ABSTRACT
Objectives: The ultrasound examination of the hip joint is performed in the static (Graf) technique in the lateral recumbent position and in the dynamic technique in the supine position. This study compares the two static and dynamic techniques and assesses the role of the patient's position in the examination of DDH. Methods: This cross-sectional study was conducted in 2020-2021 at Akbar Hospital, Mashhad University of Medical Sciences, Iran. 126 patients suspected of having DDH (199 hip) infants were enrolled in the study. All ultrasound examinations were performed with two static and dynamic techniques by a pediatric radiologist. Results: In the static and dynamic ultrasound examinations, the average alpha angle was 51.57 ± 6.41 degrees, and 53.41 ± 6.94 degrees, respectively. These changes were not statistically significant (P = 0.312). The relationship and agreement between instability with dynamic technique and instability with static technique (IIC unstable, D, III, and IV) were investigated. Significant agreement (Kappa=0.77 (95% CI: 0.66-0.87) with excellent clinical significance was obtained between the two ultrasound examination method. Also, in terms of DDH types in the static method with instability types in the dynamic method, a substantial agreement was found between the two examination methods (Kappa =0.67; (95% CI: 0.59-0.75) with good clinical significance. Conclusion: In the ultrasound examination of DDH with static and dynamic techniques, the change in the alpha angle was not statistically significant. Therefore, the hand of the radiologist is open in measuring alpha angles and there is no need to emphasize a specific position. The type of DDH in the static technique completely corresponded to the type of stability or instability in the dynamic technique.
ABSTRACT
The pandemic of COVID-19 along with high use of corticosteroids resulted in the emergence of invasive fungal infection. Here, we reported the radiologic feature of mucormycosis in COVID-19-infected cases and reviewed with available literature.
ABSTRACT
Although there is still much to learn about the types of errors committed in health care and why they occur, enough is known today to recognize that a serious concern exists for patients. Tuberculosis (TB) is an infectious disease that is frequently subject to diagnostic errors. Missed or delayed diagnosis of TB can affect patients and community adversely. Our aim in the present study was at evaluating the type of diagnostic errors in TB patients from symptom onset to diagnosis. This was a multicenter cross-sectional study conducted in three university hospitals in Mashhad, Iran. We showed a long delay in diagnosing TB that is mostly related to the time from first medical visit to diagnosis. Errors in the diagnostic process were identified in 97.5% of patients. The most common type of error in diagnosing TB was failure in hypothesis generation (72%), followed by history taking and physical examination. In conclusion, it seems likely that efforts to improve public awareness of and health literacy for TB, to coordinate the referral and follow-up systems of patients, and to improve physicians' skills in history taking and physical examination and clinical reasoning will result in reduced delay in diagnosis of TB and, perhaps, improved patient safety and community health.
