Razi Journal of Medical Sciences
Year:2012 | Volume:18 | Issue:93|Papers Count:6

Background: Life expectancy of patients with spinal metastasis is an important factor to manage these patients. Tokuhashi is a scoring system which was the sum of the points of six items: 1.general condition, 2. number of extra spinal bone metastasis, 3. number of metastasis in the vertebral body, 4. presence or absence of metastasis to major internal organs, 5. site of the primary lesion, 6. the severity of palsy. This score can predict survival time. Our study is going to evaluate predictive value of Tokuhashi score in order to select more useful treatment for patient with spinal metastases.Methods: This study is cohort. We had 109 patients with spinal metastasis that selected from February 2007 to March 2009.Tokuhashi score is determined for all patients. We compare the predicted survival from this score with actual survival. Analysis based on Kaplan Meier, Cox regression and McNemar tests.Results: The predicted survival, based on Tokuhashi score, in 38 patients was less than 6 months, in 39 patients, 6-12 months (, and 1 year or more in 32 patients and the actual survival was: 39 patients died at first 6 months of the follow up, 28 at the second six-month period and 42 patients were alive at the end of the year. No significant difference was seen between predicted and actual Survival time (p=0.116). Present study showed that the Tokuhashi revised scoring system may be practicable and highly predictive preoperative scoring systems for patients with spinal metastases.Conclusion: Our study showed the Tokuhashi score system can highly predict the survival of patients with spinal metastasis and it is a trustful tool to use for management of these patients.

Background: Candidal vulvovaginitis is a female genital infection that is occurred by the over growth of candida species and specially Candida -albicans and occasionally it appears as recurrent and chronic and resist to therapy. Fluconazole is one of the current drugs that is used in treatment of this disease and sometimes resistance is observed to this. Therefore indirection of making the therapy better we decided to investigate the activity of fluconazole in combination with silver nanoparticles against candida species isolated from chronic and recurrent candida vaginitis.Methods: This was an experimental study with convenient sampling that was performed on 30 patients. All specimens were examined in direct microscopy, culturing and differential tests to identify different candida species from each other such as culture on candida chrome agar, germ tube, temperature test and sugar assimilation with API. Then the antifungal effects of fluconazole and silver nanoparticles, each of them alone and in combination with each other, were examined. Findings were described on the base of logistic regression and man-vitni exam.Results: In our study 30 specimens of chronic genital candidiasis were diagnosed with isolated agents Candida albicans, glabrata, krusei, tropicalis, parapsilosis and Candida fermata respectively. Also findings suggested that fluconazole was able to inhibit the growth of candida species at an expanded range of concentration between 4-128 microgram per milliliter. As well antifungal activity of Fluconazole with silver nanoparticles was increased in comparison with using Fluconazole alone.Conclusion: For the prevention of recurrent cases and to establish correct diagnosis it is essential to carry out sensitivity and diagnostic tests in laboratory and also administration of silver nanoparticle in combination with fluconazole in drug formulation for topical uses in treatment of chronic vaginal candidiasis and inhibition of recurrent cases, can useful.

Background: Soft tissue sarcoma is a relatively rare disease from mesenchyme cells. Lung metastases occur in many of the patients with limb sarcoma. The aim of this study was the evaluation of lung metastasis due to limb estrogenic and soft tissue sarcoma in the hospitalized patients at Al-Zahra hospital in Isfahan between 1995 and 2008.Methods: This descriptive cross sectional study was done on the hospitalized patients at Al-Zahra hospital in Isfahan between 1995 and 2008. Lung metastases were evaluated by lung CT scan. The data were collected from the patients' dossier and their laboratory file. We used chi-square, fisher and T test, and SPSS software (v.11) for analyzing the collected data.Results: We evaluated 65 patients with limb sarcoma. Lung metastases were detected in 43.3% of the patients with estrogenic sarcoma and 11.4% of the patients with soft tissue sarcoma (p=0.005). There were no relations between occurance of lung metastases and genders, the size of the primary tumor, the side of the stricken limb, and recurrence of the tumor.Conclusion: The incidence of lung metastasis in the patients with osteogenic sarcoma is more than the patients with soft tissue sarcoma. In view of the fact that the incidence of lung metastasis in the patients with osteogenic sarcoma is high, we suggest that these patients be evaluated for lung metastasis.

