The aim of this study was to perform cost-effectiveness Analysis of IEV versus ESHAP chemotherapy... more The aim of this study was to perform cost-effectiveness Analysis of IEV versus ESHAP chemotherapy regimen in patients with Lymphoma in Iran. Our study used a cross-sectional design done as a double-blind study of 65 patients suffering from relapsed/refractory Hodgkin and non-Hodgkin's Lymphoma in Amir Oncology Hospital in Shiraz, in the south of Iran. The costs were included medical and non-medical direct costs and indirect costs. Effectiveness was reported in patient records and it was categorized into complete response, partial response and non-response The direct cost in IEV and ESHAP regimens 32159.87 and 69,143.72 respectively. In IEV arm, 53% of the patients with Hodgkin Lymphoma achieved complete response (CRs) and 35% a partial response (PRs). The overall response rate (CRs & PRs) was 88.2%. But in ESHAP arm, the overall response rate was 69.2%, 43.3% of patients achieved a complete response and 27% a partial response. The results showed that IEV versus ESHAP was dominant in the treatment of patients with lymphoma. Also, ICER
We construct a quantum mechanics based on the hypothesis of existing compact extra dimensions for... more We construct a quantum mechanics based on the hypothesis of existing compact extra dimensions for a particle that wants to detect it. By introducing a probability function, we express the transition of particle to the extra 2d window. The general properties of this function has been examined and a length scale for occurrence of particle to extra window is given. By a diverse view point we consider that, the new length scale plays another quantum criteria for another quantization, beside the Planck constant. Canonical quantization of second class constrained systems, is our method for constructing the desired quantum mechanics, in which in it the probability function enters in the structure of second class constraints. This import the phenomena of extra dimension to the 3d quantum mechanics, effectively. Some aspects of this effective double quantum theory are mentioned, which one may investigate them more focused to experience extra dimension quantum mechanically in contrast to fiel...
Background. Previous animal studies have shown a protective effect of 5-phosphodiesterase inhibit... more Background. Previous animal studies have shown a protective effect of 5-phosphodiesterase inhibitors on cancer therapeutics-related cardiac dysfunction (CTRCD) of anthracyclines. Aim. The aim of this study was to evaluate the clinical effect of sildenafil on the primary prevention of CTRCD in human. Materials and Methods. In this randomized double-blind clinical trial, the primary end point was efficacy in preventing the reduction of left ventricular ejection fraction (LVEF). The intervention group patients received sildenafil at a dose of 25 milligrams twice a day before starting the chemotherapeutic regimen, and the control group received placebo. All the patients at baseline and after the 6-month follow-up underwent 4D and speckle-tracking echocardiography and cardiac MRI, accompanied by hs-troponin I and NT-Pro-BNP measurement. Results. Sixty patients were enrolled in this study, and data from 52 patients (24 patients in the intervention group and 28 patients in the control grou...
Introduction: The aim of this study was to investigate the rate and causes of re-hospitalization ... more Introduction: The aim of this study was to investigate the rate and causes of re-hospitalization in the first 30 days after Hyper-CVAD chemotherapy in all patients with acute lymphoblastic leukemia. Methods: This descriptive, analytical and cross-sectional study was performed on 827 admissions in ALL patients aged 18 years and older with unplanned hospitalization after HyperCVAD chemotherapy in less than 30 days’ post chemotherapy from April 2016 to April 2018 in Hematology and medical oncology department. Results: The rate of unplanned re-admission was 9.91% in all patients. Mean follow-up time was 13.77 ± 6.26 months and the mean age of patients was 35.55 ± 14.6 years. Re-admission rate was more frequent in men (65.7%) and most patients were readmitted only once. The mean duration of re-admission was 8.2±4.15 days and most patients were re-admitted after cycles IB, IIIB and IVB of hyper-CVAD chemotherapy. The most common causes of readmission were febrile neutropenia and pancytope...
