Original Article

Meningioma in Focus: Charting the Terrain of Imaging, Grading, and Pathological Vistas

Ali Salehi, Behrooz Mohammad khani Pordanjani, Farahnaz Bidari Zerehpoosh, Fatemeh Moosavizadeh, Maryam Haghighimorad

Novelty in Biomedicine, Vol. 12 No. 2 (2024), 29 April 2024, Page 75- 83

Background: Meningiomas constitute a significant proportion of primary intracranial tumors, demanding a nuanced understanding of their radiological features for informed clinical decisions. This prospective study aimed to explore the intricate relationship between magnetic resonance imaging (MRI) findings and the pathological grade of meningiomas to provide insights into their diverse characteristics.

Materials and Methods: A cohort of 52 meningioma patients underwent comprehensive MRI evaluations. The study encompassed various aspects of tumor radiology, including location, peritumoral edema severity, tumor margin distinctiveness, bone infiltration, adjacent bone reaction, apparent diffusion coefficient (ADC) patterns, intratumoral calcifications, bleeding within the tumor, vascularization, and tumor enhancement.

Results: The analysis revealed that 73.1% of patients presented with grade 1 meningioma, while 26.9% exhibited grade 2 tumors, with no grade 3 cases detected. Intriguingly, while age and gender did not significantly differ between grades, several MRI findings demonstrated noteworthy distinctions. Grade 2 meningiomas were associated with moderate to severe peritumoral edema, indistinct tumor margins, increased vascularization, and heterogeneous tumor enhancement patterns. Notably, logistic regression analysis indicated that none of the investigated radiological parameters independently predicted the pathological grade of meningioma.

Conclusion: These findings emphasize the need for a comprehensive meningioma assessment approach, integrating radiological insights into clinical decision-making and prognosis for enhanced patient care.

Crystallization of Spiritual Awakening in Patients with COVID-19: A Hermeneutic Study

Mohammadreza Changiz, Fatemeh Mohammadi-Shirmahaleh, Marjan Mardani-Hamooleh, Mohammadreza Seirafi

Novelty in Biomedicine, Vol. 12 No. 2 (2024), 29 April 2024, Page 61- 67

Background: World health organization (WHO) declared the outbreak of Coronavirus disease 2019 (COVID-19) a public health emergency in January 2020, and on March 11, 2020, the organization called it a pandemic. Despite causing problems, the COVID-19 epidemic leads to the spiritual and existential transformation of people. The phenomenology of the lived spiritual experiences of patients with a history of COVID-19 was the aim of this research.

Materials and Methods: This qualitative study was conducted with a hermeneutic phenomenology approach. Data was collected between November 2022 and May 2023. The data were collected with a semi-structured in-depth interview with 14 qualified patients, and the interviews were implemented and analyzed with the phenomenological approach of Dickelman et al., 1989. Data collection and analysis were done simultaneously.

Results: The analysis of data related to 4 patients with a history of COVID-19 in the age range of 39 to 79 who had a history of hospitalization in a Hospital in Tehran, the capital city of Iran, showed that their spiritual changes can be divided into three themes of spiritual emotions, spiritual knowledge and spiritual growth and excellence and a structural pattern of crystallization of spiritual awakening.

Conclusion: According to the results, the period of illness has helped their growth and excellence; their flexibility and deeper understanding of their place in the world changed their attitudes and values and caused their personal growth and excellence. The research results emphasize the role of spirituality in providing knowledge, insight, and increasing spiritual knowledge to patients.

Carotid Intima-Media Thickness Assessment in Children with Nephrotic Syndrome

Nasrin Esfandiar, Masoumeh Mohkam, Reza Dalirani, Seyed Mohammad Taghi Hosseini Tabatabaei, Mitra Khalili, Mahmoud Hajipour, Maedeh Yavari, Reyhaneh Jamily, Samaneh Ahmadi

Novelty in Biomedicine, Vol. 12 No. 2 (2024), 29 April 2024, Page 49- 54

Background: Carotid intima medial thickness (CIMT) is a reliable marker for assessing large and medium blood vessel atherosclerosis. This study aimed to investigate the carotid intima-media thickness in children with nephrotic syndrome admitted to Mofid Hospital during 2019-2021.

Materials and Methods: This case-control study was conducted in Mofid Hospital for two years (2019-2021). The samples were selected in the case group from hospitalized children with nephrotic syndrome and the control group from hospitalized children without nephrotic syndrome.

Results: The mean thickness of the right and left carotid intima-media thickness in the case group was 0.07 ± 0.43 and 0.43 ± 0.07 millimeters, respectively, and these two values were lower and equal to 0.42 ± 0.05 millimeters in the control group, respectively (P-value= 0.02, P-value = 0.016). There was a negative and significant relationship between the level of phosphate and CIMT on the left side, and with an increase of one unit in phosphate, the value of left CIMT decreased by 0.277 times. Also, there was a negative and significant relationship between right CIMT and the level of albumin at discharge time, so with an increase of one unit in albumin, the value of right CIMT decreased by 0.256 times.

Conclusion: It is concluded that nephrotic syndrome causes an increase in CIMT and vascular damage in children. The increase of blood albumin and phosphate was associated with the decreased CIMT.

Background: Incidental findings in imaging are defined as findings that appear accidentally in radiological images, and usually, the patient does not have a complaint related to the desired finding. These findings range from no-risk to high-risk. This study aimed to evaluate the prevalence of incidental findings of gynecological diseases in hip and sacroiliac Magnetic Resonance Imaging (MRI) in Imam Hossein Hospital in 2022.

