Value of ultrasound in the detection of benign and malignant breast diseases: a diagnostic accuracy study

Objectives: We sought to determine the diagnostic accuracy of ultrasound for benign and malignant breast lesions

Methods: This retrospective study was performed to evaluate the diagnostic accuracy of ultrasound in 203 patients with complete medical records who visited Mehr Medical Imaging Center for breast ultrasound between March 2014 and February 2016. The collected data comprised of demographic characteristics, ultrasound results [consisting of the anatomic area of the lesion, the involved side, and the ultrasound characteristics of the lesion], mammogram results, and pathology reports [if surgery or biopsy was performed]

Results: For the diagnosis of malignant and benign lesions, ultrasound had a sensitivity of 93.9% and specificity of 86.5%; its positive and negative predictive values were 86.9% and 93.8%, respectively. Lesion type was significantly associated with a family history of breast cancer and fertility status [p < 0.005], but there was no significant association between the involved side and tumor type [p > 0.050]

Conclusions: Mammography is the best technique for screening and identifying patients with non-mass-like breast lesions and microcalcifications. Considering the false positive and false-negative results, ultrasound is not a perfect screening modality. Future studies are recommended to study the value of ultrasound in the detection of high-risk breast cancer patients

[Comparison of the accuracy of intraocular pressure measurement by Goldmann applanation tonometer and Keeler noncontact tonometer]

Glaucoma is one of the leading causes of blindness, and its major risk factor is elevated intraocular pressure. Intraocular pressure measurement is a major examination in patients with glaucoma for diagnosis and treatment follow-up. This study was carried out with the purpose of comparing the accuracy of two types of conventional tonometers for measuring intraocular pressure. In this descriptive cross-sectional study, after complete ophthalmologic examinations, intraocular pressure was measured in 142 patients [284 eyes], two times at 5-minute intervals using both Goldmann and Keeler tonometers. The obtained results were analyzed with paired t-test and Pearson's correlation test. Mean intraocular pressure in subjects that were in normal pressure range [<21mmHg] was obtained 14.03 +/- 2.35mmHg with Goldmann tonometer, and 14.28 +/- 3.05mmHg with Keeler tonometer. The mean difference of the two methods was 0.25 +/- 0.70 [p=0.015] and the correlation coefficient between two methods was calculated 0.83 [p<0.0001]. Mean intraocular pressure in high intraocular pressure range [>/= 21mmHg] was obtained 26.16 +/- 5.1mmHg with Goldmann tonometer, and 26.92 +/- 5.58mmHg with Keeler tonometer. The mean difference of the two methods was 0.76 +/- 0.44 [p=0.003], and correlation coefficient between two methods was calculated 0.97 [p<0.0001]. Based on the results of this study, both used tonometry methods had acceptable accuracy in normal intraocular pressure range, but in high-risk cases such as glaucoma, Goldmann applanation tonometer is preferred as the gold standard

[Family physician program: physicians' satisfactions in Hamadan, Iran]

Objectives: Physicians' satisfaction is essential for proper implementation of Family physican program. This study aimed to assess physicians' satisfaction in Hamedan, Iran

Methods: This was a cross-sectional study. Data were collected by interview and questionnaire. In order to measure physicians' satisfactions all family medicine physicians in Hamadan province were surveyed

Results: In all 121 physicans were studied. Physicians' satisfactions for most items were low. For instance, 57 [47.9%] were very dissatisfied with the program

Conclusion: The findings suggest that physicans satifaction with family physican program is very low and this might not only lead to damages the program, but also may cause decrease in community health status. Indeed, it is essential improve physicans' satisfaction prior to expanding the program

Characteristics of hospitalized patients following suicide attempt in Hamadan district, Iran

Limited research has been undertaken on suicide in developing countries. This paper aims to investigate characteristics of suicide attempts in Hamadan district of Iran. A prospective study was conducted in all university hospitals in the Hamadan district of Iran and patients admitted for attempted suicides were included. All cases were assessed by psychiatrists and visited by two trained interns of Medicine. The incidence rate per 100,000 persons of attempted suicides was 228.6 for males and 263.1 for females; moreover, 344.9 for rural areas and 222.7 for urban areas. The suicide attempt was the highest in the 15 to 24 age category for both sexes and regions. Suicide is a complex, long-term outcome that requires multifaceted theoretical constructs for the appropriate study of its antecedents. Findings of this study along with other studies in Iran revealed that unemployed men, housewives, and rural women, high-school students, and those with a low level of education were at higher risk of suicidal behaviors

