With considering of high prevalence of sinusitis and variable imaging modalities in diagnosis of it , we decided to evaluate sensitivity and specify of plain x-ray in diagnosis of acute sinusitis. In this research, CT scan and plain x-ray findings of 83 patients with suspected acute sinusitis (by otorhinolayrngologist) - with considering of ethical and economic notices - were compared and descriptive studies were done. CT scan is considered as gold standadrd.Sensitivity and specify of plain x-ray (waters and caldwell views) in diagnosis of acute sinusitis for paranasal sinuses Were maxillary (0.85 - 0.85), sphenoid (0.55 - 0.95), ethmoid (0.79 - 0.94), and frontal (0.86 - 0.93) sinuses and positive predictive value and negative predictive value were: maxillary (0.83 - 0.87), sphenoid (0.73 - 0.89), ethmoid (0.87 - 0.90), and frontal (0.83 - 0.94) respectively.Waters and caldwell views are accurate methods in primary investigation and also in follow up of patients with acute sinusitis without complication.

Background: This study aimed to investigate the association between epicardial adipose tissue (EAT) and coronary artery disease (CAD) as well as cardiovascular risk factors. Methods: Complete medical records of subjects were reviewed and cardiovascular risk factors were recorded. Epicardial fat volume (EFV) and epicardial fat thickness (EFT) were measured using digital volumetry of acquired images using a 256-slice CT-scanner. Calcium score was measured using Agatston method in non-contrast images. After contrast administration, bolus-tract images were obtained. Coronary arteries were assessed using reconstructed images in arterial phase of contrast-enhanced images. EFV and EFT measurements were compared to computed tomography angiography (CTA) findings of coronary arteries. Results: A total of 269 patients (Mean age: 55. 5 ± 12. 1, 44% female) were included. Higher means of EFT and EFV were associated with coronary artery stenosis. However, the correlation coefficients of the arterial stenosis with EFT and EFV were weak. EFV and EFT had a significant association with age (P < 0. 001, P < 0. 001 respectively), body mass index (BMI) (P < 0. 001, P < 0. 001 respectively) and hypertension (P < 0. 016, P < 0. 003 respectively). Diabetes mellitus (DM) and hyperlipidemia were not significantly associated with EFV (P = 0. 069 and 0. 639 respectively) and EFT (P = 0. 103 and 0. 366 respectively). EFV and EFT showed a weak correlation coefficient with calcium scoring (Spearman correlation coefficients: 0. 26 and 0. 22 respectively, both P < 0. 001). In multivariate logistic regression models considering coronary stenosis as dependent variable and EFV, EFT and other CAD risk factors as independent variables, EFV and EFT did not show significant P values and were omitted from the model by other CAD risk factors. Conclusion: Increased EFV and EFT are associated with CAD, age, BMI and hypertension. However, no remarkable association was found between them and calcium score, hyperlipidemia or DM. These variables could weakly predict CAD in univariate models but they are not independent predictive factors for CAD in multivariate models consisting of other CAD risk factors. Hence, EFT and EFV are not independent predictors for CADs when they are considered simultaneously with other CAD risk factors.

Serum level of Galactomannan for Aspergillus was strongly positive (1.8 ng/ml). Invasive pulmonary aspergillosis was suspected and itraconazole was replaced by voriconazole. Three days later, bronchoalveolar lavage sample revealed heavy growth of Aspergillus fumigatus. Brain CTscan showed no abnormality. Twelve days after antifungal therapy, the size of nodular lesions decreased significantly.

Lpomeningioma is a rare benign tumor of meninges that contains mature adipose tissue. The heterogeneous enhancement visualized on CTscan. mimic necrotic malignant tumors. In this article a patient that presented with a frontoparietal mass lesion and in histopathologic examination revealed a benign meningothelial neoplasia with adipose differentiation. characterizing a lipoblastic meningioma, is described.

