ABSTRACT
Background and Aim: we described the presentation, management and subsequent treatment outcomes of children and adolescents diagnosed with a pituitary adenoma in a joint neuroendocrine setting followed up by a single service as well as assessing long-term outcomes in terms of endocrine status and neurology symptoms
Methods and Materials/Patients: a total of 21 participants with histologically verified pituitary adenoma between January 2011 and June 2014 were studied. Patients' data from clinical, radiological and pathological records were analyzed using SPSS [Version 16]
Results: all these children and adolescents with pituitary adenomas were managed with microscopic transsphenoidal surgery. The most common symptom was Cushing [47.6%, n=10]. The functional type [76.2%, n=16] was more than the non-functional. The post-operative control MRI of most of them was clear [90.5%, n=19]. The lab control of most of them was normal [76.2%, n=16]. Apoplexy was seen in 5 patients [33.8%]. Gross-total resection [GTR; 100% tumor removal as judged by early post-operative imaging] was achieved in 19 cases. Only one of these patients showed evidence of radiologic recurrence
Conclusion: in our study, all patients underwent microscopic transsphenoidal surgery due to limitation of endoscopic approach in pediatric and avoided wide anatomical deficit. Doing a comparative study between these two approaches will bring about promising results
ABSTRACT
Background: We aimed to test a new approach for repairing cerebrospinal fluid (CSF) leaks and to determine the demographic, diagnostic, and treatment factors associated with the successful management of intracranial complication. Owing to the high frequency of endoscopic surgeries and the low cost of medical care in Iran, we decided to report our experience of reconstruction after CSF leaks. Methods: We retrospectively reviewed our experience in the diagnosis and management of CSF rhinorrhoea in Iran between 2005 and 2012. The locations of all pre-repair leaks were identified using simple, readily available methods. The follow-up time ranged from 2 to 72 months. Results: Of the 37 participants, 59.5% were men and the mean age was 33 years. The success rate was 86.1%, and the most common aetiological factor was trauma (57%). The most common location was the ethmoidal fovea (45.9%), followed by the sphenoid sinus (24.3%), the cribriform plate (13.5%), and the posterior table of the frontal sinus (5.4%). Conclusions: Medical care in Iran has considerable budget restrictions. This study advocates a practical method of treatment for patients in similar circumstances, with a success rate of 86.1% when compared to the 90.6% achieved with other techniques.
ABSTRACT
To prevent and control the cancers in Iran, the Iranian Department of Health has released the cancer rates data of the country. As the report has suggested, the incidence rate of thyroid cancer would be the most rapidly increasing among all the cancers. The study has aimed to carry out a qualitative assessment of thyroid cancer in Iran, during the 2004 to 2009, in a cross-sectional setting. The incidence rates, the trend of individual provinces, the mean age at which the disease occurred, the correlation between incidence rate and median urinary iodine concentration were the parameters evaluated in our study. The average annual incidence rate during these six years was 2.17 per 100000. Chaharmahal-o-bakhtiari, had the highest incidence rate, but the East Azerbaijan provinces had the lowest incidence rates respectively. The age of diagnosis was the lowest in Ardebil but the highest in West Azerbaijan. In our study, we have found the positive correlation between thyroid cancer incidences with low urinary iodine concentration among all provinces [p-value=0.025]. Presently, the only recognized measure procedure for reducing thyroid cancer risk would be perhaps the correction of median urinary iodine concentration. Further researches have seemed to be required for investigation the other factors, in order to introduce preventive measures in Iran
ABSTRACT
Based on a number of studies, magnesium sulfate [MgSO4] given after a diffuse axonal injury has gained attention as a useful neuroprotective agent. The present study was conducted to examine if magnesium sulfate has a therapeutic efficacy and safety in patients with a severe diffuse axonal injury. Adult patients admitted within 1 hour of a closed Traumatic Brain Injury [TBI] with a severe diffuse axonal injury that met eligibility criteria were randomized into two groups. Our treatment guidelines consisted of an initial loading dose of 50 mg/kg magnesium sulfate and then 50 mg/kg QID up to 24 hours after the trauma. The outcome measures were mortality, GCS, and motor function scores which were assessed up to 2 months after the trauma. Magnesium showed a significant positive effect on GCS 2 months [P=0.03]. Among those in MgSO4 group, motor functioning score improved more than control group but this was not statistically significant [P = 0.51]. At the end, we have demonstrated that administration of magnesium sulfate can have neuroprotective role following severe DAI
ABSTRACT
Hyperbilirubinemia at neonatal period is one of the major deteriorating factors of the auditory system. If left untreated, it may cause certain cerebral damage. This study aims to evaluate the impact of hyperbilirubinemia on the hearing of neonate. This study was conducted on 35 newborn babies with jaundice [bilirubin more than 20 mg/dL]. Auditory brainstem response [ABR] and transient evoked otoacoustic emission [TEOAE] tests were performed, after treatment and one year after. ABR test results indicated that 26 children [74.3%] had normal hearing but 9 [25.7%] suffered from an impairment. As for TEOAE test, 30 children [85.7%] passed whereas the remaining [14.3%] seemed to be failures. The comparative results of the two tests pointed to autonomic neuropathy /autonomic dysreflexia symptoms in 5 babies. Due to the high incidence of Autonomic neuropathy/autonomic dysreflexia among hyperbilirubinemic babies, screening in this regard seems reasonable. Our result emphasizes the necessity of more experiments on the afflicted areas