Background: Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer (BC), and... more Background: Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer (BC), and its diagnosis is associated with negative expression of hormone receptors and HER2/neu. It consists of 10-20% of all BCs diagnosed. Methods and materials: This study focuses on three groups with different pathology: group one showed complete triple-negative HER2 expression with IHC of BC; groups two and three included patients with ER-, PR-, and HER2 1+ , and ER-, PR-, and HER2 2+ with a negative FISH test. These three groups were compared from the point of prognosis, which consisted of tumor size, patients' age, lymphatic, vascular and perineural invasion, organ metastasis, number of lymph nodes involvement, and the survival rate. Results: A total of 459 TNBC patients were enrolled, of which 268 were placed in the HER2 0 group, 146 in the HER2 1+ group, and 45 in the HER2 2+ group. Distant metastasis and recurrence rate were more common in HER2 0 patients, but bone metastasis was more common in patients with low HER2 expression. All patients with HER2 0 had a smaller tumor size at the time of BC diagnosis in comparison to patients in the low HER2 expression group. Patients with HER2 2+ had less lymphatic and vascular invasion as well as axillary lymph nodes involvement, but larger tumor size at presentation, resulting in a lower rate of recurrence and higher overall survival. Conclusion: The findings revealed that patients with HER2 2+ had better outcome in comparison to the patients with HER2 0 and HER2 1+ . Furthermore, the results showed that many patients with HER2 2+ expression were not basal-like and had good prognosis amongst TNBC patients.
OBJECTIVES The aim of this study is to investigate the effect of two abundant dietary supplements... more OBJECTIVES The aim of this study is to investigate the effect of two abundant dietary supplements, quercetin and vitamin C on some factors involved in metastasis and proliferation of prostate cancer, which are resistant to conventional chemotherapies in late stages. BACKGROUND Bone and brain are two common sites of metastases in prostate cancer, nevertheless the factors involved in their metastatic pathways are not well understood. METHODS The effect of quercetin (75µM) and vitamin C (100 µM) on CXCR4, CXCR7 chemokine receptors, α4, α5 and β1 integrins, ki-67 proliferation marker and Vascular endothelial growth factor, VEGF was evaluated using Quantitative Reverse Transcription PCR (RT-qPCR). RESULTS The effect of quercetin and vitamin C alone was different on PC3 and DU145 prostate cancer cell lines, but sequential combination reduced significantly the expression of CXCR and CXCR7 chemokine receptors, α4, α5 and β1 integrin subunits, VEGF and Ki-67 proliferation markers in PC3 and ...
BACKGROUND: This is an out-of-pocket costs analysis of ifosfamide, epirubicin, and etoposide (IEV... more BACKGROUND: This is an out-of-pocket costs analysis of ifosfamide, epirubicin, and etoposide (IEV) and etoposide, solu-medrol-methylprednisolone, high-dose ara-C-cytarabine, and platinol-cisplatin (ESHAP) drug regimens in treatment of lymphoma in Iran. METHODS: This cross-sectional study was conducted in Shiraz City. Data were collected using a data-collection form. The social perspective was used to collect cost data. Three types of costs were measured, medical direct costs, non-medical direct costs, and indirect costs. RESULTS: 65 patients were treated with these two methods; 27 patients were treated with IEV and 38 with ESHAP. Moreover, the mean direct cost in IEV and ESHAP regimens in 2014 were 1191.10 ± 610.74 and 1819.57 ± 789.73 United States dollars (USD), respectively. The difference was statistically significant (P < 0.001). CONCLUSION: In this study, costs in the IEV regimen were significantly lower than the ESHAP regimen. This was particularly caused by an earlier dis...
International Journal of Organ Transplantation Medicine, 2018
Background: Cellular transplantation is a promising treatment strategy for neurological diseases.... more Background: Cellular transplantation is a promising treatment strategy for neurological diseases. Objective: To report the results of intrathecal hematopoietic stem cell therapy in different neurological diseases in the past 6 years in a single center. Methods: From October 2011 to September 2018, 220 patients with various neurological diseases were transplanted intrathecally by their bone marrow stem cells. To have a longer follow up, we only reported the first 80 patients, transplanted up to July 2015—10 patients had spinal cord injuries and paralysis, 12 had advanced Parkinson’s disease, 28 had cerebral palsy, 7 had hypoxic brain damage, 2 had autism, 4 had multiple sclerosis, 5 had progressive cerebellar atrophy, and 12 had other neurological diseases. The patients were admitted to the Bone Marrow Transplant Unit. On the first day, 50–200 (median 100) mL bone marrow was aspirated from the patients’ posterior iliac crests, mixed with 120 mL culture media (RPMI), and 12 mL heparin...
