dr. novin nikbakhsh

Primary hyperparathyroidism leads to increased secretion of parathyroid hormone and hypercalcemia. Parathyroid lesions are often in the form of adenoma, hyperplasia, and carcinoma. The aim of this study was to investigate clinical manifestations, pathological findings, and the response to the treatment in the patients with parathyroidectomy.

In this cross-sectional-analytical study (2002-2017),we extracted data from 37 records  of the patients who had undergone parathyroidectomy in the hospitals associated with Babol University of Medical Sciences. The data were about age, gender, pre-and post-operative values of laboratory indices, pathology of the lesions, and the surgical procedure. Using SPSS- 20 software, data were analyzed by, descriptive statistics, Fisher's exact and Wilcoxon's statistical tests (P<0.05).

The majority of patients were female (67.57 %) and the mean age was 47.13 ± 15.27 years. The disease with skeletal manifestations was more common (45.28%). Adenoma was the most common type of lesion in radiology (78.37 %) and pathology (63.41 %) and the predominant surgical method was unilateral exploration (64.86%). A statistically significant relationship was observed between the type of pathological lesion and the patient's age grou (p=0.037) and gender(p = 0.013). The success of parathyroidectomy surgery was evaluated as significant based on the pre- and post-operative values of calcium (P<0.001) and parathormone (P<0.001).

Primary hyperparathyroidism disease in Iran is a symptomatic disorder that most frequently manifests with bone symptoms, and parathyroidectomy surgery is the definitive treatment method. Improvement of bone symptoms, measurement of calcium, and parathormone can be considered indicators of improvement in these patients.

Laparoscopic cholecystectomy is one of the surgical procedures for cholecystectomy, which may be associated with difficulty and complications in people with high body mass index (BMI). In this study, we investigated the location of the portal infection following laparoscopic cholecystectomy and its association with BMI in hospitals affiliated with Babol University of Medical Sciences in 2012-2015.

In this cross-sectional analytical study, all patients who underwent laparoscopic cholecystectomy surgery (n=801) were included after obtaining informed consent. Demographic (e.g., gender, age, and BMI) and clinical (e.g., type of disease, number of gallstones, port site infection, and duration of surgery) information were evaluated.

Most patients were female (87%), with a mean age of 43.38 ± 14.23 years. The average BMI of the patients was reported as 31.72 ± 6.86 kg/m2; most of them were in the range of 30-39.9 (44.8%), and at least a few patients had a BMI greater than or equal to 40 (12.5%). The mean BMI of patients was 31.72 ± 6.86 kg/m2. The majority of patients had chronic cholecystitis (70.2%) and colic bilirubin (18.6%). The duration of surgery was 35.18 ± 10.59 minutes. Around 2% of the patients had an infection site of the port (1.2%), the cases of umbilical epigastric (0.5%), or both sites (0.2%). The BMI of patients with port umbilical infection was 41.48±3.45 and epigastric 30.38±5.87, and patients with port umbilical infection had significantly higher BMI than patients with epigastric infection (P<0.001). Individuals with a BMI higher than 30 were significantly more likely to have an umbilical portal infection (P<0.001).

According to the findings of this study, patients with an umbilical port site infection had a higher BMI.

One of the most important steps in the treatment of patients with mediastinal lymphadenopathy is the definitive diagnosis using tissue sampling of the intra-mediastinal lesion. Mediastinoscopy is one of the methods used for this purpose. In this regard, this study aims to investigate the role of mediastinoscopy in determining the cause of mediastinal lymphadenopathy in patients referred to Shahid Beheshti Hospital in Babol, Iran.

This cross-sectional study was conducted on 36 patients with mediastinal lymphadenopathy who were admitted to Shahid Beheshti Hospital in Babol (April 2009-March 2020) and underwent mediastinoscopy. Recorded medical information of all patients without known lung cancer under mediastinoscopy was reviewed. Mediastinoscopy was performed by a specialist doctor for all patients and the biopsy sample was sent to Shahid Beheshti Hospital Pathology for final diagnosis. Descriptive data were analyzed using SPSS25 software at a significance level of 0.05.

