Arch Iran Med
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Advanced computed tomography (CT) scanners enable concurrent assessment of coronary artery anatomy and myocardial perfusion. The purpose of this study was to assess dual-energy CT images in a group of patients suspected for ischemic heart disease and to evaluate agreement of cardiac computed tomography perfusion (CTP) images with CT angiography results in a single dual-energy computed tomography (DECT) acquisition. ⋯ Agreement of CTA and CTP in whole heart and in LAD considering DMB and significant CAD together were good to excellent; however, considering sole pathologies, most of the agreements were weak (<0.5). DECT with iodine quantification may provide a valuable method in comparison with previous methods for identifying both coronary stenosis and myocardial ischemia.
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Case Reports
Granulomatosis with Polyangiitis Manifesting as Refractory Otitis Media and Mastoiditis.
Granulomatosis with polyangiitis (GPA) is a rare rheumatologic disease characterized by small to medium vessel vasculitis and inflammation within multiple organ systems. Majority of cases involve both upper and lower respiratory tracts but other organs including brain, kidneys, joints and skin can also be involved. Patients who have recurrent otitis media and sinusitis often initially present to internists and then to ear nose and throat (ENT) physicians and may be treated with multiple courses of antibiotics without having proper workup for GPA. ⋯ The patient had complete resolution of symptoms with steroid therapy. This case reinforces the concept of high index of suspicion of GPA for patients with recurrent and resistant otitis media or mastoiditis not responding to optimal duration and doses of antibiotics. Appropriate work-up for GPA may allow for earlier diagnosis of this devastating vasculitic disease which can help prevent multi-organ dysfunction.
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Hemophilia is a rare inherited disorder associated with abnormal repeated bleeding and debilitating joint pain due to deficiency in coagulating factors VIII and IX. This study aimed to provide an updated account on the health-related quality of life (HRQoL) in children with hemophilia in Afghanistan. ⋯ Regardless of hemophilia severity, Family and Sports were the most impaired domains of QoL. Herein, we have presented the first reliable and updated data on hemophiliacs' demographic characteristics and their quality of life in Kabul.
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To construct a dietary guideline for patients with irritable bowel syndrome (IBS), data about foods these people exclude from their diet to improve their symptoms are necessary. This study was designed to assess the prevalence of food exclusions as well as the reasons for such exclusions in a large group of IBS patients. ⋯ The present study showed that IBS patients were more likely to avoid consumption of ketchup, Dough, Gaz, grapes, fresh berries and butter due to GI symptoms compared with healthy individuals. Further studies are required to confirm these findings.
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The aim of this study was to determine the challenges and opportunities of the Communicable Diseases Surveillance System (CDSS) in Iran. ⋯ The results of this study showed that CDSS has several major challenges. Authorities and policymakers must not ignore communicable diseases and their management tools, including CDSS because of their focus on non-communicable diseases. Some important strategies to overcome the challenges of CDSS can be the following: motivating policy makers to put emphasis on communicable diseases as a national security issue, the ratification and modification of laws and regulations on reporting, the involvement of the CDSS in the accreditation of hospitals and the renewal of the license for healthcare professionals, and motivating organizations outside the health sector to participate in the programs through inter-institutional agreements.