شهربانو کیهانیان

Considering the importance of disease prognosis for evaluating the disease and determining the treatment protocol, as well as for defining an accurate and appropriate nursing diagnosis to establish a care plan and identify patients at risk, counting the number of blood cells may be of help due to its convenience and cost-effectiveness.

The population of this descriptive correlational study was all patients with gastric cancer referred to Imam Sajjad Ramsar Hospital during 2012-2017. Patient demographics were used to calculate the duration of disease-free survival and overall survival.

In the present study, 134 patients were examined. Regarding the age group, 16 patients were <50 years old and 118 patients were >50 years old. The number of lymphocytes <2000 and the number of monocytes >2000 and the absolute number of lymphocyte to monocyte ratio (LMR≥ 4.8) were associated with non-metastatic gastric cancer.

The frequency of absolute low lymphocyte count, high monocyte count and lymphocyte to low monocyte ratio was significantly higher in patients with higher stage disease and lymph node involvement than in other patients. These results can be used to review and define nursing diagnoses to inform decisions for care and treatment interventions for patients with gastric cancer.

Colorectal cancer is one of the most cancers and early diagnosis improves patient survival. The aim of this study was to determine the frequency of clinical symptoms in patients with rectal cancer in Guilan Province from 2018 to 2021.

This descriptive cross-sectional study was conducted as a census. Information on patients with rectal cancer referred to the Rasht Gastroenterology Clinic from 2018 to 2021was collected using a researcher-made survey instrument. The data were analyzed using SPSS 26. Numbers and percentages were used to describe the variables.

Most of the patients were between 50 and 70 years old. Besides, 63.5% of the patients were male. In addition, the body mass index of most patients was between 18.5 and 24.9 and most of them were non-smokers (62.5%). Also, the frequencies of some symptoms such as anemia, increased bowel movements, feeling unable to defecate completely, anal pain, inability to expel flatulence, and diarrhea were 18.8, 18.8, 18.8, 11.8, 8.2, and 5.9, respectively. Moreover, the frequencies of bleeding, constipation, weight loss, and hypogastric pain were 51.8%, 25.9%, 24.7% and 20%, respectively.

According to the results of the present study, more attention should be paid to the occurrence of symptoms such as constipation, weight loss, hypogastric pain and bleeding in the lower gastrointestinal tract in people over 50 years of age, and patients should be referred to gastroenterologists for examination for possible colorectal cancer.

Fatty liver is one of the most common liver diseases. Some treatments used in breast cancer may be associated with development of fatty liver. The present study aimed at investigating the prevalence of fatty liver in breast cancer patients.

In this cross-sectional study, 117 patients with breast cancer attending Ramsar Imam Sajjad Hospital in 2017-2022 were selected using available sampling. Patients who had fatty liver before the treatment or had a history of alcohol consumption were excluded from the study. Relevant information, including age, BMI, underlying diseases, time since cancer diagnosis, type of treatment/s, and liver enzyme levels were obtained. Liver ultrasound and measurement of liver enzyme levels were done to study fatty liver. Data were analyzed in SPSS V26 applying Chi-square test.

According to findings, 54.7% of the patients were suffering from fatty liver. The majority had Grade I fatty liver. Among the patients 53.8% received all four types of treatments (surgery, chemotherapy, hormone therapy, and radiotherapy). The study showed significant relationships between the incidence of fatty liver and type of treatment, underlying disease, liver enzyme levels, and duration of breast cancer (P<0.05).

Non-alcoholic fatty liver is seen in many patients with breast cancer. Treatment methods used in these patients are associated with the development of fatty liver. Therefore, clinicians are suggested to use appropriate diagnostic and treatment methods for fatty liver to reduce the incidence of complications caused by this condition in patients with breast cancer.

Blood products are important to many patients. Due to excessive demand for blood, which causes blood loss and increases the cost of treatment and the workload of the blood bank, it is necessary to consider the demand and consumption rates of blood products.

