ORIGINAL_ARTICLE
A Case of Pancreas Squamous Cell Carcinoma with Partial Response to Treatment and Poor Prognosis
Introduction: Adenocarcinoma is the most common malignancy in pancreas. Normally there is no squamous cell in pancreas. Pancreas Squamous Cell Carcinoma (SCC) is a rare tumor and its presentation is like adenocarcinoma and no specific symptom and sign is reported. Tumor markers are not helpful for this disease. Case presentation: We report a 55 year-old female patient who had pancreas SCC. All investigations were normal and no other site of SCC, as a possible source for metastasis, was found. The tumor was not operable and she received 3 cycles of cisplatin and 5-fluorouracil. Then she received radiotherapy up to 44 Gy. Although she had partial response, operation was not again possible and then she received chemotherapy. Unfortunately she developed liver metastasis and passed away 9 months after diagnosis. Conclusion: pancreas SCC is a rare tumor and the role of surgery and radiotherapy is not well studied. Chemotherapy is better to be administered according to SCC of other sites. Despite aggressive treatment, this malignant disease has a poor prognosis.
https://www.canonjm.com/article_97240_0d85e570ce95b4b1a5f796a4822a5ba7.pdf
2019-09-01
84
90
10.30477/cjm.2019.97240
pancreas
Squamous Cell Carcinoma
cancer
Hamid
Nasrollahi
nasrolahihamid@yahoo.com
1
Assistant Professor in radiation Oncology, Department of Radiation oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Zahra
Eskandari
z.e01365@gmail.com
2
Radiation Oncologist, Radiotherapy Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Mohammad Reza
Sasani
sasanimrz@gmail.com
3
Asistant professor in Radiology, Medical Imaging Research Center, Department Of Radiology, School Of Medicine, Shiraz University Of Medical Sciences, Shiraz, Iran.
AUTHOR
Seyed Hassan
Hamedi
hamedi142@yahoo.com
4
Radiation Oncologist, Radiotherapy Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Reza
Khellat
5
Pathologist, Shafa Hospital, Shiraz, Iran
AUTHOR
Mansour
Ansari
ansarim_1999@yahoo.com
6
Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Niloofar
Ahmadloo
ahmadloon@gmail.com
7
Associate Professor in Radiation Oncology, Radiotherapy Oncology Department, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Shapour
Omidvari
omidvaris@sums.ac.ir
8
Professor in Radiation Oncology, Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Mohammad
Mohammadianpanah
mohpanah@gmail.com
9
Professor in Radiation Oncology, Colorectal Research Center, Shiraz, Iran
AUTHOR
Ahmad
Mosalaei
mosalaa@gmail.com
10
Professor in Radiation Oncology, Shiraz Institute for Cancer Research, Shiraz, Iran
AUTHOR
1. Ben Kridis W, Khanfir A, Toumi N, Ben Amar M, Boudawara T, Frikha M. Primary squamous cell carcinoma of the pancreas: a report of two cases and review of the literature. Internal medicine. 2015;54(11):1357-9.
1
2. KashaniA, Kahn M, Jamil LH. Diagnosis of primary squamous cell carcinoma of the pancreas using endoscopic ultrasound-guided core needle biopsy. Gastroenterology report. 2015.
2
3. BrijbassieA, StelowE, Shami VM. Squamous Cell Carcinoma of the Pancreas: A Case Report and Review of Literature. Gastroenterology research. 2014;7(3-4):102-4.
3
4. Mehta M, Sinha J, Ogawa M, Ganguly A, Xiang D, Poddar N. Unusual Case of Squamous Cell Carcinoma of Pancreas with Review of Literature. Journal of gastrointestinal cancer. 2015;46(4):426-9.
4
5. Rowe K, Mehta J, Nehme F, Salyers W. Primary Squamous Cell Carcinoma of the Pancreas as a Cause of Biliary Obstruction. Cureus. 2016;8(10):e856.
5
6. ModiRM, KambojAK, ShenR, Krishna SG. Endosonography and Confocal Endomicroscopy of Primary Keratinizing Squamous Cell Carcinoma of the Pancreas. ACG case reports journal. 2017;4:e17.
6
7. RaghavapuramS, VaidA, Rego RF. Squamous Cell Carcinoma of Pancreas: Mystery and Facts. The Journal of the Arkansas Medical Society. 2015;112(3):42-3.
