Pulmonary Extramedullary Hematopoiesis in a Patient with Chronic Asthma Resembling Lung Cancer: A Case Report

Background. Extramedullary hematopoiesis is most often seen in reticuloendothelial organs specially spleen, liver, or lymph nodes, and it is rarely seen in lung parenchyma. Almost all reported cases of pulmonary extramedullary hematopoiesis occurred following myeloproliferative disorders specially myelofibrosis. Other less common underlying causes are thalassemia syndromes and other hemoglobinopathies. There was not any reported case of pulmonary extramedullary hematopoiesis in asthmatic patients in the medical literature. Case. Here we reported a 65-year-old lady who was a known case of bronchial asthma with recent developed right lower lobe lung mass. Chest X-ray and CT studies showed an infiltrating mass resembling malignancy. Fine needle aspiration cytology of mass revealed pulmonary extramedullary hematopoiesis. The patient followed for 10 months with serial physical examination and laboratory evaluations which were unremarkable. Conclusion. Extramedullary hematopoiesis of lung parenchyma can be mistaken for lung cancer radiologically. Although previous reported cases occurred with myelofibrosis or hemoglobinopathies, we are reporting the first case of asthma-associated extramedullary hematopoiesis

Sonographic assessment of congenitally hypothyroid children in Iran

Introduction: Considering the high prevalence of congenital hypothyroidism (CH) in Isfahan, it seems that it is necessary to investigate the aetiology of the disorder and its related factors. The aim of this study was to determine the aetiology of CH among children in Isfahan province. Material and methods: In this cross-sectional study, the aetiology of CH and the volume of the thyroid was assessed using neck ultrasonography. The results of thyroid function screening tests were additionally recorded. The correlation between ultrasonographic findings and the level of TSH and as well as T4 was determined. Results: During this study 385 CH patients aged 0-3 years were studied. According to ultrasonographic findings, in 19.9% of patients the aetiology of CH was dysgenesis (agenesis, ectopy, and hemiagenesis) and 80.1% had normal thyroid. Mean thyroid gland volume in all studied patients was 0.78 &#177; 0.44 mL. The prevalence of ultrasonographic findings was as follows: normal 80.1%, agenesis 12.7%, hemiagenesis 5.8%, and ectopy 1.4%. There was a significant correlation between thyroid volume and TSH and T4 and as well as between TSH and ultrasonographic findings (p < 0.05). Conclusions: In spite of the limitations of ultrasonography in the field of determining the aetiology of CH, it is an appropriate imaging tool for determining the volume of the thyroid gland in children. Considering that the rate of goitrous gland was low, it seems that iodine deficiency could not be responsible for the high rate of CH in this region. (Pol J Endocrinol 2010; 61 (6): 665-670)Wstęp: Z uwagi na częste występowanie w Isfahanie wrodzonej niedoczynności tarczycy (CH, congenital hypothyroidism) należy wyjaśnić przyczyny powstania tego zaburzenia i sprzyjające jego rozwojowi czynniki. Celem badania było ustalenie etiologii CH u dzieci zamieszkałych w prowincji Isfahan. Materiał i metody: W tym przekrojowym badaniu przeprowadzono badanie ultrasonograficzne szyi w celu oceny wielkości tarczycy i ustalenia etiologii niedoczynności tego narządu. W ramach programu badań przesiewowych wykonano testy oceniające czynność tarczycy. Zbadano korelacje między wynikami badań ultrasonograficznych a stężeniami TSH i T4. Wyniki: Do badania włączono 385 dzieci z CH w wieku 0-3 lat. Badania obrazowe wykazały, że u 19,9% chorych przyczyną CH były zaburzenia rozwoju tarczycy (agenezja, ektopia i hemiagenezja). Średnia objętość gruczołu tarczowego w badanej grupie wynosiła 0,78 &#177; 0,44 ml. Uzyskano następujące wyniki badań ultrasonograficznych: obraz prawidłowy u 80,1% dzieci, agenezja - 12,7%, hemiagenezja - 5,8%, ektopia - 1,4%. Stwierdzono istotną korelację między wielkością tarczycy a stężeniem TSH i T4 oraz między stężeniem TSH a wynikami badań ultrasonograficznych (p < 0,05). Wnioski: Mimo ograniczeń ultrasonografii, jako metody określania etiologii CH, ten rodzaj badań obrazowych jest przydatny do oceny wielkości tarczycy u dzieci. Biorąc pod uwagę rzadkie występowanie wola u dzieci z CH, można przypuszczać, że niedobór jodu nie jest przyczyną wysokiej zachorowalności na tę chorobę w prowincji Isfahan. (Endokrynol Pol 2010; 61 (6): 665-670

