Iranian Red Crescent Medical Journal
Year:2015 | Volume:17 | Issue:10|Papers Count:19

Introduction: Paraquat is a widely used nitrogen-based herbicide which is lethal and causes multi-organ failure by accumulation in cells, which subsequently leads to death.Case Presentation: The present case report introduced a 25-year-old male with nausea, vomiting, and severe substernal burning sensation after incidentally ingestion of a large amount of paraquat. The treatment of the patient with antioxidants (N-acetylcysteine and vitamin E) and hemodialysis started immediately after arriving to the hospital.Conclusions: Immediate and adequate use of antioxidants and hemodialysis has an undeniable and important role in survival of patients after ingestion of a large amount of paraquat.

Background: Epilepsy affects children’s quality of life and leads to social and mental problems. Promoting the mental health of children, especially epileptic ones, and preventing problems affecting them constitute major concerns for every country. Mental health promotion requires intervention programs.Objectives: We sought to assess the efficacy of attribution retraining on the mental health of epileptic children.Patients and Methods: The present study is a semi-experimental investigation with a pretest and posttest design and includes a control group. Thirty children, comprising 17 boys and 13 girls, were selected randomly from the Iranian epilepsy association in Tehran and assigned to experimental and control groups. They answered to the general health questionnaire (Goldberg and Hiller, 1979). The experimental group participated in 11 training sessions (twice a week; 45 minutes for each session) and received attribution retraining. The data were analyzed using the multiple analysis of covariance.Results: The findings showed that the experimental group, in comparison with the control group, experienced a reduction in physical symptoms, anxiety and insomnia, social dysfunction, and depression and an increase in mental health significantly (P<0.01) after the training sessions. There were no significant differences, however, between the two groups at 6 weeks’ follow-up.Conclusions: Attribution retraining improved mental health in the epileptic children in our study. It, therefore, seems to be an appropriate intervention for promoting the mental health of children.

Background: Oocyte cryopreservation is an important part of modern fertility treatment. The effect of vitrification on the fertilization and developmental rates of embryo is still a matter of debate.Objectives: This study aimed to investigate the effect of vitrification on the success of mouse oocyte maturation, fertilization, and preimplantation development in vitro.Materials and Methods: In this experimental study, a total of 200 germinal vesicle (GV) and 200 metaphase II (MII) oocytes were obtained from ovaries and fallopian tubes of NMRI mice, respectively and divided into two control and experimental (vitrified) groups. Oocytes in the experimental group were vitrified by Cryotop using vitrification medium (Origio, Denmark) and kept in liquid nitrogen for one month. Then, they were cultured in maturation medium for 24 hours. In vitro maturated metaphase 2 (IVM-MII) and ovulated metaphase 2 (OV-MII) oocytes were inseminated and the fertilized embryos assessed until the hatching blastocyst stage. Outcomes were assessed for statistical significance by Chi-square test using SPSS software.Results: Vitrification caused a significant reduction in the maturation rate of oocytes. Of those that matured, the fertilization rate of vitrified IVM-MII (44.1%) and OV-MII oocytes (50%) was not significantly different from each other but both were significantly lower than the control group (P<0.05). There was no significant difference in developmental rates of both vitrified groups and the control group.Conclusions: The present study showed that vitrification using Cryotop and freezing medium can damage oocytes by reducing the maturation and fertilization rates in both developmental stages.

