Acute lymphocytic leukemia with severe eosinophilia (a case report)

زمینه و هدف: لوسمی حاد لنفوئیدی (ALL) یک سرطان بدخیم است و همراهی آن با افزایش ائوزینوفیل ها بسیار نادر رخ می دهد. در این مطالعه یک مورد لوسمی حاد لنفوئیدی با تظاهرات افزایش شدید ائوزینوفیل ها گزارش می گردد. گزارش مورد: در این گزارش یک پسر 18 ساله مبتلا به ALL همراه با افزایش شدید ائوزینوفیل ها، خستگی، تب خفیف، تپش قلب، ضعف دوره ای و اریترودرمی منتشر معرفی و در معاینات اولیه تنها طحال بزرگ مشاهده شد. در شمارش سلول های خون محیطی، تعداد گلبول های سفید ۵۰۰۰۰ گزارش شد که ۶۰ آن را ائوزینوفیل ها تشکیل می دادند. میزان هموگلوبین و پلاکت طبیعی بود. در آزمایش مغز استخوان، افزایش سلولاریتی به همراه افزایش تعداد ائوزینوفیل ها و لنفوبلاست ها نشان داده شد. آزمایش فلوسیتومتری بر روی سلول های خون محیطی و مغز استخوان حاکی از تشخیص لوسمی پیش ساز لنفوئید B بود. بیمار تحت درمان با رژیم دارویی CVAD با دوز بالا قرار گرفت که پاسخ نداد و بنابراین تحت درمان با رژیم دارویی FLANG قرار گرفت که منجر به بهبودی بیماری وی گردید. در نهایت بیمار برای پیوند آلوژن مغز استخوان ارجاع شد. نتیجه گیری: با توجه به گزارش حاضر توصیه می شود در بیماران با افزایش شدید ائوزینوفیل ها به بیماری ALL نیز توجه شود و اقدامات لازم و به موقع در تشخیص بیماری به عمل آید

Multiple Myeloma Presenting as Acute Tubulointerstitial Nephritis and Normal Serum Protein Electrophoresis

Multiple myeloma is uncommon in individuals younger than 40 years. Renal involvement is common in this disease, but acute tubulointerstitial nephritis is very rare. In 20% of patients, only the light chain is produced and serum protein electrophoresis is normal; however, in urine protein electrophoresis of these patients, the M spike is present. We reported a case of multiple myeloma in a 39-year-old man with acute tubulointerstitial nephritis. Serum protein electrophoresis was normal and there was no bone lytic lesion. Remission of multiple myeloma was achieved after treatment with thalidomide and dexamethasone; however, kidney failure was not improved and the patient was maintained on hemodialysis

A randomized field trial for the primary prevention of osteoporosis among adolescent females: Comparison of two methods, mother centered and daughter centered

Background: Osteoporosis is a serious public health. Since the majority of bone mass occurs during adolescence, primary prevention is important. Probably mother's participation in health education interventions leads to promote health behaviors in children. Aims: To assess a lifestyle modification intervention focused on mothers and students has an impact on osteoporosis preventive behaviors in adolescent girls. Materials and Methods: It is a randomized field trial in female high schools. 210 girls aged between 11 and 15 were randomly selected. Students in groups A and C and mothers in group B were selected Through the sampling frame. Our lifestyle modification was based on group based education in the public girls' high schools. Subjects in the intervention groups participated in three educational sessions. Students' osteoporosis preventive behaviors were measured by using a lifestyle questionnaire consisting of items assessing nutrition, physical activity and sun exposure. Repeated measure ANOVA at baseline, 4 week, 2 months and 6 months and were used to analyze the data. Results: After 1 month, diet and sun exposure scores increased significantly (P < 0.001) but it was higher in group B compared with group A. (About diet P < 0.001 and sun exposure = 0. 001). After 6 months, diet and sun exposure status in the group A approximately decreased to baseline, while in group B, diet components were significantly different compared to baseline (P < 0.001). There was no change in physical activity. Conclusion: Osteoporosis prevention intervention of adolescent can be effective when parents or girls participate in training sessions, but education is associated with better outcomes when focused on mothers

Effect of silymarin in the prevention of Cisplatin nephrotoxicity, a clinical trial study.

