A Case of Antiphospholipid Syndrome Following Gastric Signet Ring Cell Adenocarcinoma.

BACKGROUND Antiphospholipid syndrome (APS) is a rare autoimmune disease characterized by arterial, venous, and small-vessel thrombosis, pregnancy-related morbidity and the presence of antiphospholipid antibodies such as anticardiolipin antibody, and/or anti-beta2-glycoprotein I. In the recent years, APS was observed in patients with solid tumors and the renal cancer, lung carcinoma and breast tumors were the most common tumors linked with APS. CASE REPORT A 53-year-old female presented with pain and pitting edema of left lower extremity that had begun 6 months prior to hospitalization. Deep vein thrombosis (DVT) in the popliteal vein diagnosed by Doppler ultrasonography and the patient was treated with heparin followed by warfarin. Following subdural hematoma, anticoagulant therapy was stopped, and the patient underwent craniotomy. One month later, the patient returned with pain and DVT diagnosed in its right leg. Laboratory tests showed high levels of lupus anticoagulant, IgM and IgG anticardiolipin antibodies. Following a high alkaline phosphatase, diffuse bone marrow involvement was found by whole body bone scan. Looking to find primary tumor, a large infilterable lesion in gastric was seen by endoscopic images, and biopsy histopathology showed a signet ring cell adenocarcinoma. The patient refused chemotherapy and died 6 months after diagnosis. CONCLUSIONS APS is associated with gastric signet ring cell adenocarcinoma.

Prevalence of factor V leiden, MTHFR C677T and MTHFR A1298C polymorphisms in patients with deep vein thrombosis in Central Iran.

Deep vein thrombosis (DVT) is a common disease, especially among elderly patients, which is associated with high costs of treatment and high rates of recurrence. The risk factors for venous thrombosis are primarily related to hypercoagulability, which can be genetic or acquired, or because of immobilization and venous stasis. Among relevant genetic markers are a number of common polymorphisms and mutations in the genes coding for Factor V leiden and methylenetetrahydrofolate reductase. Differential associations of these polymorphisms have been reported in different populations with DVT due to ethnic variations. However, no study has been reported with respect to these polymorphisms in DVT in Iran. Thus, the aim of the present study is to determine the prevalence of FVL, MTHFR C677T and MTHFR A1298C gene polymorphisms in patients with DVT in central Iran. In the present cross-sectional study, a total of 100 patients with first and recurrent episodes of DVT and age less than 70 years were recruited during 2016-2017. Blood sample was collected from the recruited patients and FVL mutation was screened using ARMS-PCR method, MTHFR C677T and MTHFR A1298C mutations were screened using PCR-RFLP method. The results revealed that MTHFR A1298C gene polymorphism in both homozygote and heterozygote form was found to be most frequent i.e. 77% among cases, followed by MTHFR C677T (67%) and FVL (17%). The study highlights the importance of screening of these genetic markers among patients with DVT in this region.

Effect of adding the herb Achillea millefolium on mouthwash on chemotherapy induced oral mucositis in cancer patients: A double-blind randomized controlled trial.

BACKGROUND: Oral mucositis (OM) is a debilitating side-effect of chemotherapy. It has different complications, including impairment of drinking, eating and even talking, sometimes so severe that physician stops the therapy. OBJECTIVE: Investigating the effect of Achillea millefolium distillate solution in the treatment of chemotherapy-induced OM. INTERVENTIONS/METHODS: In this randomized controlled trial, 56 cancer patients with chemotherapy-induced OM were randomly assigned into control and experimental groups in similar blocks based on the severity of OM. The experimental group gargled 15 mL of a mixture of routine solution and distilled A. millefolium 4 times a day for 14 days while the control group gargled 15 mL of routine solution. The severity of OM was assessed at three times before, 7 and 14 days after intervention. Data was analyzed using Wilcoxon, Kruskal-Wallis, Mann-Whitney U, Friedman, Chi-square and Fisher's exact tests. RESULTS: The mean severity score of OM was 2.39 ± 0.875 in both groups at start of the study that was changed to 1.07 ± 0.85 and 0.32 ± 0.54 in the intervention group in days 7 and 14 (p < 0.001). However, the severity of OM was increased to 2.75 ± 0.87 and 2.89 ± 0.956 in the control group respectively (p < 0.001). CONCLUSIONS: A. millefolium distillate healed OM much more than the routine solution. Therefore, it is suggested to be used in patients with chemotherapy-induced OM. The study was registered in the Iranian Registry of Clinical Trials, Number: IRCT2013092214729N1.

A New mouthwash for Chemotherapy Induced Stomatitis.

BACKGROUND: Stomatitis is a disturbing side-effect of chemotherapy that disturbs patients and causes difficulties in patient's drinking, eating and talking, and may results in infection and bleeding. OBJECTIVES: This study aimed to investigate the effect of Yarrow distillate in the treatment of chemotherapy-induced stomatitis. PATIENTS AND METHODS: This randomized controlled trial study was conducted during 2013. The study population consisted of all cancer patients with chemotherapy-induced oral stomatitis referred to Shahid Beheshti Medical Center, Kashan, Iran. The data collection instrument had two-part; a demographic part and another part recording the severity of the stomatitis at the first, seventh, and 14th days of the intervention based on a WHO criteria checklist in 2005. In this study, 56 patients diagnosed with cancer were randomly assigned into control and experimental groups in similar blocks according to their stomatitis severity. The experimental group gargled 15 mL of a routine solution mixed with Yarrow distillate 4 times a day for 14 days while the control group gargled 15 mL of routine solution. The severity of stomatitis was assessed at the beginning of the intervention, and then after 7 and 14 days of the study. Data were analyzed using chi-square and Fisher exact test, Mann-Whitney U, Kruskal-Wallis, and Friedman tests using SPSS 11.5 software. RESULTS: At first, the median score of stomatitis in the experimental group was 2.50 that significantly reduced to 1 and 0 in days 7 and 14 of the intervention, respectively (P value < 0.001). However, in the control group, the median score of stomatitis was 2.50, which significantly increased to 3 in days 7 and 14 (P value < 0.001). CONCLUSIONS: Yarrow distillate-contained solution reduced stomatitis severity more than the routine solution. Therefore, we suggest using it in patients with chemotherapy-induced stomatitis.