In this descriptive study, blood request forms were examined for individuals over 18 years of age referred to Imam Sajjad Hospital in Ramsar from January 2019 to January 2020. Data were analyzed by SPSS software version 25 and Chi-square Test. Descriptive statistics (frequency, percentage, and mean) and blood transfusion indices including cross-matched to injected blood ratio (C/T), blood transfusion index (TI), and blood transfusion probability (T%) were calculated.

3111 blood request forms were reviewed. Out of 7640 units of requested blood, 5051 units (66.11%) were injected into patients. Among the hospital sectors, gynecology department with 58 units (1.1%) had the lowest frequency of consumption of packed RBCs. The overall C⁄T ratio was calculated to be 1.56. Overall TI was 1.22 and T٪was 65.82%.

 This study showed that the ratio of transfusion indices was appropriate for all departments of Imam Sajjad Hospital in Ramsar except for gynecology. Due to the high demand for blood compared to consumption, unnecessary requests can be significantly reduced by properly examining patients and applying the principles of blood ordering.

Breast cancer is the most commonly diagnosed and the leading cause of cancer death among females worldwide. The rate of breast cancer incidence among Iranian women is 17% of all cancers, it has been ranked first in Iran. This study aimed to investigate the factors affecting axillary lymph node involvement in female patients with breast cancer.

A cross-sectional study was conducted on 167 patients with breast cancer diagnosed between March 2012 and March 2015 at Shahid Beheshti of Babol, Shahid Rajaei of Tonekabon and Imam Sajad of Ramsar hospitals. A researcher-made questionnaire was used to collect information on the patients and pathology report of tumor and lymph nodes was completed.

The rate of axillary lymph node involvement was observed in 117 patients (70.1%). Mean age was 49.64±11.62 years in the patients with breast cancer. The highest frequency of lymph node involvement was observed in the 40-49 age group (24%). The average size of tumor was 3.39 cm and the majority of patients had a tumor 2-5 cm (T2) but the most involvement was related to T3 (>5cm). The most common type of cancer and grading were invasive ductal carcinoma (93.4%) and tumor grade 2 (52.1%), respectively. Most lymph node involvement was observed in invasive ductal carcinoma and 85.1% of patients had tumor degree 3. 22.2% of patients with vessels involvement had axillary lymph node involvement. 63% of patients’ tumors had receptors of estrogen and progesterone. A statistically significant association was observed between axillary lymph node involvement and tumor size (P=0.031), tumor type (P=0.007), tumor grade (P=0.011), estrogen receptor (P=0.008) and progesterone receptor (P=0.038).

There was a statistically significant association between axillary lymph node involvement and tumor size, type and grade, estrogen and progesterone receptor status, but there was no statistically significant association between axillary lymph node involvement and age and estrogen as well as progesterone receptor status.

Considering the increasing prevalence of breast cancer, today, the main problem in the field of women's health is the control and prevention of breast cancer. One of the main areas in preventing this disease is controlling the risk factors associated with lifestyle. Wearing of brassiere is also a lifestyle-related habit that has sparked many debates today as a risk factor for breast cancer in women. This study was conducted to determine the behavioral Habits of wearing brassiere in women with and without breast cancer. This case-control study was conducted on women with and without breast cancer.A total of 360(120 in the case group -240 in the control group) individuals were selected based on available sampling method. The study tools were Demographic and behavioral habits of wearing brassiere questionnaires. Data were analyzed by Descriptive (mean and standard deviation, Frequency) and analytical tests (Independent t test and Chi-square) by using SPSS version 18 software. Based on the results, the average hours of wearing brassiere in women with and without breast cancer was 19.2 ± 3. 21 and 17.9 ± 3.19 respectively. The mean frequency of wearing brassiere during sleep in women with and without breast cancer was 5.78 ± 1.16 and 4.18 ± 0.83 times per week. There was a significant difference between the two groups regarding the average hours of wearing brassiere, the mean frequency of wearing brassiere during sleep and the habit of wearing a tight brassiere (p<0/05). The findings of this study revealed differences in some behavioral habits of wearing brassieres in women with and without breast cancer. So, in preventive interventions for breast cancer, women's education should be considered in order to be aware of the proper behavioral habits in wearing brassieres.