Factors contributing to the burnout of the faculties of a medical university in Iran: A cross‐sectional study

Background and aims: Faculty members confront a variety of obstacles over time, the most recent of which is the coronavirus disease 2019 pandemic, which may increase their vulnerability to burnout (BO). This study aims to examine BO in medical school faculties, as well as the factors that lead to BO and well‐being in them. Methods: This cross‐sectional study was conducted in 2021 using online questionnaires completed by 222 faculty members of a medical university in Iran. The Maslach Burnout Inventory‐Human Services Survey (MBI‐HSS) and the Well‐being index (WBI) were used. Additionally, we gathered individual‐level profiles (demographic, well‐being) and occupational information (job profile, attitude toward work). Results: A total of 60 (27%) faculties reported having high BO, and 112 (50.5%) reported having low well‐being. Being female (odds ratio, OR = 2.69), having time to spend with the family (OR = .26), the intent of turnover (OR = 8.65), job recommendation to the offspring (OR = .26), and experiencing violence last year (OR = 2.97) were some of the individual‐level factors and job‐related attitudes associated with a higher BO. In the neural network for BO, the most important variables were the intention of turnover, followed by adequate family time. Conclusion: One third of the responding faculty reported severe BO, and BO was found to be significantly associated with lower well‐being. The increased levels of BO and a decreased experience of well‐being were both associated with a higher intention of turnover. According to the study, it is important to pay attention to both clinical and nonclinical field faculty members, female faculty members, those who have a high workload, and members who have experienced violence in the workplace. By acknowledging the unique challenges and experiences faced by these individuals, tailored measures can be developed to address their specific concerns and foster a supportive and inclusive environment

The Effect of ECG Training Workshop on Medical Students' Knowledge of ECG Reading and Interpretation

Background : The importance of adequate training of Medical students in regard to the reading and interpretation of ECG is obvious and there are various studies about new methods of teaching ECG interpretation. Objective : This study was aimed to determine the effect of teaching ECG interpretation in workshops and to compare it with current method of ECG training in Isfahan University of Medical Sciences. Methods: This experimental study was done on two groups of students using pre-test/ post-test design. For this purpose, 88 Medical students of an academic semester admitted to the university in the same year were selected and randomly divided into two groups of experimental group (taught in the workshop), and control group (taught by the current method) during Internal Medicine Ward. Results: In whole, 88 students participated in the study of whom 45 were in the experimental group and 43 ones in the control group . In the experimental group mean (±SD) scores of the pre-test (6 ± 1.1) and post-test test (17 ± .7) showed a significant difference (p=0.0001). Mean difference of pre- and post-test scores in experimental group was significantly higher than that in the control group (P=0.0001). Eighty five percent of students in the control group believed on the inefficacy of ECG training in the current educational system, while, 83.80% of participants in the experimental group believed on the efficacy of ECG workshop on their learning. Conclusion: Using new educational methods to improve the quality of educational system and to provide some new opportunities for students to learn by more initiative ways are highly necessary. The obtained results showed clearly the efficacy of the new method comparing to the current one. Keywords: Training, ECG (Electrocardiography), Medical student, Worksho

