Osteopetrosis: A Case Report and Review of the Literature

Osteopetrosis or marble bone disease is a rare heritable skeletal disorder that the bones becoming denser, caused by aberrant osteoclast-mediated bone resorption. This condition reveals a spectrum of heterogeneity of genetic defects. This metabolic disorder has an unequal balance between new bone formation and old bone resorption. Thus the result is increased bone density on radiographs. Presented here is a 25 years-old Persian female presented to our clinic with the chief complaint of low back pain and limping. She explained that her problem had been present for a long time. There were no other significant findings in past medical history and her parents and three siblings did not have any disorder of note, however, the parents were first cousin. No specific laboratory abnormalities found in the initial evaluation. On physical examination, an antalgic gait is noted. A Bone biopsy from proximal medial tibia revealed increased density of the cortex and part of medullary canal with hematopoietic marrow and irregular and thickened bone trabeculae. These factors suggested osteopetrosis disease. Osteopetrosis should be kept in mind as a rare cause of low back pain and limping and should be mentioned as a differential diagnosis of fluorosis, Paget’s disease, malignancies (lymphoma, osteoblastic cancer metastases) and myelosclerosis.Keywords: Osteopetrosis, marble bone disease, bone trabeculae, Iran

Exploring adults’ experiences of sedentary behaviour and participation in nonworkplace interventions designed to reduce sedentary behaviour: a thematic synthesis of qualitative studies

Background: Sedentary behaviour is any waking behaviour characterised by an energy expenditure of ≤1.5 metabolic equivalent of task while in a sitting or reclining posture. Prolonged bouts of sedentary behaviour have been associated with negative health outcomes in all age groups. We examined qualitative research investigating perceptions and experiences of sedentary behaviour and of participation in non-workplace interventions designed to reduce sedentary behaviour in adult populations. Method: A systematic search of seven databases (MEDLINE, AMED, Cochrane, PsychINFO, SPORTDiscus, CINAHL and Web of Science) was conducted in September 2017. Studies were assessed for methodological quality and a thematic synthesis was conducted. Prospero database ID: CRD42017083436. Results: Thirty individual studies capturing the experiences of 918 individuals were included. Eleven studies examined experiences and/or perceptions of sedentary behaviour in older adults (typically ≥60 years); ten studies focused on sedentary behaviour in people experiencing a clinical condition, four explored influences on sedentary behaviour in adults living in socio-economically disadvantaged communities, two examined university students’ experiences of sedentary behaviour, two on those of working-age adults, and one focused on cultural influences on sedentary behaviour. Three analytical themes were identified: 1) the impact of different life stages on sedentary behaviour 2) lifestyle factors influencing sedentary behaviour and 3) barriers and facilitators to changing sedentary behaviour. Conclusions: Sedentary behaviour is multifaceted and influenced by a complex interaction between individual, environmental and socio-cultural factors. Micro and macro pressures are experienced at different life stages and in the context of illness; these shape individuals’ beliefs and behaviour related to sedentariness. Knowledge of sedentary behaviour and the associated health consequences appears limited in adult populations, therefore there is a need for provision of accessible information about ways in which sedentary behaviour reduction can be integrated in people’s daily lives. Interventions targeting a reduction in sedentary behaviour need to consider the multiple influences on sedentariness when designing and implementing interventions

The diagnostic value of blood level of CEA and CA15-3 tumor markers in breast tumor with axillary lymph node metastases

