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Forward movement of the lower mandible in the prediction of difficult intubation: a prospective study
Hussain Khan Z, Mirazimi F,
Volume 65, Issue 5 (3 2007)
Abstract
Background: Failed endotracheal intubation is one of the principal causes of morbidity and mortality in anesthetized patients. If the anesthetist can anticipate which patients may be more difficult to intubate, can reduce the risks of anesthesia greatly and be more prepared for any difficulties that may occur. The aim of this study was to investigate the inability of patients to protrude the lower jaw in predicting difficult intubation.
Methods: In this prospective study, we enrolled 300 patients, above 16 years of age or older, who were scheduled for elective surgery. For all of the patients, before each operation, a single anesthesiologist measured the temporomandibular mobility, which was defined as the difference between the distances, from the lower incisors to the upper incisors in a neutral position and at maximum mandibular protrusion. At the time of intubation, another anesthesiologist, blinded to the preoperative airway assessment test, performed a laryngoscopy in which the laryngoscopic view of the larynx was determined according to the Cormack and Lehane scoring system. Difficult intubation was defined as laryngoscopic views of grade III and IV.
Results: Twenty-one patients were identified as having difficult intubation. Only one patient could not be intubated. The forward movement of the mandible was significantly greater in patients with easy intubation compared to those with difficult intubation (6.42±1.95 mm vs. 3.58±1.26 mm respectively, P<0.001). The use of a cut-off point of less than 5 mm for prediction of difficult intubation showed a sensitivity of 92.86% and a specificity of 70.43%.
Conclusion: The forward movement of the mandible is significantly greater in patients with easy intubation compared those with difficult intubation Although infrequent difficulties may arise, most patients that do not have indicators of difficult intubation will be easy to intubate under anesthesia.
The effect of stress on prognosis and treatment response in 100 Rheumatoid Arthritis patients
Hussain Khan Z, Mirazimi F, Najafizade S R, Pasha Meisami A,
Volume 65, Issue 5 (3 2007)
Abstract
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with several factors that contribute to its manifestation and continuation. One of the factors that initiate RA is emotional stress, which is in direct relationship with the sufficiency or insufficiency of the neuro-endocrine axis. Therefore, any stress that is not resolved in the neuro-endocrine axis might lead to RA and, as the stress continues, it causes the continuation of the disease. The aim of this study is to determine the effect of stress on continuation of RA and to find curative methods and, ultimately, the best method for treatment.

Methods: One hundred rheumatoid arthritic patients (80 females and 20 males), having a final diagnosis of RA based on the guidelines of the American College of Rheumatology and onset of disease within the last 12-36 months, were studied as case and control subjects. Data was collected using interviews and questionnaires that reflected their life events with stress as a serious factor in their disease. The patients were divided into two groups: group A with stable stress and group B with unstable stress. The same treatment method was given to both groups. The results of the treatment were evaluated and compared after two years of follow up.

Results: There was significant improvement in the patients in group B with unstable stress over that of the patients in group A with stable stress (P<0.0001).

Conclusion: The present study shows that a considerable number of RA patients suffer from serious stress that affects their clinical path and improvement, and is quite visible in the health indexes and continuity of the disease. The results further showed that stress can play an important role in the initiation and continuation of RA. Therefore, by identifying and making efforts to remove the stress factors using anti-anxiety drugs, the disease can be better controlled.


