ABSTRACT
@#Introduction: Idiopathic generalised epilepsy (IGE) refers to a group of epilepsies resulting from the activation of neurons in the whole brain. This study aimed to evaluate the metabolite changes in thalamus as diagnostic biomarkers in IGE patients compared to healthy individuals using magnetic resonance spectroscopy (MRS) technique. Methods: The MRS was performed on 35 IGE patients (26 women and 11 men) with average age of 32 (ranged from 18 to 43) and 35 healthy individuals (13 women and 22 men) with average age of 31 (ranged from 21 to 50) as the control group. The levels of N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) were measured using MRS. The NAA/Cr and NAA/Cho ratios were calculated for all participants. These values were statistically compared using t-test between the groups. Results: The NAA had significant lower values in IGE patients, 9.6 (SD = 0.8) and 9.9 (SD = 0.7) for right and left thalamus, respectively, compared to 10.9 (SD = 0.9) and 10.7 (SD = 0.9) in control group. The Cr values in the left side of thalamus were significantly higher in IGE patients (6.7 [SD = 0.8] versus 5.8 [SD = 0.5]); however, there was no difference in right thalamus. Measurements showed no difference for amounts of Cho between the groups in both sides of thalamus. The NAA/Cr ratio was 1.48 (SD = 0.14) and 1.48 (SD = 0.16) for right and left thalamus, respectively, in IGE patients in comparison with 1.83 (SD = 0.2) and 1.86 (SD = 0.26) in controls. There was no meaningful variation between the NAA/Cho ratio of the right and left thalamus among the groups. Conclusion: Thalamic NAA, Cr and NAA/Cr ratio values in IGE patients showed statistical differences compared to healthy individuals. Evaluating metabolites variations in thalamus using MRS is suggested for differentiating IGE patients from healthy individuals.
ABSTRACT
The aim was to determine the diagnostic accuracy of sonography for ovarian torsion. In this analytic descriptive study, 323 women with suspected ovarian torsion underwent a transabdominal sonography. Findings of sonography were compared with laparatomy. The ultrasound correctly diagnosed 72.1% of ovarian torsion cases and missed 27.9% of these cases [false negatives]. There was a strong correlation between sonography and surgery with a kappa value of 84.0%. The sensitivity and specificity of sonography for diagnosing ovarian torsion were determined 72.1% and 99.6%, respectively. Also, sonography had a positive predictive value [PPV] of 96.9%, a negative predictive value [NPV] of 95.9%, and a total accuracy of 96.0% for detection of ovarian torsion. Sonography is excellent to evaluate patients with suspected ovarian torsion. Abnormal blood flow is highly predictive of ovarian torsion
ABSTRACT
Misdiagnosing ovarian torsion is now suggested as an important issue in clinical setting. The aim of this study was to determine the diagnostic accuracy of sonography for ovarian torsion. In this study 323 women with acute pelvic pain with highly suspected ovarian torsion signs and symptoms attending Imam Reza Medical Center in Kermanshah between 2011 through 2012 were included and underwent a transabdominal sonography [2-5 MHz probes]. Then findings of sonography were compared with laparatomy. The ultrasound correctly diagnosed 72.1% of ovarian torsion and missed 27.9% of them [false negatives]. However, one free subject [0.4%] was misclassified as ovarian torsion [false positive]. There was a strong correlation between sonography and laparatomy with a kappa value of 84.0%. The sensitivity and specificity of sonography were 72.1% and 99.6%, respectively. Sonography had a positive predictive value of 96.9%, a negative predictive value of 95.9%, and a total accuracy of 96.0% for detection of ovarian torsion. Sonography appears to be an excellent method to evaluate patients with suspected ovarian torsion. Abnormal blood flow detected by sonography is highly predictive of ovarian torsion and is therefore useful in the diagnosis of this phenomenon