Tehran University Medical Journal

Background: The aim of study was to determine the frequency of delay referring and related factors in patients with advanced breast cancer, in Imam Khomeini Hospital in the 2000.

Materials and Methods: Successively 200 patients were entered the study if they were consentient. A questionnaire was constructed and information was obtained through interviewing.

Results: From the cases, 64 patients (32 percent) referred without delay and 136 patients (68 percent) referred tardily. The patients who were late in comparison with patients who didn’t late, had significantly higher mean age (P=0.004), lower education level (P=0.002), and lower economic status (P=0.001). The frequency rate of single were lower among them (P=0.001), fewer percent were residual of big cities (P=0.01) and they had less rate of available physician (P=0.004). 24.3 percent of delay referring patients and 53.1 percent of patients without delay has a positive family history of breast cancer (P=0.001). 62.5 percent of delay referring patients and 85 percent of patients without delay were aware about importance of Self Breast Examination (S.B.E) (P=0.002) and respectively 84.4 percent and 98.4 percent were award about symptoms of breast cancer (P=0.01). 23.5 percent and 33 percent of patients with and without delay Knew the method of B.S.E respectively. It wasn’t a significant difference.

Conclusion: Lack of awareness about necessity of medical consultation, fear, carelessly, unavailable physician and poverty were the major causes of delay in patients who referred late.

Background: Altitude diseases, the most frequent of which is acute mountain sickness (AMS), are among the most common and serious problems that recreational and professional mountain athletes may encounter. If left undiagnosed, they may lead to lethal consequences. In a cross sectional study, we investigate the prevalence of AMS disorder among the overnight guests of a mountain resort hotel.

Methods: Overnight guests staying at Hotel Tochal (elevation 3545 m), near Tehran, Iran, in the winter of 2006 constituted the study participants. A questionnaire, including demographic data, proposed risk factors and Lake Louise score, was completed by a physician for all who had headache or other symptoms of AMS. Data from daily hotel reception records were also collected.

Results: Overall, 328 persons stayed at this hotel for at least one night during the study period. Among these, 47 persons (14.3%) were admitted to the clinic for headache. According to the physician's diagnoses, only 34 guests (10.4% 95% CI: 7.1-13.7%) were affected by AMS. The concurrent symptoms of headache and vertigo or insomnia had the highest predictive value for AMS diagnosis. Ambiguous headache had a higher predictive value than other types of headache.

Conclusions: Despite the height of Tochal peak and the frequent use of high speed telecabin, it seems that the frequency of AMS is lower than that found in other studies on similar altitudes. However, more research should be done in this regard.

Background: The influenza virus is one of the most important factors for higher morbidity and mortality in the world. Recently, researchers have been focused on influenza conserved antigenic proteins such as hemagglutinin stalk domain (HA2) for vaccine production and serological studies. The HA2 plays a major role in the fusion of the virus with host cells membrane. The immunity system enables to produce antibody against HA2. The aim of this study is polyclonal antibody production against influenza HA2. Methods: This study was done in the Influenza Research Lab, Pasteur Institute of Iran, Tehran for one year from September 2013 to October 2014. In the present study, recombinant HA2 protein was produced in prokaryotic system and purified using Nickel affinity chromatography. The purified HA2 was mixed with Freund’s adjuvant (complete and incomplete) and injected into two New Zealand white rabbits by intramuscularly and subcutaneously routes. Immunization was continued for several months with two weeks interval. Before each immunization, blood was drawn by venous puncture from the rabbit ear. Function of rabbit's sera was evaluated using radial immunodiffusion (RID) in both forms, Single RID (SRID) and Double RID (DRID). Finally, antiserum activity against HA2 was evaluated using western blotting as serological assay. Results: Sedimentary line and zone was observed in RID assays (SRID and DRID) represent interaction between HA2 protein and anti- HA2 antibody. As well as, western blotting results was positive for HA2 protein. Therefore, these results showed that polyclonal antibody produced against HA2 protein can identify HA2 protein antigenic sites. Conclusion: These findings show that humoral immune responses have properly been stimulated in rabbits and these antibodies can identify HA2 protein and may be suitable for other serological methods.