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Background: Pancreatic duct (PD) dilation could be presented in both benign and malignant diseases. Endoscopic ultrasonography (EUS) is a sensitive modality that provides both structural assessment and tissue sampling. This study aims to explore the importance of PD dilation as a potential indicator related to various pancreatobiliary pathologies identified via EUS. Methods: Among 3109 subjects who underwent EUS, 599 had evidence of dilated PD and met the inclusion criteria of this retrospective study. Also, the patients underwent EUS fine needle aspiration (EUS-FNA) to evaluate the etiology when required. All data were extracted from patients' medical records to perform statistical analysis. Results: The study sample revealed 64% being male with a median age was 65-years. Pancreatic adenocarcinoma was the most common etiology diagnosed in 236 patients (39.4%), followed by sphincter of Oddi dysfunction (SOD) in 13% of subjects. Ampullary carcinoma, common bile duct stone, and cholangiocarcinoma were found at 9.5%, 8.8%, and 6.8%, respectively. Abdominal pain was the most common symptom seen in 440 (73.4%) patients. Opium consumption was reported in 170 (28.4%) subjects. Opium consumption was significantly more prevalent in patients with SOD (P < 0.05). Conclusion: We suggest that PD dilation could be associated with a wide range of pancreaticobiliary pathologies, especially pancreatic neoplasms. In this regard, PD dilation should be considered as a crucial indicator of pancreatic neoplasm despite it may be associated with no clear etiologies. [ABSTRACT FROM AUTHOR]

Objectives: Bifid mandibular canal (MC) is an anatomical variation of the MC. This study aimed to assess the prevalence and shape of bifid MC in an Iranian population. Materials and methods: A total of 681 patients who had undergone cone-beam computed tomography (CBCT) for different purposes between 2018 and 2020 were evaluated. After detection, bifid MCs were classified into four types forward, buccolingual, dental, and retromolar. CBCT images were assessed by two oral and maxillofacial radiologists. Data were analyzed by SPSS using an independent t-test and Chi-square test. Results: Bifid MC was found in 23 (3.4%) out of 681 patients, with a mean age of 32.21 years. Ten patients (1.5%) had a bifid MC on the right side, 6 (0.9%) on the left side, and 7 (1%) bilaterally. However, no significant correlation was found between laterality and the prevalence of bifid MC (P > 0.05). Bifid MC was found in 8 males (34.8%) and 15 females (65.2%). Gender had no significant correlation with the prevalence of bifid MC (P > 0.05). Forward type was the most common (n = 8, 1.2%) followed by buccolingual (n = 5, 0.73%), dental (n = 2, 0.3%), and retromolar (n = 1, 0.14%) types. Conclusion: According to the present results, bifid MC was not uncommon in the Iranian population of the present study, and forward type was the most common, followed by buccal and then dental bifid MCs. There was no significant correlation between sex and age with bifid MC but bifid MC was detected more frequently in females than males, and it was seen unilaterally in a higher percentage of the cases. [ABSTRACT FROM AUTHOR]

According to anatomical reference books, the celiac trunk (CT) is divided into three terminal branches, namely the common hepatic artery (CHA), left gastric artery (LGA), and splenic artery (SA). However, variations in the number and location of the CT branches are possible. The body of a 40-year-old deceased male was used for anatomization in the Anatomical Hall of Alborz University of Medical Sciences (Karaj, Iran). During the dissection, variations in the branching pattern of the CT, such as the orientation of the main celiac branches, the origin of the inferior phrenic artery, and the aberrant supplementary artery to supply the liver were observed. Furthermore, a variation in the location of the kidneys and renal arteries was observed. In addition to CHA, LGA, and SA, two additional branching patterns, namely the left inferior phrenic artery (LIPA), and right accessory hepatic artery (RAHA) were noticed. This variation is rarely observed in human anatomy. Therefore, awareness of the arterial anatomy and possible variations is essential during surgeries (e.g., biliary tract surgery, liver transplant) and radiological procedures. To the best of our knowledge, such variations in the branching pattern of the CT have not been reported or described in anatomical reference books. Hence, the present study aimed to highlight the existence of these variations to assist surgeons, radiologists, and anatomists. [ABSTRACT FROM AUTHOR]

