مجله دانشکده پزشکی اصفهان
پیاپی 114 (هفته دوم دی ماه 1389)

The development of venous thromboembolism is influenced by a variety of genetic and environmental risk factors. A few studies have ascertained whether thrombophilic defects are risk factors for venous thromboembolism in Middle East and Iranian populations or not.

We conducted a case-control study involving 66 consecutive patients with deep vein thrombosis without immobility and 66 healthy controls from the Al-Zahra Hospital in Isfahan, Iran.

The most frequent thrombophilic risk factor for deep vein thrombosis was homocysteine (31/66) (OR = 3.6, 95% CI = (1.66-7.84)). Anticardiolipin antibody was seen in 10.6% (OR =7.71, 95% CI = (0.99-64.55)). There were no significant differences for other risk factor such as Protein S, Protein C, Antithrombin III, Factor V leiden, and Prothrombin mutation.

In spite of western studies, Factor V leiden and Prothrombin mutation are rare between Iranian patients. However, homocysteine and anticadiolipin anti bodies are the most frequent risk factors. Screening for Factor V leiden and Prothrombin mutation have not cost benefit and further studies with larger sample size need to detect new mutations and assess the influence of ethnicity on thrombophilia.

Although acute radiation dermatitis is a common complication of radiotherapy, there is currently no general consensus regarding the prevention or treatment of choice for this adverse effect. The present study aimed to investigate the efficacy and safety use of topical honey in the treatment of radiation-induced dermatitis.

Ninety breast cancer patients undergone modified radical mastectomy, chemotherapy and chest wall telecobalt radiotherapy (48-50 Gy) and developed grade II-III radiation-induced dermatitis, were randomly assigned to received only daily washing (arm 1), topical honey plus daily washing (arm 2) or topical hydrocortisone 1% plus daily washing (arm 3). The area of wet dermatitis and the severity of subjective symptoms such as itching, pain, oozing and burning were recorded at the end of each week of follow-up for three weeks. The efficacy and safety of topical honey were the primary and the second study endpoints.

The mean age of the patients in treatment arms 1, 2 and 3, were 41.8, 44.5 and 46.1 years respectively. The mean dermatitis areas were 84.3, 84.6 and 84.8 cm2 in treatment arms 1, 2 and 3, respectively. In addition, the mean total radiation doses were 49.5, 49.6 and 49.3 Gy in treatment arms 1, 2 and 3, respectively. There was no significant statistical difference between three treatment arms regarding the rate of subjective symptoms and dermatitis severity. However, topical hydrocortisone 1% significantly improved subjective symptoms (such as itching and burning) compared to topical honey application.

The present study suggests that the topical honey cannot reduce subjective symptoms or improve radiation-induced dermatitis severity compared to topical hydrocortisone 1% or daily washing in breast cancer patients receiving radiotherapy.