Cancer related fears in Iranian patients, a survey from south east of Iran

Introduction: Cancer is a chronic disease with an increasing incidence. Other than common complications of chronic diseases, the vague prognosis and early threat of cancers may induce tension and fears among patients. Such fears are of the main destructive aspects of cancer that make it a physically and emotionally weakening disease

Patients and methods: In this study, we evaluated 111 patients with cancer who had been treated in the specialized cancer treatment center of Zahedan. They were asked to fill a questionnaire containing 44 questions about their fears and anxieties. We categorized the fears into social, individual, sexual, and disease related groups and these groups were analyzed according to the patients' characteristics

Results: 26.1% of the patients were men and 73.9% were women with the mean ages of 45.9 and 44.9 years respectively. The majority of patients [79.3%] were married. T test analysis revealed that women experienced more social [P= 0.001] and personal fears [P= 0.015] than men. Married patients had more sexual fears than other groups [P= 0.001]. One-way ANOVA for examining the effect of educational attainment, showed that the only variable with statistically significant difference among the means was the sexual fears [F [3, 108] =3.417, p=0.020]. The patients with higher education levels had lower scores in sexual fears than other groups, meanwhile such type of the fears were more in the group of middle school education

Conclusion: Cancer is accompanied by different types of fears that affect the patients' quality of life and satisfaction with treatment. It sees that detecting these fears and trying to resolve them, may help patients to have less stress during their life with cancer

[ effect of reflexotherapy on chemotherapy-induced vomiting of patients]

Vomiting as a side effect of chemotherapy causes to refuse or delay in treatment by most cases. Nowadays, for controlling these side effects researchers attempt to use noninvasive-, safe- and low cost methods, instead of expensive drugs with various side effects. This study aimed to assess effect of reflexotherapy on vomiting reduction among patients under chemotherapy, in oncology-hematology ward of Zahedan's Ali Ebn Abitaleb Hospital in 2010. This study was a before and after clinical trial [pre-test and post-test] with a group of 37 patients. The participants were selected using purposeful sampling method and based on the results of a pilot study. They were also considered once in the control group [receiving anti-vomiting drug Granisetron] and after 15 to 20 days in the interventional group [receiving reflexotherapy in a period of 10 minutes for each leg]. The Summary of Morrow Questionnaire and CTCv[2.0] [Common Toxicity Criteria Version 2] of National Cancer Institute of America were used for making a questionnaire to data collection. Face and content validity of questionnaire and its reliability [Chronbach alpha Coefficient =0.73] was confirmed beforehand. Data was analyzed using central and dispersion indexes as well as Wilcoxon and Mann-Whitney tests and Marginal modeling [generalized estimating equations GEE]. The mean age of samples was 44.73 +/- 13.38 [years]. Majority of participants were married and women. Patients were in their second to 15th cycle of chemotherapy; receiving Cisplatin-Gemzar or Adriamycincyclophosphamide and were from breast cancer cases. Assessment of severity of vomiting during first 24 hours showed more sever vomiting in the first 4 hours among control group than interventional group [p<0.001], but it was more severe in interventional gropup than control group in third 4 hours [p<0.001] and the second 12 hours [p=0.006]. During the second 4 hours, severity of vomiting was not significantly different between the two Groups [p=0.313]. Finnally, the results showed no significant difference between two treatment methods respecting their effect on severity [p=0.153] and the number of vomiting [p=0.239] during the 24 hours after treatment. Although reflexotherapy was not shown to have positive effect on chemotherapy induced vomiting of patients but it caused to reduce severity and number of vomiting in the first 4 hours after chemotherapy among patients with moderate and sever vomiting. Therefore, experimental study using reflexotherapy is recommended in multiple sessions.

[Congenial insensitivity to pain with anhydroses [CIPA]: a case report]

Introduction: Autonomic neuropathy is a rare disorder inherited as insensitivity to pain and temperature. It has been divided into five groups, the fourth of which named congenital insensitivity to pain with anhydrosis, [CIPA] is the most common type of this disorder. CIPA is a recessive inherited condition with courses of idiopathic fever, reduction of sweat glands secretion despite having normal glands, insensitivity to pain and temperature changes, and mild mental retardation. Oral symptoms due to their severe abuse in these patients are considerable. Gas shock tongue, lips and other oral mucosa have been reported

Case Report: Examination of a 15 month old boy revealed severe oral ulcers and burns in the fingers of both hands due to contact with the heater. Pathological studies and special attention to specific aspects of the patient revelead that he was insensitive to pain and thermal stimulation and was diagnosed as a possible case of CIPA

Conclusion: CIPA is a autosomal recessive disorder which is very rare in childhood, as insensitivity to pain or the incidence of abuse and lack of objective response to pain in people with peripheral and central nervous system are normal. Tyrosine gene defect related to gene code provided membrane tyrosine has been identified in these patients. Mutation in this gene results in insensitivity to pain, anhydrosis, self abuse, and mental retardation and is associated with cancer. More than half of the patients die before the age of three. Oral manifestations of this syndrome are the characteristics of the disorder and can help to make an early diagnosis

