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Background: Esophageal cancer is an invasive lethal disease with a 10-year survival rate since diagnosis. About 45% of the tumor is completely removed by surgery, which has 5% mortality and 20% survival rate. In the locoregional stage, the use of neoadjuvant chemoradiotherapy and then surgery reduces recurrence and increases survival. Objectives: This study was performed to investigate the effect of neoadjuvant chemoradiotherapy and the subsequent chemotherapy with platinum-based regimen on survival, recurrence, and response to treatment. Methods: Planning a descriptive retrospective follow-up study, during 2010 to 2016, 44 patients with esophageal cancer, who received chemotherapy with 5-Fluorouracil + Oxaliplatin + Docetaxel before and after radiotherapy (45 - 50 Gray) accompanying by oral Capecitabin, were followed up. Five operable patients underwent surgery. Response to treatment and recurrence were evaluated by periodic endoscopic biopsy and imaging. To calculate the response rate to treatment, survival, and recurrence, the data were extracted and analyzed, using SPSS version 18. The categorized variables were compared, using Pearson’s test. The survival curves were drawn, using the Kaplan Meier method and compared with the log-rank test. Results: Among 44 patients with an average age of 61.5 ± 11.5 years, 88.6% had squamous cell carcinoma (SCC) and 11.4% had adenocarcinoma; surgery was performed for 5 patients, one of whom had severe complication leading to death and 54.5% had complete response as well as more survival rate. The patients suffering from SCC and middle segment tumors had more response rate. Also, recurrence was seen in 16 patients (36.4%), of whom 9.1% had local recurrence and 27.3% had metastatic recurrence. The mean survival rate was 38.87 months and 1-, 3-, and 5-year survival rate was %81.6, %47.6, and 39.6%, respectively. It was significantly more in middle esophageal segment and also tumors with complete response to treatment. Conclusions: Regarding the results, this treatment approach increases overall and disease-free survival, and response to treatment and reduces locoregional recurrence even if no surgery is performed. This treatment is recommended as a definitive treatment for esophageal cancer without metastasis.

Background: Congenital hypothyroidism (CH) is one of the major causes of physical and mental disabilities, which are preventable and treatable. This study aimed to investigate physical growth and to evaluate the effectiveness of performed therapeutic interventions on normality of serum T4 and TSH levels in children with CH of Yazd city. Methods: This retrospective cohort study was performed on all neonates with CH, who were born during years 2006 and 2008. The growth pattern of height, weight and head circumference during the first five years of children with CH and the effectiveness of performed therapeutic interventions on normality of serum T4 and TSH levels were evaluated. The collected data were analyzed using the 22nd version of the SPSS software. Results: The pattern of height, weight, and head circumference of the girls with CH was comparable with the growth pattern of NCHS of healthy individuals. The pattern of height and weight growth of boys with CH gradually became similar to the growth pattern of NCHS of healthy boys. However, there was a decline in their head circumference growth trend after six months of age. Also it was revealed that therapeutic interventions had an appropriate effect on normalization of serum TSH, T4 levels and growth pattern in CH children under treatment. Conclusions: After treatment and care for these patients, the growth patterns and serum T4 and TSH levels of these children reached a normal and desirable range. Keywords: Congenital Hypothyroidism; Growth; Height; Weight; Head Circumference; Yazd

Background: The hepatitis C virus (HCV) is an important human pathogen affecting an estimated 120 - 170 million individuals in the world. Polymorphisms of the IL28B gene are strongly associated with sustained virological response in patients with chronic hepatitis C treated with peginterferon and ribavirin. Objectives: The aims of this study were to compare the allelic and genotypic frequencies of the IL28B rs12979860 polymorphism in sustained virological response in patients who did not respond to the standard of care treatment and to verify whether there is a correlation between the viral load and the IL28B rs12979860 polymorphism. Methods: This cross-sectional study was carried out on 75 HCV-infected patients, including 45 responders to treatment (group 1) and 30 nonresponders (group 2). We compared the allele and genotype frequencies of the IL28B rs12979860 between the two groups using the PCR-RFLP method. Results: The genotype frequencies of rs12979860 polymorphism in group 1 were CC (28.9%), CT (37.8%) and TT (33.3%) and in group 2 were CC (6.7%), CT (43.3%) and TT (50%). There was a significant difference in genotype frequencies of IL28B polymorphism between the two groups (P = 0.03). There was no significant association between the viral load and IL28B rs12979860 genotypes in either group 1 (P = 0.3) or group 2 (P = 0.2). Conclusions: Our findings indicate that patients with the homozygous CC genotype in the IL28B gene had a significantly higher rate of response to treatment than those with the TT or CT genotypes. Nor does the IL28B rs12979860 polymorphism affect the viral load.

Background: Hepatitis C virus (HCV) is an important human pathogen affecting an estimated 120 – 170 million individuals in the world. Toll-Like receptors (TLRs) are pattern-recognition receptors that recognize pathogen-associated molecular patterns, and stimulate immune responses. Objectives: The aim of this study was to determine the mRNA expression level of TLR2 and TLR7 in HCV-infected patients in comparison with normal controls. Patients and Methods: Nineteen consecutive patients with HCV infection and nineteen sex and age-matched healthy controls were studied in a case-controlled research. Results: Our results showed that the expressions of TLR7 in HCV infected samples were significantly increased in comparison those of the controls (P = 0.02), while the expression of TLR2 was similar between the case and the control group (P = 0.8). There were no associations between the expression levels of TLR2 and TLR7 with HCV viral load and HCV genotypes. Also, there was no association between viral load and genotypes of the virus. Conclusions: Our findings showed that HCV infection could lead to increased expression level of TLR7 mRNA in peripheral blood cells of HCV infected samples. The viral load and genotypes of HCV did not affect the mRNA expression levels of TLR2 and TLR7.

Background: Selection of anesthetic approach for lower extremity operations is often a controversial issue for anesthesiologists. Objectives: The aim of this study was to compare the incidence and severity of back pain between general and spinal anesthesia, and to find effective factors in developing postoperative back pain. Patients and Methods: In a randomized clinical trail, 148 patients with elective lower extremity surgeries were randomly allocated into two groups of 74. The first group received general anesthesia and the second group underwent spinal anesthesia. The incidence of back pain was observed and documented. The severity of back pain was assessed at the first, fourth and eighth postoperative weeks by visual analogue scale. Results: The mean of patients' age was 35.50 ± 13.34 years. The incidence and mean of back pain severity among all participants were respectively 35.80% and 15.95% at the first week, 7.40% and 2.43% at the fourth week, and 1.4% and 0.27% at the eighth postoperative week. The incidence and mean of back pain severity in spinal group were respectively 39.2% and 18.11% at the first, 12.2% and 3.92% at the fourth, and 2.7% and 0.54% eighth postoperative weeks. In general anesthesia group, these figures were respectively 32.4% and 13.78% at the first week and 2.7% and 0.95% at the fourth postoperative week. No back pain was reported at the eighth postoperative week. The incidence and severity of back pain in the first week showed significant difference between the two groups, while the mean severity of back pain showed significant difference at the fourth week after operation. Conclusions: Spinal anesthesia could be probably considered as the sole effective factor in the development of back pain after operation.