Although Hydatid disease eradicated in many countries, it is still widespread in communities where agriculture is dominant. Cystic hydatidosis is significant public health problem in the regions with endemic echinococcosis. The hydatid cysts tend to form mostly in the liver or lung. Brain involvement is very rare. In the present report, we describe magnetic resonance imaging findings in an 18-yr-old male with cerebral echinococcosis, in Shahid Madani Hospital, Karaj, Iran in 2015. The patient, presented with headache, hemiparesis, impairment of speech, vomiting, and nausea. Computed tomography, magnetic resonance imaging, and surgical exploration proved a cyst in the superior portion of left temporal lobe. Pathological examination showed it to be a solitary primary cerebral hydatid cyst.

Objectives: This study aimed to develop and validate the OSABSS (Objective Structured Assessment of Basic Surgical Skills), a modified Objective Structured Clinical Examination (OSCE), to assess basic surgical skills in residents. Design: A developmental study conducted in two phases. Basic skills were identified through literature review and gap analysis. The OSABSS was then designed as a modified OSCE. Setting: This study took place at Alborz University of Medical Sciences in Iran. Interventions: The OSABSS was created using Harden's OSCE (Objective Structured Clinical Examination) methodology. Scenarios, checklists, and station configurations were developed through expert panels. The exam was piloted and implemented with residents as participants and faculty as evaluators. Participants: 32 surgical residents in gynecology, general surgery, orthopedics, and neurosurgery participated. 22 faculty members were evaluators. Primary and secondary outcome measures: The primary outcome was OSABSS exam scores. Secondary outcomes were written exam scores, and national residency entrance ranks. Main results: The mean OSABSS score was 16.59 +/- 0.19 across all stations. Criterion validity was demonstrated through correlations between OSABSS scores, written scores and entrance ranks. Reliability was high, with a Cronbach's alpha of 0.87. No significant inter-rater score differences were found. Conclusions: The rigorous OSABSS development process produced an exam demonstrating strong validity and reliability for assessing basic surgical skills. The comprehensive station variety evaluates diverse technical and non-technical competencies. Further research should expand participant samples across surgical disciplines.

Background: The combination of atlantoaxial joint dislocation and fracture of the odontoid process is a rare but serious spine injury that causes instability. The estimated frequency of this combined injury is less than 2% among upper cervical spine dameges. Few clinical cases of mentioned damage has been reported in scientific resources. ...

Introduction :Brain injury is a prevalent problem in emergency department. Assessing traumatic brain injury (TBI) usually needs imaging, of them Computed Tomography scanning (CT scan) is very useful for detecting brain pathology in these patients. On the other hand in mild TBI patients, CT imaging may be used without indication which ...

Background and Importance: Alkaptonuria is a rare genetic disorder due to homogentisic acid oxidase deficiency which eventuates in the reposition of homogentisic acid in different parts of the body and multi-organ involvements. The characteristic bluish-black discoloration of the skin and cartilage tissue is known as ochronosis. Case Presentation: Herein, we reported a 45-year-old woman with chronic pain in the lumbar area and radicular pain in her left leg, aggravating gradually during the previous six months before the operation. She also suffered from progressive muscle weakness in her left lower extremity. The patient was operated for prolapsed disc herniation. Macroscopically, no abnormality of the skin, muscles, or ligaments was observed during surgery. After incision of the annulus in level L3-L4, surprisingly the excised nucleus pulposus was black. The alkaptonuria was diagnosed after histopathological examination of the black disc material and confirmed by urinalysis. Conclusion: The postoperative course was uneventful and the patient was free from low back pain and leg pain after surgery. In patients without any manifestations of alkaptonuria or ochronosis such as our case, timely diagnosis of this pathologic condition is momentous for investigation, treatment, and prevention of other organs’ involvement.