7
8. MinamiT, Fukui K, Morita Y, KondoS, Ohmori Y, KanayamaS, et al. A case of squamous cell carcinoma of the pancreas with an initial symptom of tarry stool. Journal of gastroenterology and hepatology. 2001;16(9):1077-9.
8
9. Al-Shehri A, SilvermanS, King KM. Squamous cell carcinoma of the pancreas. Current oncology. 2008;15(6):293-7.
9
10. KodavatigantiR, Campbell F, HashmiA, Gollins SW. Primary squamous cell carcinoma of the pancreas: a case report and review of the literature. Journal of medical case reports. 2012;6:295.
10
12. Adachi K. Primary squamous cell carcinoma of the pancreas: a case report. JOP : Journal of the pancreas. 2011;12(2):181-4.
11
11. Nikfam S, Sotoudehmanesh R, Pourshams A, Sadeghipour A, Sotoudeh M, Mohamadnejad M. Squamous cell carcinoma of the pancreas. Archives of Iranian medicine. 2013;16(6):369-70.
12
13. Terada T. Adenosquamous Carcinoma and Pure Squamous Cell Carcinoma of the Pancreas: Report of two Cases. Case reports in gastroenterology. 2010;4(3):369-73.
13
14. BrégeaudL, RuszniewskiP, BernadesP, BelghitiJ, FléjouJ-F. Squamous cell carcinoma and lipomatous pseudohypertrophy of the pancreas. VirchowsArchiv : an international journal of pathology. 1999;434:569-72.
14
15. De SouzaAL, Saif MW. Squamous cell carcinoma of the pancreas. JOP : Journal of the pancreas. 2014;15(6):630-1.
15
16. Schultheis AM, Nguyen GP, Ortmann M, Kruis W, Buttner R, Schildhaus HU, et al. Squamous Cell Carcinoma of the Pancreas in a Patient with Germline BRCA2 Mutation-Response to Neoadjuvant Radiochemotherapy. Case reports in oncological medicine. 2014;2014:860532.
16
ORIGINAL_ARTICLE
Right Non-Recurrent Laryngeal Nerve Discovered during Total Thyroidectomy: A Case Report
Introduction: The non-recurrent laryngeal nerve (NRLN) is an infrequent variant of inferior laryngeal nerve that takes an unusual course. Since this is a rare anatomic variation, operations on these patients carry a great risk of laryngeal nerve injury. Case Presentation: A 25-year-old woman with papillary thyroid carcinoma and cervical lymphadenopathy underwent total thyroidectomy and bilateral neck dissection levels II – VI. It was noted intraoperatively that right inferior laryngeal nerve was a NRLN and right common carotid artery originated directly from the aorta and right brachiocephalic artery was absent. The nerve was preserved and patient underwent an uneventful surgery. She was well in her follow-up visits, her voice was good and both of her vocal cords were mobile on indirect laryngoscopy examination. Conclusion: Although NRLN is a rare anatomic variation, surgeons should always think twice about this finding whenever right recurrent laryngeal nerve cannot be found according to anatomical landmarks intra-operatively.
https://www.canonjm.com/article_92985_f16496b1f7ee2aae190d27c445f3e234.pdf
2019-09-01
91
97
10.30477/cjm.2019.92985
Recurrent Laryngeal Nerve
Laryngeal Nerves
Vocal Cord Paralysis
Maziar
Motiee- Langroudi
1
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
AUTHOR
Ali
Shaghaghi
2
Cancer Research Center, Cancer Institute of IR Iran, Tehran University of Medical Sciences, IR Iran
AUTHOR
Hadi
Sharouny
hadi.sharouny@iran.ir
3
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
LEAD_AUTHOR
1- Henry BM, Sanna S, Graves MJ, Vikse J, Sanna B, Tomaszewska IM, et al. The Non-Recurrent Laryngeal Nerve: a meta-analysis and clinical considerations. PeerJ. 2017 Mar 21;5:e3012.
1
2- Stedman GW. A singular distribution of some of the nerves and arteries in the neck, and the top of the thorax. Edinburgh medical and surgical journal. 1823 Oct 1;19(77):564.
2
3- Wang Y, Ji Q, Li D, Wu Y, Zhu Y, Huang C, Shen Q, Wang Z, Zhang L, Sun T. Preoperative CT diagnosis of right nonrecurrent inferior laryngeal nerve. Head & neck. 2011 Feb;33(2):232-8.
