Evident Sclerotic Skip Metastasis in Plain Radiograph in Juvenile Femoral Osteosarcoma: A Case Report of a 15-Year-Old Boy

Background: Osteosarcoma (OS) is an uncommon bone cancer presented by tissue swelling and nonspecific bone pain. In case of distant metastasis, this malignancy commonly invades the lungs. Skip metastasis is an uncommon type of invasion originating from the malignant bone to adjoining bone tissues detected by magnetic resonance imaging (MRI) with high accuracy. Skip metastasis is an uncommon finding in plain radiography of osteosarcoma cases.Case presentation: In the current study, we have reported a case of juvenile osteosarcoma with multi-focal skip metastasis, detected by simple plain radiography at first assessments. Further imaging and pathology assessment confirmed skip lesions in the background of high-grade chondroblastic osteosarcoma. Despite the recommendations, the patient and his legal guardian did not consent for further follow up and treatment.Discussion and conclusion: Skip metastases are rarely diagnosed by plain radiography in OS cases. This condition is usually diagnosed by magnetic resonance imaging. Here, we reported a neglected and late-diagnosed case of osteosarcoma with skip lesions in a young boy, simply detected by X-ray. The following article concentrates on the importance of detecting these metastases for their correlation with patient’s survival, and describes different imaging modalities for finding them

Evaluate the Therapeutic Effect of Allicin (L-cysteine) on Clinical Presentation and Prognosis in Patients with COVID-19

The antiviral effectiveness of allicin (L-cysteine) has been shown by numerous studies in both levels of clinical and animals. The aim of this study was to evaluate the therapeutic effect of allicin (L-cysteine) on clinical presentation and prognosis. In the current study, 66 patients with COVID-19 based on clinical, radiological presentations and RT-PCR results, were enrolled in two groups of placebo and allicin. In the both allicin (L-cysteine) and placebo groups (n=33 in each group), the capsules were prescribed two times a day for two weeks. Clinical signs and symptoms, blood parameters and chest CT scan were evaluated before and two weeks after treatment. The results showed that allicin (L-cysteine) could significantly impact on improvement of signs and symptoms of COVID-19 after two weeks of treatment in comparison to placebo. Allicin (L-cysteine) not only improve the clinical signs, but also ameliorate the lab and radiological data, which suggest a therapeutic effect for this agent in COVID-19. Our data suggest the therapeutic effect of allicin (L-cysteine) on COVID-19 through improvement of clinical symptoms and acceleration of the healing process

Bilateral congenital cholesteatoma: a case report

Abstract Background Cholesteatoma is regarded as a critical health issue in the world. Nevertheless, congenital cholesteatoma (CC) is an unusual problem, and bilateral CC is extremely rare. Case presentation The present work reports a young boy with conductive hearing loss because of CC. The left side was operated using a canal-wall-down mastoidectomy method for immense destruction of the middle ear structures and mastoid air cells, and endoscopic ear surgery was performed on the second side. Conclusion Although CC is very rare, it should be considered in the differential diagnosis of hearing loss in children. Moreover, it should be carefully followed up because it can probably occur on the second side

Microcystic Mesenteric Lymphatic Malformation, a Mimicker of Solid Masses in Pediatrics

Mesenteric microcystic lymphangioma is a rare benign abdominal mass. It appears as a solid mass which may mimic a solid mesenteric or omental mass. Pure microcystic lesions are ill-defined and hyperechoic due to abundant wall interfaces. A case of mesenteric microcystic lymphangioma is presented in combination with appendicitis. A 6-year-old boy presented with rapid onset of abdominal pain accompanied by nausea and vomiting. Ultrasound showed a hyperechoic solid mass without vascularity at Doppler evaluation. Computed tomography showed a mass in the small bowel mesentery with attenuation values in the range of water. In the pathologic evaluation, mesenteric lymphangioma with small and medium-sized cysts was reported. Microcystic lymphatic malformation could be considered in the differential diagnosis of a solid abdominal mass in pediatrics and imaging features can be helpful to differentiate between them

Role of Perineal Ultrasound in Differentiating Paraurethral Cysts in Newborns

Background: Paraurethral cyst or Skene’s gland cyst is a rare congenital abnormality and a rare cause of paraurethral cysts resulting from Skene’s gland, which has been reported in few studies so far. The Skene’s duct cyst can cause urinary retention or anuria; moreover, it can appear as an inter-labial mass in neonates.Case report: Our patient was a one-day-old female neonate presented with anuria and an inter-labial mass found in physical examination. The patient was referred by a pediatric surgeon to our department for sonographic evaluation. We did an ultrasound examination and made a tentative diagnosis of paraurethral cyst based on grayscale appearance and ultrasonographic criteria of the cystic lesion. The patient underwent surgery, a biopsy was obtained, and the specimen was sent for pathologic evaluation to a pediatric pathologist. The result confirmed our diagnosis as a Skene’s duct cyst.Conclusion: In this study, it was found that paraurethral cysts in newborns can be investigated using perineal ultrasound, which can eliminate the need for invasive surgeries

