Emergency Surgery for Acute Dissection of the Ascending Aorta

Background: Aortic dissection is a nonprevalent disease and its late diagnosis can be life-threatening with a high mortality rate.The timely treatment of this disease can increase the survival rate considerably.Objectives: The aim of this study was to provide a surgery report of patients with aortic dissection operated in a community hospital.Methods: In this descriptive study, the mortality rate and operation events of five patients with an acute aortic dissection referredto a community hospital were reported during the period of 2011 to 2015.Results: In this study, 5 patients with aortic dissection referred to the cardiology emergency ward of the hospital were operated.Twoof five patients were males; one of them had the Marfan’s disease and another one had the bicuspid aortic valve. The remainderswere females; the first case was an old woman with a traumatic chest injury who died during the operation due to arrhythmia. Thesecond case was a 42-year-old pregnant woman suspicious to Marfan’s disease with a history of sudden death in her brother. Thethird woman was a case of aneurysm of ascending aorta with a bicuspid aortic valve.Conclusions: The findings of this study show that early diagnosis and timely operation can increase the survival rate of patientswith an aortic dissection

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

Diagnostic Imaging Modalities for Skeletal Metastasis in Soft Tissue Sarcoma

Soft tissue sarcomas (STS) are usually highly malignant. Bone metastasis is less common in STS but it significantly affects patients` quality of life and also is indicator of poor prognosis. Different types of imaging modalities are available for diagnosis and follow-up of STS. Bone scintigraphy is a sensitive and cost effective method for screening bone metastases however it`s poor specificity must be covered by other imaging methods like computed tomography. More sophisticated methods are available including whole body magnetic resonance imaging (MRI) and positron emission tomography (PET). Equipment limitations and high costs are the main problems with ofthese methods

Qualitative Examination of Health Tourism and Its Challenges

Introduction: Health tourism refers to travel for the use of services that improve or promote the physical or psychological health of an individual in a location apart from their place of residence lasting over 24 hours. Health tourism provides a sizeable share of revenues derived from the health sector in some countries. The high potential for health tourism in Iran, especially in the city of Mashhad, the need to establish a groundwork for health tourism in Iran that cannot be overemphasized. Because the transfer of knowledge and theoretical and practical synthesis are underlying concerns, this study examined how health tourism knowledge is transferred and applied from the perspective of health tourism officials and academics. Methods: This study adopted a qualitative approach based on grounded theory. Data collection was conducted through purposeful sampling using in-depth and semi-structured individual interviews. The conversations were recorded and then transcribed verbatim and finally analyzed using Strauss and Corbin’s coding paradigm and constant comparative analysis. Results: The results of interviews with 16 participants from among hospital managers, university professors and tourism and health insurance managers yielded 100 initial codes, out of which 60 conceptual labels or preliminary codes for broader concepts were extracted after repeated modification to reach conceptual density. Conclusion: Three categories having several subcategories were derived from the responses of participants: the challenges and benefits of health tourism, human interaction and communication and the impact of international standards

Knowledge and perception toward colorectal cancer screening in east of Iran

Background: Colorectal Cancer (CRC) is the third most common cancer in Iran and its early detection is necessary. This study is based on perception of people in the east of Iran toward CRC screening. Methods: In a cross-sectional study, 1060 randomly selected individuals who referred to Razavi Hospital of Mashhad, Iran, between September the 1 st , 2012 and February the 28 th , 2013 as patients or their visitors involved in an interview to fill a questionnaire on CRC screening. Results: The participants’ age ranged from 40 to 88 years (mean= 55). More than 90% had no knowledge of CRC and screening tests. The most cited reasons for not having screening tests were “did not have any problem” and “did not think it was needed”. Although, older people had more knowledge of CRC ( P = 0.033), there was no relationship between gender, health insurance status, family history of individuals and their knowledge about CRC ( P > 0.050). Employment, education and higher income had positive effect on the perception of people toward CRC screening ( P < 0.050). Conclusion: Lack of knowledge in people in lower socio-economical class with limited literacy is the most important barrier to CRC screening. As such, designing educational programs involving physicians and media is important to improve CRC screening rates

Trefoil Factor Family in Pre-neoplastic Lesions and Gastric Cancer

Gastric cancer is the fourth most common cancer and the second leading cause of cancer death worldwide. Although the global incidence of gastric cancer has been decreased dramatically in recent decades, north and northwest of Iran have the highest incidence rate of gastric cancer. Whilst the surgical procedures for gastric cancer have been improved, there is no cure for that. The intestinal type of GC results from pre-neoplastic conditions including atrophic gastritis, intestinal metaplasia and dysplasia. Trefoil Factors Family proteins (TFFs) are small and stable molecules secreted by the mammalian gastrointestinal tract. TFFs constitute a family of three peptides (TFF1, TFF2and TFF3) that are widely expressed in a tissue specific manner in the gastrointestinal tract. Variable TFFs expression in gastric cancer and pre-neoplastic lesions has been found. TFF1 has a tumor suppressor activity and inhibits tumorogenesis in gastric cancer. Its expression decreases in gastritis, gastric atrophy, dysplasia, intestinal metaplasia and gastric cancer.TFF2 has a protective effect on gastrointestinal epithelium. As a prognostic factor, TFF2 expression decreases in gastric ulcer, chronic atrophic gastritis and gastric cancer. TFF3 is considered as an oncogenic factor in gastric tissues. Whilst the normal gastric tissues don’t express TFF3, it increases in intestinal metaplasia. Therefore, more studies are necessary to clarify the role of TFFs in GC and pre-neoplastic conditions. This review has focused on elucidating the important role of TFFs in gastric cancer and pre-neoplastic lesions

