Diagnostic Accuracy of Acute Appendicitis by Ultrasound in Hospital Emergency

Background Acute appendicitis is the most common medical condition requiring immediate abdominal surgery.Medical ultrasound is a non-intrusive, non-expensive and available diagnostic method. In this study, the accuracy of ultrasound in diagnosis of acute appendicitis in hospital emergency was evaluated. Materials and Methods This retrospective cohort study was performed at Ahvaz Imam Khomeini hospital (Ahvaz city, Iran). The records of outpatient and inpatient of this hospital were studied to extract demographic information about the patients and radiological reports indicating the occurrence or exclusion of acute appendicitis and post-appendectomy report to allow for results comparison. Patient from 5-70 years included, with clinical suspicious to acute appendicitis, pathologic report also reviewed as gold standard of diagnosis. Results A total of 163 study subjects met the inclusion criteria,theage of the subjects ranged from 6 to 63 years. The accuracy, sensitivity and specificity were 98.1, 96 and 100%, respectively. The positive predictive value was 100%, while the negative predictive value was 82.35%. Diagnostic accuracy was 100% for the under-15 age group and 94.06% for the above 15 years age group. Conclusion The results showed that the medical ultrasound reports could be considered more credible in diagnosing acute appendicitis in under-15 male subjects which paves the way for more accurate planning of treatment and presenting patients with abdominal pains for surgery

Study on Some Effective Factors for Successful Non-Surgical Reduction in Intussusception among Children

Background Intussusception is the main cause of bowel obstruction and one of the most common surgical emergencies that can occur during childhood. That is why this study investigates the effective factors for non-surgical reduction in patients who have experienced successful reduction in intussusception to determine the effective factors. Materials and Methods This retrospective study was performed between 2011 and 2017. The following subjects, including age, gender, degree of reduction, leukocyte level, symptom onset interval, Appearance of Signs and the Visit of Children, presence of blood in stool, free abdominal fluid in ultrasound, and length of the intestinal tract involved in ultrasonography, were extracted. Results A total of 217 patients with intussusception had visited the emergency department. The average of the leukocyte level of children with successful intussusception non-surgical reduction was lesser the children with unsuccessful intussusception non-surgical reduction and there was a significant difference (

Investigating the Effect of Cochlear Size in Insertion of Electrode Depth in Patients with Cochlear Implantation evaluated by CT-Scan

Background Cochlear implant surgery is an invasive procedure for patients with bilateral Sensorineural hearing loss and may cause some risks such as cochlear damage. We aimed to evaluate the effectiveness of cochlear measures obtained by computed tomography (CT) scan in predicting depth of cochlear implant insertion. Materials and Methods This study was conducted in a retrospective and cross-sectional study on 39 patients undergoing cochlear implantation with MED-EL Device. High-resolution radiographs provided preoperative by CT-Scan were used to determine electrode array insertion depth and diameter of the cochlea’s basal turn. The insertion was considered deep when the electrode was placed at least 22 mm into the cochlea. Demographic data, CT-Scan results and cochlear implantation outcomes (deep or shallow) were evaluated. Data were analyzed by SPSS22 software and the significance level was less than 0.05. Results The mean age of patients was 8.026±1.77 years. The depth of insertion of the electrode in 34 (87.18%) patients was deep and in 5 (12.82%) patients was shallow that the difference was statistically significant (

Application of CT pulmonary angiography and echocardiography in acute pulmonary embolism: A cross‐sectional study

