Successful myomectomy during pregnancy

Leiomyoma is the most common benign tumor of the uterus and could complicate pregnancy. Here we present a case of leiomyoma in a nullipara women at the 24 th week of gestation complained of abdominal pain and nausea which was not responding to conservative therapies. A laparotomy was done and a 30*20 cm mass was resected from the uterus. She had a normal term delivery after the operation

Recurrent ectopic pregnancy in the fallopian tubes

Here, we present a case with several episodes of ectopic pregnancy in the fallopian tubes, which was treated by medical and surgical methods, and followed for two years until it ended in a term successful delivery

Some evidences about Crimean Congo Hemorrhagic Fever

[No abstract available

Modifiable risk of breast cancer in Northeast Iran: Hope for the future. a case-control study

Background: Breast cancer is the most common cancer in women. Its prevalence is increasing annually by 2. The determination of modifiable risk factors has been the subject of various studies. The aim of this study was to determine risk factors of breast cancer in women in Golestan Province. Patients and Methods: This case-control study was conducted among women with breast cancer recorded in the cancer registry system between 2004 and 2006 (n = 134), and their agematched healthy neighbors (n = 133). Data were statistically analyzed. Results: Age at marriage, menarche and pregnancy, breast feeding, positive family history, marital status, and educational level were not significantly correlated with risk of breast cancer, but age at menopause (< 46.6 years) was significantly correlated (95 confidence interval 1.15-7.37; p = 0.021). Live births, still births, and infant deaths were not significantly different between the 2 groups. For other variables, such as smoking history, no odds ratio was calculated. Conclusion: Results show that there is no significant correlation between variables and risk of breast cancer in our population, except for age at menopause. A large cohort study is recommended. © 2011 S. Karger GmbH, Freiburg

Hepatitis C in hemodialysis centers of golestan province, northeast of Iran (2005)

Background and Aims: Nosocomial transmission of blood-borne pathogens is common in a dialysis setting. Hepatitis C virus (HCV) infection is a common problem that increases morbidity and mortality in hemodialysis patients. Blood transfusion and the duration of hemodialysis are the most important factors in HCV transmission. The aim of the study was to determine the incidence rate of HCV antibody in hemodialysis patients and its association with some factors. Methods: In this descriptive-analytical study, HCV antibody was measured in 93 hemodialysis patients in all hospitals affiliated to Golestan University of Medical Sciences. Standard infection prevention measures in hospital settings and dialysis units were performed including serologic testing for HCV antibody for every new patient in the dialysis unit as well as routine testing of all patients. Negative cases of hepatitis C antibody (confirmed with ELISA 2nd generation and RIBA II Immunoblot methods) were selected and followed for 18 months. Some predisposing factors such as transfusion, duration of hemodialysis, medical procedures including surgery, transplantation, invasive odontology, suspicious sexual contact, diagnostic or therapeutic manipulation, tattooing, and IV drug abuse, were registered and considered. Other rare procedures like acupuncture, manicure and pedicure blood brotherhood rituals, perinatal risk factors, common circumcision rituals and history of abortion were also considered. Ve used a tight control policy through the separation of the rooms within the unit, specific hemodialysis apparatus for suspicious patients and a separate staff caring for the patients. We maintained a low rate of staff turnover in dialysis units and tried to control hepatitis B viral infection. Results: Marital status and living area were significantly related to HCV antibody positivity. It means that more HCV antibody positive cases were observed in married people in urban areas. History of tattooing, medical procedures including surgery, transplantation, invasive odontology and IV drug usage were not significantly related to HCV antibody status. During the follow up, three cases (4.3%) converted to positive. There was a relationship between numbers of hemodialysis per week and HCV antibody positivity (P<0.001). Conclusions: Tight control of transmission routes and severe isolation policy in this study explains an almost ideal decrease in incidence rate of HCV antibody positivity. We suggest periodical screening programs (at least every 6 months) for blood samples that remain in the dialysis apparatus and all procedures used for hemodialysis in these specific patients to achieve a better infection control

