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Background and Objective: The vertebra is the most common site of bone metastases. Diagnosis of metastases particularly in the early stages can improve patients’ prognosis and therapy. This study was done to compare the diagnostic value of magnetic resonance imaging and bone scan for the diagnosis of vertebral metastases. Methods: This descriptive study was done on 43 patients with any types of primary cancer. Patients underwent spinal magnetic resonance imaging and nuclear scan. Bone scan results were considered as the gold standard. The sensitivity and specificity were calculated for magnetic resonance imaging and nuclear scan. Results: The magnetic resonance imaging diagnosed 19 cases of thoracic vertebral metastases which previously diagnosed as negative by bone scan. Sensitivity and specificity of magnetic resonance imaging compared to bone scan was 90.7% and 95.6%, respectively. The magnetic resonance imaging diagnosed 4 cases of lumbar vertebral metastases which were reported negative in bone scan. Sensitivity, specificity and accuracy of magnetic resonance imaging in compare to bone scan were 97.6%, 97% and 97.2%, respectively. Conclusion: In diagnosis of vertebral metastases, the magnetic resonance imaging is more sensitive than bone scan.

Background and Objective: Although multiple sclerosis is a disease affecting white matter of brain and spinal cord, but involvement of basal ganglions in some studies demonstrated a decrease in T2 sequence signals. This study was done to assess signal intensity of basal ganglions in T2 magnetic resonance imaging (MRI) in multiple sclerosis Materials and Methods: This case – control study was done on 30 multiple sclerosis patients and 30 controls in Imam Reza hospital, Kermanshah, Iran, during 2010. MRI images of multiple sclerosis of patients and control group were matched according to age and sex. The basal ganglia signals were identified based on involvement areas, number of plaques, and brain atrophy in T2 and flair sequences. Data were analyzed using SPSS-16, Chi-Square, Fisher exact test and independent t-tests. Results: Among the case group, 10 patients (33.3%) demonstrated low signals in right thalamus and 14 patients (46.7%) in left thalamus, which was statistically significant compared with control group (P

Background: Obesity in polycystic ovary syndrome (PCOS) may increase the risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is an acceptable marker in assessing the risk of heart disease., Objective: This study aimed to evaluate the CIMT in PCOS women compared to non-PCOS women., Materials and Methods: This cross-sectional study was conducted on 48 women who referred to Imam Reza hospital, Kermanshah, Iran from July 2020-2021. Women were divided into 2 groups of PCOS and non-PCOS women (n = 24/each). The intima-media thickness of participants' carotid artery was measured on both sides in 3 areas, and its mean was recorded., Results: The mean thickness of the carotid artery intima-media in the case group was within the normal range; but it was significantly higher than the control group (0.71 ± 0.17 vs. 0.57 ± 0.09 mm, p = 0.019)., Conclusion: Considering the higher thickness of CIMT in women with PCOS, it can be concluded that PCOS increases the risk of heart diseases in women., Competing Interests: The authors declare that there is no conflict of interest., (Copyright © 2024 Farshchian et al.)

Background: Trastuzumab is a humanized monoclonal antibody against the human epidermal growth factor receptor 2 (HER2). This post-marketing surveillance evaluates the safety of a trastuzumab biosimilar (AryoTrust), produced by AryoGen Co. Iran in Iranian women with HER2-positive non-metastatic breast cancer (BC)., Research Design and Methods: The patients who had undergone adjuvant chemotherapy regimens received trastuzumab every 3 weeks for nine cycles. The study started in February 2017 and finished in August 2022. Data regarding safety were collected using booklets and then analyzed., Results: A total of 597 women with a mean ±SD age of 48.13 ± 10.18 years underwent 5,313 injection cycles. They received pre-study chemotherapies consisting of anthracyclines, taxanes, both, or other medications in 6.70, 7.20, 82.41, and 2.01% of the cases, respectively. One hundred and thirty-nine patients experienced at least one adverse event (AE). The most common AEs were decreased ejection fraction (EF, 5.7%), peripheral neuropathy (5.36%), and nausea (5.19%). Meningioma was the only life-threatening serious AE. Furthermore, bone pain and infusion-related reactions were the two most common grade three AEs. Nevertheless, the mean EF of patients did not change notably during the study., Conclusions: The results demonstrate that this trastuzumab biosimilar is a generally well tolerated and safe treatment for HER2-positive BC., Clinical Trial Registration: www.clinicaltrials.gov identifier is NCT06021379.