BACKGROUND Reno-protective effect of Silymarin was studied in some studies mainly on rats. In some of these studies, Silymarin was shown to have positive effects on preventing or decreasing severity of Cisplatin nephrotoxicity. OBJECTIVE The aim of this study was to evaluate the protective effect of Silymarin on Cisplatin nephrotoxicity in adult patients with malignancy. MATERIALS AND METHODS In this clinical trial study, 60 patients with malignancy, candidate of Cisplatin treatment were randomly enrolled in two equal groups. In patients of case group, Silymarin tablet 140 mg/bid was administrated seven days before Cisplatin administration together with Cisplatin, and in control group, Cisplatin was prescribed. Blood Urea Nitrogen (BUN) and serum Creatinine (Cr) were checked at the same day and 3 and 7 days after administration of Cisplatin. RESULTS Mean age of the patients in case and control groups were 51.1±14.3 y and 51.1±13.7 y respectively (p=0.99). There was no significant difference based on BUN and serum Cr in the beginning of study and three days after administration of Cisplatin in two groups of patients; however, after two weeks, BUN and serum Cr were significantly lower in the case group compared to the control group. Also, in the case group, BUN and serum Cr decreased and in the control group, they increased after two weeks after Cisplatin administration. CONCLUSION This study showed that Silymarin can decrease Cisplatin nephrotoxicity, so because of safety profile and minor adverse effect of Silymarin, we can use it as prophylaxis against Cisplatin nephrotoxicity in various Cisplatin-contained chemotherapy regimens

The Protective Effect of Curcumin on Hepatic Function in Cancer Patients Receiving Taxane-Based Chemotherapy: A Randomized Controlled Clinical Trial

Background: Cancer has become a significant health challenge in recent decades. The Taxane family is one of the popular chemotherapeutic agents which can cause hepatic injury. The present study was conducted with the aim of evaluating the hepatoprotective effect of Curcumin on cancer patients treated with Taxanes. Method: This controlled randomized clinical trial (RCT) has been conducted on 80 patients with either breast, ovary, or pancreas cancer randomly allocated to the intervention group (n = 37) treated with daily 47.5 mg Curcumin extract or the control group (n = 34) treated with placebo. Hepatic indices, including alanine transaminase, aspartate transaminase, total bilirubin, and alkaline phosphatase, were measured and compared at baseline within three and six weeks after the intervention initiation. Results: The assessments revealed a remarkable increase in all of the indices in both groups by the time (P < 0.05), while these increases were remarkably less among the patients treated with curcumin in comparison with placebo treatment (P < 0.05). The Mean ± standard deviation was 26.3 ± 8.6 and 29.8 ± 10.5 for aspartate transaminase, 25.5 ± 8.3 and 30.2 ± 10.6 for alanine transaminase, 122.9 ± 18.02 and 126.8 ± 16.9 for alkaline phosphatase, 0.88 ± 0.10 and 0.95 ± 0.12 for bilirubin in the intervention and control groups, respectively. Conclusion: Based on the current study's findings, Curcumin could act relatively as a hepatoprotective agent against Taxane; however, further studies are strongly recommended to determine the dosage and consumption instruction of this agent for patients with cancer

COVID-19-associated thrombotic thrombocytopenic purpura (TTP); a case report

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease (COVID-19) pandemic is the largest infectious crisis in the present century. It has been reported that COVID-19 infection may trigger autoimmune diseases. Herein, we report a 68-year-old male that was diagnosed with thrombotic thrombocytopenic purpura (TTP) following COVID-19 infection. To our knowledge, this is the fourth case of COVID-19-associated TTP. More attention is required regarding the possibility of developing TTP in COVID-19 patients, especially with the presence of decreased consciousness and low levels of hemoglobin and platelet

The Association of miR-451 and miR-21 in Plasma with Lymph Node Metastases in Breast Cancer