Potential mutations associated with occult hepatitis B virus status

Context: Occult hepatitis B virus (HBV) status (OHBS) is simply defined as the presence of HBV DNA in the liver (with or without detectable HBV DNA in the serum), in the absence of serum HBV surface antigen (HBsAg). Importance of OHBS is mostly clinical, related to its possible role in spreading through blood transfusion and liver transplantation; causing classic forms of HBV. Mechanisms underlying this entity are poorly defined. Several possibilities have been suggested, with major classification into two groups: defective host immune response and viral replication activity through mutations of HBV DNA sequence. Mutations are extensively investigated in all four overlapping open reading frames (ORFs) of HBV genome, to define their possible role in the pathogenesis of OHBS. Some of these mutations like S-escape mutants could not be detected by the routine available assays, making them difficult to diagnosis. Therefore, trying to detect this covert condition could be more helpful for defining better preventive and therapeutic strategies. Evidence Acquisition: In the present study we provided an in-depth review of the most important new data available on different mutations in HBV genome of patients with OHBS, which may play a role in the pathogenesis of OHBS. The data were collected through reviewing the full-text articles, identified by the PubMed search, using the following keywords and their different combinations: occult hepatitis B, HBV genome, "a" determinant, HBV open reading frames, S mutations, X mutations, P mutations and C mutations. Results: Variants within the major hydrophilic region (MHR) of the HBsAg, deletions in the pre-S1region, codon stop in the S open reading frames (ORF), sporadic non common mutations, some mutations affecting the posttranslational production of HBV proteins in the S ORF like deletion mutations, mutations in start codon and nucleotide changes in the X ORF, deletion and point mutations in P ORF and sometimes, nucleotide substitution in the C ORF are among the assumed mutations detected to have a role in OHBS appearance. Conclusions: Studies mostly lacked a control group and the whole-length HBV sequencing was scant with conflicting results, suggesting that OHBS is often a result of multiple mechanisms. Additional studies on full-length HBV genomes from occult and non-occult HBV cases may shed more light on the interplay between different mechanisms involved in the pathogenesis of OHBS. © 2014, Kowsar Corp.; Published by Kowsar Corp

Silica and esophageal cancer in Golestan province northeast of Iran

Objectives: Association of silica with diseases like cancers has been determined previously. This study was designed to determine the quantity of silis in flour produced in Golestan province and its relation to the esophageal cancer. Methodology: We took flour samples from all flour mills in Golestan province. Base-melting method in nickel cruise was used in 550° c; the extract was reduced with acid. The differences between silis concentration in various regions were compared. P-value 0.05). Conclusions: This study did not show high level of silica in the flour of Golestan province. We could not find significant differences between silica contaminations in the various areas. Further studies on the consumed bread and rice in the various regions of the province can be helpful

Opium as a fatal substance

Objective: Poisoning does the most serious damages in pediatrics. In the northeast of Iran (Golestan province), opium is used widely for symptomatic therapy of routine illnesses in young children by parents. In the present study, opium toxicity was assessed in young children referred to pediatric centers in our area. Methods: This survey was done as a prospective cross-sectional study. At first, a pilot study was undertaken to estimate the condition of opium intoxicated children and evaluate the validity of questionnaire. We collected data in collaboration with committee of Adverse Drug Reactions (ADR) in Golestan Province. All members of ADR committee in pediatric centers were trained to complete questionnaires in referred or admitted children under-5-year. Data was entered into computer and analyzed by Chi-square and Fisher exact test. Results: In this survey, 67 opium-intoxicated children were recruited. Minimum age of the cases was 6 days and maximum 5-year. Uneducated mothers, in most cases, gave opium to the child. Most of them were from the low socio-economic level. Ethnic was disparity was observed. Four deaths occurred. Conclusion: As the results showed, opioids are dangerous in pediatric population, especially under 5-year. Respiratory depression, bradypnea, coma and death are the serious outcomes of opium toxicity in pediatrics. Such a practice of unrestricted use of opium contributes to children mortality and so it is essential to launch educational programs. © 2008 Dr. K C Chaudhuri Foundation

Wild lettuce (Lactuca virosa) toxicity

Wild lettuce (Lactuca virosa) can cause toxic effects when eaten. Wild lettuce grows in the north of Iran and some natives consume it unaware of its adverse side effects. We describe eight patients with manifestations of wild lettuce toxicity, admitted to a general hospital affiliated to the Golestan University of Medical Sciences. All the patients recovered (although one had to spend 48 h in the intensive care unit) and no chronic complications were reported. A clinical suspicion of toxicity caused by wild lettuce intake and an accurate history formed the basis of the diagnosis. Conservative treatment, vital sign monitoring, control of patient intake and output, and reducing patient agitation provided the basis for treatment