Radiological features of COVID‐19‐associated mucormycosis: A report of 36 cases along with a literature review

Key Clinical Message The pandemic of COVID‐19 along with high use of corticosteroids resulted in the emergence of invasive fungal infection. Here, we reported the radiologic feature of mucormycosis in COVID‐19‐infected cases and reviewed with available literature

Design and Validation of Professional Development Environment Model Based on Task-Centered Approach in Medical Education

This study aimed to design and validate a professional development environment model based on a task-centered approach in medical education. Accordingly, a mixed research design was used, and a qualitative content analysis was performed using a synthesis research method to identify the elements and components of the proposed model. Furthermore, a descriptive survey method was employed to validate the model from the point of view of experts. For the purposeful selection of resources considering the identification of the components of the professional development environment model based on the task-centered approach, authentic scientific documents indexed in databases, such as Scopus, Science Direct, Springer, Google Scholar, ProQuest, Emerald, and PubMed from 2000 to 2022 were reviewed, and 48 documents were selected. Then, they were analyzed using open coding and axial coding. To validate the proposed model, 20 specialists in radiology, medical education, and educational sciences were selected as a sample. The data were collected through an 8-item researcher-made questionnaire the content validity of which was confirmed by calculating S-CVI and CVI. According to the analysis, 4 main components and 14 sub-components were extracted, which led to the design of the desired model. The findings in the quantitative part also showed that the presented model has high internal validity in the field of medical education. Therefore, it is suggested to use this model as an innovative strategy and guidance for medical professionals

Diagnostic value of diuretic ultrasound in evaluating the need for reoperation in children undergoing pyeloplasty

Abstract Background Pyeloplasty currently stands as the standard treatment for UPJO. Our study aimed to assess the diagnostic value of sonographic parameters following Lasix administration in patients who underwent pyeloplasty to predict the recurrence of obstruction and the need for reoperation. Methods The study included 70 children with UPJO who underwent pyeloplasty. Renal ultrasound was performed on patients three to six months after pyeloplasty. Following the Lasix administration, the changes in ultrasound parameters at the 18th and 30th minute were documented. Within two weeks, patients underwent radioisotope renography. Diuretic ultrasound's diagnostic value in predicting the need for reoperation was assessed through a comparison with radioisotope renography. Results The average age of the patients was 3.94 ± 3.52 years. Anteroposterior diameter of the renal pelvis (APD) changes at 18 and 30 min, and the average APD after surgery at 18 and 30 min was significantly higher in patients requiring reoperation. The best cutoff point of APD changes in the 18th minute was 9.50 (sensitivity = 91.7%, specificity = 82.8%). The best cutoff point of APD after surgery in the 18th minute was 25.90 (sensitivity = 91.7%, specificity = 81.0%). The best cutoff points of the resistive index (RI) in the 18th and 30th minutes were reported as 0.70 (sensitivity = 41.7%, specificity = 50.0%) and 0.71 (sensitivity = 41.7%, specificity = 37.9%), respectively. Conclusions The assessment of ultrasound findings following pyeloplasty has revealed that changes in APD can serve as a reliable means for assessing the efficacy of the operation

Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study

Abstract Background Previous research has shown that Ramadan fasting has beneficial effects on cardiovascular risk factors, however there are controversies. In the present study, the effect of Ramadan fasting on cardiovascular risk factors has been investigated. Method This is a prospective observational study that was carried out in a group of patients with at least one cardiovascular risk factor (including history of documented previous history of either coronary artery disease (CAD), metabolic syndrome or cerebro-vascular disease in past 10 y). Eighty two volunteers including 38 male and 44 female, aged 29–70 y, mean 54.0 ± 10 y, with a previous history of either coronary artery disease, metabolic syndrome or cerebro-vascular disease were recruited. Subjects attended the metabolic unit after at least 10 h fasting, before and after Ramadan who were been fasting for at least 10 days. A fasting blood sample was obtained, blood pressure was measured and body mass index (BMI) was calculated. Lipids profile, fasting blood sugar (FBS) and insulin, homocysteine (hcy), high-sensitivity C-reactive protein (hs-CRP) and complete blood count (CBC) were analyzed on all blood samples. Results A significant improvement in 10 years coronary heart disease risk (based on Framingham risk score) was found (13.0 ± 8 before Ramadan and 10.8 ±7 after Ramadan, P 0.001, t test).There was a significant higher HDL-c, WBC, RBC and platelet count (PLT), and lower plasma cholesterol, triglycerides, LDL-c, VLDL-c, systolic blood pressure, body mass index and waist circumference after Ramadan (P 0.05, t test). The changes in FBS, insulin,Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hcy, hs-CRP and diastolic blood pressure before and after Ramadan were not significant (P >0.05, t test). Conclusions This study shows a significant improvement in 10 years coronary heart disease risk score and other cardiovascular risk factors such as lipids profile, systolic blood pressure, weight, BMI and waist circumference in subjects with a previous history of cardiovascular disease.</p