First case report of atypical disseminated cutaneous leishmaniasis in an opium abuser in Iran

Leishmaniasis is a worldwide tropical infectious disease caused by different species of intracellular protozoa parasites of the genus Leishmania . Herein, we report a 78-year-old man with unusual diffuse cutaneous leishmaniasis (DCL) who had a history of opium abuse and chronic obstructive pulmonary disease (COPD). He had multiple papular, crusted and severely ulcerated lesions extended to his arm and chest. Direct smears and skin punch biopsy of the lesions were suggestive of leishmaniasis. Parasite DNA was amplified from ulcers, and identified as Leishmania major by PCR-RFLP, confirmed by sequencing analyses. The aim of the current study was to bring to attention this atypical form of disease in CL endemic countries. Thus, this is the first case of DCL in an opium abuser with COPD due to L. major in Northeastern Iran indicating that atypical and extensive forms of CL (DCL) owing to L. major are increasing in Iran

Case report: Secretory breast cancer in an 11-year-old girl

AbstractA lack of consensus about the optimal treatment modalities for breast cancer in children is because of its absolutely rare prevalence. In this article, the medical history and treatment of a secretory breast carcinoma in an 11-year-old girl is reported. Modified radical mastectomy (MRM) was performed on April 6, 2013. Systemic chemotherapy was performed after surgery because metastatic lymph nodes were found in the dissected axillary tissue. Long term follow-up had to be done

Sources of Women's Health Information: A Qualitative Study

Introduction: Equipping individuals with adequate knowledge on health can lead to optimal health outcomes. Scientific reports indicate clients' challenges in trusting and accessing formal health information sources. This study was designed to determine the sources of Iranian women's health information. Method: Study samples were selected through purposive sampling and with regarding to the inclusion criteria. Data were collected through semi-structured interviews with 17 women and using documentation and field notes until data saturation. Data were analyzed continuously and simultaneous with data collection using qualitative content analysis. Results: The 5 central themes of health care professionals, social networks (with 2 sub-categories of peers and social interactions), culture and religion (with 3 sub-categories of religious teachings, traditional medicine information, and experiences of elders and seniors), mass media (with 3 sub-categories of electronic media, print media, and internet), and self-referencing (with 2 sub-categories of self-discovery-intuition and prior experiences) emerged from data analysis. Conclusion: These findings highlighted the need for respecting the cultural and religious beliefs of a community, and also emphasized on clients' seeking rights, information needs, and empowerment in employment of formal and informal sources. Keywords: Women, Sources, Health information Seekin

Premarital addiction test and its outcomes

Introduction: Although many people around the world are dealing with addiction, still no method that can detect and permanently treat it has been found. Premarital addiction test is one of the factors of great importance in this field. An erroneous detection in this test affects the psychosocial aspects and marital decisions of the individual. The purpose of this study was to determine the effectiveness of the health system in premarital addiction tests and its psychosocial effects. Method: This interpretive qualitative study was performed using content analysis. Data were collected from 6 focus group discussions and 2 semi-structured individual interviews with couples and health care personnel. All interviews were tape-recorded and transcribed verbatim, and themes were extracted using content analysis method. Results: Qualitative content analysis determined the 2 themes of lack of professional adequacy and consequence of marriage. Conclusion: Premarital addiction test is one of the health services provided by the health care system. An incorrect diagnosis not only has a considerable impact on different aspects of individuals’ life, but is also closely related to the psychosocial concept of dignity. Therefore, the professional competence of the staff in providing these services is very important and necessary. Keywords: Addiction, Marriage, Health syste

Thoracoscopic Congenital Diaphragmatic Hernia repair in neonate: The First Experience of Iranian Group

Background: Congenital diaphragmatic hernia (CDH) occurs due to a failure in closing pleuroperitoneal membrane thus resulting in an incomplete diaphragm formation1, which allows passage of the abdominal viscera into the thorax.1,3 Until 1995, the standard method for treatment of CDH was performed by open surgery through the abdomen or thoracic cavity. Minimally invasive approach via thoracoscopy or laparoscopy is applicable for treatment of CDH since 1995.4 Now a day’s thoracoscopic repair of CDH (T’Scopy CDH) is performed in many centers. In this paper, we present our experience of T’Scopy CDH repair from Iran.Patients and Methods: From 2011 to 2015, 74 patients with CDH were admitted to Pediatric Surgery Department of Dr. Sheikh (Sarvar) Pediatric Hospital. Twenty one patients (28%) met our inclusion criteria and underwent T’Scopy CDH repair. The median age at the time of repair was 5 days (2-daysold to 4-years-old patients). Inclusion criteria were weight over 2 kg and stable hemodynamics and arterial blood gas. Fourteen cases were intubated before entering the operating room. The defect was in the left side except in two cases. In 8 cases, we used thoracic wall as part of repair. Also, mesh support was utilized in 8 cases even in cases were primary repair of diaphragm was possible in order to reinforcing the repair (5 cases). Of these 8 cases, in 3 patients, whole repair was accomplished by mesh due to presence of a large defect.Results: The mean time of operation was 80 minutes (40-230 minutes). Intraoperative mortality was zero. In hospital, mortality occurred in two cases due to septicemia in one and respiratory and cardiac failure in another. Conversion to open surgery was required in 6 cases. Late recurrence was observed in 2 cases. The mean time of follow up was 14.6 months (3-36 months).Conclusion: It seems that appropriate case selection and liberal use of thoracic wall and mesh as a part of repair may cause better results and decreased chance of early and late recurrence

Hepatic fascioliasis in Mashhad, Northeast Iran: first report

Abstract Fascioliasis is a zoonotic disease caused by a leaf-like worm (fluke) called Fasciola. Herein, we present a case of human hepatic fascioliasis. A 57-year-old man was referred to the hospital for ambiguous gastrointestinal symptoms with suspected hemangioma. Hepatic fascioliasis was diagnosed using abdominal computed tomography and serology. He tested positive for the IgG antibody against Fasciola hepatica. The patient was treated successfully with triclabendazole. This is the first published report on the occurrence of fascioliasis in Northeast Iran, a non-endemic area for fascioliasis. Our results suggest the emergence of a new focus in the region

Evaluation of the Effect of Amino Acid Administration on Hypothermia during General Anesthesia in Hypospadias Surgery on Children Aged 2 to 6 Years

Abstract Introduction: Hypothermia is an important complication during surgery, especially in children, and is highly associated with serious adverse outcomes. One of the preventive methods is the intraoperative administration of amino acids, which can be effective through increasing thermogenesis and stimulating energy consumption. No studies have been conducted in this regard on children; therefore, we evaluated the preventive effect of intraoperative administration of amino acid on hypothermia in children. Materials and Methods: Forty children, aged 2 to 6 years, who were candidates for hypospadias surgery in Dr. Sheikh Hospital, Mashhad-Iran, were divided into two groups. In the case group, 10% amino acid (2 cc/kg/h) was administered two hours before the operation, and in the control group, normal saline was given as required. All patients underwent a similar method of anesthesia. body temperature was recorded before the anesthesia, immediately after it, and every ten minutes. Results: The mean age and weight had no difference between the groups. Duration of patients' awakening time was (13.60 ± 4.91 min), which in the case and control groups was reported as (11.90 ± 5.27) and (15.30 ± 3.96 min), respectively (P<0.05). The patients' body temperature was higher in the case group. It was not significantly different between the groups before, and until 20 min after the start of the surgery. In the next measurements, the temperature was significantly different among the groups; the difference became more prominent as the time passed. Conclusion: Perioperative administration of 10% amino acid causes an increase in children's body temperature, leading to faster awakening time of the patients