Abstract Background Pulmonary Embolism (PE) is an acute and potentially fatal condition defined as the blockage of pulmonary arteries by an embolism that can be from various origins. Objective The present study aimed to investigate the findings of computed tomography pulmonary angiography (CTPA) and echocardiography in patients with acute PE. Methods The present cross‐sectional study included some patients with clinical manifestations of PE who underwent CTPA and echocardiography. The radiologic findings, PE severity, and outcome of the patients were recorded. Moreover, echocardiography was performed by an expert cardiologist using a high‐resolution device, while CTPA was performed by an expert radiologist using a 16‐slice device and a two‐step selective test bolus method. Results According to our findings, a total number of 147 patients were diagnosed with PE, including 44 (29.93%), 44 (29.93%), and 59 (40.14%) cases of mild, moderate, and severe PE, respectively. Moreover, 25 patients (17%) finally expired due to PE. Regarding the CTPA findings, 31 patients (21.1%) had septum flattening, while 35 (23.8%) had a septum deviation toward the left ventricle. Also, there were significant correlations between mortality and some CTPA findings, including severe PE (p < 0.001), the presence of septal deviation (p = 0.007), and higher diameters of the main pulmonary artery (p < 0.001) and right ventricle (p = 0.008). Conclusion CTPA is a valid and accessible modality for diagnosing and evaluating PE in suspected patients. Moreover, several findings in CTPA could predict adverse outcomes, such as death, in patients with PE

An investigation into the sensitivity of shear wave ultrasound elastography to measure the anterior bladder wall pressure in patients with neurogenic bladder

Introduction and Objective: Urodynamic testing (urodynamics) is widely used for evaluating bladder function as a result of high detrusor compliance. This aggressive and uncomfortable test is especially difficult for children. This study aimed to determine the sensitivity of shear wave ultrasound elastography (SWE) as a new method for evaluating the biomechanical characteristics of bladder to measure the anterior bladder wall pressure in children with neurogenic bladder (NB). Materials and Methods: The present prospective clinical study was carried out on 30 children with allegedly NB and 20 healthy children as control group. These children referred to Ahwaz Golestan Hospital in 2018. After clinical evaluations, urodynamics was performed for children with NB and detrusor compliance was measured in cm/H2O. The ultrasonography of the SWE was performed on the anterior wall of the bladder (Estimated bladder capacity (EBC) 50%) for the two groups. The relationship between shear wave speed (SWS) and detrusor compliance was estimated using Pearson's correlation coefficient. Independent t-test was used to compare SWS between two groups. Results: In patients with NB, there was a significant relationship between the mean SWS of the anterior bladder wall and detrusor compliance (R = 0.89, P = 0.0001). The comparison between normal and NB groups showed that the mean SWS of the anterior bladder wall in the patients was significantly higher than the healthy group (1.88 ± 0.88 m/s vs. 0.94 ± 0.15; P = 0.0001). There was also no significant relationship between SWS, gender, age, weight, and body mass index of patients (P > 0.05). Conclusion: The results showed that SWE can be used as a useful alternative for urorodynamic testing in the evaluation of NB (bladder dysfunction) in children

Evaluation of the tibial cortical thickness accuracy in osteoporosis diagnosis in comparison with dual energy X-ray absorptiometry

Background: Unlike public awareness around the world, osteoporosis is still underdiagnosed in most cases till bone fractures. Currently, the dual-energy X-ray absorptiometry (DEXA) is the gold standard diagnostic method of osteoporosis, but unfortunately this method is not available in all diagnostic centers, especially in developing countries. Aims: To evaluate the accuracy of tibial cortical thickness in the diagnosis of osteoporosis compared with DEXA. Materials and Methods: In this descriptive--analytic study, patients suspicious of osteoporosis who referred to Imam Khomeini Hospital, Ahvaz from 2016 --2017 were recruited. Data was collected for each patient including age, sex, radiography, and DEXA. The total thickness of the tibia cortex (sum of the two sides) was measured using knee anteroposterior radiography at 10 cm from the proximal tibial joint. The bone mineral density (BMD) was measured by DEXA method and reported as T-score. Results: In this study, 62 patients (90% female) were evaluated. The mean age of the patients was 57 years (range 45--80 years). T-score had a direct significant correlation with TCT level (r = 0.51, P < 0.0001). Also, T-score had a reverse and significant correlation with age of patients (r = −0.280, P = 0.028). The area under the curve (AUC) was 77%. Also, the sensitivity and specificity for the TCT level less than 4.37 mm (as cutoff point) was 100% and 39.1%, respectively. Conclusion: The findings of this study indicate that TCT has a direct significant correlation with the T-score obtained by the DEXA method. It has also been shown that TCT can be a relatively accurate diagnostic tool for predicting osteoporosis