AbstractBackground and purpose: Breast cancer is the most common malignant tumor and the leading cause of carcinoma death in women, with more than 1.000.000 cases occuring world wide annually. Recently, particular attention has been paid to sensitive/rapid and cheap laboratory methods for diagnosis of metastatic breast cancer. Evaluation of serum tumor markers including CEA and CA15-3 is one of these methods.Materials and Methods: The study was performed on 150 patients with breast cancer in Imam Khomeini and Shafa hospitals-Sari, Iran(2004-2005).Before modified radical mastectomy procedure, blood level of CEA and CA15-3 was measured with an ELISA method using CANAg kit, then mastectomy and axillary lymph node specimens were evaluated. The information was analyzed using SPSS 11 statistical software.Results: In our study, the patients were between 32-75 yrs (mean: 51.6 yrs). The patients were divided into two groups: I (89 cases): Breast cancer with axillary lymph node metastases. II (61cases): Breast cancer without axillary lymph node metastases. Statistical differences was observed between the amount of CEA and CA15-3 in the two groups (P<5%). CA15-3 and CEA showed the best efficiency in the level of 35 u/ml and 2.5u/ml, respectively. Sensitivity and specificity of CA15-3 are 78% and 88%, respectively. Sensitivity and specificity of CEA are 48% and 83%, respectively.Conclusion: CA15-3 tumor marker is useful for diagnosis of metastatic cases but CEA tumor marker does not have optimal sensitivit

Status of estrogene, progesterone receptors and HER-2/neu expression in invasive breast cancer

Background&Objective: The breast cancer is the most common malignancy in women. The normal and malignant breast tissue are under the regulatory effects of esteroid hormones and growth factors including HER-2/neu. The purpose of this study, is to determine the expression of estrogene receptor (ER) progesterone receptor(PR) and HER-2/neu among Iranian women with invasive breast cancer. Materials&Methods: The study is descriptive and cross-sectional that was performed on 50 samples of patients with invasive breast cancer in Imam-Khomeini Hospital-Sari (2005-06). After preparing the samples four tissue sections from each sample was obtained then H&E and IHC staining were performed. Results: In our study, the patients were between 28-88 yrs, (mean:52/6). ER and PR and HER-2/neu were positive in 80%, 72% and 57.1% of cases, respectively. Concurrent positive ER and PR was 70%, meanwhile 62.9% of these patient were also positive for HER-2/neu. 20% of the cases showed negativity for both ER and PR and of these 83.4% were also negative for HER-2/neu. Conclusion: In our study ER expression by itself is equal to previous studies in textbooks but PR expression, HER-2/neu and concurrent expression of ER&PR are higher in our study. Interestingly HER-2/neu expression is near to what was previously proposed by Iranian Blood Transfusion Organization and Kerman University of Medical science. It seems that racial and geographic factors are contributed for these diffrences

Antibiotic resistance of Helycobacter pylori isolated from patients admitted to Imam Hospital, Sari, IRAN, 2002-2003

Background and purpose : -Helicobacter pylori is a gram negative spiral bacilus which infects gastric mucosa and causes a wide range of gastro intestinal diseases.Unfortunately the prevalence of the infection by this organism in developing countries is high and despite numerous existing drug regimens, treatment fails to eradicate the organism in many occasions. To reach an effective and curative regimen, invitro determination of suscepibility and resistance of the organism, to various antimicrobials, is pradent. The goal of this study was to determine the prevalence of antimicrobial resistance in Helicobacter pylori,s isolated from cultures. Biopsies from 67 patients admitted to the Sari Imam Hospital were used to cultur Helicobacter pylori and determine their susceptibility and resistance to metronidazole, claritromycin and amoxycillin.Materials and methods : Disc diffusion tecniqu was used to determine the minimum inhibitory concentration , (MIC) and resistance pattern of the isolated Helicobacter pylori.In this method we used the cutoff point of MIC 90 ie , a concentration at which 90% or more of culture plates show inhibition zone around the antimicrobial test disc. Results : MIC 90 for amoxycillin and claritramycin in our study was 0.25 g/ml and all isolates were susceptible to amoxycillin. Only one isolate was resistant to claritramycin. MIC 90 for metronidzole was 16 and 4 resistant cases were isolated.Conclusion : This stndy showed low level of resistance to metronidazole and claritramycin which were comparable to the reported results from other studies. No resistance was observed to amoxycillin which was also the same as other reported results. According to the pattern of antimicrobial resistance, we can recommend the studied drugs, against Helicobacter pylori