مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
سال پنجاه و چهارم شماره 4 (پیاپی 114، زمستان 1390)

IntroductionBreast cancer is the most common cancer and second cause of death due to cancer in women. According to middle age affection (40-49 years old) and advanced cases in Iranian women, early diagnosis and detection of exact tumor size is very important to select the plan of treatment.Materials and Methods In this survey, files of 370 breast cancer patients from 2007 to 2010 were studied. Only 60 patients with sufficient information were selected. Questionnaires based on patient mammography, ultrasound and pathology findings were completed. SPSS Software was used for statistical analysis.Result The mean age of patients in this survey was 40 ±1/60 years old. Overall 16% of patients had normal mammography, 70% of them were in stage III & IV to ACR-Density classification (American College of Radiology). Mean area on lesion in mammography finding was 1042.96±1 031 mm2, sonogarphy 541.772±498 mm2 and pathology 1493.75±1617 mm2. Significant correlation (Pvalue=0/02) was seen between mammographic and metastasis tumor size. Significant correlation (Pvalue<0/001, r=0/62) was seen between mammographic and histopathologic tumor size.ConclusionSonography is a more reliable diagnostic method in detection of lesions in patients who have high density (Stage III& IV) in mammography. Although, the average area of the lesion in mammography and ultrasound was less than pathology, it is more accurate compared to ultrasound mammography in determining tumor size before surgery. A broader study with more sample size compared to newer diagnostic techniques like MRI is recommended in determining the exact size of the tumor before surgery.

IntroductionInjury is a leading cause for morbidity and mortality in otherwise healthy children. There are few data (especially in Iran)about epidemiology and incidence of injury in the first two years of life.Materials and MethodsThis research was a cross sectional descriptive study on a group of 1000 infants (6-24 months old), from all the health care centers in Mashhad, who were evaluated about the history of any kind of injury since birth. The study was performed in autumn of 2004.ResultsThe mean age of the study group was 13.8±7.8 months. During this time 55.7% of the infants had experienced some kind of injury.The occurred injuries in order of frequency were Falls (13.4%), Chocking due to foreign body aspiration (12.8%), Cuts and lacerations (11.9%), Burning (10.9%), Poisoning (3.9%) Traffic accidents (1.5%) Drowning (0.7%) and electrical injuries (0.6%). Overall Fifty infants (5%) in our group were visited (for accident) in an office by a doctor, which burning (with 16 outpatient visits) was the most common injury in this group. There was history of 80 hospital admission in the study group but only seven of them were due to accidents, and poisoning in three cases was the most common cause of injury related admission.ConclusionThe periodic prevalence of injuries in our study group was 55.7%. Falls, Chocking (due to foreign body aspiration), Cuts and burns were (in order of frequency) the most common types of the injuries in infants of Mashhad. Injury was not a significant cause for hospital admission in this age group.

IntroductionReduction in mineral bone density is a common complication following kidney transplantation and its adverse outcome could be minimized with well recognition and treatment. In this study we evaluated the prevalence of mineral bone density decrease in kidney recipients at least one year after the transplantation.Materials and MethodsKidney recipients from whom transplant surgery at least a year had passed and had a good kidney function were selected. Mineral bone densitometry using X- ray energy absorptiometry was performed. The serum levels of Ca, P, Alkaline Phosphatase and Paratormone were measured and the collected data were statistically analyzed.ResultsOverall 182 patients were studied. The total rate of mineral bone density decrease was 87.4%. Osteopenia in the femoral bone was 73.6% and osteoporosis was 13.8%. In the lumbar vertebrae an osteopenia of 66.5% and an osteoporosis of 20.9% were noticed. Variance of analysis showed that there were no statistically significant differences between duration of dialysis before kidney transplantation (P=0.777, P=0.420), duration of kidney transplantation (P=0.927, P=0.271), the mean of serum PTH (P=0.908, P=0.146) and calcium (P=0.348, P=0.265) in respect to densitometry of femoral bone and lumbar vertebrae. ConclusionThe frequency of mineral bone density reduction one year after kidney transplant in patients with a good transplanted kidney function was high.

IntroductionThe knee is one of the most frequently injured joints. Clinical tests in the diagnosis of meniscus and ligament injuries have limitations and it may not be possible to elicit objective signs repeatedly. MRI, has been shown to improve diagnostic accuracy in many knee disorders. Its principal attractiveness over arthroscopy is that it is noninvasive. To determine the effectiveness of magnetic resonance imaging in the appropriate identification of traumatic intra articular knee lesions, we compared its findings with clinical examination and arthroscopy as a gold standard technique in a descriptive cross sectional study.Materials and MethodsOverall 100 patients with knee trauma were entered and completed the study. All patients had thorough clinical examination By experienced physicians. An MRI of the affected knee was requested in all patients. Arthroscopies were performed for all of them. ResultsOverall 55 knees were reported to have ACL tear arthroscopically, Meniscal injuries were found in 75 cases. We found correlation between posterior drawer test, MRI report of PCL tear and arthroscopic PCL tear. The sensitivity of MRI for detecting Meniscal tear: represented high, for bucket handle tear of medial meniscus, and high specificity for Lateral meniscal tear.ConclusionIt is concluded that arthroscopy still remains the gold standard technique. More powerful MRI scan equipments with better soft wares will be needed in order to have much better diagnosis.

