No abstract

Patients with thalassemia intermedia (TI) experience many complications, of which the incidence varies greatly among cases. Considering the high prevalence of thalassemia in Iran, the study was carried out to determine the frequency of TI complications in Iranian patients and to find possible risk factors for each of them. Using the sampling method of "census," the authors included 153 patients who were seen in their tertiary hematology clinic with the diagnosis of TI during 1996-2010; an analytical cross-sectional study was performed and the data was analyzed by SPSS software using univariate and regression analyses. Mean age of the patients at the time of the study was 17.4 years and 36.5% were receiving transfusions (regularly or occasionally). Mean hemoglobin was 9.2 g/dL and mean serum ferritin was 858 ng/mL. Splenectomy was performed in 46.9% and it was correlated with age and the age at diagnosis in regression analysis. Cholelithiasis was found in 25.5% and was correlated with age and history of splenectomy. Pulmonary hypertension, detected in 23.5%, was correlated with thrombocytosis and mitral valve regurgitation in univariate analysis. Endocrine disease (hypogonadism, hypothyroidism, and adrenal insufficiency) was detected in 8% of the patients. In univariate analysis, endocrine disease was correlated with age of the patients. Regarding bone density of the spine, 53% of cases had osteoporosis. Thrombocytosis was present in 42% of patients and was correlated with their age. Since the severity of thalassemia intermedia vary greatly among patients, a careful evaluation of clinical, laboratory, and genetic aspects is necessary to differentiate TI in a patient at presentation. Moreover, TI patients should be carefully followed up for early detection and management of newly developed complications. The authors also suggest confirmatory controlled studies with larger sample sizes to assist in developing guidelines for surveillance and treatment of TI.

Background: Head and neck squamous cell carcinoma (HNSCC) is the 8th most common cancer worldwide. Although older age, male gender, smoking and alcohol consumption are known risk factors, an increasing number of HNSCC patients are without typical risk factors. Our aim was to define demographics of HNSCC in Iran and the potential risk factors related to Iranian ethnicity and lifestyle. Methods: We conducted a crosssectional analytical study on 262 patients with primary SCC of the larynx, hypopharynx or tongue referred to our pathology department during 1995-2010. Patients' demographics, tumor characteristics and risk factors such as smoking, alcohol consumption and anemia were analyzed and compared in two groups of patients: over 40 years (older group) and 40 years or less (young group); Chi-square and Mann-Whitney analytical tests were employed. Results: 5.7% of patients were young adults. The male to female ratio was 1.5 in the younger group and 5.6 in the older group. In young adults, 40% of tumors were located in larynx and 40% in the tongue. Age >40 was significantly associated with laryngeal location (P<0.001). History of smoking and drinking was significantly associated with age >40 and SCC of larynx in both age groups. Cervical lymph node involvement was significantly correlated with SCC of tongue (P<0.001), however, considering young adults only, SCC of hypopharynx was most frequently accompanied by lymph node involvement (60%). The most prevalent tumor among men was SCC of larynx whereas SCC of hypopharynx was the most prevalent tumor among women (61%), of whom 18.2% were ≤40. Conclusions: The incidence of HNSCC among young adults seems to be higher in Iran compared to other countries. Reduction in exposure to known risk factors, especially tobacco smoking in forms of cigarettes and bubble pipes, and search for other causative agents of HNSCC in young population is recommended.