Ovarian fibroma with elevated CA125 and OVA1 in postmenopausal woman

Ovarian fibroma is a sexcord stromal tumor, which accounts for 4% of all ovarian tumors. It is uncommon benign tumor of ovary. Clinically, it is asymptomatic and may typically be detected during routine gynecological examinations. It may be associated with ascitis and hydrothorax known as Meig's Syndrome. Usually these ovarian tumors are unilateral, solid, hard masses with small areas of cystic degeneration. Due to their solid structure, these benign tumors are sometimes confused with malignant ovarian neoplasm during clinical evaluation. A 59 year old postmenopausal woman presented with flank pain and new onset urinary incontinence. Ultrasound evaluation revealed a pelvic mass. Labs showed elevated tumor marker level. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological examination however revealed an ovarian fibroma. During the postmenopausal years, the ovaries become atrophic. The incidence ovarian neoplasm increases with age. A suspicious or persistent complex mass and increased tumor marker like CA125 and OVA1 in post-menopausal woman requires surgical evaluation. The traditional diagnostic tools for ovarian tumors are bimanual examination, pelvic ultrasound and measuring serum biomarker like CA125 level, but these methods have low specificity and sensitivity. Now-a-days the role of some tumor marker such as OVA1in the management of ovarian tumor has been approved by FDA.

Analyzing the dimensions and components of organizational culture based on normative and individual variables in the managers of education headquarters in Tehran province

The purpose of the current research is to analyze the dimensions and components of organizational culture based on normative and individual variables in the managers of education headquarters in Tehran province. According to its purpose, the research method is applicable; and in terms of execution method, it is qualitative, descriptive-exploratory; and in terms of its nature, it is among foundation data research. The statistical population of this research includes 12 experts who are well-informed and proficient in the subject of research in the field of management and have a valid scientific background in this field. Sampling method used in this research was non-random purposeful. The method of data collection is referring to documents, semi-structured interviews and questionnaires. For data analysis, Atlas ti software was used to code the interviews. The results showed that in the normative dimension, there are 10 categories: organizational justice, work maturity, ambiguity avoidance, external supervision, decision-making, job promotion, masculinity or feminism, concentration (power distance), customer orientation, productivity with 57 indicators; and in the Individual dimension also has 10 categories: sense of belonging, responsibility, individual creativity, communication, participation (teamwork), identity, self-control, motivation, conflict, interaction in 61 indicators and in 6 categories that include causal conditions, communication conditions, background factors, intervener factors, strategies, consequences were identified.Extended abstractIntroductionJust as people in the society have certain beliefs, values ​​and behaviors that represent their personality; organizations also have common assumptions and basic beliefs that shape their culture. Culture has been defined as the set of spiritual achievements of a nation. Culture is a human invention and made by human hands. This finding reflects the existence and identity of a society (Mirza Mohammadi, 2021). Organizational culture is the personality of the organization and it is considered as the basic infrastructure for transformation and change, and managers should understand its relationship with national culture and strive for organizational cohesion by taking advantage of its strategic role. Organizational culture is an interwoven set of basic assumptions, common inferences and collective wisdom that is formed in the context of previous experiences and findings in facing internal or external issues and serves as a guiding light and an invigorating source plays a role in shaping the behavior of employees and architecture of the present and future of the organization (Mohammadiyan & Shahsavari, 2019).Education is a continuous activity, comprehensive and for everyone, which leads to human growth and development, cultural enrichment and the excellence of society, and therefore, innovation should always be created in it. In other words, education is not specific to an exclusive period and time of life and has no time limit, so it must always be renewed and updated (Safaei et al, 2020). For organizational innovation, development and transformation, one of the important organizational conditions that must be considered in policies and implementation of programs is related organizational culture. The author's many years of experience in executive affairs shows that lack of paying attention to organizational culture has not always led to the desired results of innovation, development, organizational transformation and change in organizations (Hamzeh & Hamzeh, 2016). An organizational culture able to respond to environmental changes can lead to optimal organizational performance.According to the above materials, the researcher asked the main question: what are the dimensions and components of organizational culture based on normative and individual variables in the managers of education headquarters in Tehran province? Theoretical FrameworkOrganizational CultureCulture is a set of customs, standards and individual and social behaviors; therefore, while culture is the effect of many parts of religious views, it is also considered the cause of many conditions and situations. Due to the progress of communication tools and the ever-increasing expansion of their use in many social phenomena and developments, the role of culture has become far greater than in the past; in such a way that culture now plays a decisive role at the domestic, regional and international levels and is one of the tools that governments use to achieve their goals and objectives; in this way, cultural dominance is not a new phenomenon. Cultural policy in the general and customary sense includes a set of goals, principles, priorities and executive policies (Mirza Mohammadi, 2021).Normative and individual variablesIn the conceptual definition of norms, most sociologists are more or less unanimous that norms (forms) are the rules of social behavior that guide a person in social actions. Observing these patterns and rules of behavior expected by the society's culture, and avoiding them is punishable (Khabbaz Yazdiha et al, 2020).Zebardast et al, (2022) investigated the relationship between the transformational leadership factors of educational group managers on the effectiveness of university faculty members through organizational culture. The results showed that the relationship between transformational leadership style of managers and organizational culture was significant and the mediating variable of organizational culture has a significant effect on the relationship between transformational leadership style and the effectiveness of faculty members. It can be said that transformational leadership does not have a direct and significant effect on effectiveness in the final research model. However, transformational leadership affects the effectiveness of faculty members through organizational culture.Yusefi et al, (2022) investigated the impact of individual and normative variables on ethical leadership. The results of the research show that value, job satisfaction, motivation, personality, creativity, components were individual components, and organizational communication, organizational culture, organizational structure, decision-making styles, roles and expectations, goals and strategy were normative components that had a significant impact on ethical leadership.Research methodologyThis research is applicable in terms of purpose, qualitative in terms of execution method: descriptive-exploratory type, and data-based in terms of its nature. The statistical population includes 12 experts and specialists who are well-informed and proficient in the subject of research in the field of management, and have a valid scientific background in this field. Non-random purposeful sampling method is used to determine the samples and determine the experts.Research findingsThree types of coding were used to analyze the data obtained from the interview as well as theoretical foundations, which are: open coding, axial coding and selective coding. For analysis, Atlas ti software was used to code the interviews. The results showed that in the normative dimension, 10 categories were identified: organizational justice, work maturity, ambiguity avoidance, external supervision, decision-making, job promotion, masculinity or feminism, concentration (power distance), customer orientation, productivity with 57 indicators; and in the individual dimension also 10 categories: sense of belonging, responsibility, individual creativity, communication, participation, identity, self-control, motivation, conflict, interaction in 61 indicators, and in 6 categories that include causal conditions, communication conditions, background factors, intervener factors, strategies, consequences.ConclusionThe present research was conducted with the aim of analyzing the dimensions and components of organizational culture based on normative and individual variables in the managers of education headquarters in Tehran province. The results of this research are correspond with the results of Turki et al, (2021), Eimani et al, (2021), Van Dung HA (2020), Yusefi et al, (2020), Mohebbi et al, (2023), Zebardast et al, (2022). Mohebbi et al, (2023) showed that in educational organizations, organizational culture plays an important role in producing teamwork culture and achieving the benefits of the process of participation and collaboration. Educational systems have a special place according to their goals and mission, the most important of which is the training of efficient human resources for other institutions of society; and universities are the most important and key educational organizations that, in addition to training human resources, respond to the social needs for the acquisition and dissemination of knowledge and technology.According to the results obtained in three dimensions, the following suggestions are presented:- The motivation of managers to create team and collaborative activities should be improved. The opportunity to grow, develop and acquire new effective professional skills and knowledge for managers should be provided for the managers. The conditions of sustainable competitive advantage should be designed. The ground for continuous improvement of organizational intelligence in order to realize the learning organization should be prepared. Individual development and strengthening positive behaviors of managers should be considered. By creating a positive organizational atmosphere, the cooperative structure of the organization should be strengthened. Agility of the organization structure according to the suitability of the job and competence of the people and increasing the efficiency and effectiveness of the rules and regulations by simplifying matters should be considered. By supporting individual values ​​and de-stressing people, internal motivation and sense of belonging to the organization should be improved. Influence in decision-making and implementation by delegating authority should be considered. The position of managers in the organization should be changed to facilitator and leader. Try to create an active, effective and sustainable teaching and learning environment. Macro vision, goal setting, strategic planning and management, foresight, future research and future-recording and problem solving ability should be taken into consideration as important points for choosing staff managers