Prevalence of head and neck abnormalities among people with consanguineous parents
Razmpa E, Azimi C, Soltan Sanjarei M, Nazari H, Ghasempoure A, Yousefi M,
Volume 66, Issue 7 (6 2008)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: A high percentage of the patients at ENT or plastic surgery clinics have ENT abnormalities, either congenital or those developing later in life. Some are life threatening, while others cause disability and esthetic problems, with profound consequences for the affected child and the family. In addition, ENT abnormalities usually place stress on interpersonal relationships, causing social isolation, unhappiness and depression. The majority of these abnormalities is genetic and follows autosomal recessive pattern of inheritance. Geneticists believe that there is a higher frequency of autosomal recessive disorders among the offspring of consanguineous parents. The aim of this study was to find the frequency of ENT abnormalities among children born of consanguineous parents.
Methods: We studied 3503 files (pedigrees) of patients referred for genetic counseling at the Department of Genetics at Imam Khomeini Hospital, Tehran, Iran, from 1999 to 2000. We studied these cases according to degree of parental consanguinity, patterns of inheritance and gender using SPSS v.15.
Results: Of all 3503 files, 206 had ENT abnormalities, of which 157 had consangui-neous marriages. Among these 157 pedigrees, 496 cases had consanguineous parents. Out of the 496 cases, the four most frequent ENT abnormalities were: 115 cases (23.2%) of deafness, 53 cases (10.7%) of hearing loss, 12 cases (2.4%) of cleft lip and palate, and 5 cases (1%) of cleft palate.
Conclusion: This high frequency of ENT abnormalities indicates that consanguineous marriage should be discouraged by Iranian policy makers in order to reduce the burden of these disorders on society. Further research into the cultural problems that encourage consanguineous marriage and ways of resolving these problems is recommended. 


Cleft lip and cleft palate relationship with familial marriage: a study in 136 cases
Azimi C, Karimian H,
Volume 67, Issue 11 (4 2010)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Clefts of the lip and palate are one of the most common congenital birth anomalies. Genetic factors play a great role in the etiology of them and the high percentage of the consanguineous marriage of the parents of the affected persons is one of the reasons. These defects not only make abnormal changes on appearance of the neonate, but also make a lot of stress and psychological problems for the patients and their families. Study on the prevalence of clefts, their risk factors and also genetic counseling for affected persons and their families can be a guideline for general population and probably reduce these anomalies over the generations.
Methods: Patients referred to the Department of Genetics, Imam Khomeini Hospital, Tehran, Iran were studied. A total of 7374 pedigrees of all the patients admitted to the Department, were studied during 2002-2005 and 99 pedigrees with the patients with cleft lip± palate or isolated cleft palate were separated. The total number of cases among these 99 pedigrees was 136. The effects of consanguineous marriage, positive family history and sex were investigated among cases.
Results: 70.8% of patients with syndromic clefts and 58.7% of patients with nonsyndromic CL±P had parents with consanguineous marriage. In addition 44.4% of patients with nonsyndromic CL±P had positive family history.
Conclusion: In our population prevalence of nonsyndromic CL±P was estimated to be 7 in 1000 (with 95% Confidence Interval was between 5 & 9) and prevalence of nonsyndromic CP was about 3.1 in 1000 (with 95% Confidence Interval was between 1.8 & 4.4). Consanguineous marriage of parents seems to have a significant role (p=0.02) on prevalence of the clefts.


A report of multiple sclerosis patients treated by CinnoVex™ in Iran
Masood Etemadifar, Mehrdokht Mazdeh, Hamid Reza Torabi, Majid Ghaffarpour, Mojtaba Azimian, Shiva Salami, Sayyed Mohammad Amir Shahkarami,
Volume 68, Issue 1 (4 2010)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Recent studies present a high prevalence of multiple sclerosis (MS) in Iran. Treatment with interferon is now the first choice in management of MS. CinnoVexTM (an interferon beta 1-a) is available in Iran, with achievement of the technology of producing beta interferon. The aim of the present study is to evaluate the efficacy and safety of CinnoVexTM in a national study named CINA study.

Methods: This study was conducted from 2007 to 2008 in cities of Tehran, Isfahan, Mashhad, Tabriz, and Shiraz. Patients with relapsing/remitting MS with 16-50 years of age and EDSS of <4 received CinnoVexTM (30µg/week, IM) after diagnosis by a neurologist. EDSS, drug side effects, and frequency of relapse were evaluated for one year in four 3-month visits.

