Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 35 37 Shahin Akhondzadeh Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Iran 2018 12 24 2018 12 24 No Abstract https://crcp.tums.ac.ir/index.php/crcp/article/view/243 https://crcp.tums.ac.ir/index.php/crcp/article/download/243/278

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 38 41 EN Mojgan Mirabdolhagh Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Sahar Karimpour Reyhan Department of Medicine Internal, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Abbaszadeh Department of Medicine Internal, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2018 01 01 2018 06 26 Hypocalcaemia is a dangerous electrolyte imbalance with 18% prevalence in hospital admitted patients. 1 Regulation of calcium level is by 3 main calcium-regulating hormones. These hormones are parathyroid hormone (PTH), vitamin D, and calcitonin; and they act by effecting on the bowel, kidneys, and skeleton. Causes of hypocalcaemia includes vitamin D deficiency, hypoparathyroidism, renal diseases, hypomagnesaemia, hungry bone disease after parathyroidectomy, drugs like calcium chelators, massive blood transfusion, critical illness, parathyroid hormone resistance, vitamin D resistance. Pseudohypoparathyroidism (PHP) refers to a group of metabolic disorders in which resistance to parathyroid hormone leads to hypocalcaemia, hyperphosphatemia, and elevation of serum PTH level in the setting of normal renal function. Herein we report an interesting case of hypocalcaemia who came to the emergency department with suspicion to intracranial hemorrhage and lead to the diagnosis of  pseudohypoparathyroidism. https://crcp.tums.ac.ir/index.php/crcp/article/view/170 https://crcp.tums.ac.ir/index.php/crcp/article/download/170/279

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 42 43 EN Reza Bidaki Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. AND Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Farzaneh Dehghani Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2018 02 07 2018 07 22 Heterogeneous findings have been reported regarding the effects of anti-depressive drugs over platelet counts. Among antidepressant drugs, Selective Serotonin Reuptake Inhibitors (SSRIs) has been shown to reduce platelet aggregation. We report a patient with reduction in her platelets counts as well as bruising occurrence following three days of receiving sertraline. In patients with a history of bleeding, ITP or familial ITP, their psychiatric treatment and prescribing SSRI should be done with caution.     https://crcp.tums.ac.ir/index.php/crcp/article/view/184 https://crcp.tums.ac.ir/index.php/crcp/article/download/184/280

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 44 49 EN Morteza Farazi Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Marzieh Amrevani Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Zahra Ilkhani Isfahan University of Medical Sciences, Isfahan, Iran. Nasibeh Amirzargar Rofeydeh Rehabilitation Hospital, Tehran, Iran. 2018 03 04 2018 06 26 Wilson’s disease is a rare hereditary disorder passed down in the autosomal recessive way. This disorder involves the speech parts of the brain leading to dysarthria, which impairs all of the five speech systems, i.e. the respiratory, phonation, articulation, resonance, and prosody. The patient studied in this research was a 28-year-old woman with Wilson’s disease, who visited Rofaydeh Rehabilitation Hospital in Tehran City with complaints about severe speech disorders. Based on the clinical and paraclinical examinations the patient was diagnosed with a decrease in the maximum phonation time (MPT) of 2 to 3 seconds, reduced intelligibility and articulation impairment. The patient underwent medicinal, behavioral, and rehabilitation (include speech therapy) treatments. Following a continuous two-year follow-up rehabilitation, a considerable improvement in the speech was observed as an increase in intelligibility (up to 5% of the words), the consistency between respiration and speech and an increase in verbal and nonverbal communications. https://crcp.tums.ac.ir/index.php/crcp/article/view/187 https://crcp.tums.ac.ir/index.php/crcp/article/download/187/281