Background: One of the acquired biological hallmarks of tumor multistep development is the resistance of cancer cells to apoptosis; therefore, induction of apoptosis is an important therapeutic approach. Hypericum species are spread throughout the world and have been investigated for their biological properties.Objectives: Our previous studies had demonstrated cytotoxicity of Hypericum scabrum L. methanol extract against some tumor cell lines, suggesting the species for further studies. The objectives of the present study were to determine the most cytotoxic fraction of Hypericum scabrum L. and to assess the apoptosis induction ability of the most effective fraction as well as its methanol extract. The laboratory evidence has been presented to support the potency of Iranian Traditional Medicine (ITM) medicinal plants as a source of different biological activity surveys and drug discoveries.Materials and Methods: The present research is a descriptive study. The sampling strategy was based on ITM data of cancer phytotherapy. Hypericum scabrum was collected from Alborz province, Iran (2012) and the herbarium specimen was taxonomically identified. The petroleum ether, dichloromethane, and methanol fractions have been evaluated for cytotoxicity against M-CF7, A-549, HT-29, and HepG-2 cell lines through 3- (4, 5-dimethylthiazol-2-yl) -2, 5-diphenyltetrazolium bromide or MTT assay. The apoptosis induction ability has been assessed by activated caspase-3 inspection and Annexin V FITC/PI (propidium iodide) assays.Results: Di-chloromethane fraction demonstrated IC50 values of 25.72 mg/mL and 24.73 mg/mL against HT-29 and HepG-2 cell lines, respectively and IC50 values of petroleum ether fraction were 22.6 mg/mL and 18.31 mg/mL against HT-29 and HepG-2, respectively. The methanol fraction did not show cytotoxic activity. Both the methanol extract and the petroleum ether fraction of Hypericum scabrum L. revealed apoptosis induction ability.Conclusions: Considering the strong historical background about the therapeutic potential of the genus Hypericum and the considerable cytotoxic and apoptosis induction ability of Hypericum scabrum, this species is suggested for future biological studies.

Introduction: Autoimmune haemolytic anemia (AIHA) is a complex process characterized by an immune reaction against red blood cell self-antigens. The analysis of specimens, drawn from patients with cold auto-immune hemolytic anemia is a difficult problem for automated hematology analyzer. This paper was written to alert technologists and pathologists to the presence of cold agglutinins and its effect on laboratory tests.Case Presentation: A 72-year-old female presented to the Shafa laboratory for hematology profile evaluation. CBC indices showed invalid findings with the Sysmex automated hematology analyzer. Checking the laboratory process showed precipitation residue sticking to the sides of the tube. After warming the tubes, results become valid and the problem attributed to cold agglutinin disease. In this situation, aggregation of RBCs, which occurs at t<30oC, causes invalid findings meanwhile working with automated hematology analyzer.Conclusions: Knowledge of this phenomenon can help prevent wasting too much time and make an early and accurate diagnosis.

Background: Perceived sociocultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Adolescents face special problems that are less common during childhood. Several studies indicate that the prevalence of eating disorders has been increased among adolescents.Objectives: The aim of the present study was to investigate the occurrence, prevalence and correlates of eating disorders (ED) among adolescents in two cities of Iran, Urmia and Tabriz.Patients and Methods: This was a cross-sectional survey in which 1990 adolescent boys and girls were selected through multistage random sampling. The study was based on self-report questionnaires including eating attitudes test (EAT-26) and DSM-IV criteria for the presence of eating disorders. To analyze the obtained data we calculated measures of central tendency and dispersion, linear and logistic regression and Fisher’s exact test.Results: According to diagnostic criteria of EAT-26, 492 students (24.2%) were at risk of ED and scored above the recommended cut-off point on EAT-26. Among 1990 students, a total of 51 cases (0.25%) of eating disorder (14 anorexia nervosa, 18 bulimia nervosa, and 19 eating disorder not otherwise specified) were diagnosed.Conclusions: The obtained prevalence of ED in our study was higher than previous studies in Iran. We found high numbers of boys with ED. Overweight adolescents were shown to be more susceptible to strict dieting than normal-weight adolescents. These results suggest that it is necessary to provide screening and treatment services for Iranian adolescents. Further research is needed to develop intervention programs to control eating disorders among Iranian adolescents.