BACKGROUND AND OBJECTIVE: The expression of some circulating microRNAs (miRNAs) in biological fluids of healthy individuals is different from cancerous patients. circulating miRNAs are a new class of cancer biomarkers because of their high stability and sensitivity, ease of measurement and specificity due to their correlation with various cancer states. According to the miR-451 and miR-21 functions in the metastasis of some cancers, the aim of this study was to investigate the differences of expression levels of miR-451 and miR-21 in the plasma of breast cancer (BC) patients with and without lymph nodes metastasis (LNM). METHODS: In this descriptive-analytical study, blood samples were collected from 47 women with BC and 24 healthy women with mammography confirmation. The presence/or absence of LNM was recognized from patients' medical records. The expression levels of miR-451 and miR-21 in the plasma, were investigated using Real-Time PCR. FINDINGS: The median of expression of miR-451 in BC patients with LNM and without LNM was 1.739 and 3.187, respectively, and its expression in lymph node metastatic patients decreased 0.444 folds in comparison with non-metastatic patients (p=0.031). The median of expression of miR-21 in patients with LNM and in non-metastatic lymph nodes patients was 5.922 and 2.157, respectively, and its expression in metastatic status was 2 folds higher than non-metastatic (p=0.029). CONCLUSION: The results of this study indicated that decreased miR-451 and increased miR-21 expression in plasma of BC patients was associated with LNM status

Clinical Manifestations of β-Thalassemia Major in Two Different Altitudes; Bushehr and Shahrekord

Background: Patients with β-thalassemia major (TM) develop iron overload through increased iron absorption and transfusional therapy and it’s the most important complication of TM. Thalassemia is common in coastal regions and lands with low altitudes. The aim of this study is to determine the effect of high and low altitude on serum ferritin and treatment requirement in two groups of β-thalassemia major (TM) patients. Subjects and Methods: Patients were divided into two groups, the first group (No: 50) living at sea level (in the port of Bushehr, Iran) and the second group (No: 40) living at the altitude of 2061 m (in the city of Shahrekord, Iran). All patient’s clinical history, blood transfusion and laboratory tests including complete blood count and hemoglobin electrophoresis were reviewed. Results: There were no significant difference in ferritin levels, transfusion period and diabetes incidence of the two cities patients (P>0.05). Patient’s cardiac function and liver condition were significantly better in patients of Bushehr (P<0.05). Patients under 20 years in Bushehr were less splenectomized in comparison with Shahrekord (P<0.05). Conclusion: Our result showed that some of clinical manifestations of patients in low altitude such as cardiac and liver condition were better. But it did not affect ferritin level probably due to transfusion and chelating therapy. Totally patients of Bushehr had better conditions and had longer survivals. Keywords: β-thalassemia major, Ferritin level, Cardiac function, Altitud

Main barriers and potential solutions in development of energy efficient buildings in warm climate of Iran

Iran is considered as one of the developing countries in the Middle East with high levels of energy consumption. Enhancing the energy efficiency of buildings can be regarded as a sustainable method of reducing the energy consumption and subsequently, the environmental impacts in Iran. Only a few buildings in Iran are constructed via using EE strategies, but they are built with less or unsuccessful operations and neglects in the implementation of EE technical solutions. The aim of this study is to identify the experiences of EEB in Iran especially in warm climate and identifying the barriers and drivers in the developing of EEBs in Iran. The study adopted a qualitative methodological approach and strategy in data collection and analysis. 8 EEBs and designs in Iran were selected as case studies. Qualitative method by using case study, observation, semi-structured interviews were used to interview architects of 8 EEBs and designs in Iran. Observations were conducted on these 8 case buildings for collecting evidences of neglect in their design, constructions and operation. semi-structured interviews were conducted among 16 architects to understand main barriers and drivers in the developing of EEB in Iran. Due to great diversity of barriers to finding and implementing solutions, it will be useful to group these barriers in some way which should not seen as rigid, but as a framework for identification and analysis. In gauging this understanding, a Trudgill (1990) framework for analysis consist of six major groups of barriers – agreement, knowledge, technological, economic, social and political was used. The study identified 63 barriers deterring the development and implementation of applying EE solutions in Iranian buildings and these were grouped into 8 categories: 1) Low energy prices in Iran, 2) Lack of interest by client for applying EE solutions in their building, 3) Applying EE solutions in building cost too much, 4) Lack of political will, legislation and enforcement, 5) Lack of technical understanding among project team members, 6) Lack of interest by project team members, 7) Lack of some of the EEB components on the Iran markets, and 8) Lack of leadership in EEB projects. For the solutions to overcome the obstacles 94 answers were suggested by 16 interviewees and these were grouped into 4 categories: 1) Action by government, 2) Action by education Sector, 3) Action by private sector, and 4) Action by Clients. The benefits of research is to identified the EEBs and their opportunities like economic benefits, environmental benefits, reduction in energy usage as well as one of the best strategic solutions for the decreased air pollution and global demand for energy etc. for the Iranian public and Iranian building industry players