The mean age of the patients was 47.97±11.04 years (range: 28-76 years). The majority of patients were women (n=27; 75.00%). According to the pathology results, the final diagnosis for 33 people (91.67%) was benign, and 3 people (8.33%) were diagnosed with malignant. The most common pathology result was sarcoidosis with 23 cases (63.90%), active infection in 4 cases (11.11%), and squamous cell carcinoma in 3 cases (8.33%). Other benign results were reported with the frequency of one case (78.2%). Pathology findings had no significant relationship with the age and gender of patients (P<0.05).

Based on the findings of the study, it can be concluded that mediastinoscopy can help determine the causes of mediastinal lymphadenopathy and it is still a reliable method for examining mediastinal lesions.

 Breast cancer (BC), as a significant global health problem, is the most common cancer in women. Despite the importance of clinical cancer registries in improving the quality of cancer care and cancer research, there are few reports on them from low- and middle-income countries. We established a multicenter clinical breast cancer registry in Iran (CBCR-IR) to collect data on BC cases, the pattern of care, and the quality-of-care indicators in different hospitals across the country.

 We established a clinical cancer registry in 12 provinces of Iran. We defined the organizational structure, developed minimal data sets and data dictionaries, verified data sources and registration processes, and developed the necessary registry software. During this registry, we studied the clinical characteristics and outcomes of patients with cancer who were admitted from 2014 onwards.

 We registered 13086 BC cases (7874 eligible cases) between 1.1.2014 and 1.1.2022. Core needle biopsy from the tumor (61.25%) and diagnostic mammography (68.78%) were the two most commonly used diagnostic methods. Stage distribution was 2.03% carcinoma in situ, 12% stage I, 44.65% stage II, 21.32% stage III, and 4.61% stage IV; stage information was missing in 1532 patients (19.46%). Surgery (95.01%) and chemotherapy (79.65%) were the most common treatments for all patients.

 The information provided by this registry can be used to evaluate and improve the quality of care for BC patients. It will be scaled up to the national level as an important resource for measuring quality of care and conducting clinical cancer research in Iran.

Unlike some regions of the world where digestive system cancers are not considered as important health problems, these neoplasms are among the most common malignancies in the northern region of Iran.

This observational analytical study was carried out based on data collected by the Cancer Registration Center affiliated to the Vice Chancellery for Health of Babol University of Medical Sciences, North of Iran, during 2008-2017. Crude incidence rate (CR), and age-standardized incidence rate (ASR) have been calculated for different GI cancers, based on the primary involved site; and have been compared in different years, patients' age, gender and place of residence.

Totally, 4332 records were related to digestive system cancers. Mean age of patients was 63.48±14.73 years; men (2743; 63.3%) were more affected than women (1589; 36.7%) (p<0.001). The most incident malignancies of digestive system were from stomach, colorectal and esophagus in men; and colorectal, stomach and esophagus in women, respectively. These three cancers accounted for 3725 (85.98%) of total GI malignancies. The mean age of patients in various types of GI cancers was statistically different (p<0.001). Age- standardized incidence rate showed different values in different years; from 521.40 (95% CI: 462.79-580.00) in year 2016 to 1834.33 (95% CI: 1637.36-2031.29) in year 2008.

Gastric, esophageal and colorectal cancers were the most prevalent digestive system malignancies in Babol, North of Iran, and accounted for about 86% of all GI tract cancers. A considerable variation has been found in incident gastrointestinal cancers in different years.

Pain, anxiety, and depression are common but often neglected problems in patients with cancer.

Considering the importance and impact of anxiety and depression as common psychiatric symptoms in people with cancer, the present study aimed to assess the effectiveness of escitalopram in the reduction of pain, anxiety, and depression in patients with breast cancer.

This single-blind controlled trial was conducted on 32 patients diagnosed with breast cancer who were referred for modified radical mastectomy (2018-2019). The intervention group received daily oral capsules containing 10 milligrams of escitalopram for four weeks, while the control group received placebo capsules containing starch on a daily basis. Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale were administered to the patients at the commencement of the study and four weeks after the intervention. In addition, at baseline examination, personality factors were assessed by the NEO Five-Factor Inventory-3 questionnaire.

