فهرست مطالب karimollah hajian-taliki

 Anemia, thrombocytosis, and leukocytosis, are commonly found in a variety of malignancies. The prognostic role of preoperative leukocytosis, anemia, and thrombocytosis on stages and grades of endometrial cancer (EC) in women undergoing surgery was the subject of this study.

 In this cross-sectional study, 105 women suffering from EC at Babol Ayatollah Rouhani Hospital from 2011 to 2018 were considered. Anemia, thrombocytosis, and leukocytosis were defined as prognostic factors. Then, the patients were placed at stages I, II, III, and IV, and ECs were graded as well, moderately and poorly differentiated or undifferentiated.  SPSS 22 software, Chi-square, analysis of variance (ANOVA), and receiver operating characteristic (ROC) were used for statistical analysis (p < 0.05).

 Higher rates of leukocytosis (54.3%), anemia (47.4%), and thrombocytosis (66.7%) were detected in tumor grades III, II, and III, respectively. A higher rate of leucocytosis (51.4%), anemia (60.5%), and thrombocytosis (51.9%) were reported in tumor stages III, I, and III, respectively. The relationship between tumor grade and tumor stage with leucocytosis and thrombocytosis was statistically significant (p <0.001). The white blood cell (WBC) sensitivity (70%) and specificity (70%), Hb sensitivity (37%) and specificity (39%), and platelets sensitivity (73%) and specificity (74%) were determined. There was a significant relationship between levels below the 3-variable curve and tumor stage with WBC (p <0.001) and platelet (p <0.001).

 Preoperative leukocytosis and thrombocytosis are related to the severity, stages, and grades of EC. Both of them have a prognostic role in women suffering from EC.

Gestational diabetes mellitus (GDM) is also defined as a metabolic disease associated with relative insulin resistance during pregnancy, and elevated circulating insulin may increase the risk of EH and EC development. This study aimed to investigate the association between GDM and the incidence of EH and EC.

We conducted a retrospective case-control study, including 300 women with abnormal uterine bleeding (AUB) referred to Ayatollah Rouhani Hospital in Babol. Cases (n=152) were patients with HC and EC based on medical records, and the controls (n=148) were individuals without HC and EC. The groups were compared according to demographic information, GDM or diabetes mellitus (DM) history, and body mass index (BMI). The Chi-square, independent t-test, and logistic regression analyses were performed to compare groups.

Of 300 women studied, 72 people (24.1%) had a GDM history, and 64 people had a diabetes mellitus history. There was a significant difference between the incidence of EC and EH with GDM (P=0.001). Both GDM and DM were associated with the increased EC (OR: 17.98, 95% CI: 6.73-48.08, and OR: 1.84, 95% CI: 1.26-2.68, respectively). GDM was also associated with the increased risk of EH (OR: 6.68, 95% CI: 2.77-16.10), whereas diabetes mellitus had not a significant role in the increased risk of EH (P=0.14).

This study indicated that a GDM history is significantly associated with HC and EC. Therefore, to prevent and control these two complications in the future, management and monitoring of diabetes during pregnancy should be considered.

Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associated with bone mineral density (BMD) loss. This study aimed to determine the status of BMD in non-compliant women who used PRED alone for RA.
Non-adherent RA taking 6 months, and RA patients taking methotrexate 㴑 (RA control) were compared with age-matched non-RA controls. BMD was measured by dual energy x-ray absorptiometry (DXA) method and osteoporosis (OP) was diagnosed by WHO criteria. Influence of PRED on RA bone mass, and the risk of OP in RA was assessed by comparing PRED users RA and RA control,versus non-RA controls.
Sixty-four PRED user RA, 39 RA controls and 111 non RA-controls, with respective mean (±SD) age of 52±11; 8, 51±11; and 52±7.5 years (p=0.91) were studied. Median duration of treatment in PRED users and RA control was 2.5 and 4 years, respectively. BMD g/cm2 at the femoral neck (FN-BMD) and lumber spine (LS-BMD) in PRED users and RA control was significantly lower than non-RA control (P=0.001). The prevalence of OP at either FN or LS in both RA groups was significantly higher than controls (P=0.001). In PRED users, the risk of OP increased by OR=4.9, P=0.001) and in RA controls by OR=1.7 (P=0.20). The risk of OP in PRED user RA was 2.89 times (P=0.014) greater than RA controls.
These findings indicate significantly lower BMD, and higher prevalence of osteoporosis in non-compliant women with RA taking low-dose PRED alone for a median period of 2.5 years, as compared with patients taking standard treatment comprising methotrexate 㴑.

Intravenous regional anesthesia is a simple and reliable method for upper extremity surgery. In order to increase the quality of blocks and reduce the amount of pain, many drugs are used with lidocaine. In this study, the effect of ketorolac-lidocaine in intravenous regional anesthesia was investigated.
40 patients undergoing elective upper limb with America Society of Anesthesiologists class I and II were selected and randomly divided into two groups. The first group of 20 patients received 200 mg of lidocaine, and the second group, 200 mg of lidocaine with 20 mg of ketorolac. In both groups, the drug was diluted to 40 ml. In both groups, the onset of sensory block, onset of tourniquet pain, the onset of pain after opening the tourniquet, score of postoperative pain and analgesic prescription in the first 24 hours, during 1, 6, 12 and 24 hours were studied. A measure of the quality of analgesia was evaluated by VAS.
The mean onset of tourniquet pain in the two groups was not significantly different (P=0.443). In the ketorolac group, the onset of pain after opening the tourniquet was significantly longer than lidocaine group (p Adding ketorolac to lidocaine for regional anesthesia can reduce the postoperative pain for up to 24 hours after opening the tourniquet.