Cancer patients encounter with series of challenges that can affect family support and eventually life satisfaction. Therefore, the aim of this study was to determine the relationship between family social support and life satisfaction in cancer patients. This descriptive-analytical study was performed on 76 patients, referred to the Department of Oncology of Imam Sajjad Hospital in Ramsar in 2017. The sampling method was census and the data-gathering tool included: 1) demographic characteristics 2) satisfaction with life scale (SWLS) 3) functional social support questionnaire (FSSQ). The scores were ranged from 79 to 316. The data were analyzed using SPSS 19 with ANOVA, T-test, Pearson and regression tests. The results indicated that the overall scores of family social support were very good (with mean and standard deviation of 256.16 ± 36.42) and life satisfaction was moderate (with  mean and standard deviation of 21.79±6.53). There was a significant relationship between the total social support scores of the family and life satisfaction (p= 0.002 and r=0.375). Linear regression analysis suggested that family emotional support was the predictor factor of life satisfaction. Based on the present research, family social support was one of the factors influencing on patient satisfaction, but it did not seem adequate because the life satisfaction was moderate despite the fact that family social support was high. Therefore, it is suggested that more research should be performed in order to promote the life satisfaction.

Background and

The aim of this study was to determine the genetic variability of CYP1A1 m1 and m2 polymorphisms in cancer patients compared with healthy population in the west of Mazandaran province, Iran.

A case-control study was carried out in 120 non-relative healthy volunteers (60 males and 60 females) and 84 non-relative patients (39 males and 46 females) with diagnosis of cancer, attending the Hematology/Oncology ward in Ramsar Imam Sajjad Hospital between July 2016 and December 2017. Peripheral blood samples (3ml) were taken from the participants and stored at -20°C. The PCR-RFLP method was used to determine the distribution of CYP1A1 gene polymorphisms.

Among the two gene variants m1 and m2, individuals with AG and GG genotypes of CYP1A1 m2 polymorphism were found to have a significantly higher and increased risk for cancer (OR=3.94, 95%CI=2.05-7.57, P= 0.00, OR=9.46 , 95%CI=1.92-46.49, P= 0.00, respectively) and the TC genotype of CYP1A1 m1 polymorphism also had a significantly higher and increased risk for cancer (OR= 2.6 , 95% CI = 1.4-4.6, P=0.00). The ‘G’ allele was detected to have a strong association with cancer (P<0.001). The ‘C’ allele also showed strong association with the incidence of cancer (P<0.001). Thus, both CYP1A1 m1 and m2 polymorphisms showed an increased risk for cancer.

Our study suggested that the presence of ‘C’ allele of m1 polymorphism and ‘G’ allele of m2 polymorphism as the leading alleles that increase cancer susceptibility in the studied population

Background and Breast cancer is the most common type of cancer in women and the second cause of cancer death in Iran. Widespread use of mammography and sonography could increase survival in patients with early detection. Sensitivity and specificity of mammography and sonography are different in various sources. This study aimed at assessing the concordance of mammography-sonography reports with pathology reports in tumor size among patients with breast cancer. This research studied 100 women with pathologically proven invasive breast cancer attending Ramsar Imam Sadjad Hospital, 2016-2017. The concordance of mammography-sonography reports with pathology report was studied. Pearson correlation coefficient was applied to investigate the correlations. The mean age of the patients was 48±7.45. Most of them were married with history of labor and breastfeeding. Many patients had BMI>25. In most cases left breast and external upper quadrant were involved and most tumors had ductal pathology. The correlation coefficient between tumor size in mammography and pathology was 0.80 (p<0.0001) and between ultrasonography and pathology was 0.81 (p<0.0001). In most cases, tumor size in mammography and sonography was found to be similar to that reported by pathology. Compared to mammography, sonography was found to be more sensitive in measuring the tumor size which was also more concordant with pathology results.