Results: A total of 1050 patients entered the study. Complete data were collected from 627 (60%) patients. Mean age was 30.7±8.6 year and 514 (82%) were female. The most common onset presentations were sensory symptoms (44%). Changes of EDSS through the study showed a significant decrease in the last 3-month of evaluation (p<0.05). Drug side effects were observed in 47%, 50%, 61%, and 61.4% (p>0.05) and relapse was occurred in 13.4%, 15.7%, 16.9%, and 2.4% of the patients in the first, second, third, and forth evaluation visits (p=0.001), respectively.

Conclusion: CinnoVexTM prevents progression and improves clinical course of MS. The conventional side effects of beta interferon therapy, however, are observed with CinnoVexTM.


The factors relevant to the onset of vascular complications after coronary intervention in Shahid Rajaei Cardiovascular Center in Tehran, Iran
Yousefi Aa, Madani M, Azimi Hr, Farshidi H,
Volume 69, Issue 7 (7 2011)
Abstract

Background: Vascular complications, as the most common complications of diagnostic catheterization and percutaneous coronary intervention (PCI), are important factors in the morbidity of patients undergoing such procedures thus, this study was done to evaluate the prevalence of these complications and their related factors.

Methods: This is a descriptive study composed of 2097 consecutive patients who underwent percutaneous coronary intervention in Shahid Rajaei Cardiovascular Center in Tehran, Iran from January 2008 to January 2009. Occurrence of vascular complications in course of hospitalization and the related factors leading to the complications were investigated.

Results: Out of 2097 patients, 1544 (73.6%) were male and 553 (26.4%) were female, and the mean age of the participants was 57±10 years. Vascular complications from the time of PCI to the time discharge were observed in 19 (0.9%) patients. The other complications included: hematoma in 10 cases (52.6%), pseudoaneurysm in five cases (26.3%), retroperitoneal hemorrhage and arteriovenous fistula in 2 (10.5%) patients each. The complications were significantly more common in female patients (P=0.003), in patients with a history of hypertension (P=0.02), people of shorter stature (P=0.004), and being on gp IIIa/IIb inhibitors (P=0.003).

Conclusion: The rate of vascular complications post-percutaneous coronary interventions is low and it is considered to be a good treatment option for patients with coronary stenosis provided that sufficient compression is applied on the vascular access point in the right time after removal of the arterial sheath. PCI is of fewer vascular complications, especially in female patients, history of hypertension, and higher anticoagulant concentrations.


The prevalence of nosocomial infections caused by Enterobacter cloacae and antibiotic resistant patterns in samples isolated from patients in two hospitals in Tehran
Rahbar Mohammad, Azimi Leila, Mohammad-Zadeh Monaaranak, Alinejad Faranak, Soleymanzadeh Somayeh, Sattarzadeh Mahboobeh, Rastegar Lari Abdolaziz,
Volume 70, Issue 3 (4 2012)
Abstract

Background: The increasing use of β-lactam antibiotics in clinics for the treatment of different bacterial infections since early 1980s has led to increased rates of resistant bacteria isolated from patients. One of the problems in the treatment of nosocomial infections is related to resistant bacteria such as Enterobacter cloacae due to cross resistance through extended-spectrum beta-lactamase production. The aim of this study was to determine the prevalence of extended-spectrum beta-lactamase producing E. cloacae from different clinical specimens collected from hospitalized patients.

Methods: In the present study, 101 E. cloacae confirmed by standard specific microbiologic tests were collected from different specimens in Milad and Motahri hospitals in Tehran, Iran during February 2010 and September 2011. Antibiotic susceptibility tests were conducted according to the process recommended by the Clinical and Laboratory Standards Institute for 13 antibiotics of choice. Extended-spectrum beta-lactamase producing strains were screened for by combined disk method as a phenotypic diagnostic test.

Results: From a total of 101 E. cloacae, 33 (33%) were shown to produce extended-spectrum beta-lactamase by phenotypic tests 5% of the bacteria were resistant to imipenem too.