Congenital anomalies in infant with congenital hypothyroidism

Congenital hypothyroidism is characterized by inadequate thyroid hormone production in newborn infants. Many infants with CH have co-occurring congenital malformations. This is an investigation on the frequency and types of congenital anomalies in infants with congenital hypothyroidism born from May 2006-2010 in Hamadan, west province of Iran. The Iranian neonatal screening program for congenital hypothyroidism was initiated in May 2005. This prospective descriptive study was conducted in infants diagnosed with congenital hypothyroidism being followed up in Pediatric Endocrinology Clinic of Besat Hospital, a tertiary care centre in Hamadan. Cases included all infants with congenital hypothyroidism diagnosed through newborn screening program or detected clinically. Anomalies were identified by clinical examination, echocardiography, and X-ray of the hip during the infant's first year of life. A total of 150 infants with biochemically confirmed primary congenital hypothyroidism [72 females and 78 males] were recruited during the period between May 2006-2010. Overall, 30 [20%] infants had associated congenital anomalies. The most common type of anomaly was Down syndrome. Seven infants [3.1%] had congenital cardiac anomalies such as: ASD [n=3], VSD [n=2], PS [n =1], PDA [n=1]. Three children [2.6%] had developmental displasia of the hip [n=3]. The overall frequency of Down syndrome, cardiac malformation and other birth defect was high in infants with CH. This reinforces the need to examine all infants with congenital hypothyroidism for the presence of associated congenital anomalies

Therapeutic effect of vitex agnus castus in patients with premenstrual syndrome

Medical therapies have been widely used for premenstrual syndrome [PMS], but in all of them side effects are predominant. Herbal remedies rarely have side effects and people have more tendencies toward them than chemical therapies. In this study the therapeutic effect of Vitex agnus castus on women who had the PMS, in comparison with placebo, were investigated. In this randomized, placebo-controlled, double-blind study, from134 selected patients 128 women suffered from PMS were evaluated [active 62, placebo 66]. All patients answered to a self assessment questionnaire about their headache, anger, irritability, depression, breast fullness and bloating and tympani during the premenstrual period before the study. Forty drops of Vitex agnus extract or matching placebo, administrated for 6 days before menses for 6 consecutive cycles. Patients answered the self-assessment questionnaires after 6 menstrual cycles, again. Each item rated using a visual analogue scale [VAS]. The mean age was 30.77 [SD=4.37] years in the active group and 30.89 [SD=4.02] years in the placebo group. Rank of variables had significantly difference in active and placebo group before and after the study [P<0.0001] also we noticed significant differences on the use of Vitex agnus in comparison with placebo [P<0.0001]. Vitex agnus can be considered as an effective and well tolerated treatment for the relief of symptoms of mild and moderate PMS

Relationship between oral poor hygiene and broken teeth with oral tongue squamous cell carcinoma

Previous studies on etiology of squamous cell carcinoma [SCC] of the tongue have reported results with respect to long term exposure to cigarette smoking and alcohol abuse. The aim of this study was to investigate risk factors for SCC of the tongue in a set of patients with minimum exposure to cigarette smoking and alcohol. Sixty four cases with diagnosis of oral tongue SCC were reviewed in this study. The patients underwent surgical management at the educational and therapeutic centers, Imam and Buali Hospitals [Hamedan, Iran] between the dates of January 1990 and December 2006. Eighty five percent of patients were older than 40 years of age. Most of patients had poor oral hygiene, dental decay and halitosis. It appears that poor oral hygiene and nutritional deficiency can be considered as risk factors for the SCC of the tongue in west of Iran

One-month survival after coronary artery bypass graft [CABG]

To determine One-month survival after CABG in Shariati Hospital. We followed 340 patients who underwent Isolated-CABG in Shariati Hospital and used survival analysis to compare common coronary risk factors and to assess surgical factors related to survival after CABG. Smoking was more prevalent in males than in females but prevalence of hypertension, diabetes and hperlipidemia was greater in women. Female subjects were older, had greater Body Mass Index [BMI] and left ventricular ejection fraction [LVEF] and had undergone more non-elective surgery compared to males. Most patients had received 3 or 4 grafts [range 1-6 grafts]. There was no difference in aortic cross clamp and anesthesia time between the two genders. Females were hospitalized for longer periods after surgery and their mortality rates were greater. One-month survival ratio estimated by the Kaplan Meier method was 97.1% and 88.4% in males and females respectively. The overall survival rate was 95.3%. The factors related to poor survival were: female gender, non-elective surgery, lengthy aortic cross clamp and anesthesia time and the history of: hypertension, hyperlipidemia, previous CABG and CCU hospitalization