Based on the results, the scores of HADS anxiety, total HADS, and pain reduced after the intervention in the case group; however, the HADS depression score demonstrated a slight increase. A significant difference was observed between the case and control groups for HADS anxiety score after the intervention (P=0.01). The correlation of personality characteristics with HADS anxiety and depression subscales pointed out a significant negative correlation between the HADS depression score and conscientiousness (r=-0.40; P<0.05).

Due to minor side effects of escitalopram, this drug is suggested to be used for the reduction of anxiety symptoms and pain intensity in patients with breast cancer.

Percutaneous dilatational tracheostomy (PDT) is a common surgical procedure in the ICU. The present study was conducted to compare semi-surgical percutaneous dilatational tracheostomy (SSPDT) with conventional percutaneous dilatational tracheostomy (CPDT).

The present randomized clinical trial was conducted on 160 patients hospitalized in the medical intensive care units (ICUs) with an indication for tracheostomy and were systematically divided into two equal groups of 80. In the CPDT group, after a small incision, a 16-gauge needle was blindly inserted into the trachea and the guidewire was placed inside the lumen. A stoma was created by passing a single dilator over the guidewire. In the SSPDT group, a transverse incision (2 cm) was made 1 cm below the cricoid, and the tracheal ring was then fully reached by releasing the subcutaneous tissues using the index figure, and PDT was then performed. The two groups were compared in terms of their tracheostomy complications (including bleeding, pneumothorax, stoma infection and accidental decannulation) and duration of the procedure.

The two groups were homogeneous in terms of age, gender, mean APACHE score (P>0.05). There were no significant differences between the two groups in terms of the mean time from tracheal intubation to tracheostomy (P=0.869). The duration of the procedure was 5.16±1.72 minutes in the SSPDT group and 6.42±1.71 in the CPDT group (P<0.001). The complication rate was 7(8.75%) in the SSPDT group and 16(20%) in the CPDT group (P=0.043).

SSPDT is safer and has fewer complications than CPDT in ICU patients.

Gastric cancer is among the most common cancers worldwide that currently lacks effective diagnostic biomarkers and therapeutic targets. Next-generation RNA sequencing is a powerful tool that allows rapid and accurate transcriptome-wide profiling to detect differentially expressed transcripts involved in normal biological and pathological processes. Given the function of this technique, it has the potential to identify new molecular targets for the early diagnosis of disease, particularly in gastric adenocarcinoma.

In this study, whole-transcriptome analysis was performed with RNA sequencing on tumoral and non-tumoral tissue samples from patients with early-stage gastric cancer. Gene ontology and pathway enrichment analysis were used to determine the main function of the specific genes and pathways present in tissue samples.

Analysis of the differentially expressed genes revealed 5 upregulated and 234 downregulated genes in gastric cancer tissues. Pathway enrichment analysis revealed significantly dysregulated signalling pathways, including those involved in gastric acid secretion, drug metabolism and transporters, molecular toxicology, O-linked glycosylation of mucins, immunotoxicity, metabolism of xenobiotics by cytochrome P450, and glycosylation. We also found novel downregulated non-coding RNAs present in gastric cancer tissues, including GATA6 antisense RNA 1, antisense to LYZ, antisense P4HB, overlapping ACER2, long intergenic non-protein coding RNA 2688 (LINC02688) and uncharacterized LOC25845 (PP7080).

The transcriptomic data found in this study illustrates the power of RNA-sequencing in discovering novel genes ‎and tumorigenic pathways involved in human carcinogenesis. The anomalies present in these genes may serve as promising tools for the development of accurate diagnostic biomarkers for the detection of early-stage gastric cancer.

Mucinous cystadenocarcinoma is a relatively uncommon histological subtype of breast cancer that is a cystic form of papillary mucinous carcinoma.  It is regularly negative for estrogen and progesterone receptors and it is most often diagnosed in older than 55-60 years old. The incidence of breast mucinous cystadenocarcinoma is about 1-6% of primary breast cancers. Here, we present a case of breast mucinous cystadenocarcinoma of left breast in a 69-year-old female which is positive for estrogen and progesterone receptors.

In this article, we describe a case of a-69-year-old female with a painful mass in her left breast. Based on intraoperative pathology consult, neoplastic tissue mostly floating in mucinous lakes with invasion to surrounding stroma was seen. Immunohistochemistry profile showed positive estrogen and progesterone receptors and negative for HER2.