Introduction: Epilepsy is one of the most important disorders in children. Ten to thirty percent of epileptic children are medically intractable. The aim of this study was to determine main predictive factors of intractable epilepsy and early identification of children at risk for development of this disease. Material and Methods: In this case - control study epileptic children under 15 years old that referred to pediatric neurology clinic of Imam Reza hospital divided in two groups. Group I which contained 51 patients with refractory seizures who had a minimum of one episode of seizure per month while taking at least two antiepileptic drugs and group 11which included 80 cases were chosen randomly among patients who have not had any seizure during 6 month after starting the treatment. Results: There were 39 males and 12 females in group I while 42 males and 38 females in group  11. In groups I age at onset of seizures was under one year old in 64.7% of patients whereas in group II was 22.5%. Comparison of other factors between two groups showed that in group I 13.7% family history of epilepsy, 80.4 %  eurological defects, 13.7% myoclonic seizures, 66.7% daily seizures, 17.6% neonatal seizures, 96.1% abnormality in first EEG, 52.9 % abnormality in brain CTscan , 11.8% history of status epilepticus and in group 11above results were 12.5% , 8.8 %, 2.5%,22.5 % , 5% , 83.8% ,13.6% and 11.3% respectively. Conclusion: Male sex, age at onset of seizures under one year old, myoclonic seizures, neurologic defects, daily seizures, history of neonatal Seizures, abnormality in first EEG and abnormality in brain CTscan are factors affect on the occurrence of intractable epilepsy.

Case report: We report a case of atypical facial pain in a 16-year-old girl who was admitted to the kashani clinic because of pain in the left side of face, weight loss, and depression. In physical examination, left nasal cavity was wide, inferior turbinate was absent, and a large amount of crust was seen. Brain MRI was normal. In coronal CTscan of Para nasal sinuses, middle turbinate was not seen in the left side, but a small part of inferior turbinate was seen. The diagnosis was empty nose syndrome (ENS) and surgery was done.

Background: Myelolipoma is one of the rare benign tumors of adrenal gland containing lipid and hematopoietic tissues. While the tumor is often detected incidentally, recently it can be diagnosed by modern radiological methods.Case report: The present study is the report of a 58year old man suffering from mild hypertension who had been referred to an endocrine clinic for the investigation of his right adrenal gland mass. The adrenal mass was detected incidentally through abdominal sonography when he was investigated for his chief complaint of epigastric pain. In adrenal CT scan, it was shown that a fat density mass between superior pole of right kidney and liver was attached to the internal side of right adrenal gland.Conclusion: Since adrenal myelolipoma is a nonfunctional mass with no hormonal secretion, it could be diagnosed efficiently through radiology rather than the conventional endocrine tests.

Antiphospholipid antibody syndrome (APS) is a recently-diagnosed syndrome presenting with arterial and venous thrombosis, recurrent miscarriages and thrombocytopenia in the presence of antiphospholipid antibodies.A 16- year-old man referred due to right sided chest pain, dyspnea and cyanosis of two fingers presented for 2 months. After a complete workup, diagnosis of pulmonary thromboembolism was confirmed through clinical examination, spiral chest CTscan and lower limb Doppler sonography.He had positive anticardiolipin antibody, lupus anticoagulant, ANA and anti dsDNA. Based on these findings, diagnosis of APS (probably secondary to SLE) was made. Symptoms were improved by anticoagulant, prednisolone and chloroquine therapy. In a conclusion, pulmonary embolism may be the first presentation of APS, especially in young adults.

Background: Pancreatic simple cysts are smaller than the complex cysts and are located in distal areas of pancreas. Papillary solid and cystic tumor is a rare neoplasm in children and elderly, and often occurs in young women and girls.Case Report: A forty-year-old woman with a history of epigastria pain for five years had referred several times to medical centers was conducted to be candidate to pancreatic systectomy with general anesthesia. She underwent distal pancreatectomy. Patient postoperative follow-up was continued.Conclusion: Papillary solid and cystic tumor of the pancreas is a rare neoplasm with unknown origin and often benign. It presents with vague abdominal pain. Ultrasound, magnetic resonance imaging (MRI) and CT-scan would help to make diagnosis before the surgery. Surgery is the choice treatment and the diagnosis would be proved with histology and immunohistochemistry.