Background: Breast cancer is an extremely unpleasant and unbearable experience that can have a profound impact on a person's life. Compared to other types of cancer, breast cancer has a more severe psychological impact on women., Purpose: This study aimed to investigate the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer., Method: A sample of 30 women with breast cancer were randomly divided into intervention and control groups. The research was conducted in the oncology division of Imam Reza Hospital in Kermanshah by the clinical trial method with a two-group pretest-posttest design and a 2 month follow-up. Participants in the intervention group received Mindfulness-integrated cognitive behavior therapy for eight sessions. The intervention was carried out individually in weekly 60 min sessions. While the control group received self-help treatment (through an educational book). A demographic questionnaire, Demoralization Scale (DS-II), Body Image Scale (BIS), and Female Sexual Function Index (FSFI) were used to collect data. For data analysis, means and standard deviations were calculated and repeated measures and the Bonferroni test was conducted using SPSS 26., Results: The results showed the effectiveness of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function (p < 0.05). Concerning demoralization in the intervention group, the pre-test mean was 16.73 ± 3.33, and it reduced to 11.93 ± 1.49 in the post-test. The body image mean score showed a decreasing trend in the intervention group, from 12.47 ± 1.88 in the pre-test to 8.80 ± 3.21 in the post-test. The mean score for sexual function showed an increasing trend, increasing from 18.06 ± 2.29 in the pre-test to 23.07 ± 0.91 in the post-test. There was no significant difference in the mean score of the post-test compared to the pre-test and follow-up in the control group (p < 0.05)., Conclusion: MICBT can be used in conjunction with pharmaceuticals and medical treatments to improve the psychological symptoms of women with breast cancer, according to this study's results. Trial registration (IRCT20160103025817N6). 2022-04-06., (© 2024. The Author(s).)

Introduction: The primary objective of radiation therapy (RT) is to deliver lethal radiation doses to abnormal cancer cells so that healthy cells are exposed to minimal radiation. In the present study, changes in electrocardiography (ECG) and echocardiography(ECHO) following adjuvant RT were investigated in patients with left-sided breast cancer., Materials and Methods: 30 patients with left-sided breast cancer who had previously undergone breast-conserving surgery or mastectomy underwent RT after completing chemotherapy from February 2019 to January 2020. ECG and ECHO tests were performed before RT, immediately following RT, and three months after RT. Dose-volume parameters of the heart and its substructures as an organ at risk were analyzed., Results: The mean heart dose (±SD) for all patients was 7.51 ± 2.42 Gy. T-wave inversion was observed 3 months after RT in 47% of patients. T-wave decline was associated with mean heart radiation dose (β = 0.605, p-value = 0.005). The present study showed that the left ventricular volume receiving the 5 Gy (LV-V 5 ) parameter was associated with a reduction in ST segment duration (p-value = 0.027) as well as with an increase in left ventricular systolic diameter (LVESD, mm) (P-value = 0.027)., Conclusion: RT-induced ECG and ECHO changes are frequent in patients with left breast cancer. LVEF and Twave abnormalities were observed after RT in our patients. ECG and ECHO modalities can be used to monitor the cardiac function after RT in patients with left-sided breast cancer., (Copyright © 2023. Published by Elsevier Inc.)

