Multiple Pseudotumors of the Liver Associated with Adenocarcinoma of the Colon: A Case Report

Hepatic inflammatory pseudotumor (IPT) is a rare non-neoplastic process of unknown etiology, generally following a benign inflammatory condition. It is often mistaken as an either primary or metastatic malignancy in imaging studies. We report a 48 year-old female with numerous target lesions (2-4 cm) seen on high resolution ultrasound, spiral CT scan, and MRI in all liver lobes compatible with metastasis. Guided biopsies of the lesions were performed twice, but the pathologies showed no evidence of malignancy. Colonoscopy revealed adenocarcinoma of the colon. This case highlights liver pseudotumor in the differential diagnosis of hepatic tumoral lesions

Viable Extreme Preterm Birth and Some Neonatal Outcomes in Double Cerclage versus Traditional Cerclage: A Randomized Clinical Trial

The pregnant women at higher risk of preterm labor, referred to the perinatal clinic of Kosar University Hospital in Urmia district of Iran, were enrolled into a parallel randomized clinical trial. In the investigational arm of the clinical trial, a double cervical cerclage procedure was performed addition to McDonald cerclage. In the control group however, only McDonald cerclage was performed. Extreme preterm labor (GA < 33 weeks) was the primary endpoint of this clinical trial. Age, gestational age at cerclage time, and gravidity were not found to be statistically different between the groups. Means of gestational age were 37.4 and 36.2 weeks, respectively, for the investigational and control groups. The gestational age was 1.2 weeks longer for double cerclage group but the difference was not found to be statistically significant. Preterm birth before 33 weeks of gestation was not experienced by any of the patients who received double cerclage, but five women in control group developed such an extreme preterm labor (P < 0.05). The absolute risk reduction in using double cerclage over traditional method was 18 percent (95% confidence interval, 4%–32%). Double cerclage appeared to have higher efficacy than traditional cerclage in preventing preterm labor <33 weeks of gestation

Forecasting of rainfall using different input selection methods on climate signals for neural network inputs

Long-term prediction of precipitation in planning and managing water resources, especially in arid and semi-arid countries such as Iran, has a great importance. In this paper, a method for predicting long-term precipitation using weather signals and artificial neural networks is presented. For this purpose, climatic data (large-scale signals) and meteorological data (local precipitation and temperature) with 3 to 12 months lead-times are used as inputs to predict precipitation for 3, 6, 9 and 12 months periods in 6 selected stations across Iran. A genetic algorithm (GA) and self-organized neural network (SOM) along with the application of winGamma software were comparatively used as input selection methods to choose the appropriate input variables. Examining the results, out of 96 predictions performed at all stations, in 43 cases, GA, in 28 cases, winGamma, and in 25 cases SOM have the best results compared to the other two methods. According to this, as a generalized assumption, it can be said that at least for the selected stations in this paper, the GA method is more reliable than the other two methods, and can be used to make predictions for future applications as a reliable input selection method. Moreover, among different climatic signals, Pacific Decadal Oscillation (PDO), Trans-Niño Index (TNI) and Eastern Tropical Pacific SST (NINO3) are the most repetitive indices for the most accurate forecast of each station

Dextrose Hydration May Promote Cisplatin-induced Nephrotoxicity in Rats: Gender-related Difference

BACKGROUNDS: Cisplatin (CP) as an anticancer drug may affect the plasma glucose level while diabetic subjects are protected against CP-induced nephrotoxicity. In the current study, the role of dextrose hydration during CP therapy on CP-induced nephrotoxicity was evaluated.METHODS: Sixty-nine male and female rats were divided into 12 groups. The rats were hydrated with 15 mL/kg vehicle or different doses of 2%, 10% and 20% dextrose before and after 7.5 mg/kg CP administration. One week later, the biochemical and kidney function markers, and histology finding were determined.RESULTS: All the animals co-treated with CP and 20% dextrose, were dead during one week of the experiment. Administration of CP alone increased kidney tissue damage score (KTDS) and kidney weight (KW). It also elevated the blood urea nitrogen (BUN) and BUN-creatineine ratio (BUN/Cr) levels in the serum. In addition, CP decreased body weight and creatinine (Cr) clearance (ClCr) significantly in both male and female rats (p<0.05). However, 2% and 10% dextrose did not alter the mentioned parameters in male, but 10% dextrose supplement increased the serum levels of BUN, Cr and BUN/Cr ratio, KW and KTDS significantly in female rats (p<0.05).CONCLUSION: Our data suggest that not only do not support the nephro-protective role of dextrose hydration during CP therapy, the dextrose hydration can act as risk factor to promote CP-induced nephrotoxicity in female rats. Prohibition of high carbohydrate (glucose) diet during CP therapy is recommended.KEYWORDS: cisplatin, nephrotoxicity, dextrose, rat, gende

Study of GLN223ARG leptin receptor genetic variation in women with unexplained infertility and fertile women