Background: Bronchoalveolar lavage (BAL) is a noninvasive and useful technique for evaluating interstitial lung diseases (ILDs). Flow cytometric analysis of BAL fluid reveals specific diagnostic information in some unusual ILDs, and helps to narrow down the possible causes of interstitial diseases in most patients with more common disorders. A high BAL CD4/CD8 ratio is highly specific for sarcoidosis but can also be seen in other ILDs.Objectives: In this retrospective, descriptive, cross-sectional study, we compared BAL fluid characteristics and clinical variables in patients with sarcoidosis and non-sarcoidosis ILDs in a large cohort.Patients and Methods: The study was conducted in a tertiary university hospital in Zonguldak, the biggest city of the western Black Sea region of Turkey. Between 2004 and 2014, all patients who underwent both fiberoptic bronchoscopy and BAL with a suspicion of ILD were included in the study, retrospectively. Patients were divided into two main groups: sarcoidosis and non-sarcoidosis ILDs. Non-sarcoidosis ILDs were further divided into subgroups: pneumoconiosis, tuberculosis (TB), collagen vascular diseases, idiopathic interstitial pneumonias, malignancies, and unclassified ILDs. The clinical data of patients, including age, gender, smoking status, pulmonary function tests, and BAL flow cytometric analysis results, were compared among groups.Results: In total, 261 patients (119 sarcoidosis and 142 non-sarcoidosis ILDs) were enrolled. The median (interquartile range) BAL CD4/CD8 ratio and lymphocyte fraction were significantly higher in sarcoidosis than in non-sarcoidosis ILDs: 3.88 (3.76) versus 0.88 (1.01), respectively, and 20.6 (28.3) versus 6.0 (13.7), respectively. T cell receptor γ delta, CD16+56+, CD103+, CD8+103+, and CD3+16+56+cells were significantly lower in sarcoidosis than in non-sarcoidosis ILDs. The median BAL CD4/CD8 ratios were significantly higher in patients with TB (1.87, P=0.01) and malignancies (1.69, P=0.03) than in other non-sarcoidosis ILDs.Conclusions: Among BAL fluid flow cytometric parameters, CD4/CD8 and lymphocyte fraction may be helpful for distinguishing sarcoidosis from other ILDs, but they are neither specific nor diagnostic for any lung disease. Thus, a multidisciplinary diagnostic discussion is required to differentiate various ILDs.

Background: Hand hygiene is considered one of the most important infection control measures for preventing health care-associated infections. Although the techniques involved in hand hygiene are simple, compliance with hand hygiene recommendations is poor worldwide.Objectives: We sought to perform a knowledge, attitudes, and practices (KAP) study on hand hygiene among medical residents at Imam Hossein hospital, Tehran, Iran.Patients and Methods: This cross-sectional KAP study was conducted among medical residents in Imam Hossein hospital, Iran, 2013. All medical residents from different wards were invited to participate in this study (270 in total). The world health organization questionnaires and an observational checklist were used to collect data. The χ2 test and the Fisher exact test were utilized to analyze the qualitative variables. Since the quantitative variables had no normal distribution, the Mann-Whitney test and the Kruskal-Wallis method were employed. A P value<0.05 was considered statistically significant. The data were analyzed using SPSS, version 17.Results: The mean overall score of the residents’ knowledge was 14.2 ± 2.6 (mean ± SD). The residents received weak scores in attitudes and practices. Forty-nine percent (n=124) of the residents responded to the questions on attitudes toward hand hygiene, and only 20.16% (n=25) managed to identify the correct answer. Moreover, 3.1% (n=8) of the residents adhered to the 8 standard steps, 12.1% (n=31) washed their hands for 20 - 30 seconds, and only 2 residents observed the sequences of hand hygiene. Additionally, none of the residents performed hand washing with available means (water and hand-washing liquid) in the morning visit hours.Conclusions: Concerning hand hygiene, the residents had moderate knowledge but overall poor attitudes and practices. The present study underscores the need for further improvement in the existing training programs to address the gaps in KAP regarding hand hygiene.

