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BACKGROUND Background Recently, a real-time system, named cancer diagnostic probe (CDP), has been developed to diagnose the presence of pre-neoplastic/neoplastic cells in breast cavity side margins. Detecting mechanism is real-time determination of the ROS/H2 O2 released from cancer or atypical cells, through reverse Warburg effect and hypoxia glycolysis pathways. AIMS Here, we designed a human model study based on real-time checking of 387 internal margins (IM) from 39 neoadjuvant breast cancer cases by CDP. MATERIALS & METHODS: Each lesion was checked by entered needle sensor and electrical scores were recorded. The permanent pathology result of each tested lesion was our gold standard to evaluate CDP scoring. CDP results were compared with permanent pathology of tumour side margins (as a conventional margin evaluation procedure). RESULTS Results showed that the sensitivity of CDP in scoring the cavity side margins of those cases is 91%. A total of 18 involved IM which had been detected by CDP were declared as free margins in pathology section of tumour side samples. Just five involved IM were missed by CDP. DISCUSSIONS Such sensitivity revealed that metabolism based (here: hypoxia glycolysis) tracing of cancer cells show distinct electrochemical responses between clear and involved cavity side margin evaluation. CONCLUSION This human study showed the promising role of CDP to achieve clear margins after BCS of neoadjuvant cases.

Background: One of the most important alterations in breast cancer treatment is the change of view in axillary lymph node management. At the moment, sentinel lymph node biopsy (SLNB) is the standard care in axillary lymph node management. However, in patients with clinically positive lymph nodes or in patients, who have no willingness to receive radioactive drugs, axillary lymph node dissection (ALND) must be done. To the best of our knowledge, there is no overall survival (OS) benefit in ALND, especially at the early stage of breast cancer, during which this procedure is not justified. Objectives: Herein, we have reported the results of 27 years of experiments in limited axillary lymph node dissection (LALND) in comparison to ALND as well as the relationship among the number of removed lymph nodes, OS, and disease-free survival (DFS) at the early stage of breast cancer. Methods: OS and DFS for 588 cases, who were at the early stage of breast cancer and treated by LALND between 1984 and 2019, were compared with 1026 patients, who were treated by ALND during the same interval in this study. Notably, SLNB cases were excluded. Results: The results revealed no significant difference among the groups in terms of DFS (P = 0.268, 0.123, and 0.333). Also, there was no difference in terms of OS between the LALND group (1 - 4 nodes, 5 - 6 nodes, and 7 - 8 nodes) and ALND group (≥ 9 nodes) in patients without lymph node involvement (AHR less than 2). However, in the patients with axillary lymph node metastasis (N1, N2), similar results were obtained. Correspondingly, in this group, the best results were observed in those patients, whose 7 - 8 lymph nodes were removed. Conclusions: Regarding the results of the current study; it can be concluded that performing the LALND in the defined anatomic range and removing 7 - 8 lymph nodes instead of removing 10 lymph nodes are not inferior when it is not possible to do SLNB (there is no access to it) and/or being a contraindication to do it for evaluating the status of axillary lymph nodes in the patients at the early stage of breast cancer.

Cancers are serious life-threatening diseases which annually are responsible for millions of deaths across the world. Despite many developments in therapeutic approaches for affected individuals, the rate of morbidity and mortality is high. The survival rate and life quality of cancer patients is still low. In addition, the poor prognosis of patients and side effects of the present treatments underscores that finding novel and effective complementary and alternative therapies is a critical issue. Melatonin is a powerful anticancer agent and its efficiency has been widely documented up to now. Melatonin applies its anticancer abilities through affecting various mechanisms including angiogenesis, apoptosis, autophagy, endoplasmic reticulum stress and oxidative stress. Regarding the implication of mentioned cellular processes in cancer pathogenesis, we aimed to further evaluate the anticancer effects of melatonin via these mechanisms.

