Journals Portal, Shahid Beheshti University of Medical Sciences
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Ripped from The Cradle: Neonatal Gastric Perforation - A 10-Year Review of a Devastating Condition
Full text linkIntroduction:
Neonatal gastric perforation(NGP) is a rare but life threatening condition affecting the neonates. The exact mechanism of NGP is poorly understood but its often associated with preterm birth, hypoxia and sepsis. But spontaneous cases of NGP are unpredictable resulting in complicated diagnosis and management. In the present study we elucidate the risk factors, clinical findings,management strategies and the outcomes in patients restrospectively over a period of 10 years
Materials and methods:
A retrospective study of all the patients presenting with NGP was conducted over a period 10 years from march 2013 to march 2023 at our institution and a complete data of 87 of these patients were accrued and analysed. A compete demographic data, preoperative chateristics, clinical presentation,intraoperative characteristics, clinical outcomes and postoperative complications were recorded and analysed. Besides comparison was made between the surviving and non-surviving neonates to elucidate the risk factors in morality.
Results :
A total of 87 cases of neonatal gastric perforation were included in our study. The majority of NGP patients were male (73.56%, M:F = 2.78:1), preterm (59.77%), and of low birth weight (51.72%). Common clinical presentations included abdominal distension (88.5%), vomiting (71.26%), and respiratory distress (57.47%). Key laboratory findings included mean hemoglobin of 15.84 ± 1.2 g/dl, leucocyte count of 18.71 ± 4.12 × 10³/µl, and serum pH of 7.26 ± 0.14. Radiological findings prominently showed the "football sign" (93.1%) and gas under the diaphragm (74.71%). Gastric perforations predominantly involved the greater curvature (36.78%) and were mostly single (82.75%) and small (<5 cm, 65%). Spontaneous perforation was the most common cause (65%), followed by trauma (21%) and necrotizing enterocolitis (NEC, 10%). Surgical management included gastric repair with peritoneal lavage and venting gastrostomy. Postoperative complications included respiratory issues (74 cases), sepsis (54 cases), and wound infections (25 cases). Neonatal mortality was 42.53%, with significant predictors including male sex(p value=0.004), prematurity(p value=0.002, low birth weight(p<0.001), thrombocytopenia(p value<0.001), high CRP levels(p value<0.001) acidosis(p value<0.001), and elevated lactate levels(p<0.001).
Conclusion:
Neonatal gastric perforation presents a substantial risk of mortality, particularly among male, preterm, and low birth weight infants. Early recognition of clinical signs, prompt surgical intervention, and vigilant postoperative care are crucial to improving survival rates. Monitoring laboratory indicators such as platelet counts, CRP levels, pH, and lactate levels can aid in assessing prognosis and guiding treatment strategies
Pediatric Minimally Invasive Open Cholecystectomy : A New Approach Involving 27 Cases
Full text linkAbstractPurposeThis study introduces a compelling alternative to traditional pediatric laparoscopic cholecystectomy.MethodWe conducted a three-year prospective study from 2020 to 2022 in two different centers. This preliminary descriptive and analytic study included a randomized trial and statistical analysis to determine whether Minimally Invasive Open Cholecystectomy (MIOC) is comparable to laparoscopic surgery, using the Pearson coefficient test with significance set at better than 1%. Children were randomly selected and the “open” cholecystectomy was performed by the same pediatric surgeon for all cases. We conducted tracking and tracing to identify the gallbladder's projection on the abdominal skin. Our surgical procedure involved tracking and tracing to identify the gallbladder’s projection on the abdominal skin, followed by retrograde dissection towards gallbladder’s neck, with cholecystectomy either anterograde or retrograde.ResultsTwenty-seven children aged from zero to fifteen were recorded (19 cases at ARCH and 8 cases at IPGH) among 1,965 treated in the two departments during the study, resulting in an incidence rate of 0.0137. The average age of the children was three years, with a range from eighteen months to eleven years. The most represented age group was six to eight years old. Our series included 15 boys and 12 girls, giving a sex ratio of 1.25. The most common reason for surgery was cholelithiasis, accounting for 74.1% of the cases. The mean operating time was 65 minutes (range 50-92 minutes), and celiotomy length varied from 20 to 28 mm. Anterograde cholecystectomy was performed in 92.6% of cases, with bile drainage needed in two patients (7%). The median follow-up period was 24 months, and all patients experienced good postoperative results. The minor complications were infection and jaundice. The average length of hospital stay was 3 days (range 2-6 days). There was a positive correlation between cosmetic and functional outcomes for open surgery (P=0.3). Conclusion : the authors present an effective minimally invasive open cholecystectomy.Keywords: Minimally invasive surgery; Pediatric mini-laparotomy; Cholelithiasis; Cholecystectomy
