Galen Medical journal
Volume:3 Issue: 3, 2014

Human Epidermal growth factor Receptor-2 (HER-2) as a new prognostic and predictive factor has been believed as an essential measurement in breast carcinoma. About 280 articles were reviewed and 115 were referred in this review article on HER-2. HER-2 is an oncoprotein epidermal growth factor receptor produced by a so-called cell surface oncogene. Overexpression results in aggressive behavior، early metastasis to lymph nodes and distant areas، and poor prognosis in breast cancer. HER-2 seems to be a prognostic and predictive factor and must be considered in all breast cancer cases.

Breast cancer is one of the most frequent malignancies among Iranian women. Triple-negative breast cancer (TNBC) is referred to a type of breast cancer which three biomarkers of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2), are negative. In this case control study, immunohistopathologic data of patients with TNBC were compared with non-TNBC patients. According to pathological reports, frequency, age, gender, type, size, and tumor grade, involvement and the number of involved lymph nodes, mitosis, Ki-67, necrosis, nuclear grade, tumor side, involvement of the margins, skin involvement, nipple involvement, tumor location, vascular invasion, perineural invasion, presence of in-situ compartment and the benign accompanied tumors, granulomatosis reaction, and calcification were compared between both groups. Two hundred fourteen pathological samples of patients with breast cancer were evaluated. TNBC was seen in about 14% of breast cancers in this study on Iranian population. The mean age of TNBC group was 43±12 years and non-TNBC was 50±12 years (p=0.03). TNBC had significantly higher grade, high mitotic indices, more possibility of P53 positivity and higher level of Ki-67. Presence of vascular and nerve invasion and involvement of the margins at the time of diagnosis were seen in the TNBC group comparing with the non-TNBC group. Younger age, higher grading, neurovascular invasion, P53 positivity, and high levels of Ki-67, lead clinicians to evaluate the biomarkers of TNBC, and in case of confirming TNBC diagnosis, appropriate treatment methods should be added to the routine ones in breast cancer.

Status epilepticus (SE) is one of the most common neurological emergencies with high mortality and morbidity. This study aims to determine the most common causes and outcomes of SE in adult patients from Fars Province in southern Iran. 134 patients with SE (either convulsive or non-convulsive), admitted to Namazi Hospital, were enrolled from January 2006 to February 2012. We designed a questionnaire to collect the patients'' demographics and disease characteristics and their outcomes according to Glasgow Outcome Scale (GOS). Statistical analyses were performed using SPSS software version 15. P-value<0.05 was considered statistically significant. Seventy patients were female and 64 were male with mean age of 42.97±19.66 years and 39.42±18.89 years old, respectively. Sixty-two patients (46.26%) had a history of epilepsy, and 72 patients (53.73%) had no history of epilepsy. Antiepileptic drugs (ADEs) withdrawal and cerebral infarction were the most common causes of SE in epileptics and non-epileptics, respectively. One hundred and twenty-three patients (91.8%) had generalized tonic-clonic SE. Thirty patients (22.4%) could return to work and 33 (24.6%) died during hospitalization. There was a significant relationship between mortality and age over 60 years (P<0.001), and mortality and cerebral infarction or anoxia (P= 0.022). ADEs withdrawal in the epileptic patients was the main cause of SE (28.40% of the total population and 62% of the epileptic patients) that can be prevented by patient and family education. This study showed that high mortality and morbidity were significantly related to the increasing age and etiology of SE.

Wilson disease (WD) is an autosomal recessive progressive degeneration of hepatolenticular tissue that causes the increase of copper deposition in the liver and other organs, with resultant hepatic, neurologic and psychological manifestations. WD is fatal if left untreated. The aim of the current study was to evaluate the clinical and Para-clinical findings in children with WD in Shiraz, Southern Iran.Patients and The Medical records of all children less than 18 years of age with definite diagnosis of WD, who were admitted in Nemazee Teaching Hospital from 2001 to 2009, or were under follow up at the Pediatric Hepatology Clinic affiliated to Shiraz University of Medical Sciences, were reviewed. Overall, 70 patients with WD (41 males, 29 females) were studied. The mean age at the onset of diagnosis was 10.3±3.2 years and the most common first presentation in our patients was hepatic (90%). The most common biochemical abnormalities were increased urinary copper content, increased liver enzymes (92.9%), and increased prothrombin time (71.4%). Wilson index was ≥11 in 44.3% of the patients. WD is a rare and fascinating disorder that often poses a diagnostic and therapeutic challenge for the physician. Maintaining a high index of suspicion is critical in diagnosing this readily treatable disease and early treatment can decrease its mortality rate.

Surgically induced weight loss is a treatment option for the management of obesity and the related common disorders. This study evaluated the beneficial effects of bariatric surgery on metabolic profile and the prevalence of metabolic syndrome (MetS) among Iranian patients. A prospective observational study was performed on 26 morbidly obese patients scheduled for bariatric surgery, using laparoscopic Roux-en-Y gastric bypass (LRYGB). The parameters of hypertension, type 2 diabetes mellitus (T2DM), hyperlipidemia, MetS prevalence, and anthropometric measurements of Iranian patients, were recorded, at the preoperative visit and in follow-ups. The follow-up was performed for a median of 12 months, and the change in MetS prevalence and its componnts were assesed. LRYGB induced a mean weight loss of 69.0±21.2%, after 12 months. Preoperative MetS was diagnosed in 21 patients (84%) and decreased to 6 patients (24%) after LRYGB (P=0.001). Likewise, the prevalence of hypertension was significantly decreased from 76% (pre-LRYGB values) to 20% (post-LRYGB values) (P=0.001). The prevalence of T2DM was also decreased from 20% to 8% (P=0.5). According to our results, RYGB produced a rapid and significant weight loss and improvement in hypertension and MetS within one year but there was a controversy about the improvement of T2DM, in Iranian morbidly obese patients.