Materials and Methods: In this cross-sectional descriptive study, all patients referred to Imam Hossein Hospital (Iran-Tehran) during one year (2022) who underwent hip and sacroiliac MRI were evaluated. Hip and sacroiliac MRI images were reviewed. The following pathological findings were recorded: pelvic vascular congestion, ovarian cyst, myoma, and ovarian masses. Patients' information about age and underlying disease were also extracted from patients' files. Hip and sacroiliac diseases were also recorded. Finally, all recorded data were analyzed using the SPSS program.

Results: Hip and sacroiliac MRI of 364 female patients were assessed. The mean age of the patients was 50.18±13.46 years. Discopathy was the most prevalent finding in the MRI (41.76%) as a pathological finding. The prevalence of incidental findings was 32.3%. The most common incidental finding in MRI was free fluid with a prevalence of 12.1%, and ovarian cyst was seen in 6.3% of patients. There was a significant relationship between most of the incidental findings and age (P-values<0.05).

Conclusion: The prevalence of incidental findings of gynecological diseases in women undergoing hip and sacroiliac MRI is considerable and shows the importance of the radiologist’s attention to review and report the entire MRI images.

Evaluation of Radiographic, Neuropathological, and Demographic Findings in Children Aged 1 To 18 Years with Brain Tumor

Sasan Saket, Yalda Nilipour, Reza Taherian, Niloufar Fattahi Marnaanni

Novelty in Biomedicine, Vol. 12 No. 2 (2024), 29 April 2024, Page 55- 59

Background: Brain tumors in children can involve different parts of the brain and cause high mortality. These tumors have different types, and they cause different conflicts and complications. So far, limited studies have been conducted in Iran on children's brain tumors. This study aimed to evaluate radiographic, neuropathological, and demographic findings in children aged 1 to 18 years with brain tumors.

Materials and Methods: In this descriptive study, which was conducted for children aged 1 to 18 years with brain tumors admitted to the children's ward of Shohada Hospital (Iran-Tehran) in 2012-2018, 64 children were evaluated. Patient information was extracted from patients' files, including basic data radiological and clinical findings. A significance level was considered less than 0.05.

Results: Twenty-six patients (40.6%) were girls, and 38 (59.4%) were boys. 96.9% of the children were term, and the mortality rate was 40.6%. 57.8% were diagnosed in less than one month from the onset of symptoms. 47.6% of patients had a positive family history, and none of them had a history of brain infection. The most common clinical complaint was N/V. The most common location of the tumor was the fourth ventricle (31.3%), and acute hydrocephalus was also seen in 19 patients (29.7%). The most common tumor was medulloblastoma (93.8%), and the most common stage was grade 4 (98.4%). Desmoplastic medulloblastoma was the most common form of medulloblastoma. 9.4% of patients were positive for tumor marker P53. None of the patients were positive for Beta-Catenin.

Conclusion: The findings have shown that being a boy, involvement of the fourth ventricle and medulloblastoma are the most common characteristics of brain tumor involvement in Iranian children.

Case Report

Hypoglycemia-induced Bispectral index changes during Coronary Artery Bypass Surgery (CABG): A case report

Firoozeh Madadi, Faranak Behnaz, Hamideh Ariannia, Ako Faridi, Mahtab Khorasanizadeh

Novelty in Biomedicine, Vol. 12 No. 2 (2024), 29 April 2024, Page 83- 85

Background: Diagnosing hypoglycemia is a widely known challenge for anesthesiologists during the perioperative period, especially under general anesthesia, during which many signs and symptoms would be masked. On the other hand, the bispectral index, which has recently been utilized to measure the depth of anesthesia, may be influenced by other factors such as hypo and hyperglycemia.

Cases Report: Herein, we have presented a case of a patient who experienced an abrupt decrease in the Bispectral index following hypoglycemia.

Conclusion: Although the Bispectral index is widely used to monitor anesthesia depth, it can be utilized to continuously monitor other contributing factors such as glycemic condition, hypothermia, hypovolemia, and cerebral ischemia.

Fibrous Obliteration in a Middle-Aged Woman: A Case Report

Anita Zarghami, Mahsa Ebrahimi, Alireza Tajik, Samaneh Ahmadi

Novelty in Biomedicine, Vol. 12 No. 2 (2024), 29 April 2024, Page 86- 88

Background: Fibrous obliteration or appendiceal neuroma is a rare type of appendiceal tumor that causes appendiceal obstruction and then presents as appendicitis. This neural tumor has no specific presentation and, after appendectomy, is diagnosed by the pathologist accidentally. Fibrous obliteration is described as a proliferative lesion. The pathogenesis of this lesion is unknown, but it is mentioned that the etiology of this problem is secondary to recurrent inflammation processes. These processes cause neuroendocrine cell hyperplasia in the submucosa and lamina propria of the wall of the appendix. The repetitive occurrence of these sub-clinical inflammatory processes causes fibrosis.

Cases Report: We presented a 55-year-old woman who was referred to our clinic with persistent pain in the right lower quadrant for five days in this report. The pain mimicked appendicitis presentation, and it suddenly started from the periumbilical area and then shifted to the right lower quadrant of the abdomen. Her laboratory study showed a 9600/microliter white blood cell count with 70% neutrophils. An increase in the appendix loop with 9 millimeters diameter was reported in the ultrasound. There was also severe fat haziness around the tissues and visceral inflammation of the terminal ileum in the sonogram. She underwent an appendectomy after the diagnosis of appendicitis, and the pathologist diagnosed fibrous obliteration or appendiceal neuroma.

Conclusion: It is concluded that fibrous obliteration or appendiceal neuroma mimics acute appendicitis, and in patients with this presentation, appendectomy is the best choice for treatment. The main diagnostic method is pathologic assessment, and it is important for the differentiation of this tumor from other malignant tumors of the appendix because fibrous obliteration is a benign tumor.