The rapidly spreading outbreak of infection by novel coronavirus 2 (SARS-CoV-2) from Wuhan, China... more The rapidly spreading outbreak of infection by novel coronavirus 2 (SARS-CoV-2) from Wuhan, China around the world has started since December 2019. Since the epidemic spread of this infection, individuals with comorbidities are at high risk of severe disease and increased rate of mortality. As patients with cancer are considered immunosuppressed caused by some host and treatment factors, a more detailed investigation on the impact of cancer on COVID-19 outcome seems to be necessary. This review article provides data on cancer patients affected by SARS-CoV-2 infection. Although underlying immunosuppression has not proven as a risk factor for severe COVID-19 infection, most authors have identified cancer patients as a highly vulnerable population. We need more detailed especially randomized studies to compare the outcome of cancer and non-cancer patients with SARS-CoV-2 infection. The more precise studies would help oncologists to make the best decision in cancer therapy.
Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used ... more Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality -adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were estimated. In addition, the robustness of results was examined by sensitivity analysis. The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP (43 patients with Hodgkin's and 22 with non-Hodgkin lymphoma). The results of decision tree showed that in the IEV arm, the expected cost was $20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was $31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen. Conclusions: According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance.
In this paper we show that one can have asymptotically de Sitter (dS), antide Sitter (AdS) and fl... more In this paper we show that one can have asymptotically de Sitter (dS), antide Sitter (AdS) and flat solutions in Gauss-Bonnet gravity without any need to a cosmological constant term in field equations. First, we introduce static solutions whose 3-surfaces at fixed r and t have constant positive (k = 1), negative (k = -1), or zero (k = 0) curvature. We show that for k = ±1, one can have asymptotically dS, AdS and flat spacetimes, while for the case of k = 0, one has only asymptotically AdS solutions. Some of these solutions present naked singularities, while some others are black hole or topological black hole solutions. We also find that the geometrical mass of these 5-dimensional spacetimes is m + 2α |k|, which is different from the geometrical mass, m, of the solutions of Einstein gravity. This feature occurs only for the 5-dimensional solutions, and is not repeated for the solutions of Gauss-Bonnet gravity in higher dimensions. We also add angular momentum to the static solutions with k = 0, and introduce the asymptotically AdS charged rotating solutions of Gauss-Bonnet gravity. Finally, we introduce a class of solutions which yields an asymptotically AdS spacetime with a longitudinal magnetic field which presents a naked singularity, and generalize it to the case of magnetic rotating solutions with two rotation parameters.
Invasive fungal infections (IFIs) are amongst the most important causes of morbidity and mortalit... more Invasive fungal infections (IFIs) are amongst the most important causes of morbidity and mortality in immunocompromised patients. To more effectively approach IFIs both in prophylactic and therapeutic perspectives, one of the crucial imperatives is to know about the local fungal epidemiology. This is relatively lacking in our current setting. Insufficient diagnostic tools as well as the progressive and life-threatening course of IFIs when consolidated, compromise the IFI treatment outcome in many cases. This necessitates primary antifungal prophylactic approaches in immunocompromised hosts who are mainly at risk. To stay aligned with regard to IFI prophylactic strategies in our practice and to pave the path towards definition of local guidelines, the “Shiraz IFI Study Group” held a consensus meeting on 6th December 2012, in Namazi hospital, Shiraz, Iran. Experts from hemato-oncology and infectious disease fields reviewed the available evidence-based data with regard to prophylactic ...
Skin infiltration in leukemia occurs rarely. Leukemia cutis has a wide range of cutaneous manifes... more Skin infiltration in leukemia occurs rarely. Leukemia cutis has a wide range of cutaneous manifestations from maculopapular to tumorous stage. Patients with Leukemia cutis usually have concomitant systemic leukemia, but occasionally skin involvement precedes the in-volvement of the bone marrow or peripheral blood. Complete remission could be achieved with chemotherapy, however, the long term prognosis is poor.
