Drug-induced vasculitis in a breast cancer patient receiving chemotherapy

Introduction: Drug-induced vasculitis following chemotherapy has been rarely reported. We report such a case of drug-induced vasculitis following chemotherapy in a breast cancer patient

Report of the Case: A 52 year old woman with stage III breast cancer developed pathologically proven vasculitis presenting as bilateral severe erythema, edema and ulceration on both feet 10 days following the 4th cycle of adjuvant chemotherapy. Chemotherapy consisted of docetaxel, doxorubicin, and cyclophosphamide in each cycle that was preceded by premedication including dexamethasone, granisetron, and H1 and H2 blockers. Furthermore, filgrastim [5 micro g/kg] was administered following each cycle of chemotherapy during days 5-9. By discontinuing chemotherapy and starting high-dose intravenous methylprednisolone, vasculitis was resolved. The patient did not experience vasculitis following the re-challenge of chemotherapy excluding docetaxel and filgrastim

Conclusion: This case suggests that docetaxel and filgrastim might be added to the list of agents causing drug-induced vasculitis

Fine needle aspiration diagnosed skin metastasis in a young man with rectal cancer

Introduction: Although colon cancer is one of the most common human cancers, skin metastasis in this disease is rare and necessitates pathological confirmation

Report of the Case: Herein we present a 33 year old man with rectal cancer with ascites. Six cycles of Oxaliplatin based chemotherapy were given. The ascites improved. After three weeks, skin lesions appeared in the upper trunk, both chest wall and back, with extension to the anterior neck Fine Needle Aspiration from the lesions showed malignancy and second line chemotherapy was started. Although the skin lesions showed partial response, unfortunately, the patient died after the fourth chemotherapy injection

Conclusion: Skin metastasis in colorectal cancer, although rare, is a devastating sign, and a careful dermatologic examination should be included in these patients' follow up visits

[Determining the effect of zizphus jujba extract together with phototherapy in reducing bilirubin concentration in neonatal jaundice]

Neonatal jaundice is observed in the first week of birth among 60% of mature and 80% of immature neonates. This epidemic puts a lot of cost on the society. Today, phototherapy is used for the treatment of neonatal jaundice. Reducing the treatment period decreases the hospitalization costs. The Purpose of this study was to determine the effect of Zizphus Jujba extract and phototherapy on reducing both Bilirubin concentration and also the hospitalization period of neonatal jaundice patients. This was a clinical-trial study which was conducted at Imam Sajjad Hospital of Yasuj in 2009. 121 of the hospitalized neonates were chosen and divided into 2 groups: case group [63 neonates] and control group [58 neonates]. 1 cc of the Zizphus Jujba extract per each kilogram of body weight was orally given three times a day to the case group. Also phototherapy was used in the case group. Phototherapy was the only treatment used for the control group. The Bilirubin concentration of the hospitalized patients was measured two times a day in the hospitalization period. The collected data was analyzed by the SPSS software using t-test. The mean and standard deviation of the Bilirubin concentration in the control group before the intervention were 20.9 +/- 2.3 milligrams per 100 and after intervention was 12.27 +/- 1.23 milligrams per 100 while in the case group before intervention was 22.3 +/- 0.05 and after intervention was 12.27 +/- 1.01 milligrams per hundred. A significant difference was seen between the case and control group before and after intervention [p=0.001. Moreover, a meaningful reduction of the hospitalized days and a meaningful increase of excrement and urine in the case group were observed. This study revealed that administration of Zizphus Jujba extract with increasing amount of excrement and urine of the neonates can lead to Bilirubin discharge and can be effective on curing neonatal jaundice

Cervical ectopic pregnancy: successful treatment with methotrexate

The incidence of cervical ectopic pregnancy varies between 1/2400 to 1/50000 of pregnancies and less than one percent of ectopic pregnancies. Predisposing factors are previous abortion, Asherman syndrome previous caesarian, exposire to DES, leiomyoma IVF. Our patient was a thirty two year's old lady with menstruation problems for three months and positive Bhcg test and vaginal bleeding. According to physical exam and paraclinical procedures diagnosis of cervical ectopic pregnancy was made and multiple dose of methotrexate was given to the patient with successful outcome