[Evaluating the validity of chest x-ray in diagnosis of congenital heart diseases and acquired valvular heart diseases]

One of the important diseases in the population is heart disease. Congenital heart disease complicated approximately one percent of all live births. Acute rheumatic fever involve the heart which can be fatal during the acute stage or lead to rheumatic heart disease, a chronic condition due to scarring and deformity of the heart valves. In this research have been investigated about the value of chest-X-Ray in 74 patient in the diagnosis of heart disease in patients of Modarres hospital during year of 1379 and decrypted radiographic appearances of heart disease through enlargement of cardiac chambers, vascularity of lung and final diagnosis of heart disease. Results of this research may be play a role in the planning for diagnosis of heart diseases and answer to this question that is it any role for CXR PA that is a simple and routine investigation for patients. The sensitivity and specificity of conventional radiology in the diagnosis of left to right shunt is 96.15 and 90.47 percent respectively and positively and negative predictive value is 86.2 and 97.43 percent respectively. In left a trial enlargement was 96.96 and 82.35 percent respectively and positive and negative predictive value is 84.2 and 96.55 percent respectively. In left ventricular enlargement was 73.3 and 82.5 percent respectively and positive and negative predictive value is 75.86 and85.5 percent respectively. In right a trial enlargement was 53.3 and 100 percent respectively and positively and positive and negative predictive value is-100 and 8735 percent respectively. In right ventricular enlargement is 86.95 and 72.72 percent respectively and positive and negative. The final diagnosis of heart predictive value is 89.95 and 72.72 percent respectively. Disease with conventional radiology consists of: 28.37 percent true definite diagnosis, 58.1 percent true differential diagnosis and 13.5 percent false diagnosis

Comparison of doppler ultrasonographic findings in complicated and uncomplicated lower-limb varicose veins

Comparing anatomicopathologic findings in complicated and uncomplicated lower-limb varicose veins by ultrasonography. Totally, 231 consecutive patients [148 [64%] men; mean age, 46.8 +/- 14.3 years [range: 16-88 years]]; 155 [54%] left and 132 [46%] right variceal legs were evaluated by Doppler ultrasonography with color-flow imaging using a 7.5-10 MHZ linear probe. The lower extremity venous system [including perforators and valves] were evaluated in the supine and standing position, at rest and during Valsalva's maneuver. Chi square and Fischer's exact tests were used for statistical analysis. We also performed a logistic regression analysis considering presence of any type of complication as the dependent variable and anatomic pathologies as independent variables. Of the 287 limbs with varicose veins, 124 [43%] had at least one complication [ulceration, pigmentation or infection]. The highest complication rate was seen simultaneously with chronic deep vein thrombosis [DVT] with segmental obstruction [76.9] and the lowest complication rate in the incompetent valves was seen in patients with perforan vein reflux [50.4%]. Mostly, the complication rate was higher in patients with the pathology in comparison to patients without it [p values<0.005]. In a multivariate logistic regression model, presence of DVT and saphenofemoral incompetency were statistically significant in the model in comparison to other pathologies [OR=10.6 and 7, respectively, p values<0.02]. In 175 patients [75.8%] one of the legs were involved Presence of ulcer, pigmentation and infection are significantly associated with a higher incidence of DVT, deep vein, saphenofemoral and saphenopopliteal incompetency in patients with lower limb varices

Intracranial manifestations of tuberous sclerosis: a pictorial essay

Tuberous sclerosis is an autosomal dominant genetic disease that involves multiple organs. Hamartomas are the predominant lesions. Classically, tuberous sclerosis has been characterized by a classical clinical triad of facial angiofibromas [90%], mental retardation [50-80%], seizure [80-90%] and all three in 30% of the patients. Two major features or one major feature plus two minor features are necessary for the definite diagnosis of this disease. We had some patients admitted with different presentations of tuberous sclerosis and a past history of convulsion from childhood, skin lesions and also mental retardation with a new onset headache and a changed pattern of convulsion. In physical examination, facial angiofibromas and subungual fibromas were apparently detected. Brain CT scan study with contrast showed multiple calcified nodules associated with tubers, ventriculomegaly and also enhancing enlarged nodules at the foramen of Monro, which were suggestive of subependymal giant cell astrocytoma [SGCA]. MRI showed the same brain findings [tubers, white matter lesions and subependymal nodules associated with SGCA], which were detected better. After surgery, SGCA was proved. In abdominal and pelvic CT scan and ultrasonography, massive bilateral angiomyolipomatosis and focal hypodense hyperechoic liver lesions were detected

