incidence of breast cancer in northwest Iran [2003 -2008]

Breast Cancer is the most common cancer in Iranian women and Iranian patients are relatively young. Given that Iran has a female population of about 38 million, this corresponds to a total number of 6000 new cases of breast cancer annually. This study aims to demonstrate the characteristics of breast cancers according to pathologic records in East Azerbaijan province, Iran. In this retrospective cross-sectional study, 159314 pathology records of the main hospitals and pathology laboratories were observed for a period of 5 years. For each patient, sex, age, breast specimen pathology, pathological grading of malignant lesions and place of residence of patients were collected and statistically analyzed. There were 12083 cancer cases; 902 of which were primary breast cancer. Breast cancer was the most common cancer in females [22.2%] but it ranks the 22nd in males. The annual incidence of breast cancer in women was 52.3 per 100,000. The mean age of women with breast cancer was 48.3 +/- 12.7 years [range, 16-85] and for male 54.0 +/- 13.6 years [range, 23-76]. The highest frequency of malignancies was observed in the 40-49 year old age groups [34.5%]. Invasive ductal carcinoma was the most common histological type diagnosed in both sexes. In Iran, breast cancer affects women at least one decade younger than developed countries. In spite of the rare incidence of breast cancer in men, the descriptive epidemiology of this malignancy is surprisingly similar to that of women. A considerable proportion of cancers of our research were in breast which mandates a national cancer detection program encouraging women for breast self-examination and participation in screening tests to improve breast cancer care.

Comparison thoracic epidural and intercostal block to improve ventilation parameters and reduce pain in patients with multiple rib fractures

Chest wall blunt trauma causes multiple rib fractures and will often be associated with significant pain and may compromise ventilator mechanics. Analgesia has great roll in rib fracture therapies, opioid are useful, but when used as sole agent may re-quire such high dose that they produce respiratory depression, especially in elderly .the best analgesia for a severe chest wall injury is a continuous epidural infusion of local anesthetic. This provides complete analgesia allowing inspiration and coughing without of the risk of respiratory depression. sixty adult patients who with multiple rib fractures were enrolled in this study. They were divided into Group A or thoracic epidural with bupivacaine 0.125% +lmg/5ml morphine and group B or intercostal block with%0.25 bupivacaine. The patients were assessed through ICU and hospital stay length, ventilation function tests. Pain score among the patients was measured with verbal rating scale, before and after administration of the analgesia. We found a significant improvement in ventilatory function tests during the 1st, 2nd, and 3rd days after epidural analgesia compared with the intercostal block [P < 0.004]. Changes in the visual Analogue Scale were associated with marked improvement regarding pain at rest and pain caused by coughing and deep breathing in group A compared group B... ICU and hospital stay markedly reduced in Group A. thoracic epidural analgesia is superior to intercostals block regarding pain relief of rib fractures. Patients who received epidural analgesia had significantly lower pain scores at all studied times

Pulmonary arterio-venous malformation

Pulmonary arterivenous malformation [PAVM] is an abnormal communication between the pulmonary and the pulmonary vein. PAVMs are usually congenital in origin. In this study we reported 32-year-old women that referred to the clinic with the chief complain of frequently coughs and hemoptysis for three months. Also her past medical history revealed that she had a thoracotomy and decortication of the right lung due to clotted hemothorax, about 12 years ago while she had a term pregnancy. CT angiography and spiral CT-scan demonstrated in the right hemithorax. These masses were enhanced like pulmonary vessels and had feeding artery and evacuator vein. So three PAVMs were diagnosed in the right lung. The patients underwent right postrolated thoracotomy. Two of the PAVMs were in the lower lobe which treated by resection but the one in the middle lobe was performed

Factors associated with Limb salvage following complex blunt popliteal injury

The purpose of this study is to report management techniques and factors associated with early limb salvage following high risk popliteal vascular injury. Additionally controversial aspects of popliteal vascular injury management unique to an Iranian trauma center are discussed. A retrospective analysis was conducted of prospectively collected data Ji.om Tabriz Medical Trauma Center. Patients were divided into two study groups: Group 1 Limb salvage and Group 2 Amputation. Subgroup analysis consisted of university analysis comparing the Group land Group 2 as well as multivariate analysis examining factors associated negatively and positively with the primary endpoint, limb salvage. Sixty of the patients [97%] were male, two female [3%]; the mean age was 34.years [16-49 years].The overall amputation rate in the present study was 23 amputations [37%].On logistic regression analysis, significant [P<0.05] independent factors associated negatively with limb salvage were combined tibia and fibula fracture [OR 0.133; CI 0.01 7 -1.01 8], concomitant artery and vein injury [OR 0.039; CI 0.004- 0.407], ligation of venous injury [OR 0.326; CI 0.161 - 0.660], lack of back flow after Fugarty catheter thrombectomy [OR 0.129; CI 0.023-0.729], while repair of popliteal artery and vein injury [OR 2.81; CI 2.22 -6.53] when present was associated with improved early limb salvage. Expeditious recognition of vascular injury, transport to repair and repair of associated venous injury when possible are necessary to optimize limb salvage. A low threshold for timely amputation when limb salvage is not possible is important to prevent life-threatening complications

Epidemiological study of lung cancer in East Azerbaijan, Iran

Lung cancer is the most common cause of cancer death worldwide with more than 1.3 million people dying of the disease annually. In Asia, the incidence and mortality rates of lung cancer are generally lower than those in western countries. We aimed to obtain cancer incidence data from the East Azerbaijan. Iran; to select the target populations for our future cancer field studies. Diagnosed primary lung cancer cases and pleura and trachea during five years [2002-2006] were collected from the hospital or private pathology laboratories in East Azerbaijan and analyzed using SPSS 13.0 after metastatic and same cases exclusion. In this study 159314 pathology records were studied in hospitals and laboratories; 12083 of them were cancer cases. 9166 of them were primary cancer patients and Azerbaijan residents. A total of 469 new lung cancer cases [81% male, 19% female] were diagnosed during the years 2002-2006, the age-adjusted incidence rate [A%] per 100,000 being 16.6 for males and 4.2 for females. Squamous cell carcinomas the most common histological type [58.5%], the proportion of adenocarcinoma being 27.6%, small cell carcinoma 12.6% and large cell carcinoma 0.6%. ASR was calculated for cancer of pleura [0.4, 0.3] and for cancer of trachea [0.2, 0.1] per 100000 in male and female, respectively. This study is the first report of respiratory tract cancer incidence in East Azerbaijan. The results of the present study are statistical analysis of the cancer prevalence and incidence in Iran which mainly correspond with the international reports and is a scientific tool we want to offer to all those who work in the prevention, care and treatment of cancer in Iran