Glioma is the most common type of primary brain tumour which accounts for about 30% of all brain and central nervous system tumours, and approximately 70% of adult malignant brain tumours. Numerous studies have been performed to assess the relationship between ERCC2 rs13181 polymorphism and the risk of glioma development, yet these findings of these studies are often inconsistent and contradictory. Therefore, the aim of this study is to conduct a systematic review and meta-analysis to assess the role of ERCC2 rs13181 in glioma developing. In this work, we have conducted a systematic review and meta-analysis. In order to collect the results of relevant studies on the association of ERCC2 rs13181 gene polymorphism with glioma, we initially searched the Scopus, Embase, Web of Science (WoS), PubMed, and ScienceDirect databases, without a lower time limit, and until June 2020. In order to analyse the eligible studies, the random effects model was used and the heterogeneity of the studies was investigated with the I 2 index. Data analysis was performed within the Comprehensive Meta-Analysis software (version 2). The total number of studies that focused on patients with glioma was 10. The odds ratio of GG vs TT genotype in patients with glioma based on meta-analysis was 1.08 (0.85-1.37: 95% confidence interval), which indicates the increasing effect of GG vs TT genotype by 0.08. The odds ratio of GG + TG vs TT genotype in patients with glioma was 1.22 (1.38-1.7: 95% confidence interval) based on meta-analysis, which indicates the increasing effect of GG + TG vs TT genotype as 0.22. The odds ratio of TG vs TT genotype in patients with glioma was 1.2 (0.38-1.4: 95% confidence interval), which shows the increasing effect of TG vs TT genotype by 0.2. The odds ratio of G vs T genotype in patients with glioma based on the meta-analysis was 1.15 (1.26-1.4: 95% confidence interval), which indicates the increasing effect of G vs T genotype by 0.15. The odds ratio of GG vs TG + TT genotype in patients with glioma based on meta-analysis was 1.22 (1.33-1.45: 95% confidence interval), which indicates the increasing effect of GG vs TG + TT genotype by 0.22. The results of this systematic review and meta-analysis show that ERCC2 rs13181 polymorphism and its genotypes are an important risk factor for genetic susceptibility to glioma tumour., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Aims: Cancer is a major public health problem worldwide, the leading cause of death in developed countries. Radiotherapy is an important treatment for many malignancies. The main purpose of this study was to compare the two techniques of supine and prone in prostate and rectal cancers using DVH extraction parameters., Methods and Material: Clinical and dosimetry data of 41 rectal and prostate cancer patients were evaluated in both the supine and prone positions with belly board. Administered dose was daily 180 cGy. The four box fields in the first phase and two lateral fields in the second phase with 18 MV photon fields were used. Each patient underwent CT scan, at both the positions using a contrast agent with a full bladder., Statistical Analysis Used: By using IBM SPSS software v23, all the data were described. The normal distribution of the data was performed using the KS sample statistical test. For data analysis, paired t test was used in the normal data and the Wilcoxon test was used in the non-normal data., Results: In patients with rectal cancer, there is no change in the received minimum dose by organs at risk. A significant decrease in received maximum dose, except for the prostate organ, could be due to the spatial proximity of the two organs to each other. Also, the received average dose in the small intestine was significantly reduced (P = 0.005). But in other organs, the dose reduction was not significant. In patients with prostate cancer, there is no change in the received minimum dose by OARs, except for the bladder organ (P = 0.003). Except the bladder organs (P = 0.011), there is no significant decrease in the received average dose by OARs. The maximum dose of the OARs is significantly reduced, except for the colon where there was not much overlap in the PTV, in addition to receiving the dose in the range. There was no significant relationship between CI in the rectal field and UI in the prostate field (P > 0.05), but there was a significant relationship between CI in the prostate field and UI in the rectal field with change in patient position., Conclusions: In the prone position, in both patients' groups, the OARs receive an optimal and better dose than the supine position, especially the small intestine organ in the rectal field and the bladder and rectum organs in the prostate field. However, it seems that this change in the position of rectal cancer patients is ineffective in reducing the dose of prostate and needs further investigation., (Copyright © 2023 Copyright: © 2023 Journal of Cancer Research and Therapeutics.)

Purpose: This study aimed at evaluating the value of uterine biophysical profile (UBP) scoring to predict the pregnancy rate after IUI., Methods: This prospective study was carried out on 85 women who were referred to our tertiary teaching center with infertility of male factor or unknown etiology infertility in 2018. To measure the uterine biophysical criteria, transvaginal ultrasonography (TVS) was performed on the day of beta-human chorionic gonadotropin (B-hCG) injection, and the results were evaluated based on positive B-hCG., Results: 85 patients were included with a mean age of 30 years; of those 12 (14.1%) were able to conceive. UBP (p = 0.151) and it's parameters (including endometrial thickness, number of endometrial layers, myometrial echogenicity, uterine artery pulsatility index, myometrial blood flow internal to arcuate vessels, endometrial blood flow in the third zone of endometrium, myometrial contraction frequency, and ovarian follicle (OF) size [p = 0.05, 0.89, 0.59, 0.79, 1, 1, 0.59, and 0.77, respectively]) were not significantly associated with pregnancy rate. 91.7% of the cases with positive pregnancy test results, had a UBP score of > 13; however, UBP score was not meaningfully associated with IUI treatment success rate (p = 0.15)., Conclusions: UBP scoring system seems to need more data for external validation, or it might require modifications before implementation, as it may cause false reassurance., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Introduction: Available treatments for hot flashes in patients with breast cancer are not always tolerable or effective for all patients., Methods: Patients diagnosed to have primary breast cancer were randomly allocated to receive 10   mg of escitalopram, placebo, or progressive muscle relaxation therapy. Patients were asked to report the frequency and duration of hot flashes during day and night, at baseline and after ten weeks of treatment, and completed the menopause rating scale., Results: Eighty-two patients were randomly assigned to receive escitalopram ( n   =   26), PMRT ( n   =   28), and placebo ( n   =   28). PMRT and escitalopram could effectively decrease number and duration of diurnal and nocturnal HFs in patients with breast cancer, with a better effect observed from escitalopram. They could both decrease the total score of MRS., Conclusion: Both escitalopram ad PMRT can reveal nocturnal and diurnal HFs in terms of frequency and duration in patients with breast cancer.