International journal of hematology-oncology and stem cell research, 2015
Despite multiple published studies reporting result of salvage regimens for relapsed and refracto... more Despite multiple published studies reporting result of salvage regimens for relapsed and refractory Hodgkin's lymphoma, there are no comparisons of different combinations. A Total of 44 patients identified with refractory or relapsed Hodgkin's Lymphoma were considered eligible for this study. The Patients were randomly divided into two groups of 22, one of which were treated with GDP regimen (gemcitabine, dexamethasone and cisplatin) and the other with EHSAP regimen (etoposide, methyl prednisolone, cisplatin and cytarabine) in a prospective manner. The results of each group were compared. There were 27.3% complete response, 31.8% more than 50% response, and 40.9% no response with GDP. ESHAP results were 29.5%, 24% and 45.5%, respectively. There is no significant difference in response rate between GDP and ESHAP regimens as salvage chemotherapy in refractory or relapsed Hodgkin's Lymphoma.
International journal of organ transplantation medicine, 2013
Transient bone marrow suppression, characterized by acute inability of the bone marrow to produce... more Transient bone marrow suppression, characterized by acute inability of the bone marrow to produce circulating blood cells, may strongly relate to the pathogenesis of some viral infections. To study the prevalence of some DNA and RNA viruses in patients with transient bone marrow suppression. EDTA-treated blood samples were collected from 27 patients with clinically- and laboratory-confirmed transient bone marrow suppression. The genomic DNA of hepatitis B virus, adenovirus, polyomavirus BK, and parvovirus B19, and genomic RNA of hepatitis C and G viruses were extracted and amplified by sensitive and specific in-house simple and nested PCR and RT-PCR protocols, respectively. The risk factors that might be related to the studied viral infections were analyzed. Hepatitis B virus infection was diagnosed in 9 (33%) of 27 patients; adenovirus infection in 2 (7%); and parvovirus B19 infection in 7 (26%) of 27 patients. The genomic DNA of polyomovirus BK was not detected in any patients. Bo...
The aim of this study was to perform cost-effectiveness Analysis of IEV versus ESHAP chemotherapy... more The aim of this study was to perform cost-effectiveness Analysis of IEV versus ESHAP chemotherapy regimen in patients with Lymphoma in Iran. Our study used a cross-sectional design done as a double-blind study of 65 patients suffering from relapsed/refractory Hodgkin and non-Hodgkin's Lymphoma in Amir Oncology Hospital in Shiraz, in the south of Iran. The costs were included medical and non-medical direct costs and indirect costs. Effectiveness was reported in patient records and it was categorized into complete response, partial response and non-response The direct cost in IEV and ESHAP regimens 32159.87 and 69,143.72 respectively. In IEV arm, 53% of the patients with Hodgkin Lymphoma achieved complete response (CRs) and 35% a partial response (PRs). The overall response rate (CRs & PRs) was 88.2%. But in ESHAP arm, the overall response rate was 69.2%, 43.3% of patients achieved a complete response and 27% a partial response. The results showed that IEV versus ESHAP was dominant in the treatment of patients with lymphoma. Also, ICER
We construct a quantum mechanics based on the hypothesis of existing compact extra dimensions for... more We construct a quantum mechanics based on the hypothesis of existing compact extra dimensions for a particle that wants to detect it. By introducing a probability function, we express the transition of particle to the extra 2d window. The general properties of this function has been examined and a length scale for occurrence of particle to extra window is given. By a diverse view point we consider that, the new length scale plays another quantum criteria for another quantization, beside the Planck constant. Canonical quantization of second class constrained systems, is our method for constructing the desired quantum mechanics, in which in it the probability function enters in the structure of second class constraints. This import the phenomena of extra dimension to the 3d quantum mechanics, effectively. Some aspects of this effective double quantum theory are mentioned, which one may investigate them more focused to experience extra dimension quantum mechanically in contrast to fiel...
