ObjectiveOne of the best known side effects of using opium is spasm of the sphincter of Oddi, which may increase the diameter of the extrahepatic bile ducts. Ultrasound is the first imaging modality used for evaluating the biliary system because it is commonly available and noninvasive. The principal objective of this study was to measure the common bile duct (CBD) diameter via ultrasonography in opium addicts and to evaluate the relation between the CBD diameter and the period of addiction.Materials and MethodsThis research was an analytical-cross sectional study that was done on 110 opium addicts that were admitted to a drug treatment center. The diameter of the CBD in these cases was measured by ultrasonography and the results were analyzed with other factors like age, the period of addiction and the laboratory findings.ResultsAccording to the findings, there is a significant increase in the range of the CBD diameter in comparison with normal bile ducts. Also, the mean diameter of the CBD in the different age groups showed a significant difference (p < 0.0001) and there was a significant relation between the CBD diameter and the period of addiction (p < 0.001, r = 0.74); so, with the increased length of the addiction period, the mean CBD diameter increases.ConclusionOpium addiction is one of the factors that causes extrahepatic bile duct dilatation, so in these cases, if no obstructing lesion was found on ultrasound examination and the serum bilirobine and alkaline phosphatase levels are normal, then further evaluation is not needed.

Background: Creutzfeldt-Jakob disease (CJD) is a progressive and fatal prion disease in human and its annual incidence is estimated one per million. Sporadic form of CJD is the most common form of the disease that involved 85% of cases. Case Report: We presented two cases of CJD with the different clinical presentation; a 58-year-old woman who referred with amnesia, depression and a 59-year-old woman with ataxia as her chief complaint. Based on the findings and roled-out the other differential diagnosis, the CJD was confirmed. Both of them died before 12 months after diagnosis. Conclusion: Although CJD is a rare disease with different clinical manifestation, it is considered as one the differential diagnosis of progressive dementia.[GMJ.2019;8:e1357]

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Background: Head injury has been recognized as a major public health problem and is a frequent cause of death and disability in young people and makes considerable demands on health services. Motor vehicle accidents are the major causes of traumatic brain injury (TBI) that its occurrence has been increasing in our country in recent years. We decided to study head injury in our region to evaluate the Epidemiological, clinical and radiological features of this health problem. Methods: We reviewed 200 TBI-patients records in Ali Ibn Abi Taleb hospital of Rafsanjan during 2012-2013. A Questionnaire including age, sex, job, the cause of trauma, Glasgow coma scale (GCS), brain computed tomography (CT) scan findings and clinical symptoms for every head trauma patient; was completed. Data were analyzed by SPSS software using Chi-square test and P-value less than 0.05 was considered significant. Results: From the total of 200 patients, 73.5% were males, and 26.5% were females. The most common age group was 20-24 years. The majority of patients were students. Traffic accidents were the major cause of injuries (64.5%), and 35.5% of them were a motorcyclist. The most frequent finding of brain CT scan was skull fracture, and subdural hematoma and 25% of patient had a severe head injury. In clinical symptoms in conscious patients, headache, nausea, vomiting and vertigo was common. Conclusion: This study showed that we should pay more attention to traumatic brain injury young patients who are the most active potential forces of our society. Traffic accidents are the major reason for head injuries. Pay attention to prevention of this accident can perform an important role in decreasing of head injuries.