ABSTRACT
Background: Insulin resistance has an important role in pathophysiology of polycystic ovarian syndrome [PCOS]. Yet there are certain controversies regarding the presence of insulin resistance in non-obese patients
Objective: The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women
Materials and Methods: In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese [BMI >/=25] and 45 patients were non-obese [BMI <25]. Presence of insulin resistance and endocrine-metabolic abnormalities were compared between two groups. Collected data were analyzed with SPSS version 16.0 and p<0.05 was considered as statistically significant
Results: There was no significant difference in presence of insulin resistance [HOMA-IR >2.3] between two groups [p=0.357]. Waist circumference [p<0.001], waist/hip ratio [p<0.001], systolic [p<0.001] and diastolic [p<0.001] blood pressures, fasting blood sugar [p=0.003] and insulin [p=0.011], HOMA-IR [p=0.004], total cholesterol [p=0.001] and triglyceride [p<0.001] were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone [p=0.634] and androstenedione [p=0.736] between groups whereas Dehydroepiandrotendione sulfate [DHEAS] was significantly higher in non-obese PCOS women [p=0.018]. There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively
Conclusion: Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients
ABSTRACT
Background: Genital tuberculosis [TB] is an important cause of infertility in the developing countries, where hysterosalpingograply [HSG] remains an initial diagnostic procedure in the evaluation of tubal and peritoneal factors leading to infertility. Objective: The aim of this study was to determine the HSG findings of genital TB in infertile women. Materials and Methods: We retrospectively reviewed HSG findings in 20 women with genital tuberculosis. HSG was performed in these women as part of infertility wodc up over 5 years. The other diagnostic procedures used included endometrial curettage and biopsy, histological examination, culture, laparoscopy, hysteroscopy and polymerase chain reaction. Results: The mean age of the participants was 30.518 years. All women had clinical history of infertility for at least 4 years. Women presented with pelvic abdominal pain [30-35%] and menstrual disturbances [20-25%]. Reviewing 20 cases of female genital TB were encountered various presentations on HSG. Conclusion: HSG is an invaluable procedure in suggesting the diagnosis of genital TB in patients being investigated for infertility
ABSTRACT
Introduction: Pulmonary embolism [PE] is a common lethal disease that its clinical symptoms may be seen in many other diseases. Computed tomography pulmonary angiography [CTPA] is a valuable diagnostic modality for detection of PE. In addition, it can accurately detect the other diseases with clinical symptoms similar to PE. The aim of this study is to evaluate the frequency of PE and nonembolic disease with similar clinical symptoms including pulmonary, pleural, mediastinal, and cardiovascular diseases that have been detected by CTPA and to describe the importance of reporting these CT findings
Materials and Methods: In this cross-sectional study, we evaluated the medical records of CTPA in 300 patients of suspected PE between March 2012 and February 2013 in Imam Reza Hospital and Ghaem Hospital in Mashhad University of Medical Sciences, Mashhad, Iran. Demographic information and the results of CTPA of these patients were re-evaluated. One radiologist reviewed all of the CTPA and the results have been analyzed by SPSS-16 soft
Results: In this study, PE was detected in 18.7% of patients. Multiple incidental imaging findings were diagnosed as follow: pulmonary consolidation [33.2%], pleural effusion [48.7%], pulmonary nodules [10%], pulmonary masses [1.3%], pneumothorax [4.7%], mediastinal mass and lymphadenopathy [9.3%], aortic calcification [42%], coronary arteries calcification [27.3%], mitral valve calcification [2 %], cardiomegaly [30.7%], and the evidences of right ventricular dysfunction [6.7%]
Conclusion: A group of disease can cause the clinical symptoms similar to that of PE. Among them, pulmonary consolidation and pleural effusion have much higher frequency than PE. In addition, CTPA can show pathologic findings in the patients that need follow-up. It is important to detect and report these imaging findings because some of them may change the treatment and prognosis of patient who are suspected to have PE
ABSTRACT