The present research aimed at examining the comparison the effectiveness of imagery rescripting and reprocessing therapy and mindfulness-based stress reduction on insomnia and negative automatic thoughts in cancer women. This research method was semi experimental with pretest-posttest design. Using Kendal & Hollon`s negative automatic thoughts and Morien`s insomnia intensity questionnaires, 42 women of cancer who had negative automatic thoughts and insomnia were randomly selected and were voluntarily assigned in two experimental and one control group (each group was 14). The first experimental group received 7 sessions IRRT techniques based on the Smoker`s educational package (once a week) and the second experimental group received 8 sessions MBSR techniques based on the Kabat-Zinn’s educational package (once a week) and the control group did not receive any training in this field. After executing the IRRT and MBSR, negative automatic thoughts and insomnia of the members of the three groups were measured again. Multivariate covariance analysis (Man Cova) was used to analyze data. Calculated F for negative automatic thoughts and insomnia showed a significant difference in all three groups, also IRRT has also been more effective in reducing negative automatic thoughts than MBSR but these two therapeutic methods have no significant difference in insomnia. In general, this research indicated that the IRRT and MBSR method can be considered an effective intervention in reducing negative automatic thoughts and insomnia in women with cancer.

Background and Estrogen hormone is a physiological regulator of breast tissue proliferation and changes in its signaling pathways, including the alpha-estrogen receptor, occurs during breast cancer and its progression. Single-nucleotide polymorphisms (SNPs) in genes can lead to differences in cancer susceptibility and response to treatment in different populations. In the present study, we investigated rs2234693 C/T single-nucleotide polymorphism in ESRα gene in breast cancer patients and healthy population in west of Mazandaran province, Iran.
A case-control study was performed in 91 healthy women without family history of breast cancer and 71 women with breast cancer admitted to oncology department in Ramsar Imam Sajjad Hospital between April and September 2017. Peripheral blood (3 ml) was taken from the subjects and stored at -20°C. The PCR-RFLP method was used to determine the distribution of rs2234693 polymorphisms.
The incidence of breast cancer in individuals with homozygous TT genotype was significantly higher (p To the best of our knowledge, this study for the first time suggested that T allele of rs2234693 C/T polymorphism might be a leading allele that cause increased breast cancer susceptibility in west of Mazandaran province.

Breast cancer is the most common cancer and the second leading cause of cancer death among women, which is associated with age. Delay in the diagnosis and treatment of breast cancer can lead to disease progression, ultimately increase mortality and reduce survival rates in patients. The aim of this study was to evaluate the interval from the onset of the first sign of breast cancer to start of treatment in patients with breast cancer during 2009-2014. In this retrospective descriptive-analytic study, 100 women were selected using census method. Data were collected from the patients' medical records and documents using a checklist. Data were analyzed using SPSS 22 through descriptive (Mean and standard deviation, frequency) and analytical (Chi-square) tests. The significance level was considered p<0/05. Based on the results, the first sign was breast mass in 61% of the patients. In 39% of patients, the first physician to whom the patients referred was a general surgeon. In 71% of cases, the interval from the onset of the first sign to referral to the physician was less than 3 months and in 29% of patients was more than 3 months. Moreover, in 84% of patients, the time interval from referral to physician to diagnosis was less than 1 month. The interval from diagnosis to surgical treatment in 86 % and from final surgical treatments to chemotherapy in 87% of patients was less than 1 month. There was no statistically significant relationship between patients' demographic characteristics and patient and health care system delays (p> 0.05). Considering the 47% delay of patient in the referral process to the physician, it seems that women's education on breast cancer screening methods should be emphasized. In addition, due to the growing trend of age-related cancer, the special screening programs for women especially in elderly age should be developed and implemented.

