Abnormal brain MRI in a case of acute ataxia as the only sign of abdominal neuroblastoma

Ataxia is a movement disorder that may manifest an acute, intermittent, non progressive or chronic progressive course. Ataxia alone is rare as a paraneoplastic sign, especially if it is due to neuroblastoma [abdominal or chest]. We report an abdominal neuroblastoma in a two-year-old girl presenting with only acute ataxia and abnormal neuroimaging. Brain MRI showed abnormal signal finding in the medulla, pons, corticospinal tract and the periventricular space. In the abdominal CT, a mass was detected in the right adrenal gland with calcification and the histopathologic examination re-vealed neuroblastoma. We suggest in children with acute ataxia, with or without opsoclonus-myoclonus, neuroblastoma should be considered

Anxiety, depression and health-related quality of life in those injured by landmines, Ilam, Islamic Republic of Iran

We assessed depression, anxiety and health-related quality of life [HRQOL] in 137 cases of landmine I injury in Ham province, using the Hospital Anxiety and Depression Scale [HADS] and the Short Form Health Survey [SF36] questionnaires. We also compared their scores with an uninjured control group [n - 360]. Most of the injured were male [93.4%] and illiterate [54.7%] with some irreversible sequelae [86.9%]. Overall, 69.3% of the injured participants scored high for both anxiety and depression. The level of anxiety and depression was significantly higher in older cases, those not completely recovered compared with recovered cases and those with amputation compared with those without amputation. The injured also had significantly lower mean scores in all HRQOL components than the control group. Landmine injured should be monitored for early identification and treatment of depression and anxiety

Radiographic findings of pulmonary tuberculosis in Tehran in comparison with other institutional studies

Tuberculosis [TB] is one of the most common worldwide infections, especially in developing countries. Early diagnosis is very important for prevention of the chronic form of the disease and sequel formation. Chest x-ray [CXR] is an easy, feasible, non-expensive and quick tool for the diagnosis of pulmonary tuberculosis. We retrospectively evaluated 200 chest x-rays of secondary pulmonary TB cases in university-affiliated hospitals. These cases were all proved by a positive sputum smear or culture for mycobacterium tuberculosis. In this study, we correlated CXR findings of 100 male and 100 female patients. The peak age of involvement in both groups was 61-80 years. None of the chest x-rays were normal. The main radiographic findings were consolidation-infiltration, fibrosis, pleural effusion, cavitation, pleural thickening and bronchiectasis. Mediastinal lymphadenopathy was detected in 9% of the cases. Pulmonary infiltration with consolidation was the most common finding [55%]. Miliary shadowing, atelectasis and pneumomediastinum were the least common presentations. Lymphadenopathy was more common in 40 to 60-year-old women. Right lung involvement was more common than the left side and the upper zones were involved in most cases. The most common underlying diseases were hypertension and diabetes mellitus. Infiltration in diabetic patients and fibrotic appearances in hypertensive patients were common findings. There was no significant difference between our data and the other studies carried out in Iran. The patients were younger in the studies from other countries. However, cavitary lesions were more common in other studies than this study, which seems to be due to the higher prevalence of underlying diseases such as HIV or diabetes

Adding liver window setting to the standard abdominal CT scan protocol: is it useful?

Hepatic lesions may be missed in the routine abdominal computed tomography [CT] scan protocol using soft tissue window setting. The ability to find these lesions is very important in the assessment of metastasis and follow-up of patients. Patients and Methods: In this study, 411 patients who underwent abdominal CT for various causes were evaluated separately by two radiologists blindly. All liver images were viewed in two different window settings, soft tissue window setting: window width [WW] of 350-400 Hounsfield unit [HU], window level [WL] of 35-50 HU, and liver window setting: WW of 150 HU, WL of 50-100 HU, at the workstation. Out of 411 patients, 181 [44%] were referred for cancer follow-up and 230 [56%] for evaluation of abdominal discomfort. Soft tissue window setting revealed no lesion in 334 [81.26%] patients, single lesion in 30 [7.31%], and multiple lesions in 47 [11.43%] patients. Liver window setting revealed no lesion in 313 [76.2%] patients, single lesion in 35 [8.5%], and multiple liver lesions in 63 [15.3%] patients. Compared to liver window, soft tissue window setting revealed 77.77% of all detectable liver lesions. Liver window showed new lesions in 22 [6.6%] of patients in whom no lesion had been found in soft tissue window setting. Therefore, liver window setting brought 5.3% increase in the diagnostic yield of CT in our series, and changed the decision for treatment in 2.4% of patients studied. Liver window setting added to the standard soft tissue setting protocol of abdominal CT at the workstation can improve the diagnosis and follow-up of patients, especially for those who have known cancer. Image review with this new setting takes a few minutes and the cost is also low; there is no added radiation exposure to patients

Radiological findings of pulmonary tuberculosis in infants and young children

Pulmonary tuberculosis [TB] is a common worldwide lung infection. It remains an important cause of morbidity and mortality. Radiographic manifestations of pulmonary tuberculosis are diverse and varied. This study was performed to define the various radiographic manifestations of this infection in the pediatric age group in children who were referred to Mofid Children's Hospital. We reviewed chest x-rays of 30 pulmonary TB patients admitted to our hospital to ascertain the extent of parenchymal and mediastinal involvements on chest xray. Male to female ratio was 1.7:1. The patients' age ranged from 2-163 months with a mean age of 36.9 months. Mediastinal lymphadenopathy was detected in 90% of the cases and pulmonary involvement, especially alveolar shadowing was seen in 83.3% of the cases [of which 43.3% had an air-space pattern and 40% had an interstitial pattern]. 19 of the 30 patients [66.3%] were under 36 months, in which 17 of the 19 patients [89.5%] revealed lymphadenopathy. Therefore 63% of all detected lymphadenopathies were seen in this age group. Mediastinal lymphadenopathy was more common on the right side [73.3%]. Furthermore, 60% of all alveolar infiltrations were seen on the right side. Pulmonary tuberculosis most commonly represents as a mediastinal and thereafter as a parenchymal involvement. Hilo-mediastinal lymphadenopathy is the most common presentation in infants and young children

Pleuro-pulmonary blastoma in a 4-year-old child

Pulmonary blastoma is a rare malignancy with various histopathological appearances in children which present as an intra-thoracic mass. In this case report we present a 4-year-old boy with pleuro-pulmonary blastoma which was unrecognized for several weeks and was managed as pleural effusion and pneumonia. We decided to present this case because of the diagnostic difficulties and radiographic appearances

Causes of violence against women referring to Tehran legal medical center in 2003

In most societies, violence against women exists in which, economical problems, alcohol, marriage related, familial and cultural problems are among effective factors. This study is done to determine the effective causes of violence against women referred to Tehran legal medical center. This is a descriptive study performed in 2003 at Tehran Legal medical center. The sample consisted of 171 subjects and data collecting instrument was a questionnaire which was completed by researcher was consisting of demographic information of samples and their strikers and causes of violence. Results were analyzed using SPSS software and descriptive statistical methods. Out of 171 subjects, 40.4% were in age group of 26-30 with mean age of 29.58 +/- 10.15 and 47.4% had high school education, 5.8% were illiterate and 0.6% gave no response. 29.8% of strikers had high school education and 3.5% of them were illiterate. The most effective cause of violence [27.0%] in married women was husband's skepticism and among singles [38.23%] was street clashes. Since most of violence causes in married samples are husband's suspicion which is a psychological problem, therefore more studies should be done to eradicate such problem. Street clashes are also a social difficult which is the most violence cause in single samples. These problems originated from our social and cultural disorders which should be considered deeply