Background: Radiation exposure to the thyroid gland seems unavoidable in breast cancer (BC) patients receiving radiation therapy (RT) to the supraclavicular (SC) region. Hence, this study aimed to evaluate the effects of SC region RT on thyroid function and the prevalence of radiation-induced hypothyroidism (RIHT) in BC patients at regular intervals post-treatment., Materials and Methods: Twenty-one patients with BC were enrolled in this analytical cross-sectional study by simple and convenient sampling, from March 2019 to March 2020. Thyroid function and the prevalence of RIHT were evaluated and compared by measuring the serum of thyroid-stimulating hormone (TSH) and free thyroxine hormone (fT4) levels before radiation therapy (pre-RT) and 3 and 6 months after radiation therapy (post-RT). The patients underwent 3 dimensional conformal. radiation therapy (3D CRT) of breast/chest wall, axillary, and supraclavicular lymph nodes with 50 Gy/25 fractions/5 weeks. The collected data were analyzed using SPSS software (version 20)., Results: Serum levels of TSH increased at 3 and 6 months post-RT, this increase was not statistically significant (p > 0.05). Nevertheless, serum levels of fT4 were significantly elevated at 3 and 6 months post-RT (p < 0.01). A correlation was observed between the follow-up period and the incidence of RIHT, where it was 0% at 3 months and 9.5% at 6 months post-RT. RIHT was not significantly associated with any factors, including patient's age, type of surgery, thyroid gland dose, and thyroid gland volume., Conclusions: It seems that SC region RT does not have a significant adverse effect on the thyroid function among BC patients at 3 and 6 months post-treatment. Hence, a long-term follow-up with a larger sample size is suggested., Competing Interests: Conflict of interests None declared., (© 2022 Greater Poland Cancer Centre.)

Background: Glaucoma is a progressive disease of the optic nerve that has several underlying causes, but in most cases, the cause is unknown. Given the importance of the role of nitric oxide in the occurrence of ocular nerve damage and the effect of eNOS gene polymorphic sites on protein function, to better understand the mechanism of formation of POAG, the relationship between polymorphisms rs2070744 and rs1799983 eNOS gene with POAG risk was investigated in this study using meta-analysis., Methods: In this study, systematic review and meta-analysis of study data related to the study of polymorphisms rs2070744 and rs1799983 eNOS gene in patients with POAG using the keywords eNOS, NOS3, Gluuc8898, POAG, primary open-angle glaucoma. It was extracted from SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science, and Google Scholar search engines without a time limit until May 2020. To perform the analysis of qualified studies, the model of random effects was used and the inconsistency of studies with the I 2 index was investigated. Data analysis was performed with Comprehensive Meta-Analysis (Version 2)., Results: In a review of 16 studies (9 studies on polymorphism rs2070744 and seven studies on polymorphism rs1799983) with a sample size of 1631 subjects and a control group of 2405 subjects related to polymorphism rs2070744 and a group of 1456 subjects and a control group of 2240 subjects related to polymorphism 9997 rs1, the odds ratio of TT, CT, and CC genotypes was reported to be 0.95, 1.01, and 1.14, respectively, and the odds ratio of GG, GT and TT genotypes to be 0.88, 0.97, and 1.31, respectively, was reported in patients with POAG., Conclusion: The results of our systematic review and meta-analysis study show that the eNOS gene polymorphisms rs2070744 and rs1799983 may increase the risk of POAG among individuals. However, further studies are needed to confirm these findings., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Head and neck cancers are currently the most common types of cancers. 3D-conformal radiation therapy is the most common dose delivery technique for head and neck cancers. Eye Lens is a radio sensitive structure and cataract formation as a visual disorder associated with exposure to ionizing radiation which is documented., Objective: Determining the radiation dose to eye lens during head and neck radiography and estimating the probability of cataract induction are essential., Material and Methods: This experimental study was performed on 14 patients with head and neck cancers through experimental study analysis. The maximum opacity of the eyes lens were measured by pentacam TM before radiation therapy. CT data of patients were transmitted to Isogray treatment planning Software, and dose calculations for each patient was performed. At the end of radiation treatment, 3 and 6 months after radiotherapy, the eye lens opacity of the patients was assessed., Results: Overall, 28 lenses were studied. Statistical one sample K- S test proved normality of obtained data. Using repeated measures test, the relation before and 3 months after radiotherapy, as well as the relationship before and 6 months after radiotherapy proved a significant relationship., Conclusion: The opacity caused by radiation in eyes is a non-statistical and linear-quadratic response curve with no threshold. This opacity can also appear within 3 months after completion of radiation therapy., (Copyright: © Journal of Biomedical Physics and Engineering.)