The present research aimed at examining the effect of imagery rescripting and reprocessing therapy (IRRT) on negative automatic thoughts and dysfunctional attitudes of women with cancer. This research was semi-experimental with comparison design of unequal control group. Using Kendal and Hellonn`s (date?) Negative Automatic Thoughts and Weissmen & Beck`s Dysfunctional Attitudes Questionnaire, 28 women with cancer who had negative automatic thoughts and dysfunctional attitudes were randomly selected and were voluntarily assigned into experimental and control groups (14 person in each group). The experimental group received 8 sessions of IRRT techniques on basic Smoker`s educational package (one session weekly) and the control group did not receive any intervention. After the intervention of IRRT, negative automatic thoughts and dysfunctional attitudes of the members of both groups were measured again. MANCOVA was used to analyze the data. Calculated F for negative automatic thought and dysfunctional attitudes variables showed significant difference in both groups. Generally, this research in the agreement with other similar studies indicated that the IRRT method might be an effective intervention in decreasing negative automatic thoughts and dysfunctional attitudes of women with cancer.

Breast cancer is the most prevalent type of cancer among Iranian women as well as the most important cause of their death. Mastectomy can be associated with mood disorders such as depression. Given the significance of the issue, we addressed the prevalence of depression in patients with breast cancer undergoing mastectomy.
This cross-sectional study enrolled 100 patients with breast cancer undergoing mastectomy presenting to the oncology ward of Imam Sajjad Hospital in Ramsar and Tonekabon's Oncology Clinic in 2016. Convenience sampling technique was used. The data were collected using Beck Depression Inventory (BDI). Moreover, the data were analyzed in SPSS software version 24 using Chi-square, Fisher test and independent t-test. Furthermore, the significance level was set at less than 0.05.
The stage of breast cancer was reported as I in 10 (%10), II in 41 (%41), III in 32 (%32), and IV in 17 (%17) cases. The mean score of depression was 12.24 ± 10.127 in the patients. Depression scores were 0-13 in 56 patients (%56), 14-19 in 20 patients (%20), 20-28 in 18 patients (%18), and 29-63 in 6 patients (%6). Depression scores had no significant relationship with the type of mastectomy (P=0.664), staging (P=0.623), age (P=0.109), marital status (P=0.416), occupation (P=0.192) and financial support (P=0.121).
Our results revealed that about %45 of patients with breast cancer undergoing mastectomy experienced some degree of depression.

Methotrexate (MTX) is commonly used in the hematology-oncology units and is frequently associated with adverse effects. High-dose methotrexate (HDMTX) is indicated in the treatment of acute lymphoblastic leukemia (ALL), osteosarcoma, systemic non-Hodgkin lymphoma and primary central nervous system (CNS) lymphoma. The side effect profile of MTX varies markedly according to dose. The aim of this study was to evaluate the uses and adverse effects of HDMTX in a cancer center in north of Iran.
This cross-sectional descriptive study carried out in Emam Sajjad Hospital, Ramsar, Iran from June 2016 to July 2017. Doses more than 500 mg/m2 of MTX was considered as a high-dose. Hydration status, evaluation of the renal and hepatic function, blood tests, urine pH, doses and frequencies of leucovorin administration, measurement of serum levels of MTX and side effects were evaluated. Recommendations of UpToDate 2017 were considered as standards of administration of HDMTX.
Forty-four courses of HDMTX were evaluated in this study. HDMTX were prescribed for lymphoma (30 cases), ALL (8 cases) and osteosarcoma (6 cases). In all patients, hydration was done with 1340.9±894 normal saline plus 25 ml sodium bicarbonate 8.4%, one to two hours before HDMTX. The solution used for dilution of MTX was 5% dextrose (1022.7±105.5 ml). Urine pH was not measured in any patient. The frequency of leucovorin administration was 5.64±3.03 times with doses of 17.6±1.7 mg/m2 every 6 hours. Serum levels of MTX were not measured in any patient. Blood urea nitrogen and creatinine measurement was carried out before administration of HDMTX in all patients. The most common adverse effects were nausea (64.4%), anxiety (44%) and headache (43.2%).
The appropriate aspects of HDMTX usage were good hydration, urine alkalinization with bicarbonate and administration of leucovorin in patients receiving HDMTX, whereas monitoring of serum levels of MTX and administration of bicarbonate based on urinary pH were not done in any of the patients.