Mucinous cystadenocarcinoma of breast is typically triple negative for hormone receptors. But ER and PR positive variant of this tumor is rare, giving the chance of a better prognosis for the patient with hormonal therapy.

Rigid bronchoscopy is often used to diagnose and treat the location of resection of the tracheal stenosis. It is a selective procedure for the dilatation of tracheal stenosis, especially when accompanied by respiratory distress.

We introduced patients who were diagnosed with tracheal stenosis and candidate for rigid bronchoscopy dilatation by the upper airway nerve blocks.

This prospective observational study was conducted on 17 patients who underwent dilatation with rigid bronchoscopy in tracheal stenosis at Hospitals affiliated with Babol University of Medical Sciences from 2002 to 2017. The patients were given three nerve blocks, 6 bilateral superior laryngeal nerve block, bilateral glossopharyngeal nerve block, and recurrent laryngeal nerve block (transtracheal) before awake rigid bronchoscopy using 2% lidocaine. We evaluated the demographic data, the cause of tracheal stenosis, the quality of the airway nerve block (Intubation score), patients’ satisfaction from bronchoscopy and thoracic surgeons’ satisfaction. Complications of nerve blocks were recorded.

From 2002 to 2017, 17 patients (14 were male and 3 were) female with tracheal stenosis who were candidates for dilatation with bronchoscopy and accepted the upper nerve block were included. The quality of the block was acceptable in 16 (94%) patients. 15 patients received fentanyl, and only two patients did not need to intravenous sedation. The mean age of patients was 29.59 ± 11.59. The average satisfaction of the surgeon was 8.82 ± 1.13 and the satisfaction of patients with anesthesia was 8.89 ± 1.16. There was one serious complication (laryngospasm) in one patient.

The upper airway nerve block method is a suitable anesthesia technique for patients with tracheal stenosis who are candidates for the tracheal dilatation with rigid bronoscopy, especially when the patient has respiratory distress and has not been evaluated before surgery.

This study was conducted to evaluate the ability and knowledge of using information technology and its relationship with research and innovative performance of facultymembers of BabolUniversityofMedical Sciences.-The statistical population of the faculty members of BabolUniversityof-Medical Sciences was347,and 180 people were selected by stratified Cochran's formula using stratified random sampling. Data collection was performed by researching letters made by a researcher measuring the ability and knowledge of using technology with15 questions,measuring innovative performance with 8 questions and measuring research performance with13questions.Formal and content validity was confirmed by experts.Cronbach's alpha for the ability and knowledge of using information technology(0.86),research performance(0.84) ,innovative performance(0.77). Data analysis was performed by regression analysis tests,YumanWhitney, Croscal Wallis, by Spss24 software.The results showed that there was a significant relationship between the ability and knowledge of using information technology with research performance and innovative performance of faculty members.The ability and knowledge to use the information technology of faculty members and their research performance is in a relatively-desirable situation and innovative performance in an unfavorable situation.Increasing efforts by medical education policymakers and government officials are needed to create more opportunities for education and to persuade faculty members to use information and communication technology in academic activities and to discuss current technological situations.

Breast cancer is one of the most frequent women malignancies in the world. The cytochrome P450 1A1 (CYP1A1) is a key enzyme in xenobiotics metabolism. Moreover, CYP1A1 plays a critical role in the etiology of breast cancer by involving in 2‑hydroxylation of estrogen. Therefore, single‑nucleotide polymorphisms (SNPs) of its coding gene have been verifed to be important in cancer susceptibility. The aim of the study was to evaluate the association of CYP1A1 M2 (A2455G) includes rs1048943 of this SNP polymorphism with the risk of breast cancer in Mazandaran province. Ninety‑six breast cancer patients with known clinicopathological
characters and 110 healthy women as control were genotyped for CYP1A1 M2 polymorphisms by the restriction fragment length polymorphism technique. The analysis of CYP1A1 gene (polymorphism M2) showed that the frequency of homozygous wild genotypes (AA), heterozygous (AG), and mutant genotype (GG) in the patient group, respectively, 78%, 22%, and 0%, and also the frequency of genotypes AA, AG, and GG in healthy included 82%, 16%, and 2%, respectively. Statistical analysis by Logistic regression model at P < 0.05 showed no
signifcant correlation between polymorphisms in CYP1A1M2 and breast cancer risk (odds ratio = 0.84, confdence interval = 0.33–2.17). The results indicated that the M2 allelic genotypes were signifcantly associated neither with breast cancer risk nor with clinicopathological characteristics in Mazandaran province.