Bone Marrow and Karyotype Findings of Patients with Pancytopenia in Southern Iran

Background: Pancytopenia is a manifestation of a wide range of disorders. The main prognostic factor for predicting outcome and response to treatment is based on the underlying cause. To detect the root cause of this problem, depending on other accompanied signs or symptoms, the need for bone marrow examination and other advanced work ups is different at least at the practical level. This study focuses on the karyotype abnormality and to demonstrate the ability of this complimentary study in diagnosis and prognosis of such patients. Methods: In this cross sectional study, bone marrow aspiration samples of all patients with Pancytopenia underwent cytogenetic investigation on bone marrow aspiration. Gathered data were analyzed by SPSS software. Results: Among the 100 eligible patients, 67% revealed hypercellular, 19% had hypocellular and 13% had normocellular marrow. Most common causes of pancytopenia were myelodysplastic syndrome (MDS) (33%), MDS vs. megaloblastic anemia (23%) and acute leukemia (18%). Thirty one patients had karyotype abnormality in which majority (13 patients) were diagnosed as MDS followed by 11 patients with acute leukemia. Conclusion: Beside bone marrow examination, there is a need for more supplementary studies like karyotyping to detect the exact cause of pancytopenia. It is concluded that cytogenetic study on bone marrow aspiration can be a complementary test in diagnosis of pancytopenic patients. However, there are also cases where diagnosis even with implementing bone marrow examination and cytogenetic analysis is not possible. Such patients require more clinical follow-up and investigation

K-ras Mutation in Colorectal Cancer, A Report from Southern Iran

There are very few studies about K-ras mutations in colorectal cancer (CRC) from developing countries such as Iran. It is therefore essential to conduct studies to learn about the molecular signature of such tumors, allowing the determination of an appropriate management plan. In the present study, we aimed to determine the frequency and types of K-ras mutations among patients with CRC in Iran. Formalin-fixed paraffin-embedded specimens of 100 cases of CRC were collected from hospitals affiliated with Shiraz University of Medical Sciences (June 2011 to June 2013). All of the H&E slides were examined and proper slide with a minimum of necrosis and maximum of well-preserved tumor cells (at least 70% tumor in each slide) were selected. Recurrent, metastatic, and post chemotherapy cases were excluded from the study. Mutation of codons 12 and 13 of K-ras gene by PCR was performed, followed by direct sequencing by Sanger method. From 100 eligible cases (55 male and 45 females with mean age of 59 years), 32% had mutant K-ras gene; the most common substitution was 12G>C followed by 12G>A and 13G>A, respectively. It is found that K-ras mutation rate, among the selected population of the southern province of Iran, was as high as 32% (codon 12: 71.8% and in codon 13: 25% and one in both codons: 3.1%)

The Efficacy of New Method of Cardiopulmonary Resuscitation Training in Promoting Knowledge and Skills of 4th Year Medical Students

Introduction: Educational goals of CPR (CardioPulmonary Resuscitation) training are not fully achieved by traditional methods. The aim of this study was to present a new method for teaching CPR to medical students and also to compare the effect of this new method on knowledge and skills of medical students with current CPR training method. Methods: In this quasi-experimental study, Forty 4th year medical students were divided into two experiment and control groups randomly. The control group passed the current method of CPR training and the experiment group participated in a 3 day workshop (first day: theoretical session, second day: group work and practice on model, third day: confrontation to real environment). The test for assessing knowledge and skills was held before and after the workshop. Then the mean scores were compared using independent t-test and paired t-test Results: Comparing the mean scores of pre-test and post-test showed a significant difference in both knowledge and skills of the experiment group. The mean of the difference between pre-test and post-test scores of the two groups in theoretical and practical exams were also compared which revealed a significant difference Results: Considering the higher mean of difference between pre and post tests in the experiment group, it seems that educational intervention enhanced the knowledge and proficiency of medical students in performing CPR. Some reasons could be successive theoretical and practical sessions, devoting much more time to practice, confrontation with real environment, and education through group work