Background. Previous animal studies have shown a protective effect of 5-phosphodiesterase inhibit... more Background. Previous animal studies have shown a protective effect of 5-phosphodiesterase inhibitors on cancer therapeutics-related cardiac dysfunction (CTRCD) of anthracyclines. Aim. The aim of this study was to evaluate the clinical effect of sildenafil on the primary prevention of CTRCD in human. Materials and Methods. In this randomized double-blind clinical trial, the primary end point was efficacy in preventing the reduction of left ventricular ejection fraction (LVEF). The intervention group patients received sildenafil at a dose of 25 milligrams twice a day before starting the chemotherapeutic regimen, and the control group received placebo. All the patients at baseline and after the 6-month follow-up underwent 4D and speckle-tracking echocardiography and cardiac MRI, accompanied by hs-troponin I and NT-Pro-BNP measurement. Results. Sixty patients were enrolled in this study, and data from 52 patients (24 patients in the intervention group and 28 patients in the control grou...
Introduction: The aim of this study was to investigate the rate and causes of re-hospitalization ... more Introduction: The aim of this study was to investigate the rate and causes of re-hospitalization in the first 30 days after Hyper-CVAD chemotherapy in all patients with acute lymphoblastic leukemia. Methods: This descriptive, analytical and cross-sectional study was performed on 827 admissions in ALL patients aged 18 years and older with unplanned hospitalization after HyperCVAD chemotherapy in less than 30 days’ post chemotherapy from April 2016 to April 2018 in Hematology and medical oncology department. Results: The rate of unplanned re-admission was 9.91% in all patients. Mean follow-up time was 13.77 ± 6.26 months and the mean age of patients was 35.55 ± 14.6 years. Re-admission rate was more frequent in men (65.7%) and most patients were readmitted only once. The mean duration of re-admission was 8.2±4.15 days and most patients were re-admitted after cycles IB, IIIB and IVB of hyper-CVAD chemotherapy. The most common causes of readmission were febrile neutropenia and pancytope...
Background: Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer (BC), and... more Background: Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer (BC), and its diagnosis is associated with negative expression of hormone receptors and HER2/neu. It consists of 10-20% of all BCs diagnosed. Methods and materials: This study focuses on three groups with different pathology: group one showed complete triple-negative HER2 expression with IHC of BC; groups two and three included patients with ER-, PR-, and HER2 1+ , and ER-, PR-, and HER2 2+ with a negative FISH test. These three groups were compared from the point of prognosis, which consisted of tumor size, patients' age, lymphatic, vascular and perineural invasion, organ metastasis, number of lymph nodes involvement, and the survival rate. Results: A total of 459 TNBC patients were enrolled, of which 268 were placed in the HER2 0 group, 146 in the HER2 1+ group, and 45 in the HER2 2+ group. Distant metastasis and recurrence rate were more common in HER2 0 patients, but bone metastasis was more common in patients with low HER2 expression. All patients with HER2 0 had a smaller tumor size at the time of BC diagnosis in comparison to patients in the low HER2 expression group. Patients with HER2 2+ had less lymphatic and vascular invasion as well as axillary lymph nodes involvement, but larger tumor size at presentation, resulting in a lower rate of recurrence and higher overall survival. Conclusion: The findings revealed that patients with HER2 2+ had better outcome in comparison to the patients with HER2 0 and HER2 1+ . Furthermore, the results showed that many patients with HER2 2+ expression were not basal-like and had good prognosis amongst TNBC patients.
OBJECTIVES The aim of this study is to investigate the effect of two abundant dietary supplements... more OBJECTIVES The aim of this study is to investigate the effect of two abundant dietary supplements, quercetin and vitamin C on some factors involved in metastasis and proliferation of prostate cancer, which are resistant to conventional chemotherapies in late stages. BACKGROUND Bone and brain are two common sites of metastases in prostate cancer, nevertheless the factors involved in their metastatic pathways are not well understood. METHODS The effect of quercetin (75µM) and vitamin C (100 µM) on CXCR4, CXCR7 chemokine receptors, α4, α5 and β1 integrins, ki-67 proliferation marker and Vascular endothelial growth factor, VEGF was evaluated using Quantitative Reverse Transcription PCR (RT-qPCR). RESULTS The effect of quercetin and vitamin C alone was different on PC3 and DU145 prostate cancer cell lines, but sequential combination reduced significantly the expression of CXCR and CXCR7 chemokine receptors, α4, α5 and β1 integrin subunits, VEGF and Ki-67 proliferation markers in PC3 and ...