An Exophytic Mass of the Lower Labial Mucosa: An Exophytic Mass of the Lower Labial Mucosa
No full textLichenoid and Granulomatous Stomatitis Diagnosis and Treatment: Report of Three Cases
Full text linkObjective(s): Lichenoid and granulomatous stomatitis (LGS) is a rare inflammatory condition of the oral mucosa that clinically mimics oral lichen planus, posing diagnostic and therapeutic challenges. Case: This report described three cases of LGS in adults aged 55–63, each presenting with persistent burning sensations and chronic ulcers of the upper labial mucosa. Histopathologic evaluation in all cases revealed features consistent with lichenoid and granulomatous inflammation. Despite initial misdiagnosis and ineffective corticosteroid treatment, all patients showed marked improvement with chlorhexidine mouthwash. Conclusion: Accurate diagnosis of LGS is essential due to its resistance to standard corticosteroid therapies commonly used for similar lesions. Chlorhexidine may be an effective alternative, and early histopathological confirmation is recommended for proper management
Advantages and Disadvantages of Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer
Full text linkNeoadjuvant chemotherapy (NAC) has been a standard treatment in the management of muscle-invasive bladder cancer (MIBC), especially for cisplatin-eligible patients. However, its widespread adoption is hampered by unresolved controversies. Various systematic reviews and meta-analyses support the role of NAC in improving survival. While in a meta-analysis published by Li G and colleagues in 2017, no difference in Overall Survival (OS) was observed between the group receiving NAC and the group that did not receive NAC (1). In addition to its advantages, it is necessary to examine its possible disadvantages and challenges
The Link between Human Papillomavirus and Prostate Cancer; A Narrative Literature Review
Full text linkProstate cancer (PCa) remains a leading cause of cancer mortality in men globally. Age, genetic predisposition, and inflammation are the major risk factors. Increasing evidence suggests that oncogenic viruses, HPV types 16/18, could be involved in prostate carcinogenesis. This review critically examines the potential association between HPV infection and prostate cancer, including both molecular mechanisms and epidemiological evidence. We conducted a narrative literature review by systematically searching PubMed, Scopus, and Google Scholar for papers published from 2013 to 2025. We used search terms such as prostate cancer, HPV, oncogenic viruses, and viral carcinogenesis. We reviewed several peer-reviewed papers that involved molecular information, clinical documentation, and meta-analytic data. The evidence reports HPV DNA in 15-36% of PCa tissues, the most common being HPV-16/18. Mechanistically, HPV proteins (E6/E7) inactivate central tumor suppressors (p53, Rb), activate anti-apoptotic proteins (Bcl-2, survivin), and induce changes associated with cancer onset (through N-cadherin/TWIST), as observed in HPV-positive anogenital cancers. Genomic signatures reveal that HPV-positive PCa has characteristic patterns of mutation (e.g., KMT2C/D disruption). Nonetheless, heterogeneity across HPV detection assays and small sample sizes in a few studies call for cautious interpretation.
Today, we have data suggesting that HPV may cause PCa, possibly through inflammation (NF-κB) and unstable genes; however, the exact mechanism remains unclear. We require large trials in many centers and additional screens to determine the role of HPV in this. As we can prevent HPV, these findings suggest that HPV vaccines could be of critical importance in preventing PCa. We must find out more
بررسی عوارض جانبی به دنبال واکسن کوید-19 : مطالعه مروری
No full textهمهگیری بیماری کووید-19 نیاز فوری به توسعه واکسن را برانگیخت که در این میان نگرانیها در مورد اثرات نامطلوب واکسنها قابل بحث میباشد. این مطالعه تجزیه و تحلیل جامعی از عوارض جانبی واکسنهای کووید-19 انجام داده است.
