Ali Hajigholami

Background and Aims: Breast cancer continues to impose a considerable burden on women's health worldwide and represents one of the primary causes of cancer‐related mortality. Despite extensive research, regional data on its distribution and associated determinants remain essential. The present study evaluated the frequency of breast cancer and explored potential related factors among middle‐aged women in Isfahan, Iran. Methods: A cross‐sectional epidemiological survey was performed between March 2021 and March 2022 across four university‐affiliated health centers in Isfahan. Information regarding sociodemographic characteristics, lifestyle behaviors, and medical history was gathered using a structured data collection form. Descriptive statistics were applied to summarize the data. Group comparisons were conducted using independent t ‐tests for continuous variables and chi‐square tests for categorical variables. A confidence level of 95% was considered for statistical inference. Results: Among the 1001 women included in the analysis, 92 cases of breast cancer were identified, whereas 909 participants had no diagnosis of the disease. Statistical analysis revealed significant relationships between breast cancer and alcohol use ( p = 0.014) as well as height greater than 175 cm ( p = 0.048). No meaningful associations were observed for the remaining evaluated variables ( p > 0.05). Conclusion: The study findings indicate a potential link between alcohol consumption, increased height, and breast cancer occurrence in middle‐aged women. Further large‐scale, multi‐center investigations are warranted to confirm these observations and to enhance understanding of modifiable and non‐modifiable risk factors that may inform preventive strategies.

Breast cancer accounts for one third of cancer-related deaths in women and has complications such as bone and brain metastases in other organs. Investigati

Background and Objective: Cancer‐related fatigue (CRF) is recognized as one of the most common side effects of cancer and its treatment and can affect the quality of life of individuals. Studies have shown that there is an inseparable link between CRF and inflammation. Selenium, known as an antioxidant and anti‐inflammatory agent, reduces the production of inflammatory markers as well as the accumulation of free oxygen radicals. Therefore, a decrease in selenium levels leads to increased inflammation and, consequently, greater fatigue. This study aimed to determine the level of selenium and its relationship with CRF. Methodology: A total of 70 patients who met the entry criteria for the study were examined after the level of fatigue was determined through the Multidimensional Fatigue Inventory (MFI) questionnaire, and the selenium content in the serum was measured by atomic absorption spectrophotometry. Findings: In this study, 70 cancer patients who underwent chemotherapy, including 32 men and 38 women, were examined. The total fatigue score measured through the MFI questionnaire was 57.82 ± 10.42, and the level of selenium in the blood of the patients was 77.75 ± 19.24 μg/L. Conclusion: The results of this study demonstrated that there was a significant negative correlation between selenium levels and CRF ( p < 0.001, r = −0.524), indicating that with decreasing selenium levels, the amount of CRF increased. These results vary depending on the type of cancer.

Breast cancer is one of the most common diseases globally that may have side effects on liver and renal function. Pharmacological treatments to reduce adverse liver and renal effects are still limited. It has been proposed that silymarin may possess hepatoprotective and anti-inflammatory properties. The present trial aims to assess the hepatorenal protective efficacy of silymarin supplementation in cancer patients receiving chemotherapy in an outpatient setting. This is a randomized, placebo-controlled clinical trial that recruited female breast cancer patients. Participants were randomly assigned to one placebo group and two intervention groups. The control group received 140 mg of placebo daily, while the two intervention groups received 140 mg silymarin daily. Follow-up assessments were conducted at baseline, 3 weeks, and 6 weeks. At the beginning of the study, the patients were subjected to a computed tomography (CT) scan, and the liver and renal parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, Blood urea nitrogen (BUN) and Creatinine (Cr) were examined through laboratory tests. Despite two deaths and three dropouts, 100 patients completed the study. Silymarin showed significant effects on liver enzymes in the levels of ALP and bilirubin (P < 0.05), with no significant impact on renal function in the levels of Blood urea nitrogen (BUN) and Creatinine (Cr) (P > 0.05). The medication was well-tolerated, with minimal reported side effects (P > 0.05). The study suggests that silymarin may have hepato-renal protective potential in breast cancer patients and improve patient tolerance to chemotherapy. The data presented on the efficacy and safety of silymarin may provide stronger foundation for further trials and for a possible use in clinical practice. Registration Number: IRCT20201123049474N2, First Trial Registration: 16/08/2021, Access: https://www.irct.behdasht.gov.ir/trial/57641

Introduction: Scientific studies confirm that unhealthy habits play an important role in the development of various disorders in all age groups. The field of medicine is a challenging period for students of this field that causes unwanted changes in their health habits and lifestyle. Objectives: The aim of this study is the evaluate and compare the lifestyle among first and last year medical students of Isfahan university of medical sciences. Patients and Methods: This study is a descriptive-analytic study that was conducted in two groups of first year and last year medical students in Isfahan university in academic year 2019-2020. The learning styles questionnaire (LSQ) is used in this study. It consists of 70 questions and measures lifestyle in 10 domains. This questionnaire is based on 6-point Likert scale and each question receives at least one point and maximum 6 points. Results were obtained by SPSS software version 22 and independent t-test and chi-square test. Results: The age range of first year students was 18-24 years with a mean of 19.5 years and the age range of last year students was between 24 and 27 years with a mean of 25 years, which showed a significant difference (P<0.05; independent t test). There was no significant difference between the two groups in gender distribution and living status however, there was a significant difference between the two groups in marital status distribution. The mean scores of lifestyle scores in physical health dimensions and sport and physical activity in first year students were significantly higher than last year students since, the mean score of other aspects of life style was not significantly different between Junior and senior students. Conclusion: Overall, the mean scores of lifestyle scores in physical health dimensions and sport and physical activity in first year students were significantly higher than last year students however, the mean score of other aspects of life style was not significantly different between freshmen and senior students.

