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The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is primarily a respiratory virus. However, an increasing number of neurologic complications associated with this virus have been reported, e.g., transverse myelitis (TM). We report a case of a 39-year-old man admitted to Namazi Hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In December 2020, the patient was infected with Coronavirus Disease 2019 (COVID-19). During hospitalization, the patient suffered from sudden onset of paraplegia, and urinary retention, and had a T6-T7 sensory level. TM was diagnosed and an extensive workup was performed to rule out other etiologies. Eventually, para-infectious TM associated with COVID-19 was concluded. The patient received pulse methylprednisolone therapy of 1 g/day for 10 consecutive days followed by seven sessions of plasma exchange without a favorable response. The patient then underwent regular physical rehabilitation and tapering oral administration of prednisolone 1 mg/Kg. As a result, weakness in the lower extremities improved slightly after six months. Overall, we suspect a correlation between COVID-19 and TM, however, further studies are required to substantiate the association. [ABSTRACT FROM AUTHOR]

Introduction: Palpable thyroid nodules are stated in 4 to 7% of individuals. This study was designed to evaluate the relation of Thyroid Imaging Reporting and Data System (TIRADS) and fine-needle aspiration (FNA) based cytology reports in patients with thyroid nodules. Materials and Methods: In this retrospective cross-sectional study, individuals with thyroid nodules who were selected for ultrasonographic-guided FNA enrolled in this study. Demographic data, radiologic assessment, and cytology report were gathered based on hospital medical records. TIRADS grading of the nodules was assessed for each nodule. Cytology was performed on all samples. Sensitivity and specificity were calculated by comparing cytology with ACR-TIRADS and also cytology with TIRADS 4-5 cut-off point as a radiologic malignant lesion. Results: 172 patients were studied, 151 of whom were female and 21 were male. The mean age of the patients was 49.46 years. Most of the patients had TIRADS 4 (53.5%) followed by 3 (31.4%), and 5 (11.6%). 151 patients (87.8%) had a benign lesion in cytology. Of them, 118 had colloid nodules. There was a statistically significant relation between TIRADS and cytology (p-value<0.001). Sensitivity, specificity, AUC, and positive and negative predictive value for ACR-TIRADS classification were 76.19%, 47.54%, 0.619, 20.00%, and 92.06%, respectively. These values for cut-off "4-5" classification was 86.36%, 38.00%, 0.622, 16.96%, and 95.00%. Conclusions: According to the significant concordance between TIRADS and cytology, as shown in the results of our study, it seems that TIRADS could be used to decrease the amount of unnecessary FNA in individuals with thyroid nodules. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a demyelinating disease with multiple symptoms. To examine the effect of medications, magnetic resonance imaging (MRI) imaging can be performed. Objectives: This study aimed to compare the visual assessment of MRI images by physicians and the results of a MATLAB-based software developed for evaluating theMS plaque volume. Patients and Methods: TYSABRI (natalizumab)-treated patients were enrolled in this study. MRI was performed before and after treatment. A MATLAB-based software was developed to evaluate the MRI images. The images were then subjectively evaluated by three specialists and objectively assessed by the software, and the results were then compared. Results: Thirty-five patients participated in this study. According to the software, the status of 37.14% of the patients improved; however, 62.86% of cases deteriorated after a year of treatment. There was less than 50% agreement between the physicians and less than 55% agreement between the physicians and the software results. A disagreement of almost 45% was observed between the physicians and the software results, as in some cases, small changes were detected in successive images. The second cause of disagreement could be the physicians' expectations; although the patient's recovery was highly expected in some cases, their condition deteriorated. Conclusion: The results revealed that the objective assessment of sequentialMRI images of MS patients reduced human errors and improved the evaluation of this disease. [ABSTRACT FROM AUTHOR]