One of the main goals of standard orthodontic treatment is having the roots of teeth adjacent to extraction sites parallel to each other. The purpose of this study was to compare standard edgewise and preadjusted straight wire (MBT) methods in achieving this goal. For comparing root parallelism, 228 maxillary quadrants and 225 mandibular quadrants of 127 patients in whom 1st premolar had been extracted during orthodontic treatment plan were evaluated. On pre and post-treatment panoramic views long axis of canines and 2nd premolars of each quadrant were traced and the angulations between them were measured to assess root parallelism. For comparing mean value of angulations measured in post-treatmentviews between MBT and SEW method, independent T-test and for comparing root parallelism of canines and 2nd premolars Chi-square test was used. Evaluating root movement and root parallelism of maxillary and mandibular canines and 2nd premolars did not show any statistically significant difference between treatment groups. (P> 0.05) There is no difference between 2 methods of MBT and standard edgewise in achieving favorable root parallelism of teeth adjacent to extraction site. If each of these methods is used properly good root parallelism can be achieved in most of the cases.

Musculoskeletal disorders represent a substantial cause of morbidity worldwide. The contribution of work to these disorders has been well established by various epidemiological and laboratory-based researches. The aim of this study is to investigate the prevalence and associated factors of musculoskeletal disorders in truck drivers. This cross sectional study included truck drivers referred to Transportation Company in Qom province. We evaluated musculoskeletal disorders by Nordic questionnaire and demographic data. The questionnaire was filled by direct interview. Data analysis was done in SPSS and P value below 0.05 was significant. Age of 173 male participated in this study was 38.82 years with body mass index (BMI) of 26.02 (Kg/m2) and mean work duration of 8.85 years. In the period of past week and past year, prevalences of musculoskeletal disorders at all of the nine body regions of drivers were 56.6% and 78.6%, respectively. The most common musculoskeletal involvement was lumbar, back and neck regions. There were significant relationship among musculoskeletal problems with age, work duration, and BMI (P<0.05). This investigation showed the importance of frequent musculoskeletal disorders among drivers in different body regions particularly in lumbar area and its correlation with work duration, high weight, and age.

Pregnancy as a stressful event may cause some consequence for both mother and infant such as low birth weight (LBW). LBW is seen in about 7% of pregnancies in Iran. It was proved there is a correlation between infants weight and maternal social support. This study was designed to evaluate maternal perceived social support in LBW infants and infants with normal weight.Methods and Materials: This was a case-Control study which was done in Isfahan, Iran during April-November 2012 on 188 participants in 2 groups. In case group we had evaluated mothers with low birth weight infants and control group were mother with normal infants. Farsi version of Multidimensional Scale of Perceived Social Support (MSPSS-P) was used for social support evaluation. In LBW group mean family support subscale score was 14.87 ± 4.33, Mean friends support subscale score was 9.65 ± 5.89 and significant others support subscale mean score was 15.18 ± 5.11. In normal weight group mean family support subscale score was 18.46 ± 3.98, Mean friends support subscale score was 15.4 ± 6.41 and significant others support subscale mean score was 18.46 ± 4.1. Maternal perceived prenatal social support could be a predictor for infants birth weight. Supportive family could helps pregnant women to reduce adverse pregnancy out comes such as low birth weight.

Methotrexate (MTX), a folic acid antagonist, is widely used as a treatment for malignancies as well as in the treatment of various inflammatory and autoimmune disorders. Nephrotoxicity is an important side-effect of this drug. Prevention and treatment of MTX-induced renal dysfunction are essential to prevent potentially life-threatening MTX-associated toxicities, Present study was undertaken to determine whether vitamin E could ameliorate methotrexate-induced oxidative renal injury in rabbit. Twenty eight rabbits were randomly assigned into four groups (n=7): Group 1 (control group), Group 2 (Received 20mg/kg MTX): Group 3 (Received MTX plus vitamin E 100 mg/kg orally), group 4: (vitamin E 100 mg/kg orally). On 6th day rabbits were anesthetized and renal tissue sampled for pathologic and biochemical assessment. Data showed that renal tissue injury index and malondialdehyde (MDA)level were lower in MTX+vitamin E group comparing to MTX group significantly (P<0.05). Renal tissue injury index and MDA were higher in MTX+vitamin E group comparing to control group significantly (P<0.05). These findings suggest that vitamin E, by improving cellular anti-oxidant defense system, reduction in lipid peroxidation production and tissue damage, appears to have a protective role in the MTX-induced oxidative injury in renal tissue, however, further studies are essential to elucidate the exact mechanisms of MTX-induced renal toxicity, and protective effect of vitamin E.

Pemphigus vulgaris (PV) is one of the most common and studied autoimmune disorders of skin. The knock down of desmogleins in the skin by IgG antibodies will eventually leads to mucocutaneous problems in both genders. Targeting the cardinal molecules involved in the pathways of immune response is the main goal of given therapy. With regard to the side effects of long term use of immunosuppressive treatments, patients may use various adjuvant drug combinations. Sulfasalazine (SSZ) and Pentoxifylline (PTX) are two low-cost anti-TNF medications that can halt the acantholysis in PV. Tetracycline is an effective antibiotic with immunomdulatory properties on down-regulation of pro-inflammatory molecules such as NO, IL-1β. Moreover, the anti-inflammatory effects of Omega-3 take this supplement into account as a potential addition to anti-PV armamentarium. Thus, this complex could be utilized as a safe and effective adjuvant capsule against PV.