Pak J Med Sci
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Our objective of the study was to determine the association between frequent use of Penicillins and Cephalosporins with developmental defects of enamel in pediatric age group. ⋯ This study concludes that frequent use of antibiotics such as penicillins and cephalosporins has positive association with enamel hypomineralization in developing tooth structure.
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Fibroids are smooth muscle benign tumors; most commonly arise from uterus but may also rise from extra uterine sites like broad ligament. This case report of broad ligament myoma with extensive cystic degeneration is presented for its rarity and diagnostic challenges as they mimic pelvic adenexal tumors. Mrs. X, 43 years old p5+2, asymptomatic women with no co-morbids presented with mass in abdomen. The MRI showed mix attenuation mass of 19.7 x 16.8 x 13.7cms arising from right side of uterus extending up to epigastrium, with cystic and solid components and ascitic fluid. Resection of mass with abdominal hysterectomy with bilateral salphingo oophrectomy was done. No local or abdominal organ metastases were seen. Histopathology showed left broad ligament leiomyoma weighing 4000 grams with cystic degeneration. ⋯ Huge broad ligament leiomyoma with cystic degeneration and abdominal ascites may cause diagnostic dilemma with ovarian malignancy. This differential diagnosis must be considered before surgery.
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Patients with posttraumatic stress disorder (PTSD) frequently complain of sleep disturbances such as insomnia and nightmares. Evaluation of sleep disturbances is often difficult due to the subjective nature of the complaints. Polysomnography (PSG) and other sleep studies are generally not indicated in the evaluation of insomnia or nightmares associated with PTSD. Actigraphy, (electronic activity monitoring) has been used in research to evaluate sleep disturbances in patients with PTSD. We reviewed the literature on the use of actigraphy in evaluation of sleep problems in patients with PTSD. ⋯ Actigraphy has been used to evaluate circadian rhythm sleep disorders. Use of actigraphy in psychiatry clinics is uncommon. There is no data to support that there are specific actigraphic sleep related findings in PTSD patients. However, it can be a useful tool to complement the use of sleep diaries when assessing sleep and wake patterns in patients with PTSD.
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Misdiagnosing ovarian torsion is now suggested as an important issue in clinical setting. The aim of this study was to determine the diagnostic accuracy of sonography for ovarian torsion. Methods : In this study 323 women with acute pelvic pain with highly suspected ovarian torsion signs and symptoms attending Imam Reza Medical Center in Kermanshah between 2011 through 2012 were included and underwent a transabdominal sonography (2-5 MHz probes). Then findings of sonography were compared with laparatomy. Results : The ultrasound correctly diagnosed 72.1% of ovarian torsion and missed 27.9% of them (false negatives). However, one free subject (0.4%) was misclassified as ovarian torsion (false positive). There was a strong correlation between sonography and laparatomy with a kappa value of 84.0%. The sensitivity and specificity of sonography were 72.1% and 99.6%, respectively. Sonography had a positive predictive value of 96.9%, a negative predictive value of 95.9%, and a total accuracy of 96.0% for detection of ovarian torsion. ⋯ Sonography appears to be an excellent method to evaluate patients with suspected ovarian torsion. Abnormal blood flow detected by sonography is highly predictive of ovarian torsion and is therefore useful in the diagnosis of this phenomenon.
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Retracted Publication
The effects of 21 and 23 milimeter aortic valve prosthesis on hemodynamic performance and functional capacity in young adults.
Early and medium-term improvement of functional capacity and regression of left ventricular hypertrophy was evaluated in the young adult patient group following application of 21 mm or 23 mm bileaflet aortic mechanical valve prosthesis due to aortic stenosis. Methods : Twenty two patients (10 male, 12 female; mean age 27+-8.2 (19-43)) who underwent isolated aortic valve replacement due to rheumatic aortic stenosis, were included in the study. 21 mm and 23 mm bileaflet mechanical prosthesis was used respectively in eight and fourteen patients. The mean body surface area was 1.86 m(2) and 1.68 m(2) respectively in 23 mm and 21 mm prosthesis while 1.73 ±0.25 m(2) for the whole group. Functional capacity was New York Heart Association (NYHA) class II in 9 patients and class III in thirteen patients. Implantation was performed without enlarging the aortic root in all except four patients. In all patients transvalvular gradients, effective orifice area and the diameter of left ventricle were measured with transthoracic echocardiography during rest and after maximal exercise. Mean follow-up was 34±12 months (range 11-57 months). ⋯ Our findings show that replacement with 21 mm and 23 mm mechanical prosthesis provides a significant improvement in regression of symptoms and increase of functional capacity in young adults in early and mid-period without increasing mortality and morbidity.