Long term survival in unresectable stage iv esophageal squamous cell carcinoma treated with chemoradiation: a case report

Introduction: Esophageal squamous cell carcinoma is one of the most common gastrointestinal cancers in Iran. Development of para-aortic lymphadenopathy is classified as stage IV and long term survival is rare. We report a case of esophageal squamous cell carcinoma with paraaortic lymphadenopathies, who was treated with systemic and nonsurgical locoregional therapy

Report of the case: A 39-year-old female with squamous cell carcinoma of the distal esophagus and proximal stomach, that was unresectable on laparatomy, was referred to our center for palliative treatment. She received six cycles of chemotherapy [Paclitaxel / Cisplatin], and then concurrent chemotherapy and radiotherapy to the primary tumor and paraaortic region with a total dose of 5220 centigray [cGy]. Six years later, she was still alive without any complaints or disease progression

Conclusion: It seems that patients with locally advanced unresectable esophageal squamous sell sarcinoma can be treated radically with systemic and nonsurgical locoregional therapy, to achieve long term survival

Effect of educational interventions based on theory of planned behavior [TPB] in selecting delivery mode among pregnant women referred to Rasht health centers

In recent years, most developed countries have aimed at reducing the cesarean rate through education and other interventions. In our country, however, despite all efforts, the cesarean rate remains very high. The aim of this study was to determine the effects of educational intervention based on the Theory of Planned Behavior [TPB] on choosing delivery mode in pregnant women, who were referred to the Rasht Health Centers. This quasi-experimental study included 72 pregnant women referred to various Health Centers in Rasht in the spring and summer of 2010. After a pre-test by using a valid and reliable questionnaire for both groups, specific training was provided for the intervention group based on the Theory of Planned Behavior. At the end of the pregnancies, post-test were performed in both groups and the results were analyzed by SPSS-13 software. The results indicate that there were significant differences in the mean knowledge, evaluations of behavioral outcome, attitude [P =0.000], perceived behavioral control, subjective norms, and behavioral intention [P < 0.05] among pregnant women in the test group compared with the control. There was a significant difference in behavior between the two groups [P < 0.05]. The results show that maternal educations in the field for persuasion of normal delivery had been effective. Therefore, we recommend implementing training programs based on Theory of Planned Behavior, in order to persuade pregnant women for normal delivery and decreasing the rate of the cesarean section

[Women's attitudes toward elective delivery mode based on the theory of planned behavior]

Cesarean section [CS] delivery is more risky than normal vaginal one for both mothers and neonates. However, due to various reasons, the rate of CS is rising unfortunately. Unawareness and unfounded attitudes are among the more common reasons for this increasing rate of CS. To survey women's attitudes toward elective delivery mode based on the Theory of Planned Behavior [TPB] in Rasht, northern Iran. This descriptive-analytical study was carried out with 207 women referred to health centers in Rasht, using cluster sampling, in winter 2010. Questionnaires were used to collect the respective data which were analyzed by SPSS-13. Findings showed that 43% of the women have had normal vaginal delivery, 36.2% caesarean section for medical reasons and 20.7% elective cesarean section. In the elective cesarean section group, the mean scores of knowledge, attitude, evaluation result and perceived behavioral control were 42.56, 55.87, 60.33 and 47.28, respectively. The tendency of more than 70% of the women was CS absolutely while the two other groups favored normal delivery. All the three groups support the physician as the best source to consult for the selection of delivery mode. As demonstrated, the mean scores of knowledge, attitude, evaluation result and perceived behavioral control for the women with elective cesarean section were lower than the corresponding scores for the two other groups. Since the majority of the women in the study were primiparous, appropriate strategies including training programs for pregnant women and young girls based on behavioral theories and models such as TPB, and counseling with families, arranged by health centers and the mass media can be suggested

effective factors on anti-HBs titer after vaccination in Beta the alassemic patients

In transfusion dependent thalassemia major patients, HBV infection is common, thus immunization against HBV will reduce and prevent the rate of infection. In this study we want to evaluate the anti-HBs titer after vaccination. This trail was done on 217 patients, 18.4% of patients had no response, 23% had low response and 58.5% had normal response to anti-HBV vaccination. Except the duration of vaccination, we did not find any relation between age, splenectomy, chelation therapy, transfusion, serum ferritin level and anti-HBs titer. There were also 26 patients with positive HBc-Ab, among these patients, 42.31% were not detectable. Although we found acceptable anti-HBs titers after vaccination, but because of low incidence of HBV infection and high cost of producing the vaccine, and no response to booster, it seems that revaccination is unnecessary