Conclusion: This study clearly showed the high prevalence of resistance to broad-spectrum beta-lactam antibiotics in the isolated E. cloacae among which 5% were multi drug resistant. All the isolated E. cloacae were susceptible to Colistin. These results can be alarming for physicians treating resistant E. cloacae infections, especially extended-spectrum beta-lactamase producing species.


Stroboscopic findings in patients with benign laryngeal lesions: a brief report
Dabirmoghadam P, Azimian S, Mokhtari Z,
Volume 70, Issue 8 (5 2012)
Abstract

Background: Laryngeal videostroboscopy is an important noninvasive diagnostic tool in patients with dysphonia. More than 50% of patients with dysphonia have a benign laryngeal lesion on vocal fold examination. The aim of this study was to evaluate patients with benign laryngeal lesions by videostroboscopy.
Methods: This cross-sectional study was done on 159 patients with dysphonia in Amiralam Hospital in Tehran, Iran during 2006-2007. All the patients underwent stroboscopic examination of the vocal folds, including their movement. We also evaluated the patients for mucosal status, mucosal wave and patterns of glottal closure.
Results: Eighty-two patients participating in the study were female and 77 were male. Reflux laryngitis and muscle tension dysphonia were the most observed disorders in the patient population. Patients with sulcus vocalis and intracordal cysts had the worst mucosal wave patterns.
Conclusion: Laryngeal videostroboscopy is a useful tool for the diagnosis and treatment planning in patients with benign laryngeal lesions.


Higher frequencies of chromosomal aberrations in lymphocytes of children with acute lymphoblastic leukemia after in vitro gamma irradiation
Azimi C, Aghamohammadi A, Ramyar A, Safari Z, Divsalar K, Mahmoodi M,
Volume 70, Issue 9 (5 2012)
Abstract

Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in childhood, characterized by excess lymphoblasts, and immature white blood cells that are continuously multiplying and overproducing in the bone marrow. The aim of this investigation was to measure the sensitivity of lymphocytes against gamma irradiation in patients with acute lymphoblastic leukemia, and also find out the effect of such irradiations in causing chromosomal abnormalities.
Methods: In this investigation performed between April 2010 and July 2011, at the Department of Genetics, Cancer Institute of Iran, we studied the effects of gamma irradiation on the lymphocytes of 20 children with acute lymphoblastic leukemia. The lymphocytes of 30 healthy donors were used to establish as a normal response to gamma irradiation and seven age-matched ataxia telangiectasia patients were recruited as positive control. The chromosomal radiosensitivity was assessed with the G2- and the G0-assay. We compared the mean number of chromosomal abnormalities such as chromosome and chromatid breakages, chromosome and chromatid gaps, and chromatid exchanges in one-hundred metaphases of patients and control groups.
Results: The frequency of chromosomal aberrations was statistically higher among patients with acute lymphoblastic leukemia than the normal controls (P<0.01). In total, 65% of the patients were sensitive to gamma irradiation, but the remaining 35% were similar to the normal controls. Patients with ataxia telangiectasia showed the highest sensitivity to gamma irradiation (P=0.001).
Conclusion: Our results showed that a high percentage of patients with acute lymphoblastic leukemia were sensitive to irradiation, meaning that maximum care should be taken during their treatment to avoid unnecessary X-rays or radiotherapies.


