[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

Estimation of Chronological Age According to Risser's Sign

Risser's sign, a measure of excursion in the iliac crest apophysis, has been used to evaluate the remaining skeletal growth. The objective of this study was to evaluate the value of Risser's sign in estimation of chronological age in a number of university-affiliated referral hospitals in Tehran, Iran. Our study group consisted of 206 patients aged between 10 and 25 years with a stable hemodynamic condition who were referred due to trauma in regions other than the head and neck. All cases underwent AP spine and proximal pelvis radiographies. All radiographies were graded by Risser's scoring system. Among our patients, 121 [58.6%] were male and 85 [41.3%] were female. Risser's score of 0, 1, 2, 3, 4 and 5 were seen in 13 [6.3%], 7 [3.4%], 24 [11.7%], 48 [23.3%], 35 [17%], and 79 [38.3%] of the patients, respectively. Risser's score was determined for all age groups. All cases aged over 18 years had a Risser's score >/= 3. Risser's score is useful for the estimation of age in adults especially for legal purposes, though further multicenter studies are required for more comprehensive and precise data of the normal Iranian population

Ultrasonographic assessment of normal amniotic fluid index in a group of Iranian women

The objective of this study was to determine the normal values of amniotic fluid index [API] at different gestational ages among a group of Iranian women. The four-quadrant sum of amniotic fluid pockets, API, was studied in 489 normal pregnant women with 20-42 weeks of gestational age. Those with diabetes mellitus, hypertension, ultrasonographically detectable anomalies, premature rupture of membranes, intra-uterine growth retardation, and any known fetal abnormalities were excluded from the study. The mean 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of API for each gestational age were calculated. The mean [ +/- SD] gestational age of the pregnant women studied was 31.46 +/- 6.1 [range: 20-41] weeks. The mean [ +/- SD] API was 13.26 +/- 4.59 [range: 5.1-26.1] cm. The mean [ +/- SD] API was 12.1 +/- 1.6 cm [Confidence Interval 95%: 8.9-15.3] at the 20th week, increased to 14.6 +/- 1.2 cm [CI95%: 12.2-17] at the 27th week, which then declined to 10.9 +/- 1.2 [CI95%: 8.5-13.3] at the 41st week. Our study determined the curve of normal values of API for each gestational age and the upper and lower normal limits in a group of Iranian women

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

[Normal values of mucosal thickness of bladder]

Background: Mucosal thickness of bladder increases following to the UTI, chemotherapy, neurogenic bladder, posterior urethral valve, stone and inflammation. Due to the importance of normal values of mucosal thickness and existing controversies, this study was performed on normal population visiting medical centers affiliated to Shahid Beheshti Medical University

Materials and methods: This was a cross-sectional study on 212 normal adult individuals. The studied group included all patients underwent ultrasonography. Not due to urinary problems such as abdomen pain, probable anomalies and routine check-up. All those didn't have predisposing factors on increase of mucosal thickness. The probe was 3.5-5 MHZ. The thickness was measured sagitally and cross-sectionally from posterior-lateral trigone. Age, sex and fullness of the bladder were determined as influencing factors on bladder thickness

Results: The range of age was 12 to 70. 78% were female and 22% male. The thickness of full bladder was 2.57+/0.57 mm with the range of 1.41 to 3.65 mm and the thickness of empty bladder was 5.48 +/- 0.12 mm with the range of 7.10 to 3.86 mm

Conclusions: The thickness of bladder was reported to be 2-3 mm in one reference and 4-6 mm in another. The previous findings are compatible to some extent with those from our study for full bladder but nothing mentioned for empty bladder

Normal values of mucosal thickness of bladder

Mucosal thickness of bladder increases following to the UTI, chemotherapy, neurogenic bladder, posterior urethral valve, stone and inflammation. Due to the importance of normal values of mucosal thickness and existing controversies, this study was performed on normal population visiting medical centers affiliated to Shahid Beheshti Medical University. This was a cross-sectional study on 212 normal adult individuals. The studied group included all patients underwent ultrasonography. Not due to urinary problems such as abdomen pain, probable anomalies and routine check-up. All those didn't have predisposing factors on increase of mucosal thickness. The probe was 3.5-5 MHZ. The thickness was measured sagitally and cross-sectionally from posterior-lateral trigone. Age, sex and fullness of the bladder were determined as influencing factors on bladder thickness. The range of age was 12 to 70. 78% were female and 22% male. The thickness of full bladder was 2.57 +/- 0.57 mm with the range of 1.41 to 3.65 mm and the thickness of empty bladder was 5.48 +/- 0.12 mm with the range of 7.10 to 3.86 mm. The thickness of bladder was reported to be 2-3 mm in one reference and 4-6 mm in another. The previous findings are compatible to some extent with those from our study for full bladder but nothing mentioned for empty bladder

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

Post surgical desmoid tumors in familial adenomatous polyposis: a case report

Literature review indicates that desmoid tumors are exceedingly common in familial adenomatous polyposis [FAP], where the comparative risk is 852 times that of the general population. Prior abdominal surgery has been found in as many as 68% of FAP patients with abdominal desmoid. Fifty-five percent develop these lesions within 5 years of surgery. We describe a 45-year-old patient with Gardner's syndrome complicated by a desmoid tumor 2 years after he had a prophylactic colectomy

[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

Normal values of the diameter of potal vein and its major right and left branches

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. The portal vein diameter was measured using ultrasonography [Aloka Japan] which has a phased array convex 3.5 MHz, and was compared according to sex standard values in main text books and articles. The portal diameter vein was 9.56 +/- 1.71, major right branch 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]. 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