Background: The Dupuytren disease is a benign fibroproliferative disorder that leads to the formation of the collagen knots and fibres in the palmar fascia. The previous studies reveal different levels of Dupuytren's prevalence worldwide; hence, this study uses meta-analysis to approximate the prevalence of Dupuytren globally., Methods: In this study, systematic review and meta-analysis have been conducted on the previous studies focused on the prevalence of the Dupuytren disease. The search keywords were Prevalence, Prevalent, Epidemiology, Dupuytren Contracture, Dupuytren and Incidence. Subsequently, SID, MagIran, ScienceDirect, Embase, Scopus, PubMed and Web of Science databases and Google Scholar search engine were searched without a lower time limit and until June 2020. In order to analyse reliable studies, the stochastic effects model was used and the I 2 index was applied to test the heterogeneity of the selected studies. Data analysis was performed within the Comprehensive Meta-Analysis Software version 2.0., Results: By evaluating 85 studies (10 in Asia, 56 in Europe, 2 in Africa and 17 studies in America) with a total sample size of 6628506 individuals, the prevalence of Dupuytren disease in the world is found as 8.2% (95% CI 5.7-11.7%). The highest prevalence rate is reported in Africa with 17.2% (95% CI 13-22.3%). According to the subgroup analysis, in terms of underlying diseases, the highest prevalence was obtained in patients with type 1 diabetes with 34.1% (95% CI 25-44.6%). The results of meta-regression revealed a decreasing trend in the prevalence of Dupuytren disease by increasing the sample size and the research year (P < 0.05)., Conclusion: The results of this study show that the prevalence of Dupuytren disease is particularly higher in alcoholic patients with diabetes. Therefore, the officials of the World Health Organization should design measures for the prevention and treatment of this disease.

Background: Several psychological and neurological pathways are described to explain the emergence and maintenance of psychiatric disorders, and changes in brain volumes and brain activity are observed as correlates of psychiatric disorders. In the present study, we investigated if and to what extent specific voxel-based morphometric brain volume differences could be observed among individuals with methamphetamine-induced psychosis (MAIP) and schizophrenia spectrum disorder (SSD) compared to healthy controls., Methods: A total of 69 individuals took part in the present study. Of those, 26 were diagnosed with MAIP, 23 with SSD, and 20 were healthy controls. After a thorough psychiatric assessment, participants underwent brain volume measurement., Results: Compared to healthy controls, participants with MAIP had smaller volumes for left caudate and left and right parahippocampal gyrus. Compared to healthy controls, participants with SSD had smaller volumes for the gray and white matter, left amygdala, left hippocampus, left parahippocampal gyrus, left putamen, and the total volume. Compared to individuals with MAIP, individuals with SSD had a lower white matter brain volume., Conclusions: The pattern of results suggests that individuals with MAIP and SSD showed specific and regional brain atrophies on the left hemisphere, always compared to healthy controls. Given the cross-sectional design, it remains undisclosed if specific and regional brain atrophies were the cause or the consequence of the psychiatric issues., (© 2019 S. Karger AG, Basel.)

The occurrence of chronic proctitis as a side effect among radiotherapy patients is about 5%. Radiation proctitis and consequent development of chronic proctitis are not associated to each other. However, a lot of samples of proctitis that are limited easily could be treated by typical remedial techniques. Improvements in radiotherapy techniques that make possible the delivery of superior doses of radiation could easily reduce both chronic and acute proctitis. The step-by-step remedial procedure for treatment of this disorder starts with conservative remedial management and includes iron substitution as a second-line therapy. For patients who did not receive initial therapies, sucralfate injection, topical corticosteroids, and antidiarrhea therapy were provided as a means of aggressive care. In cases of continuous rectal bleeding, remedial laser techniques and formaldehyde administration should be attempted before surgical therapy. When surgical therapy is required, a descending or transverse colostomy must be carried out. Advanced methods such as intraperitoneal injections of formalin or novel methods of cold therapy and radiofrequency ablation (RFA) provide a wider remedial field. Exceptionally, unanticipated conclusion of neosquamous wound healing via RFA may have additional preponderances in stopping symptoms and may require better assessment through accurate randomized examination. Since aggressive treatments like coloanal anastomosis and colorectal surgery are correlated with remarkable mortality and morbidity, they must be considered as the final course of remedial treatment., Competing Interests: There are no conflicts of interest.

