2024-03-29T03:20:30Z
https://ijp.iranpath.org/?_action=export&rf=summon&issue=6028
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Knowledge of Laboratory Medicine in Medical Students: Is It Sufficient?
Hiva
Saffar
Maryam
Saatchi
Anahita
Sadeghi
Fahimeh
Asadi Amoli
Seyed Mohammad
Tavangar
Farzaneh
Shirani
Ali
Aliasgari
Background & Objective: Appropriate use of laboratory testing is essential for achieving safe and effective care to patient. Insufficient knowledge could lead to poor case management and increase the health care costs. It is believed that education on laboratory testing for undergraduate medical student is inadequate. This study was designed to evaluate the level of knowledge of 5 and 6 year undergraduate medical students in field of laboratory medicine. Methods: Totally, 59 questions including 8 basic questions concerning individual assessment of their knowledge and 51 objective questions focusing on various stages of test ordering and interpretation were asked. Result: Thirty seven undergraduate medical students at the level of internship participated. On average, 47.9% of students evaluated themselves as “weak" in 8 self-assessment questions. There was no significant difference between responders assessment on their own knowledge in various aspects of laboratory testing (P=0.184). In the objective questions regarding various stages of test ordering including pre-analytic, analytic and post analytic phases,45.6%,51.9% and 50% correct answers were reported ,respectively. Comparison of the level of the knowledge of the students regarding various stages of pathology testing did not show significant difference (P=0.638). Conclusion: Prioritizing an effective teaching method of laboratory medicine to medical students on appropriate time should be considered in medical school curriculum for better clinical decision making and optimal modern medical care.
Clinical pathology
education
Laboratory medicine
Medical student
2020
04
01
61
65
https://ijp.iranpath.org/article_38287_d3dc299e38f1144ef0b1faaa668f1e62.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Modified Ultrafast Papanicolaou Stain in Ultrasound Guided FNAC of Intra-abdominal Lesions
Sweta
Kamalkant Shastri
Archana
Joshi
Background & Objective: Modified Ultra-fast Papanicolaou (MUFP) stain has been developed from Papanicolaou stain (PAP) with the goal to improve staining quality, minimize staining time for obtaining immediate cytological diagnosis and to check specimen adequacy during Ultrasound guided Fine needle Aspiration Cytology (US guided FNAC). The aim of this research was to study the cytomorphological features of intra-abdominal lesions with help of US guided FNAC and to assess the diagnostic utility of Modified Ultrafast Papanicolaou stain in cytological diagnosis. Methods: This cross-sectional study enrolled consecutive 100 subjects in N.K.P Salve Institute of Medical Sciences and Research Centre, Nagpur, which is a tertiary teaching hospital in India, from July 2015 to June 2017 who underwent US guided FNAC for Intra-abdominal lesions. Fine needle aspiration was done under ultrasound guidance and the smears were divided into two groups. Wet smears were fixed in 95% ethyl alcohol for conventional PAP staining and air dried for MUFP. After staining, results were evaluated on basis of the cytological features. Scores were given according to four parameters namely background of smears, staining pattern, cell morphology and nuclear staining. Quality index was calculated from the ratio of score achieved to the possible maximum score. Result: The most common organs involved were ovaries (46 %) followed by liver (11%) and most common lesions were malignant (68 %). The cytological characteristic showed significant difference in all four parameters (P<0.05) when MUFP stain smears were compared with PAP stain smears. There was also statistically significant difference when cumulative score and Quality Index were compared (P<0.001) between the two stains. Conclusion: The US guided Fine needle aspiration (FNA) is simple, safe, rapid and inexpensive technique useful in cytological diagnosis. MUFP stain is fast, reliable and has better diagnostic utility for cytological diagnosis when compared to PAP stain.