3
4- Henry JF, Audiffret J, Denizot A, Plan M. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery. 1988 Dec 1;104(6):977-84.
4
5- Toniato A, Mazzarotto R, Piotto A, Bernante P, Pagetta C, Pelizzo MR. Identification of the nonrecurrent laryngeal nerve during thyroid surgery: 20-year experience. World journal of surgery. 2004 Jul 1;28(7):659-61.
5
6- Hong KH, Park HT, Yang YS. Characteristic travelling patterns of non-recurrent laryngeal nerves. The Journal of Laryngology & Otology. 2014 Jun;128(6):534-9.
6
7- Skandalakis JE, Skandalakis PN, Skandalakis LJ. Surgical Anatomy and Technique. 2nd Edition. İstanbul: Nobel Tıp Kitapevi; 2000.
7
8- Kayhan C, Yiğitler C, Yılmaz F, Yıldız M, Uzar Aİ, Arslan I. The effect of recurrent laryngeal nerve dissection on morbidity. Ankara Cerrahi Dergisi. 1999;4:219-22.
8
9- Yetisir F, Salman AE, Çiftçi B, Teber A, Kiliç M. Efficacy of ultrasonography in identification of non-recurrent laryngeal nerve. International Journal of Surgery. 2012 Jan 1;10(9):506-9.
9
10- Avisse C, Marcus C, Delattre JF, Cailliez-Tomasi JP, Palot JP, Ladam-Marcus V, Menanteau B, Flament JB. Right nonrecurrent inferior laryngeal nerve and arteria lusoria: the diagnostic and therapeutic implications of an anatomic anomaly. Surgical and Radiologic Anatomy. 1998 May 1;20(3):227-32.
10
11- Ongaro D, Elia S, Cazzaniga R, Taglietti L. Right non-recurrent inferior laryngeal nerve discovered during carotid endarterectomy: A case report and literature review. Int J Cardiovasc Thorac Surg. 2016;2(4):29-33.
11
12- Page C, Monet P, Peltier J, Bonnaire B, Strunski V. Non-recurrent laryngeal nerve related to thyroid surgery: report of three cases. The Journal of Laryngology & Otology. 2008 Jul;122(7):757-61.
12
13- Wang Z, Zhang H, Zhang P, He L, Dong W. Preoperative diagnosis and intraoperative protection of nonrecurrent laryngeal nerve: a review of 5 cases. Medical science monitor: international medical journal of experimental and clinical research. 2014;20:233.
13
14- Citton M, Viel G, Iacobone M. Neck ultrasonography for detection of non-recurrent laryngeal nerve. Gland surgery. 2016 Dec;5(6):583.
14
15- Kato K, Toriumi Y, Kamio M, Nogi H, Shioya H, Takeyama H. Nonrecurrent inferior laryngeal nerves and anatomical findings during thyroid surgery: report of three cases. Surgical case reports. 2016 Dec 1;2(1):44.
15
ORIGINAL_ARTICLE
Features of Acute Coronary Syndrome in Shariati Hospital, Isfahan, Iran in 2017-2018
Introduction: Cardiovascular diseases are the leading cause of death for people worldwide. The purpose of this study was to determine the diagnostic accuracy of acute coronary syndromes assessment by emergency medicine specialists with accordance to the latest guidelines in shariatic hospital of Isfahan. Methods: This cross-sectional study involved all consecutive patients that assessed in Emergency Department because of cardiac symptoms throughout one year (April 2017 to January 2018). The raw data were analyzed with SPSS software version 23. Results: One hundred and seventy-five patients were included in this study. Moreover, pain radiation in the left shoulder (p-value=0.02), cold sweating (p-value=0.01), obesity (p-value=0.00), and chronic diseases (p-value=0.45) recorded more in ACS patients compared to control group. Result showed that the using of nitrate drug leads to significant reduction in pain intensity in ACS patients and make significant higher change in their electrocardiogram (ECG) in comparison to control group. Finally, results indicated that using the troponin test in the final diagnosis, ACS patients showed higher troponin levels compared to control group. Finally, results indicated that using the troponin test in the final diagnosis, ACS patients showed higher troponin levels compared to control group. Conclusion: Patients with a final diagnosis of ACS are older than the control group. Moreover, the retrosternal pain, chest pain, exertional dyspnea, radiating pain in left shoulder or hands and cold sweating were significantly more common in patients with ACS. Based on this, the quick actions relates to ACS should be implemented to improve the diagnostic accuracy in the future.