Background: Stressful situations and life-threatening issues such as preeclampsia can lead to Post-traumatic stress disorders [PTSD]. It seems that within social supports, family support has more effect on mental health.Objectives: The aim of this study was to determine the association between family supports in the postpartum period with occurrence of post-traumatic stress disorder following preeclampsia.Patients and Methods: In this descriptive longitudinal study, 100 women with preeclampsia admitted in government hospitals of Mashhad were selected using convenience sampling. Post-traumatic stress disorder was diagnosed by psychiatrist interview and perinatal posttraumatic stress questionnaire (PPQ) in sixth week postpartum and family support was measured by family support scale (FSS) in second and sixth weeks postpartum. Data analyzed by SPSS 16 using Spearman correlation coefficient, paired sample T-test and Kruskal-Wallis test.Results: A reverse significant association was found between family support in weeks 2 and 6 (92.6 ± 22.6, 83.7±21.6, respectively) and PTSD (mean score of 4.8±2.5) (respectively, P=0.010 and P=0.011). The most important variables affecting PTSD with presence of family support in weeks 2 and 6 were postpartum depression in week 6 as well as trait anxiety at the time of admission.Conclusions: The more support in weeks 2 and 6 postpartum, the less PTSD occurs. Therefore, it is suggested to health care providers who face mothers after delivery to evaluate the support received by mothers and help those with inadequate or inappropriate support.

Background: The factors affecting the correlation between Parkinson disease (PD) and depression have remained unclear.Objectives: We assessed the prevalence of depression among patients with PD and the association between PD-related variables and depression severity.Patients and Methods: This is a cross-sectional study performed in Kermanshah Province of Iran. Sampling was based on recruitment of subjects according to inclusion and exclusion criteria. Patients with confirmed Parkinson disease who were referred to clinics of Kermanshah University of Medical Sciences participated in this study. Depression was evaluated with Beck Depression Inventory-II (BDI-II). Clinical characteristics of PD, including tremor, rigidity, impaired posture, loss of autonomic movement, changes in speech and handwriting, masked face, and hyposmia were indexed. Anhedonia was assessed with Farsi version of Snaith-Hamilton Pleasure Scale. Data were collected between April 2010 and March 2014.Results: A total of 350 patients (52.9% men and 47.1% women) participated in this investigation. Female gender (36.5% in women vs.13.0% in men, P<0.0001), impaired posture (27.2% in affected individuals vs.18.8%, P=0.002), masked face (39.0% vs.5.2%, P<0.0001), and hyposmia (48.7% vs.21.0%, P=0.001) were associated with higher susceptibility to profound depression. Lower scores of all domains of Farsi version of Snaith-Hamilton Pleasure Scale (including interest/pastimes, social interaction, sensory experience, and food/drink) were related to more severe depression (P<0.0001 for all subscales). Severe and profound depression was found in 44% of the participants.Conclusions: This study estimated that the prevalence of major depression among Iranian individuals with PD living in Kermanshah as 44%. Major determinants of depression were female gender, rigidity, impaired posture, masked face, hyposmia, and anhedonia.

Background: There are several studies regarding sexual dysfunction in chronic diseases such as diabetes and renal failure; however, no significant study has been done on Iranian rheumatoid arthritis (RA) patients.Objectives: In this study, we aimed to identify and compare sexual dysfunction between RA patients and the normal population.Patients and Methods: In this case-control study, two groups of females (87 RA patients and 89 controls) were randomly selected from the rheumatology clinic of Baqiyatallah Hospital, Tehran, Iran. General health questionnaire (GHQ-28) and multidimensional sexual self-concept questionnaire (MSSCQ) were used to evaluate RA patients. We used SPSS for statistical analysis mainly by the t-test and chi-square test. P values less than 0.05 were considered significant.Results: In the GHQ-28 evaluation, RA patients had lower social function; however somatization rated higher in normal patients (P<0.05). Sexual health was lower in the RA population (P<0.05). No significant difference was found in sexual desire. Except sexual pain, other sexual health parameters were lower in RA patients. The scores were as follow: sensation 13.6±4.4 vs.12.2±4.5, P=0.024; lubrication 6.9±2.1 vs.6.2±2.1, P=0.017; orgasm 10.4±2.8 vs.9.5±3.2, P=0.37; pain 10.1±2.2 vs.10.8±1.9, P=0.013; enjoyment 23.8±5.8 vs.21.3±7.5, P=0.009 and partner related - 8.5±1.7 vs.7.6±2.4, P=0.005. Furthermore, the concern of losing their sexual partner was higher in the normal population.Conclusions: Our study demonstrated that almost all GHQ and MSSCQ parameters were lower in RA patients, which indicates lower quality sexual life in RA patients. We recommend further consideration for the treatment and care of these patients.