Fine needle aspiration cytology
Intra-abdominal lesions
Modified Ultrafast Papanicolaou Stain
Papanicolaou Stain
Quality Index
2020
04
01
66
74
https://ijp.iranpath.org/article_38288_56efbdcffea8beee2f5be0f8a07865cf.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Micronucleus Assay of Buccal Mucosa Cells in Waterpipe (Hookah) Smokers: A Cytologic Study
Mehdi
DehghanNezhad
Noushin
Jalayer Naderi
Hasan
Semyari
Background & Objective: Micronucleus assay of buccal mucosa cells is a simple bio- monitoring method for diagnosing the genetic damages of toxic agents. The aim was to study the genotoxic effect of waterpipe smoking on buccal mucosa cells using micronucleus assay. Methods: This was a case control. A total of 30 male waterpipe smokers and 30 non-smokers were included in the study. The exfoliated buccal mucosa cells were scrapped using wooden spatula and were spread over glass slides. The mean number of micronuclei was determined using Feulgen-stained slides. The number of micronuclei per 1000 cells was calculated and compared between the two groups of smokers and non-smokers. Result: The mean number of micronuclei in waterpipe smokers and non-smokers was 1.94±0.39 and 1.68±0.35, respectively. The micronuclei count in waterpipe smokers was significantly higher than non-smokers (P=0). The difference between the number of waterpipe smoking and micronuclei count was significantly different (P=0). Conclusion: The mean number of micronuclei in buccal mucosa cells of waterpipe smokers was significantly higher than non-smokers. The genotoxicity effect of waterpipe was dose-dependent.
Assay
Buccal Mucosa
Genotoxicity test
Micronucleus
Smoking
2020
04
01
75
80
https://ijp.iranpath.org/article_38292_1b5199e6c9464002a45a400a980e8ac2.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Napsin-A Expression, a Reliable Immunohistochemical Marker for Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas
Fatemeh
Nili
Mansoureh
Tavakoli
Narges
Izadi-Mood
Hana
Saffar
Soheila
Sarmadi
Background & Objective: Clear cell carcinomas (CCC) differ from other types of ovarian and endometrial carcinomas in biology, behavior and response to chemotherapy. Histopathologic diagnosis may be challenging in some situations which necessitates immunohistochemistary (IHC) assessment. In this study we investigated the diagnostic utility of Napsin-A in diagnosis of ovarian and endometrial CCCs. Methods: Ovarian and endometrial CCC samples from 2013 to 2018 in 3 general and women’s hospital in Tehran were re-evaluated by 2 expert pathologists. Forty-two samples were included as case and 42 non-clear cell carcinomas (Non-CCC) of ovary and endometrium were selected as control group. Based on IHC study tumors with sum intensity and percentage score ≥2 (at least 1+ staining in more than 1% of tumor cells) were considered positive. Result: The prevalence of endometrial and ovarian CCC in the case group were 15 and 27 respectively. The tumors in the control group included 22 cases of endometrioid, 2 high grade papillary serous carcinoma (HGSC) of endometrium, 6 endometrioid and 12 HGSC of ovary. Napsin-A positivity was observed in 35 (83%) of CCCs while 7 (17%) samples including 3 out of 15 endometrial and 4 out of 27 ovarian CCCs were Napsin-A negative. No positive reaction was seen in control group. The overall accuracy, specifity and sensitivity of Napsin-A for diagnosis of ovarian and endometrial CCCs were 83%, 100% and 83%, respectively. Sensitivity for ovarian and endometrial CCCs were 85% and 80%, orderly. Conclusion: Napsin-A is an accurate and reliable marker for distinction of CCCs from non-CCCs in ovary and endometrium. A panel of antibodies may yield the highest diagnostic accuracy.
Clear Cell Carcinoma
Diagnosis
Endometrium
Ovary
Napsin-A
2020
04
01
81
85
https://ijp.iranpath.org/article_38303_91efbdef7f962e2182d0c6184d0faaae.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City
Kosar
Jalalvand
Nasrin
Shayanfar
Freshteh
Shahcheraghi
Elahe
Amini
Masha
Mohammadpour
Pegah
Babaheidarian
Background & Objective: Carbapenem-resistant Enterobacteriaceae is a growing concern worldwide including Iran. The emergence of this pathogen is worrying as carbapenem is one of the 'last-line' antibiotics for treatment of infections caused by multi drug resistant gram- negative bacteria. The main objective of this study was to determine the prevalence of carbapenem-resistant Enterobacteriaceae in a referral hospital in Tehran, Iran. Methods: In this study, all positive isolates of Enterobacteriaceae recorded in blood, urine, and other body fluids were studied during April 2017 to April 2018 in a referral hospital in Tehran. All cases of resistance to carbapenems were first tested by modified Hodge test. All cases with positive or negative test, after gene extraction, were examined genotypically based on the primers designed for the three Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), and OXA-48 genes by conventional PCR method. Result: 108 isolates (13.6%) were resistant to all cephalosporins as well as to imipenem and meropenem. In a genotypic study, including 45 isolates, 13 isolates were positive for OXA-48 gene, 11 isolates for OXA-48 and NDM genes, 11 isolates for OXA-48, NDM and KPC genes, 4 isolates for OXA-48 genes and KPC, 3 isolates for NDM, one isolate for KPC. On the other hand, two isolates were negative for all three genes examined. Conclusion: OXA-48 gene was one of the most common genes resistant to carbapenems in Iran. According to studies, the prevalence of antibiotic resistance in Iran is rising dramatically, which reduces the choice of antibiotics to treat severe infections in the future.
