Epidemiology and outcome of 2,590 burned patients in Northwest Iran

Burns are calamities with considerable morbidity and mortality rates. We attempted to examine the epidemiology of burns in Zanjan city, in northwest Iran, by a systematic study of existing information. The medical files of 2,590 thermal burn patients treated in our hospital in Zanjan city, Iran, from December 2010 to November 2016 were studied. Patient information, including age, sex, burn degree, season, cause of burn, hospital stay and treatment results were analyzed. About 65% of the patients were male (n=1691). Most burns (92.8%) were less than 30% total body surface area. Mean age and hospital stay were 25.4 years old and 9.1 days, respectively. The most common causes of burn were hot liquids, gas explosion and fire, respectively. Except for self-immolation, which was more common among men, there was no significant relationship between cause of burn and the studied variables. The six-year mortality rate was 2.9%, and was more common in the years 2011 to 2013. In addition, distribution of causes of burn had a significant trend (variation). Fire burn had a decreasing trend and gas and chemical burn had increasing trends in this period. In northwest Iran the causes of burn changed over the six years. Chemical burns, gas explosion burns and burn mortality increased. Some of these results were due to economic and pharmaceutical sanctions in Iran. Because of Iran's industrial development, it is recommended that preventive measures for chemical, gas and electrical burns be conducted.

Serological Study on Cytomegalovirus and Toxoplasma Gondii in Thalassemia Major Patients of Yazd, Iran

BACKGROUND

Beta-thalassemia patients receive blood products from blood transfusion centers repeatedly. Blood transfusion can transmit Cytomegalovirus (CMV) and Toxoplasma gondii. The aim of this study was serological evaluation of these two infectious agents in thalassemia patients.

MATERIALS AND METHODS

In a cross-sectional study, the enzyme-linked immunosorbent assay (ELISA) testing was performed to detect IgM and IgG antibodies against CMV and Toxoplasma gondii in 96 thalassemia patients (under 18 years) and 144 healthy people. Data were analyzed by SPSS software and Chi-square test.

RESULTS

A significant difference was observed in CMVIgM antibody levels between test groups in women (p<0.05). The prevalence of CMV IgM, CMV IgG, Toxo-IgG, and Toxo IgM antibodies in thalassemia patients were 5.2%, 95.9%, 16%, and 0%, respectively.

CONCLUSION

In all thalassemia patients, Cytomegalovirus IgG is higher than healthy people. In addition, CMV IgM antibodies are higher in female patients. Antibody screening (IgM) on blood products for detecting Cytomegalovirus is necessary, but for Toxoplasma gondii is not necessary in the Yazd transfusion center.

Trismus Resulting from Infantile Hemangioma of the Parotid: A Rare Case Report

Vascular abnormalities are characterized by increasing number of vessels. Salivary gland tumors are uncommon and their overall incidence is about 3 per 100000 per year. Salivary gland hemangioma makes up 1 % of all salivary gland tumors. Trismus resulting from parotid hemangioma is so rare. The patient was a 6-month-old boy with a huge lesion in his right parotid who referred to Shahid sadoughi hospital of Yazd, Iran. The lesion appeared at 4 months of age and had rapid growth and was suspected as hemangioma after clinical examination and patient had trismus. The lesion was excised without any complications. Five months after surgery, area of the lesion appeared normal. Parotid hemangioma has low potential to turn into malignant form but early detection and biopsy are necessary for decreasing complications. Removal of the mass was the best treatment for the patients with large or complicated hemangioma; however, it should be performed with caution because the tissues may bleed profusely. Patients may have long term survival after surgery.

A study on comparison of overall survival and disease- free survival among gastric cancer patients treated with two adjuvant and neoadjuvant methods

The optimal management of locally gastric cancer persists a matter of intense discussion. Frequently cases with esophagogastric cancer are handled with preoperative chemotherapy [the more typical European method] or mixed chemoradiotherapy. The present research examines a comparison of overall retention and disease-free retention among gastric cancer cases managed via two Adjuvant and Neoadjuvant methods. We showed the features of quick gastric neoplasms operated by ESD. This research showed that ESD for quick gastric neoplasms is a typical approach since the en bloc and curative resection percentages are very high, and residual infection or recurrence is limited. Nevertheless, we further demonstrated that the obstacles connected to this method are the long method time and comparatively high rates of procedure-related developments. We should explore methods to reduce the method time and reduce these difficulties.

