Sedigheh Khazaei; Babak Izadi; Zhaleh Zandieh; Azadeh Alvandimanesh; Siavash Vaziri
Volume 9, Issue 3 , July 2014, , Pages 206-212
Abstract
Background and Objective: Tuberculosis is still a major health problem, involving about 1/3 of the world´s population. Diagnosis is difficult when we only use Ziehl-Neelson staining. Many cases may be missed. A more rapid and sensitive diagnostic method is necessary. PCR may be helpful. The aim ...
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Background and Objective: Tuberculosis is still a major health problem, involving about 1/3 of the world´s population. Diagnosis is difficult when we only use Ziehl-Neelson staining. Many cases may be missed. A more rapid and sensitive diagnostic method is necessary. PCR may be helpful. The aim of this study was to compare PCR, Zieh-Neelsen staining and histopathologic findings in diagnosis of tuberculosis on formalin-fixed paraffin-embedded tissues. Methods: Paraffin blocks of the submitted specimens of the patients clinically suspicious for tuberculosis or containing granuloma were selected. Ziehl-Neelsen Staining & TB-PCR (IS6110 element) was carried out. The results of the tests were compared by using the McNemar test. Statistical significance was accepted when the P value was less than 0.05. Results: Forty five specimens were included in the study, 35 had granulomas (19 with caseous necrosis). Acid-fast bacilli were identified in 17 specimens (37.8%). TB-PCR was positive in 16specimens (84%) with caseating granulomatous, 11 specimens (68.8%) with non-caseating granulomas & 6 specimens (60%) without granulomas. (P value = 0.59). Conclusions: TB-PCR on paraffin–embedded tissue is a potentially useful approach for early, rapid and sensitive diagnosis of tuberculosis. It is especially useful when granuloma is seen in tissue section, while acid-fast stain is negative. If there was no facilities for PCR, histopathological diagnosis with clinical correlation are more reliable in comparison to AFB results.
Babak Sayad; Peyman Eini; Hosein Hatami; Alireza Janbakhsh; Siavash Vaziri; Mandana Afsharian; Maryam Rezabeygi
Volume 1, Issue 1 , January 2006, , Pages 35-39
Abstract
Objectives: Immunodeficiency duo to HIV infection can produce unusual diseases in infected individuals & CD4 count is the main predictor of disease progression. In this study clinical syndromes resulting in admition, are considered according to CD4 count for the beter diagnosis and treatment of clinical ...
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Objectives: Immunodeficiency duo to HIV infection can produce unusual diseases in infected individuals & CD4 count is the main predictor of disease progression. In this study clinical syndromes resulting in admition, are considered according to CD4 count for the beter diagnosis and treatment of clinical problemes in HIV infected patients. Materrial & Methods: This is a cross - sectional study that was performed since March 2002 to March 2003 in Kermanshah Sina Hospital. HIV infection was confirmed with positive duble ELI SA and Western Blot. CD4 count was measured by flucytometery, clinical syndromes were collected with final diagnosis, and the rest of the data were gathered according to the patients' interviews. Statistical analysis was performed by SPSS 11.5. Results: During this study, 72 out of 215 admssions were enrolled. All of them were male with the mean age of 33.4 9.1 years. 64 cases (88.9%) were addicted and 40 cases (55.6%) had prison history. Clinical and/or laboratory indicators of AIDS were observed in 32 cases (44.4%). The average of CD4 count was 356/μL.Patients with lymphadenopathy, neurologic and pneumonia syndromes had the least count of CD4 with the averages of 90, 241 and 269/μL and patients with sepsis , endocarditis and hepatitis syndromes had the highest CD4 average count of 646, 394 and 373/μL respectively. Statistically correlations were observed between pneumonia syndrome with CD4<200/μL(Pvalue=0.005), and addiction history(Pvalue =0.0001). Suffering from hepatitis syndrome was also statistically correlated with being at prison. Conclusion: High prevalence of AIDS in our study was a trait which means high prevalence of asymptomatic HIV infection in general population .Also in patients with CD4<200/μL, especially those who are addicted, pneumonia syndrome may occur. Lymphadenopathy, neurologic and pneumonia syndromes are more common in CD4<300/μL whereas sepsis, Endocarditis and hepatitis syndromes are common in CD4> 300/μL, that shows the effect of CD4 count in appearance of clinical syndrpmes. Unsafe injections in prisons may cause acquisition of viral hepatitis in these patients.