Enterobacteriacea
Drug resistance
Microbial
Polymerase chain reaction
primer
DNA
gene
2020
04
01
86
95
https://ijp.iranpath.org/article_38304_ba838a8d425fcb0f059d03fc89a1dcdb.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Assessment of Susceptibility to Five Common Antibiotics and Their Resistance Pattern in Clinical Enterococcus Isolates
Sara
Masoumi Zavaryani
Reza
Mirnejad
Vahhab
Piranfar
Mehrdad
Moosazadeh Moghaddam
Nikta
Sajjadi
Somayyeh
Saeedi
Background & Objective: Enterococcus Species are the common cause of nosocomial infections, which are highly resistant to different antibiotics. Therefore, determination of their antibiotic susceptibility patterns and simultaneous resistance to antibiotics is important for better treatment strategies. Methods: 400 clinical Enterococcus isolates were collected from different hospitals in Tehran, Iran. Standard phenotypic-biochemical tests and PCR were used to identify the Enterococcus species. The antimicrobial susceptibility patterns and simultaneous resistance to selected antibiotics were determined by disk diffusion method according to the CLSI guidelines. All data analysis was performed using Python packages Scipy and Stats models. Result: According to the biochemical and PCR analyses, among 400 Enterococcus species, 72% of samples were Enterococcus faecalis, 10.75% Enterococcus faecium, and 17.25% other Enterococcus species. The results determined antimicrobial resistances of these strains against gentamicin, vancomycin, fosfomycin trometamol, teicoplanin, and quinupristin/dalfopristin. Results confirmed a significant correlation between resistance to vancomycin and resistance to teicoplanin. This correlation remains significant when including only E. faecium or E. faecalis species. We also found a negative correlation between resistance to teicoplanin and quinupristin/dalfopristin. Additionally, Quinupristin/dalfopristin was the least effective antibiotic while vancomycin and teicoplanin were the most effective ones. Conclusion: Based on the results and association between simultaneous resistance to some antibiotics such as vancomycin and teicoplanin, in the case of antibiotic resistance, the choice of a second antibiotic can be very important which can lead to good or bad effects.
Enterococcus faecalis
Enterococcus faecium
Multiple drug resistance
Correlation
2020
04
01
96
105
https://ijp.iranpath.org/article_38257_65c945692a2321bea4fdd1bafbccf1fa.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Comparison of Diagnostic Methods in Detection of Squamous Cell Abnormalities in Iranian Women with Abnormal Pap’s Smear Test and Associated Demographic and Issues
Fatemeh
Samiee Rad
mehdi
Ghaebi
Simin
Zarabadipour
Arezoo
Bajelan
fatemeh
Pashazade
Mehri
Kalhor
Amane
Barikani
Background & Objective: Premalignant lesions of cervix have increased dramatically in recent years. Early diagnosis and management of abnormalities have an effective role in preventing the invasion of the disease and also in timely treatment. This study aimed to compare diagnostic methods in the detection of squamous cell abnormalities with abnormal Pap smear test. Methods: This cross-sectional study was performed on 1000 women with abnormal Pap smears in 2007-2018. Sampling was performed with simple method. All samples were subjected to an immediate assessment of colposcopy and histopathology if suspected. The checklist included demographic information as well as symptoms, cytopathology, colposcopy and histopathology findings. Data analysis was performed using descriptive and statistical analysis (P<0.05). Result: A significant relationship between histopathology and Pap smear findings was found (P=0.009), also there was a significant correlation between histopathology and colposcopy findings (P=0.001). However, there was no significant relationship between clinical symptoms and histopathology findings (p=0.8). Sensitivity , specificity , positive and negative predictive value of Pap smear were 43%, 65.9%, 75.4%, 32.2% and of colposcopy were 74.7%, 39.5%, 75%, 39.1%, and of clinical symptoms were 72.6%, 28.1%, 71.1%, 29.7%, respectively. Conclusion: Pap smear findings have the appropriate diagnostic accuracy in comparison with colposcopy and histopathology findings for screening and diagnosis of squamous intra-epithelial lesions. Also, there was higher sensitivity of colposcopy compared with Pap smear to detect cervical lesions. Therefore, it is advisable to use these methods simultaneously.
