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After two years, again another PCI was done due to in-stent restenosis. Conclusion Revascularization should be considered in MB refractory to medical treatment. However, coronary perforation, in-stent restenosis and graft failure are major concerns.Background Knowledge of variations in the origin of vertebral artery (VA) is indispensable to vascular surgeons. Aberrant origin of vertebral artery on either side is an uncommon finding. There are unilateral and bilateral variability in VA origin. Case presentation We present a case of vertebral artery dissection who was found to have bilateral VAs aberrant origin. The right VA took origin from the right common carotid artery (CCA) which is a completely a rare finding, and the left VA originated from the arch of aorta. Conclusion Unlike most similar reported cases, the VA diameter at origin was larger on the left than on the right side. The possible embryological mechanism is discussed.Background Persistent thyroglossal duct leads to a fibrous cyst formation named thyroglossal cyst which is the most common form of congenital cyst and usually located in the midline neck below the hyoid bone. Rarely the thyroglossal cyst is associated with thyroid cancer. Although the Sistrunk procedure is often considered adequate, currently there is no clear consensus on the optimal management of thyroglossal duct cyst especially duct cyst carcinoma. In addition, there is no consensus about concurrent thyroidectomy in patients with thyroglossal cyst duct carcinoma. Case presentation In this article, we present four patients with thyroglossal duct cyst and papillary thyroid cancer. Papillary thyroid cancer was located into the thyroglossal duct cyst (thyroglossal duct carcinoma) in two patients and two patients had thyroglossal duct cyst with thyroid carcinoma in thyroid tissue. Cervical lymph nodes were involved in one of the three patients. Sistrunk procedure and total thyroidectomy were performed for all. The thyroid lobes were not involved in patients with thyroid duct cyst carcinoma. Tumor or thyroglossal duct cyst recurrence did not occur in any of the patients in follow-up. Conclusion The correlation between thyroglossal cyst and papillary thyroid carcinoma is high. In subjects with thyroglossal duct cyst, in addition to cyst assessment, thyroid gland and neck lymph nodes should be evaluated for malignancy.Background Bernard-Soulier syndrome (BSS) is a rare, autosomal recessive platelet function disorder which is commonly mistaken for idiopathic thrombocytopenic purpura (ITP).The report includes seven cases of BSS that have been diagnosed and treated as ITP for a long time. Methods Between 2006 and 2016, data of seven BSS patients who have long been diagnosed and treated as ITP were collected and analyzed. Results Two patients were males and 5 were females. The patient's age range was between one day and four years at the onset of symptoms. Easy bruising, nose bleeds and mucocutaneous bleeding were the most frequent symptoms. Bleeding attacks of the gum, gastrointestinal tract and menorrhagia also occurred and in one case bleeding in the injection site of the first vaccination was reported. In 6 patients, parents were relatives and in three cases, there was a family history of low platelet counts. Variable thrombocytopenia, prolonged bleeding time (BT), and large platelets with increased bone marrow megakaryocyte were seen in all cases. Most patients were treated with steroids, Intravenous immunoglobulin (IVIG), and some with IV anti-D, Azathioprine, Danazol, Rituximab. Splenectomy was performed in one case. In supplementary tests the platelet aggregation to ristocetin was absent and GPIb expression level by flow cytometry method was lower than 10%. Conclusion BSS should always be considered in differential diagnosis of ITP especially in persistent and refractory ITP.Background One of the complications of urodynamic study is urinary tract infection. The aim of this study was to determine the rate of urinary tract infection (UTI) after UDS in patients referred to the pelvic floor clinic with regard to the specific conditions of these patients, such as presence of pelvic organ prolapse and high post voiding residual volume (PVR). Methods In a prospective descriptive-analytic study, 146 female candidates for UDS from January 2016 to June 2017 entered the study. Patients were examined for urinary tract infection before UDS (up to 5 days before USD) and were enrolled in the study if they did not have bacteriuria or urinary tract infection. Patients did not receive antibiotic prophylaxis before performing UDS. Peficitinib inhibitor The patients were asked to do U/A and U/C three days after the UDS test. Results Among the 146 patients, 9 (6.2%) patients had considerable bacteriuria and 7 (4.8%) patients had UTI. The mean maximum detrusor pressure during urination and abnormal PVR before UDS had a significant correlation with positive urinary cultures after UDS (p less then 0.05). Conclusion The results showed that this diagnostic procedure is low risk and the prophylactic antibiotic therapy is not required before UDS in pelvic floor clinic. It seems that prophylactic antibiotic therapy is only appropriate in case of PVR greater than 50 ml and possibly of the high detrusor pressure.Background Given that the world's population is aging, the problems associated with osteoporosis and related fractures are increasing. The aim of the study was to evaluate the effect of flaxseed extract on bone mineral density (BMD) in Wistar rats using digital radiography. Methods In this experimental study, 25 male and 25 female Wistar rats were randomly divided into 5 groups 1. Control, 2. Calcium and vitamin D (Ca/VitD), 3. 100 mg/kg flaxseed, 4. 200 mg/kg flaxseed, and 5. 400 mg/kg flaxseed. Then, the animals were kept for thirty days. Maxillary and mandibular BMD as well as serum levels of calcium, vitamin D and phosphorus were measured at baseline and after 30 days of keeping the rats. Results The results showed that serum levels of calcium and phosphorus were not significantly different in all five groups before and after 30 days. Serum levels of vitamin D were significantly higher in the group receiving Ca/vit D (with a mean of 61.6±15.8 in the male group and 85±12.9 in the female group) as compared with other groups (P less then 0.
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