در این مطالعه مروری جهت یافتن مقالات مرتبط با کلیدواژههای مرتبط با موضوع ("adverse effect*"[ti] OR complication[tiab] OR safety[ti]) AND (covid-19[ti] OR sars-cov-2[ti]) AND vaccin*[ti] در پایگاه های اطلاعاتی Google Scholar، Web of Science ،PubMed ، Scopus از ژانویه 2021 تا دسامبر 2023 مورد جستجو قرار گرفتند. از 1720 مقاله به دست آمده، از مجموع 90 مطالعه مرتبطی که به دنبال تزریق واکسن کووید-19 عوارض جانبی را گزارش کرده بودند، 15 مقاله منتخب که در خصوص عوارض و امنیت واکسنهای کووید به بحث و بررسی پرداخته بودند، انتخاب و مورد بررسی جامع مروری قرار گرفتند. در کشورهای مختلف، رویدادهای نامطلوب به دنبال تزریق واکسن، به روشهای مختلفی همچون ویزیتهای حضوری تا روشهای مبتنی بر پلتفرم و اطلاع رسانی از طریق تلفن یا سامانههای مبتنی بر وب ثبت شده است. عوارض واکسن به دو دسته اصلی غیرجدی و جدی و از لحاظ شدت به خفیف، متوسط و شدید تقسیمبندی شده است. عوارض مرتبط غیر جدی معمولا تب خفیف و علائم موضعی بوده است. عوارض شدید در چندین گروه اصلی گروه شامل عوارض انعقادی، عصبی، قلبی عروقی، عروقی مغزی و سایر عوارض طبقه بندی شدند. بروز عوارض جدی مرتبط با واکسیناسیون شامل فوت و بستری در بیمارستان میباشد. عوارض جانبی واکسیناسیون کووید-19 عمدتا خفیف و گذرا بوده، در حالی که بروز عوارض جدی به طور استثنایی نادر بوده است. این یافتهها نقش حیاتی واکسیناسیون را در حفاظت از سلامت عمومی جهانی در نبرد مداوم علیه این بیماری همهگیر تقویت میکند و کارآیی واکسنها را در نجات زندگی برجسته میکند
Predicting mental health in people with multiple sclerosis through Attachment style, pain experience, and coping strategies
No full textObjective: This study aimed to predict mental health through Attachment style, the experience of pain, and coping strategies in MS patients of the Iranian MS association.
Materials and Methods: The present study is a cross-sectional Study. It was conducted using the available Sampling method over 345 MS patients of the Iranian MS association. After obtaining informed consent, the General Health Questionnaire (GHQ-28), Short Form-McGill Pain Questionnaire-2 (SF-MPQ-2), Adult Attachment Inventory (AAI), and Coping Inventory for stressful situations short form (CISS-SF) responded. Used statistical methods, including Pearson correlation coefficient and multiple regression, were used for data analysis software were used SPSS24.
Results: Mental health has a positive and significant relationship (sig=0.00 t=7.1 β=0.30) and plays a significant role in predicting mental health. Also, coping strategy (sig=0.03 t=2.1 β=0.90) and pain experience (sig=0.00 t=11.3 β=0.48) significantly predicted mental health in people with MS.
Conclusion: These results suggested that mental health can predicting through attachment style, pain experience, and coping strategies
The Impact of Vital Pulp Therapy on Normal Root Development in Immature Teeth: A Case Report
Full text linkVital pulp therapy is one of the least invasive and simplest and most economically acceptable treatment alternatives for immature teeth with pulpitis. The success rate of this treatment, with calcium silicate-based cements, ranges from 85% to 100%. Vital pulp therapy prevents the development of apical periodontitis and promotes normal root development, allowing the tooth to remain in the dentition and perform its functions. The patient was a nine-year-old boy with pain on chewing and a positive response to cold. The panoramic radiograph showed an immature permanent lower molar with deep caries. Partial pulpectomy and root pulp sealing with pre-mixed calcium silicate-based cement were performed under aseptic conditions. The absence of symptoms and the formation of roots with apical sealing were successfully achieved and observed by follow-up and radiographic control, making this treatment a viable option for immature teeth with pulpitis
Combination of Different Laser Wavelengths as a Treatment Strategy for Maxillary Osteonecrosis: A Case Report: Laser therapy as treatment for maxillary osteonecrosis
No full textIntroduction: Osteonecrosis causes the death of bone tissue due to insufficient blood flow, which bdisrupts the supply of oxygen and nutrients, compromising the structural integrity of the bone. The jaws are particularly vulnerable due to their high bone turnover and vascularization. This study aimed to present the complex case of a patient diagnosed with maxillary osteonecrosis associated with osteomyelitis, treated exclusively with laser therapy.
Case Report: We present the case of a 62-year-old male patient with maxillary osteonecrosis associated with osteomyelitis, manifested by an oroantral fistula located in the upper jaw. The treatment consisted of various laser therapy modalities, starting with the surgical phase on hard tissue for the excision of the necrotic bone (Er,Cr:YSGG 2780 nm laser), followed by photodynamic therapy (650 nm diode laser) for wound disinfection and intravascular laser irradiation of blood (ILIB) therapy (880 nm diode laser) in each session.
Conclusion: The combination of different laser wavelengths was effective for the treatment of osteonecrosis