Aberrant Right Subclavian Artery: A Life‑threatening Anomaly that should be considered during Esophagectomy

Aberrant right subclavian artery (ARSA) is a rare anomaly, in which the right subclavian artery arises directly from the aortic arch instead of originating from the brachiocephalic artery. This anomaly should be taken into consideration during surgical procedures around esophagus, such as esophagectomy. Any unintentional injury of this artery during surgical procedures could be extremely life threatening. A 56‑year‑old woman presented with dysphagia, with concurrent aberrant subclavian artery and esophageal cancer. The transhiatal esophagectomy was performed successfully since the anomaly was preoperatively diagnosed using computed tomography scan. The presence of ARSA during esophagectomy may be challenging, but if diagnosed preoperatively, the precise and diligent dissection of the retroesophageal space during esophagectomy, may prevent any injury to the aberrant artery and consequent complications.Key words: Aberrant subclavian artery, esophageal cancer, esophagectomy, lusori

Esophageal cancer in northwestern Iran

Background: Esophageal cancer (EC) is one of the most frequent and serious cancers worldwide, but its geographic distribution is disparate. Northern Iran is known as one of the hot spots for EC, but there is inadequate evidence available regarding its characteristics in northwestern region of Iran. Therefore, this study aimed to describe some demographic and histopathologic features of EC in this region of Iran. Materials and Methods: 166 hospital referral patients from a hospital in the northwestern region of Iran who underwent endoscopic biopsy for the chief complaint of dysphagia or odynophagia, and were admitted with the pathologic diagnosis of esophageal cancer during 3 years were enrolled in this study. Results: The mean age of the patient was 61.8 \ub1 12.0 years old. Male/female ratio was 0.84. With respect to the site of tumor, tumor was located in cervical esophagus in 7 cases (4.2%), upper thoracic in 5 patients (3%), middle thoracic in 64 patients (38.6%), lowers thoracic in 68 cases (41%), and cardia in 22 cases (13.2%). There was a significant difference among the site of tumor in different age groups (P = 0.021) and different sex groups (P = 0.001). In men, EC usually involves the lower parts, whereas in women it usually involves the upper parts of esophagus. Squamous cell carcinoma was the most common type of EC in all age groups, but the prevalence rate of adenocarcinoma seems to increase with age (P = 0.045). Conclusions: Demographic and histopathologic pattern of esophageal cancer in northwestern region of Iran is different from its histopathologic pattern in western countries in accordance with other reports from Golestan province in north-eastern region of Iran

Esophageal cancer in northwestern Iran

Background: Esophageal cancer (EC) is one of the most frequent and serious cancers worldwide, but its geographic distribution is disparate. Northern Iran is known as one of the hot spots for EC, but there is inadequate evidence available regarding its characteristics in northwestern region of Iran. Therefore, this study aimed to describe some demographic and histopathologic features of EC in this region of Iran. Materials and Methods: 166 hospital referral patients from a hospital in the northwestern region of Iran who underwent endoscopic biopsy for the chief complaint of dysphagia or odynophagia, and were admitted with the pathologic diagnosis of esophageal cancer during 3 years were enrolled in this study. Results: The mean age of the patient was 61.8 ± 12.0 years old. Male/female ratio was 0.84. With respect to the site of tumor, tumor was located in cervical esophagus in 7 cases (4.2%), upper thoracic in 5 patients (3%), middle thoracic in 64 patients (38.6%), lowers thoracic in 68 cases (41%), and cardia in 22 cases (13.2%). There was a significant difference among the site of tumor in different age groups (P = 0.021) and different sex groups (P = 0.001). In men, EC usually involves the lower parts, whereas in women it usually involves the upper parts of esophagus. Squamous cell carcinoma was the most common type of EC in all age groups, but the prevalence rate of adenocarcinoma seems to increase with age (P = 0.045). Conclusions: Demographic and histopathologic pattern of esophageal cancer in northwestern region of Iran is different from its histopathologic pattern in western countries in accordance with other reports from Golestan province in north-eastern region of Iran

Hepatitis E among Pregnant Women in Urmia, Iran

Introduction: Although the hepatitis E virus mostly causes a self-limited disease in general population, but the disease is more severe in pregnant women. Hepatitis E accounts for about 10% of pregnancy associated deaths in southern Asia. But the prevalence in Iran is almost unclear, so this study is aimed to investigate the seroprevalence of anti-HEV IgG among a population of pregnant women in West Azerbaijan of Iran.   Materials and Methods: 136 pregnant women who referred to an urban health centers of Urmia for pursuing pregnancy-related health services were selected randomly and enrolled in a descriptive, cross-sectional study. Each subject was tested for the presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay (ELISA, Dia.Pro; Diagnostic Bioprobes, Italy).   Results: The mean age among 136 pregnant women was 25.12±4.91 years old (range of 14-39 years). Only five cases (3.6%) among all 136 subjects were demonstrated to be seropositive for anti-HEV IgG using ELISA method. There was no significant difference between age (P=0.88), income level (P=0.19) of two seropositive and seronegative groups. All seropositive cases were from urban areas.   Conclusion: The seroprevalence of anti-HEV IgG is low in the population of pregnant women in Urmia, Iran. Because of limited sample size in this study, we recommend to perform further studies with larger sample size in other regions of Iran in order to be able to systematically generalize the findings of studies to the population of Iranian pregnant women.   Keywords: Pregnancy, Hepatitis E, women ELIS