Background: Endometriosis is a benign disease of female genital system, which often occurs in the reproductive age and it is defined by the presence of tissue resembling endometrial glands and stoma outside the uterine cavity. Endometriosis is found in two types of pelvic and extra pelvic. The most common type of extra pelvic endometriosis is cutaneous endometriosis which can occur either spontaneously or secondary to abdomino-pelvic surgeries. Abdominal wall endometriosis is the most common type of cutaneous endometriosis that its diagnosis is difficult. The purpose of this study is to determine the prevalence of abdominal wall endometriosis in patients with endometriosis.Methods: In this retrospective cross-sectional study, 323 patients with endometriosis and definite histopathological diagnosis who admitted in Rasool-Akram, Shariati and Atieh Hospitals during 1384 to 1389 were enrolled. The sampling method was census and the study variables included patient age, history of pelvic or abdominal surgery, history of cesarean section and the delivery frequency of patients, location of endometriosis and its clinical presentation. Information was gathered from medical records of patients. Finally, data analysis was performed using SPSS software.Results: The prevalence of Extra Pelvic endometriosis was calculated 14.8% (48 cases that 40 cases were abdominal wall endometriosis, 5 cases cervical endometriosis, vaginal endometriosis in 1 case and 2 cases of perineal endometriosis). The prevalence of abdominal wall endometriosis was 12.3 percent of all cases of endometriosis in which cesarean scar endometriosis and umbilical endometriosis were found in 38 cases (11.7 %) and 2 cases (0.6%) respectively. History of previous cesarean section in patients with abdominal wall endometriosis was significantly more than patients with other types of endometriosis (100% vs.24.6%) (p=0.0001). Average number of delivery and cesarean section in patients with abdominal wall endometriosis were significantly higher than other patients (p=0.002 and p=0.0001 respectively). Infertility in patients with endometriosis in other places was significantly higher than patients with abdominal wall endometriosis (p=0.01). The predominant symptom in patients with abdominal wall endometriosis was, localized pain and swelling in abdominal wall at the surgical scar that become worse during menstruation.Conclusion: abdominal wall endometriosis is seen in two forms of surgical scar and umbilical endometriosis. The prevalence of abdominal wall endometriosis among all types of endometriosis was 12.3% and all the cases of abdominal wall endometriosis have the positive history of cesarean section.The mean age of these patients was 34 years, and attention to this prevalence, predominant symptoms, prevalent age, and history of cesarean section in patients, will help and facilitate the diagnosis.

Background: As there are some limited studies, we aimed to evaluate the relation between Idiopathic hematuria and preeclampsia in Iranian multiparas.Methods: 400 women between 11th and 21th weeks of pregnancies without UTI and other kidney disease were enrolled.200 women, had shown Idiopathic hematuria, matched by age and other condition to others. Mean, median, range, standard deviation, frequency and frequency percentage were determined using statistical software SPSS V.19 and descriptive analyses. For comparison of qualitative means, independent T test was used after the normal distribution of data to determine. It is followed by 1-sample KS. K.s-Ttest-Chi square statistical test was used for the comparison of qualitative ratios. In all tests, significance level was considered as two tails, and p<0.05.Results: 31 of hematuric pregnant (%15.4) and 14 of non-hematuric women (%7.2), developed preeclampsia. Which was significant (PR=1.91, p=0.002 and has shown a two- fold increased risk of preeclampsia among hematuric women. However there were no significant correlation between gestational hypertension and hematuric event (PR=0.69, p=0.12).Conclusion: Idiopathic hematuria identified during pregnancy is associated with greater risk of preeclampsia but not gestational hypertension.

Background: Acute vomiting is one of the most common side effects of chemotherapy during the first 24h in patients with cancer. This study investigated the palliative effect of ginger extract on the rate of this complication.Methods: This study was a randomized, double-blind, placebo-controlled clinical trial that was conducted from August to December 2009 in Imam Khomeini Hospital on 80 women with breast cancer undergoing 1-day chemotherapy periods and suffering from vomiting. After obtaining written consent, the samples were randomly assigned into intervention and control groups. Two groups were matched with each other based on the age and emetic risk of chemotherapy drugs used. Participants of the ginger group received ginger capsules (250mg, orally), four times a day (1gr/d) and the samples from the control group received placebo capsules containing starch from three days before to three days after chemotherapy. During this period, to measure the effect of capsules, a two-part questionnaire was used. So, the patients filled these tools out every night. Then, gathered data were analyzed using statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square by the STATA software version 8.Results: The two groups were matched with each other according to the emetic risk of chemotherapy drugs and disease duration (p=0.1, p=0.06, respectively). Results indicated that the cases of vomiting in the acute phase were significantly lower in the ginger group compared with placebo group (p=0.04). Also taking ginger capsules compared with placebo did not wake certain complications (p=0.06).Conclusion: Taking ginger powder capsules (1gr/d) starting three days before chemotherapy for six days and beyond the routine anti-emetic regimen could reduce the acute phase vomiting.