A Study of the Relationship between Job Satisfaction and Burnout among Neonatal Intensive Care Unit Staff

Background: Considering the importance of job satisfaction and occupational burnout among nurses, the present study aimed to determine the prevalence of occupational burnout and the degree of job satisfaction among neonatal intensive care unit (NICU) nurses.Methods: The current research was a cross-sectional study in which the Job Descriptive Index and Maslach Burnout Inventory were distributed among the NICU nurses. The collected data were analyzed using SPSS software.Results: A total of 30 NICU nurses working in two public and private hospitals participated in the present study. The mean age of the participants was measured at 37.46±6.93 years, most of them (73.3%) held a Bachelor’s degree and more than 60% were married. No significant relationship between job satisfaction and burnout was observed among the nurses. Both variables were moderate among the NICU nurses as representatives of the staff working in special units.Conclusion: It is widely believed that people who are exposed to extreme stress for a long time are more likely to suffer from occupational burnout. Moreover, considering the importance of this issue in healthcare environments for the provision of services that physically and mentally affect patients, it is recommended to pay greater attention to employee satisfaction and burnout process in hospital settings

The Effect of Zinc Supplementation on Cognitive Performance in Schoolchildren

Introduction Zinc is a vital micronutrient in humans and its deficiency in children can thwart their growth and development, compromise their immunity and cognitive function. However, there is a paucity of studies about the effect of zinc supplementation on cognitive functions. This study is an attempt to quantify the impact of zinc supplementation on cognitive performance of schoolchildren. Materials and Methods This randomized, double-blind, placebo-controlled field trial was carried out in public elementary school in Mashhad- Iran to investigate the effect of Zinc on cognition of 45 healthy children. The cognitive test used in the trial was Raven IQ (Intelligence Quotient) test. A total of 45 first grade children aged 6 to 8 years were enrolled and divided into two experiment and control groups. The cases group, received 20 mg of zinc sulfate syrup vs.  the control group  received a placebo each day for 6 months. Raven IQ test was administered under basal conditions before and after the supplementation of zinc or placebo. Results The memory and intellectual development in the experimental group was significantly more than in the control group (P < 0.05). Conclusion The results of the study demonstrate the positive relationship between zinc administration and some aspects of intellectual development and personality features, emphasizing the significance of this element in the normal psychological status of children

Sub Cortical Osteoid Osteoma of the Capitulum: A Case Report

Osteoid osteoma near the joints is a rare case which is difficult to diagnose. Osteoid osteomas refer to solitary, benign, agonizing lesions of the bone with a nidus of 1.5 to 2 cm, which consists of osteoid, osteoblasts, and varying quantity of fibrovascular stroma. This study reports the case of 37-year-old man with a painful flexion contracture of left elbow for 18 months, then was diagnosed a peri-articular osteoid osteoma. Any attempt for movement, whether passive or active, exacerbated the pain. His conditions was treated as tennis elbow and treated for several months, but his pain persisted continuously. A subcortical osteoid osteoma was observed in fine-cut CT scan within the posterior cortex of the capitulum. Thus, a wide en bloc surgical excision of the nidus was implemented, with total mitigation of pain and quick return to daily activities. It is stressed that history of disease and detailed physical examination can help diagnosis

A Report on Emergent Pulmonary Embolectomy

Introduction: Pulmonary embolism is one of the leading causes of mortality in patients.The mortality rate of this disease can be significantly reduced with appropriate treatment. Surgical intervention can be highly effective for the treatment of acute massive pulmonary embolism. This article presents a report on the experience of acute pulmonary embolectomy. Materials and Methods: Demographic data, rate of mortality, as well as surgical and post-operative complications were recorded and analyzed. Results: In general, 12 patients with mean age of 60±13.39 year were included in the study. None of the patients had significant arrhythmia during the surgery, but 25% suffered from post-operative arrhythmia. Moreover, electrical cardioversion was administered to 8% of the patients, 8% received pharmaceutical interventions, and the rest of the patients sustaining arrhythmia (9%) survived with specific metabolic correction. The diagnosis of acute pulmonary embolism was correct in 100% of the patients, with 33.3% of the cases suffering from this disease due to recent surgeries. In 41.6% of the patients, blood clots were observed in the pulmonary artery, right atrium, and right ventricle. The three-month follow-up of the patients showed that 83.3% of the cases were alive. There were two cases of mortality, one of which occurred at the end of surgical procedure and the other one happened in the intensive care unit. The results of independent t-test did not indicate any significant relation between mortality and ejection fraction of the patients (P=0.189). Moreover, there were not any significant differences between the patients’ pre- and post-operative laboratory tests (P˃0.05). Nonetheless, hemoglobin and hematocrit levels were significantly different pre- and post-operation (P=0.0001). Conclusion: Our data suggest that acute pulmonary embolism can be treated successfully with favorable outcome and a mortality rate of approximately 16.6%, if evaluation and diagnosis are done as soon as possible in patients who require surgical intervention