Uterus dysplasia associated with cervico-vaginal agenesis

Mullerian ducts can form upper parts of normal female reproductive system and any failure in ductal fusion may result in to mullerian duct anomalies [MDA]. We present a case of MDA and a uterus dysplasia with no evidence of cervical or upper vaginal tissue. This case showes the role of magnetic resonace imaging [MRI] on MDA diagnosis and urges the need for a unified reliable and practical classification more compatible with clinical practice

Prevalence of Enterobius vermicularis among Children in Iran: A Systematic Review and Meta-analysis

OBJECTIVES: Enterobius vermicularis is a parasitic disease that is common in crowded areas such as schools and kindergartens. Primary investigations of electronic evidence have reported different prevalences of E. vermicularis in Iran. Therefore, we aimed to estimate the total prevalence of this infection among Iranian children using a meta-analysis. METHODS: Relevant studies were identified in national and international databases. We selected eligible papers for meta-analysis after investigating titles, abstracts, and full texts; assessing study quality; and applying inclusion/exclusion criteria. Data were extracted by two independent researchers. The results were combined using a random effects model in Stata v. 11 software. RESULTS: Among 19 eligible articles including 11,676 participants, the prevalences of E. vermicularis among all children, boys, and girls were 1.2%–66.1%, 2.3%–65.5%, and 1.7%–65.5%, respectively. Pooled prevalences (95% confidence interval) of E. vermicularis among all children, boys, and girls were 17.2% (12.6%–21.8%), 17.2% (12.6%–21.8%), and 16.9% (9.03%–24.8%), respectively. CONCLUSION: This meta-analysis showed that a great majority of Iranian children are infected with E. vermicularis, possibly due to poor public health.

Lumbosacral Sagittal Alignment in Association to Intervertebral Disc Diseases

STUDY DESIGN: A cross-sectional case-control study was designed to compare the sagittal alignment of lumbosacral regions in two groups of patients suffering from low back pain, one with intervertebral disc pathologies and one without. PURPOSE: To evaluate the correlation between lumbosacral sagittal alignment and disc degeneration. OVERVIEW OF LITERATURE: Changes in lumbar lordosis and pelvic parameters in degenerative disc lesions have been assessed in few studies. Overall, patients with discopathy were shown to have lower lumbar lordosis and more vertical sacral profiles. METHODS: From patients with intractable low back pain undergoing lumbosacral magnetic resonance imaging, 50 subjects with disc degeneration and 50 controls with normal scans were consecutively enrolled. A method was defined with anterior tangent-lines going through anterior bodies of L1 and S1 to measure global lumbosacral angle, incorporating both lumbar lordosis and sacral slope. Global lumbosacral angle using the proposed method and lumbar lordosis using Cobb's method were measured in both groups. RESULTS: Lumbar lordosis based on Cobb's method was lower in group with discopathy (20degrees-67degrees; mean, 40.48degrees+/-9.89degrees) than control group (30degrees-62degrees; mean, 44.96degrees+/-7.68degrees), although it was not statistically significant. The proposed global lumbosacral angle in subject group (53degrees-103degrees; mean, 76.5degrees+/-11.018degrees) was less than control group (52degrees-101degrees; mean, 80.18degrees+/-9.95degrees), with the difference being statistically significant (p=0.002). CONCLUSIONS: Patients with intervertebral disc lesions seem to have more straightened lumbosacral profiles, but it has not been proven which comes first: disc degeneration or changes in sagittal alignment. Finding an answer to this dilemma demands more comprehensive long-term prospective studies.

Malaria or flu? A case report of misdiagnosis

We present and discuss elaborately a case of malaria misdiagnosis in a 27-year-old woman in Chalus, Mazandaran Province, North Iran in 2013. The patient has been complaining of fever, shivering and myalgia for three months. Although she visited two physicians during this time, the problem still remained owing to misdiagnose. Eventually in hospital after a precise examination on her thick and thin blood film, the causative agent of disease was diagnosed as plasmodium vivax. The patient received treatment accordingly and all clinical manifestations were vanished.

Molecular and seroepidemiological survey of visceral leishmaniasis among humans and domestic dogs in Mazandaran province, north of Iran

New cases of visceral leishmaniasis [VL] have been reported recently in some parts of Mazandaran Province, north of Iran where the first human case of VL was reported in 1949. This study aimed to determine the present status of Leishmania infantum infection among humans and domestic dogs using serological and molecular methods in central parts of Mazandaran Province. In this cross-sectional study, blood samples were randomly collected from 402 humans and fortynine domestic dogs throughout 2009 and 2010 in the central part of Mazandaran Province including Semeskadeh and Kiakola districts where recent cases of human visceral leishmaniasis had been reported there. All the collected samples were tested by direct agglutination test [DAT] for the detection of anti- Leishmania infantum antibodies as well as convenience PCR assay on whole blood samples for detection of leishmanial infection and identification of Leishmania species. None of 402 collected human [402] and dog [49] blood samples showed anti Leishmania infantum antibodies at titers 1:3200 and 1:320 as cut-off values of DAT, respectively but only 2 of domestic dogs [4.1%] were found PCR-positive corresponding to L .infantum. This study confirms the circulation of L. infantum at least among domestic dogs and highlights the sporadic pattern of VL in the studied areas. Further investigations regarding to sand flies fauna and wild canines as reservoir hosts of the disease, are recommended

Cortical representation of Persian word production: an fMRI study

Neural correlates of single word reading with the use of a functional MRI [fMRI] scan have been widely studied in different languages. These study patterns of cortical activation differ in different languages. In this report we used a similar technique to study cortical activation when reading single Persian words. The subjects were comprised of nine healthy right-handed bilingual individuals who performed three consecutive fMRI paradigms. Our study showed activation of the inferior frontal gyrus [IFG] when single Persian words were read. These results revealed that the pattern of brain activation during word production in Persian has a similar topography to that of English equivalents. The paradigms selectively activate word production areas and are useful in neurological assessment of the Persian population

Fungal peritonitis in Iranian children on continuous ambulatory peritoneal dialysis

Fungal peritonitis [FP], causing catheter obstruction, dialysis failure, and peritoneal dysfunction, is a rare but serious complication of peritoneal dialysis. In this study, the frequency and risk factors of FP are evaluated in children who underwent peritoneal dialysis. A retrospective multicenter study was performed at the 5 pediatric peritoneal dialysis centers in Iran from 1971 to 2006, and FP episodes among 93 children were reviewed. Risk ratios were calculated for the clinical and demographic variables to determine the risk factors of FP. Ninety-three children aged 39 months on average were included in study. Sixteen out of 155 episodes of peritonitis were fungi infections, all by Candida albicans. The risk of FP was higher in those with relapsing bacterial peritonitis [P = .009]. Also, all of the patients had received antibiotics within the 1 month prior to the development of FP. Catheters were removed in all patients after 1 to 7 days of developing FP. Six out of 12 patients had catheter obstruction and peritoneal loss after the treatment and 5 died due to infection. Fungal peritonitis, accompanied by high morbidity and mortality in children should be reduced by prevention of bacterial peritonitis. Early removal of catheter after recognition of FP should be considered