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The prevalence of struma onset in uterine tube is lower than ovary’s stuma. In this report a 63 year old woman was referred to main hospital in the city of Yazd, Iran in 2008. The patient referred with abdominal swelling in pre-umbilical and supra pubic region associated with losing weight and frequent constipation since 5 years ago. After the hospitalization the patient underwent the laparatomy. in pathology report the masses was struma ovarii and mature cystic teratoma associated with struma salpingi and peritoneal steremosis. Special demonstration accompanied struma salpingi in this case are struma ovarii and multiple vesicular vegetasion in choledosac, Peritoneum and bladder. This report was a very rare case of struma salpingi accompanied with struma ovarii and steremosis.

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Background and Objective: Computerized tomographic angiography (CTA) is a minimally invasive modality to image the vasculature without the morbidity of direct large vessel vasculature access and its major indications in urology are assessment of the renal vasculature in preparation for donor nephrectomy, identification of extravessel in evaluation of ureteropelvic junction obstruction and for diagnosis of renal artery stenosion. This study was done to evaluate vescels of kidney donors using CTA and formal angiography and comparison with intraoperative findings. Materials and Methods: In this descriptive study, kidney vessels of 70 and 30 living kidney donor were assessed with computerized tomographic angiography and formal angiography respectively. The pattern of vessels of kidney during operation were examined. Two observers assessed the findings of preoperative CTA and formal angiography with intra operation observations. Results: In CTA group there were two patients each with two main renal veins which were observed during operation was not recorded on computerized tomographic angiography. In formal angiography group there was one patient with unrevealed two main renal veins prior to surgery. In both groups, the accuracy of anatomical diagnosis of the main kidney artery were 100%. Conclusion: This study showed that kidney vascular assessment by either the computed tomography angiography or formal angiography have similar clinical diagnostic accuracy.

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Pulmonary aspiration of gastric contents during the peri-operative period is rare but with significant morbidity and mortality. A 21 years old pregnant woman with preeclampsia was scheduled for an emergency cesarean section under spinal anesthesia. After 18 hours of operation, epilepticus status was occurred. One day after control of seizure, aspiration pneumonitis was diagnosed and treated with mechanical ventilation and positive end-expiratory pressure (PEEP). In patients with the history of loss, consciousness, complication of aspiration, aspiration pneumonia and pneumonitis particularly should be considerated. In case of onset of pneumonitis, PEEP treated procedure with other mechanical ventilation is recommaded.

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Background and Objective: Hepatitis B vaccination has been conducted in neonates in the routine vaccination in Iran since 1993. This study was carried out to evaluate the serum hepatitis B antibody level in vaccinated children after 14 years in Kashan, Iran. Materials and Methods: This prospetive cohort study was conducted on 200 fourteen-year-old children which were selected via a simple random sampling method in Kashan, Iran drung 2008-09. This subjects were have been vaccined according to the govermental guildline at 0, 2 and 6 months old. Two ml blood specimens were obtained from children and serum hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc) were determined by ELISA method. Immunity was interpreted as anti-HBs≥10 IU/L. Data were analyzed using SPSS-13, Chi-Square and Fisher’s exat tests. Results: 92% girls and 95% boys, totally 187(93.5%) children had serum anti-HBs≥10 IU/L. Anti-HBc was positive in 3 (3%) girls and 5(5%) boys, totally 8(4%) which all of them had serum anti-HBS≤10 IU/L. No case of positive HBs Ag was detected. Immunity was detected in 11 of 18 (61.1%) children with birth weight<2.5 kg and in 176 of 182 (96.7%) children with birth weight≥2.5 kg (P<0.05). Conclusion: The immunity following the complete series (0, 2, 6 months old) of hepatitis B vaccination remained detectable after 14 years.

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Background and Objective: Thyroid nodules are common among the general population and they increase the risk of thyroid malignancies. This study was done to evaluate the correlation of findings of ultrasound based on Thyroid Imaging and Reporting Data System (TIRADS) and cytology of fine needle aspiration (FNA) based on Bethesda system to evaluate of thyroid nodules.
Methods: This descriptive-analytical study, was performed on 165 patients (152 females and 13 males) referred to the sonography center of Sayyad Shirazi Educational Hospital, Gorgan, northern Iran during 2018. Ultralosonographic features of nodules were recorded in the pre-filled checklist. According to TIRADS and endocrinologist clinical suspicion, couple of patients was eligible for FNA under the ultrasound guidance. The cytology of FNAs was reported based on the Bethesda system classification.
Results: The mean age was significantly lower in patients with malignant nodules (35.4 vs 44.8; P<0.05). Frequency of malignancy was 8 times higher among females than males (16 vs. 2). TIRADS 3 and 4 were the most common categories among the others with the prevalence of 44.4% and 32.3%, respectively. Bethesda 2 and 4 were the most prevalent categories with prevalence of 58.8% and 20.6%, respectively. The strongest agreement was observed between TIRADS 2 and Bethesda 2 that showed benign findings. Kappa index was 0.061 between TIRADS and Bethesda (P<0.05). Echogenicity, echogenic foci, shape, and margin of nodules were seen significantly more in malignancy.
Conclusion: The most accurate prediction of TIRADS belongs to benign nodules. The correlation between TIRADS and Bethesda was evaluated to be significant overall and the maximum level of correlation was at benign findings. Therefore, these two systems can efficiently be used in order to rule out malignancies and reduce the rate of invasive interventions.