Cholangiocarcinoma in Magnetic Resonance Cholangiopancreatography and Fascioliasis in Endoscopic Ultrasonography

Fascioliasis is a worldwide zoonotic infection with Fasciola hepatica and Fasciola gigantica. The zoonoses are particularly endemic in sheep-raising countries and are also endemic in Iran. Typical symptoms that may be associated with fascioliasis can be divided by phases of the disease, including the acute or liver phase, the chronic or biliary phase, and ectopic or pharyngeal fascioliasis. Cholestatic symptoms may be absent, and in some cases diagnosis and treatment may be preceded by a long period of abdominal pain, eosinophilia and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 4 years, with imaging suggesting cholangiocarcinoma. Considering a new concept of endoscopic ultrasonography, at last F. hepatica was extracted with endoscopic retrograde cholangiography

Prevalence of Abnormal Findings in Computed Tomography and Magnetic Resonance Imaging in Patients with Neurophthalmic and Orbital Complaints in Sabzevar city (2016)

Introduction: Nowadays, every subspecialty in medicine is taking effect from new imaging modalities. Ophthalmology and studying disorders of the eye are no exception. As same as other developments in medicine, there are some imaging indication developed in order to reduce false diagnosis and unnecessary costs. While patients with ocular problems are not only visited by ophthalmologists, the imaging tests will be ordered by different specialists. So, by evaluating the rate of ordered CT scan and MRI imaging by different specialists, we will be able to prospect the rate of ordered imaging studies in Vasee and Emdad Hospital, Sabzevar, Iran. Material and methods: Every patients who meet the study inclusion criteria, had different eye compliments and were referred by different specialist from Sabzevar City for taking CT scan or MRI study were enrolled in this cross sectional study. Patient’s demographic and imaging interpretation data were gathered. Then, the prevalence of abnormal imaging findings and their relation with study variables were analyzed by SPSS version 18 software. Results: Two hundred and sevnty one patients (46/9% male and 53/1% female) enrolled in this cross sectional study with average and mean of 39. and 36 years respectively. General physicians, ophthalmologists, neurologists, internal medicine and emergency medicine specialists referred 3%, 5.5%, 71/6%, 3% and 7% of patients respectively. Most of the patients were referred for MRI (51/3% versus 48/7) than CT scan. Only 30/3% of patients had abnormal finding in their imaging study. Patients referred from a neurologist had significantly higher rate of abnormal findings (P=0/0032). Increase in age and illness period was significantly related to higher rate of abnormal findings (P=0/00 , P=0.00 respectively). Only 21/4% of patients had imaging findings in line with their clinical presentation. The most common finding was maxillary (9/6%) and ethmoidal and frontal sinusitis (3/3%). Only 2% of patients with positive findings had solid tumors on imaging studies. Conclusion: Sinusitis was the most common imaging finding in this study. While a plan radiograph can help physician in diagnosing this disease, performing MRI or CT scan for this finding seems expensive and time consuming in first step. Also, paying more attention to accurate history taking and physical examination will reduce the normal imaging ordered. Keywords: Magnetic resonance imaging, Computed tomography, Eye diseas

Intracranial meningiomas: Prognostic factors and treatment outcome in patients undergoing postoperative radiation therapy

Background: Meningioma constitutes 20% of the intracranial neoplasms. Followed by surgery as the primary treatment for most patients, radiotherapy becomes indicated in high-grade tumors with incomplete surgical removal. We evaluated the prognostic factors and overall outcome in meningioma patients who underwent radiotherapy. Materials and Methods: In this retrospective analysis, data from all patients with documented diagnosis of meningioma who referred to the Omid and Ghaem Oncology Centers (Mashhad, Iran) from 2002 to 2013 were included. We calculated the overall survival rates using the Kaplan–Meier method and compared the survival curves between groups by the log-rank test. Results: Eighty-three patients with a median age of 50 years (ranging: 16–84) were included. Grade I, II, and III meningiomas were seen in 40 (48%), 31 (37%), and 12 (15%) patients, respectively. Radiation therapy was indicated due to tumor recurrence, incomplete excision, or tumor grade in 32, 8, and 43 patients, respectively. Tumor grade had a significant effect on the overall survival with a 3-year overall survival of 76.7%, 43.5%, and 13.3% in Grade I, II, and III, respectively (P < 0.001). Gender, age, and tumor location were not correlated with the overall survival. Moreover, patients with Grade II and III who underwent total resection had a significantly higher overall survival than those with subtotal resection or biopsy alone (5-year survival rates of 82% vs. 17.1%, respectively; P = 0.008). Conclusion: Tumor grade was the most important prognostic factor in meningioma patients undergoing radiation therapy. In patients with Grade II and III tumors, the extent of surgical resection is significantly correlated with the overall survival

Survey on association between Mycoplasma hominis endocervical infection and spontaneous abortion using Polymerase Chain Reaction

Background: Mycoplasma infections are suggested as etiology of adverse pregnancy outcomes. Objective: The aim of this study was to evaluate the association of Mycoplasma hominis (M. hominis) infection and spontaneous abortion among pregnant women. Materials and Methods: In this case-control study that was conducted from August 2012 to January 2013, totally, 109 women were included with spontaneous abortion with gestational ages of 10-20 weeks (Cases), and 109 women with normal pregnancy with gestational ages between 20-37 weeks (Controls) in Sanandaj, Iran. Using specific primers and extracted DNA from endocervical swabs, a PCR test was conducted for detection of M. hominis infection in women. For comparison of qualitative and quantitative variables, independent Fisher tests were used and p<0.05 was considered significant. Results: The total frequency of M. hominis infection was 6 (2.75%) in women. The frequency of M. hominis infection was 2 (1.83%) in the case group (spontaneous abortion) and 4 (3.66%) in the control group, respectively. In both case and control groups, no association was seen between M.hominis infection and spontaneous abortion (OR=0. 49, CI 95%: 0.08-2.73, p=0. 683). Conclusion: M. hominis was positive in the genital tract of some pregnant women, but it was not associated with spontaneous abortion. However, to prevent adverse pregnancy outcomes in women, foetus and neonate, routine screening and treatment for the genital Mycoplasma is recommende