احسان زابلی

Anemia in cancer patients and following chemotherapy in affected patients is one of the factors affecting the health status and even the survival of patients, which should be evaluated. Considering the significant prevalence of cancer in Mazandaran province, this study was conducted to determine the incidence of anemia caused by chemotherapy and determine some factors related to it in patients with solid tumors in Imam Sari Hospital.

The current research is a cross-sectional study. The samples were selected from patients with solid tumors who were referred to the chemotherapy centers of Imam Sari Hospital in 2021 and 2022. The convenience sampling method was used. The inclusion criteria were patients over 18 years of age with solid tumors and the exclusion criteria were history of receiving blood in the last three months, radiotherapy, and anemia requiring treatment at the beginning of the study. CBC results of patients before and after chemotherapy cycles were recorded, and anemia was determined based on hemoglobin values. According to hemoglobin, the patients were classified into 4 categories: normal, mild anemia, moderate anemia, and severe anemia. Also, a decrease in hemoglobin (2 units or more) in the intervals between chemotherapy cycles was considered chemotherapy-induced anemia. In addition, information such as age, gender, type of cancer, and the type of chemotherapy regimen received were also recorded.

The total number of people who entered the study was 146, and the number of males was 91 (62.3%). The mean±standard deviation of the age of the participants was 56.8±12.7 years. Breast tumors in 56 people (38.4%), stomach in 48 people (32.9%), colorectal in 18 people (12.3%), and lung in 7 people (4.8%) were more than others. 51 people (34.9%) had Platinum-based chemotherapy, at first 39 people (26.7%) had normal hemoglobin, 80 people (54.8%) had mild anemia and 27 people (18.5%) had moderate anemia. 51.8% of patients with breast tumors, 22.2% of genitourinary tumors, and 8.8% of patients with gastrointestinal tumors had normal hemoglobin at the beginning of the study. The frequency of moderate anemia increased from 18.5% before chemotherapy to 36.1% after the third cycle of chemotherapy and 1.4 to 2.7% of patients developed severe anemia after different cycles of chemotherapy. 23 people (15.8 percent) of the examined patients had 2 or more units of hemoglobin drop after the first stage of chemotherapy, which happened in 10 people after the second stage (8.8 percent) and after the third cycle in 1 person (1.8 percent), it was observed. There was no significant relationship between 2 units or more hemoglobin drop with gender, age, tumor type, and type of chemotherapy regimen after the first cycle of chemotherapy (P<0.05).

The results of the present study showed that there was mild anemia in a large number of cancer patients, which increased after the first cycle of chemotherapy. Age, sex, type of tumor, and type of chemotherapy regimen had no significant relationship with hemoglobin drop in cancer patients undergoing chemotherapy.

Being Overweight is a global health problem and is related to important underlying diseases such as cardiovascular disease, malignancy, diabetes, fatty liver, etc. Over the past three decades, obesity has increased globally, especially in low-and middle-income countries. Numerous studies have shown that obesity increases the risk of developing chronic and threatening diseases including diabetes, cardiovascular diseases, blood pressure, and reduces life expectancy. On the other hand, chronic inflammation around fat cells plays an important role in obesity-related diseases. Also, changes in blood parameters are associated with increased body mass and chronic inflammation in obesity, and peripheral blood cells, such as the number of platelets, neutrophils, lymphocytes, and monocytes, are related to the progression of various types of diseases and inflammatory conditions. Therefore, the purpose of this study is to find the relationship between blood count biomarkers and anthropometric indicators in the adult group according to the Tabari cohort data.

Materials and methods:

 In the present study, cross-sectional data from a population-based cohort study called "Tabari Cohort Study" collected from 2014 to 2016 were used. This study is part of a nationwide study called "Epidemiological Prospective Study Group in Iran (Persian Cohort)". In the first phase of the Tabari cohort study, 10,255 participants aged between 35-70 years from urban and rural areas of Sari city were registered. Exclusion criteria in this study were inflammatory diseases, autoimmunity, malignancy, cardiovascular diseases, transplantation, and receiving any type of immunosuppressive drug, and finally 9939 people including 4043 men and 5896 women were included in the study. Age, height, weight, anthropometric measurements (BMI, waist circumference), CBC parameters including leukocytes, platelets, neutrophils, lymphocytes, and monocytes), and platelet distribution width (PDW) were recorded from the participants. By using the histogram drawing method to check whether the variables follow the normal distribution to decide between parametric or non-parametric analysis, T-test and ANOVA statistical tests, and SPSS 21 software, the results were extracted. The significance level in this study was considered to be 0.05 or less.

