Findings of breast sonography in patients with focal asymmetric breast density on mammography

The imaging parameters that mandate further diagnostic workup in focal asymmetric breast densities are not clearly defined. To identify indications for further workup in Focal asymmetric breast densities [FABD] by doing ultrasonography. One-hundred women underwent breast ultrasonogrphy after incidental discovery of FABD on mammograms. Mammograms and sonograms were evaluated for lesion location, associated calcifications, architectural distortion and change from previous examination when available. Twenty three patients had abnormal sonographic findings and the site of sonographic abnormal findings was the same as the site of FABD on mammography. Sonographic findings were 7 focal increases in fibrous tissue, 5 ductal ectasias, 4 simple cysts, complex cyst in one, 4 benign solid masses, one malignant solid mass and one with fibrous tissue at the site of previous breast surgery. There was a significant relation between FABD in upper inner quadrant and normal sonography [p=0.036] and FABD in retroareolar region and ductal ectasia in sonography [p=0.002]. FABD usually present a benign etiology and can safely be managed by follow up. Sonography helps the physician do tissue diagnosis by detection mass with features of possibly malignancy, in the women with negative physical examination

[Fatal poisoning and its related factors among children admitted in Loghman hospital, 1995 -2004]

Children are vulnerable to different sort of injuries, including poisoning which may have inevitable effects and even significant mortality among this group. The aim of this study was to determine the pattern of poisoning-related deaths in Loghman hospital in Tehran. It was an existing-data type study from March 1995 to March 2004; all intoxication fatalities of under 12 year-old subjects which had been occurred in Loghman hospital were reviewed. Demographic data were reviewed for each case via a questionnaire and reported with descriptive statistics. A total of 11150 childhood severe poisonings were hospitalized during this period, of which 37 [0.33%] died. 32.4% were dead on arrival time. Male to female ratio was 1.2/1. The majority of fatalities occurred in children aged 1-4 years [59.1%]. Their mean age was 4.3 +/- 3.5 years old. All poisonings happened accidentally. Thirty [81%] of exposures were via ingestion and most of them were in summer [37.8%]. Most of deaths had not occured in Tehran but in rural areas or other cities and 35% reffered to hospital with more than 6 hours delay. Hydrocarbons were the most common cause of mortality [27%] followed by carbon monoxide, poisonous mushrooms and opium [10.8% for each of them], organophosphates pesticides and botulism [co-ingested with rice tablet] [8% for each], mercury vapor [5.4%] and scorpion sting and corrosive acid ingestion [2.7% for each] and 13.5% were other drugs. Our study points out the need to proper management of childhood dangerous poisoning like hydrocarbons, opium, organophosphates, etc. We also have to bear in mind that the prevention is an important issue

Effect of cyproheptadine on combat related posttraumatic stress disorder nightmares

Recent studies have shown the role of serotonergic system in posttraumatic stress disorder [PTSD]. Terazodone and nefazodone [5HT[2] receptor antagonists] ameliorated PTSD nightmares but the reports are mixed. This study prompted an open trial of cyproheptadine for Iran versus Iraq combat PTSD patient nightmares. 25 patients studied in an eight-week, before-after trial of cyproheptadine. The participants were male and chronic PTSD patients with combat related nightmare. The exclusion criteria included current substance abuse or dependence, psychotic disorders and any medical condition that contraindicated the use of cyproheptadine. Five patients were excluded from the study because of side effects including dizziness and somnolence. Twenty patients completed the study. Average of nightmare severity decreased from 6.85 to 5.05, which was statistically significant [P<0.01] The data suggest that cyproheptadine, as a 5HT[2] antagonist, may be effective in treament of PTSD nightmare