Prevalence of incidental thyroid nodules diagnosed by ultrasound in an Iranian population

Since Iran is an endemic region for iodine deficiency, we conducted this study to determine the prevalence of incidental thyroid nodules in our university-affiliated hospitals. Four hundred and ten consecutive patients who attended our center for color Doppler ultrasound of carotid or other sites of the neck-other than the thyroid gland-from September 2005 to May 2006 were included in this study. All patients underwent dedicated thyroid ultrasound for detection of thyroid nodules. We found one or more nodules in 210 [51.2%] of our patients. The mean [ +/- SD] age of patients with incidental thyroid nodules was 62.9 +/- B.1 [range: 14-100] years. The nodules were unilateral in 56.5% and bilateral in 43.5% of the patients. Incidental thyroid nodules were detected in 46.9% of men and 58.8% of women [P=0.017]. Among our patients, 61% had only one nodule. The mean [ +/- SD] largest diameter of nodules among those with only one nodule was 10.6 7.9 mm while it was 14.2 11 mm among those with more than one nodule [P=0.03]. The prevalence of thyroid incidentalomas in the population we studied was higher than many other studies. This may be due to iodine deficiency in our country

Evaluation of CT scan and MRI findings of pathologically proved gliomas in an Iranian population

The aim of this study was to report the main CT scan and MRI findings of gliomas in a group of Iranian patients. The MRI and CT scan of 96 pathologically proven patients of gliomas were retrospectively evaluated in a period of five years in our university affiliated hospital. We included all cases who had both CT scan and MRI in our study. Among our patients, 60 [62.5%] were male and 36 [37.5%] were female. The mean age of our patients was 41.8 +/- 19.3 [7-78]. The most common location of tumor was in the parietal lobes [54.2%] followed by the temporal lobes [52.1%], and the frontal lobes [39.6%]. The most common subtype was glioblastoma multiform in 42 patients [43.8%]. Edema, cystic formation, and hemorrhage were more frequently found in MRI in comparison with CT scan, while CT scan showed calcification better than MRI. In contrast to many other studies, the most common site of gliomas in our patients was parietal lobes

Association between clinical symptoms and CT findings in chronic rhinosinusitis

This study was conducted to find out the association between the clinical symptoms of chronic rhinosinusitis [CRS] and CT findings. 50 patients with CRS were studied. Their clinical symptoms were recorded according to the sinonasal outcome questionnaire [SNOT-20] and their CT findings were graded by the Lund-Mackay grading system. The Pearson correlation coefficient was assessed between these two scores. Also we used multiple regression models for adjusted association among variables. The mean +/- SD of SNOT-20 and the Lund-Mackay score were 45 +/- 8.7 [range: 29- 67] and 18.5 +/- 5 [range: 8-24], respectively. The mean +/- SD SNOT-20 score was higher for postnasal drip [PND] and facial pain; the lowest mean scores were for dizziness and ear pain. Pearson's correlation coefficient of SNOT-20 and the Lund-Mackay grading system was 0.74 [p=0.0001]. In simple regression analysis considering the Lund-Mackay score as dependent variable and SNOT symptom domains [nasal, oropharyngeal, sleep, facial, and systemic] as independent variables, the best associated clinical symptom domain was the nasal symptom domain [model r2=0.76; p<0.0001]. In the multivariate linear regression model, considering the five symptom domains as independent variables, the model r2 was 0.8 [p<0.0001] and the only significant variable in the model was the nasal symptom domain [p<0.0001]. Patients with higher symptom scores are more likely to have CT imaging evidence of rhinosinusitis

Computed tomography findings in patients with mild head trauma

To determine the frequency of computed tomography [CT] findings in patients with mild head trauma. In this cross-sectional study conducted between September 2005 and April 2006, 708 patients with mild head trauma as defined by a Glasgow Coma Score [GCS] of 13-15, were underwent standard clinical examination and cranial CT. The mean +/- SD age of our patients was 26.8 +/- 19.03 years [range: 1 month to 89 years]. 489 [68.9%] patients were male and 219 [30.8%] were female. GSC was 13 in 1%, 14 in 4.6% and 15 in 94.4% of patients. The most common mechanism of trauma was car accident and falling down, each of which happened for 132 patients [18.6%].The most common findings on CT were subgaleal hematomas in 213[30%] and intracranial lesions were seen in 41 patients[5.8%] ;among them 37 were male. Among intracranial lesions, the most common finding was epidural hematoma in 18 patients followed by hemorrhagic contusion in 13 patients. Intracranial lesions were observed in 28.6% of patients with GCS of 13; in 15.2% with GCS of 14 and in 5.1% with GCS of 15 [P=0.002]. Many of patients with GCS equal to 15 after head trauma have considerable intracranial lesions and minor focal neurologic signs revealed by careful physical examination could be a good marker of these lesions

