Vinorelbine and docetaxel combination as the first line treatment in patients with metastatic breast cancer: results of a multi-centric phase ii trial in Iran

Introduction: We conducted a multi-centric phase II study to evaluate the tumor response and safety of the combination of vinorelbin and docetaxel in treatment of metastatic breast cancer patients

Patients and methods: Forty one metastatic breast cancer patients, who had at least one measurable lesion and had not been treated for metastasis before, were enrolled from March 2006 to June 2009. Treatment contained vinorelbine 25mg/m2 IV and docetaxel 30mg/m2 at day 1 and 8. Cycles were repeated every 21 days for 6 cycles. We evaluated response to chemotherapy every three weeks and toxicity every week

Results: The mean age of patients was 50.4 years [range 30-81]. Twenty eight patients [68.2%] had received prior neoadjuvant anthracycline based chemotherapy. No patient had received adjuvant chemotherapy within the last 3 months. Twenty four patients [58.3%] had two or more metastatic sites. Thirty six patients were evaluable for their response. An objective tumor response [either complete response or partial response] was achieved in 32 [88.8%] and complete response was seen in 9 [25%] patients. Thirteen patients [31.6%] developed grade 3-4 neutropenia and neutropenic fever was reported in 11 [26.8%]. Grade 3 anemia was observed in 1 patient [2.4%]. No grade 4 non-hematological toxicity was noted and the most frequent grade 3 non-hematological toxicities were hair loss [39%], stomatitis [7.3%] and diarrhea [4.8%]. Median time to progression was 7 months and median overall survival was 11 months

Conclusion: Vinorelbine-docetaxel combination shows a considerable tumor response and manageable toxicity as the first line treatment for metastatic breast cancer. It seems logical to conduct phase III trials to further evaluate this regimen

[Prevalence of carpal tunnel syndrome in women of boyerahmad township]

Carpal tunnel syndrome [CTS] is caused by the entrapment of the median nerve in the carpal tunnel of the wrist. CTS is a rather frequent complication in pregnancy. Thud, the prevalence of CTS is higher in women compared to men. However, the percentage of CTS related to pregnancy is not known in some countries such as Iran. The main aim of this study was to determine the prevalence and severity of CTS in pregnant and non-pregnant women of Boyerahmad township. This is a cross-sectional descriptive study was done during the period of February 2010 to January 2011 in OB and GYN clinics among 2,656 non-pregnant and 1,508 pregnant women. Among the women whom were referred to the OB and GYN specialists, 175 exhibited the clinical symptoms of CTS and were subjected to standard electrodiagnostic studies performed for either ruling in or out CTS by a Physiatrist. The prevalence of CTS in women who had clinical symptoms was 2.7%. The prevalence of CTS in pregnant and non-pregnant women was 3.4% and 2 .3%, respectively. Overall, out of a total of 51 pregnant women who were suffering from CTS, 59.4% had mild, 18.8% had moderate, and 21.9% had severe CTS. Sixty one non-pregnant women had CTS that 73.6% of whom had mild, 20.8% had moderate, and 5.6% had severe CTS. The prevalence of CTS in pregnant women is higher than non-pregnant women. Also the rate of severe CTS is higher among pregnant women

Prevalence and severity of carpal tunnel syndrome in women

Carpal tunnel syndrome [CTS] is entrapment of median nerve in carpal tunnel of the wrist. The prevalence of CTS related to pregnancy and non-pregnancy is unknown in some countries such as Iran. The main aim of this study was to determine the prevalence of CTS in women of Boyerahmad Township located in South-West part of Iran. This cross-sectional descriptive analytic study was done since February 2010 to January 2011 in Obstetrics and Gynecology clinics in 2656 non-pregnant and 1508 pregnant women. The women that had clinical symptoms of CTS performed standard electro diagnostic techniques for rule in or rule out of CTS. The prevalence of CTS in pregnant and non-pregnant women was 3.4 and 2.3 percent respectively. The prevalence of CTS in all women was 2.7%. Overall, 51 pregnant women had CTS that 59.4% had mild, 18.8% had moderate and 21.9% had severe CTS. Sixty-one non-pregnant women had CTS that 73.6%had mild, 20.8%t had moderate and 5.6% had severe CTS. Although the prevalence of CTS in Iranian pregnancy is higher than non-pregnancy women conservative treatment is safe and more effective

[Study of topical human umbilical cord blood serum in the treatment of alkaline corneal epithelial wounds in rabbit model]