[Frequency of oral mucosal disease in referral patients to dental faculty of Tabriz in 2007]

Oral disease is a significant burden to all countries of the world. Since there is little know about this in Iran we decided to identify of oral mucosal disease in patients referred to Oral Medicine Center affiliated to Tabriz Dental School. A consecutive sample of admitted patients to OMC between April to June 2007 were included in this study. We employed a standard questionnaire in order to. Eight hundred two patients were completed the requested questionnaire. Seventy percent was female. The mean age of the study sample was 32.68 [SD=12.25] years. Approximately 70% of subjects had oral lesion,%19.2 had normal mucosa and%21.60 of patients had oral mucosal lesions that need to follow and control. The most common lesions were ankiloglossia [%29.7] then fissural tongue [%25.7] and coated tongue [%23.7]. Many patients attending the center were unaware of oral lesions in their soft oral tissue which needed to follow up. This emphasizes that examination of soft oral tissue should be considered by health policy makers in oral health agenda at national level

[Mercury concentration in unstimulated whole saliva in high school students in Tehran]

Mercury is a natural-occurring metallic substance. There are quantities of mercury found in air, water, soil, and all living matters. It is considered as one of the harmful metals to human being. Study of normal mercury content in human internal organs, blood, urine and saliva can be useful in assessing the level of environmental exposure. Such information may be useful and contributes to medico-legal expert opinions. The present study was conducted to determine the un-stimulated whole saliva mercury content in high school students in Tehran. This cross sectional study recruited 130 volunteer high school students [65 male, 65 female]. They were selected randomly from 5 different geographical sites in Tehran. All examinations conducted in this study were undertaken during the day from 9AM to 12PM, at least 2 hours after last intake of food and drink. By using spilling method, about 5CC of saliva was collected in a specially prepared test tube. Mercury was measured by Cold Vapor Atomic Absorption Spectrometry [CVAAS]. SPSS software and Man-Whitney U test were used for data analysis. The average student age was 16.5 and the average saliva mercury concentration was 0.17 micro g/dl, with 0.20 micro g/dl in males and 0.16 micro g/dl in females. No significant difference was detected between males and females saliva mercury levels. This study showed that a trace of mercury is detectable in saliva of people who have no amalgam fillings. Such information may be useful for relevant studies conducted in future

Cutaneous complication after electron beam therapy in breast cancer

Breast cancer is the most common cancer in women and the second cause of death among them. There are several treatment methods for breast cancer, one of which is radiation therapy. There are two important methods of radiation therapy: tangential field and single oppositional field. Main goal of this study is evaluation of factors that have a role in producing acute side effects such as skin burning in breast cancer patients treated by electron beam,in order to decrease these side effects. From 1/2003 through 7/2004, 200 consecutive patients were evaluated during 18 months in seid-al-shohad hospital, whose mean age was 49 years old. In this study a questionnaire was used including some questions about personal profile such as patient's name, address, registration number, age and some other factors. All patients who were candidated to enter in this investigation filled out the questionnaire at the end of radiation therapy. The patients were examined and their skin burning grades were evaluated by RTOG scale. Data were analyzed by chi-square test using SPSS 11 software. None of patients showed grades O or 4 of burning. 31.5% of Patients showed grade 1, 64.5% showed grade 2, 4% showed grade 3 of burning. There was statistically significant correlation between posterior axillary field and skin burning and there wasnot any meaning between the other factors. It is necessary to pay more attention to posterior axillary field planning including field size, location, photon energy, depth and dose of treatment

[Radiation effect on the number of circulating blood cells in patients receiving pelvic radiotherapy]

There is considerable controversy in scientific literature regarding the need to monitor the complete blood count of patients undergoing radiation therapy. While some advocate weekly examination of the peripheral blood, others deem it unnecessary. Since reduction in the number of blood cells has considerable effect on the treatment outcome, this study evaluates the effect of pelvic radiation therapy on the number of blood cells. This study designed as a cohort study of pre- and post-treatment evaluation. After excluding patients who didn't complete treatment or had problem in first blood count, 51 patients who had received radiation therapy in pelvis area selected, evaluated by taking a blood sample before and 24-48 hours after completion of the radiation course, thus comparing the mean count of the circulating blood cells before and after therapy. The average of hemoglobin and white blood cell count compared by t-test and after stratified patients according to dose and volume to "low", "moderate" and "high" groups, averages compared by ANOVA. Fifty-one patients included 25 male and 26 female evaluated. The mean of white blood cells, red blood cells and platelets decreased. However, a significant difference in white and red blood cells was found. In despite of significance difference between means of red and white blood cells, there is no need for blood transfusion or increase risk of infection due to this reduction, so this reduction isn't clinically significant. It is recommended that weekly monitoring of CBC in patients with normal CBC before radiotherapy is non necessary