https://www.canonjm.com/article_107153_a8f061bfe97f615f2a3da868a8709a17.pdf
2019-09-01
98
109
10.30477/cjm.2019.107153
Acute coronary syndrome
Diagnosis
Symptom Assessment
Diagnostic errors
zahra
karimi
zahrakarimi1532@gmail.com
1
Bushehr university of Medical Sciences, Faculty of Nursing and midwifery
LEAD_AUTHOR
Ali
Torkan
msh.khani77@gmail.com
2
Clinical Research development center, Najafabad branch, Islamic Azad University, Najafabad, Iran
AUTHOR
Malihe
Aslani
ftmamk1991@gmail.com
3
Clinical Research development center, Najafabad branch, Islamic Azad University, Najafabad, Iran
AUTHOR
Mohammad
Mohammadi
izdmoh@gmail.com
4
Bushehr university of Medical Sciences, Faculty of Nursing and midwifery
AUTHOR
1. Majidi SA, Nasiripour AA, Tabibi SJ, Masoudi I. Evaluation of emergency department performance improvement-A systematic review on influence factors. INTERNATIONAL JOURNAL OF MEDICAL RESEARCH & HEALTH SCIENCES. 2016;5(5):85-100.
1
2. Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. The lancet. 2016;388(10053):1459-544.
2
3. Schewe J-C, Kappler J, Dovermann K, Graeff I, Ehrentraut SF, Heister U, et al. Diagnostic accuracy of physician-staffed emergency medical teams: a retrospective observational cohort study of prehospital versus hospital diagnosis in a 10-year interval. Scandinavian journal of trauma, resuscitation and emergency medicine. 2019;27(1):36.
3
4. Goodacre S, Cross E, Arnold J, Angelini K, Capewell S, Nicholl J. The health care burden of acute chest pain. Heart. 2005;91(2):229-30.
4
5. Martínez-Sellés M, Bueno H, Sacristán A, Estévez Á, Ortiz J, Gallego L, et al. Chest pain in the emergency department: incidence, clinical characteristics, and risk stratification. Revista Española de Cardiología (English Edition). 2008;61(9):953-9.
5
6. Bhuiya FA. Emergency department visits for chest pain and abdominal pain: United States, 1999-2008: US Department of Health and Human Services, Centers for Disease Control and …; 2010.
6
7. Mockel M, Searle J, Muller R, Slagman A, Storchmann H, Oestereich P, et al. Chief complaints in medical emergencies: do they relate to underlying disease and outcome? The Charité Emergency Medicine Study (CHARITEM). European journal of emergency medicine. 2013;20(2):103-8.
7
8. Ekelund U, Akbarzadeh M, Khoshnood A, Björk J, Ohlsson M. Likelihood of acute coronary syndrome in emergency department chest pain patients varies with time of presentation. BMC research notes. 2012;5(1):420.
8
9. Bjørnsen LP, Naess-Pleym LE, Dale J, Grenne B, Wiseth R. Description of chest pain patients in a Norwegian emergency department. Scandinavian Cardiovascular Journal. 2019;53(1):28-34.
9
10. Shahverdi E, Khani MA. Cardiology & Cardiovascular Medicine Journal. 2016.
10
11. Shahverdi E, Maki M, Rasouli M, Allahverdi Khani M, Rad HJJoC-TM. Possible effect of CABG on moderate mitral regurgitation. 2019;7(3):462-8.
11
12. Nguyen HL, Nguyen QN, Ha DA, Phan DT, Nguyen NH, Goldberg RJ. Prevalence of comorbidities and their impact on hospital management and short-term outcomes in Vietnamese patients hospitalized with a first acute myocardial infarction. PloS one. 2014;9(10):e108998.
12
13. Beyranvand M, Kolahi A, Ghafelehbashi S. Charactristics and final diagnosis of patients with primary diagnosis of acute coronary syndrome. 2008.
13
14. Ahmadi A, Sajjadi H, Etemad K, Khaledifar A, Mobasherii M. Epidemiological characteristics and determinants of mortality in acute coronary syndrome in Iran. Journal of Mazandaran University of Medical Sciences. 2015;25(124):1-9.
14
15. Scheuermeyer FX, Wong H, Yu E, Boychuk B, Innes G, Grafstein E, et al. Development and validation of a prediction rule for early discharge of low-risk emergency department patients with potential ischemic chest pain. Canadian Journal of Emergency Medicine. 2014;16(2):106-19.
