Mohammad Hadi Bagheri

Triangular Cord Sign in Detection of Biliary Atresia: Is It a Valuable Sign?

Background Early detection of biliary atresia (BA) has a vital role in prevention of liver cirrhosis in these patients. There are some evidences that triangular cord (TC) sign, i.e., triangular structure located cranial to the portal vein bifurcation on ultrasonographic examination, is suggestive of BA in suspected cases. The aim of this study is to evaluate and compare the sensitivity, specificity, and accuracy of TC sign with other methods of diagnosis such as hepatobiliary scan. Methods Fifty-eight infants referred to pediatric gastroenterology ward with diagnosis of infantile cholestasis from March 2004 to March 2008 were evaluated to find the cause of cholestasis. Diagnosis was made by means of history, clinical examination, hepatobiliary scan, and liver biopsy. Ultrasonographic examination was focused on presence of TC sign in patients. If the diagnosis was in favor of BA, patient was sent for direct cholangiography as a gold-standard test for confirmation of the diagnosis. The sensitivity, specificity, and accuracy of the tests were compared with golden standard. Results Among 58 infants with infantile cholestasis, BA was diagnosed and confirmed in 10 infants (17.2%). Hepatobiliary scintigraphy had 80% sensitivity, 72.9% specificity, and 74.1% accuracy. TC sign had 70% sensitivity, 95.8% specificity, and 91.3% accuracy. Conclusion TC sign is more accurate than hepatobiliary scan and has acceptable sensitivity and specificity for diagnosis of BA.

Primary epidural malignant hemangiopericytoma of thoracic spinal column causing cord compression: case report

CONTEXT Hemangiopericytoma is an uncommon mesenchymal neoplasm that rarely affects the spinal canal. Primary malignant hemangiopericytoma of the spinal column is extremely rare. CASE REPORT We report on a case of primary epidural malignant hemangiopericytoma of the thoracic spinal column that invaded vertebral bone and caused spinal cord compression in a 21-year-old man. The patient presented with progressive back pain over a four-month period that progressed to paraparesis, bilateral leg paresthesia and urinary incontinence. The surgical intervention involved laminectomy and subtotal resection of the tumor, with posterior vertebral fixation. Postoperative involved-field radiotherapy was administered. A marked neurological improvement was subsequently observed. We describe the clinical, radiological, and histological features of this tumor and review the literature.

Stem cells optimization algorithm

Optimization algorithms have been proved to be good solutions for many practical applications. They were mainly inspired by natural evolutions. However, they are still faced to some problems such as trapping in local minimums, having low speed of convergence, and also having high order of complexity for implementation. In this paper, we introduce a new optimization algorithm, we called it Stem Cells Algorithm (SCA), which is based on behavior of stem cells in reproducing themselves. SCA has high speed of convergence, low level of complexity with easy implementation process. It also avoid the local minimums in an intelligent manner. The comparative results on a series of benchmark functions using the proposed algorithm related to other well-known optimization algorithms such as genetic algorithm (GA), particle swarm optimization (PSO) algorithm, ant colony optimization (ACO) algorithm and artificial bee colony (ABC) algorithm demonstrate the superior performance of the new optimization algorithm.

Bilateral renal lymphangiomatosis: Sonographic findings

Renal lymphangiomatosis is an exceedingly rare disorder characterized by developmental malformation of the lymphatic system surrounding the kidneys. We report a case of bilateral renal lymphangiomatosis in a 21‐year‐old man who underwent abdominal sonographic examination that revealed numerous cystic areas of varyious sizes around both kidneys with extension along the renal hilum. Subsequent abdominal CT examination demonstrated bilateral, multilocular, fluid‐filled cystic masses with thin walls in the perirenal and peripelvic region. MRI of the patient revealed bilaterally enlarged kidneys with multiple hyperintense lesions in both perirenal spaces and the peripelvic area on T2‐weighted images. These cystic spaces appeared hypointense on T1‐weighted images with no enhancement in postcontrast images. The diagnosis of renal lymphangiomatosis was made based on typical imaging findings.

Migrainous Prolonged and Reversible Bilateral Inferior Altitudinal Visual Field Defect

Migrainous patients may have visual field deficits at times between migraine attacks that mostly are unilateral and resolve after 7‐10 days. Herein, we report a 25‐year‐old woman, a known case of classic migraine, with bilateral inferior altitudinal visual field defect and complete recovery after 4 months. All lab tests, including brain magnetic resolution imaging and angiography, coagulation tests and visual evoked potentials, were normal.