Overlap articles of respiratory system in databases Scopus and Web of Science: brief report
Seyed Javad Ghazimirsaeed, Zahra Pouramini ,
Volume 72, Issue 12 (March 2015)
Abstract
Background: Due to the overlap between the databases of the subject and content, resulting in the purchase of duplication and waste of resources, in this study, the degree of overlap between respiratory system papers indexed in the database, Scopus and Web of Science during the years 2001 to 2010 were examined. Methods: In this survey study, researcher followed by obtaining percent overlap in the articles related to respiratory system field from 2001 to 2010. At first sub-headings contained in the following subject headings from medical thesaurus of (Mesh 2012) extracted and then each keyword in title of articles in both database search and articles were retrieved. Then bibliographic information of these articles enter into EndNote version X3 (Thomson Reuters Inc., New York, NY, USA) and then in alphabetical order title arranged and as a result, common articles between the two databases and unique articles to each site was determined. Using SPSS software version 0.1.0.8 amount of the relative overlap and traditional overlap between the two databases was calculated and the results by using descriptive statistics to determine and were presented in tables. Results: In total 18099 articles were retrieved. That number of 9768 common articles, there were 7225 articles uniquely Scopus and 1106 articles from Web of Science. Amount of percent traditional overlap 53.97% and the overlap percent Web of Science with Scopus was 57.48% and Scopus with Web of Science was 89.83%. Conclusion: Because of overlaping the contents of two information databases such as scopus and web of sciences searching for accessing to respiratory system from scopus is better due to containing unique papers ,However it is highly recommended to pay to this point while buying and sharing the mentioned resources.
C-MYC amplification and expression in stomach cancer samples in Iranian population using two techniques of CISH and IHC
Malihea Khaleghian , Issa Jahanzad , Abbas Shakoori , Neda Zargari, Maryam Mohamadi , Cyrus Azimi ,
Volume 73, Issue 4 (July 2015)
Abstract
Background: The incidence rate of gastric cancer in Western countries has shown a remarkable decline in recent years although it is still the almost common cancer between men in Iran. The proto-oncogene MYC, located at 8q24.1, regulates almost 15% of human genes and is activated in 20% of all tumors. MYC amplification and overexpression of its protein product are observed in 15-30% of gastric neoplasia. The objective of this study was to find the preference of CISH or IHC in the diagnosis and prognosis of gastric cancer. Methods: In this cross-sectional investigation, 102 paraffin blocks samples of Iranian patients with gastric cancers were studied. All the patients had undergone primary surgical resection at the Cancer Institute Hospital, Tehran University of Medical Sciences from 1987 to 1993. CISH and IHC techniques were applied to the samples. CISH was carried out on 3-µm-thick tissue sections and with a ZytoDot CISH Implementation Kit (ZytoVision GmbH, Germany). IHC was down using the HRP method with the monoclonal antibody. A universal peroxidase-conjugated secondary antibody kit was used for the detection system. All samples were gastric adenocarcinoma and were selected randomly. Results: Our data revealed that both diffuse and intestinal types of gastric cancer occurred significantly in men more than women. Our results showed an indication of some correlation between grades and CISH results, although the difference was not significant. Our data also showed that CISH+ patients (43.1%) were more frequent in comparison with IHC+ patients (14.7%). There was a correlation between CISH and IHC. This result revealed that there was a significant difference between grades and IHC. There was also no statistically significant difference between CISH amplification in diffuse and intestinal types. Conclusion: Our conclusion is that for the treatment, management of stomach cancer, and monitoring of progress and prognosis of the tumor that is almost important for patients and clinicians, CISH test is a better and feasible to IHC test, with regards to sensitivity and specificity.
Chromosomal radiosensitivity in lymphocytes of head and neck cancer patients as determind by mironucleus and G2 assays
Farshid Farhan , Cyrus Azimi , Majid Mahmoodi , Mohammad-Ali Mohagheghi , Farideh Farzanfar , Azam Noor-Mohammadi, Malihea Khaleghian , Abbas Jafari , Mehrangiz Ghaem-Maghami , Kouros Divsalar ,
Volume 74, Issue 1 (April 2016)
Abstract

Background: It is reported that high frequency of chromosomal aberrations in peripheral blood lymphocytes of individuals is a marker of cancer predisposition. The aim of this study was to investigate the in vitro frequency of chromosomal damage in lymphocytes of patients with head and neck cancer against gamma irradiation compared with those in healthy individuals.