Background: Articular cartilage injuries of the knee are among the most debilitating injuries leading to osteoarthritis due to limited regenerative capability of cartilaginous tissue. The use of platelet concentrates containing necessary growth factors for cartilage healing has recently emerged as a new treatment method.Objectives: The efficacy of two types of different platelet concentrates were compared in the treatment of acute articular cartilage injuries of the knee in an animal model.Materials and Methods: Eighteen adult Iranian mixed breed male dogs were used to conduct this experimental study. Full thickness articular cartilage defects (diameter 6 mm, depth 5 mm) were created in the weight bearing area of femoral condyles of both hind limbs in all dogs (n=72). Twelve dogs were randomly selected to receive treatment and their right and left hind limb defects were treated by L-PRP and L-PRF implantation respectively, while no treatment was undertaken in six other dogs as controls. The animals were euthanized at 4, 16 and 24 weeks following surgery and the resultant repair tissue was investigated macroscopically and microscopically. At each sampling time, 4 treated dogs and 2 control dogs were euthanized, therefore 8 defects per group were evaluated.Results: Mean macroscopic scores of the treated defects were higher than the controls at all sampling times with significant differences (P<0.05) observed between L-PRF treated and control defects (10.13 vs.8.37) and L-PRP treated and control defects (10 vs.8.5) at 4 and 16 weeks, respectively. A similar trend in mean total microscopic scores was observed with a significant difference (P<0.05) between L-PRP treated and control defects at 4 (9.87 vs.7.62) and 16 (13.38 vs.11) weeks. No significant difference was observed between the platelet concentrate treated defects in either mean macroscopic scores or mean total microscopic scores.Conclusions: Both L-PRP and L-PRF could be used to effectively promote the healing of articular cartilage defects of the knee.

Background: It cannot be denied that many improvements in female and child health have been achieved worldwide through international family planning programs. More than half of the females (57%) with unintended pregnancy admitted that they had not used birth control the month before conception.Objectives: The aim of this study was to promote family planning practice among females of Zahedan (southeast of Iran) through the transtheoretical model (TTM).Patients and Methods: The current quasi-experimental study was conducted on 96 eligible females, who were allocated either to the case or the control group and were selected from homes in the border of Zahedan city (southeast of Iran) during 2010. Convenience sampling by door-to-door visits was used for finding eligible cases. A TTM-based self-administrated family planning questionnaire was used for data collection. Participants in the intervention group received education in two groups, based on their stage of change: precontemplation, contemplation, preparation, action, maintenance, and all groups were followed for three months.Results: The result of the chi-square test did not show any significant difference in the stage of change: precontemplation, contemplation, preparation, action, maintenance before education between the control and intervention groups (P=0.55). After education, subjects in the intervention group moved forward through stage of change and got at least one step closer to the family planning behavior., with this change being significant (P<0.001), while the movement of participants through stage of change not being significant in control group (P=1). The results of statistical tests illustrated that the mean knowledge of the intervention group was 7.5±7.1 versus 0.5±4 for the control group (P<0.001), mean of attitude of the intervention group was 5.5±5.41 versus 0.09±2.04 for the control group (P<0.001), and practicing family planning methods (P<0.007) in the intervention group was higher than the control group after education based on TTM.Conclusions: According to this study, the educational plan based on TTM was effective in changing knowledge, attitude, and practice and directing females towards taking action. Moreover, self-efficacy, perceived barriers and benefits are factors that affect the use of family planning methods.

