Background: For any radiologist, intra-observer agreement in observing and decision making in diagnosis of any disease is of great importance, and so is observing and reading ultrasound pictures of ovarian masses and distinguishing amongst their categories. Aims: In this study, the reliability and consistency of ultrasound diagnosis of ovarian tumors have been evaluated. Settings and Design: Two experienced and three less experienced radiologists assessed ultrasounds of 40 patients of Mirza Koochak Khan Hospital in Tehran, Iran, in 2005. Materials and Methods: In this prospective observational study, the ultrasounds were performed by an expert radiologist, with a single apparatus. These ultrasounds have been evaluated separately and independently in two periods (with a 1-week interval). Statistical Analysis Used: Weighted kappa was used to calculate intra-observer agreement (reliability), and two statistical models were applied to assess category distinguishability (consistency). SPSS version 10, SAS version 8, and EXCEL 2003 have been used to do an appropriate statistical analysis. Results: Mean of weighted kappa was 0.81, and mean of distinguishability was 0.995 for our experienced radiologists, due to their superior results. Because of weaker results obtained by the less experienced radiologists, mean of weighted kappa and mean of distinguishability were 0.65 and 0.967 respectively. Overall mean of distinguishability for benign and borderline categories was 0.969; and for malignant and borderline categories, it was 0.987. Conclusion: Although experienced radiologists functioned better than the less experienced radiologists, all of them showed appropriate distinguishability and intra-observer agreement in diagnosis and categorization of the ovarian masses. Distinguishing benign category from borderline was more difficult than distinguishing malignant category from borderline. In general, experienced radiologists showed better results compared to less experienced radiologists.

Background: Clinical diagnosis of neurocysticercosis (NC) is established by CT scan and MRI. However, absolute diagnosis is not possible in a fair number of cases, and serological assays are used as adjunct. Besides, CT scan and MR imaging are resource-intensive tests and not practical for screening in endemic areas. Aim: To provide a low-cost, efficient, and reproducible assay for the detection of antibodies against cysticerci. Hence we have attempted to standardize and evaluate the diagnostic utility of the cysticercus fasciolaris antigen in a Dot ELISA assay for diagnosis of NC. Setting and Design: Tertiary hospital-based, case-control series. Materials and Methods: Confirmed cases of NC diagnosed by presence of ring lesions in CT scan or MR imaging with presence of scolex were taken as positive controls (n = 50). Negative controls (n = 50) included subjects with normal CT scan studies (n = 30) and diseased controls with ring lesions in CT scan confirmed to be neurotuberculosis (n = 20). Dot ELISA was standardized and validated with commercially available ELISA (UBI, USA) using sera from the study groups. Statistical Analysis: Chi-square test was used to compare the immunodiagnostic performance of the two tests. P value less than .05 (P <0.05) was considered significant. Results: The Dot ELISA had a sensitivity of 88% and specificity of 74% with a positive predictive value of 77.19% and negative predictive value of 81.06%. Likelihood ratios for a positive and a negative test were 3.4 and 0.2. The sensitivity and specificity of commercial ELISA were 92% and 84% respectively. Difference between the performances of the two tests was not significant statistically. Conclusions: Dot ELISA has sensitivity and specificity comparable to ELISA for the diagnosis of NC. The test is simpler, not requiring expertise and instrumentation. Further validation of the test as a screening tool is required.

Background: Young children living with parents who smoke are exposed to unacceptable health hazards. Aim: To determine patterns of parental smoking, the level of parental awareness about hazards of secondhand smoke, and the effect of risk awareness on smoking behavior. Setting: Health centers affiliated with two teaching hospitals in Tehran. Design: Cross-sectional. Materials and Methods: Data was collected from parents of preschool children visiting the health centers, through face-to-face interview, during a period of 18 months. Statistical Analysis: Data was analyzed by multiple logistic regression, and analysis of variance was done for comparison of means. Results: In a total of 647 families, prevalence of parental smoking was 35.7%, (231 families). In 97.8% of smoking families, only the fathers smoked; and in 5 (2.2%) families, both parents were regular smokers. Prevalence of smoking was higher in poor families as compared with families who were well-off (39% vs. 25%; P = 0.025), and also in families with lower educational level. There was no significant difference in risk awareness between smokers and nonsmokers (P > .05). Conclusion: Low socioeconomic status and low education were identified as risk factors for children's exposure to secondhand smoke; parental risk awareness had no apparent effect on the smoking behavior. Unlike western societies, fathers were the sole habitual smokers in most families. Since factors that influence smoking behavior vary in different cultures, interventional strategies that aim to protect children from the hazards of tobacco smoke need to target diverse issues in different ethnic backgrounds.

In mass disaster situations, demands frequently exceed the capacity of personnel and facilities. In the last few years, there has been an increased incidence of civil disasters; the spectrum of possible catastrophes has also dramatically increased as a result of an increasingly technologically sophisticated society. During the last 15 years, varied terrorist activities have become increasingly common as expressions of the opinions of extreme political groups, especially in India. In Mumbai itself, we have witnessed disasters such as widespread riots, terrorist bomb blasts, floods, and fires. There have been other disasters in India, such as earthquakes, floods, cyclones, as well as tsunamis Though most of the hospitals in India manage the medical problems associated with these disasters fairly efficiently, an analysis of the situation is presented so that this may form the basis for future planning in disaster preparedness and provide a template for other communities that may want to implement preparedness protocols. We present our experience with disaster management in Mumbai, India. A successful medical response to multi-injury civilian disasters, either natural or man-made, dictates formulation, dissemination, and periodic assessment of a contingency plan to facilitate the triage and treatment of victims of disaster.