Two Invasive Thymomas Incidentally Found during Coronary Artery Bypass Graft Surgery

Thymoma, the most common neoplasm of the anterior mediastinum, is a rare tumor of thymic epithelium that can be locally invasive. We reported 2 cases of invasive thymoma incidentally found during routine coronary artery bypass graft (CABG) surgery at Faghihee Hospital of Shiraz University of Medical Sciences of Iran in a period of about 6 months. The 2 patients were male and above 60 years old. They had no clinical symptoms and radiological evidence of mediastinal mass before detection of the tumor during operation. For both patients mass was completely excised and sent to the laboratory. The ultimate pathological diagnosis of both masses was invasive thymoma (stage 2). There are few reports in which thymomas were found incidentally during cardiac surgery. In spite of rare coincidence, due to being asymptomatic and possibly invasive, special attention to thymus gland during cardiac surgery or other mediastinal surgery and preoperative imaging studies seem to be reasonable approach

Renoprotective Effects of Origanum majorana Methanolic L and Carvacrol on Ischemia/Reperfusion-Induced Kidney Injury in Male Rats

Background. The most important cause of acute renal failure in normal kidneys is ischemia-reperfusion (I/R) injury. The aim of the current study was to investigate the protective effects of Origanum majorana (OM) methanolic extract, carvacrol, and vitamin E on I/R-induced kidney injury in male rats. Material and Method. Thirty Wistar male rats were randomly allocated into 5 groups; sham, I/R, I/R + OM (300 mg/kg), I/R + carvacrol (75 mg/kg), and I/R + vitamin E (100 mg/kg). Renal function markers, oxidant-antioxidant parameters, and histopathological examination were evaluated. Results. It was exhibited that the urea, creatinine, protein carbonyl, glomerular filtration rate, total thiol, ferric reducing antioxidant power, and histopathological changes markedly reversed in the treatment groups with OM or carvacrol in comparison to the I/R merely group. Conclusion. We conclude that OM extract or its ingredient, carvacrol, exerts renoprotective impacts in I/R-induced kidney injury possibly by scavenging free radicals and increasing antioxidant power

Comparing Resident Evaluation of Attending Surgeons to Attendings Self-Evaluation

Introduction. Studying the educational situation of surgery residents according to the perspective of residents and attending surgeons could lead to recognizing the strengths and weaknesses of their education and also to evaluating faculty performance. The purpose of this study was to determine the residents' viewpoints on evaluating their attending surgeons and compare the obtained results with their own attendings' perspective in this regard. Methods. Seventeen surgical residents selected through census sampling method took part in this descriptive study by filling a valid and reliable questionnaire including 20 items, in which they evaluated all their 18 attending surgeons on doing their educational duties in the operating room, surgical ward, clinic and conference. The same written evaluation forms were distributed among the faculty members to examine their own performance in the units mentioned above. SPSS software was used for statistical analysis and, independent t-test and paired t-test for comparisons. Results. The mean scores that residents considered for attending surgeons in the operating room, other clinical settings and overall scores were 3.97 0.62, 3.86 0.57 and 3.91 0.58 out of 5, respectively. The mean scores for attendings' self-evaluation in this three sections were calculated 4.22 0.67, 4.05 0.85 and 4.14 0.67 out of 5, respectively. The attending surgeons who completed the self-evaluation forms received higher scores from residents but no significant difference was observed.. Conclusion. This study shows that attending surgeons should pay more attention to teaching the side effects of surgeries as well as providing appropriate feedback for residents and also to designing and supervising educational system. The results of these kinds of study can help attending surgeons to recognize the strength and weaknesses of their education. More studies are recommended to help for promoting the educational situation of surgery residents