One of the important functions of the cornea is to maintain normal vision by refracting light onto the lens and retina. This property is dependent in part on the ability of the corneal epithelium to undergo continuous renewal. Ocular surface failure which follows a variety of endogenous and exogenous precipitating factors, the most common being: chemical trauma, infection, alkaline burn, inflammation and hereditary conditions, lid or lash abnormalities tear deficiency or reduced sensation. The core principal underpinning management strategy for ocular surface failure is establishing or promoting new growth of healthy conjunctiva and corneal epithelium. This process is mediated by many proteins that are inducers of corneal cell migration, proliferation, and differentiation. The current study was performed to investigate the efficacy of umbilical cord serum on alkaline corneal epithelial wound healing in the rabbit model. In this study conducted at Yasuj University of Medical Sciences in 2010, thirty two rabbits were randomly assigned into two equal groups. Central corneal alkali wound was formed in one eye of the rabbits by applying a 6-mm round filter paper, soaked in 1 N NaOH, for 60 seconds. Group one of animals received umbilical cord blood serum; and group two received Sno Tear in the eyes. The treatment was dosed 4 times a day with the eye drops, and epithelial wound closure was recorded using slit lamp. The data were analyzed to determine the rate of wound closure. The mean wound radius closure rate was 0.77 mm/day [SD=0.013] for umbilical cord blood serum-treated eyes, 0.73 mm/day [SD=0.018] for artificial tear-treated eyes. This study shows that alkali-injured corneal epithelial wound heal faster when treated with umbilical cord blood serum than with artificial tear in rabbit model

[Evaluation of ophthalmologists' sitting position]

To evaluate ophthalmologists' sitting position during ocular examination and surgery and to evaluate any correlation between musculoskeletal disorders and mean work time. This cross-sectional study was performed on ophthalmologists in Isfahan, Iran in different occupational positions including the office, during slitlamp examination and in the operating room. The evaluation included neck angle, lumbar lordosis, pelvic angle and the position of lower leg and foot. Ophthalmologists were asked about spinal and shoulder pains and mean work time in the office and operating room. Among 73 studied ophthalmologists [including 60 male and 13 female subjects], there were malpositions in neck angle in 43 [58.9%], lumbar lordosis in 36 [49.3%], hip angle in 9 [12.3%], lower leg in 49 [67.1%] and foot in 31 [42.4%] cases. Among 62 ophthalmologists who performed surgery there were malpositions in neck angle in 38 [61.3%], lumbar lordosis in 38 [61.3%], hip angle in 2 [37.1%], knee angle in 43 [69.4%] and foot in 44 [71.0%] cases. There was a significant correlation between spinal pains and mean work time in the office [P=0.02] and operating room [P=0.01]. According to the correlation between spinal pains and work time, it is necessary to educate ophthalmologists for correct sitting position during work

[Survival rate and its related factors in patients with acute myocardial infarction]

It has been noted that the myocardial infarction is an increasing episode in Islamic Republic of Iran and there are many procedures and methods which can help to reduce the number of death from this ongoing event. The aim of this study was to determine the survival rate in those patients who have had acute myocardial infarction and its association with different variables. This descriptive analytic study evaluates 111 cases of acute myocardial infarction admitted in Yasuj Imam Sajjad hospital during the year 2004 and 2005. Data were collected using a questionnaire which was completed through direct interviewing by trained personnel. The data were analyzed by standard statistical tests using SPSS software. The mean age of patients was 57 +/- 12 years. The mean time of having access to physician after MI was 4 +/- 2.2 hours. The mean time of reaching hospital after physician order was 5 +/- 4.9 hours. The mean time of hospitalization was 4 +/- 1.67 days. Considering the past history of these patients revealed that 31 percent were smokers, 16 percent had the history of previous ischemic heart disease, 63 percent had hypertension, 8 percent had diabetes mellitus, 95 percent had clip I, 95 percent had no previous block, 82 percent had Ml with Q wave. The survival rate in our study was found to be 0.91 in the first 10 hours, 0.847 in the first day, 0.829 in the first 28 days, 0.820 in the first third months, 0.792 in the first six months and 0.771 in the first 10 months of disease. The mortality rate during the first month among the patients with heart failure turned out to be higher than that of the other similar studies performed in other parts of the country; however, the annual survival rate proved to be less. The most important causes of survival after the stroke are being single, smoking, fatness and angina pain