Knowledge, attitude, and practice of interns and practitioners graduated from the Medical Universities of Shahid Beheshti, Tehran, and Iran about colorectal cancer screening between 2014-2015

Background: Cancer is the third most common cause of death in Iran. Colorectal cancer is an ideal tumor for screening. Therefore, early diagnosis through screening can reduce its prevalence and mortality. On the other hand, knowledge of practitioners about screening programs has a direct relationship with their performance.Methods: In the present cross-sectional-educational study, knowledge, attitude, and practice of medical interns and practitioners about colorectal cancer screening were evaluated in 2014-2015 and were reviewed using Chi2 and ANOVA statistical tests. Results: From among 300 physicians surveyed, 17.3% knew the age of the screening for colorectal cancer, 73% knew the average-risk, and 68% knew the high-risk criteria correctly. About 48% of the respondents recommended Fecal Occult Blood Test (FOBT) method for population at medium risk and 75% of recommended colonoscopy as a screening method in highrisk populations. Also, 90% of physicians knew the signs and symptoms of colorectal cancer. About half of the practitioners asked their patients about risk factors and advised them to undergo screening. About 55% of the participants who had family members needing screening decided to undergo screening and 6.3% of them who needed screening, decided to undergo screening.Conclusion: Colorectal cancer is growing in the country; a fact that can be prevented. The results of the present study showed that practitioners have little knowledge of appropriate age of screening and screening methods and insufficient attitudes and actions about this issue. It is recommended that general practitioners and family physicians, who are the first lines of encounter with the patients, be properly trained.Keywords: Knowledge; Attitude; Performance; Colorectal cancer; Medical student

The diagnostic accuracy of endobronchial ultrasound and spiral chest computed tomography scan in the prediction of infiltrating and non-infiltrating lymph nodes in patients undergoing endobronchial ultrasound

Purpose: Endobronchial ultrasound (EBUS) and spiral chest computed tomography (CT) scan are important methods in the prediction of infiltrating and non-infiltrating lymph nodes, and the determination of their diagnostic accuracy would result in a reduction of the burden of problems and an improvement in prognosis. The purpose in this study was to determine the diagnostic accuracy of endobronchial ultrasound and spiral chest CT scan in the prediction of infiltrating and non-infiltrating lymph nodes in patients undergoing endobronchial ultrasound. Material and methods: In this observational prospective study, 40 consecutive patients with infiltrating and non-infiltrating lymph nodes in Masih-Daneshvari Hospital in 2017 and 2018 were enrolled, and the sensitivity, specificity, and accuracy of EBUS and CT-scan versus fine needle aspiration pathology results were determined in them. Results: The results in this study demonstrated that the congruence between EBUS and CT scan was 80.5% (p = 0.0001). The sensitivity, specificity, and accuracy for CT scan were 100%, 22.6%, and 40%, respectively, and the sensitivity, specificity, and accuracy for EBUS were 100%, 16.1%, and 35%, respectively. Conclusion: According to the obtained results, it may be concluded that CT scan and EBUS results have good congruence and high sensitivity to differentiate infiltrating and non-infiltrating lymph nodes. Hence, these methods are useful for screening methods, but due to their low specificity and accuracy the use of them for a confirmative approach is not beneficial. However, regarding the accessibility and less invasive nature, use of chest CT scan is more rational and is recommended in these patients

Computed tomography pulmonary angiography for acute pulmonary embolism : prediction of adverse outcomes and 90-day mortality in a single test

Purpose: Pulmonary embolism (PE) is a potentially fatal cardiopulmonary disease; therefore, rapid risk stratification is necessary to make decisions of appropriate management strategies. The aim of this study was to assess various computed tomography (CT) findings in order to find new prognostic factors of adverse outcome and mortality. Material and methods: The study enrolled 104 patients with acute PE. Based on their outcome, patients were categorised into four groups. Comorbidities such as ischaemic heart disease were obtained from their medical records. Patients CT angiography were reviewed for recording variables such as main pulmonary artery diameter and right ventricle (RV)/left ventricle (LV) ratio. Patient deaths up to three months since diagnosis of PE had been registered. Logistic regression analysis was performed to find predictors. Results: Based on multiple logistic regression, RV/LV ratio, LV diameter, and right-sided pulmonary infarction are predictors of mortality in 30 days. An RV/LV ratio of 1.19 could successfully discriminate patients who died within 30 days and those who did not. Conclusions: RV/LV ratio, LV diameter, right-sided pulmonary infarction, assessed with helical CT, can help predict 30-day mortality

Comparison of Leishmanin Skin Test and Direct Smear for the Diagnosis of Cutaneous Leishmaniasis

Cutaneous leishmaniasis (CL) is an endemic disease in some parts of Iran and it has high morbidity in some areas of the country. The disease is detected by parasitological examinations including direct microscopic and culture tests. This comparative study aimed to evaluate the relationship between positivity of the leishmanin skin test (LST), microscopically examination and clinical forms of CL for the diagnosis of human cutaneous leishmaniasis. This study was performed on 66 patients suspected to cutaneous leishmaniasis. CL cases evaluated by both microscopical examination and leishmanin skin test. In this study, 1 ml of leishmanin fluid (lot no 121/1, produced in Pasteur institute of Iran) was injected intradermally in forearms of all patients and indurations were measured after 72hours. Induration of 5 mm and higher was considered as positive results. The collected data were statistically analyzed using the SPSS version 13.5. From 66 CL patients who were evaluated in this study, 30 (45.5%) of them had positive microscopically results while 28(42/4%) of them had showed positive leishmanin skin test (≥5mm diameter). From 36 (54.5%) patients who had negative microscopical examination, only 6(16/6%) of them had positive leishmanin skin test. The agreement between two tests was 87.9 % by kappa analysis (p< 0.01). In attention to the results of this study, it seems the LST would be used as an alternative diagnosis method when there is a strong clinical doubt to cutaneous leishmaniasis even there is no parasite in direct smea

Does Adding the Pulmonary Infarction and Right Ventricle to Left Ventricle Diameter Ratio to the Qanadli Index (A Combined Qanadli Index) More Accurately, Predict Short-Term Mortality in Patients with Pulmonary Embolism?

Background The Qanadli index can be used to assess the severity of pulmonary arterial involvement in patients with acute pulmonary embolism. However, it seems that considering pulmonary infarction and right ventricle/left ventricle (RV/LV) ratio along with this index (called the combined Qanadli index) can provide a more accurate view of changes in cardiovascular parameters in these patients and help predict mortality in a better manner. In this regard, we evaluated the ability of the combined Qanadli index versus the Qanadli index in predicting short-term mortality in patients with pulmonary embolism