Candidiasis is a common fungal infection caused by various Candida species. Theproduction of extracellular enzymes, like proteinase, as a pathogenic factor plays a significant role inyeast adherence andpenetration to the host. Regarding this, the present study was conducted toevaluate the production of proteinase enzyme in cancer patients with oral candidiasis. A total of 20 oral swab specimens were collected from cancerous and noncancerous patients with oral candidiasis referring to the Oncology Center of Ramsar and Tonekabonhospitals, Iran, in 2014-2015. The samples obtained from the cancerous and non-cancerous patientswere assigned into the case and control groups, respectively. These specimens were cultured inSabouraud dextrose agar containing chloramphenicol. The yeast isolates were identified by means ofphenotypic method. The evaluation of proteinase enzyme activity was accomplished on a specificmedium. The diameter of the halo formed around each colony was also measured to determine therate of enzyme production. Out of the 20 samples, 19 (95%) and 6 (30%) Candida species were isolated from the caseand controlgroups, respectively. Candida albicans and Candida glabrata had the prevalence of 16(84%) and 3 (16%), respectively. In the control group, all isolated yeasts were identified as Candidaalbicans. The mean diameter of the halo around the yeast cells producing proteinase enzyme incancer patients with oral candidiasis was 2.21 mm in comparison to the non-cancerous group. Proteinase enzyme production as an important virulence factor leading to oralcandidiasis was significantly higher in the cancer patients than that in the non -cancer ones

Introduction Breast cancer is one of the most common cancers among women and is spreading with the highest rate in developing countries. The aim of this study was to evaluate serum levels of D-dimer in patients with breast cancer.
In this cross-sectional study, 100 the patients with the diagnosis of breast cancer who have been admitted at Imam Sajjad Hospital for further treatment were enrolled.
Results The average serum D-dimer in stage IV was 628±304, in stage III was 229±101 and in stage II was 180±29. In addition, the frequency of abnormal D-dimer was higher in patients at stage IV. The D-dimer level and the frequency of abnormal D-dimer level were higher in patients with lymph node involvement. Moreover, patients who had abnormal CEA and CA15-3 tumor markers had higher D-dimer level. We have also found serum D-dimer levels in patients 41-50 years old group was higher than other groups.
Conclusion In general, increase in serum D-dimer levels are associated with advanced disease stage, lymph node involvement, and worse prognosis and since the D-dimer is a safe, inexpensive, and available marker can be used to assess prognosis of disease and survival of the patients

Background and Considering the importance of pain management in cancer patients, this study aimed to assess the prevalence of pain, its severity, analgesics used to control pain, and the extent of pain control in cancer patients attending a medical center in North of Iran.
One hundred cancer patients attending Ramsar Imam Sajjad Hospital (2015) were prospectively enrolled in the study. Clinical and demographic data and all analgesics used were recorded. Pain intensity were determined based on the Numeric Rating Scale from 0 (pain-free) to 10 (the most severe pain ever experienced) in two sequential visits, 3 weeks apart.
The average age of participants was 54.7±3 years. NSAIDs (98 cases, 98%) and opioids (49 cases, 49%) were the most common analgesics prescribed. Among opioids, codeine (67.3%) and morphine (24.5%) were used more frequently. The pain score was 3.94±0.342 at first visit and 3.65±.316 following analgesic use (P=0.002). For opioid users, the pain scores were 4.29±0.53 and 3.84±0.506, respectively (P=0.007).
The pain scores statistically reduced, however, the decrease was not clinically prominent since the pain severity was between 3 and 4 in NRS scale. More attention to pain control is recommended in cancer patients while considering the standard pain management guidelines.