IntroductionEvaluation of epidemiology and seasonal variation of Rhegmatogenous Retinal Detachment (RRD), in patients undergoing retinal detachment surgery. Materials and MethodsMedical records of 416 patients admitted in KHATAM eye hospital (Mashhad, IRAN) were reviewed between years 2000 to 2008. Information about sex, age, season and month of incidence and operation and concomitant risk factors of patients, were gathered and analyzed.ResultsAverage age of patients was 41 years old. Most of the cases of the disease were observed in the age group of above 60 y/o (35%). The frequency of the RRD was higher in male patients than in females. (Ratio: 1.7 to 1).Distribution of our cases in different seasons showed no significant difference between them (P value = 0.142). The highest and lowest rate of RRD was observed in October and September respectively with October having 51 patients (12.3%) and September having 23patients (5.5%).Myopia and pseudophakia were most common risk factors. There was no statistically significant relationship between age and month (and season) of incidence (or diagnosis and surgical procedure) of the RRD, likewise for gender. ConclusionThis study showed more RRD in male patients. Patients above than 60 years old have greater risks of incidence of RRD. No seasonal incidence pattern for RRD was founded; however, most of cases occurred in October, and at least in September.

IntroductionSick Building Syndrome has mostly been examined in office environments than in residential spaces. However, in this research, this problem is surveyed in residential buildings of Ekbatan town.Materials and MethodsThree hundred and thirty cases were, randomly, chosen from among the inhabitants of Ekbatan town. The questionnaires involved questions about the irritative and mental symptoms. A relation was established between the intensification of these symptoms and the physical conditions of buildings e.g. light, ventilation and other factors such as gender and age. ResultsSymptoms of Sick Building Syndrome were positive in 56.4 percent of cases. The strongest symptoms observed among the residents include eye irritation during using the computer (8.8%), sore throat (8.5%) and nose irritation (6.4%) near the garbage shooting. The results showed that the residents of buildings without natural sunlight and appropriate central air-conditioning system with (P= 0.04, OR=1.60) have higher chances of sick building syndrome than residents of buildings exposed to sunlight and good air-conditioning system (with P =0.001, OR =2.41). ConclusionThe factors influencing the Sick Building Syndrome in this town include inefficient central air-conditioning system, double windows, improper operation and maintenance of shooting system, improper cleaning, and lack of compressor. The neighboring location of Ekbatan town with the polluted areas such as Azadi’s West Terminal and Mehr Abad International Airport is among the factors which contribute to the prevalence of the syndrome, as well.

IntroductionIn recent years the metabolic syndrome has been highly common among psychiatric patients. Since many factors including genetic factors contribute to the prevalence of this syndrome, it seems necessary to look for metabolic syndrome among Iranian psychiatric patients. Materials and MethodsThis cross-sectional study was performed on 130 female patients admitted to psychiatric ward of Mashhad 22 Bahman hospital since March 2009 until December 2009 to find whether they had metabolic syndrome. Questionnaires were completed for patients. Pregnant women and those who had had a delivery during the last 6 months were excluded. Data were analyzed through statistical tests such as t-test and chi square and SPSS software version 17. P-value less than 0.05 was regarded as meaningful result.ResultsIn this study the prevalence of metabolic syndrome was, according to criteria of NCEP (ATP III), 39.8%, which is deemed as significantly more than expectable range for healthy Iranian population. Older age, higher waist circumference, BMI and weight, persistence of diabetes mellitus and hypertension, low educational level and marriage status were proven to be associated with increased risk of metabolic syndrome.(p-value<0.05) There were no meaningful relation between metabolic syndrome, duration of administration and type of drugs, and mental disorder. (p-value>0.05)ConclusionIn the present study, the prevalence of metabolic syndrome was examined. And it was proved that the rate of the prevalence of metabolic syndrome is more than what is typically found in similar studies among Iranian psychiatric population. no relationship was detected between metabolic syndrome and any specific drug, however, more extensive studies are suggested.

IntroductionCervical cancer is the most common cancer in women living in developing countries. Recently, for treatment of diseases such as cancer, herbal medicine is used as a supplementary.The Aim of this study was assessment of anticancerous effects of polygonum aviculare herbal extract on Hela cervical cancer cell lineMaterials and MethodsHeLa cells were cultured in RPMI -1640 with 10% Fetal Bovine Serum in 5% Co2 and at 37ºC in different concentrations (0, 0.005, 0.05, 0.01, 0.025, 0.075, 0.1, 0.125, 0.15, 0.175, 0.2, 0.25, 0.3, 0.35, 0.5, 5 mg/ml) of polygonum aviculare. For assessment of viability of cells, trypan blue staining was performed. MTT assay was used for proliferation detection.

our results showed that in 0.15, 0.20 and 0.35 mg/ml proliferation of HeLa cells decreased according to MTT assay.ConclusionIt was proved that polygonum aviculare had antioxidant component and could be a scavenger of free radical. Because of high production of free radicals in diseases such as cancer, the use of the herbal medicine with high amount of antioxidant could be a supplementary treatment in cancer and other diseases.

IntroductionPatients with arrhythmogenic right ventricular cardiomyopathy have Ventricular Tachycardia (VT) and left bundle branch block contours with right-axis deviation and T-waves inversion in pericardial leads. Case reportPresenting case was a 28 years old man admitted with palpitation and syncope. The electrocardiography showed Ventricular tachycardia with left bundle branch block contour and T wave inversions in V1 to V6 and incomplete right bundle branch block and T wave inversions in V1 to V3. Echocardiography revealed right ventricular (RV) dilatation. RV function was abnormal, and aneurismal formation in free wall was seen in 3D echocardiography. ConclusionArrhythmogenic right ventricular cardiomyopathy remains as a primary diagnoses, in case of patients with ventricular tachycardia, left bundle branch block contour and T waves inversion in pericardial leads and without any history of ischemic heart disease,