Razi Journal of Medical Sciences

  Lymphangiomas are rare benign tumors which involve the small bowel and produce multiple intraluminal and intramural filling defects. The patient is a 38 year old female which presented with abdominal discomfort and loss of apetite for 18 months, in small bowel transiet exam mutiple small sharply demarcated intraluminal and intramural filling defects observed. After surgical resection of the involved bowel and pathologic exam, lymphangioma was diagnosed. It is impossible to differentiate these lesions from many of the other causes of filling defects by radiological examinations alone.

 The causes of small bowel obstruction are very different and one of the intraluminal causes are enteroliths which are found in Patients who have chronic obstruction of the bowel, such as regional enteritis.

  The patient is a 41 year-old male with 12 year history of regional enteritis which presented with acute bowel obstruction in X-Ray studies. Eliptical calcifications with pointed ends and radiolucent center in RLQ has been observed and enteroliths due to prune pits ingestion has been diagnosed as a cause of obstruction.

    Background & Aim: Doppler ultrasonography is important in diagnosis of renal diseases by demonstrating vascular anatomy and hemodynamics. There is not any fix doppler indices in all of the references and it is suggested that each center should have its own standards. Also it is proved that biologic indices are not the same in different societies. The present study was performed on normal Iranian population to measure normal limits for renal doppler indices. Patients & Methods: In this research ultrasonography was done on 256 healthy people including 126(49.2%) female and 130(50.8%) male. The mean age was 31.1 years with standard deviation of 8.64. The minimum age was 14 years and maximum age was 57 years. Doppler indices were measured in all of the cases and normal limits were calculated. Results: In main renal arteries PSV mean was 86.01(87.80, 84.25) cm/s and EDV mean was 39.01(40.40, 37.80) cm/s. In intrarenal arteries mean PSV was 75.32(77.12, 72.89) cm/s, mean EDV was 32.23(33.41, 31.45) cm/s, mean RI was 0.55(0.56, 0.54) and mean AT was 29.35(30.75, 28.35) ms. Conclusion: The obtained values are normal renal doppler indices in healthy Iranian population and we suggest that it should be used in clinical studies.

    Background & Aim: Measuring the length of kidneys is an important issue in diagnosis and treatment of renal diseases. In various diseases, kidneys become larger or smaller than normal. Ultrasonography is a suitable method for measuring renal length because it is accurate, noninvasive, available and with low cost. Nowadays, multislice spiral CT scanners are widely used for evaluation of renal diseases and are capable of making different reconstructions on images including multiplanar reconstruction(MPR) and in many situations, measurements like measuring renal length are done on these reconstructed images. Hence, knowing the accuracy of measurements on reconstructed images is very important. This research was done to evaluate the accuracy of renal length measurement on multiplanar reconstructed images of spiral CT scan. Patients & Methods: In a cross-sectional study, spiral CT scan was performed on all of the patients referred to CT scan department of Hashemi Nejad Hospital for abdominal CT scan during July and August 2004. Multiplanar reconstruction was carried out on all of the images and the maximum length of kidneys was measured. Then ultrasonography was done for all of the patients and the maximum length of kidneys was measured as gold standard. The lengths of kidneys obtained from these two methods were compared with each other. Results: 40 patients(80 kidneys) with the mean age of 42 years were evaluated. Analysis with SPSS and paired t-test revealed that the mean renal length at ultrasonography was 107.1 mm with standard deviation of 12.08 and the mean renal length at spiral CT scan was 110.18 mm with standard deviation of 11.93. The mean length of kidneys resulted from ultrasonography was 3.08 mm less than the mean length of kidneys resulted from multiplanar reconstructed images of spiral CT scan, and considering P<0.05, the difference was considered significant. Conclusion: Measuring the renal length on reconstructed images doesn’t have enough accuracy. Therefore, in situations when knowing the exact size of the kidney is important, measurements should be done on the basic CT images(without reconstruction) or on other methods like ultrasonography.

    Background & Aim: Varicocele is the dilation of the pampiniform venous plexus of testis more than 2 mm and is one of the most common causes of sperm abnormalities in infertile men. The main diagnostic test for varicocele is ultrasonography that evaluates the vein diameter in B mode exam and venous reflux in color Doppler exam, but there is no single agreement on the importance of these two findings in different references. This research was performed to evaluate the effect of these two factors on sperm analysis test. Patients & Method: This descriptive analytical cross-sectional study aimed to evaluate the relation of diameter and reflux to sperm analysis in patients with varicocele. With the help of sonography, maximum diameter of pampiniform venous plexus, presence and duration of reflux during valsalva maneuver were measured in 62 patients with varicocele. Then the patients were referred to the laboratory unit for sperm analysis(S/A). Results: The mean age of the patients was calculated to be 25.6 years(SD=5.08). 85.5% of the cases had left side involvement and 14.5% showed bilateral involvement. Mean diameter of left venous plexus and its mean reflux time were 3.62 mm and 2.30 seconds, while mean diameter of right venous plexus and its mean reflux time were 2.93 mm and 1.06 seconds respectively. Reflux was absent in 20.96% of them. Regarding routine criteria such as motility, morphology, sperm count, and the like, 54.66% was presented with abnormal S/A, of which abnormal morphology had the highest frequency(41%). The analysis of data revealed a direct significant statistical relationship between the diameter of left venous plexus and its reflux time, which means the reflux time increased significantly with increasing diameter of vein(PV=0.00, r=0.378). A reverse statistically significant relationship was observed between left side vein diameter and sperm motility(PV=0.019, r=-0.297) and between left side reflux time and sperm motility(PV=0.009, r=-0.325), which means motility decreases with increasing diameter and reflux time. In addition, the results of t-test showed a statistical difference between left side vein diameter and its reflux time for both groups with motility <50 and motility>50(PV=0.35, PV=0.002), which indicates that both vein diameter and reflux time were apparently more for the group with motility<50 than the normal group, but left side diameter and its reflux time showed no relation to other parameters of S/A such as abnormal morphology and sperm count, and the same was found about right side diameter and its reflux time. Moreover, no relation was detected between presence or absence of reflux and S/A abnormalities, and bilateral or unilateral involvement bore no relationship to sperm count, motility and abnormal morphology. Conclusion: We noticed that the presence or absence of reflux is not a suitable factor to determine prognosis or sperm abnormalities.

