We present a rare case of intramuscular Haemangioma of the forearm with PERIOSTEAL REACTION of radius and ulna. A 38-year-old female presented with a tumefaction in distal and dorsoulnar side of the right forearm. She had 1.5 years history of tumor which was painful during resent 2 months. Plain xray and MRI was done and the diagnosis of Haemangioma was proved by open biopsy. The tumor plus PERIOSTEAL REACTION and enlarged bone was respected. After 4 years follow-up no recurrence was seen.

Introduction: New bone productions, a frequent feature in many bone diseases, may originate from normal bone forming elements (trabeculae, and periosteum) or from tumor cells. Although estrogenic and chondrogenic tumors alone are able to produce new bone, some neoplasm's infections, trauma and some other diseases can initiate react ional ontogenesis. It is of paramount importance to distinguish one from the other.The purposive this study was recognition of different types of preinstall REACTIONs which are helpful in differential diagnosis radio logically. Here is a report of a rare case of buccal cyst with preinstall REACTION.Results: The CT scan technique, panoramic and periapical radiography didn't show the preinstall REACTION in this buccal cyst and preinstall activity with onion-skin pattern was well apparent in cross-sectional occlusal technique.conclusion: Regarding the overview of different preinstall REACTIONs, it can be concluded that the recognition of different radiographic patterns and choosing the proper radiographic technique accompanied with clinical finding, helps us in final diagnosis of bony lesions.

Introduction: Celiac Disease (CD) is an autoimmune disease that occurs in 1% of the general population. Diarrhea and iron deficiency anemia or osteopromalacia may be the presentation of the disease. Arthritis is commonly found in patients with CD and this disease may predispose patients to secondary hypertrophic osteoarthropathy (HOA) which is characterized by clubbing and PERIOSTEAL REACTION of long bones and arthritis.Case: Our patient was a 22 year old man with a known history of CD for 10 years. He had arthritis of both knees and ankles since 1.5 years ago and in physical examination he had pachydermoperiostosis and clubbing of fingers and linear PERIOSTEAL REACTION in his long bones.Discussion: This is an unusual case of CD accompanied by pachydermoperiostosis, a common feature of primary HOA.

Objective: To study the outcome of mastoid cavity obliterations where inferiorly pedicled PERIOSTEAL-pericranial flaps were used.Study Design: A prospective longitudinal study with a minimum follow-up of 18 months.Methods and Materials: Between 2004 and 2009, 63 mastoid cavity obliterations were performed on 59 patients. Of these, 24 were revision surgery and the remainder were primary surgeries. All the patients underwent open cavity tympanomastoidectomy, where the mastoid cavity was obliterated with inferiorly pedicled PERIOSTEAL-pericranial flap and bone pate.Results: A total of 63 consecutive ears underwent open cavity tympanomastodectomy with mastoid obliteration; 55 (87%) had a very small dry healthy mastoid cavity,  five ears (8%) had occasional otorrhea, which was relatively easily managed by topical therapy, and three ears (5%) had small granulation tissue that was treated with silver nitrate.Conclusion: Obliteration using the inferiorly pedicled PERIOSTEAL-pericranial flap and bone pate is an effective method to manage patients with pre-existing cavities and also those not previously operated.

Background and Aim: Culture and specific staining (including Zeil-Nelson and fluorescent methods) are standard measures for the diagnosis of tuberculosis (TB). Because these methods are time-consuming and, sometimes, due to their low accuracy faster and more accurate methods are necessitated. Methods, which can substitute invasive procedures, when obtaining smear samples and culture is not possible, and in addition to being simple and fast, they have an acceptable diagnostic accuracy.The aim of the present study was to verify the diagnostic value of blood Polymerase Chain REACTION (PCR) method in pulmonary TB.Materials and Methods: This case-control study included 64 proven pulmonary TB cases (according to The National TB Protocol) and 28 subjects who were completely healthy. 4.5ml of blood was derived from each participant and then mixed with 0.5ml EDTA. Finally, DNA extraction and PCR testing using SI 6110 primers was performed for all blood samples.Results: Mean age of the cases and controls was 49.8±18.6 and 48.2±18.5, respectively. 49.2% of the cases and 25% of controls were male. Blood PCR in 23 patients with TB was positive, but none of the controls had a positive PCR (thus, sensitivity of 35.7% and specificity of 100%).Conclusion: With regard to specificity of 100% in PCR method (despite its low sensitivity), in conditions where there is no access to an appropriate specimen, a positive blood PCR can obviate invasive procedures and rapid and definitive diagnosis of the disorder and timely treatment of the patient, his life is saved.

Background: The genitourinary system is one of he most common sites of infection in non-pulmonary tuberculosis (TB). The clinical symptoms and radiologic findings of urinary TB are nonspecific. Current diagnostic tests are of low sensitivity and labor-intensive. Therefore, this study was aimed to evaluate diagnostic value of urine PCR in genitourinary tuberculosis (GNTB).Methods: This was a descriptive study on 33 patients with confirmed genitourinary TB. Demographic data, clinical symptoms, laboratory and radiologic findings were collected. For each patient, three consecutive early morning urine specimens were examined by PCR. The diagnostic value of PCR in mycobacterium tuberculosis (MTB) in comparison with standard microbiological methods was assessed.Findings: There were 33 patients with a mean age of 47.27 16.1 years. The most common presenting symptoms were irritative voiding symptoms (51.5%), flanks pain (27.2%), gross hematuria (9%) and suprapubic pain (9%). Laboratory findings in U/A were hematuria (75.8%) and pyuria (60.6%). IVU was abnormal in 61.5% of patients. Most common abnormalities were pyelocalyceal dilation (44%), ureteral stricture and hydroureter (37%) and multiple small calyceal deformities (25%). Of the 33 patients PCR for MTB was positive in 16 cases (48.5%). In patients with abnormal IVU, PCR was positive in 62.5%.Conclusion: A high index of clinical suspicion is necessary for diagnosis of GUTB. PCR is recommended for instant diagnosis and screening before further examination, it cannot be the only method in identification of GUTB.

Introduction: PERIOSTEAL releasing incision (PRI) is nearly always essential to advance the flap sufficiently for a tension-free flap closure in bone augmentation procedures. However, hematoma, swelling, and pain are recognized as the main consequences of PRI with scalpel. The aim of this case series was to investigate the effectiveness of laser-assisted PRI in guided bone regeneration (GBR) procedure. In addition, postoperative hematoma, swelling, and pain and implant success were assessed.Methods: Seventeen patients needed GBR were included in this study. Diode laser (940 nm, 2 W, pulse interval: 1 ms, pulse length: 1 ms, contact mode, 400-μm fiber tip) was used in a contact mode to cut the periosteum to create a tension-free flap. Facial hematoma, swelling, pain, and the number of consumed nonsteroidal anti-inflammatory drugs (NSAIDs) were measured for the six postoperative days. Six months after implant loading, implant success was evaluated.Results: Minimal bleeding was encountered during the procedure. A tension-free primary closure of the flap was achieved in all cases. The clinical healing of the surgical area was uneventful. None of the patients experienced hematoma, ecchymosis, or intense swelling after surgery. The mean value of maximum pain (visual analogue scale – VAS) was 20.59±12.10 mm (mild pain). Patients did not need to use NSAID after four postoperative days. All implants were successful and functional and none of them failed after 6 months of implant loading.Conclusion: This study revealed the effectiveness of laser-assisted PRI in GBR procedure. This technique was accompanied with minimal sequelae at the first postoperative week. All implants were successful and no complication was noted during the course of this study.