Objective:Any operation leads to body stress and tissue injury that causes pain and its complications. Glucocorticoids such as Dexamethasone are strong anti-inflammatory agents, which can be used for a short time post-operative pain control in various surgeries. Main purpose of this study is to evaluate the effect of administration of intravenous (IV) Dexamethasone on reducing the pain after cesarean.Methods:A double-blind prospective randomized clinical trial was performed on 60 patients candidate for elective caesarean section. Patients were randomly assigned into two groups: A (treatment: 8 mg IV Dexamethasone) and B (control: 2 mL normal saline). In both groups, variables such as mean arterial blood pressure (MAP), heart rate (HR), respiratory rate (RR), pain and vomiting severity (based on visual analog scale) were recorded in different time points during first 24 h after operation. Statistical methods using repeated measure analysis of variances and t-test, Mann-Whitney and Chi-square tests were used for analyzing data.Findings:The results indicated that within-group comparisons including severity of pain, MAP, RR and HR have significant differences (P < 0.001 for all variables) during the study period. Between group comparisons indicated significant differences in terms of pain severity (P < 0.001), MAP (P = 0.048) and HR (P = 0.078; marginally significant), which in case group were lower than the control group.Conclusion:IV Dexamethasone could efficiently reduce post-operative pain severity and the need for analgesic consumption and improve vital signs after cesarean section.

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Background:As elongated styloid process is one of the causes of recurrent oropharyngeal pain and carotid nerve plexus compression called Eagle's syndrome and this length is not similar in different communities, the aim of the current study is to determine average length of styloid process by paranasal multidetector computed tomography.Materials and Methods:This is a retrospective cross-sectional study about 393 patients who underwent paranasal MDCT scan for trauma in Radiology Department without pathologic finding. Styloid length from temporal bone junction to tip of the process was measured using Workstation software. Demographic data including age, sex, and height were gathered from the patients' records, and patients were questioned about symptoms of Eagle's syndrome before trauma. Data were analyzed using SPSS version 20 with the methods of t-test, Chi-square, and ANOVA. P < 0.05 was considered statistically significant.Results:Two-hundred and sixteen males and 177 females underwent MDCT. The length of right, left, and mean length of both sides were 25.4 ± 7.3, 25.2 ± 7.8, 25.3 ± 7.1, respectively. The mean length of both sides' process was more among male that was statistically significant (P = 0.025 and 0.043, respectively). Right and left side styloid process' higher length was in correlation with patient's height (P = 0.002, r = 0.153, P = 0.029, r = 0.110, respectively) and number of symptoms (P < 0.001, r = 0.300, P < 0.001, r = 0.334, respectively).Conclusion:The mean length of styloid process was 25.3 ± 7.1 that was in accordance with some studies and different from others. Styloid process length is higher in males. The length of styloid process is in association with height and number of symptoms as well.

SummaryBackgroundThere are controversies regarding the usefulness of coronary artery calcium score (CACS) for predicting coronary artery stenosis. The aim of this study was to determine the prognostic value of CACS for determining the presence and severity of coronary artery disease (CAD) in patients with sign and symptoms of the disease.Material/MethodsIn this cross-sectional study, 748 consecutive patients with suspected CAD, referred for coronary computed tomography angiography (CCTA), were enrolled. The mean CACS was compared between patients with different severities of coronary artery stenosis. The association between CACS and different CAD risk factors was determined as well. Different cutoff points of CACS for discriminating between different levels of coronary artery stenosis was determined using receiver operating characteristic (ROC) curves.ResultsThe mean CACS was significantly different between different levels of coronary artery stenosis (P<0.001) and there was a significant positive association between the severity of CAD and CACS (P<0.001,r=0.781). ROC curve analysis indicated that the optimal cutoff point for discriminating between CAD (presence of stenosis) and the non-stenosis condition was 5.35 with 88.6% sensitivity and 86.2% specificity. Area under the curve for different levels of coronary artery stenosis did not have sufficient sensitivity and specificity for discriminating between different levels of CAD severity (<70%).ConclusionsThe study demonstrated that there is a significant association between CACS and the presence as well as the severity of CAD. CACS could have an appropriate prognostic value for the determination of coronary artery stenosis but not for discriminating between different severities of stenoses.

Background: Hematologic malignancies are the fifth most common malignancies worldwide. Pulmonary symptoms are among the patient’s common complaints. Early diagnosis based on patient symptoms, laboratory testing, and imaging may lead to an appropriate therapeutic approach. Objectives: To evaluate thoracic computed tomography (CT) scan findings in known cases of hematologic malignancy with acute respiratory symptoms. Methods: A cross-sectional study was conducted on 200 patients with hematologic malignancies admitted to Khansari cancer center for acute pulmonary symptoms, from December 2019 to May 2020. Collected data included demographic data, physical examination, laboratory tests and findings of thoracic CT images. Descriptive analysis and chi-Square test were performed to analyze the data using SPSS version 20. Results: Non-Hodgkin lymphoma was the most common malignancy, accounting for 48% of total cases. The most common radiological findings included atelectasis (49%), followed by pleural effusion (42%), mediastinal lymphadenopathy (38.5%), consolidation (37%), and ground-glass opacities (33.5%). Mediastinal lymphadenopathy was more prevalent in patients diagnosed with lymphoma. Among pulmonary pathologies, pneumonia was the most prevalent disease (41.5%), followed by small airway disease (13.5%), mediastinal lymphadenopathy (12.5%), chronic pulmonary disease (6.5%), and pulmonary metastasis (6%). Normal thoracic CT scan was detected in 20% of participants. Overall assessment of clinical symptoms, laboratory tests, and imaging findings did not lead to the diagnosis of acute lung involvement in 5.5% of study participants, because complete clinical data were not available in some participants. Conclusions: Assessment of the most common thoracic imaging findings in patients diagnosed with hematologic malignancies, may help make better diagnosis and planning of a rapid therapeutic approach.