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Background: Gallbladder agenesis (GA) is a very uncommon disorder of the biliary system. Diagnosis of GA can be difficult and may result in unnecessary procedures. In this case report, we will discuss our experience with an intraoperative accidental diagnosis of GA in a middle-aged woman that was effectively treated. Case Presentation. A 46-year-old woman presented with abdominal pain, nausea, vomiting, and intolerance to meals. Laparoscopic surgery was conducted based on sonographic imaging and a preliminary diagnosis of chronic cholecystitis. No gallbladder was seen during laparoscopy, and the patient was diagnosed as a case of GA. The laparoscopy was terminated, and the patient was referred for magnetic resonance cholangiopancreatography (MRCP) to confirm the diagnosis. Finally, endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy were performed to alleviate symptoms. After one year of follow-up, the patient's overall condition is satisfactory and symptom-free. Conclusion: Our case exemplifies this common blunder. Therefore, we are reporting a case of GA discovered intraoperatively to increase surgeons' awareness and preparedness for this possible differential diagnosis and minimize unnecessary operational intervention.
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BACKGROUND: Attention deficit hyperactivity disorder and conduct disorder are amongrelatively prevalent disorders during childhood and adolescence.Considering the negative impact of the parents' drug dependency andbipolar disorder, the present study aimed to determine the prevalence ofADHD and conduct disorder in children of drug-dependent and bipolar parents. METHODS: In this case-control study, the case group included two groups ofpatients with drug dependency and bipolar disorder hospitalized inShahid Beheshti hospital in Kerman who had 7 to 11-year-old children.The control group included healthy individuals without any drugdependency or other psychiatric disorders. Data were collected usingRutter scale Form A (parents' form) and a demographic questionnaire.Data were analyzed with ANOVA, Chi-square and Tamhane's post-hoc test. FINDINGS: Rutter's abnormal scores were generally 7.11% in children of drugdependent parents, 14% in children of bipolar parents and 1.6% in childrenof healthy parents demonstrating no significant difference. The frequencyof conduct disorder in the bipolar and drug dependent group was higherthan the healthy group, but the difference was not significant. Thefrequency of ADHD was 8.9% in the drug dependency group and 1% inthe control group which shows a significant difference. CONCLUSION: Drug dependency in parents may be a leading factor to mentaldisorders such as ADHD and conduct disorder in children.
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In this paper, a heuristic method for determining the optimal number of clusters is proposed. Four clustering algorithms, namely K-means, Growing Neural Gas, Simulated Annealing based technique, and Fuzzy C-means in conjunction with three well known cluster validity indices, namely Davies-Bouldin index, Calinski-Harabasz index, Maulik-Bandyopadhyay index, in addition to the proposed index are used. Our simulations evaluate capability of mentioned indices in some artificial and medical datasets.
