Magnetic resonance imaging study of incidental findings in the paranasal sinuses and ostiomeatal complex.

Purpose: This study aimed to assess incidental abnormal findings in the paranasal sinuses and anatomical variations of the ostiomeatal complex (OMC) on magnetic resonance imaging (MRI) scans. Materials and Methods: MRI scans of 616 patients (mean age, 44.0±19.4 years) were evaluated. Prior to obtaining the MRI scans, a checklist of patients' clinical symptoms was filled out after obtaining their consent. The Lund-Mackay classification was used to assess the paranasal sinuses and OMC. The prevalence of abnormal findings and their associations with patients' age, sex, and subjective symptoms were analyzed by the chi-square test, independent-sample t-test, and analysis of variance. The level of significance was set at 0.05. Results: Abnormal findings in the paranasal sinuses were detected in 32.0% of patients, with a significantly higher prevalence in males (P<0.05), but no significant association with age (P>0.05). Epithelial thickening and retention cyst were the most common abnormal findings in the paranasal sinuses. According to the Lund-Mackay classification, 93% of the study population had normal sinuses (score<4). Concha bullosa and paradoxical concha were detected in 15.3% and 3.4%, respectively, with no significant association with the presence of septal deviation or Lund-Mackay classification (P>0.05). Conclusion: Considering the relatively high prevalence of abnormal findings in the paranasal sinuses, it appears that clinical symptoms alone are not sufficient to diagnose sinusitis. A more accurate strategy would be to assess radiographic images of the paranasal sinuses and use a classification system. Sinusitis should be suspected in patients receiving a high score in this classification.

Aggressive angiomyxoma of vulva in 28-years old patient: A case report of second recurrence.

INTRODUCTION: Aggressive angiomyxoma is an uncommon mesenchymal tumor in women who are in reproductive age, that occurring in the pelvis and perineal zone with a high risk of local infiltration and recurrence. CASE PRESENTATION: We describe a case of a 28-year-old woman with a huge recurrent vulvar aggressive angiomyxoma. CLINICAL DISCUSSION: Our patients underwent surgery and tumor resection for two times but had relapsed every 2 years through 5 years and finally she underwent total vulvectomy. The patient received Decapeptide for 3 months to prevent tumor recurrence after surgery and to date,there has been no evidence of local recurrence. CONCLUSION: Aggressive angiomyxoma is a rare tumor with high recurrence rate. The best treatment is surgical resection by experienced Gyn-oncologist in teamwork and territory Hospital.

Fertility-sparing uterine lesion resection in a woman with hemoperitoneum due to invasive mole: A rare case report.

INTRODUCTION: Gestational trophoblastic neoplasia comprises a unique group of human neoplastic diseases that derive from fetal trophoblastic tissues. The hydatidiform mole is the most common form of GTD, representing 80 % of cases. An invasive mole is a hydatidiform mole characterized by the enlarged hydropic villi invading into the myometrium, into vascular spaces, or into extrauterine sites. CASE PRESENTATION: Here is a case with invasive mole after the evacuation of complete molar pregnancy, presented with an acute abdomen. We desired to preserve the uterine because our 21 years old patient doesn't have a child. CLINICAL DISCUSSION: An emergency abdominal ultrasound scan showed a 47 ∗ 34 ∗ 55 mm ill-defined hyperechoic heterogeneous mass with anechoic cystic vascular spaces within it, in the posterior wall of the uterus away from the endometrium that extended to the serous layer of the uterus. Laparotomy was done. After the evacuation of 2 L of hemoperitoneum, an approximately 5 × 4 metastatic, vesicular mass was seen in the posterior wall of the uterus, which was resected and uterine preservation was successful. CONCLUSION: This case report describes the clinical, imaging, surgical and histopathological findings of Invasive mole after a hydatidiform molar pregnancy. Our case highlights the feasibility of fertility-preserving surgery in the case who experienced life-threatening hemorrhage due to a ruptured uterus.

The effect of topiramate on weight loss in patients with type 2 diabetes.

BACKGROUND: Obesity has been associated with several co-morbidities such as diabetes and increased mortality. In general, the use of medication promotes only a modest weight loss in the range of 2 to 10 kg, usually most effective during the first 6 months of therapy; however, studies have shown positive effects on other risk factors such as blood pressure and serum glucose levels, but there are fewer studies in patients with diabetes. The aim of this study was to assess the effect of topiramate on weight reduction patients with type 2 diabetes. MATERIALS AND METHODS: This was a 32-week randomized clinical trial study of 69 subjects during 2008-2010. Patients, in two treatment groups were given topiramate (39 patients) and Placebo (30 patients) and were subjected to participation in a non-pharmacologic lifestyle intervention program; which were randomly allocated in our two groups. The percentage change in body weight and Body Mass Index (BMI) at the end of the study was the primary efficacy endpoint and secondary indicators were changes in blood pressure (BP), proportion of subjects who achieved 5% or 10% weight loss, changes in lipid profile (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides); and changes in glycosylated hemoglobin (HgA1c). Paired samples and independent samples t-test was used for statistical analysis. (RCT code: IRCT201112036027N2). RESULTS: All results were extracted on base of 69 (Intended to treat) ITT patients. Mean BMI changes was significantly higher in patients treated with topiramate (-1.08 1.90 vs. +0.086 ± 1.05 kg/m², P = 0.006). Mean weight loss percentage was significantly different between active and placebo groups (-3.02 ± 5.78% vs. +0.32 ± 3.54%, P = 0.005) and systolic blood pressure and HgA1C significantly decreased in patients treated with topiramate (P = 0.021 and P = 0.047, respectively). CONCLUSION: Topiramate induced weight loss and improved glycemic control in obese, diabetic patients.

Relation between C-reactive protein and body mass index in patients with polycystic ovarian syndrome.

INTRODUCTION: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. These patients share common features like obesity with metabolic syndrome. C-reactive protein (CRP) is a low-grade chronic inflammation biomarker that independently predicts high-risk patients for cardiovascular diseases (CVD). Although many studies showed increased plasma CRP levels in patients with PCOS, there is still less evidence that can link obesity and CRP levels in patients with PCOS. The objective of this study was to investigate the relations between body mass index (BMI) and CRP plasma levels in patients with PCOS. METHOD: Forty patients with PCOS and 30 controls matched by age and BMI were included. Blood sample was obtained from all individuals in early follicular phase of menstrual cycle. CRP, fasting blood sugar (FBS), triglyceride (TG), and total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), blood pressure, waist circumference (WC) and BMI was measured for all subjects. RESULT: CRP and TG levels were higher in patients with PCOS (p < 0.001 and p = 0.011, respectively). CRP level increased significantly only in patients with PCOS with BMI ≥ 25 kg/m(2) (p = 0.001) but was not significant in patients with PCOS with BMI < 25 kg/m(2) (p = 0.067). In further analysis, BMI and WC affect CRP rising in patients with PCOS (p = 0.001). CONCLUSION: In patients with PCOS, serum CRP levels were higher than age and BMI-matched controls. Furthermore, BMI was strongly related to CRP only in overweight patients with PCOS.