Methods: In a case and control study, peripheral blood lymphocytes of 101 patients with head and neck cancer were collected before the onset of radiotherapy. Lymphocytes of 40 healthy individuals were also collected as controls. Head and neck cancer patients and the control group were consecutively recruited between April 2012 and February 2015 from Clinics of Cancer Institute, Imam Khomeini Hospital, Tehran, Iran. Lymphocytes of patients or control group were cultured and exposed to gamma radiation in G2- and G0- phase of the cell cycle. The induced chromosomal aberrations such as chromosome and chromatid breakages, chromosome and chromatid gaps, chromatid exchanges and micronuclei were scored in one-hundred metaphase cells of each individual. The mean of each chromosomal aberration was compared in patient and control groups. Early and late tissue reactions were scored during radiotherapy treatment or thereafter.

Results: There was no significant difference in demographic characterization between the two study groups. The frequency of radiation- induced G2 aberrations in lymphocytes of patients was significantly higher than in those of healthy donors (P= 0.001 for chromosomal breaks). The frequency of radiation-induced micronuclei in G0 assay was also higher in patients than in those in controls (P= 0.05). The results also indicate that there is no correlation between the two assays. No significant correlation was also observed between aberration frequencies in lymphocytes and the degree of both early and late normal tissue reactions.

Conclusion: The results indicate that the in vitro chromosomal radiosensitivity of peripheral blood lymphocytes of patients with head and neck cancer against gamma irradiation was significantly higher than that in healthy individuals.


Local injection of anesthetic agent in surgical incision in post-operation pain control: a review article
Masoomeh Tabari , Marjaneh Farazestanian, Helena Azimi, Maryam Esmaeilpour, Malihe Hasanzadeh Mofrad ,
Volume 79, Issue 9 (December 2021)
Abstract
Today surgery is supposed as the cure for many diseases and the fear of post-operation pain burdens stress over the patients. Postoperative pain can, especially if severe, complicate the patient's condition and may lead to chronic postoperative pain. post-operation pain control is effective in the recovery process, hospitalization period and patients’ satisfaction. Insufficient post-operation pain control increases complications and care costs. Local analgesia is one of the components of multimodal postoperative. analgesic protocol to control pain. Local analgesia technique is a simple, accessible and feasible method for various surgeries. The opioid analgesics to control post-operation pain are associated with some complications such as opium addiction, nausea and vomiting, late return of bowel function and social costs. This review study aims. to review previous studies on the effect of injection of analgesic agents in the surgical incision in post-operation pain control. This is a Narrative review study. to related scientific documentaries a search was conducted in Persian and English using the keywords of local injection of the incision site, wound infiltration with analgesic agents and post-operation pain control in Google scholar, PubMed and Scopus database during the years 2000 to 2020. The obtained articles included systematic reviews, Meta-analyses and randomized clinical trials (RCT). We reviewed studies that had utilized single-dose injection of analgesic agents in surgical incisions at the end of surgery to control post-operation pain. A total of ten studies were reviewed. There were 4 studies in the field of laparoscopic gynecological and non-gynecological surgeries, three studies in the field of laparotomy and three review studies. injection of analgesic agents in the surgical incision to control post-operation pain is easily available and does not necessitate any special skill. On the other hand, it is a safe method without further complications and does not increase the duration of surgery. Regardless of the differences in various studies and the kind of analgesic agents, a general reduction in pain severity and consumption of opioid and non-opioid analgesic agents were observed using the injection of analgesic agents in surgical site incision.

