ABSTRACT
Ovarian torsion is an emergency whereby challenges in diagnosis may lead to delayed management. The morbidity associated with delayed diagnosis can be severe and includes loss of ovarian function. We present a case of a 24-year-old female who presented to the hospital with left lower quadrant abdominal pain with unremarkable physical examination. A transabdominal and transvaginal ultrasound were acquired and demonstrated a mildly enlarged left ovary and fallopian tube without other significant findings. However due to worsening pain and up trending inflammatory markers, diagnostic laparoscopy was performed and demonstrated a 12cm ovarian cyst, a necrotic left adnexal mass and a torsed left tubo-ovarian pedicle. These findings were not appreciated on the initial Doppler ultrasound acquired but retrospective analysis demonstrated a double bladder sign. Our case report aims to aid sonographers and physicians to promptly diagnose ovarian torsion through the "double bladder sign" and other salient ultrasonographic and clinical features.
ABSTRACT
BACKGROUND: One dietary strategy aimed at improving both diabetes control and control of cardiovascular risk factors is the use of low glycemic index diets. These diets have been reported to be beneficial in controlling diabetes, and also increase high density lipoprotein cholesterol (HDL-C), lower serum triglyceride, and reduce glycated protein. AIM: Therefore, we aimed to investigate the effect of a low glycemic index-low glycemic load (GL = 67-77) diet on lipids and blood glucose of poorly controlled diabetic patients. MATERIALS AND METHODS: In an intervention study, 100 poorly controlled diabetic patients (age 52.8 ± 4.5 years) who were taking insulin or on oral medication underwent administration of low GL diet (GL = 67-77; energy = 1800-2200 kcal, total fat = 36%, fat derived from olive oil and nuts 15%, carbohydrate = 41%, protein = 22%) for 10 weeks. Patients were recommended to follow their regular lifestyle. Total cholesterol, low density lipoprotein (LDL), HDL, triglyceride, glycated hemoglobin (HbA1c), weight, and body mass index (BMI) were measured before and 10 weeks after the intervention. RESULTS: Before intervention, initial blood cholesterol and triglyceride concentrations were 205.9 ± 21.6 and 181.5 ± 22.2, respectively, and were reduced to 182.6 ± 18.2 and 161.6 ± 16.7, respectively, after 10 weeks intervention (P < 0.001). LDL reduced and HDL increased significantly. The HbA1c percentage reduced by 12% (from 8.85 ± 0.22% to 7.81 ± 0.27%) (P < 0.001), and also their weight significantly reduced from 74.0 ± 5 kg to 70.7 ± 4.6 kg (P < 0.001). CONCLUSION: This study demonstrated that low GL diet having lower carbohydrate amount and higher fat content is an appropriate strategy in blood lipid and glucose response control of poorly controlled diabetic patients.
ABSTRACT
INTRODUCTION: Young physicians have many recruitment barriers in Iran. Therefore, for planning purpose, assessment of the attitudes of medical intern students towards their future career is important. METHODS: This cross-sectional study assessed the view points of 300 medical students through a self administered questionnaire. Data were analyzed using SPSS software with P value < 0.05. RESULTS: Two hundred and forty students (80%) of the students had responded to the questionnaire. Among them, 67.5% were female with mean age of 21.7±2.4. The main factors for deciding to study in medicine were their interest (64.1%), family pressure (13.5%) and social prestige of medical career (9.8%). The mean score of attitudes was 2.3±0.6. In total, 24.5% of students demonstrated not having interest in studying medicine. The most important cause of their interest change was long duration of education (24.4%) and cost of studying in medicine (13.8%). In total, 88.6% of students had negative viewpoint towards their medical career in future. CONCLUSION: In general, the attitude of medical students toward their future career was negative.
