Assessment of a breast cancer screening programme in Shiraz, Islamic Republic of Iran

A breast cancer screening programme was evaluated for approximately 10,000 women aged 35 years and older. There were 67 cases of breast cancer. Highest rates of attendance were seen among younger women [35-44 years] and middle socioeconomic groups. Lowest rates were among those aged over 65 years and low socioeconomic groups. The rate of detection by self-examination was similar to that by health personnel examination. At all stages of screening, positive findings were most common among the high socioeconomic class. Attendance decreased steadily from first to last stages of serial screening. Although mammography is the most sensitive method of detection, because of its high cost we suggest establishing breast self-examination education programmes and encouraging women to self-examine

Reproductive behaviour in women in Shiraz, Islamic Republic of Iran

Data on the reproductive behaviour of women in Shiraz are presented. A total of 9934 randomly selected women aged >/= 35 years of all socioeconomic levels were interviewed. The mean age at menarche +/- standard deviation was 13.96 +/- 1.23 years, mean age at first marriage was 17.10 +/- 4.24 years and mean age at first pregnancy was 19.50 +/- 3.90 years. The mean number of children was 4.56 +/- 1.70 children, although for illiterate women it was 6.76 +/- 1.76 children and for high-school or university-educated women it was 3.36 +/- 1.70 children. The mean age at menopause was 47.80 +/- 3.78 years

Shiraz Breast cancer study part II: screening mammography in a population-based breast cancer survey

The purpose of this study was to assess the detection rate of mammography in breast cancer and the attendance rate in response to the call for screening mammography in females before the development of symptoms. One-thousand four-hundred and thirty-eight women over 35 years of age who had no complaint and had normal breast examinations were called for mammography. Out of the 10,000 women under study for breast cancer, 1,438 women were randomly called for mammography and actually 985 subjects turned up for mammography. All the mammograms were reported by the same radiologist, and physical examination of the breast was carefully performed by both radiologist and surgeon on any patient suspected of having a lesion in mammography. A total of 4 malignant non-palpable lesions were detected in 985 screening mammograms. The prevalence of breast malignancy is lower in our female population compared with the west and our detection rate in subjects with no physical findings comprises 0.4%. Since only 985 women turned up for screening mammography, the attendance rate is calculated as 68.5%. Mammographic findings consisted of 96 cases of benign-appearing breast nodules, 194 cases of calcification, 25 intra-mammary lymph nodes, 189 enlarged axillary nodes and 83 dense breasts. In conclusion, although mammography is a very helpful procedure in screening for breast cancer, the response can be low for a call for mammography and the prevalence of malignancy of the breast has been underestimated in the past

value of ultrasound in the prediction of non-surgical reducibility of pediatric intussusception

Intussusception is the most common cause of mechanical bowel obstruction in infants and, if diagnosed early, it can be reduced by the hydrostatic pressure of barium or saline or by air enema. In this study, we show that ultrasound measurement of thickness of the edematous middle layer of the mass of intussusception can be a reliable index to predict whether the intussusception can be reduced non- surgically. The study was performed on 24 cases, the average of edema thickness in non-surgically reducible cases being 6.8 mm, while in those in which non-surgical reduction was not possible, this average was 10.4 mm. In 11 patients we used barium enema, and in 13 patients air was used to reduce intussusception. With barium, the success rate was 18%, while with air it was 46%. The diagnostic accuracy of intussusception by ultrasound was 100%. The average time interval between onset of symptoms and the patients' referral to our center was 3.3 days. Ultrasonography can be a valuable tool in the diagnosis and proper management of pediatric intussusception

Cervical spine involvement in functional class III rheumatoid arthritis

One hundred patients with Functional Class III Rheumatoid Arthritis were evaluated clinically and radiologically for cervical spine instability. Fifty patients had roentgenographic manifestation of such instability. Atlantoaxial subluxation was observed in 22, vertical settling in 9, and subaxial subluxation in 37 cases. In 18 patients, more than one type of instability was observed. Thirty-four patients were asymptomatic in the presence of radiologic instability. Neck pain was the most common complaint in the symptomatic group [16 patients]. Only one patient had long tract sign requiring cervical fusion

Atlantoaxial subluxation in Morquio-Brailsford syndrome: report of two cases

Atlantoaxial subluxation with myelopathy is the most severe complication of Morquio-Brailsford syndrome. It is life threatening and if undiagnosed can cause serious problems. In this report, two cases with this complication are described, both of whom benefitted from operation. However, one patient died of respiratory failure a month later

Traumatic retrolisthesis of lumbosacral junction with fracture of L1 vertebra: a case report

Traumatic retrolisthesis of L[5]-S[1] with Chance fracture of L[1] vertebra is an extremely rare type of spinal injury. Here is a report of an 18-year-old woman with this type of fracture dislocation and spinal cord injury who has been successfully managed and her 14 months follow-up is quite satisfactory