Objective: One of the complications of chemotherapy is peripheral neuropathy. Various studies have shown that potent norepinephrine and serotonin reuptake inhibitors such as gabapentin, venlafaxine and duloxetine have therapeutic effects on neuropathy. The aim of this study was to compare the effects of venlafaxine vs. duloxetine on chemotherapy-induced peripheral neuropathy., Methods: In this clinical trial, cancer patients who were suffering from chemotherapy-induced peripheral neuropathy comprised the study population. They were randomly assigned to three pharmacotherapy groups including venlafaxine, duloxetine and placebo. Cranial, sensory, motor neuropathies as well as neuropathic pain were evaluated on day 1, week 2, and week 4 after enrollment., Results: Grade of cranial, motor, sensory and neuropathic pain decreased significantly in venlafaxine and duloxetine groups. This reduction was more considerable in duloxetine group compared to venlafaxine group (P < 0.05)., Conclusion: Duloxetine seems to be more effective than venlafaxine in decreasing the symptoms of chemotherapy-induced peripheral neuropathy. Duloxetine was more effective than venlafaxine in decreasing motor neuropathy and neuropathic pain grade.

Purpose: To evaluate the visual, refractive, and tomography changes after femtosecond laser-assisted intrastromal corneal ring segment (ICRS; Intacs ® SK) implantation in patients with keratoconus., Methods: In this prospective interventional case series, Intacs SK ICRSs were inserted using a femtosecond laser into eyes with stage I-IV keratoconus. Visual, refractive, and corneal tomography changes, along with surgical complications, were analyzed 1 week, 2 months, and 6 months postoperatively., Results: The study evaluated 71 eyes of 52 patients (mean age: 27.5 years). Six months postoperatively, the spherical equivalent, mean sphere, and mean cylinder were decreased by 2.07, 1.47, and 1.13 diopters (D), respectively. The mean preoperative uncorrected distance visual acuity (UDVA) increased from 0.87 ± 0.26 to 0.46 ± 0.19 LogMAR and the mean preoperative corrected distance visual acuity (CDVA) increased from 0.55 ± 0.21 to 0.28 ± 0.17 LogMAR ( P < 0.001). Flat and steep keratometry decreased by a mean corneal power in the 3-mm zone, and mean anterior elevation decreased by 0.91 D, 2.52 D, and 1.03 microns ( P < 0.001), respectively. Among all eyes, 93.0% gained one or more lines of CDVA. Mean internal anterior chamber depth decreased from 3.25 ± 0.33 to 3.14 ± 0.45 mm ( P = 0.001), and mean irregularity in the 3-mm zone decreased from 5.63 ± 1.71 to 5.24 ± 1.82 ( P = 0.006). However, mean posterior elevation and irregularity in the 5-mm zone did not change significantly., Conclusion: Implantation of one or two Intacs SK segments is safe and effective to treat keratoconus, leading to significant improvement in UDVA, CDVA, and refractive error., Competing Interests: There are no conflicts of interest.

Background: Cancer is one of the main public health issues in the world. Breast cancer is one of the most common types of cancer among women. It is also the second cause of mortality in women. The association between the use of oral contraceptive pills and breast cancer is controversial and a main issue in public health. Some findings have shown that taking these pills does not have a significant effect in increasing the risk of breast cancer, while others have confirmed the carcinogenic effect of these products. These contradictory findings necessitated this meta-analysis, through of all correlated studies in Iran., Methods: All published studies were considered from June 2000 until June 2015, using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, and Science Direct, and Persian database like SID, Irandoc, IranMedex, and Magiran. Finally, 26 papers were selected: 24 studies were case control while two were population based studies. A total of 26 papers with 46,260 participants were assessed since 2001., Results: Overall estimate of OR for the effect of oral contraceptive pills on breast cancer is 1.521 (CI = 1.25-1.85), which shows that the intervention group had more chance (52%) compared to the control group ( P = 0.001). Using these pills increased the risk of breast cancer up to 1.52 times., Conclusions: Because of directly increasing levels of estrogen and the role of estrogen in gaining weight indirectly, oral contraceptive pills can stimulate the occurrence of breast cancer. More studies should be conducted for controlling the period of pill use.