this study aimed to determine the diagnostic value of frozen tissue sections in comparison with definitive pathology in terms of its reliability in the diagnosis of breast and thyroid lesions in patients referring to educational hospitals of Babol University of Medical Sciences from 2011-2016.

all patients who underwent thyroidectomy or breast surgery due to a mass that frozen sections was performed were included. Patients demographic characteristics, frozen section diagnosis and Permanent pathology diagnoses were collected and analized.

Of 137 cases(104 cases of thyroid and 33 cases of breast)  who required frozen section,totally, 91 cases (66.4%) were reported benign lesions and 46 cases (33.6%) were reported malignant. Also, based on a permanent diagnosis, 52 cases (38.0%) were malignant and 85 (62.0%) were benign.The diagnostic value of the frozen section in detecting malignant thyroid lesions was 63% sensitivity, specificity was 99%, the positive predictive value was 92%, negative predictive value was 92%, and diagnostic accuracy was 92.3%. In cases of breast, the result of frozen tissue sections is consistent with permanent pathology, therefore, the diagnostic value of frozen tissue sections in determining the malignant lesions of the breast can not be calculated.

Considering the high rate of consistency of frozen sections with permanent pathology in breast and thyroid lesions, it can be concluded that the frozen tissue section is considered as a precise and valuable method.

Depression is a common psychiatric disorder in patients with breast cancer. This study was performed to follow-up breast cancer patients with depression receiving citalopram and group psychotherapy for six months. This clinical trial was conducted in 40 breast cancer patients with depressive disorder. Among the patients, 20 received citalopram (20-40 mg/day) and the rest, besides the same dose of citalopram, attended 8 sessions of group psychotherapy. The patients were assessed at baseline and six months later. Hospital Anxiety and Depression Scale (HADS) and WHO-QOL BREF questionnaires were administered. Then treatment outcomes and quality of life were compared between the two groups applying t-test. The mean scores for depression and anxiety were 12.05±2.19 and 13.25±2.90 at baseline which declined to 2.05±2.06 and 4.55±2.42, respectively, after six months (P<0.05). Quality of life score in patients attending group psychotherapy sessions improved significantly after six months (80.86) compared to that at baseline (40.82), while slight changes were observed in the group receiving only citalopram (P<0.001). Citalopram and group psychotherapy were found to be significantly effective after six months on depression, anxiety, and quality of life in breast cancer patients with depressive disorder receiving citalopram.
(Clinical Trials Registry Number: IRCT2015063022991N1)

Percutaneous dilatational tracheostomy is widely accepted in many Intensive Care Units (ICU) in the word. The aim of this study was to compare the complications of Modified Percutaneous Dilatational Tracheostomy (MPDT) with or without bronchoscopy. A randomized clinical trial was performed in 270 ICU patients, candidate for tracheostomy in Babol Rouhani Hospital, between April 2013 and May 2018. They were systematically divided into two groups. MPDT was carried out in both groups. At first, the transverse section (2 cm) was given 1 cm below the cricoid cartilage, then PDT was performed after seeing the trachea ring. In the first group, PDT was performed without a bronchoscope and in the second group the PDT was done applying bronchoscopic guide. The procedure time, waiting time to tracheostomy, complications such as hemorrhage, stomal infection, and pneumothorax were compared in two groups. Data were analyzed in SPSS V22 using Chi-square, independent sample, and Fisher exact test. There were no differences between the two groups in age, sex, mean apache score, and mortality (P> 0.05). The mean waiting time to tracheostomy was not significantly different (P= 0.632). The procedure time in the PDT without bronchoscopy was 6.44 ± 3.54 min and in the PDT with bronchoscopy was 9.25 ± 3.30 min (P<0.001). The complication rate in the PDT without bronchoscopy was 14 (10.4%) and in the bronchoscopy group was 12 (8.9%) (P= 0.680). Modified PDT without bronchoscopy is as safe as PDT with bronchoscope.