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 26 50 52 EN Farnoosh Moafi Department of Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran. Hooshang Saberi Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran. Zahra Bajalan Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran 2018 03 13 2018 07 22 Vestibular Schwannoma (VS) is a brain tumor arising from the internal auditory canal, growing towards the cerebellopontine angle. Diagnosis and management of these tumors during pregnancy may present a therapeutic challenge. Herein, we report a case, of a huge VS presented in pregnancy by nonspecific symptoms. Thus, despite increased intracranial pressure and its possibly dangerous sequela, the patient delivered full-term vaginally. Finally, three months after delivery, VS underwent retrosigmoid microsurgical removal. The postoperative period was uneventful, with total hearing loss in her left ear and, transient paralysis of the left seventh cranial nerve. Gynecologists and Obstetricians should consider brain tumors in the differential diagnosis of CNS symptoms in the prenatal period, if there are no pregnancyrelated etiologies to explain. https://crcp.tums.ac.ir/index.php/crcp/article/view/188 https://crcp.tums.ac.ir/index.php/crcp/article/download/188/282

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 53 56 EN Maryam Orooji Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran. Saeed Khosravi Zharfa Medical Imaging Center, Tehran, Iran. Farzaneh Malekpour Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran. Mohammadreza Shalbafan Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran. 2018 04 19 2018 07 21 Due to low prevalence of late onset Obsessive-Compulsive Disorder (OCD), it is more likely to have an organic etiology. In this article we present a 59-year-old man, referred for recently developed obsessive compulsive symptoms, with no prior history of OCD in the past. The symptoms were included ego-dystonic recurrent obsessional doubts, leaded him to compulsive checking several times a day and caused a remarkable distress and functional impairment. His neurological exam revealed no deficit. The most prominent finding in MRI was two large areas of focal gliosis and porencephaly located at head of right caudate. The size was 12 mm which is compatible with lacunar infarct. Frontal subcortical areas of signal change were noted. The symptoms were almost recovered only after 2 months treatment with sertraline 100 mg/daily and bupropione 150 mg/daily. It seems that there is a remarkable relationship between basal ganglia and frontal lesions, particularly infarction, with late-onset OCD. https://crcp.tums.ac.ir/index.php/crcp/article/view/193 https://crcp.tums.ac.ir/index.php/crcp/article/download/193/283

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 59 61 EN Nooshin Shirzad Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran, Department of Endocrinology, Vali Asr Hospital, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahboobeh Hemmatabadi Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran 2- Department of Endocrinology, Vali Asr Hospital, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran. Arezoo Saeedinia Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran. Hoda Rashidian Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, IranEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran. 2018 05 18 2018 07 28 A 30-year-old woman with a 20-year history of type 1 diabetes referred to our clinic with the complaints of facial acne, hirsutism, and irregular menstrual cycles (hirsutism was identified in physical examination). On biochemical analysis, high serum levels of antiTPO and DHEA-S were detected. Based on ultrasonographic findings indicative of thyroiditis and positive anti-TPO test, the diagnosis of Hashimoto's thyroiditis was made. A diagnosis of Polycystic Ovary Syndrome (PCOS) was confirmed later according to the Rotterdam criteria (revised 2003). The patient received metformin and insulin for 3 months and her menstrual cycles became regular. https://crcp.tums.ac.ir/index.php/crcp/article/view/196 https://crcp.tums.ac.ir/index.php/crcp/article/download/196/285

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 62 63 EN Cihan Bedel Department of Emergency Medicine, , Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey. Sefa Türkoğlu Department of Radiology,Denizli State Hospital, Denizli, Turkey. 2018 06 06 2018 07 22 Tracheal bronchus is a rare congenital bronchial anomaly with a prevalence of 0.1-5.0%. The anomaly is generally asymptomatic in adults and detected incidentally bronchoscopy or radiologic examinations. Herein we report a case of tracheal bronchus in an adult male presenting with recurrent haemoptysis and cough. https://crcp.tums.ac.ir/index.php/crcp/article/view/202 https://crcp.tums.ac.ir/index.php/crcp/article/download/202/286

Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 3 2 2018 12 24 57 58 EN Morteza Daraei Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2018 04 29 2018 07 23 Too Many Calcifications https://crcp.tums.ac.ir/index.php/crcp/article/view/194 https://crcp.tums.ac.ir/index.php/crcp/article/download/194/284