Waist-to-hip ratio was associated with higher WBC (P<0.001), platelet (P<0.001), and lymphocyte percentage (P<0.001). Higher waist-to-hip ratio was associated with higher WBC (P<0.001), platelet (P<0.001), lymphocyte percentage (P<0.001), and monocyte percentage (P<0.001). Higher BMI values were associated with higher WBC (P<0.001), platelet (P<0.001), lymphocyte (P<0.001) and monocyte (P<0.001) percentages. WBC, platelet, lymphocyte, and monocyte percentage were significantly higher in people who had a higher ratio of waist circumference to height (P<0.001).

The results showed that the relationship between anthropometric indicators and blood findings in favor of inflammatory conditions and obesity can affect indicators related to whole blood count.

Breast cancer is one of the most common cancers among women. Abnormal expression of microRNAs is associated with cancer. Therefore, this study aimed to evaluate the expression of miRNA-210 in the serum of breast cancer patients.

The studied population included 49 breast cancer patients and 55 healthy individuals, and the samples were evaluated using Real Time PCR.

The data analysis of this study revealed that the expression level of miR-210 in the blood of breast cancer patients is significantly higher compared to the blood of healthy people. Also, there is a negative correlation between the age of breast cancer patients and the expression of miR-210 (r=-0.309, P=0.031) and a significant positive correlation between the increase in the expression of mir-210 and the expression of the Ki- 67 marker (r=0.412, P = 0.004).

Evaluation of miR-210 can be used as a diagnostic marker in breast cancer.

Breast cancer is one of the most common cancers and the first cause of cancer-related deaths in women. Evidence suggests that allergies may be associated with cancer progression. Immunoglobulin E as part of the allergic immune response plays a role in the occurrence of type 1 hypersensitivity responses and allergic diseases such as asthma, allergies, allergic rhinitis, and probably cancers.

We carried out a cross-sectional study in breast cancer patients as a case group and people without cancer as a control group. Total IgE level in the groups was measured by ELISA method using the monoset kit by Calbiotech (USA). Data, including total IgE level and eosinophil percentage of the patients along with participans’ age were recorded in excel. Data analysis was done in SPSS V19 using T-test, Mann-Whitney and partial correlation.

In this study, 160 patients were examined. The mean ages of patients in the case group and control group were 48.18±10.49 years and 41.68±7.95 years, respectively. There was a significant difference between the two groups in mean age (P<0.001). IgE level was not found to be significantly different between the two groups (P=0.92). Findings revealed no significant difference in eosinophil percentage between breast cancer patients and healthy patients (P=0.82). We observed no significant correlation between age and IgE levels (r=-0.043, P=0.594) and eosinophil percentage (r=0.145, P=0.068) after control for groups.

This study showed that the levels of IgE and the percentage of eosinophils in the peripheral blood cannot be not considered as a predictive factor in the diagnosis of breast cancer.

The northern regions of Iran have a high incidence of esophageal cancer. This study was conducted with the aim of epidemiological investigation of esophageal cancer patients in the population covered by Mazandaran University of Medical Sciences.

In this cross-sectional descriptive study, the records of 170 patients over 18 years of age who were referred to Tuba Oncology Clinic (affiliated with Mazandaran University of Medical Sciences) between 2014 and 2016 were reviewed. All relevant information, including age, sex, occupation, marital status, level of education, clinical and pathological findings of patients were collected and analyzed in SPSS V22 using Chi-square and Fisher’s exact test.

The mean age of patients with esophageal cancer was 68.2±12 years. The disease was more frequent in patients aged 70-79 years old. There were 53.5% male patients and 94.1% of patients had dysphagia. The frequency of squamous cell carcinoma (SCC) was found to increase by aging. The most and least metastatic segments were middle and upper parts of the esophagus, respectively.

Esophageal cancer is common in old age and age is probably the most important factor in developing the disease.

Connective tissue diseases, including scleroderma, may be associated with an increased risk of lung cancer. The most common type of lung cancer associated with systemic sclerosis is adenocarcinoma or bronchoalveolar carcinoma, and small cell carcinoma is rare. This reports presents a 54-year-old non-smoker woman with a history of scleroderma who was examined due to aggravation of shortness of breath and cough for the last two months. On radiography and CT scan, a mass was seen in the sub pleural area of the upper right lobe of the right lung, and pathological examination showed small cell carcinoma of the lung. Small cell carcinoma is very rare in non-smokers, therefore, it may be associated with interstitial lung tissue disease in scleroderma.

The association between ABO blood types and Coronavirus disease 2019 (COVID-19) have been investigated in several studies but there are inconsistencies in results. The purpose of this study was to investigate the association between ABO blood types and COVID-19 infection based on serologic results.

A cross-sectional seroepidemiologic study was carried out in 1504 people living in Mazandaran province, north of Iran. Blood samples were drawn to determine blood groups. Also, IgG and IgM antibodies were measured by ELISA. Data analysis was done using Chi-square, Fisher’s exact test, univariate and multivariate logistic regression analyses in SPSS V25.

The frequency of IgG positive among blood groups A, B, AB, and O was 12.7%, 11.8%, 9.4%, and 9.6%, respectively. After adjusting for suspicious confounding factors, the odds ratio of COVID-19 infection was 1.19 (95% CI:0.85-1.67) in blood group A, 1.33 (95% CI:0.94-1.87) in blood group B, 0.82 (95% CI:0.44-1.55) in blood group AB, and 0.70 (CI 95%:0.50-0.98) in blood group O based on serologic results (IgG+/IgM+).

The odds ratio for COVID-19 was significantly lower (30%) in blood group O compared to other blood groups, so blood group O can be considered as a protective factor against COVID-19.

Stress management of patients with breast cancer, especially patients receiving chemotherapy is one the goals of service providers all over the world. This review aimed at investigating the effect of non-pharmacological interventions on stress of women with breast cancer undergoing chemotherapy.

In this systematic review, electronic databases including Google Scholar, PubMed, Scopus, Springer, Web of Science, Science Direct, Cochrane Library, Magiran, Scientific Information Database, and Iranian Registry of Clinical Trials were searched. The search keywords were Distress, Stress, Chemotherapy, Breast Cancer, and Non- Pharmacological Intervention in both Persian and English. A total of 74,590 articles were found from which nine were selected after removing the duplicate and irrelevant articles and using Jadad scale to screen the methodological quality of the articles.

Findings were classified into two main categories: psychological interventions, including Problem solving and Cognitive Behavioral Therapy and Complementary medicine interventions including: music therapy, Reiki therapy, yoga, and physical exercise. Most of the modalities reduced the stress in patients studied.

Non-pharmacological interventions could reduce stress in breast cancer women undergoing chemotherapy, therefore, they should be informed with the benefits of this approach and have the right to select an appropriate method. To achieve this goal care providers empowerment is highly necessary.

Decreasing the quality of life in cancer patients is an essential factor that influences their lives during the process of treatment and after that. A lot of studies have been done to evaluate the efficacy of medical agents on quality of life. In this study, we evaluate the efficacy of Bupropion as an antidepressant agent in quality of life of cancer patients.

In this double-blind randomized placebo-controlled clinical trial, a total of 30 eligible cancer patients suffering from fatigue were randomly divided into two 15-individual groups of bupropion and placebo. Bupropion was administered 75 mg/day for the first three days and 150 mg/day (in two doses) till the end of the study for group bupropion. Quality of life was measured by EORCT-QLQ-C3 scale. Adverse effects were assessed based on NCI Common Terminology Criteria for Adverse Events. The study was six weeks long and assessments were done at baseline, second week and sixth week.

There was no significant difference in scores between placebo and bupropion at baseline and second week. While, significant difference was seen at the week six (P=0.005 for function, P=0.036 for symptoms and P<0.001 for health).  Between group assessments showed better average score for bupropion in comparison to placebo. Only two cases of adverse effects were reported.

bupropion can be effective in improvement of quality of life in cancer patients