15
16. Christenson J, Innes G, McKnight D, Thompson CR, Wong H, Yu E, et al. A clinical prediction rule for early discharge of patients with chest pain. Annals of emergency medicine. 2006;47(1):1-10.
16
17. Keikha S. Electrocardiographic Results of Patients with Acute Coronary Syndrome. Iranian Journal of Emergency Medicine. 2015;2(1):1.
17
18. Majidi S, Sharifi M. Comparison of signs and symptoms associated with acute coronary syndrome in male and female patients. Journal of Guilan University of Medical Sciences. 2012;20(80):60-6.
18
19. Henrikson CA, Howell EE, Bush DE, Miles JS, Meininger GR, Friedlander T, et al. Chest pain relief by nitroglycerin does not predict active coronary artery disease. Annals of internal medicine. 2003;139(12):979-86.
19
20. Leite L, Baptista R, Leitão J, Cochicho J, Breda F, Elvas L, et al. Chest pain in the emergency department: risk stratification with Manchester triage system and HEART score. BMC cardiovascular disorders. 2015;15(1):48.
20
21. DeVon HA, Penckofer S, Larimer K. Midwest nursing research society sage best paper award: The association of diabetes and older age with the absence of chest pain during acute coronary syndromes. Western journal of nursing research. 2008;30(1):130-44.
21
22. Majahalme SK, Smith DE, Cooper JV, Kline-Rogers E, Mehta RH, Eagle KA, et al. Comparison of patients with acute coronary syndrome with and without systemic hypertension. The American journal of cardiology. 2003;92(3):258-63.
22
ORIGINAL_ARTICLE
Comparing the accuracy of different blood pressure determination methods: a cross-sectional study of adolescents in Isfahan, Iran
Introduction: Hypotension and hypertension have the potential ability to injure the vital organs. Controlling blood pressure is necessary to stabilize the patient's hemodynamic situation. There are different blood pressure measurement methods such as invasive blood pressure measurement (IBP), noninvasive blood pressure measurement (NIBP) and auscultatory method. Methods: This cross-sectional study was conducted on 20 inpatients of angiography ward of Sina hospital, Isfahan, Iran. The measurement accuracy of IBP, NIBP and auscultatory method compared and the effective parameters in each technique discussed. Results: The mean error and standard deviation of IBP and oscillometric in all patients was -4.06±8.9 for MAP, -3.64±10.3for systolic and -4.22±4.9 for diastolic. The mean error and standard deviation of oscillometric and auscultatory for all patients was -1.73±6.5 in systolic pressure and 0.42±4 in diastolic pressure. Based on gender, systolic pressure error in men was -3.3±4.2 and -0.78±3.6 in women; diastolic pressure error in men was -4.37±9.5 and -4.37±8.9 in women and MAP error reported -4.2±8.57 and -1.2±8.17 in men and women respectively. Conclusion: Findings showed that in the range of normal pressure and prehypertension, the accuracy of IBP, NIBP and auscultatory method was nearly the same but for hypertension grade 1 and 2, only the mean error and standard deviation of MAP is acceptable. Considering the effect of gender on blood pressure manifest that the error of systolic pressure, diastolic pressure and MAP for women is less than men.
https://www.canonjm.com/article_107154_914e04922b684cfad049e582fd274ba3.pdf
2019-09-01
110
117
10.30477/cjm.2019.107154
Auscultation
Oscillometry
CATHETERIZATION
blood pressure
Farzaneh
Mehry
drfarzanehmhry@gmail.com
1
Clinical Research development center, Najafabad branch, Islamic Azad University, Najafabad, Iran
LEAD_AUTHOR
Vida
Behzadfar
ftmamk1991@gmail.com
2
Clinical Research development center, Najafabad branch, Islamic Azad University, Najafabad, Iran
AUTHOR
Ali
Torkan
msh.khani77@gmail.com
3
Clinical Research development center, Najafabad branch, Islamic Azad University, Najafabad, Iran
AUTHOR
1. Konstantinidis L, Guex-Crosier YJCoio. Hypertension and the eye. 2016;27(6):514-21.
1
2. Lip GY, Coca A, Kahan T, Boriani G, Manolis AS, Olsen MH, et al. Hypertension and cardiac arrhythmias: executive summary of a consensus document from the European Heart Rhythm Association (EHRA) and ESC council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). 2017;3(4):235-50.