Considering the importance and incidence of hematologic malignancies and emphasis on chronic lymphoproliferative disorders, the aim of this study was to evaluate the epidemiology and clinicopathology of these hematologic malignancies. In this descriptive cross-sectional study, the information of the patients referred to Ramsar Imam Sajjad Hospital Oncology Clinic with final diagnosis of chronic lymphoproliferative was studied in 2009-2014, . To determine the type of chronic lymphoproliferative, Bone marrow aspiration , biopsy and flowcytometry were performed. Data were analyzed usin SPSS 20. The main complaints of 134 patients was: lymphadenopathy(41.8%), fever and infection (17%), and lethargy and weakness (3.7%). Most patients with chronic lymphoproliferative disorder had Hodgkin's lymphoma (41%), non-Hodgkin lymphoma (35%), Chronic lymphocytic leukemia (22.4) and Hairy cell leukemia (1.5%). Considering the difference in incidence of lymphoproliferative disorders in terms of age, sex, geographical area, and type of malignancy, and considering the valuable role of nurses in educational programs in the three levels of prevention, treatment and rehabilitation, and with regard to the frequency of this disease in Mazandaran, these results can help nurses and other people of the treatment team to familiar with the risk factors of the disease in educational programs to promote people's awareness about preventive strategies and appropriate measures in suspected cases

Gastric cancer is one of the most prevalent cancers of digestion system. Despite a decrease in incidence in recent decades, gastric cancer is still one of the most common causes of death worldwide. Many prognostic factors identified to affect the survival rate include age, depth of tumor invasion to gastric wall, grade, tumor diameter and regional lymph node involvement. In areas without screening for gastric cancer, diagnosis are late and have a high frequency of nodal involvement. It is important to evaluate LN status preoperatively for proper treatment strategy.
We reviewed 90 patients with gastric cancer who had gastrectomy over a 5-year period (2010-2015) using a retrospective study design.
Our study showed a high incidence of lymph node involvement in patients (73%) and most of them had N3 involvement. The study consisted of 65% male with ratio of 1.94:1 and ranged from 23-83 (mean age 63). Most patients were at grade III, stage IV, and most tumors had above 4cm in diameter and invasion to subserosa (T4). The most frequent clinical sign was epigastric pain, followed by loss of appetite and weight. The correlation between the lymph node status and other parameters showed that the maximum risk for nodal metastasis depend on tumor diameter and depth of invasion.
In this study high incidence of LN metastasis shows that gastric cancer diagnoses late in advanced stages because of lack of screening methods and knowledge about disease. Due to high frequency of disease in this area, it is necessary to have screening methods for earlier diagnose and increase the rate of 5-year survival.

Cancer is a devastating chronic disease that affects all aspects of life. Lifestyle is an important factor which is related with higher incidence of breast cancer, and it can be modified by education. Investigation of the role of lifestyle on the incidence of cancer in women needs special attention. This study aimed to assess the lifestyle in women with breast cancer. This was a descriptive study. The sample was 60 patients admitted in oncology ward of Imam Sajad Hospital, Ramsar for chemotherapy in 2015. Lifestyle in patients assessed by lifestyles questionnaire (LSQ). Data analyzed by descriptive statistics, Chi-square test and SPSS software. The lifestyle scores in five cases (8.33%) were undesirable, in 47 cases (78.33%) were relatively desirable, and eight cases (13.34%) had a desirable level of lifestyle. The chip-square test showed there was not significant relationship between the lifestyle and the elapsed time of cancer diagnosis, age, job, estrogen & progesterone receptor and menopause on subjects. (P>0.05) The relationship between lifestyle and education level, marital status, HER-2 oncogenes were significant (P Although our study results showed better lifestyle scores than previous studies, but they were significantly lower than ideal levels. With proper counseling and interventions (e.g. teaching relaxation techniques, appropriate physical activity, healthy diet, maintaining proper sleep patterns, and stress management) the lifestyle of patients can be promoted.