Background: Breast cancer is the most common cancer among women in Iran and the world. Multiple environmental factors and genetic variations such as genetic polymorphisms are of its main causes. p53 gene plays an important role in conserving and sustaining the genome as a tumor suppressing gene. Change and polymorphism at codon 72 of p53 gene are correlated with increased risk of lung, mouth, endometrial, prostate, and colorectal cancers, and could be considered an indicator of susceptibility to breast cancer., Methods: Twelve studies (1,190 cases and 1,145 control studies with evaluation of three types of Arg/Arg, Arg/Pro, and Pro/Pro genotypes) have been conducted using keywords, such as polymorphism at codon 72, gene p53 polymorphisms, and the relation between polymorphisms and breast cancer, from databases in Iran, including Magiran, Medlibe, Sid, and Iranmedex, as well as Latin databases such as PubMed, Google Scholar, Science Direct, and Scopus., Results: The OR for Arg/Arg is 1.58 (95% CI: 2.45 to 1.01), the OR for Arg/Pro is 0.75 (95% CI: 1.10 to 0.51), and the OR for Pro/Pro is 0.62 (95% CI: 0.93 to 0.42). p53 gene polymorphism at codon 72 is statistically significant in Arg/Arg and Pro/Pro genotypes., Conclusions: Arg/Arg genotype can be considered as a risk factor for breast cancer, and Pro/Pro genotype can be accounted for as a protective factor against breast cancer.

Aim: The aim of the present study is to quantify differences in dose calculations caused by using CA and determine if the resulting differences are clinically significant., Background: The influence of contrast agents (CA) on radiation dose calculations must be taken into account in treatment planning., Materials and Methods: Eleven patients with pelvic cancers were included in this study and two sets of CTs were taken for each patient (without and with CA) in the same position and coordinates. Both sets of images were transferred to the DosiSoft ISOgray treatment planning system for contouring and calculating the dose distribution and monitor units (MUs) with Collapsed Cone and Superposition algorithms, respectively. All plans were generated on pre-contrast CT and subsequently copied to the post-contrast CT. Radiation dose calculations from the two sets of CTs were compared using a paired sample t-test., Results: The results showed a statistically insignificant difference between pre- and post-contrast CT treatment plans for target volume and OARs (p > 0.05), except bladder organ in the prostate region (p < 0.05) but the relative mean dose and MU differences were less than 2% in any patient for 18 MV photon beam., Conclusions: Treatment planning on contrasted images generally showed a lower radiation dose to both target volume and OARs than plans on non-contrasted images. The results of this research showed that the small radiation dose differences between the plans for the CT scans with and without CA seem to be clinically insignificant; therefore, contrast-enhanced CT can be used for both target delineation and treatment planning of prostate and rectal cancers.

Background: Worldwide, colorectal cancer (CRC) is reported to be the fourth most common cancer in men and the third most common in women. KRAS is a protooncogene located on the short arm of chromosome 12. The aim of this study was to evaluate the KRAS oncogene and its relationship it with clinicopathologic features in 33 Kurdish patients., Materials and Methods: Metastatic CRC between 2012 and 2016 that came to Imam Reza hospital, Kermanshah province, Iran, were analysed for KRAS mutations using allele specific PCR primers and pyrosequencing. Correlations between variables was analyzed in PASW SPSS and overall survival curves were plotted in Graph Pad prism 5., Results: The mean age for them at diagnosis was 51.5±12.6 years (range, 2276 years). Among the 33 patients that were sequenced, 12 samples in the KRAS gene had a nucleotide change, 11 in codon 12 and 1 in codon 13.There was no significant relationship between the mutation and clinical and pathological aspects of the disease., Conclusions: Knowledge of the KRAS status can help in decisionmaking to treat metastatic colorectal cancer patients more efficiently and increase survival. However, many Kurdish people due to economic problems are not able to do this valuable genetic test. In addition, we need more careful research of KRAS oncogene at the molecular level in young populations with more patients.