Comparing the diagnostic accuracy of bedside ultrasound with wound exploration in diagnosis of nerve and tendon injuries in upper extremities: a brief report
Marzieh Khademi, Maryam Masaeli, Mehdi Azarmnia, Masoud Shahabian, Maziar Karamnejad, Mohammad Reza Azimi Aval , Azadeh Asghari Birbaneh,
Volume 80, Issue 4 (July 2022)
Abstract
Background: Trauma is one of the most common causes of death in all ages. Considering the prevalence of trauma in the general population, and its costs and complications, it is important to use aiding tools to accelerate the diagnosis in order to act in time. The aim of this study was to evaluate the efficacy of ultrasound in diagnosing nerve and tendon injuries in the upper extremities.
Methods: This study is a cross-sectional study, which was carried out at the emergency department of the Besat Hospital, Tehran from march 2018 to march 2019. The statistical population was all patients who had been referred with deep lacerations in upper extremities and had injuries in the superficial or deep compartments (nerves/ tendons). For all the patients who met the inclusion criteria, bedside sonography with 11 Mhz Linear probe was performed by the researcher and under the supervision of the radiologist. The results were compared with the results from local exploration of the wounds. Local exploration of the wounds was also done under the surgeon's supervision. After completing the sample size and data collection, SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) was used for statistical analysis
Results: In this study, from 144 patients with penetrating trauma in the upper extremities, 56 patients were suspected with nerve injuries and 50 patients were suspected with tendon injuries. After evaluation with an ultrasound probe, 21 out of 23 cases suspected of nerve injuries were confirmed by local exploration. Local exploration confirmed that 27 out of 28 cases were suspected of tendon injuries. The accuracy of ultrasound in the assessment of nerve damage was estimated at 99.64% and in tendon damage at 92%, and the sensitivity of ultrasound in the diagnosis of nerve damage was 91.30% and in the diagnosis of tendon damage was 96.42%.
Conclusion: By the results of this research it can be concluded, that ultrasound leads to a faster diagnosis. It provides a wider field of view, can reduce possible secondary injuries and increases the accuracy of the diagnosis.

Comparison of magnetic resonance imaging and CT scan in patients with complaints of mediastinal and chest wall mass
Mahdi Yadollahzadeh, Nader Rezaei , Mohsen Farrokhpour , Mehdi Azimi, Maedeh Barahman, Mohammad Bahadoram , Amirhossein Forouzanmehr , Seyed Ali Javad Mousavi ,
Volume 81, Issue 6 (September 2023)
Abstract
Background: The realm of diagnosing intrathoracic lesions involves a spectrum of imaging methodologies, among which computed tomography (CT)-scan and magnetic resonance imaging (MRI) stand prominent. In the context of Iran, where there is no study comparing the efficacy of CT-scan and MRI for evaluating intrathoracic lesions, our study endeavors to bridge this gap. Mindful of the nuanced advantages and drawbacks inherent in each method, we aim to conduct a comprehensive comparative analysis of CT-scan and MRI in diagnosing intrathoracic lesions, focusing on patients seeking care at Firoozgar Hospital's pulmonary clinic.
Methods: Embarking on a cross-sectional exploration at Firoozgar Hospital Pulmonary Clinic in Tehran, Iran, our investigative journey unfolded between April 2020 and March 2021. Thirty patients, spanning ages 21 to 69, presenting with intra-thoracic lesions encompassing mediastinal and chest wall anomalies, underwent simultaneous CT scan and MRI examinations. In pursuit of diagnostic certainty, histopathology was ordained as the gold standard, and the ensuing results underwent meticulous scrutiny and analysis utilizing SPSS 23 statistical software.
Results: Our study cohort comprised 30 patients, averaging 44.83 years (SD=12.71), with males constituting 60% of the population. Delving into the histological reports, CT-scan and MRI accurately diagnosed 25 (83.3%) and 28 (93.3%) cases, respectively, in retrospective analysis. The Kappa matching coefficient for CT-scan stood at 0.783, while for MRI, it soared to 0.912. A notable revelation surfaced as the Kappa matching coefficient for both CT-scan and MRI maintained a robust 0.783 (P<0.001 in all three cases).
Conclusion: MRI might wield a superior diagnostic prowess compared to CT-scan in evaluating intrathoracic lesions. The robust Kappa matching coefficients endorse a substantial concordance between the two imaging modalities. The implications further beckon contemplation that, in select scenarios, the acquisition of biopsy and histopathology may prove redundant when scrutinizing intrathoracic lesions using the tandem approach of CT-scan and MRI. However, to etch these findings into the annals of medical certainty, a multicenter study endowed with a judicious sample size emerges as an imperative next step.