2
3. Chung HJ, Hwang HB, Lee NYJBri. The association between primary open-angle glaucoma and blood pressure: two aspects of hypertension and hypotension. 2015;2015.
3
4. Duschek S, Hoffmann A, del Paso GARJJopr. Affective impairment in chronic low blood pressure. 2017;93:33-40.
4
5. Ameloot K, Palmers P-J, Malbrain MLJCoicc. The accuracy of noninvasive cardiac output and pressure measurements with finger cuff: a concise review. 2015;21(3):232-9.
5
6. Földi S, Horváth T, Zieger F, Sótonyi P, Cserey GJBpm. Comparison of a noninvasive 3D force sensor-based method and the invasive arterial cannula in postsurgery intensive care patients: a pilot study. 2019;24(6):310-4.
6
7. Li-wei HL, Saeed M, Talmor D, Mark R, Malhotra AJCcm. Methods of blood pressure measurement in the ICU. 2013;41(1):34.
7
8. Krishna BV, Das S, Sen SJIp. Correlation between blood pressure measurement by non-invasive and invasive methods in critically-ill children. 2018;55(4):297-300.
8
9. Lakhal K, Martin M, Faiz S, Ehrmann S, Blanloeil Y, Asehnoune K, et al. The CNAP™ finger cuff for noninvasive beat-to-beat monitoring of arterial blood pressure: an evaluation in intensive care unit patients and a comparison with 2 intermittent devices. 2016;123(5):1126-35.
9
10. Langwieser N, Prechtl L, Meidert AS, Hapfelmeier A, Bradaric C, Ibrahim T, et al. Radial artery applanation tonometry for continuous noninvasive arterial blood pressure monitoring in the cardiac intensive care unit. 2015;104(6):518-24.
10
11. Duncombe SL, Voss C, Harris KCJJoh. Oscillometric and auscultatory blood pressure measurement methods in children: a systematic review and meta-analysis. 2017;35(2):213-24.
11
12. Alfano G, Fontana F, Cappelli GJN. Noninvasive blood pressure measurement in maintenance hemodialysis patients: comparison of agreement between oscillometric and finger-cuff methods. 2017;136(4):309-17.
12
13. Park S-H, Park Y-SJBpm. Can an automatic oscillometric device replace a mercury sphygmomanometer on blood pressure measurement? a systematic review and meta-analysis. 2019;24(6):265-76.
13
14. Briant L, Charkoudian N, Hart EJEp. Sympathetic regulation of blood pressure in normotension and hypertension: when sex matters. 2016;101(2):219-29.
14
ORIGINAL_ARTICLE
Evaluation of the atherosclerotic plaque of coronary arteries: A 10-year epidemiological surveillance study
Background: Coronary arteries are the main vessels supplying the heart. Various factors can affect their performance, which causes coronary diseases and impaired blood supply and irreparable complications. Coronary artery disease (CAD) is one of the most common cardiovascular diseases with the highest mortality rate and disability among patients. The objective of this study is to investigate the epidemiological and anatomical characteristics of the atherosclerotic plaques in coronary arteries and their risk factors in Mazandaran Heart Center. Method: This cross-sectional study with a census design performed on all patients with atherosclerotic plaque, who undergone atherectomy surgery, from November 2009 to January 2019. Patient’s information was extracted from their medical records archive with ethical points. SPSS 16.0 was used for statistical analysis. Result: Out of 156 patients with atherosclerotic plaque, 60.9% were male. The mean age of patients was 61.58± 8.9 years. The most incidence of atherosclerotic plaques was seen in 50-80 age category. Atherosclerotic plaques were mostly found in the right coronary (RCA) (53.8%) followed by left anterior descending (LAD) (41%) arteries, which was more common in men. No significant relationship was observed between sex, age, the number of arteries involved and level of biochemical variables. Conclusion: We found that gender, age, calcification, FBS, TG, TC, HDL, and LDL do not have significant effect on “site” of plaque in different coronary arteries which might due to same physiological and histological structure of these arteries. Further studies are being needed for etiology and mechanism involved.
