Assessment of renal transplant dysfunction by doppler sonography: A systematic review and meta-analysis.

Background: Doppler sonography parameters, particularly the resistive index (RI), have been identified as an essential tool for assessing renal transplant dysfunction (RTD). However, there is some ambiguity in the findings of previous research studies on this matter. Therefore, the objective of our study is to examine the relationship between changes in RI subsequent to RTD. Methods: This was a systematic review and meta-analysis study. We searched three electronic databases PubMed, Web of Science, and Scopus, from the year 2000 to 10 May 2022. The main effect size was considered as the mean RI differences of cases with RTD confirmed by biopsy with control patients with no RTD. We used random effect models to pool the effect size. Results: Thirteen studies were included in our review. The pooled mean (95% CI) for the control group was calculated to be 0.71 (0.67, 0.75) and for patients with renal transplant dysfunction was 0.73 (0.68, 0.78), under a random effect model with high heterogeneity for both analyses (I2=98% and 97%, respectively). The pooled mean was significantly different between the control group and patients with RTD (P= 0.05), based on a t-test of pooled effect sizes. Conclusions: Based on the result of our study, we showed that there is a significant difference between RI in patients with kidney transplant dysfunction and the control group. However, RI cannot substitute kidney biopsy in the management and diagnosis of RTD.

Hyaluronic acid gel application versus ovarian suspension for prevention of ovarian adhesions during laparoscopic surgery on endometrioma: a double-blind randomized clinical trial.

BACKGROUND: This study aimed to compare the effect of ovarian suspension and hyaluronic acid gel to prevent re-adhesions after laparoscopic endometrioma surgery. METHODS: This randomized clinical trial was conducted at Rasoul-e-Akram and Pars Hospitals, Tehran, Iran, 2016-18. Fifty patients with bilateral endometrioma and pelvic adhesions, the candidates of laparoscopic surgery, were included. In each patient, at the end of ovarian cystectomy and adhesiolysis, one of the ovaries was randomly sutured to the abdominal wall, and the HYAcorp Endogel covered the other; the adhesion rate was compared between the groups by ultrasonography, three-month after surgery. RESULTS: Mean age of patients was 32.6 years. Presurgical variables were similar between right and left ovaries and the study groups (P > 0.05). Postsurgical ultrasonography showed that ovarian soft markers, including < 1/3 ovarian adhesions (minimal adhesions) in 80.5% of ovaries of the Endogel group and 35.5% of the ovarian suspension group (P < 0.001) with higher ovarian mobility in the Endogel group (65% vs. 22%) (P = 0.001). In addition, site-specific tenderness and ovarian fading margin were lower in the Endogel group (P < 0.001). Trial registration Clinical trial registry number: IRCT2015081723666N1, 12.19.2015, Date of registration: 01/02/2016; https://en.irct.ir/trial/20174?revision=20174 . Date and number of IRB: 2015, I.R.IUMS.REC.1394.24703. CONCLUSION: Hyaluronic acid gel can be more effective than ovarian suspension in preventing ovarian adhesions after laparoscopic treatment of endometriosis.

Diagnostic value and agreement of transrectal in comparison with transvaginal sonography among women with abnormal uterine bleeding.

AIMS: Transvaginal sonography (TVS) is not applicable for evaluating the endometrium in some cases with abnormal uterine bleeding (AUB) such as virgin women. The aim of the present study was to investigate the diagnostic value of transrectal sonography (TRS), as a non-invasive alternative for TVS, among women with AUB. METHODS: In this cross-sectional study, 40 women over 40 years of age with AUB first underwent TRS and then TVS. Endometrial biopsy was also performed as a gold standard method to evaluate endometrial pathologies. The findings of the two endometrial ultrasound methods were compared with the biopsy results. Also, the findings of the two methods were compared in terms of the agreement on other uterine markers and adnexal findings. RESULTS: There was a high agreement between the findings of TVS and TRS for uterine size, endometrial thickness and homogeneity, endomyometrial junction, myometrial homogeneity, uterine lesions, uterine lesions size, ovarian size and ovarian echogenicity. When comparing the results of these two methods with biopsy findings, sensitivity, specificity as well as positive and negative predictive values of both methods were similar (82%, 100%, 100%, and 0%, respectively). CONCLUSION: When it is not possible to use TVS in women with AUB, TRS is a suitable, non-invasive and inexpensive alternative method for evaluating the endometrium and other genital organs.

Height estimation based on second cervical vertebra measured using three-dimensional computed tomographic scanning in Iranian adults.

OBJECTIVES: The cervical vertebrae are more durable than other skeletal components, and therefore may be the only remnants of a dead body. The present study aims to investigate the role of several linear dimensions of the second cervical vertebrae measured by Three-Dimensional Computed Tomographic Scanning (3D CT Scan) in height estimation of Iranian adult population. In this cross-sectional study, height determination was performed by measuring 15 indexes of the second cervical vertebrae. Indexes were obtained by screening cervical CT scan of 66 patients (33 males and 33 females) aged ≥ 18 years at Rasoul Hospital. Chi square, T student and logistic regression tests were used for statistical analysis. The significance level was considered to be < 0.05. RESULT: In the total population, among the indexes for the second cervical vertebrae, the Max height of the axis (AMA) (r = 0.470, P = 0.0001), Max length of the axis (CMA) (r = 0.320, P = 0.007), and Sagittal max body diameter (DSMC) (r = 0.281, P = 0.019) had a strong and positive correlation with height. The results of this study showed the accuracy of linear dimensions of cervical vertebrae in determining the body height of the Iranian adult population.

Hydatid cyst of the parotid gland.

Primary hydatid cyst of the parotid gland is extremely rare, even in the endemic areas. A 23-year-old woman presented with slowly progressive swelling in the right periauricular region. Computed tomography (CT) scan of the head and neck revealed a round, well-demarcated water-density mass in the right parotid gland. At the operation, the cystic mass replacing most of the superficial part of right parotid gland was demonstrated. Superficial parotidectomy was carried out. Histopathological examination confirmed the diagnosis of hydatid disease. CT scan is a valuable imaging method for diagnosis of parotid cystic lesions; however, other acquired and congenital cystic lesions of parotid gland may have similar appearance and should be differentiated. Where the incidence of the disease is high, hydatid cyst of parotid gland should be considered in the differential diagnosis of lesions causing swelling of the parotid area.

Hydatidosis of the pelvic cavity: a big masquerade.

We report and discuss a case of primary hydatidosis of the pelvic cavity in a woman who presented with severe weight loss and abdominal pain. This unusual presentation was initially considered as a tumor process until surgical exploration and microscopic studies confirmed the diagnosis. The gynecologists should be aware of possibility of primary hydatid cyst of the pelvic cavity and should be considered in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic.