Results of treatment of esophageal carcinoma in 110 patients in north-west Iran

Background: Esophageal carcinoma is one of the most common lethal malignancies in north and north‐west Iran. It is usually advanced in presentation and is rarely diagnosed in the early stages. The aim of this article is to describe the clinicopathological features and survival of esophageal carcinoma in the advanced and early stages. Methods: One hundred and ten patients (49 men and 61 women) with esophageal carcinoma treated by surgery and combination therapies in a referral hospital were studied over a 5‐year period. The clinicopathological features, treatment received, complications of the treatment and survival data of these patients and also the time of diagnosis, stage of cancer, demographic features, surgical therapy and survival were analyzed. Results: Among the 110 patients with esophageal cancer who were undergone surgery, there was none in stages 0 and 1. The frequency of patients in stages 2, 3, and 4 were 21%, 70% and 9%, respectively. Of the tumors, 87% were squamous cell carcinomas and 13% adenocarcinomas. Anastomotic leakage and pneumonia were the most common operative complications. The 5‐year survival rate in this study was 2.7%. Conclusion: Most of the esophageal cancers in north‐west Iran are detected in the late stages and the survival rate is lower than reported in other studies. Screening and education in order for early detection are important preventive interventions in this region.     

Incidence rate of cervical cancer and precancerous lesions in East Azarbayjan, Iran

Background: Most of deaths from cervical cancer occur in low and medium income countries and opportunistic screening for cervical cancer does not decrease the incidence rate, thus organized mass screening is needed for control of the disease. Methods: Pathology reports of cervical smears, biopsies, endocervical curettings, and hysterectomy specimens were collected from 22 pathology centers in East Azarbayjan during 2003–2004. Incidence rates for low‐grade squamous intraepithelial lesion (LSIL), high‐grade squamous intraepithelial lesion (HSIL) and cervical carcinoma were calculated by (Incidence/Population at risk) ×100 000. At risk population for cervical intraepithelial neoplasia (CIN) (between 18 and 64 years old) and invasive carcinoma of the cervix (between 30 and 64 years old) were 1 103 109 and 537 217 respectively. Result: The adjusted incidence rates for LSIL, HSIL and cervical carcinoma were 3.68, 1.19 and 5.11 per 100 000 women at risk, respectively. Conclusion: In contrast to developed countries we identified a higher incidence rate of cervical invasive cancers than preinvasive lesions, therefore, the importance and necessity of well organized mass screening in our country must be emphasized.     

Predictors of Syncope in Patients with Hypertrophic Cardiomyopathy

Background: Approximately 30% of patients with hypertrophic cardiomyopathy (HCM) suffer syncope and syncope was the only symptom associated with sudden death. However, no systematic studies in large cohorts looking at predictors of syncope are available in the literature. Therefore, we sought to determine predictors of syncope in patients with HCM.
Methods: One hundred and seventy-three consecutive patients with HCM and a mean age of 42 ± 18 years (range 10–78) underwent extensive clinical, electrocardiographic, and echocardiographic testing to identify predictors of syncope.
Results: During the mean follow-up duration of 50 months, syncope occurred in 28% of the HCM patients. Univariate analysis showed male gender, age <40 years, family history of sudden death, PR interval, QRS width, ≥2 bursts of nonsustained ventricular tachycardia (NSVT), ≥3 bursts of nonsustained supraventricular tachycardia (NSSVT), maximum left ventricular wall thickness ≥30 mm, and abnormal blood pressure response, out of 24 demographic, clinical, hemodynamic, electrocardiographic, and echocardiographic features, to be significantly associated with syncope. Of these nine variables, the only independent predictors of syncope at multivariate analysis were age <40 years (odds ratio [OR]: 4.4, 95% confidence interval [CI]: 2.2–16, P = 0.003), ≥2 bursts of NSVT (OR: 9.9, 95% CI: 2.0–46, P = 0.0001), and ≥3 bursts of NSSVT (OR: 2.7, 95% CI: 0.38–8.25, P = 0.001). The concomitant occurrence of all three variables had a sensitivity of 87% and specificity of 73% in identifying the patients with syncopal events.
Conclusions: The results of this study showed that age <40 years, bursts of NSVT, and NSSVT were independently associated with the risk of syncope in patients with HCM. Demographic data and ambulatory ECG findings could help in risk stratification of patients with HCM.     

Hydatid Cyst Surgeries in Patients Referred to Hospitals in East Azerbaijan Province during 2009-2011

Background

Hydatidosis, as the most important zoonotic parasitic disease in Iran, has posed many health and economic losses. This study was conducted to investigate the demographic characteristics of hydatid cyst surgeries in hospitals of East Azerbaijan Province, Northwest of Iran.

Methods

Demographic characteristics of all patients with hydatid cyst surgery in hospitals of the province, during 2009-2011 were gathered including age, gender, occupation, number and location of the cyst, clinical symptoms, place of residence and history of contact with dog. They were extracted from reports of health center and were analyzed using STATA 11 software.

Results

Out of 52 hydatid cyst surgeries, 27 cases were females. Mean age of patients was 38.3 yr. Liver was reported as the most involved organ. The most clinical symptoms were abdominal and liver pain. Housewives comprised the most victims of the disease. Forty seven percent of patients had one cyst and 59% had the history of contact with dog. The majority of the patients were living in rural areas.

Conclusion

Due to the high costs of diagnosis and treatment of hydatidosis, collecting data on the prevalence and transmission of the disease as well as on vulnerable groups seems to be essential as the first step in controlling and preventing the disease.