Studying Malnutrition-Related Factors in Patients with Head and Neck Cancer Following Surgery

Background: Nutritional dysfunction with or without aspiration is a common complication following head and neck cancer (HNC) surgery and patients frequently present with weight loss secondary to dysphagia and malnutrition.Aim: The aim of this study was to investigate the incidence of weight loss and malnutrition in patients with HNC following surgery through the Malnutrition Universal Screening Tool (MUST) scale.Methods: A total of 28 patients with a confirmed diagnosis of head and neck cancer mainly of the oral cavity referring for surgery for the first time were enrolled. A researcher-designed questionnaire was used for data collection. Further, a single nutritionist evaluated each patient’s nutritional status before and 6-8 weeks' post-surgery according to MUST to measure the level of malnutrition. Significance level was set at p<0.05.Results: Among the subjects, 57% were younger than 70 years; 61% were in stage II of cancer while the rest were in stage III. Weight, body mass index (BMI), serum hemoglobin, and albumin levels showed a significant reduction following surgery (p<0.05). Specifically, 18% had less than 5%, 36% had 5-10%, and 46% had >10% weight loss. According to MUST scale, 18% of Patients with HNC had low, 25% had moderate, and 57% had high risk of malnutrition. A significant relationship was found between severe malnutrition and patients older than 70 years of age.Conclusion: In head and neck cancer patients, weight loss increases the morbidity and mortality, therefore nutritional interventions should be initiated before cancer treatment begins and these interventions need to be ongoing after completion of treatment to ensure optimal outcome

Effect of Training Based on Choice Theory on Health-Promoting Lifestyle Behaviors among Menopausal Women

Background & aim: Menopause is considered as a stage of life that is often encountered by all women with symptoms as hot flashes, sweating, palpitations, sleep disorders, and urinary tract problems. The improvement of health-promoting lifestyle behaviors is one of the effective measures to moderate these symptoms by facilitating the women to enhance their lifestyle behaviors through making proper choices. The aim of this study was to measure the effect of training based on choice theory on health-promoting lifestyle behaviors in menopausal women. Methods: This two-group pretest-posttest design was conducted on 40 menopausal women within the age range of 45-55 years, referring to healthcare centers in Mashhad, Iran, in 2016. The subjects were randomly assigned into intervention and control groups using simple random sampling method. The data collection instruments included a demographic questionnaire, a menopause knowledge/attitude questionnaire, as well as Health-Promoting Lifestyle Profile II (HPLPII), which consisted of six dimensions of nutrition, physical activity, responsibility for health, stress management, interpersonal relationships, and spiritual growth. The intervention group received training in seven 90-minute sessions based on choice theory. The data were analyzed in SPSS software using descriptive statistics, Mann-Whitney U test, independent t-test, paired sample t-test, and Friedman test. Results: According to the results, after the intervention, the mean scores of total health-promoting lifestyle behaviors (

Immunohistochemical evaluation of C4d and C3d markers in bullous pemphigoid as a substitute for direct immunofluorescence technique

Background: There are several methods for the diagnosis of autoimmune bullous disease. Direct immunofluorescent (DIF) testing is an important diagnostic method in the diagnosis of immunobullous disease but requires skilled pathologist, fresh tissue and well-equipped laboratory to perform the procedure. The immunohistochemistry analysis of C4d and C3d is easily compared with other methods. This study was conducted to assess the value of immunohistochemistry (IHC) analysis for expressions of C3d and C4d in the diagnosis of bullous pemphigoid (BP). Aims and Objectives: This study was conducted to assess the value of immunohistochemistry (IHC) analysis for expressions of C3d and C4d in the diagnosis of bullous pemphigoid (BP). Materials and Method: We applied C4d and C3d immunohistochemistry on formalin-fixed, paraffin-embedded tissue on 30 cases of bullous pemphigoid that was confirmed by direct immunofluorescence (DIF) evaluation as well as 16 cases in control group (12 cases of herpetiform dermatitis, 3 cases of linear IgA dermatosis and 3 cases of bullous lichen planus). Results: Mean and SD of age were 68.13 ± 14.00, female to male ratio was 1:3. In cases where both C3d and C4d staining were positive, the intensity of C3d staining was higher than C4d. Twenty-two cases showed C4d-positive staining in IHC study, such that in seven cases focal staining and in 15 cases diffuse staining were observed. Also 26 cases showed C3d-positive staining in IHC study such that in four cases focal staining and in 22 cases diffuse staining were observed. In cases with C3d-positive staining, there were 21 cases of deposition only on the bullous floor, one case on the bullous roof and four cases on the bullous roof and floor. In cases with C4d-positive staining, there were 17 cases of deposition on the bullous floor, two cases only on the bullous roof and three cases on the roof and floor. All control cases were negative for C3d and C4d staining in the dermoepidermal junction. For C3d immunohistochemical staining, sensitivity, specificity, positive predictive value and negative predictive value were 86.66%, 100%, 100% and 80%, respectively, and for C4d immunohistochemical staining, respectively, were 73.3%, 100%, 100% and 66.66%. Conclusion: The immunohistochemical specificity of C4d and C3d on tissue blocks is the same as that of direct immunofluorescence test on fresh tissue, but it is less sensitive, so positive results for C3d and C4d immunohistochemical staining on paraffin blocks can be used to confirm the diagnosis of bullous pemphigoid