Background: Opium consumption is associated with increased risk of atherosclerosis and a hyper-inflammatory state which are suggested as contributing factors to the development of coronary artery ectasia (CAE). We aimed to determine if opium consumption is an independent risk factor of CAE. This study aimed to explore the relationship between opium consumption and CAE. Methods: In this propensity score-matched study, we enrolled patients who underwent elective coronary angiography between September 2004 and March 2017 in Tehran Heart Center. We studied patients with CAE and without coronary artery disease (CAD) as cases. The control group, patients with normal coronary angiograms, were selected after applying the propensity score matching to match for age, sex, diabetes mellitus, hypertension, hyperlipidemia, family history of coronary artery disease, and cigarette smoking. Results: We studied 242 patients with pure CAE and selected 968 control patients. The prevalence of opium consumption was not significantly different across these groups: 17 (7.5%) in the pure CAE group compared to 76 (8.6%) in the control group (Odds ratio: 0.81; P = 0.455). Amongst the patients with pure CAE, Markis scores were not significantly different between opium consumers and non-consumers (P = 0.136). Conclusion: We found no significant difference regarding opium consumption between patients with pure CAE and those with normal coronary angiograms. In addition, there was no correlation between opium consumption and Markis scores in patients with pure CAE. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer is the fourth most common cancer and the second cause of cancer-related death worldwide. Various types of gastric cancer are common in different areas in Iran. In this study, we aimed to evaluate 10 years of endoscopic and histopathological data of patients diagnosed with gastric cancer in Babol, Iran. Materials and Methods: This descriptive cross-sectional study included all patients with recorded data who were referred to the endoscopic unit with gastric cancer during 2006-2016. Data included demographic characteristics (age, sex, body mass index [BMI], smoking, opium addiction), endoscopic characteristics (site of involvement in different gastric areas), and histopathological types (adenocarcinoma, lymphoma, gastrointestinal stromal tumor (GIST)), which were extracted from the endoscopy unit database and were analyzed using SPSS software. Results: 435 cases of gastric cancer were studied. The mean age was 66.75 ± 14.03 years, with a minimum and maximum age of 21 and 94 years, respectively. The data demonstrated that men were affected 2.3 times more than women (69.2% were men and 30.8% were women). 420 out of 435 patients were diagnosed with adenocarcinoma. Also, 46 cases (or 10.9%) were signet ring adenocarcinoma, and 374 cases (89.1%) were non-signet ring adenocarcinoma. Eight cases were lymphoma, and seven cases were GIST. In addition, 112 patients (25.8%) had proximal, and 323 patients (74.2%) had distal involvements, mostly involving the antrum (36.8%). Regarding the effects of cigarette smoking and opium addiction, 124 patients diagnosed with gastric cancer were investigated. 13 patients (10.4%) had a history of smoking. Also, five patients (4%) had a history of opium addiction. Three patients (2.2%) had a history of both. Conclusion: In our study, non-cardiac intestinal type adenocarcinoma was more prevalent than cardiac type. [ABSTRACT FROM AUTHOR]

Background: One of the great physicians in Iran who had expertise in medicine, surgery, and pharmacy was Sadid al-Din Kazeroni. He was a 14th century physician. No information is available on his birth and death -- only "Al-Mughni", a book, has been left to make him famous in surgical and medical knowledge. Methods: We used desk and historical research methods in this research, with a historical approach. This commonly used research method in human sciences was used to criticize and study the birthplace and works of Sadid al-Din Kazeroni. Results and Conclusion: Sadid al-Din Kazeroni discussed the exact issues in the field of anatomy, surgery, and gynecology. He was fluent in pharmacology. In his pharmacology book, for the first time, he named drugs considered necessary before and after surgery. In this study, we reviewed the biography and introduction of the works and reviewed "Al-Mughni", a book on breast cancer. [ABSTRACT FROM AUTHOR]

Background: Verbal autopsy (VA) is one method to obtain valid estimates of causes of death in the absence of valid medical records. We tested the reliability and validity of a VA questionnaire developed for a cohort study in Golestan Province in northeastern Iran. Method: A modified version of the WHO adult verbal autopsy was used to assess the cause of death in the first 219 Golestan Cohort Study (GCS) subjects who died. The GCS cause of death was determined by two internists who independently reviewed all available medical records. Two other internists (''reviewers'') independently reviewed only the VA answers and classified the cause of death into one of nine general categories; they repeated this evaluation one month later. The reliability of the VA was measured by calculating intra-reviewer and inter-reviewer kappa statistics. The validity of the VA was measured using the GCS cause of death as the gold standard. Results: VA showed both good validity (sensitivity, specificity, PPV, and NPV all above 0.81) and reliability (kappa.0.75) in determining the general cause of death independent of sex and place of residence. The overall multi-rater agreement across four reviews was 0.84 (95%CI: 0.78-0.89). The results for identifying specific cancer deaths were also promising, especially for upper GI cancers (kappa = 0.95). The multi-rater agreement in cancer subgroup was 0.93 (95%CI: 0.85-0.99). Conclusions: VA seems to have good reliability and validity for determining the cause of death in a large-scale adult follow up study in a predominantly rural area of a middle-income country. [ABSTRACT FROM AUTHOR]