Patellar bone tumor

Background: Patella is uncommon site for all of primary and metastatic bone tumors; but in some reports chondroblastoma and giant cell tumor were the most common tumors in this site. Surgical management varies in patients based on the kind of tumor. Also, function of knee after treatment varies based on the kind of the surgery and tumor. Previous surveys on this object are a few case reviews or reports in literature reviews. Methods: 13 patients with patellar tumor treated between 1985-2006 in Shafa-Yahyaian, Pars, and Milad hospitals were assessed. Signs, symptoms and paraclinical data before and after operation were evaluated. All of the patients underwent surgical management. Results of treatment were assessed in long term fallow up. Findings: From 13 patients, 5 cases were chondroblastoma, 3 cases were giant cell tumor, 2 were ABC, 2 were metastases, and 1 case was UBC. Pain and knee effusion were the most common symptoms of patellar tumor. Range of motion of knee and the force of quadriceps muscle after surgery without patellectomy were better than the surgery of patellectomy. Recurrence was seen in one patella retained case. Conclusion: In our study, chondroblastoma was the most common tumor in patella. Pain and knee effusion were the most common symptoms in patella tumors. Range of motion of knee and the force of quadriceps muscle in patella retaining were better than patellectomy. © 2008, Isfahan University of Medical Sciences(IUMS). All rights reserved

Changing prevalence and treatment of depression among older people over two decades

Background Depression is a leading cause of disability, with older people particularly susceptible to poor outcomes.Aims To investigate whether the prevalence of depression and antidepressant use have changed across two decades in older people.Method The Cognitive Function and Ageing Studies (CFAS I and CFAS II) are two English population-based cohort studies of older people aged ≥65 years, with baseline measurements for each cohort conducted two decades apart (between 1990 and 1993 and between 2008 and 2011). Depression was assessed by the Geriatric Mental State examination and diagnosed with the Automated Geriatric Examination for Computer-Assisted Taxonomy algorithm.Results In CFAS I, 7635 people aged ≥65 years were interviewed, of whom 1457 were diagnostically assessed. In CFAS II, 7762 people were interviewed and diagnostically assessed. Age-standardised depression prevalence in CFAS II was 6.8% (95% CI 6.3-7.5%), representing a non-significant decline from CFAS I (risk ratio 0.82, 95% CI 0.64-1.07, P = 0.14). At the time of CFAS II, 10.7% of the population (95% CI 10.0-11.5%) were taking antidepressant medication, more than twice that of CFAS I (risk ratio 2.79, 95% CI 1.96-3.97, P < 0.0001). Among care home residents, depression prevalence was unchanged, but the use of antidepressants increased from 7.4% (95% CI 3.8-13.8%) to 29.2% (95% CI 22.6-36.7%).Conclusions A substantial increase in the proportion of the population reporting taking antidepressant medication is seen across two decades for people aged ≥65 years. However there was no evidence for a change in age-specific prevalence of depression

Maternal Anxiety, Depression and Posttraumatic Stress Disorder (PTSD) After Natural Disasters: a Systematic Review

OBJECTIVE: To measure the prevalence of maternal anxiety, depression and posttraumatic stress disorder (PTSD) in those exposed to natural disasters. METHODS: A literature search of the PubMed database and www.clinicaltrials.gov from January 1990 through June 2020 was conducted. A PRISMA review of the available literature regarding the incidence and prevalence of maternal anxiety, depression and posttraumatic stress disorder (PTSD) following natural disasters was performed. A natural disaster was defined as one of the following: pandemic, hurricane, earthquake and post-political conflict/displacement of people. Studies were selected that were population-based, prospective or retrospective. Case reports and case series were not used. The primary outcome was the prevalence of maternal anxiety, depression and PTSD in the post-disaster setting. Two independent extractors (I.F. & H.G.) assessed study quality using an adapted version of the Effective Public Health Practice Project Quality Assessment tool. Given the small number of studies that met inclusion criteria, all 22 studies were included, regardless of rating. Data were extracted and aggregate rates of depression, anxiety, and PTSD were calculated to provide synthesized rates of maternal mental health conditions among participants. RESULTS: Twenty-two studies met the inclusion criteria. A total of 8357 pregnant or birthing persons in the antepartum and postpartum periods were studied. The prevalence of post-pandemic anxiety, depression and PTSD were calculated to be 48.2%, 27.3%, and 22.9%. Post-earthquake depression and PTSD rates were 38.8% and 22.4%. The prevalence of post-hurricane anxiety, depression and PTSD were 17.4%, 22.5%, and 8.2%. The rates of post-political conflict anxiety, depression and PTSD were 48.8%, 31.6% and 18.5%. CONCLUSION: Given the high rates of anxiety, depression and PTSD among pregnant and birthing persons living through the challenges of natural disasters, obstetrician-gynecologists must be able to recognize this group of patients, and provide a greater degree of psychosocial support

Detection and identification of Leishmania isolates from patients with Cutaneous Leishmaniasis (CL) in Isfahan (central region of Iran) by PCR method

Leishmaniasis is caused by parasitic protozoa of the genus Leishmania. Cutaneous leishmaniasis (CL) is a complex disease with wide spectrum of clinical manifestations. In order to identify leishmania species causing CL in Isfahan by a definite molecular technique (PCR method), this study was undertaken over 2010- 2011. 124 Patients with suspicious lesion of Leishmaniasis and positive direct smear from lesion were selected. Samples were cultured in NNN and RPMI 1640 media Negative and positive control and clinical samples was applied for PCR in the same condition. In the next step, standard PCR was carried out using classic protocol. From 124 patients, 111 (89.51%) cases were infected as L. major and 12 (9.67%) cases were infected by L. tropica, However only in one patient simultaneous infectious with both L. major and L. tropica was identified by PCR techniques which could not be possible in microscopy. L.major was the most prevalent species in the studied patients (p-value<0.001)