    Background & Aim: Hemodialysis increases the survival of patients with chronic renal failure. However, prolonged hemodialysis causes some complications including abnormal bone changes. This research was done to evaluate the frequency of the radiological changes of osteoarthropathy in hand joints in hemodialysis patients referred to Hashemi-Nejad Hospital. Patients & Methods: In a cross-sectional study, 240 hemodialysis patients who referred to Hashemi-Nejad Hospital in Tehran were evaluated. Antero-Posterior radiography of hands from finger tips to distal bones of forearm was performed in all of these patients. Results: Prevalence of osteoarthropathy was 39.5%. The most common radiologic finding was osteopenia with frequency of 36%. Other changes included: bone erosion(15%), periarticular cyst(8%), and articular narrowing(2%). Osteoarthropathy was seen in males more than females and in individuals with more than 10-year dialysis. The prevalence of vascular calcification as an incidental finding was 24%. Conclusion: There was a high prevalence of osteoarthropathic changes in patients under hemodialysis. This prevalence increases with long duration of dialysis. Therefore, the early kidney transplantation is necessary for these patients. Also, the amount of aluminium in dialysis solutions should be controlled as much as possible.

    Background: Pre-menstrual Syndrome (PMS), refers to a cyclic appearance of somatic and psychiatric symptoms in some women. Finding an effective and safe solution for the treatment of PMS had been always under consideration.The purpose of the present study is to evaluate of the effect of Omega-3 fatty acids on the treatment of PMS.

Methods: A randomized double blind controlled trial was performed on 135 eligible women, and finally 120 women finished the study. The women were randomly assigned into two groups. In the case group (Omega-3 group= group A , n=68), Omega-3 in a dose of 2 gram (2 one gram pearls), and in the control group (Placebo group =group B, n=67), 2 placebo pearls which were completely similar to the Omega-3 pearls, were prescribed. Then, the severity and the duration of each of the symptoms were compared in  both groups, 1.5 and 3 months after beginning of the treatment. Then statistical analysis was performed using SPSS V. 11. Also, t and Chi² tests were used for analysis. p value less than 0.05 was considered as significant.

Results: There were no significant differences between the two groups according to age, BMI, level of education, and the severity and duration of primary symptoms. Forty five days after the beginning of Omega-3, the mean severity of depression (1.85±0.73 vs. 3.72±0.65, p=0.03), anxiety (1.53± 1.04 vs. 4.07±0.91, p=0.02), lack of concentration (2. 49± 1.26 vs. 5.73±1.34, p= 0.03), and bloating (0.95± 0.15 vs. 2.31± 0.19, p=0.02) in the case group were significantly lower than the control group. Also the duration of depression (4.25±1.02 vs. 7.21±1.32 days, p=0.04) and bloating (5.53±2.27 vs. 8.33±1.04 days, p=0.031) in the case group were less than the control group. Ninety days after the beginning of the treatment, the mean severity of depression (0.95±0.75 vs. 3.43±0.65, p=0.007), anxiety (0.79± 1.04 vs. 3.89±0.91, p=0.004), lack of concentration (1.48±1.26 vs. 5.63±1.34, p=0.009), bloating (0.74±0.15 vs. 2.14±0.19, p= 0.004), nervousness (2.15±0.93 vs. 6.09±0.86, p=0.01), and the duration of depression (2.12±0.25 vs. 7.46±0.02, p=0.01), nervousness (2.04±0.39 vs. 6.33± 1.45, p=0.02), anxiety (4.45±1.02 vs. 8.23±1.94, p=0.03), lack of concentration (2.16±0.26 vs. 5.55±1.02, p=0.02), bloating (3.32± 1.01 vs. 8.38± 2.32, p=0.004), headache (2.12±0.94 vs. 4.28±1.58, p=0.04), breast tenderness (4.35±1.31 vs. 7.85±2.08, p=0.02) were lower in the case group.

Conclusion: It seems that Omega-3 fatty acids may reduce the psychiatric symptoms of PMS including depression, nervousness, anxiety, and lack of concentration and also may reduce the somatic symptoms of PMS including bloating, headache and breast tenderness, which these effects are increased by longer duration of treatment.