Infratemporal hydatid cyst: a case presenting with blindness.

OBJECTIVE: We report a very rare case of a hydatid cyst in the infratemporal fossa, causing visual loss over a 10-day period, which disappeared with rapid surgical and medical treatment. CASE REPORT: A 14-year-old girl presented with right exophthalmos and visual loss. Over a 10-day period, her visual acuity had decreased to detection of hand motion only, due to pressure on the optic nerve caused by a parapharyngeal cyst pressing through a inferior orbital fissure on the right side. A craniotomy had previously been performed for a right frontoparietal hydatid cyst. The patient had been treated intermittently with albendazole. The patient was primarily diagnosed with hydatid cyst, on the basis of her previous medical history and radiological findings, and underwent surgery. Three cysts were carefully removed from the right maxillary sinus, via a standard Caldwell-Luc approach, and the surgical area was irrigated with hypertonic saline. CONCLUSION: Infratemporal hydatidosis is very rarely reported in the world literature, although hydatid cysts are endemic in many countries, including Iran. We discuss the common presenting features, investigation and treatment options for infratemporal hydatosis. Constant evaluation of adjacent organs is necessary, with treatment as required, due to the propensity of hydatidosis to recur in essential organs. Immediate surgery is recommended, both to prevent the development of disease and to improve the prognosis.

Auricular leishmaniasis mimicking squamous cell carcinoma.

OBJECTIVES: We report a rare case of auricular involvement by leishmaniasis, in order to demonstrate the importance of thorough investigation of cutaneous head and neck lesions, and also the importance of inclusion of infections such as leishmaniasis in the differential diagnosis of auricular lesions, especially in endemic areas. CASE HISTORY: A 42-year-old man with multiple lesions on his head, neck and hands was referred to our centre. He had the following lesions: a painful, crusted, 8 x 8 cm plaque with indurated margins on the left parotid region and auricle; a red papule on the right temporal region; an ulcerative lesion on the skin overlying the proximal interphalangeal joint of the fifth finger of the right hand; and a bluish papule on the neck. Although histopathological examination of the Geimsa-stained specimen was misleading, a direct smear prepared from biopsies showed amastigotes, and therapy resulted in complete recovery. CONCLUSION: Leishmaniasis can be both under- or over-diagnosed. Especially in endemic areas, parasitic causes of chronic infections should always be kept in mind.

Poor physical activity in the elderly as assessed by a visual analogue scale is associated with dyslipidemia.

The aim of the present study was to evaluate the association between a subjective measure of physical activity assessed by a Visual Analogue Scale (VAS) and dyslipidemia in an elderly population of Iran. A total of 74 elderly subjects (39 males) aged 65 years and older who referred to the Cardiovascular Department of the Hospital were studied. Physical activity was assessed on a 100 mm VAS according to which patients were then divided in to two groups active (activity score > or = 50; n = 31) and inactive (activity score < 50; n = 43). Body Mass Index (BMI), systolic and diastolic blood pressure, triglycerides, total cholesterol, Low-Density Lipoproteins (LDL) and High-Density Lipoproteins (HDL) were measured by standard methods. TG (p = 0.021) and LDL (p = 0.006) were significantly higher and HDL was significantly lower (p = 0.028) in the inactive group. No significant associations were found for other variables. As the first report from Iran, present results are important given the race differences that exist in response of plasma lipids to exercise training. Limitations of the present study include its cross-sectional, rather than prospective, structure and the relatively small sample size. It remains to be seen whether VAS can be used as a rapid screening tool for the presence of dyslipidemia in the elderly.