Since esophageal cancer is highly prevalent, and has a high cost for patients and society, this study aimed to investigate the result of surgery in esophageal cancer with esophagogastrostomy method to lower the problems of these patients.

In this cross-sectional study, all patients who were diagnosed with esophageal and upper gastric cancer with surgical indications during 2004 to 2011 in Shahid Beheshti hospital, Babol City, Iran, participated. Patients then underwent esophagogastrostomy surgery. Patients’ data were gathered using a survey and analyzed using t and chi-square tests via SPSS software. A P-value of less than 0.05 was deemed statistically significant.

A total of 47 patients who were confirmed as having esophageal cancer by pathologic evaluation, were investigated. A significant relationship was observed between body mass index and complications after surgery (P = 0.04). 57.1% of underweight patients and 100% of obese patients experienced complications. No significant relationship was seen in other factors. The average age of patients who experienced complications was higher than those who reported no complications, and the difference was statistically significant (P = 0.03). Moreover, the duration of surgery was significantly higher in patients with complications (P = 0.01).

It would seem that complications after surgery were higher in underweight patients and the duration of surgery was higher in these patients. No significant relationship was seen in other factors.

Depression is a common psychiatric disorder in breast cancer patients. This study was designed to evaluate the clinical efficacy of group psychotherapy on breast cancer patients with depressive disorder who took citalopram. This clinical trial was conducted on 40 breast cancer patients with depressive disorder. The control group received citalopram 20-40 mg/ day for 12 weeks and the intervention group participated in 8 sessions of group psychotherapy in addition to the same dose of citalopram. At the baseline and 3, 6, and 12 weeks after treatment, patients were followed- up. Treatment outcomes and quality of life were compared between the 2 groups. Overall, the depression score of Hospital Anxiety and Depression Scale (HADS) at baseline with the mean of 11.6±1.6 was signed in the range of clinical depression and after intervention it declined to 8.8±3.6 (in the 3rd week), 7.1±3.9 (6th week), and 5.9±4.5 (12th week). Furthermore, HADS anxiety score at baseline with the mean of 12.6±2.6 was signed in the range of clinical anxiety and after intervention it declined to 9.1±3.0, 7.3±4.1, and 6.0±4.0, respectively. This improvement was significantly more in the combined therapy intervention group (p<0.001). The mean score of quality of life based on WHO QOL-BREF questionnaire increased by 1.85 fold in the case group, improved from 44.09 to 81.70, while the slight change was observed in the control group (p<0.001). During the treatment, no significant adverse drug event was observed in the 2 groups (p>0.05). Group psychotherapy has a significant effect on improving depression, anxiety, and quality of life in breast cancer patients

Breast cancer is the most prevalent malignancy in women throughout the world. Similar to other cancers, a strong relationship between breast cancer and environmental factors such as infectious agents has been reported. Toxoplasma gondii is a protozoan parasite which may play a role in cancer induction. The present study aimed to investigate a possible association between a history of T. gondii infection and breast cancer by detecting T. gondii DNA in malignant and non-malignant breast and lymph nodes tissues from breast cancer patients with latent toxoplasmosis. Formalin-fixed, paraffin-embedded (FFPE) tissue blocks from malignant/non-malignant breast and lymph nodes were obtained from twenty-nine breast cancer patients who were positive for anti-Toxoplasma antibodies (IgG). FFPE tissue blocks were deparaffinized by hot water method, and DNA was extracted. A conventional PCR analysis was performed to amplify partial regions of T. gondii B1 and REP-529 genes. Ninety-three samples from 29 patients were examined. All patients were negative for anti-T. gondii antibodies (IgM). T. gondii DNA was detected in 3 (10.3%) patients by PCR analysis of either B1 or REP-529 genes. These include two malignant breast and one normal lymph node samples. Sequence analysis of these genes showed a good similarity with previously published B1 and REP-529 sequences of T. gondii in NCBI GenBank. This study did not find any association between T. gondii infection and breast cancer. Furthermore, it is the first molecular identification of T. gondii in FFPE tissue samples obtained from breast cancer patients.