Background: The annual religious ritual of Arba’een is the global largest mass gathering of pilgrims from different countries participating in a mass movement on an 80-km pathway to visit the Shrine of Imam Hussein, the grandson of Prophet Muhammad. The provision of health care for such a mass movement has always been an important vital issue for the health care system. Objectives: The current study investigated the common illnesses in addition to the quantity of health care services offered by temporary clinics and health stations located on the way to the shrine to such a mass gathering of on-feet pilgrims in Iraq in Arba’een 2019. Methods: This cross-sectional study was conducted at temporary clinics and health stations where pilgrims in need of nursing, midwifery, and pharmaceutical care were provided with services by general and expert physicians on the way from Najaf to Karbala in Iraq during a week in October 2019. Results: Imam Reza Temporary Clinic offered services to a total of 26,875 patients, including 9,934 females (36.96%) and 16,941 males (63.04%), on all days of the week. The most common chief complaint reported by the patients were musculoskeletal problems (n=11,945; 21.99%), foot blisters (n=11,372; 20.94%), and skin lesions (n=10,662; 19.62%). Conclusions: The present study highlighted the need for providing more organized services, especially in emergency health care, and necessity of paying further and closer attention to the significance of the health history of those pilgrims attending such religious mass gatherings in previous years.

Background: Among different common types of cancer, Gastric cancer (GC) is a worldwide health priority in both developing and developed countries. The aim of this study was to map the distribution of incident cases of GC in Iran to provide a geographical presentation of the incidence of the disease.Methods: This study used the Iranian National Cancer Registry (INCR) data from 2004 to 2014. Excel was used to do the primary analysis including calculation of GC incidence for each province and also to provide a frequency table of the type and location of GC by the provinces. ArcGIS 10.5 (Redlands, CA, USA) mapping software was used to map the provincial age-standardized incidence rates by sex. The type and location of the GC cases were obtained from the NCR dataset.Results: According to the results of the present study, the patients were predominantly male 49,907 (70.0%). During the study period, the highest and lowest age-standardized incidence rates of GC in Iran in 2014 were reported from Ardebil (IR=30.19) and Ghom (IR=1.00) respectively. A significant difference was observed when the distribution of the location of GC tumors was compared between males and females (PConclusions: The results of the current study suggested a lower rate of GC incidence rate was reported in Iran when compared to the global figure in both females and males. The findings suggest involving different factors with different effects in GC among Iranian populations. Further studies are needed to better understand the epidemiology and etiology of the disease.

Introduction. Surgery has been known as the procedure of choice for breast cancer management since 1700 years before Christ. Nowadays, breast-conserving surgery and mastectomy are performed in selected cases with specific clinical criteria. Here, we compare these two procedures for breast cancer patients with variable features in Cancer Research Center, Tehran, as a single institution experience. Methods. In this 25-year follow-up retrospective cohort study, we identified breast cancer patients who had undergone breast-conserving therapy or mastectomy. Disease-free survival and overall survival were evaluated using Kaplan–Meier survival analysis and the log-rank test between the two groups. A p value less than 0.05 was considered statistically significant. Results. A total of 3358 breast cancer patients, including 61% breast-conserving therapy and 39% mastectomy cases were identified, with a mean follow-up time of 94 months. The overall survival and disease-free survival of all cases were significantly better in breast-conserved patients, particularly in early-stage breast cancer with favorable clinical, pathological, and biological features. Ten-year disease-free survival and overall survival in breast-conserving therapy and mastectomy cases were 74%, 88% and 58%, 80%, respectively. Conclusion. Breast-conserving surgery and radiation therapy prove to be an appropriate treatment option for breast cancer patients in terms of overall survival and disease-free survival when indicated.

A 4-year (2008–2011) community-based participatory research was implemented in the Kohgiloyeh and Boyerahmad province, Iran. A steering committee was established from academics, policy makers, health officials, and representatives of health sectors. This committee selected six regions within Boyerahmad and Dena counties based on administrative divisions. Health companions consisting of stakeholders, academics, local leaders, health providers, and public representatives were established to guide the project in each region. The health companion groups were enabled by attending workshops dealing with need assessment, priority setting, and research methodology. Health companion groups adopted a Planned Approach to Community Health (PATCH) methodology including community mobilization for data collection, health priority setting, developing of a comprehensive intervention plan, and evaluation. A list of main health issues and their priorities for each region was provided. Subsequently, research topics were determined and six surveys and intervention programs were planned and implemented. After intervention most of top priority health risk factors were decreased and the preventive programs that targeted risk factors were increased significantly. This project is found to be an effective approach for building stronger partnerships between researchers and community members for the development of effective solutions for local health concerns and promote public health.