Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

<p>Abstract</p> <p>Introduction</p> <p>Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations.</p> <p>Case presentation</p> <p>A 73-year-old cachectic Asian man (Iranian) presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP) were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement.</p> <p>Conclusion</p> <p>Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.</p

Genetic Linkage Analysis of the DFNB21 Locus in Autosomal Recessive Hearing Loss in Large Families from Khuzestan Province

Background: Hearing loss (HL) is the most common congenital defect in humans. One or two in thousand newborn babies have prelingual hearing loss. Autosomal recessive non-syndromic hearing loss (ARNSHL) is the most common form of hereditary deafness. Hearing loss is more common in the developing countries which is due to genetic and environmental (cultural -health factors) reasons. HL has a wide range of clinical demonstrations including: congenital or late onset, conductive or sensoryneural, syndromic or non-syndromic hearing loss. The goal of this project is to determine the portion of the DFNB21 (TECTA) in ARNSHL in families with negative GJB2 gene in Khuzestan province. Materials and Methods: We studied 21 families with ARNSHL with at least 4 patients and negative for GJB2 mutations from Khuzestan province. Genetic linkage analysis was performed using STR markers linked to DFNB21 locus. Results: Following genetic linkage analysis and haplotyping, out of 21 families with ARNSHL, one family showed linkage to the DFNB21 (TECTA) locus. Conclusion: The results of this project confirm other studies in Iran and give insight into the most common loci causing ARNSHL in Iran which could be helpful in research and clinic

Mutation screening of GJB2 and GJB6 and genetic linkage study of three prevalent DFNB loci in Iranian families with autosomal recessive non-syndromic hearing loss

Background and aim: The incidence of prelingual hearing loss (HL) is about 1 in 1000 neonates of which, more than 60% of cases are inherited. Non-syndromic HL (NSHL) is extremely heterogeneous: more than 100 loci have been identified. The most common form of NSHL is the autosomal recessive form (ARNSHL). Here, we have investigated CX26 (GJB2) and CX30 (GJB6) gene mutation and linkage analysis of 3 known loci in Iranian families. Methods: A cohort of 36 big ARNSHL pedigrees from 7 provinces of Iran was investigated. All of the families were examined for the presence of GJB2 and GJB6 (del D13S1830 and del D13S1854) mutations using direct sequencing and multiplex PCR, respectively. The negative mutations pedigrees for the above- mentioned mutations, were then tested for the linkage to the 3 known loci, including DFNB3(MYO7A), DFNB4(SLC26A4) and DFNB7/11(TMC1), using STR markers and conventional PCR and PAGE. Results: Six families had GJB2 mutations. No GJB6 mutation was found. Totally, 3 families showed linkage to DFNB4 and 1 family was linked to DFNB7/11. Conclusion: DFNB1 (GJB2) and DFNB4 are the main causes of ARNSHL in our study samples and GJB6 mutations are apparently absent in the Iranian populatio

Whole body bone scintigraphy in osseous hydatosis: a case report

Hydatid disease is common in many parts of the world, and causes considerable health and economic loss. This disease may develop in almost any part of the body

Antimicrobial resistance pattern of Gram –negative bacilli isolated of Vali-Asr Hospital wards in Arak

Background: Infectious diseases are of the most important causes of mortality all around the world particular in developing countries. Recently, the most important thing that has worried medical society is antibiotic resistance. Multi-resistant gram_negative rods are important pathogens in hospitals, causing high rate of mortality.The main goal of this study was to investigate the antimicrobial resistance patterns among common gram-negative bacilli isolated from patients of Vali-Asr Hospital. Material and Methods: This is a cross-sectional descriptive study conducted between the years 2010-2012 in Vali-Asr hospital in Arak. In this study 1120 specimen were examined. Bacterial strains were isolated by conventional methods from various clinical samples of patients including: blood, urine, wound, sputum, CSF, andetc.All isolates were examined for antimicrobial resistance using disc diffusion method. Results: In this study 737 specimen were positive cultures. A total of 332 isolates of Gram-negative bacilli were identified. The most frequent gram negative bacteria were isolated from urine, wound, blood, respiratory secretion and catheter. The most frequent pathogens were E.coli followed by k.pneumonia, entrobacter, p.oaeruginosa, Acinetobacter spp, citrobacter and proteus. High rate of resistance to third generation of cephalospoins & carbapenems observed amang isolates of Acintobacter spp.Prodution of extended spectrum beralactamases (ESBLS) was found in 51.4% of all Gram negative bacteria. Conclusion: Antibiotic resistance, particularly multi-drug resistance is frequent among microorganisms of ValiAsr Hospital. Resistance in our country, like other countries have been shown to be increased, so it is highly recommended to prohibit unnecessary prescription of antibiotics

Multiple cerebral hydatid cysts: A rare case report

Brain hydatidosis is a rare disease which may have no symptoms or sign for a long time. In this case report, the woman 46-year-old has had a typical multiple cysts in the right parieto-occipital lobe of brain for years that it seems to be silent for long time because eight cysts formed on brain cavity. The patient with vague headaches and blurred vision and cerebrovascular accident, clogged arteries, and stutter symptoms was referred to the Vali-e-Asr Hospital in Arak, located in Markazi Province, central of Iran. The results of the CT scan and MRI revealed multiple hydatid cyst in brain due to the surgery on of the cyst was ruptured, and the cavity was washed with silver nitrate solution for prevention of secondary hydatid cyst. After the surgery, the patient woke up with full consciousness and general well-being. In patients with hydatid cyst, it should be considered as a differential diagnosis of lesions related to the cystic space of the brain

A PCR-Based Molecular Detection of Strongyloides stercoralis in Human Stool Samples from Tabriz City, Iran

Strongyloides stercoralis is a nematode causing serious infections in immunocompromised patients. In chronically infected patients, the low parasitic content as well as the resemblance of the larvae to several other species make diagnosis basedonmorphology difficult. In the present study, a PCR-based method targeting the internal transcribed sequence 2 (ITS2) of the rDNA region was examined for the molecular detection of S. stercoralis infection from the stool samples. A total of 1800 patients were included. Three fresh stool samples were collected per patient, and S. stercoralis isolates were identified by the morphological method. A subset of isolates was later used in the PCR-based method as positive controls. Additionally, negative and no-template controls were included. Data analysis was accomplished using an x2 test. Ap-value less than 0.05 was considered significant. In total, fivestool samples were found to be infected with S. stercoralis using the morphology method. PCR method detected S. stercoralis DNA target from all of the fiveDNA samples extracted from positive fecal samples. Conclusions: The PCR method used for amplifying a short fragment was successful for diagnosis of S. stercoralis in fecal samples and can be reliable for directly detecting the parasite bypassing morphological method

Post‐COVID‐19 splenic infarction in a patient with chronic atrial fibrillation: A case report

Abstract We describe splenic infarction (SI), an infrequent condition, in an 82‐year‐old COVID‐19 patient with chronic atrial fibrillation (AF). COVID‐19 may cause thrombosis, and AF is a predisposing factor for splenic infarction. Suspicion of SI may be warranted in COVID‐19 patients with abdominal pain, especially if a predisposing factor exists