Abstract:Introduction: Myxopapillary ependymoma (MPE) is a benign and slow growing tumor that originates exclusively from the conus medullaris and cauda equina nervous tissue. It occurs more commonly in young patients. In addition, clinical presentations are non-specific and may mimic benign conditions. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating this tumor. We hereby report on two young patients with long-lasting non-specific symptoms, which were clinically attributed to benign conditions. However, cauda equina tumor was revealed on MRI in both patients. Case report: Two cases of cauda equina MPE, a 19-year-old female and a 38-year-old male, with different clinical manifestations are reported. The first patient presented with paresis and paresthesia of the lower limbs, and the second patient's complaint was chronic low-back pain and urinary incontinence. In both cases, MRI detected a tumor originated from the cauda equina, and histopathologic examination was compatible with MPE. Conclusion: Cauda equina tumors should be considered as a differential diagnosis in the young patients presented with neurologic deficits in the lower limbs, sphincter or erectile dysfunction, and even a simple low-back pain (particularly when symptoms are long-lasting and/or progressive).
Introduction: Keratoconus is a progressive, non-inflammatory, bilateral, ecstatic disease of the cornea that is characterized by corneal steepening which progresses to irregular conical shape, with subsequent irregular astigmatism and decreased visual acuity. In early stages of disease, spectacles or RGP lenses are the main treatment. At advanced stages, when these treatment options fail to correct visual acuity, surgical procedures such as penetrating keratoplasty or lamellar keratoplasty are required. METHODS: Keraring segments were placed in 30 eyes of 21 keratoconus patients. The mean follow-up time was 6.2 months. All patients underwent a complete ocular examination and corneal topography which was obtained by Pentacam (Oculus Pentacam®, USA). Improvement in uncorrected visual acuity (UCVA), best spectacle corrected visual acuity, refraction and topographic changes including keratometry, maximum anterior and posterior elevation, central corneal thickness and thinnest point thickness and location were evaluated. RESULTS: No intraoperative or postoperative complications occurred in any of the patients. ICRS implantation significantly improved UCVA (P=0.005) and BSCVA (P=0.000). Mean Spherical equivalent significantly reduced from-6.66±3.52 to-4.42±3.20 (p=0.000). A clinically significant reduction in mean keratometry (p=0.000), Max Ant Elevation (P=0.024) and Max Post Elevation (P=0.002) were recorded. No clinically significant changes in central corneal thickness, thinnest point thickness and thinnest point location were observed. Conclusion: With mean follow-up of 6.2 months, Keraring segments implantation caused significant clinical improvement in UCVA, BCVA Refractive Error and Keratometric findings of the most keratoconic patients.
Background: This study aimed to develop and validate a well-being questionnaire based on the wisdom of Nahj al-Balagha. Methods: The method of this research was descriptive. Accordingly, based on a predefined psychological well-being model, 74 items were formulated and approved by three experts from the Nahj al-Balagha field. The statistical population of this study included all adults aged 20 to 50 years, in Tehran. Using a simple sampling method, 200 people were selected as the study sample. Also, the reliability of the questionnaire was calculated through the Cronbach alpha coefficient. The validity of the questionnaire was assessed in two ways: validity and construct validity. The correlation of the questionnaire with the Ryff questionnaire was obtained for the validity of the questionnaire, and a confirmatory factor analysis was used to evaluate the construct validity. Results: The data were analyzed using the SPSS and Amos software. The results showed that the psychological well-being questionnaire had an appropriate internal consistency in the range of 0.62 to 0.85 for the subscales and 0.95 for the total scale. Also, the total score of the researcher-made questionnaire was significantly correlated with the Ryff 53-item questionnaire, using the Pearson correlation coefficient. Moreover, the fitness indices obtained from confirmatory factor analysis showed a proper construct validity for the scale; most of the items had a factor load of above 30. Conclusion: The questionnaire indicated good psychometric properties for assessing psychological well-being in Iranian society.
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