Comparing the operational related outcomes of a robotic camera holder and its human counterpart in laparoscopic ovarian cystectomy: a randomized control trial

Purpose: Glioblastoma Multiforme [GBM] brain tumor is heterogeneous in nature; so, its quantification depends on how to accurately segment different parts of the tumor, i.e. active tumor, edema and necrosis. This procedure becomes more effective when physiological information like diffusion-weighted-imaging [DWI] and perfusion-weighted-imaging [PWI] are incorporated with the anatomical MRI. In this preliminary tumor quantification work, the idea is to characterize different regions of the GBM tumors in an MRI-based multi-parametric approach to achieve more accurate characterization of pathological regions, which cannot be obtained by using individual modalities. Methods: For this purpose, three MR sequences, namely T2-weighted imaging [anatomical MR imaging], PWI and DWI of five GBM patients were acquired. To enhance the delineation of the boundaries of each pathological region [peri-tumoral edema, tumor and necrosis], the spatial fuzzy C-means [FCM] algorithm is combined with the region growing [RG] method. Results: The results show that exploiting the multi-parametric approach along with the proposed segmentation method can improve characterization of tumor cells, edema and necrosis in comparison to mono-parametric imaging approach. Conclusion: The proposed MRI-based multi-parametric segmentation approach has the potential to accurately segment tumorous regions, leading to an efficient design of the treatment planning, e.g. in radiotherapy

Serum cholesterol level nomograms for Iranian population; suggestion for national cut-offs

High cholesterol levels are associated with increased risk of coronary heart disease and stroke. Under-standing the distribution of serum cholesterol levels in each country is valuable index for use in public health planning. This study aimed to construct nomograms of total cholesterol [TC] levels and establish the cut-points specific to Iranian population. Data on serum TC levels of 19,630 non-institutionalized individuals aged 25-64 years from third national survey on non-communicable diseases [SuRFNCD] in 2007 were used to construct cholesterol nomograms. We pro-posed cutoff values for borderline and high TC levels based on rounded 75th and 90th percentiles in three age groups [25-34, 35-44 and 45-64] respectively. Average yearly increase of TC for males up to the age of 45 and females up to 64 were 1.15 and 1.03 mg/dl, respectively. TC levels were higher in females. In males, cutoff values for "borderline and high" TC levels were 195 and 220 mg/dl in 25-34, 210 and 240 mg/d in 35-44 and 215 and 245 mg/dl in 45-64 years old individuals. In women, these values were 200 and 225 mg/dl in 25-34,215 and 240 mg/dl in 35-44 and 235 and 265 mg/dl in 45-64 years old individuals respectively. Since TC levels are different in two sexes and change with age, we proposed different cutoffs for sex and age group. We think these cutoffs could be used in national public health planning

Bilateral dislocation of temporomandibular joint induced by haloperidol following suicide attempt: a case report

Drug induced dystonic reactions are among common presentations of patients in emergency departments, and typically occur with antidopaminergic agents as their extra-pyramidal side effects. Dystonic reactions usually occur within the first few hours or days after commencing a drug or dose increase. Unlike other extra-pyramidal side effects, a patient may experience acute dystonic reactions [ADRs] with the administration of just a single dose. Oromandibular dystonia is a subtype of dystonia which can present with perioral manifestations. In extreme cases, it can lead to temporomandibular dislocation. Haloperidol, as a high potent typical antipsychotic drug, can induce dystonia with blocking D[2] dopamine receptors. The present paper reports a case of bilateral dislocation of temporomandibular joint following ingestion of haloperidol in a suicidal attempt in a 17 years old girl

Validity, reliability and factor structure of hepatitis B quality of life questionnaire version 1.0: findings in a large sample of 320 patients

Background: Quality of life is of significant importance in chronic hepatitis B [CHBV]. We aimed to assess the psychometric properties of the Hepatitis B Quality of Life Questionnaire v1.0 [HBQOL] in a large sample of 320 Iranian patients with CHBV

Methods: After adapting the Iranian version through forward-backward translation and expert panel discussion, we administered HBQOL together with Short-Form 36 [SF-36], Medical Outcome Study Social Support Questionnaire [MOS-SS], Hospital Anxiety and Depression Scale [HADS], and the Iowa Fatigue Scale [IFS] to 320 non-cirrhotic Iranian patients. We used principal component analysis with Varimax rotation to determine the factor structure. To evaluate the psychometric properties of HBQOL, test-retest and internal consistency reliabilities, divergent and convergent validity with other instruments, and discriminatory power were calculated

Results: Thirty-one questions loaded on to six factors [Anticipation anxiety, Stigma, Psychological well-being, Vitality, Transmissibility and Vulnerability] which explained 63.6% of total variance. Test-retest reliability was 0.66. Cronbach's alpha was 0.94 for the overall scale and between 0.7 and 0.9 for subscales, with the exception of the Vulnerability subscale. HBQOL and its subscales showed acceptable convergent and divergent validity with other instruments. Furthermore, Vulnerability subscale of HBQOL discriminated between patients with chronic active and chronic inactive hepatitis

Conclusion: The Iranian version of HBQOL is reliable, valid, and sensitive to the clinical conditions of the patients. This instrument has acceptable factor structure to measure several aspects of quality of life in patients with chronic HBV

Isolated fallopian tube torsion: a case report and review of literature

Isolated fallopian tube torsion is rare and often difficult to diagnose. Definitive diagnosis is always made at laparoscopic or via laparotomy exploration performed for suspected ovarian torsion. Early diagnosis and conservative laparoscopic treatment especially in a reproductive age woman is warranted as a means of preserving fallopian tube integrity and maintaining fertility. Here, we describe a case with isolated right fallopian torsion being managed by conservative laparoscopic surgery