Acquired hemophilia (AH) is a potentially life-threatening hemorrhagic disorder. We report the second confirmed case of COVID-19-associated AH in a 45-year-old female which, unfortunately, expired as her treatment failed. She presented to the emergency department with abnormal bleeding and spontaneous hemoptysis about ten days after a removal surgery of her epiglottis tumor. Aggregation tests, such as partial thromboplastin time (PTT), are recommended in patients with COVID-19 infection that have bleeding episodes.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease (COVID-19) pandemic is the largest infectious crisis in the present century. It has been reported that COVID-19 infection may trigger autoimmune diseases. Herein, we report a 68-year-old male that was diagnosed with thrombotic thrombocytopenic purpura (TTP) following COVID-19 infection. To our knowledge, this is the fourth case of COVID-19-associated TTP. More attention is required regarding the possibility of developing TTP in COVID-19 patients, especially with the presence of decreased consciousness and low levels of hemoglobin and platelet.

Introduction: Developing patients’ tolerance in receiving treatment and enhancing their life expectancy has been increasingly recognized as the important end-points in cancer disease. Objectives: This cross-sectional study aimed at exploring the relationship between received social support and its correlation with life expectancy in cancer patients during chemotherapy. Patients and Methods: Around 210 cancer patients were selected through simple sampling procedure from the clinics of Isfahan medical science University, Iran. Sherbourne and Stewart questionnaire and Miller questionnaire were used to assess social support and life expectancy, respectively. The collected data were analyzed by independent t test and linear regression. Results: We found a significant positive correlation between total social support score and life expectancy scores. Additionally, a significant positive correlation between different aspects of social support — tangible support, emotional support and kindness—with positive social interaction and life expectancy was detected. Conclusion: Our results highlights that social support may develop life expectancy in cancer patients depending on the extent of disease; however, extensive and longitudinal studies on social support and life expectancy in cancer patients should be performed.

Introduction: Malignancy is one of the causes of anemia in chronic diseases. Anemia can commonly complicate the malignancy process. Objectives: This study aimed to compare improvement in the quality of life and hemoglobin levels between cancer patients with chemotherapy-related anemia receiving erythropoietin and injectable iron supplement versus patients receiving erythropoietin and oral iron supplement. Patients and Methods: This investigation was a randomized clinical trial carried out on 79 anemic individuals with metastatic and non-metastatic carcinoma who were undergoing chemotherapy. Individuals included in the study were randomly assigned to the two groups. The first group received erythropoietin and Venofer while the second group received erythropoietin and ferrous sulfate for 6 weeks. The quality of life for patients was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30). Results: Hemoglobin levels in both groups increased significantly while the difference between them was not significant. Despite improvement in more indexes of the questionnaire, post-treatment quality of life in both groups had no significant statistical difference (P>0.05). The changes in indices after interventions showed no difference between the oral and injectable iron supplements groups (P>0.05). Conclusion: The results of this study showed that administration of erythropoietin and iron supplements, either orally or intravenously, even with a shorter duration of treatment could increase hemoglobin levels in chemotherapy-induced anemia group, however to improve the quality of life, it may be necessary to employ larger sample sizes and prolong treatment courses. Trial registration: This randomized controlled trial was registered in the Thai Clinical Trials Registry (identifier: TCTR20200915003; http://www.clinicaltrials.in.th).

Background: Germ cell tumors (GCTs) are the most common solid tumors in young men, with a peak incidence at 25-35 years. Approximately 50% of the testicular GCTs are pure seminomas and 50% are non-seminomas. Late relapse of testicular cancer (LRTC) is a rare disease with the incidence rate of 2.6% and is defined as >2 years interval between initial treatment and recurrence. Case Presentation: We report here a patient with nonseminomatous GCT who experienced relapse 27 years after his first diagnosis. He came with gross hematuria and huge abdominal mass. There was a giant retroperitoneal mass with invasion to the left kidney and other organs in computerized tomography. A biopsy was conducted and pathology revealed recurrence of malignant mixed nonseminoma GCT. The tumor was unresetable. Therefore patient was treated with four cycles of chemotherapy. PET scan was conducted after chemotherapy showed residue of tumor thus retroperitoneal lymph node dissection (RPLND) was done. Conclusions: We concluded that with increasing lifespan of cancer patients, follow up of these patients for very late relapse must be conducted lifelong.