Spontaneous rupture of splenic artery aneurysm in a pregnant woman: a case report
Mansoureh Baradaran, Mohammd Ashraf Azimi , Rasoul Nikdel, Seyed Hassan Seyed Sharifi ,
Volume 81, Issue 6 (September 2023)
Abstract
Background: Splenic artery aneurysm is seen in less than 0.1% of the population. Aneurysm of the splenic artery is more common in pregnant women. One of the life-threatening complications of splenic artery aneurysm is the spontaneous rupture of the aneurysm, which causes hemorrhagic shock. This complication is more common in pregnant women than other people in the society and has more mortality and morbidity. In this study, a pregnant patient with spontaneous rupture of splenic artery aneurysm is reported.
Case Presentation: The patient is an 18-year-old woman, 20 weeks pregnant, who came to the Emergency department of Bentolhoda Hospital in Bojnurd with diffuse  sudden onset of abdominal pain in the September of 2023. On examination, the patient's vital signs were unstable, which was due to the presence of hemorrhagic shock. In the examination of the patient's abdomen, or generalized tenderness and rebound tenderness? was evident, suggesting peritonitis. According to the ultrasound report, abundant free fluid and fluid containing blood was drained from the abdomen under ultrasound guidance. The patient underwent surgery with the diagnosis of hemorrhagic shock with a midline incision of the abdomen above and below the umbilicus. In the performed surgery, evidence of splenic artery aneurysm rupture was evident. For the patient, ligature and resection of splenic vessels (artery and vein) and splenectomy were performed. After surgery and stabilization of the patient's condition, fetal health ultrasound was performed, and the fetus had no heartbeat. Therefore, medical induction of abortion was performed, and after 48 hours, the fetus was completely expelled, and then mother was transferred to the ward. And four days after the surgery, she was discharged with general improvement. No remarkable adverse effects were observed after surgery.
Conclusion: One of the rare diseases is splenic artery aneurysm, which is difficult to diagnose due to its asymptomatic rupture and high mortality rate.

Grade five liver laceration following cardiopulmonary resuscitation: a case report
Mohammad Ashraf Azimi , Rasul Nikdel, Seyed Hassan Seyed Sharifi ,
Volume 82, Issue 2 (May 2024)
Abstract
Background: Cardiopulmonary resuscitation (CPR) is a potentially life-saving treatment for cardiac arrest but puts the subject at risk for iatrogenic skeletal and soft tissue injuries including the liver. In this study, an elderly patient with grade 5 liver rupture after cardiopulmonary resuscitation following laparotomy is reported.
Case Presentation: A 76-year-old female patient with diffuse abdominal pain that started a week ago and worsened since 2 days ago in the winter of 2024, referred to the emergency room of Imam Ali Bojnurd Hospital. In the examination, the patient met the criteria for shock. Abdominal examination revealed peritonitis. After initial resuscitation and stabilization of the patient's condition, an X-ray was performed for the patient. According to the Standing chest x-ray, pneumoperitoneum report, the patient underwent surgery with midline incision. In the performed surgery, evidence of gangrene and perforated was evident in a part of the small intestine, and The patient is a candidate for resection of the gangrenous and perforated intestinal segment, and then the two proximal and distal ends of the resected area were removed as an ileostomy from the right side of the abdomen. At the end of surgery, before closing the abdominal wall, the patient suffered a cardiac arrest, and CPR was started for the patient in operation room. After starting the chest massage, the patient suffered a grade 5 liver tear, the bleeding of the liver was stopped by packing with four Large Abdominal pads and CPR continued for 45 min, but unfortunately the patient died.
Conclusion: One of the rare complications of cardiopulmonary resuscitation and chest massage is visceral damage, including liver rupture. Considering that its symptoms are similar to cardiac arrest, it is difficult to diagnose in case of rupture and has a high mortality rate. According to the reports of liver and visceral damage after CPR, some studies have recommended the use of Focused Assessment with Sonography for Trauma (FAST) to detect visceral damage after CPR.

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