Fine needle aspiration (FNA) is the most important method in the diagnosis of thyroid nodules before surgery. Recently, the efficiency of FNA in thyroid nodule management has been debatable. On the other hand, intraoperative frozen section (FS) has been used to confirm the diagnosis of FNA and select the proper surgical approach. In this regard, the present study aimed to assess the diagnostic value of FNA as compared to FS in the diagnosis of thyroid nodules.
This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other.
This retrospective study was performed on 69 patients with FNA and FS and histopathological examination from 1993 to 2014 in Babol, northern Iran. FNA was classified into 5 groups: benign (colloid goiter), lymphocytic thyroiditis, follicular lesions, suspicious and malignant, and FS was classified as after benign or malignant. The results of both methods were compared with each other.
FNA was considered as a simple, less invasive and cost effective method with fewer side effects for evaluation of thyroid nodules. Particulary it had a high sensitivity and specificity in experienced and skilled hands.

Cytochrome P450 2E1 (CYP2E1) enzyme metabolically activates a large number of low molecular mass xenobiotics probably involved in gastric cancer incidence through activation of procarcinogens. North of Iran is amongst high incidence rate areas of gastric carcinoma where environmental carcinogenic compounds, including agricultural pesticides, are massively used. In this report, we quantitatively compared CYP2E1 gene expression between tumoral and nontumoral-marginal tissues of gastric cancer patients as well as normal healthy gastric tissues by real-time PCR. Results showed that CYP2E1 gene cDNA copy numbers were relatively increased in tumoral group vs. nontumoral-marginal and normal healthy groups. Comparison of means DDCT by Dunkan’s test statistically verified significant differences of cyp2E1 cDNA copy numbers between tumoral and healthy tissues (P=0.0018). It seems that the increased CYP2E1 gene expression may be associated with increased risk for gastric cancer. So, we recommended that CYP2E1 gene expression may be an appropriate molecular marker to determine individual sensitivity to gastric cancer and also for designing cancer prevention programs.

In evolution and innovation program of medical education which has been announced to the medical universities of the country since 2015, as a part of the health sector reform in IRAN, promoting professionalism is one of the emphasized subjects. This study aimed to evaluate activities conducted in this university to promote professionalism. In this descriptive research, all activities performed in Babol University of Medical Sciences in the years 2015 and 2016 in order to achieve the objectives of professionalism were recorded in a data collection form. The subject, target group, the extent of each activity, and outcomes were recorded and compared with data related to years before 2015. Totally, 19 major activities have been recorded to promote professionalism in this university in these two years. Sixteen activities (84.2%) have been implemented after medical education reform of IRAN. The extent of activities was calculated as 10088 person-hour and most of these major activities (12 activities, 63.2%) was attributed to achieve the objective of "implementation structural and program requirements, an organized system for need assessment, pathology and improvement of the values of ethics and professionalism". After implementation of medical education reform in IRAN, Babol University of Medical Sciences has adopted multiple new activities to promote professionalism in this university.

Appendectomy intra-abdominal is the most frequently performed emergency surgery. This study was conducted to determine the role of postoperative antibiotics in reducing surgical site infections (SSIs) and abscess formation after open appendectomy.
In the Department of Surgery, Shahid Beheshti Hospital, Babol, Iran, from October 2013 to October 2014 one hundred and fifty two patients, who underwent appendectomy for nonperforated appendicitis (NPA) and fulfilled the selection criteria, were randomized into two groups. Group A patients received a single dose of preoperative antibiotics (ceftriaxone and metronidazole) and group B patients received the same regimen, in addition, antibiotics were administered 24 hours postoperatively. Patients of both groups were followed-up for 30 days to assess the postoperative infectious complications.
Both groups comprised 76 patients, as well both groups were compared in baseline characteristics. Statistically, there was no significant difference in rates of SSIs between both groups. None of the patients developed intra-abdominal collection.
Single dose of preoperative antibiotics (ceftriaxone and metronidazole) was sufficient in reducing SSIs after appendectomy for NPA. Postoperative antibiotics did not add an appreciable clinical benefit in these patients.

