Idiopathic granulomatous mastitis is a rare and benign disease that primarily affects young women of reproductive age. Various factors have been suggested as possible causes, including pregnancy, breastfeeding, history of taking birth control pills, hyperprolactinemia, smoking, and history of trauma. Due to unknown etiology, opinions on its treatment have varied, resulting in differing recurrence rates and side effects. Therefore, conducting a comprehensive systematic review and meta-analysis can aid in understanding the causes and recurrence of the disease, thereby assisting in the selection of effective treatment and improving the quality of life. A systematic literature review was conducted using predefined search terms to identify eligible studies related to risk factors and recurrence up to June 2022 from electronic databases. Data were extracted and subjected to meta-analysis when applicable. A total of 71 studies with 4735 patients were included. The mean age of the patients was 34.98 years, and the average mass size was 4.64 cm. About 3749 of these patients (79.17%) were Caucasian. Patients who mentioned a history of pregnancy were 92.65% with 76.57%, 22.7%, and 19.7% having a history of breastfeeding, taking contraceptive pills, and high prolactin levels, respectively. Around 5.6% of patients had previous trauma. The overall recurrence rate was 17.18%, with recurrence rates for treatments as follows: surgery (22.5%), immunosuppressive treatment (14.7%), combined treatment (14.9%), antibiotic treatment (6.74%), and observation (9.4%). Only antibiotic and expectant treatments had significant differences in recurrence rates compared to other treatments ( value = 0.023). In conclusion, factors such as Caucasian race, pregnancy and breastfeeding history, and use of contraceptive hormone are commonly associated with the disease recurrence. Treatment should be tailored based on symptom severity and patient preference, with surgery or immunosuppressive options for recurrence.

Background: Airway management is an important skill for emergency physicians, and confirmation of correct endotracheal tube (ETT) placement is a crucial component of airway management. Objectives: Due to the occurrence of incorrect ETT positioning in emergency departments, the present study aimed to compare the diagnostic sensitivity of ultrasound using suprasternal and subxiphoid methods for confirming the correct placement of ETT compared to capnography. Methods: This cross-sectional study was conducted by examining patients requiring intubation. Ultrasound was performed by two independent emergency medical assistants using two suprasternal and subxiphoid methods to confirm correct ETT placement; the results were then interpreted. To observe the tube passage through the vocal cords, capnography and lung auscultation were applied as the gold standards, and the results of two ultrasound methods were compared. Results: A total of 66 patients, who were intubated in the emergency department, participated in this study. The positive and negative predictive values, sensitivity, and specificity of supernatural ultrasound were 96.72%, 80%, 98.33%, and 66.67%, respectively. Also, positive and negative predictive values, sensitivity, and specificity of subxiphoid ultrasound were 97.95%, 29.41%, 80%, and 83.33%, respectively. The diagnostic odds ratios of suprasternal and subxiphoid ultrasounds were 1.026 and 1.024 compared to capnography, respectively. Conclusions: Ultrasonography using the suprasternal method was feasible. Considering the high sensitivity and specificity of this method in confirming correct ETT placement, it produced reliable results. Overall, this modality can be used as one of the main methods to verify correct ETT placement in emergency departments.

Subarachnoid hemorrhage (SAH) is still considered a life-threatening medical condition with a high mortality rate, particularly in developing countries. Thus, the present study aimed to investigate the angiographic findings of non-traumatic or spontaneous SAH. This retrospective cohort study included 642 health records of patients with non-traumatic SAH over a 10-year period, from 2010 to 2020. The required data, including demographic information, aneurysm type, size, location, disease severity classification, and secondary complications, were extracted. The study included 642 patients, with 262 (40.8%) being male. The mean age of the participants was 54.72±13.51 years. The most prevalent type of aneurysm was saccular (89.1%), while serpentine (0.2%) and dissecting saccular (0.2%) aneurysms had the least prevalence. The most frequently involved arteries were the anterior communicating artery (ACoA; 38%), internal carotid artery (ICA; 27.6%), and middle cerebral artery (MCA; 13.4%). There was a significant correlation between sex and aneurysms occurring at ACoA and ICA (p< 0.0001), and ACoA – A1 (p=0.02). Patient age and sex were also significantly correlated with one another (p<0.0001). There was no statistically significant correlation between sex, aneurysm size, Glasgow coma scale (GCS), and modified Rankin scale (MRS). Based on our findings, the presence of aneurysms at ACoA, ACoA – A1, and ICA should be thoroughly ruled out in patients with severe headaches of sudden onset, particularly male patients of younger ages.

First carpometacarpal (CMC1) joint dislocations are uncommon injuries. However, they can limit hand functions and lead to serious complications. Herein, we report the case of a multiple trauma man with dorsal dislocation of thumb CMC joint that was successfully treated with closed reduction and casting. The patient was a 47-year-old male with multiple traumas complaining of right wrist pain. Tenderness, deformity, and reduced range of motion of the right thumb CMC joint were observed. X-ray showed dorsal dislocation of the CMC1 joint. Closed reduction of the dislocated joint was performed under general anesthesia, and the joint was immobilized by a thumb-spica cast for 14 days. The patient was eventually discharged in good condition and had no complications or manual dysfunction after a 1-month follow-up. The optimal management of the CMC1 joint dislocations is controversial. The closed reduction seems adequate for these injuries. However, patients whose joints remain unstable after closed reduction, especially those with manual activities, should be considered for open reduction and surgical ligament repair.