Background. The present study was performed to investigate the factors related to the expression level of estrogen and progesterone receptor in patients with colorectal cancer. Material and Methods. This crosssectional study was performed on 54 patients suffering from colorectal cancer referring to Imam Reza Hospital in Birjand during 2018-2019. After the biopsy performed during surgery, the specimen was sent for immunohistochemistry, and the status of receptors was determined. Eventually, the data were analyzed by SPSS 22. Results. Out of the 54 patients studied, 64.8% were male. The mean age of the patients was 62.28 ± 14.03 years. The level of expression of beta-estrogen receptors and progesterone receptors had a significant relationship with age, consuming drugs of abuse, and familial history ( P = 0.001 ). Also, the level of expression of estrogen and progesterone receptors of patients with a more advanced stage of cancer was significantly lower ( P = 0.001 ). Conclusion. The extent of expression of estrogen and progesterone receptors affects the progression and prognosis of disease. Thus, through hormone therapy, a step can be taken to reduce the progression and even to treat colorectal cancer.

Introduction: Pain management is one of the most essential components of postoperative care. Nowadays, the common treatment methods for pain include the use of two large groups of analgesics, namely opioids and nonsteroidal antiinflammatory drugs (NSAIDs). Therefore, the present study aimed to compare the effects of ketorolac (i.e., a noninflammatory drug) and pethidine (i.e., a synthetic opioid pain medication) on pain and complications due to hemorrhoidectomy. Methods: This randomized controlled trial included 90 patients with hemorrhoids who underwent hemorrhoidectomy at Imam Reza Hospital in Birjand, Iran, from May 2017 to 2018. The participants were assigned into two groups, namely ketorolac group who received ketorolac therapy and pethidine group who received pethidine. The severity of pain and complications were measured immediately, as well as at 6, and 12 hours after surgery in both study groups. The quantitative data were expressed as mean and percentage. Data analysis was performed using SPSS software (version 22.0) through Mann-Whitney, Friedman, and Chi-square tests. A p-value less than 0.05 was considered statistically significant. Results: According to the obtained results, out of 90 patients with hemorrhoid, 70.3% were males. The mean age of the participants was 48.29±8.8 years, and there was no significant difference between two study groups regarding age (47.2±8.7 years in the pethidine group, and 49.4±9 years in the ketorolac group, P=0.196). In the ketorolac group, the mean pain scores were 2.33±1.36, 2.28±1.00, and 1.57±0.75, immediately, as well as at 6, and 12 hours after surgery, respectively. In addition, in the pethidine group, the mean pain scores were obtained at 3.15±1.61, 2.64±1.00, and 1.97±0.69, immediately as well as at 6, and 12 hours after surgery, respectively. Accordingly, the pain level was significantly lower in ketorolac group, compared to that in the pethidine group (P<0.05). However, the pain level was higher at 24 hours after surgery in ketorolac group than that in the pethidine group; nevertheless, the difference was not statistically significant (P=0.996). Conclusions: The findings of the present study suggest more significant therapeutic effects of nonsteroidal NSAIDs, compared to opioid drugs on pain after hemorrhoidectomy.

Background: Pulmonary thromboembolism (PTE) is a major health problem worldwide. The present study was conducted to investigate epidemiology of acute PTE and its outcomes in Birjand city, locating in South Khorasan, Iran. Methods:In this descriptive epidemiological study, 79 patients with PTE referred to Vali-Asr Hospital, Birjand, Iran were studied during 2011 -2016. In this study, demographic data, medical history, risk factors, symptoms, and information on diagnostic methods including echocardiography findings, electrocardiographic findings, treatment procedure, duration of hospitalization, and therapeutic outcomes were collected in information form for each patient. One year later, the patients were re-visited, and echocardiography was performed for all the subjects. Finally, data were analyzed by Chi-Square and Fisher's exact tests at a significant level of 0.05 using SPSS software.Results: Results showed that annual incidence of PTE was 5.7 per 100,000 people in Birjand in 2016. History of recent surgery (18.8%) followed by hospitalization, and complete bed rest for more than 3 days (15.7%) were the most common risk factors. More than 78% of patients with PTE had abnormal echocardiography, and pulmonary arterial hypertension was the most common finding. Results of statistical analysis showed that complications were not statistically significant according to age and gender of patients (P < 0.05), but complications were higher in patients with massive PTE compared to others (P = 0.01). Comparison of in-hospital complications showed a significant difference between different treatment modalities (P < 0.01). Conclusions:History of recent surgery and hospitalization were the most common predisposing factors for PTE. Therefore, necessary programs should be more vigorously pursued for prevention of PTE.

Introduction: Appendectomy is one of the most performed surgeries worldwide. There are lots of factors involved in the incidence of appendicitis, and most of them vary among populations. Therefore, the present study aimed to evaluate the epidemiological aspects of appendicitis in Birjand, Iran, for the first time.Methods: This prospective study included 666 cases out of 673 acute appendicitis patients treated surgically in Imam Reza Hospital in Birjand, Iran, from May 2017 to 2019. The data were analyzed regarding gender, age groups, and season in SPSS software (version. 22) using a t-test and the Chi-square test. A p-value less than 0.05 was considered statistically significant. Results:The annual incidence of acute appendicitis in Birjand was 12.74 per 10.000 population with the mean age of 25.43±14.97 years. The highest frequency of appendectomy was observed in 11-20-year-old groups (32.1%) and then in 21-30-year-old groups (27.3%). The frequency of the appendectomy was higher in male than female (P=0.005), and the peak of the surgeries was in the summer. Moreover, the majority of the admitted patients in the summer were male (n=123), whereas the frequency of female patients in the autumn was higher than that of male (n=81). The most frequent pathological diagnosis in both genders was acute gangrenous appendicitis (i.e., 44% in female and 40% in male). Furthermore, the incidence rates of advanced stages of appendicitis, such as "acute supportive appendicitis and periappendicitis" and "acute supportive appendicitis and priappendicitis with perforation" were significantly higher in male than female (P<0.05). Conclusions:The findings of this study provide basic epidemiological information for the first time regarding appendicitis status in Birjand, Iran. Since the appendicitis was more frequent among youth and was more complicated in male, it is essential to inform these target groups about the signs and symptoms of this medical emergency.