Background and Pancytopenia, is a great group of hematological diseases. Determining the etiology and pathology of the disease is of paramount importance for timely and proper treatment. This study aimed at investigating the clinical and hematological findings in patients with pancytopenia.
We conducted a cross-sectional study in which relevant information was extracted from 126 records of patients with pancytopenia in Ramsar Imam Sajjad Hospital and Sari Imam Khomeini Hospital in Mazandaran province, Iran (2009-2014). Data was analyzed in SPSS V. 21.
The patients were 56 females and 70 males. The study population included 60 patients in the center and 66 in the west of Mazandaran province. Preliminary clinical findings showed lymphadenopathy in 42 patients (33.3%), splenomegaly in 34 (26.9%), and hepatomegaly in 15 patients (11.9%) and there were 35 cases (27.7%) with no clinical findings. The causes of pancytopenia according to biopsy and aspiration results were megaloblastic anemia in 34 patients (27%), HL in 29 (23%), aplastic anemia in 15 (11.9%), NHL in 14 (11.1%), MDS in 13 (10.3%), normal biopsy in 10 (7.9%), Erythroid hyperplasia in 9 (7.1 %), and Hairy cell leukemia in 2 patients (1.6%).
The most common causes of pancytopenia in this study were lymphoma and megaloblastic anemia. Therefore, complete examination of patients with blood abnormalities is required for early treatment and reducing the mortality and morbidity rates.

Introduction and Aims: Bone metastases have bad potential effects on the individual life period. One of these complications is hypercalcemia that cause dizziness, nausea, constipation and azotemia. Pamidronate reduces skeletal complications in patients with bone metastases. This study evaluated effect of Pamidronate on hypercalcemia BUN and Cr in cancer patients.
In this quasi-experimental study, 41 patients with malignancy referring to Ramsar Imam Sajjad hospital were selected by convenience sampling. In this study 90 mg of Pamidronate was injected intravenously monthly for 3 months. Data collection was done through demographic and clinical data questionnaire and blood samples. Data of before and after intervention were compared. Statistical analysis was performed using paired t tests, chi-square, Friedman and Wilcoxon tests with SPSS v.11.5 and P The most common cancer was breast (43.9%) and bone metastasis point in most patients (65.9%) was diffuse. The results of this study indicated that there was significant difference between serum Ca (calcium) (P=0.015), BUN (Blood Urea Nitrogen) (P=0.031), ALKP (Alkalin Phosphatase) (P=0.002) before and after treatment, but there was no significant difference between Cr (Creatinine) concentration before and after treatment (P=0.41).
Pamidronate is effective in prevention of hypercalcemia and decrease BUN and Cr. So, it can be used as main and routine treatment.

Chronic lymphocytic leukemia(CLL) is a prevalent form of leukemia and it most frequently occurs in older adults. Leptomeningeal Involvement in chronic lymphocytic leukemia is very rare.The patient is a 79 year old man with a past history of controlled CLL which admitted 5 days ago with fever, shaking chills, vomiting, coma and neck stiffness. Evaluations for infectious meningitis were negative and he did not respond to antibiotics and antiviral medications. Intrathecal methotrexate caused improvement of clinical and cerebrospinal fluid abnormalities.Clinical manifestations of leukemic meningitis can mimic acute bacterial meningitis.

Background and Nausea and vomiting are amongst annoying side effects of chemotherapy in cancer treatment. Appropriate use of medications is important for prevention of chemotherapy-induced nausea and vomiting (CINV). In this regard, several guidelines have been proposed. The aim of this study was to investigate the adherence with National Comprehensive Cancer Network (NCCN) guidelines for control of CINV in Ramsar Emam Sajjad Hospital.
This concurrent observational study was carried out in 100 patients with cancer who were receiving either in-patient or outpatient chemotherapy. Relevant patients’ demographic data, chemotherapy regimens and antiemetics were collected. NCCN guideline version 2013 was used as criterion for appropriate treatment.
The mean age of patients was 55.72 ±16.67 years old in male and 50.75 ±13.52 years old in female. The most common types of cancers were breast (25%), colon (21%) and gastric (12%). The rate of adherence to the antiemetic NCCN guidelines according to the type of drug and dosage of prescriptions were 77% and 6%, respectively. The guidelines were fully executed only in 5% of the patients. Non-adherence was mostly due to the lack of aprepitant and failure to comply in doses.
This study demonstrated that in most cases the NCCN guidelines were not implemented. High cost of drug supply is believed to be a major cause of non-compliance with aprepitant usage.