Background: Stomatitis is a common oral complication which affects 100% of patients undergoing head and neck radiotherapy. Acute stomatitis might cause failure and delay radiotherapy. Attention to mouth hygiene, particularly using mouthwash, has a fundamental importance for these patients.Objectives: The current study came to addresses the effects of pure natural honey on radiation-induced stomatitis in patients with a variety of head and neck cancers.Patients and Methods: The present single-blinded nonrandomized controlled trial was conducted on 105 patients undergoing radiotherapy due to head and neck cancer at the radiation unit of Shafa hospital in Kerman, Iran, from October 2012 to March 2012. The research groups were selected by writing the names of the protocols (the mouthwashes of chamomile, honey and the common caring protocol at ward which uses water) on three cubes. The first extracted cube was related to the chamomile mouthwash (Matrica), the second to the honey mouthwash and the last cube to the water mouthwash. The first experimental group (n=35) gurgled a solution containing 20 mL diluted honey, the second group gurgled a solution containing German chamomile, and the 35 patients in the control group were advised to gurgle 20 mL water (the ward routine).Results: The results showed that severe stomatitis in groups of honey, chamomile and control was 0, 5.7%, and 17.6%, respectively. On the 14th day, it was 0, 0, and 17.6%, respectively. There were significant differences between the three groups regarding the severity of stomatitis in the 14th day (P<0.001).Conclusions: The application of natural honey is effective in managing and preventing radiation-induced stomatitis in patients with head and neck cancers.

Background: Because of occupational accidents, permanent disabilities and deaths occur and economic and workday losses emerge.Objectives: The purpose of the present study was to investigate the factors responsible for occupational accidents occurred in Iran.Patients and Methods: The current study analyzed 1464 occupational accidents recorded by the Ministry of Labor and Social Affairs’ offices in Iran during 2008 - 2012. At first, general understanding of accidents was obtained using descriptive statistics. Afterwards, the chi-square test and Cramer’s V statistic (Vc) were used to determine the association between factors influencing the type of injury as occupational accident outcomes.Results: There was no significant association between marital status and time of day with the type of injury. However, activity sector, cause of accident, victim’s education, age of victim and victim’s experience were significantly associated with the type of injury.Conclusions: Successful accident prevention relies largely on knowledge about the causes of accidents. In any accident control activity, particularly in occupational accidents, correctly identifying high-risk groups and factors influencing accidents is the key to successful interventions. Results of this study can cause to increase accident awareness and enable workplace’s management to select and prioritize problem areas and safety system weakness in workplaces.

Background: Studying medicine is perceived to be stressful, and a high level of stress may have a negative effect on cognitive functioning and mental health of the students.Objectives: In this study, we assessed perceived stress and its severity, sources and determinants.Patients and Methods: In this cross-sectional study, we assessed the perceived stress and its severity, sources and demographic variables in 341 (136 males, 205 females) randomly selected medical students of Tehran university of medical sciences, Iran, in October 2013. A self-administered valid and reliable questionnaire with a possible range of scores from 0 to 56 was used to collect the data. Stress sources were determined using logistic regression analysis.Results: The overall perceived stress mean was 32.02 (SD=5.08). Eighty-three percent of the medical students perceived stress. Students in clinical phase perceived more stress than basic sciences ones [OR 2.25, 95% CI 1.809 - 4.032]. Logistic regression analysis showed demographic (including gender and residential status), psychosocial and academic factors and the phase of study as sources of stress.Conclusions: The results of this study show that most of the medical students declared perceived stress. So, a change in medical education environment and empowering students to effectively cope with the perceived stress sources and their families to support their children is needed.