Giant pedunculated polypoid submucosal lipoma of the splenic flexure of colon: case report and review of the literature

Lipomas of the colon are rare but clinically important conditions that require suitable evaluation for guiding appropriate therapy. The majority of lipomas arise from the submucosal layer in the ascending colon, especially near the ileocecal valve, which causes difficulties in diagnosis. Giant lipomas may be misinterpreted as a premalignant adenomatous polyp, particularly when arising in the left colon. A 38-year-old man presented with manifestations including hypogastric pain, constipation, loss of appetite and weight, accompanied by anaemia, nausea, vomiting and haematochezia. Colonoscopy revealed a large submucosal polyp about 5 x 4 cm, which was located at the splenic flexure of colonic. Surgery detected an oval polypoid tumour measuring 70 x 50 x 45 mm in size, having a pedunculated appearance and a stalk diameter of 20 mm. Histopathologic examination of the biopsy from the lesion confirmed diagnosis of a giant submucosal lipoma. In our experience, most giant colonic lipomas are found to be sessile and occur in the ascending colon in older patients. Herein, we report a pedunculated tumour in a 38-year-old male located in the splenic flexure of colon.

Infantile fibrosarcoma in a child: a case report

BACKGROUND

Infantile Fibrosarcoma is a rare soft tissue tumor in infants and children mostly located in extremities. An infantile and adult form has similar histopathological patterns but survival prognosis is much better in infantile form. Recurrence of infantile fibrosarcoma is common but the rates of metastasis are less than 10 percent in children younger than five Years and 50 percent in children more than 10 years old.

CASE PRESENTATION

In this case report, we presented a nine years girl with a relapsing mass in her left hand. The pathologic findings showed sheets of spindle-shaped cells with suggested diagnose of infantile fibrosarcoma. She was successfully treated with combination of surgery and chemotherapy with a good outcome.

CONCLUSION

Infantile fibrosarcoma is a differential diagnose of soft tissue mass in infants and children. It has a good prognosis and distant metastasis is uncommon. Choice of treatment is surgery but chemotherapy and radiotherapy were useful in decrease metastasis.

Accuracy of Sentinel Node Biopsy in Breast Cancer Patients with a High Prevalence of Axillary Metastases

Background:

Sentinel lymph node biopsy (SLNB) has become a standard diagnostic tool for axillary staging of breast cancer and has many advantages in comparison with axillary dissection. The goal of our study was to determine accuracy and predictive value of SLNB for assessing the axillary lymph nodes involvement in breast cancer.

Materials and Methods:

Thirty three patients with breast cancer at Mehr and Taleghani hospitals in Tehran between July 2005 and 2006 were randomly selected. All women underwent presurgical lymphoscintigraphic mapping followed by sentinel node biopsy guided by intraoperative gamma probe and blue dye. Sentinel nodes were examined by standard hematoxylin and eosin (H&E) staining. Among studied patients, T1 stage accounted for 3%% of the patients, T2 for 6%, T3 for 66.7% and T4 for 24.3%. Statistical analyses were performed by evaluating of sensitivity, specificity, accuracy, and positive and negative predictive values of SLNB in comparison to axillary lymph node dissection (ALND).

Results:

The sentinel lymph nodes in 30.3% of patients were well imaged by lymphoscintigraphy. A mean of 4.8 sentinel lymph nodes were removed per patient. Sensitivity and specificity of SLNB were 92% and 87.5%, respectively. Totally, in comparison to ALND, the accuracy of SLNB was 90.9% and false negative rate of this method was also 8%.

Conclusion:

Our experience shows SLNB to be reliable and accurate for axillary staging in breast cancer patients with a high prevalence of axillary metastases and can be replaced diagnostic ALND in our breast cancer centers.