Carotid intima-media thickness [cIMT] has been known as a criterion of generalized atherosclerosis and a marker of cardiovascular disease progression in many studies which can be measured by ultrasound using high-resolution device. This is a case-control study. A total of 40 children [16 males and 24 females] with typel diabetes mellitus and control group consisting of equal numbers [17 males and 23 females] who were otherwise healthy were included in the study from May 2007 to January 2008. The two groups were age matched, with the mean age of 10.56 +/- 3.21 years in control group and 10.67 +/- 4.18 years in diabetic patients. Left and right cIMT were measured by ultrasound. There was a significant difference between case and control subjects in terms of mean cIMT [P<0.001]. cIMT was significantly higher in the diabetic group. Among variables including age, BMI and diabetes, diabetes was the only influential parameter in this respect The mean time length of type 1 diabetes in our diabetic group was reported 4.24 +/- 3.02 years, with a minimum of four months and a maximum of ten years. There was a statistically significant difference between the two diabetic patients with below and above four years of disease duration [P=0.03 for right carotid artery and P=0.01 for left carotid artery]. cIMT has been identified as an early indicator of atherosclerosis in many studies. It increases in patients with type 1 diabetes as the disease progresses and this can be followed by macro and microvascular atherosclerotic changes
ABSTRACT
Solitary pulmonary nodule [SPN] is a frequent finding on the chest x-ray and computed tomography. Nuclear medicine techniques play an important role in the diagnosis and management of SPN. In the current review, we briefly will explain the different nuclear medicine modalities in this regard including positron emission tomography [PET] using 18-F-FDG, and 11-C-Methionine, and single photon emission computerized tomography [SPECT] using somatostatin receptor scintigraphy, 201-Thallium, and 99m-Tc-MIBI
ABSTRACT
Physical Examination [PE] and breast MRI are two of the current methods which have usually used in diagnosis of primary breast cancer. Their accuracy in detection of: either complete response or presence of residual tumor, however, has not yet been established in patients who have been received Neoadjuvant Chemotherapy [NAC]. The purpose of this study was to evaluate the diagnostic accuracy of breast MRI in assessment of residual neoplastic tissue after NAC in patients with Locally Advanced Breast Cancer [LABC]. Twenty patients with LABC have undergone contrast-enhanced MRI before and after the NAC. Considering histology as the gold standard, the tumor sizes in MRI and PE have compared with the histology results. We have calculated for all below: the accuracy, sensitivity, specificity, Positive Predictive Value [PPV] and Negative Predictive Value [NPV] for each of MRI and physical examination, as well as Pearson's correlation coefficients between the results of MRI and PE, and their histology results. We have found an accuracy of 85% for MRI with a sensitivity of 100%, a specificity of 50%, a PPV of 83.3%, and an NPV of 100%. In addition, the accuracy for PE was 70% with a sensitivity of 71.4%, a specificity of 66.6%, a PPV of 83.3%, and an NPV of 50%. In this study, the calculated Pearson's correlation coefficient for MRI and histology was 0.817 [p<0.0001] versus 0.26 [p=0.26] for correlation between PE and histology. MRI has higher sensitivity but less specificity than PE for detection of residual tumor after NAC in locally advanced breast carcinoma. Also, the tumor size that has measured by MRI had highly correlation with the histology
Subject(s)
Humans , Female , Breast Neoplasms/classification , Breast Neoplasms/pathology , Neoadjuvant Therapy , Magnetic Resonance Imaging , Treatment OutcomeABSTRACT
Intracystic carcinoma of the breast is a rare form of breast carcinoma. Among all malignant breast tumors, this lesion has an incidence of 0.2-0.5%. These neoplasms have certain characteristic imaging findings which help to differentiate these lesions from other focal breast abnormalities. This report is on the case of a 48-year-old woman with a palpable, painless lump in her right breast. Mammography demonstrated an oval well-circumscribed mass without calcification. Breast ultrasonography showed a cystic lesion with an intracystic solid component projecting from its posterior wall. Cyst aspiration revealed a hemorrhagic fluid and a suspicious cytology. Excisional biopsy revealed papillary carcinoma suggesting of intracystic papillary carcinoma
Subject(s)
Humans , Female , Carcinoma, Papillary , Mammography , Ultrasonography, Mammary , Biopsy, Fine-NeedleABSTRACT
Breast tuberculosis is considered a rare clinical entity throughout the world. It has no defined clinical manifestation. Radiological imaging is not diagnostic also. Diagnosis is based on identification of typical histological features or cultures. A 48-year old woman was admitted because of painful lump in her right breast. Her mammogram showed a lobulated mass, accompanied by swelling and retraction of the skin and nipple, suspected to be carcinoma. The diagnosis was made by histopathologic study and revealed to be tuberculosis. The tumor was excised and anti-tuberculosis drugs were commenced. Satisfactory out comes revealed during follow up. Breast tuberculosis is a rare form of extra-pulmonary tuberculosis which may presents with features of breast carcinoma. The basis of treatment is anti-tuberculosis antibiotic therapy, and conservative surgery for any residual masses or deformities