https://www.canonjm.com/article_108187_6d8a979f8e7f24302cc25e7638ef792d.pdf
2019-09-01
118
129
10.30477/cjm.2019.108187
Coronary arteries
atherosclerotic plaque
heart disease
risk factor
Mohammad
Zahedi
mohammadzhd9435@yahoo.com
1
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
Mahdie
Khezri
darvishkhezri1377@yahoo.com
2
medical laboratory, student research committee, mazandaran university of medical science, Sari, Iran
AUTHOR
Amirhossein
Hessami
hessami.amirhossein@gmail.com
3
Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran,
AUTHOR
Ali Akbar
Rezaei
mohammadzhd5514@gmail.com
4
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
AUTHOR
Samere
Asadpour
a.rezaei1977@gmail.com
5
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
AUTHOR
Soheil
Azizi
s.azizi@mazums.ac.ir
6
Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
LEAD_AUTHOR
Fatemeh
Amuzad
a.kh.ftm97@gmail.com
7
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
AUTHOR
Parham
Mortazavi
parham2276@gmail.com
8
Student Research Committee, School of pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
AUTHOR
1. Saadat S, Yousefifard M, Asady H, Moghadas Jafari A, Fayaz M, Hosseini M. The Most Important Causes of Death in Iranian Population; a Retrospective Cohort Study. Emerg (Tehran). 2015;3(1):16-21.
1
2. Mack M, Gopal A. Epidemiology, traditional and novel risk factors in coronary artery disease. Heart failure clinics. 2016;12(1):1-10.
2
3. Munnur RK, Cameron JD, Ko BS, Meredith IT, Wong DT. Cardiac CT: atherosclerosis to acute coronary syndrome. Cardiovascular diagnosis and therapy. 2014;4(6):430.
3
4. Patel J, Al Rifai M, Blaha MJ, Budoff MJ, Post WS, Polak JF, et al. Coronary Artery Calcium Improves Risk Assessment in Adults With a Family History of Premature Coronary Heart Disease CLINICAL PERSPECTIVE: Results From Multiethnic Study of Atherosclerosis. Circulation: Cardiovascular Imaging. 2015;8(6):e003186.
4
5. M R, SR N, H S, S RS, A A. The sonographic findings of subclinical atherosclerosis in common carotid arteries: Rheumatoid arthritis patients Versus control group. Tehran University Medical Journal. 2010;68(6):330-4.
5
6. Kazemiyan M, Afrasiab H, Pashaei MH. Comparison of the plaque rupture risk in different double-stenosis arrangements of coronary arteries by modeling fluid-structure interaction. Modares Mechanical Engineering. 2016;16(2):10-8.
6
7. Shikada T, Washio M, Nishizaki A, Kakino T, Ooe K, Ishibashi Y, et al. Risk factors for coronary artery calcification in Japanese patients. Journal of cardiology. 2015;66(1):36-40.
7
8. Madhavan MV, Gersh BJ, Alexander KP, Granger CB, Stone GW. Coronary artery disease in patients≥ 80 years of age. Journal of the American College of Cardiology. 2018;71(18):2015-40.
8
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10. Ghafarzadegan R, Noruzi M, Mousavi M, Alizadeh Z, Harorani M, Javaheri J. The Effect of a Combined Herbal Ointment (Pepper, Rosemary, Peppermint) on Low back Pain after Coronary Angiography. Journal of Medicinal Plants. 2018;4(64):76-82.
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14. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. Journal of the American College of Cardiology. 2017;70(1):1-25.
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28
ORIGINAL_ARTICLE
Antibiotic misuse and overuse in hospitalized patients with nosocomial infections in North of Iran
Background: Improper use of antibiotics increases the cost of treatment, incompetent therapy, longer hospitalization time, more visits to the doctors, and improper treatment of the patients, lack of infection control, and the development and spread of antibiotic resistance. The objective of this study was the evaluation of antibiotic misuse and overuse in hospitalized patients with nosocomial infections in BuAli Sina hospital, in the north of Iran. Method: This retrospective cross-sectional study was performed by census methods on all nosocomial infections patients hospitalized in BuAli Sina's educational and therapeutic hospital. Data were collected from March 2016 to March 2018. All data were obtained from computerized archives and manual archives of the hospital. SPSS 16.0 was used for statistical analysis using Chi-square, Kolmogorov-Smirnov, and Mann-Whitney tests. Result: Out of 517 patients studied, 221 (42.7%) of them were male. The average age of the patients was 45.64±34.01. The Most Common isolated bacteria from all patients were Escherichia coli (48.8%) and Staphylococcus epidermidis (22.9%). According to the antibiotic prescription in the present study, most patients (35.8%) took at least two antibiotics. The most antibiotics falsely prescribed by physicians in the present study were used for the treatment of the infections caused by E. coli (50.34%) and Klebsiella pneumoniae (20.97%). Conclusions: There seems to be a need to set up a team to prevent antibiotic misuse and microbial resistance and to pay attention to the antibiotics prescribed for infectious patients. These include training programs for physicians, consulting with infectious disease specialists, reducing empirical prescriptions by physicians, and spontaneous antibiotic use by patients.