Erectile dysfunction in diabetic patients

Background and Objective: Erectile dysfunction (ED) is the most neglected complications of diabetes mellitus that reduce the quality of life. The purpose of this study was to evaluate the erectile dysfunction and related risk factors in diabetic patients. Materials and Methods: This descriptive analytical study was done on 700 diabetic men aged 20-69 years at Sina hospital and Abouzahr Health Center in Tehran- Iran during 2002-03. Patients were screened for erectile dysfunction using the International Index of Erectile Function (IIEF) questionnaire. Data were analyzed using SPSS software and Chi-Square test the P≤0.05 was considered to be significant. Results: Prevalence of erectile dysfunction was 35.1%. Prevalence rate of erectile dysfunction was 25.8% and 36.7% in type 1 and type 2 diabetic patients, respectively (P<0.05). Prevalence of mild, moderate and severe erectile dysfunction were 5.6%, 19.6% and 10%, respectively. Prevalence of erectile dysfunction reached from 9.7% in men aged 20-30 years to 35% in those aged over 60 years (P<0.05). In comparison with reporting diabetes lasting≤5 years (25.4%), prevalence of erectile dysfunction was less than those reported diabetes 6-11 years (34.3%) and 12-30 years (43.5%) (P<0.05). Erectile dysfunction increased significantly in those who had poor glycemic control. Prevalence of erectile dysfunction in good, fair and poor glycemic control was 28.4%, 39% and 44.4%, respectively (P<0.05). Conclusion: This study showed that good glycemic control and reducing the cigaret smoking are necessary to reduce prevalence of erectile dysfunction in diabetic men

A dual H-type tracheoesophageal fistula; why not being repaired simultaneously? A case report and review of literature

Abstract Background H-type Tracheoesophageal Fistula (TEF) is a particular type of congenital esophageal anomalies, in which patients present with non-specific symptoms that can result in delayed diagnosis. Here, we report two pediatric cases with a rarer variant called ‟dual H-type TEFˮ. Case presentation We present two cases of H-type TEF. The first was a 45-day-old boy with feeding problem and cyanosis while feeding, and the second was a three-month-old girl with cough and choking after feeding from the first day of birth. In both cases, two separate TEFs were detected during diagnostic evaluation by flexible bronchoscopy. Both were repaired simultaneously through a cervical incision. The first patient deteriorated 13 days after the surgery, disturbancing in acid-base balance and expired unfortunately. Conclusion Hence, it is necessary to consider the possibility of double TEF in any newly diagnosed H-type TEF

Saudi Oncology Society clinical management guidelines for testicular germ cell tumors

In this report, guidelines for the evaluation, medical and surgical management of transitional cell carcinoma of testicular germ cell tumors is presented. It is categorized according to the stage of the disease using the tumor node metastasis staging system, 7th edition. The recommendations are presented with supporting level of evidence