North of Iran is amongst high incidence rate areas of gastric carcinoma where environmental carcinogenic compounds especially agricultural pesticides are massively used. Cytochrome P450 2E1 (CYP2E1) enzyme metabolically activates a large number of low molecular mass xenobiotics. The polymorphic nature of cyp2E1 gene control elements is associated with interindividual differences for toxicity of its substrates and may be responsible for increased gastric cancer susceptibility. The current study investigated the allelic frequencies of cyp2E1 gene RsaI/PstI polymorphisms and its association with gastric cancer risk in north of Iran.
This case-control study comprised of 120 gastric cancer patients and a group of 135 healthy individuals as control. Genotyping of cyp2E1 gene PstI/RsaI polymorphisms were carried out by PCR-RFLP method. Statistical analyzes were performed by Logistic regression model and P TNM classification showed that most patients (88%) were in advanced stages when the disease was diagnosed. Frequencies of C1C1 and C1C2 genotypes of PstI/RsaI polymorphisms were 96 and 4% in case, and 99 and 1% in control group, respectively whereas homozygote C2C2 genotype was not observed in any of the subjects. In Logistic regression model no significant association was found between RsaI/PstI allelic variants and gastric cancer risk (p =0.443, OR=0.386, CI=0.034-4.395). Furthermore, no significant correlation was seen between genotypic frequencies and clinicopathological characteristics.
No significant association was found between cyp2E1 gene PstI/RsaI allelic variants and gastric cancer risk or clinicopathological characteristics of gastric cancer patients in north of Iran.

Chylothorax results from leakage of lymph in the pleural cavity because of thoracic duct injury which is associated with severe metabolic disorders. The aim of this study was to evaluate the rate of chylothorax and its causes among hospitalized patients in Shahid Beheshti Hospital of Babol city, North of Iran.
In this cross-sectional study, all patients with chylothorax admitted to the surgery department of Shahid Beheshti Hospital during 2002-2015 were included. Information including gender, age, duration of symptoms, laboratory findings, causes of disease and the type of treatment were extracted from the patient's records.
Of the 42 patients, 27 (64.3%) were men and 15 (35.7%) were women. The mean age of the study population was 51.03±16.95. The most common clinical symptoms were dyspnea (66.7%) and dyspnea with cough (21.4%), respectively. In all patients, the pleural fluid triglyceride level was greater than 110 mg/dl, whereas the presence of lymphatic in pleural fluid was eventful in 18 (42.8%) patients. The causes of the disease were traumatic (54.8%), non-traumatic (38.1%) and unknown (7.1%), which were not significantly correlated with gender. Nineteen (45.2%) patients were operated, 16 (38.1%) patients received supportive therapy, and 7 (16.7%) patients had the treatment of the underlying conditions and then supportive therapy.
According to the results, trauma was the most common cause of chylothorax. Therefore, identification and control of the traumatic factors seem to be the steps to prevent and reduce the chylothorax incidence and its complications.

Mammographic screening to diagnose the breast cancer showe false-negative and false-positive results in young women and therefore a non-invasive and low cost method is needed, to diagnose the breast cancer in the early stages. DNA methylation changes are the most common molecular changes in human cancers and including breast cancer. Therefore, The pattern of tissues methylation can be used in the early diagnosis of cancer. Also similar methylation patterns found in tumors and in plasma shows potential application of molecular detection of breast cancer, based on blood. The aim of this study was to assess the promoter methylation for the clinical diagnosis of breast cancer.
Material and To examine the promoter methylation 21 tumor tissues and 21 normal tissues have been studied for clinical diagnosis of breast cancer. 6 gene methylation status (NANOG1, RASSF1A, SFN, CASP8, WIF1 and CTSL2) was analyzed by methylation specific PCR (MS-PCR).
The results show that NANOG gene was methylated in 94.7% of tumor specimen and 100% of normal specimen, RASSF1A gene was methylated in 9.5% of tumor specimen and 0% of normal specimen, SFN gene was methylated in 14.3% of tumor specimen and 27.8% of normal specimen, CASP8 gene was methylated in 30% of tumor specimen and 23.5% of normal specimen, WIF1 gene was methylated in 80% of tumor specimen and 27.8% of normal specimen, CTSL2 gene was methylated in 28.6% of tumor specimen and 23.5 % of normal specimen were methylated. Data analysis did not show a significant relationship between these results. (P >0.05).
The results of this study demonstrate that 6 gene methylation status was not enough to differentiate between the cancer and normal groups. This study demonstrates the methodological problems (MS PCR) which was used to assess the methylation markers to evaluate the methylation status as diagnostic biomarkers.