Association between body mass index and mitral valve prolapse

Introduction: Body mass index [BMI] can affect cardiac morphology; however, the relationship between BMI and valvular heart diseases has not been thoroughly evaluated. This study aimed to determine the relationship between BMI and mitral valve prolapse [MVP] as one of the most common valve diseases worldwide. It can help us to better understand pathophysiology of this common disease

Materials and Methods: In this descriptive study we enrolled 200 patients with isolated MVP. This patient was referred from 2014 to 2015 to our cardiology clinic in Mashhad, Iran, with chief complaint of chest pain, dyspnea, and palpitation. patients underwent transthoracic echocardiography. We document the patients' height, weight, and demographics data. BMI distribution was categorized as higher and lower than 18.5 kg/m[2]. Chi-square and independent samples t-test were performed using SPSS version 19 to analyze the data

Results: The results showed that 92 [46%] and 108 [54%] of the samples were male and female, respectively, and their mean age was 24.29 +/- 3.75 years. Most of the patients [n=110] had low BMI [55% of the patients had BMI lower than 18.5 kg/m2]. Left atrial and ventricular diameters had a significant relationship with BMI of all the underweight patients [n=110] [P=0.026 and 0.032, respectively]. The main complaints were chest pain [n=55,50%] and dyspnea [n=58,64.44%] in the patients with low and normal BMI, respectively

Conclusion: Symptoms and echocardiographic features in MVP patients vary with BMI. While mitral valve annulus diameter was the same in both BMI groups, the results showed that left atrial and ventricular diameters in the underweight patients were less than those with normal BMI

Mismanagement of a huge ovarian serous cystadenoma in a young girl; a case report

While ovarian masses are common findings in gynecology, unusually huge masses are quite rare. However, such cases can still be found today. Mismanagement of common complaints in patients can be a leading cause of facing such findings. Herein, we introduce a case of a giant ovarian cyst, which was mismanaged in a young virgin female patient. The patient had received gastrointestinal medications for months before being admitted to our clinic, given the bloating sensation and lack of any gynecologic problems. Ultrasonography disclosed a giant cyst, probably related to the ovary, originating from the pelvis and extending toward the diaphragm. After a successful surgery, the ovarian cyst, measuring 40 centimeters and weighing 8 kilograms, was removed. Pathology report revealed serous cystadenoma. Existence of such cases can be an alarming sign for physicians to manage prevalent complaints more seriously, particularly those non-responsive to treatment

Chronic recurrent multifocal osteomyelitis; manifestation, imaging and diagnosis

Chronic recurrent multifocal osteomyelitis [CRMO] is an inflammatory bone disease usually affecting children. A 9-year old boy presented with recurrent lower extremities pain and discomfort lasting for two years. In every time, symptoms vanished after several weeks. The patient received antibiotics only in one period of bone pain. In other occasions the patient didn't received any antibiotics. In last episode of bone pain, symptoms disappeared by use of naproxen. In patient's X-rays, there were multifocal areas of sclerosis with a wide transitional zone accompanied by a fine periosteal reaction. Regarding his history and MRI, bone scan findings were more in favor of active inflammatory process in the involved regions. In needle biopsy and bone curetting of left and right tibiae, osteonecrosis, mild inflammatory fibrosis, and scattered chronic inflammatory cells consistent with chronic osteomyelitis were noticed. No malignant neoplastic tissue was identified. In 2-year follow-up, diagnosis of CRMO was confirmed by serial laboratory tests, three-phase bone scan, CT and MRI findings. This diagnosis was proved by pathology evaluation following needle bone biopsy

Inflammatory myofibroblastic tumor of salpinx: a very rare case treated with a less aggressive method

Inflammatory pseudotumour describes as a wide range of neoplastic and reactive lesions. One of the rare presentations of these tumors is found in the salpinx. This case report characterizes a thirty six year old woman with a history of left sided abdominal pain for a few months. Further examinations revealed that she had a complex cyst in her left salpinx. The patient had normal levels of tumor markers such as CA125, Alfa Fetoprotein [AFP], and Human Chorionic Gonadotropin [hCG], while other paraclinical test were in normal values Additionaly The patient underwent left salpingectomy by a gynecologist. The pathological diagnosis of the lesion was inflammatory myofibroblastic tumor [IMT]. In immunohistochemistry the tumor stains was moderately positive in anaplastic lymphoma kinase [ALK] and also actin positive. Total resection of tumor was performed with no complications and remained disease free during follow up for 40 months. Although Inflammatory Myofibroblastic Tumor [IMT] is benign in nature, but in order to improve the prognosis, this tumor requires low intensity surgical treatment

comparative study of the management of stage 2 hypertension by combined therapy with losartan, amlodipine and hydrochlorothiazide

The most effective and accurate treatment of hypertensive patients reduces cardiovascular events and improves the quality of life. This study compared the efficacy and safety of combined [combination therapy] with an angiotensin-receptor blocker [ARB] a calcium-channel blocker [CCB] [Losartan / Amloidipine 50/10mg] vs maximal combination doses of ARB with hydrochlorothiazide [Losartan /HCTZ 100/25 mg] and maximal combination doses of CCB with HCTZ [Amlodipine /HCTZ 10/25 mg] in the management of stage 2 hypertension. This randomized clinical trial [RTC] comprised 478 hypertensive patients with mean age 50.5 +/- 5.21 years, and took place between January 2010 and December 2011 in Vasei Hospital clinic in Sabzevar. Antihypertensive drugs were washed out after 5 days of discontinuation of drugs and the patients with mean blood pressure in sitting position >/= 160 and <200 mmHg in systole and >/= 100 and <110 mmHg in diastole were randomized into three groups: Losartan / Amlodipine 50/10 mg [n =164], Losartan / HCTZ 100/25 mg [n =155] and Amlodipine / HCTZ 10/25 mg [n =159]. The end point was reaching the blood pressure below 140/90 within 56 days of treatment in each group. There was a significant difference in systolic blood pressure reductions between treatment groups [P<0.001] and also there was a significant difference between groups in reducing diastolic blood pressure [P<0.01]. The highest systolic and diastolic blood pressure reduction respectively was found in Amlodipine/losartane and losartane/HTCZ group. The ANCOVA analysis revealed that only treatment regimen had a significant effect [P=0.01] and other factor including Age, Gender, Diabetes Mellitus, Smoking and High serum cholesterol didn't have significant effect on blood pressure reduction. ARB/CCB combination therapy reduced blood pressure more effectively than the maximal doses of ARB or CCB with HCTZ in stage 2 hypertensive patients within this period of study