A novel meta-heuristic algorithm for numerical function optimization: Blind, naked mole-rats (BNMR) algorithm

Optimization algorithms inspired by the world of nature have turned into powerful tools for solving the complicated problems. However, they have still some drawbacks need the investigation of new and better optimization algorithms. In this paper, we propose a new meta-heuristic algorithm called blind naked mole-rats (BNMR) algorithm. This algorithm has been developed based on the social behavior of the blind naked mole-rats colony in searching the food and protecting the colony against invasions. By introducing this algorithm, we have tried to overcome many disadvantages of the usual optimization algorithms including getting trapped in local minimums or having low rate of convergence. Using several benchmark functions, we demonstrate the superior performance of the proposed algorithm in comparison with some other well-known optimization algorithms.

Comparison of metoclopramide oral tablets and solution in treatment of dysmotility-like dyspepsia

PURPOSE The clinical effects of metoclopramide oral solution and tablets in patients with dysmotility-like dyspepsia (DLD) were compared. METHODS In a prospective study, 63 patients with DLD, selected according to Rome II criteria and randomly divided into three groups, received metoclopramide tablets 5 mg t.i.d., metoclopramide oral solution 2 mg t.i.d., or placebo for one week. Assessment was based on symptom score determined by interviews and on gastric emptying time measured by ultrasonography before and after drug consumption. Two antral and stomach body biopsies were taken to evaluate infection with Helicobacter pylori and the intensity of gastritis. RESULTS Symptom score and gastric emptying time were significantly reduced in both metoclopramide groups (p < 0.05) but not in the control group. Patients receiving the oral solution had a greater reduction in the symptom score than those receiving tablets (p < 0.05). The absence or presence of and intensity of gastritis or H. pylori infection had no correlation with the symptom scores or gastric emptying times. CONCLUSION Metoclopramide oral solution 2 mg t.i.d. was at least as effective as metoclopramide tablets 5 mg t.i.d. in reducing symptoms of DLD and gastric emptying time.

Articular cartilage changes in experimental osteoarthritis in rabbits: MRI and morphological findings

The objective of the present study was to determine the magnetic resonance imaging (MRI) and gross pathological findings of articular cartilage in osteoarthritis experimentally induced in rabbit as an animal model. Ten adult Dutch male rabbits were randomly divided into two equal groups. In group one, in the left knee (stifle), the cranial (anterior) cruciate ligament (CCL) was sectioned [transected group (TG)], and in the second group, only arthrotomy was performed through the same approach, but the CCL was left intact [arthrotomy group (AG)]. In both groups, the right knees were considered as controls. Thirty days after operation, MRI was performed under general anesthesia, and then the animals were sacrificed for gross pathological study. MRI was performed by a 1.5-T scanner with a wrist coil to evaluate the coronal and sagittal gradient echo T2-weighted proton density and T1- and T2-weighted sequences. A magnification loupe was used to inspect the menisci, femoral and tibial cartilages, and synovium. The results revealed that the measured mean articular cartilage thickness by MRI was less in TG in comparison to AG and control groups (p < 0.05), whereas the difference between AG and control was not significant. Statistical analysis of the results revealed that the measured mean articular cartilage thickness by MRI was less in TG than those of AG and control groups, whereas the difference between AG and control was not significant. There were no significant differences in meniscal degeneration, joint effusion, and MRI overall grades between AG and the control groups. The difference was significant between TG with AG and the controls in relation to MRI findings. The gross examination revealed that there were no gross abnormalities in AG but there were also significant differences between the TG and AG, and between TG and the controls. Changes were localized primarily to the distal aspect of the medial femoral condylar cartilage. It was concluded that the MRI findings in early osteoarthritis process consisted of articular cartilage loss and meniscal degeneration. The quantitative alterations in articular cartilage thickness measured by MRI can be a noninvasive way to predict osteoarthritis. The MRI findings were also well correlated with the results of pathological study.

Hydatid Cyst of the Foramen Magnum: Case Report

Hydatid cysts of the central nervous system (CNS) are rare. A patient with quadriparesis caused by a primary solitary hydatid cyst of the foramen magnum is described. Based on a search of the pertinent literature, this is the second case of a foramen magnum hydatid cyst reported. A 25-year-old male farmer presented with weakness in his upper and lower limbs and an inability to walk. A magnetic resonance imaging (MRI) scan revealed a cystic lesion that exerted a pressure effect on the cervicomedullary junction extending from the intracranial to C2 level. MRI scans confirmed the cystic nature of the lesion and demonstrated intensities that were similar to those of cerebrospinal fluid. Surgical exploration of the foramen magnum region with unruptured removal of the cyst was performed. A midline posterior fossa approach was used via a suboccipital craniectomy and C1-C2 laminectomy. Adjuvant therapy with mebendazole or albendazole was not administered. Hydatid cysts of the CNS can present in unusual locations such as in this case. The second case of a hydatid cyst of the foramen magnum is reported. Hydatid cyst should be considered in the differential diagnosis of cystic lesions of the foramen magnum in endemic areas.

Pneumatosis intestinalis associated with duodenal atresia

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