Nocardiosis is an uncommon infection caused by Nocardia species, a group of aerobic actinomycetes. Nocardiosis may affect immunocompromised or immunocompetent patients and as this case was affected by a rare disorder, we describe it in this study. This paper describes a case of nocardial mycetoma from a hospital affiliated to Shiraz University of Medical Sciences. The case was a 52-year-old man with diabetes mellitus, who was admitted to our institution with a 5-year history of right lower extremity swelling with multiple discharging sinuses localized in distal part of the leg and dorsum of the foot following a penetrating injury to the affected foot. The wound culture yielded the growth of Nocardia species after incubation. Nocardiosis should be considered in the differential diagnosis of skin lesions, especially if patients have a history of trauma or contact with soil-contaminated materials. Our reported case increases knowledge about this rare, sporadic infection in our country. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a demyelinating disease, involving almost 2.5 million people around the world. There are different MR pulse sequences, which are used to detect MS plaques. Objectives: This study aimed to compare, T2 weighted, short-tau inversion recovery (STIR) and phase-sensitive inversion recovery (PSIR) pulse sequences, for detecting cervical spinal cord lesions in MS patients. Patients and Methods: Sixty patients with definite MS diagnoses, participated in this study from June to December 2016. 1.5 T Siemens (Avanto, Erlangen, Germany) MR scanner and three pulse sequences (T2 weighted, STIR and PSIR sequences) were used for cervical cord MR imaging. To assess the effectiveness of these pulse sequences, the lesion to cord ratio (LCR) and lesion to noise ratio (LNR) were calculated. Results: The LCR and LNR of the T2 and PSIR were the same (LCR of 0.04, -0.03 and LNR of 2.74, -2.09 respectively), just the intensities were reverse. STIR had a significantly different LCR and LNR [0.23 (P < 0.001) and 22.7(P < 0.001) respectively], hence it was better in diagnosing cervical cord MS plaques. Conclusion: According to the results, using 1.5 T MRI machine, it implies that the STIR pulse sequence was the best pulse sequence in comparison to T2 and PSIR in detecting cervical cord MS plaques. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the possible role of brain magnetic resonance imaging (MRI) in cataract detection. Patients and Methods: This study was performed on patients who were referred to Shahid Faghihi hospital with a known disease for brain MRI. Patients were classified in two groups of case and controls. Cases were 44 eyes with abnormal signal of the lens and controls were 88 eyes with normal signal intensity of the lens. All patients underwent an ophthalmological examination and the presence of cataract and intraocular lens (IOL) was assessed in these patients. Average lens signal, average muscle signal, average fat signal, lens to muscle signal ratio, and average lens signal to average fat signal ratio were recorded. Results: The mean of the average lens signal in the case group was significantly higher than controls (370 versus 161, respectively) (P value < 0.0001). Sixteen (36.4%) out of 44 eyes in the case group had cataract, but 48 (54.5%) of 88 eyes in the control group had cataract (P value = 0.049). In the case group, 18.2% had IOL, and this was 6.8% in the controls (P value = 0.046). The mean of the average lens signal in eyes with cataract was 218.5 and in normal eyes, it was 249.1 (P value = 0.36). In eyes with IOL, the mean of the average lens signal was 347.5 and in normal eyes, this was 223.1 (P value = 0.036). Conclusion: Cataract in eyes with abnormal lens signal was significantly lower than eyes with normal lens average signal. The lens signal in eyes with cataract was similar to eyes without cataract. So, average lens signal in brain MRI does not lead to early detection of cataract. [ABSTRACT FROM AUTHOR]

Background: Catheter hemodialysis is the last choice for end stage kidney disease patients. Unfortunately, long-term catheterization can lead to problems that make re-catheterization challenging. Sometimes the physician has to try catheterization through several veins and stays close to the patient during the procedure that may lead to a high radiation dose exposure to the radiologist, so that some radiologists refuse to admit such patients. Objectives: The objective of this study was an assessment of the radiation dose of radiologists and patients during the placement of double lumen catheter in difficult cases. Patients and Methods: The thermoluminescent dosimeter (TLD) was used to measure the delivered radiation dose to physicians. During the procedure, a package of dosimeter was placed on the thyroid shield and another on the chest, under the apron in order to calculate the occupational effective dose. Moreover, patient information and parameters of the procedure were recorded in order to estimate the patient dose during the procedure. Results: The mean effective dose provided by TLDs, dose/procedure, and the annual dose of physicians resulted from this procedure were 30.38 μSv, 0.02 μSv/procedure, and 350.20 μSv/y, respectively. The mean dose area product, dose, and calculated peak skin dose obtained in this study were 151.44 cGy.cm²,851.71 mGy, and 384.97 mGy, respectively. Conclusion: The mean effective dose of physician per case is about 0.02 μSv/procedure which is much less than the radiation dose per other procedures. Briefly, it can conclude that double lumen replacement does not deliver an unacceptable radiation dose to the physician and even the radiation dose resulted from these cases are much less than the other procedures. [ABSTRACT FROM AUTHOR]

Background: Fluoroscopy guided imaging, which is going to be more routine these days, requires a long time of fluoroscopic observing that could increase the radiation dose of the physician and other staff who have to stay near the patient during the procedure. In our department, one of the senior interventionists observed hair loss in his lower limb. Objectives: The objective of this study was to measure the radiation dose of the physician's leg during common procedures in order to find out that whether the radiation dose exceeds the threshold of deterministic effects of radiation. Patients and Methods: Thermoluminescent-dosimeters (TLD-100) set on the leg part of the anthropomorphic whole body phantom PBU-50 was used in order to measure the radiation dose in two centers where our interventionist worked. Meanwhile, the duration of exposure in important procedures was observed and recorded in center 1 for 2 months. During this period, data including age, height, and weight of the patients, and radiation exposure time, dose (mGy) and dose area product (dap) (μGy.cm²) were recorded. Results: The result of TLD dosimetry showed that the mean effective dose in center 1 and 2 was 0.20 and 0.86 mSv, and also the mean-dose (mSv)/min) in these centers was 0.02 ± 0.00 and 0.20 ± 0.015 mSv/min, respectively. Conclusion: The effective annual dose of interventionists who work in center 1 and 2 was 143.08 and 1226.78 mSv, respectively. The high radiation dose delivered to the leg of physicians in center 2 could be an important cause of radiation dermatitis occurred on the leg of our interventionist. Patient dose during most of the procedures was less than the threshold dose for occurring erythema. However, unfortunately in transjugular intrahepatic portosystemic shunt (TIPS) procedure, which is a time-consuming procedure, the patient radiation dose exceeds the threshold. It would be useful if a plan was designed to reduce the dose of patients and even physicians. [ABSTRACT FROM AUTHOR]