and arthroscopy were recorded in the data collection form. Results Overall, 35 patients comprised the study. Based on the kappa coefficient, the results indicate that the results of both imaging methods are in agreement with the arthroscopic findings, but the I-MRA consensus rate is higher than that of MRI (0.612±0.157 and 0.749±0.101 vs. 0.449±0.160 and 0.603±0.113). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI in detecting labrum tears were77.77%, 75.00%, 91.30%, 50.00%, and 77.14%, respectively, and those of I-MRA were 88.88%, 75.00%, 92.30%, 66.66%, and 85.71%. Conclusions Here, I-MRA showed higher diagnostic value than MRI for labral tears. Therefore, it is recommended that I-MRA be used instead of MRI if there is an indication for potential labrum lesions

Studying the relationship between the risk factors of cardiovascular diseases and carotid intima‐media thickness (CIMT) in renal patients undergoing hemodialysis admitted to Razi Hospital and Caspian Dialysis Center in Rasht, 2017

The increase in CIMT is known as an early warningsign of atherosclerosis. CIMT examinationusing ultrasonography is a non-invasive, precise,and practical way to detect atherosclerosis. As cardiovasculardiseases are of the main causes of mortality in dialysispatients, this study tried to examine the relationshipbetween cardiovascular risk factors and CIMT in renal patientsundergoing hemodialysis.This case-control study was conducted on 60 hemodialysispatients and 60 non-dialysis patients at Razi Hospital andCaspian Diabetic Center in Rasht in 2017. After examiningthe risk factors of cardiovascular diseases, ultrasonographywas performed to measure CIMT. Finally, data were analyzedusing SPSS21 and appropriate statistical methods.Mean CIMT in dialysis patients (0.88 ± 0.16 mm) wassignificantly higher than the non-dialysis patients (0.69± 0.14 mm) (P<0.0001). Mean CIMT in terms of genderand smoking was statistically significant only in non-dialysispatients (P = 0.025 and 0.028, respectively). Age(P<0.0001, β = 0.004), gender (P<0.027, β = 0.05), systolicblood pressure (P = 0.024, P = 0.001) Body massindex (BMI) (P = 0.017, β = 0.005) and TG (P <0.0001,β = 0.002) were considered as factors related to CIMT.Moreover, CRP (P <0.0001, β = 0.132), intact parathyroidhormone (iPTH) (P <0.0001, β = 0.003) and Ca-P product(P = 0.023, P <0.001) 0 = β) were considered for havingthe most importance among the new generation of riskfactors associated with CIMT.The results showed that the mean CIMT in dialysis patientswas significantly higher than that of non-dialysis patients.Furthermore, age, gender, systolic blood pressure,BMI and TG had direct connection with CIMT. CRP, iPTHand Ca-P product were identified as the most importantnew generation risk factors for CIMT

Placenta accreta outcomes and risk factors in a referral hospital in north of Iran: A case control study

Abstract Background Placenta accreta syndrome (PAS) may led to heavy blood loss and maternal death. Here we analyzed the main risk factors of PAS+ pregnancies and its complications in a referral hospital in the north of Iran. Methods In a case control study, all pregnant women with PAS referred to our department during 2016 till 2021 were enrolled and divided in two groups case (PAS+) and control (PAS−) based on preoperative imaging, intraoperative findings, and pathological reports. The sociodemographic features and neonatal‐maternal outcomes also were recorded. Results The most frequent reason for cesarean (C/S) was repeated C/S (62.9%, 56/89). A significant difference showed up in the time lag between previous C/S and the present delivery (p < 0.001) which shows that when the time distance is longer, the risk of PAS rises (OR: 1.01 [95% CI: 1.003−1.017]). Also, a positive history of prior abortion and elective type of previous C/S were related to PAS+ pregnancies. Our other finding showed that PAS+ pregnancies will end in lower gestational age and have a longer duration of operation and hospitalization, heavy blood transfusion, and hysterectomy. Also, PAS+ pregnancies were not related to poor neonatal outcomes. Conclusions It seems that, in addition to repeated C/S as a strong risk factor, previous abortion is a forgotten key which leads to incomplete evacuation or damage the endometrial‐myometrial layers