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Background: Multiple sclerosis (MS) is a debilitating, non-traumatic, neurological disorder in young adults and can reduce quality of life (QoL) by interfering with the ability to work, leisure activities, and routine living tasks. Various studies have shown the dissatisfaction of people with MS in different areas of care services. Regarding the patients' weakness with care and services, we sought to identify the challenges for patients with MS in receiving care and services in Iran. Methods: This cross-sectional study was conducted in 2016-2018 using a researcher-made questionnaire (designed by MS Specialists in an MS research center). The questionnaire examined the care challenges in four areas: 1) costs of medication, hospitalization, and rehabilitation services, 2) family support, insurance system, and job protection, 3) access to transportation system and treatment team, 4) quality of the provided care and services. Results: Completed questionnaires were received from 945 respondents. The mean age of responders was 35.92 years. In total, 731 (77.8) participants were women and 208 (22.2) were men. Academic education was reported among 615 (65.3) participants and 367 (40.2) were employed during the study, while 99 (10.5) of the subjects were not able to walk a minimum of 20 meters. The prioritization of care services challenges was as follows: the cost of pharmaceutical services (49.1), lack of telephone counseling (47.4), uninsured home rehabilitation (44.7), lack of qualified care centers (41.2), and rehabilitation costs (40.2). Conclusion: We found that patients who could not walk at least 20 meters and unemployed individuals had more problems and lower QoL. The patients who had non-academic education had more challenges with the cost of medication, transportation, and lack of familial support. This study shows the challenges of MS patients in receiving health care in Iran that vary in age, education, employment, and ability to walk. As the abovementioned challenges are of great importance in determining the QoL of people with MS, an appropriate solution is provided in this study to overcome these challenges.

Background: Sentinel lymph node dissection after neoadjuvant chemotherapy is of questionable accuracy. Objectives: In this study, accuracy and feasibility of sentinel lymph node biopsy in patients with breast cancer presented with clinically positive axillary nodes were evaluated. Methods: We conducted a cross sectional study on patients with breast cancer treated at Milad Hospital of Tehran, Iran from June 2014 to February 2015. Clinically node positive patients (proven by biopsy), who became clinically node-negative by ultrasonography and physical examination following neoadjuvant chemotherapy and had been dissected up to 3 lymph nodes according to sentinel lymph node pattern, were included in the study. We used a 2 × 2 contingency table to analyze the feasibility of sentinel lymph node biopsy (sensitivity, specificity, false negative ratio, and accuracy). STATA statistical software (version 13.0, StataCorp LP, Texas, USA) was used for statistical analysis. Results: Among 52 patients, who entered the study, 47 patients had been dissected up to 3 lymph nodes according to sentinel lymph node pattern. We achieved a sensitivity of 100% (16/16), false-negative rate of 0% (0/21), a negative predictive value of 100% (26/26), and an overall accuracy of 89.4%. Conclusions: Sentinel lymph node dissection seems to be feasible and accurate in clinically lymph node positive patients with breast cancer, who achieve a clinically negative node status by ultrasonography and physical examination, following neoadjuvant chemotherapy.

Background: Colorectal cancer is a highly prevalent cancer around the world and Iran. There are different criteria that can affect the survival rate of this disease. Surgical margin status is one of these criteria; there are still challenges about how it can change the surveillance of the disease. Objectives: In this study, we assessed the relativity between surgical margin status and the stage of disease in Iranian patients suffering from colorectal cancer. Methods: This is an observational cross-sectional study. A total of 797 patients with colorectal cancer were included and a checklist of demographic, clinical, and pathological data was filled for each one. Based on the pathology result of the biopsy, the patients were divided into different histological groups. Surgical margin status was defined individually. To declare the relativity between surgical margin status and independent variables, we used Spearman’s rho test. Results: The stage of the disease and its histological type and grade were significantly correlated. There was also a significant correlation between histological grade and type of the disease. Conclusions: Surgical margin status and stage of the disease are challenging prognostic factors in disease recurrence and survival. The patients who participated in this study had meanly higher age and stage of diagnosis than earlier studies either global or local. It can be due to a lack of a systematic program for early detection of CR cancer in Iran that emphasizes the necessity of GI screening systems.

Anti-JC virus (JCV) antibody index is the predictive factor of progressive multifocal leukoencephalopathy (PML) for multiple sclerosis (MS) patients treating with natalizumab. The aim of this study is to evaluate the prevalence of anti-JCV antibody positivity and index among Iranian patients who are the candidate for natalizumab and its correlation with their demographic data and previous therapies. A cross-sectional design was assessed for receiving anti-JCV antibody test results between January 2014 and December 2016. Demographic data and disease characteristics were also obtained. Statistical analysis and logistic regression were done using SPSS. Among 803 MS patients that were observed, the prevalence of anti-JCV antibody positivity was 67.9% (mean of index = 2.23 ± 1.16) and 67.6% of positive patients had an index ≥ 1.5. Males were more antibody positive than females (81.7 and 64% respectively; significance (sig.)

Background Colitis, a colonic inflammatory condition, showed a linkage with hepatobiliary disorders such as cirrhosis. It has been reported that both endogenous opioids and nitric oxide (NO) play critical roles in colitis pathogenesis. Moreover, opioid and NO levels showed elevation in patients with cirrhosis. The aim of this study was to evaluate the effect of cirrhosis on the experimental model of colitis and the possible involvement of opioidergic/nitrergic systems in rats. Methods Colitis was induced by acetic acid 28 days after bile duct ligation (BDL). L-NAME, as an inhibitor of NO synthase and naltrexone, as an antagonist of opioid receptors were administered intraperitoneally to animals during 3 days after induction of colitis. Macroscopic colitis lesion area, inflammatory mediators change, NO metabolite levels, and colon microscopic injuries were assessed 3 days after induction. Results Cirrhosis significantly reduced the severity of damages to the colon. Administration of L-NAME (10 mg/kg), naltrexone (10 mg/kg) and co-administration of L-NAME (1 mg/kg) and naltrexone (5 mg/kg) significantly decreased the protective effect of BDL on colitis. Nitrite elevated levels in BDL rats were significantly diminished in L-NAME- and naltrexone-treated animals. Histopathology parameters and cytokines level alterations in the colon of acetic acid-treated animals after BDL was reversed after injection of L-NAME, naltrexone, and co-administration of L-NAME (1 mg/kg) + naltrexone (5 mg/kg). Conclusion Cirrhosis improved the intestinal damages induced by acetic acid in rats which may be mediated through interaction of nitrergic and opioidergic systems.

Breast cancer is the most prevalent Iranian female malignancy. Breast screening reduces the number of malignant breast diseases. We aimed to assess the results of the pilot breast cancer screening on early detection in female medical staff in Milad Hospital, Tehran, Iran. A cross-sectional study. Female medical staff from Milad Hospital, Tehran, Iran, were examined by a specialist in 2016. A checklist, including demographic data, was completed by the participants. If necessary, they referred to as sonography or mammography. Data were analyzed using SPSS software. Of 746 people enrolled, 137 had no pathological point, 609 had suspicious or positive findings that were referred for further investigation, 449 had normal findings, and 7 had suspicious mass and were biopsied, 6 were benign. One case had primary invasive cancer. Since screening for breast cancer helps to early detection of this disease, the implementation of cancer screening programs should be on the priority of health authorities.