https://www.canonjm.com/article_108245_89fcf33d800c1d7bdb387be930cd6208.pdf
2019-09-01
130
144
10.30477/cjm.2019.108245
Inappropriate Antibiotics
Misuse
overuse
Antibiotics prescription
Infectious Disease
Mohammad
Zahedi
mohammadzhd9435@yahoo.com
1
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
Mohammad Moein
Maddah
moeinof77@gmail.com
2
Student Research Committee, School of Medicine, Mazandaran university of Medical Sciences, Sari, Iran.
AUTHOR
Mahdi
Abounoori
abounoori.mahdi@gmail.com
3
Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran,
AUTHOR
Amir Hossein
Khosrozadeh
m.ahmadi767676@gmail.com
4
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
Mohammad
Ahmadi
mohammad7697ahd@gamil.com
5
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
AUTHOR
Parham
Mortazavi
parham2276@gmail.com
6
Student Research Committee, School of pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
AUTHOR
Fatemeh
Amuzad
a.kh.ftm97@gmail.com
7
Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
AUTHOR
Aghil
Mollaie
a.molaei@mazums.ac.ir
8
Student Research Committee, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
AUTHOR
Amirreza
Nasirzadeh
nasirzadeharnz@gmail.com
9
Student of Basic Sciences in Nursing, Student Research Committee, Gonabad University of Medical Sciences, Gonabad, Iran
AUTHOR
Hamid Reza
Goli
ali.zhd49@gmail.com
10
Department of Medical Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
LEAD_AUTHOR
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35
ORIGINAL_ARTICLE
Comparing Pedicle and Free Flaps for Reconstruction of Defects in Head and Neck Neoplasm: An Assay for Quality of Life
Introduction: Reconstruction surgeryfor head and neck cancers restore patients’ function and appearance. Careful selection of flap for reconstruction of a defect after an ablative surgery can be a complex process and may affect on quality of life (QOL) of the patients. This study aimed to compare the quality of life between free and pedicle flap reconstruction groups in head and neck neoplasm patients. Methods: This was a cross-sectional study of QOL in patients withhead and neck neoplasm that attend follow-up clinics from July to September 2019. All patients that underwent reconstructive surgery with either pedicle or free flaps were included in the study. At least 6 month-time was elapsed from the reconstructive surgery. QOL of the patients was evaluated using Medical Outcomes Study Short Form (MOS SF-36) questionnaire. The patients’ demographic data and medical history were collected using electronic patients’ records. Results: Seventy patients completed the questionnaire. Forty one (58.57%) patients underwent pedicle and 29 (41.43%) patients free flap reconstructive surgery. There was no significant difference between pedicle and free flap groups with regard to age, gender, radiotherapy or chemotherapy (P>0.05). The present study indicates that there was no statistically significant difference between pedicle and free flap groups with regard to 8 domains of SF-36 questionnaire (P>0.05), neither was significant difference between two groups with regard to the physical or mental component summaries (P>0.05). Conclusion: The present study on quality of life of head and neck neoplasm patients that had undergone pedicle or free flaps showed no significant difference between two groups.
https://www.canonjm.com/article_118044_ca569aa58ba9ffeab76d6ab5479922a6.pdf
2019-09-01
145
157
10.30477/cjm.2019.118044
Free Tissue Flaps
Surgical Flaps
Quality of Life
head and neck neoplasms
Mehrdad
Jafari
dr.jafari@yahoo.com
1
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
AUTHOR
Maziar
Motiee Langrudi
dr.motiee@yahoo.com
2
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
AUTHOR
Seyed Taghi
Heydari
dr.heidari@yahoo.com
3
Heath Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Ebrahim
Karimi
dr.karimi@yahoo.com
4
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
AUTHOR
Hadi
Sharouny
hadi.sharouny@iran.ir
5
Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
LEAD_AUTHOR
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