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Byline: Abolfazl. Firouzian, Alieh. Kiasari, Gholamali. Godazandeh, Afshin. Baradari, Abbas. Alipour, Arman. Taheri, Amir. Zeydi, Maryam. Montazemi Background and Aims: Post-operative nausea and vomiting (PONV) is a common and distressing [...]

Aims: The aim of this study was to explore the protective role of social support and spirituality in the prevention of depression, anxiety and fatigue severity. Design: In a cross‐sectional study, 305 women of breast cancer survivors were recruited in the study. Methods: The participants answered a self‐reported the hospital anxiety and depression scale, fatigue severity scale (FSS), social support and spiritual health questionnaires. The data were analysed using a multiple linear regression model to estimate the adjusted regression coefficients. Results: A greater proportion of patients had moderate depression (62.9%) and moderate anxiety (67.3%). The higher level of social support was significantly associated with a lesser degree of depression (β=−0.05, p =.001) and anxiety (β=−0.04, p =.001), but there had been no association with the severity of fatigue score, while the association of spiritual health with depression and anxiety was not independently significant. This study highlights the importance of perceived social support in the prevention of depression and anxiety. [ABSTRACT FROM AUTHOR]

Abstract Introduction Several complications have been reported with inguinal hernias. Although hematuria and flank pain, either as the presentation or as a complication of inguinal hernia, are infrequent, this condition may lead to the development of obstructive uropathy, which can have diverse manifestations. Case presentation A 71-year-old Iranian man with Persian ethnicity presented with new onset episodes of gross hematuria and left-sided flank pain. A physical examination revealed a large and non-tender inguinal hernia on his left side. An initial workup included an abdominal ultrasound, an intravenous pyelogram and cystoscopy, which showed left hydronephrosis and a bulging on the left-side of his bladder wall. On further evaluation, computed tomography confirmed that his sigmoid colon was the source of the pressure effect on his bladder, resulting in hydroureteronephrosis and hematuria. No tumoral lesion was evident. Herniorrhaphy led to the resolution of his signs and symptoms. Conclusion Our case illustrates a rare presentation of inguinal hernia responsible for gross hematuria and unilateral hydronephrosis. Urologic signs and symptoms can be caused by the content of inguinal hernias. They can also present as complications of inguinal hernias.

Background: Gastric cancer is one of the most common cancers in the world. Programmed death-ligand 1 (PD-L1) is the main ligand of the programmed death-1 receptor that plays a key role in apoptosis in patients with gastric cancer. Materials and Methods: In this study, forty gastric cancer patients and forty healthy controls were enrolled. Serum PD-L1 was measured by enzyme-linked immunosorbent assay. Results: The mean (interquartile range) value of expression level of PD-L1 was 70.6 (36.6–127.3) in patients and 47.7 (29.9–92.1) in controls. There were no significant differences in PD-L1 expression between the two groups and tumor characteristics, but there was a statistically significant difference between the high expression level of PD-L1 and gastric cancer development (P = 0.044, odds ratio = 2.77, 95% confidence interval = 1.12–6.86). Conclusions: PD-L1 level increases in gastric cancer patients, so it could be used as a predictor factor. [ABSTRACT FROM AUTHOR]

Gastric cancer (GC) is one of the most common causes of cancer‐related death in the world, with multiple genetic and epigenetic alterations involved in disease development. CYLD tumor suppressor gene encodes a multifunctional deubiquitinase which negatively regulates various signaling pathways. Deregulation of this gene has been found in different types of cancer. This study aimed to evaluate for the first time the CpG island methylation pattern of CYLD gene promoter, and its expression level in gastric adenocarcinoma. CYLD messenger RNA expression and promoter methylation in 53 tumoral and their non‐neoplastic counterpart tissues were assessed using quantitative polymerase chain reaction and bisulfite sequencing. Also, we investigated the impacts of the infectious agents including Helicobacter pylori (H. pylori), EBV, and CMV on CYLD expression and promoter methylation in GC. Results showed that the expression level of CYLD was downregulated in GC, and was significantly associated with gender (female), patient's age (<60), high grade, and no lymph‐node metastasis (p = 0.001, 0.002, 0.03, and 0.003, respectively). Among the 31 analyzed CpG sites located in about 600 bp region within the promoter, two CpG sites were hypermethylated in GC tissues. We also found a significant inverse association between DNA promoter methylation and CYLD expression (p = 0.02). Furthermore, a direct association between H. pylori, EBV, and CMV infections with hypermethylation and reduced CYLD expression was observed (p = 0.04, 0.03, and 0.03, respectively). Our findings indicate that CYLD is downregulated in GC. Infectious agents may influence CYLD expression. CYLD is a tumor suppressor gene which negatively regulates various signaling pathways. Infections may cause epigenetic modifications that affect CYLD gene expression in gastric cancer. [ABSTRACT FROM AUTHOR]

Background: Hypocalcemia is a well-recognized complication after total thyroidectomy. Hypovitaminosis D may have additional effect in the development of hypocalcemia. This study aimed to determine the effect of total thyroidectomy on postoperative serum calcium in patients with and without hypovitaminosis D., Methods: This prospective study was performed on patients who underwent total thyroidectomy from 2011 to 2014 in Imam Khomeini General Hospital of Mazandaran University of Medical Sciences. Serum calcium and vitamin D values were recorded before and after surgery. The patients were classified according to serum vitamin D concentrations as less 10 ng/ml (vitamin D deficiency) or higher (control group). The mean values of postoperative calcium level for each class of serum vitamin D were determined and compared. Hypocalcemia was defined as a postoperative calcium level <8 mg/dl., Results: 125 patients due to thyroid disease underwent total thyroidectomy. The incidence of symptomatic and asymptomatic hypocalcemia after surgery was 12% (n=15) and 3.2% (n=4) respectively. 82 (65.6%) patients had vitamin D deficiency and 43 (34.4%) patients had sufficient vitamin D level. There was not any significant difference in calcium level (8.67±0.58 mg/dl vs. 8.70±0.59 mg/dl) between two vitamin D studied groups after thyroid surgery (p>0.05)., Conclusion: The findings of this study indicated that vitamin D deficiency had no significant effect on post-thyroidectomy serum calcium level.

Objective: Overtime, malignant pleural effusion (MPE) arises in advanced-stages of malignancies and frequently heralds a poor prognosis. If the underlying malignancy is chemo sensitive, systemic chemotherapy may control pleural effusion. A common method for the management of the patients with refractory MPE is pleurodesis through the introduction of sclerosing agents such as talc, bleomycin administered/instilled into the pleural cavity. However, the present prospective study aimed to investigate the efficacy and safety of pleurodesis with povidone-iodine (Betadine) in patients with MPE admitted in Sari General Hospital during 2008-2011., Methods: Thirty-six patients who underwent pleurodesis by instilling povidone-iodine through a thoracostomy tube, as a bedside procedure were enrolled in the study. For evaluating the effect of povidone-iodine on thyroid gland, the authors measured the thyroid function tests before and after the pleurodesis at 1 week., Results: The response to this procedure was complete in 26 patients (72.2%) and partial in 7 patients (19.4%). Treatment failure was displayed in 3 patients (8.3%). The overall success rate was 91.6%. In post-procedure, the most common complaints of the patients were pain (35.9%) followed by dyspnea, burning and fever. Povidone-iodine does not affect on thyroid function tests., Conclusions: Povidone-iodine is an effective, inexpensive, safe and feasible agent for chemical pleurodesis in management of MPE.