Hepatobiliary fascioliasis: Clinical and radiological features

Fascioliasis is a worldwide but unevenly distributed zoonosis caused by the trematode Fasciola hepatica that infects domesticated herbivores. Fasciolosis also occurs accidentally in humans by ingestion of metacercaria-laden freshwater or water plants. Human infections are common in developing countries and are not rare in Europe. The clinical course has been conventionally described in two phases: an acute phase of hepatic parenchymal invasion of an immature worm larva [parenchy-mal phase] and a stationary phase after residence in the bile duct and production of eggs [ductal phase]. We report a 34 years old woman from Ilam, western Iran with hepatic disorder, RUQ pain, and jaundice. The diagnosis was made by sonography, CT scan and serologic studies. Serologic exam [ELISA] was positive and CT findings were compatible with fascioliasis

Malignant transformation of multiple dermal cylindromas

Cylindromas are benign tumors appearing as small solitary slow growing nodules on the head and neck. Multiple cylindromas may form a turban tumor. Here, we report an unusual case of multiple cylindroma with transformation to cylindrocarcinoma. The patient is a 61-year-old woman who developed a cylindrocarcinoma on a pre-existing cylindroma of head and neck, with deformity of head due to soft tissue masses, lytic lesions of scalp with invasion to brain, and destruction of orbit leading to unilateral visual loss

prevalence of carotid artery disease in candidates of coronary artery bypass graft

Patients with concomitant coronary artery disease and carotid artery disease are at risk of developing serious neurologic events in pre- and post-coronary artery bypass graft [CABG] operation. The objective of this study was to determine the carotid Doppler ultrasonography findings in candidates for CABG. Between September 2004 and October 2005, we performed preoperative Doppler study of carotid vessels in all candidates for CABG admitted to our hospital. We evaluated the level of stenosis, and the type, site and nature of the plaque for all patients according to the Nicoladis guideline. Mean +/- SD age of patients studied was 67.5 +/- 8.6 [range: 29.84] years. Among 352 patients undergoing CABG, 143 [40.3%] had carotid disease. Stenosis >50% was observed in 10.5% of females and 5% of males [P=0.07]. Significant stenosis [>/= 50%] was seen in 32 [9.1%] of patients, while 13 [3.8%] had critical stenosis [>/= 70%]; 2 [0.6%] had complete occlusion of the left internal carotid artery. The prevalence of carotid stenosis and atherosclerotic plaques was higher in patients aged >60 years [P=0.002]. The frequency of carotid stenosis in our patients is similar to other reports. Age is the important associated factor for carotid artery disease in candidates of CABG

[Normal values of the diameter of portal vein and its major right and left branches]

Background: Regarding to the importance of the portal vein diameter and inadequate knowledge of it in our county and due to determining its normal values, this survey was performed in patient visiting Loghman Hakim medical center within 1383

Materials and methods: The portal vein diameter was measured using ultrasonography [Aloka Japan I] which has a phased array convex 3.5 MHz, and was compared according to sex standard values in main text books and articles

Results: The portal diameter vein was 9.56+/-1.71, major right brach was 6.44+/- 0.89 and major left branch was 5.61+/-0.87. The obtained values for all three variables were more in males than females [P<0.0001]

Conclusions: It seems that normal values obtained for males were different with standard values, whereas obtained values and standard values were cmpatible in females

Tuberculous meningoencephalitis: intracranial tumoral presentation

A 37-year-old Iranian woman presented acutely with decreased level of consciousness and bi-lateral mydriasis to the emergency ward. CT scan and MRI showed a large intracranial mass in the left frontotemporoparietal region of the cerebrum. The clinical and imaging findings were suggestive of an intracranial tumor. Frontotemporal lobectomy was performed and the resected specimen contained white caseating material. Grossly, the resected specimen was white and firm. Microscopically multiple granulomatous le-sions with epitheliod histiocytes and Langerhans giant cells and central caseation were seen, surrounded by inflammatory infiltration of plasma cells and neutrophils as well as meningeal congestion. These findings were compatible with necrotizing granulomatous encephalitis of tuberculosis. Parenchymal CNS tuberculosis with or without extra-cerebral manifestations may present as a space-occupying lesion. Because a tuberculoma is rarely suspected especially if there is atypical morphology, biopsy is required to establish the diagnosis and specific treatment