Diagnostic Value of MRI Compared to Histopathological Results in Differentiating Benign from Malignant Ovarian Masses.

Introduction and aim: Ovarian cancer is a prevalent neoplastic condition among females. Early diagnosis is essential in improving patient outcomes. This study aimed to determine the diagnostic value of magnetic resonance imaging (MRI) compared to histopathological diagnosis to distinguish between benign and malignant ovarian masses. Methods:The present cross-sectional study, which was conducted between 2021 and 2022, included a cohort of women with ovarian mass. Gyneco-oncologists referred all patients to the MRI center. The imaging protocol encompassed T1 and T2 weighted images, T1 fat-suppressed sequence, post-contrast and diffusion-weighted images (DWI). After surgery, the histopathological results were compared to the MRI diagnosis. Statistical analysis was done by using SPSS v.25 software. Results:A total of 67 women aged 15-82 years old were included in this study. Compared to histopathological diagnosis, MRI had a sensitivity of 96%, a specificity of 69%, a positive predictive value of 64.9% and a negative predictive value of 96.7%. Among patients under 40 years old, MRI showed a sensitivity of 100%, a specificity of 76.2%, a positive predictive value of 72.2% and a negative predictive value of 100%. Solid component and contrast enhancement within the solid component was significantly more frequent in patients with malignant diagnoses than those with benign masses (p<0.05). Conclusion:According to the results of the study, MRI is valuable for discriminating between benign and malignant ovarian masses, especially in patients under 40.

Comparing the effect of clomiphene citrate and letrozole on ovulation induction in infertile women with polycystic ovary syndrome.

OBJECTIVE: To compare the effects of letrozole and clomiphene citrate in women with polycystic ovaries. METHODS: The double-blind randomised clinical trial study was conducted from September 22, 2012 to March 20, 2013, at the Islamic Azad University of Medical Sciences, Mashad, Iran, and comprised infertile women with polycystic ovaries. The subjects were classified into two groups. Patients who received letrozole 5mg tablets per night formed group A, and those who received clomiphene citrate 50mg tablets per night formed group B. The medication continued for 3-7 days in each group. On the 13th day, transvaginal sonography with multi-frequency vaginal probe was done to check the number and the size of dominant follicle and endometrial thickness. Human chorionic gonadotrophin 5000 IU ampoule, 10000 IU per night, was administered intramuscularly for ovulation in the case of dominant follicle over 18mm and the insemination was recommended 24-36h after injection. Beta human chorionic gonadotrophin was determined 16 days after the injection by immunoassay technique. The patients were followed up for 12 months. SPSS 16 was used for data analysis. RESULTS: There were 220 patients; 110(50%) in each of the two groups. The mean age of patients in group A was 26.2±3.6 years and that in group B was 27±3.6 years. Endometrial thickness in group A was significantly greater compared to group B (p=0.001). The clinical consequence of drug use (pregnancy) in group A was better than group B (p=0.007). CONCLUSION: Although more clinical studies are needed, letrozole is recommended for women with polycystic ovaries and those resistant to clomiphene citrate.

Chronic Recurrent Multifocal Osteomyelitis in a 9-year-old Boy.

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare aseptic, auto-inflammatory bone disorder. CRMO presents with bone pain with or without fever. The diagnosis of CRMO is a diagnosis of exclusion and should be included in the differential diagnosis of chronic inflammatory bone lesions in children. Cultures of the bone are typically sterile, antibiotic therapy does not result in clinical improvement whereas anti-inflammatory drugs improve the condition. Furthermore, biopsy should be considered in chronic and relapsing bone pain and swelling unresponsive to treatment. Herein, we present a nine-year-old boy complaining of recurrent pain in his upper and lower extremities. On examination he had mild fever and cervical lymphadenopathy. He also had experienced bone pain and weight loss in the recent month. Based on biopsy and bone scan he was finally diagnosed with CRMO. Naproxen and Pamidronate was prescribed and he was getting better and returned to normal life and activity without need to corticosteroids.