BACKGROUND: This is an out-of-pocket costs analysis of ifosfamide, epirubicin, and etoposide (IEV... more BACKGROUND: This is an out-of-pocket costs analysis of ifosfamide, epirubicin, and etoposide (IEV) and etoposide, solu-medrol-methylprednisolone, high-dose ara-C-cytarabine, and platinol-cisplatin (ESHAP) drug regimens in treatment of lymphoma in Iran. METHODS: This cross-sectional study was conducted in Shiraz City. Data were collected using a data-collection form. The social perspective was used to collect cost data. Three types of costs were measured, medical direct costs, non-medical direct costs, and indirect costs. RESULTS: 65 patients were treated with these two methods; 27 patients were treated with IEV and 38 with ESHAP. Moreover, the mean direct cost in IEV and ESHAP regimens in 2014 were 1191.10 ± 610.74 and 1819.57 ± 789.73 United States dollars (USD), respectively. The difference was statistically significant (P < 0.001). CONCLUSION: In this study, costs in the IEV regimen were significantly lower than the ESHAP regimen. This was particularly caused by an earlier dis...
International Journal of Organ Transplantation Medicine, 2018
Background: Cellular transplantation is a promising treatment strategy for neurological diseases.... more Background: Cellular transplantation is a promising treatment strategy for neurological diseases. Objective: To report the results of intrathecal hematopoietic stem cell therapy in different neurological diseases in the past 6 years in a single center. Methods: From October 2011 to September 2018, 220 patients with various neurological diseases were transplanted intrathecally by their bone marrow stem cells. To have a longer follow up, we only reported the first 80 patients, transplanted up to July 2015—10 patients had spinal cord injuries and paralysis, 12 had advanced Parkinson’s disease, 28 had cerebral palsy, 7 had hypoxic brain damage, 2 had autism, 4 had multiple sclerosis, 5 had progressive cerebellar atrophy, and 12 had other neurological diseases. The patients were admitted to the Bone Marrow Transplant Unit. On the first day, 50–200 (median 100) mL bone marrow was aspirated from the patients’ posterior iliac crests, mixed with 120 mL culture media (RPMI), and 12 mL heparin...
The rapidly spreading outbreak of infection by novel coronavirus 2 (SARS-CoV-2) from Wuhan, China... more The rapidly spreading outbreak of infection by novel coronavirus 2 (SARS-CoV-2) from Wuhan, China around the world has started since December 2019. Since the epidemic spread of this infection, individuals with comorbidities are at high risk of severe disease and increased rate of mortality. As patients with cancer are considered immunosuppressed caused by some host and treatment factors, a more detailed investigation on the impact of cancer on COVID-19 outcome seems to be necessary. This review article provides data on cancer patients affected by SARS-CoV-2 infection. Although underlying immunosuppression has not proven as a risk factor for severe COVID-19 infection, most authors have identified cancer patients as a highly vulnerable population. We need more detailed especially randomized studies to compare the outcome of cancer and non-cancer patients with SARS-CoV-2 infection. The more precise studies would help oncologists to make the best decision in cancer therapy.
Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used ... more Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality -adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were estimated. In addition, the robustness of results was examined by sensitivity analysis. The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP (43 patients with Hodgkin's and 22 with non-Hodgkin lymphoma). The results of decision tree showed that in the IEV arm, the expected cost was $20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was $31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen. Conclusions: According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance.