Background: Lithium is one of the most effective medications in the treatment of mood disorders. The long-term lithium therapy can alter kidney morphology and function., Objective: To evaluate the relation of Magnetic resonance imaging (MRI) of the kidneys and renal function in patients undergoing chronic lithium therapy., Methods: Thirty five consecutive patients with mood disorders who were undergoing lithium therapy for at least two years were evaluated with a 1.5 tesla MR imaging and renal function tests. The relationship between renal size, the presence, number and location of renal microcyst with renal function were evaluated. The partial correlation analysis was performed to assess correlation between variables., Results: The mean size of kidney was 106.0 mm ± 6.0 and 106.0 mm ± 11.0 in right and left kidneys respectively. The mean number of microcysts in both kidneys was 6.2. There was a positive correlation between duration of lithium treatment and number of renal microcyst (P-value=0.03). Correlation between MRI findings and renal function tests was not statistically significant., Conclusion: The present study revealed that longer duration of lithium therapy can increase number of renal microcysts which is well shown with MR imaging. It seems that increasing renal microcysts may not be consistent with renal function impairment especially in earlier treatment phase. Thus the question arises is that MRI may not be as the first line method for clinicians who aim to assess renal function during long term lithium therapy.

Objectives: To evaluate the diagnostic accuracy of sonography and Fine Needle Aspiration Cytology (FNAC)., Methodology: This follow-up study was approved by review board and conducted at Endocrine Clinic and Radiology Department of Imam Reza, Kermanshah. The patients were diagnosed to have thyroid nodule examined by FNA and Sonography suspicious malignant cases underwent surgery. RESULTS were entered in SPSS 11.5 chi-Square and Fisher exact test applied to compare malignant and benign nodule characters., Results: In this study 144 patients were examined and 14 cases (9.7%) had malignant nodule. Most of malignant nodules were single (p=0.001), solid (p < 0.001), hypo-echo (p=0.001), with irregular margins (p < 0.001) and with calcification (p=0.041). There was no significant relationship between malignancy and nodule size of larger than 15 mm (p=0.395). Compared with surgery, FNA sensitivity and specificity were calculated as 92.8% and 100% respectively., Conclusion: Based on the result of this study, thyroid nodule size must not be considered as a criterion for malignancy and thyroid nodules of any size must be suspected as malignant. Important criteria for malignancy include irregular edges, being solid, hypoechogenicity and being a single nodule respectively. Compared with Surgery, FNA Sensitivity and specificity were calculated as 92.8% and 100% respectively.

Objective: To assess the effect of injecting magnesium sulfate on Doppler parameters of fetal umbilical and middle cerebral arteries (MCA) in women with severe preeclampsia., Materials and Methods: A total of 21 patients with severe preeclampsia admitted to Imam Reza Hospital, Kermanshah (Iran), were evaluated. Before and after administration of magnesium sulfate, Doppler ultrasound scan was carried out to measure fetal middle cerebral artery and umbilical artery blood flow. Paired t-test was used for statistical analysis., Results: After injection of magnesium sulfate, the mean resistivity index (RI)-umbilical, and pulsatility index (PI)-cerebral showed a statistically significant reduction (P < 0.001). The cerebroumbilical C/U ratio increased after the intervention (P < 0.001). The PI-umbilical (P = 0.1) and pre- and post-RI-cerebral (P = 0.96) did not have statistically significant changes., Conclusions: Infusion of magnesium sulfate significantly decreases the flow in the fetus RI-umbilical and PI-MCA, and it increases C/U ratio indices in color Doppler ultrasound.

Purpose: Today, distinguishing metastatic lymph nodes from secondary benign inflammatory ones via using non-invasive methods is increasingly favorable. In this study, the diagnostic value of chemical shift artifact (CSA) in magnetic resonance imaging (MRI) was evaluated to distinguish benign lymphadenopathy., Subjects and Methods: A prospective intraindividual internal review board-approved study was carried out on 15 men and 15 women having lymphadenopathic lesions in different locations of the body who underwent contrast-enhanced dynamic MR imaging at 1.5 T. Then, the imaging findings were compared with pathology reports, using the statistics analyses., Results: Due to the findings of the CSA existence in MRI, a total of 56.7% of the studied lesions (17 of 30) were identified as benign lesions and the rest were malignant, whereas the pathology reports distinguished twelve malignant and eighteen benign cases. Furthermore, the CSA findings comparing the pathology reports indicated that CSA, with confidence of 79.5%, has a significant diagnostic value to differentiate benign lesions from malignant ones., Conclusion: Our study demonstrated that CSA in MR imaging has a suitable diagnostic potential nearing readiness for clinical trials. Furthermore, CSA seems to be a feasible tool to differentiate benign lymph nodes from malignant ones; however, further studies including larger numbers of patients are required to confirm our results., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)