We report a case of a 65-year-old woman who sustained a left neck of femur (NOF) fracture following low-energy trauma. Computed tomography (CT) scan for the neck, chest, abdomen and pelvis was normal apart from enlargement of the right lobe of the thyroid. Interestingly, thyroid function was normal. While waiting for the result of thyroid cytology and bone histology, the patient recovered well from the operation and started to engage well with physiotherapy. The result of the investigation showed presence of diffuse large B-cell lymphoma in the left NOF and right lobe of the thyroid. As the presence of lymphoma only in these two organs is extremely rare, it is not yet clear what is underlying mechanism for such association. Therefore, such observations may raise many future research questions as detailed in the discussion of this case report. This case also illustrates the importance of a multidisciplinary approach in identifying, evaluating, and treating unique and complex presentations of NOF fracture, with a focus on the patient’s history, clinical examination and applying diagnostic tools.
Introduction: Coronary artery bypass graft (CABG) surgery is a common therapeutic intervention performed in patients with coronary artery disease. However, this operation has several postoperative complications; One of the most common complications after CABG surgery is right ventricular dysfunction. Therefore, the aim of this study is to evaluate RV deformations indices after CABG surgery. Methods: This cross-sectional study was performed from 2019 to 2020 in the cardiac surgery ward of Farshchian Hospital in Hamadan. 40 patients with cardiac ischemia were studied as single vessel disease (SVD), two vessels disease (2VD) and three vessels disease (3VD) who were candidates for CABG surgery. All patients underwent color and tissue Doppler echocardiography and Strain RV imaging, before and one month after CABG. Data analysis was performed using SPSS version 21 and a p-value less than 0.05 was considered statistically significant. Results: Among 40 patients (32 males and 8 female), the average age was 65.17 (SD 7.87) and average body mass index was 25.59 (SD 3.20). 4 patients underwent off-pump CABG surgery. Mean LVEF, SPAP, and RV diameter one month after CABG significantly increased compared with pre-surgery and TDI (SM), Strain RV (GLS), FAC, MPI RV, and TAPSE were decreased, which was less in the group B (3VD) than the first group (P <0.001). There was no significant difference between RVDD and LVDD before and one month after CABG (P> 0.05). No significant correlation coefficient was observed between Strain RV changes and pump time. Conclusion: Changing the right ventricular geometry after CABG, leads to reduction of Longitudinal deformation while maintaining overall RV function. Therefore, it is recommended to consider lower normal values for these indices after CABG to be taken.
Introduction: Overactive bladder (OAB) is a common problem that involves therapeutic challenges. Therefore, finding new and effective treatment modalities in these patients is essential. The aim of this study was to compare the therapeutic effect of percutaneous tibial nerve stimulation (PTNS) with drug therapy in patients with OAB. Methods: In this randomized controlled clinical trial, 74 patients with OAB were randomly divided into two groups: PTNS (twice a week for 12 weeks) and drug treatment (Solifenacin 10 mg daily for 12 weeks). OAB Symptom Score, q-OAB and Health-Related Quality of Life Questionnaire (HRQL) were completed and then compared at the beginning and end of the study for the two groups. Findings were analyzed using SPSS software version 20. Results: The drug intervention group consisted of 33 (89.2%) females and 4 males (10.81%), and PTNS group consisted of 31 females (83.8%) and 6 males (16.21%), (P = 0.496). Mean quality of life score, mean OABSS score, OAB screening score and urinary incontinence in both groups before the intervention did not show a statistically significant difference. After treatment, the mean quality of life in both groups increased significantly compared to before the intervention, but this increase was significantly higher in PTNS when compared with other group (74.2±6.9 vs. 68.9± 7.3). The mean OABSS score, OAB screening score and urinary incontinence in both groups decreased significantly compared to before treatment, but the mean OABSS score and OAB and urinary incontinence screening scores showed a significant decrease in PTNS group compared to drug treatment. Conclusion: Based on the findings, PTNS was found to be more effective than drug treatment in increasing the quality of life and controlling symptoms of OAB.
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