Background: Nutritional factors play an important role in cataract disease and the healthy eating index (HEI) is a unique approach to study the relationships between diet and diseases.Objectives: The current study aimed to evaluate and compare healthy eating index among the patients with cataract and healthy individuals.Patients and Methods: This case-control study was conducted on 97 patients with cataract and 198 healthy people (as a control group) in Iran. Individuals were selected by the convenience sampling method and the food frequency questionnaire (FFQ) was completed for them. At first, HEI was calculated and then the HEI scores were compared in cataract patients and healthy individuals.Results: The analysis of FFQ showed that the scores of vegetables (7.81 v.10), nutritional variation (5.5 v.7) and sodium (2 v.6) groups (P<0.001) were significantly lower among the patients with cataract than the healthy individuals. Also this significant difference was observed in the scores of total HEI and fruits (respectively 73.26 v.79.30 and 7.1 v.9.8) (P<0.01). On the other hand, the scores of saturated fatty acids (10 v.9; P=0.02), total fat (8 v.7; P=0.004) and cereals (10 v.10; P<0.001) were higher among the patients with cataract than the healthy individuals. The comparison of dietary intake among all types of cataract shows that the scores of the meat group were significantly higher in the patients with nuclear cataract and mixed cataract than the ones with posterior cataract (respectively 9.4 v.6.5 and 9 v.6.5) (P=0.02). In addition, after adjusting the confounding factors the results showed that the HEI high score was associated with reducing the risk of coming down with cataract (OR=0.18, CI: 95%, P<0.001, 0.08 - 0.41).Conclusions: The results of the current study suggest that increasing the quality of the diet calculated according to HEI can reduce the risk of coming down with cataract.

Introduction: A rare condition in newborns called congenital chylothorax (CC) occurs when lymphatic fluid accumulates within the pleural cavity. Here is a presentation of a birth traumatic case with bilateral pleural effusion successfully treated by octreotide.Case Presentation: A 3100-g-term male newborn delivered vaginally from a 33-year-old mother was admitted to the neonatal intensive care unit with respiratory distress signs. Early chest x-ray (CXR) showed bilateral pleural effusion. The thoracentesis pleural fluid had been drained with these characteristics: glucose: 1.9425 mmol/l, protein: 11 g/l, cholesterol: 1.295 mmol/l, and triglycerides: 3.39 mmol/l. Counts of red blood cells and white blood cells were 10, 000 and 2500 per Cu/mm, respectively; so, congenital chylothorax was diagnosed and total parenteral nutrition (TPN) were initiated. Accumulation of plural fluid was approximately stopped after begging TPN for two weeks. Therefore, we started feeding with a medium chain triglyceride (MCT), but plural effusion was seen once again and we had to restart TPN. We decided to start octreotide subcutaneously (1 mg/kg/day). Finally, the CXR and ultrasound ’did not show any pleural effusion in both sides and the ultrasound done in the third month showed no pleural effusion either.Conclusions: Octreotide therapy as one of the conservative managements for CC can be considered before surgical methods. This treatment method also had some effects on the feeding initiation time and helped us to start feeding sooner. However, more studies like clinical trials are still necessary to investigate all aspects of octreotide treatment to determine the amount of its dose, initiation time, treatment duration, etc.

Background: Alterations in p53 and p27KIP1 have been documented as important events in the carcinogenesis of various cancers, but their prognostic role in oral squamous cell carcinoma (OSCC) remains controversial.Objectives: The present investigation aimed to evaluate the clinicopathologic and prognostic significance of p53 and p27KIP1 expression in a group of Iranian patients with OSCC.Patients and Methods: In this analytical cross-sectional study, medical records of patients with primary OSCC, diagnosed from 1994 to 2004 were reviewed and 28 subjects were selected based on the inclusion/exclusion criteria. Immunohistochemical staining using monoclonal antibodies against p53 and p27KIP1 was performed on representative archival paraffin blocks. Demographic data along with information on p53 and p27KIP1 expression, recurrence, and tumor grade was statistically analyzed using the Fischer exact test. Prognostic factors for overall survival were determined by Cox regression analysis (P<0.05).Results: p53 and p27KIP1 expression were found in 28.57% (8 positive versus 20 negative) and 67.85% (19 positive versus 9 negative) of OSCC cases, respectively. There was no significant association between these two proteins (P=0.371), and neither of them showed a significant relationship with the studied clinicopathologic variables (P>0.05). In survival analysis, only histopathologic differentiation (17 low and moderate, 11 poor) demonstrated a significant correlation with overall survival (P=0.048).Conclusions: Despite the fact that abnormalities in p53 and p27KIP1 may be involved in the development of OSCC, their clinical significance in the studied population seems limited. Further investigation on the combined p53/p27KIP1 expression may be helpful in predicting the biologic behavior of this tumor.