In this paper we show that one can have asymptotically de Sitter (dS), antide Sitter (AdS) and fl... more In this paper we show that one can have asymptotically de Sitter (dS), antide Sitter (AdS) and flat solutions in Gauss-Bonnet gravity without any need to a cosmological constant term in field equations. First, we introduce static solutions whose 3-surfaces at fixed r and t have constant positive (k = 1), negative (k = -1), or zero (k = 0) curvature. We show that for k = ±1, one can have asymptotically dS, AdS and flat spacetimes, while for the case of k = 0, one has only asymptotically AdS solutions. Some of these solutions present naked singularities, while some others are black hole or topological black hole solutions. We also find that the geometrical mass of these 5-dimensional spacetimes is m + 2α |k|, which is different from the geometrical mass, m, of the solutions of Einstein gravity. This feature occurs only for the 5-dimensional solutions, and is not repeated for the solutions of Gauss-Bonnet gravity in higher dimensions. We also add angular momentum to the static solutions with k = 0, and introduce the asymptotically AdS charged rotating solutions of Gauss-Bonnet gravity. Finally, we introduce a class of solutions which yields an asymptotically AdS spacetime with a longitudinal magnetic field which presents a naked singularity, and generalize it to the case of magnetic rotating solutions with two rotation parameters.
Invasive fungal infections (IFIs) are amongst the most important causes of morbidity and mortalit... more Invasive fungal infections (IFIs) are amongst the most important causes of morbidity and mortality in immunocompromised patients. To more effectively approach IFIs both in prophylactic and therapeutic perspectives, one of the crucial imperatives is to know about the local fungal epidemiology. This is relatively lacking in our current setting. Insufficient diagnostic tools as well as the progressive and life-threatening course of IFIs when consolidated, compromise the IFI treatment outcome in many cases. This necessitates primary antifungal prophylactic approaches in immunocompromised hosts who are mainly at risk. To stay aligned with regard to IFI prophylactic strategies in our practice and to pave the path towards definition of local guidelines, the “Shiraz IFI Study Group” held a consensus meeting on 6th December 2012, in Namazi hospital, Shiraz, Iran. Experts from hemato-oncology and infectious disease fields reviewed the available evidence-based data with regard to prophylactic ...
Skin infiltration in leukemia occurs rarely. Leukemia cutis has a wide range of cutaneous manifes... more Skin infiltration in leukemia occurs rarely. Leukemia cutis has a wide range of cutaneous manifestations from maculopapular to tumorous stage. Patients with Leukemia cutis usually have concomitant systemic leukemia, but occasionally skin involvement precedes the in-volvement of the bone marrow or peripheral blood. Complete remission could be achieved with chemotherapy, however, the long term prognosis is poor.
International journal of hematology-oncology and stem cell research, 2015
Despite multiple published studies reporting result of salvage regimens for relapsed and refracto... more Despite multiple published studies reporting result of salvage regimens for relapsed and refractory Hodgkin's lymphoma, there are no comparisons of different combinations. A Total of 44 patients identified with refractory or relapsed Hodgkin's Lymphoma were considered eligible for this study. The Patients were randomly divided into two groups of 22, one of which were treated with GDP regimen (gemcitabine, dexamethasone and cisplatin) and the other with EHSAP regimen (etoposide, methyl prednisolone, cisplatin and cytarabine) in a prospective manner. The results of each group were compared. There were 27.3% complete response, 31.8% more than 50% response, and 40.9% no response with GDP. ESHAP results were 29.5%, 24% and 45.5%, respectively. There is no significant difference in response rate between GDP and ESHAP regimens as salvage chemotherapy in refractory or relapsed Hodgkin's Lymphoma.
International journal of organ transplantation medicine, 2013
Transient bone marrow suppression, characterized by acute inability of the bone marrow to produce... more Transient bone marrow suppression, characterized by acute inability of the bone marrow to produce circulating blood cells, may strongly relate to the pathogenesis of some viral infections. To study the prevalence of some DNA and RNA viruses in patients with transient bone marrow suppression. EDTA-treated blood samples were collected from 27 patients with clinically- and laboratory-confirmed transient bone marrow suppression. The genomic DNA of hepatitis B virus, adenovirus, polyomavirus BK, and parvovirus B19, and genomic RNA of hepatitis C and G viruses were extracted and amplified by sensitive and specific in-house simple and nested PCR and RT-PCR protocols, respectively. The risk factors that might be related to the studied viral infections were analyzed. Hepatitis B virus infection was diagnosed in 9 (33%) of 27 patients; adenovirus infection in 2 (7%); and parvovirus B19 infection in 7 (26%) of 27 patients. The genomic DNA of polyomovirus BK was not detected in any patients. Bo...
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