Background: Unexplained infertility refers to cases in which the standard diagnostic procedures available do not lead to a specific cause for the infertility. Gln223Arg polymorphism was associated with high serum leptin and consequently obesity, polycystic ovarian syndrome and infertility. The aim of this study was to investigate genetic variation of leptin receptor gene in unexplained infertile women. Materials and Methods: This case-control study was performed in 2015-2016. The subjects were 102 women with unexplained infertility and 112 fertile women with normal hormone profile. All participants gave their signature in consent document. After an overnight fasting, 5 CC blood sample was drawn from all subjects in the day 3 of menstruation. Genotyping of Gln223Arg polymorphism was performed using RFLP-PCR technique. Results: No significant association was observed between Gln223Arg polymorphism and unexplained infertility. The studied population was in Hardy-Weinberg equilibrium for Gln223Arg polymorphism. Therefore, there were not disturbing factors of Hardy-Weinberg equilibrium in the population. Conclusion: In present study, LEPR Gln223Arg polymorphism is not a risk factor for women with unexplained infertility. However, more studies on larger populations and the other leptin receptor polymorphism are suggested to understand the role of this polymorphism in women with unexplained infertility

Comparison of the effects of pegylated granulocyte-colony stimulating factor and granulocyte-colony stimulating factor on cytopenia induced by dose-dense chemotherapy in breast cancer patients

Background: Myelosuppression is one of the frequent side effects of chemotherapy in breast cancer patients. Granulocyte-colony stimulating factor (G-CSF) and pegylated G-CSF are used for the prevention of neutropenia after chemotherapy. Pegylated G-CSF has longer half-life of action and can be used as a single dose in comparison to G-CSF. The aim of this study is to compare the grade of cytopenia and side effects between G-CSF and biosimilar pegylated G-CSF in breast cancer patients treated with dose-dense chemotherapy. Materials and Methods: In the cross-over clinical trial study, 24 women with breast cancer were randomly divided into two groups and treated with dose-dense chemotherapy. The first group was treated with single dose of 6 mg biosimilar pegylated G-CSF 24 h after the first course of chemotherapy and the second course was followed by 300 μg daily injection of G-CSF for 6 days. The chemotherapy regimen was combination of doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2. The second group was treated with G-CSF after the first course and pegylated G-CSF after the second course. Cell blood count (CBC) and side effects were evaluated 1 and 2 weeks after both courses of chemotherapy. Results: In this study, no significant carryover effect and treatment effect about the CBC parameters was found between pegylated G-CSF and G-CSF. Patients who were treated with biosimilar pegylated G-CSF had significantly higher side effects such as bone pain (P = 0.09) and gastrointestinal effects (P = 0.005) in comparison to G-CSF. Conclusion: G-CSF and biosimilar pegylated G-CSF are effective in reducing cytopenia in breast cancer patients treated with dose-dense chemotherapy, but side effects induced by pegylated G-CSF (Pegagen) are higher

New indications for dabigatran: A suggestion from a drug use evaluation study

Objective: Dabigatran etexilate is a novel oral anticoagulant with several advantages over warfarin such as no need for routine monitoring and fewer drug interactions. This drug was added to our hospital's formulary in 2012. The objective of this study was to assess the rational drug use of dabigatran at a large teaching hospital. Methods: A prospective cross-sectional study was performed from November to June 2015 at Alzahra teaching hospital, Isfahan, Iran. All patients who received at least one dose of dabigatran were eligible for inclusion. Data were collected on patient demographics, indication, dosing regimen, adverse events, concurrent anticoagulant therapy, and laboratory data (including renal function). Findings: A total of sixty patients were included in our study. The majority of patients (n = 40, 66.7%) was prescribed dabigatran for deep vein thrombosis prophylaxis. Only one patient received dabigatran with appropriate indication, dose, and duration. Thirty-six (60%) of our patients had thrombocytopenia at the time of dabigatran initiation. We also detected that ten patients (16.7%) received this drug for heparin-induced thrombocytopenia (HIT). In 32 patients, platelet levels increased after dabigatran initiation. Only seven patients received the appropriate dose of dabigatran (regarding both indication and renal function). Conclusion: Unlabeled use and incorrect dosing of dabigatran in this study emphasize the need to develop a hospital protocol for dabigatran use within our facility. We suggest proper education of clinicians about novel drugs, pharmacist interventions, and further studies about the safety and efficacy of dabigatran for the new indication (such as HIT)

The feasibility of PETHEMA ALL-96 regimen on treatment of patients with acute lymphoid leukemia

Background: Asparaginase-based treatment regimen for acute lymphocytic leukemia (ALL) is considered as feasible, but there is still a lack of data. In this study, considering the results of other regimen that were not optimum in previous studies. Here, we aimed to investigate the feasibility of PETHEMA ALL-96 treatment regimen. Materials and Methods: This is a retrospective feasibility study that was performed in 2019–2021 on 13 patients diagnosed with B-cell ALL. Patients were treated by PETHEMA ALL-96 regimen during induction, consolidation, reinduction, and maintenance phases. Patients were followed for 2 years after initiation of PETHEMA ALL-96 regimen for disease-free survival (DFS) and overall survival (OS) of all patients were evaluated after 2 years. Results: Data of 11 patients were analyzed. Within 28 days after treatments, all patients (100%) had no blasts in the bone marrow that was considered as complete remission (CR). The CR rate was 100% within 6 months and 12 months and 81.8% within 2 years after the treatments. Evaluation of OS, CR, and DFS regarding 6, 12, and 24 months showed 100% for all items after 6 and 12 months. After 24 months, the CR was 90.9%, the OS was 81.8% and the DFS was 90.9%. None of the patients died during the induction phase and during the 12 months study. No side effects were observed. Conclusion: The PETHEMA ALL-96 had high feasibility and survival rates with no side effects during the study course. It is believed that PETHEMA ALL-96 regimen has beneficial outcomes in young patients with ALL