Pap smear
Cytology
Colposcopy
pathology
cervical cancer
Atypical Cervical Squamous Cells
2020
04
01
106
116
https://ijp.iranpath.org/article_38305_fdec102aefe1cf4e253192ae6cbb0946.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Changes in Cytokeratin 18 during Neoadjuvant Chemotherapy of Breast Cancer: A Prospective Study
Danial
Fazilat-Panah
Somaye
Vakili Ahrari Roudi
Alireza
Keramati
Azar
Fanipakdel
Mohammad hadi
Sadeghian
Fatemeh
Homaei Shandiz
Soudabeh
ShahidSales
Seyed Alireza
Javadinia
Background & Objective: Prediction of response to neoadjuvant treatment is an important part of treatment of patients with breast cancer. This study aimed to assess changes in serum levels of Cytokeratin 18 during neoadjuvant chemotherapy in patients with locally advanced breast cancer and its association with neoadjuvant treatments. Methods: This research was performed on newly diagnosed breast cancer patients referred to Omid Radiotherapy Center and radiotherapy and oncology departments of Emam Reza and Ghaem hospitals, in Mashhad, Iran. Serum levels of M30 and M65 fragments of Cytokeratin 18 were measured before and 24 hours after the first course of neoadjuvant chemotherapy. Changes in serum levels of Cytokeratin 18 and its fragments and their correlation with pathologic response were analyzed. Result: Pre- and post-chemotherapy levels of M30 were respectively 223.9±18.94 and 250.7±23.92 U/L (P=0.24). For M65, these levels were respectively 301.5±313.9 and 330.2±352.2 U/L (P=0.1). Changes in M30 level during chemotherapy in patients with and without pathologic complete response were -20±92.69 and 43.1±106.5, respectively (P=0.1). For M65, these changes were respectively -247±55 and 76±240 (P=0.1). Baseline levels of M30 and M65 had no relation with menopausal status, tumor grade, hormone receptor status, Ki67 expression, molecular subtype, and stage. Conclusion: Our findings showed statistically insignificant changes in the level of Caspase-cleaved- (M30) and uncleaved- (M65) cytokeratin 18 fragments (apoptotic and necrotic indicators, respectively) during neoadjuvant chemotherapy in patients with breast cancer. There was no notable relationship between tumor-related factors and either baseline levels or serum changes of CK18 fragments. Also, there was no correlation between M30/M65 level and pathologic response to neoadjuvant chemotherapy.
Breast carcinoma
Neoadjuvant Therapy
Cytokeratin-18
M30 cytokeratin-18 peptide
M65 cytokeratin-18 peptide
2020
04
01
117
126
https://ijp.iranpath.org/article_38306_35ac16669b04b86a385364a16a3aa7ab.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Persister cells formation and expression of type II Toxin-Antitoxin system genes in Brucella melitensis (16M) and Brucella abortus (B19)
Fatemeh
Amraei
Negar
Narimisa
Behroz
Sadeghi
Vahid
Lohrasbi
Faramarz
Masjedian Jazi
Background & Objective: Persister cells are defined as a subpopulation of bacteria that are capable of reducing their metabolism and switching to dormancy in stress conditions. Persister cells formation has been attributed to numerous mechanisms, including stringent response and Toxin-Antitoxin (TA) systems. This study aimed to investigate the hypothetical role of TA systems in persister cells formation of Brucella strains by evaluating toxins of type II TA systems (RelE, Fic, Brn T, cogT) expression. Methods: Brucella strains treated with a lethal dose of gentamicin and ampicillin and to determine the number of surviving cells, bacterial colonies were counted at different time intervals. The role of TA systems in persister cell formation was then determined by toxin expression levels using qRT- PCR method. Result: Our results showed the viability of persister cells after 7 h. The results of relative qRT- PCR showed higher levels of toxin gene expression due to stress conditions, suggesting the possible role of TA systems in persister cells formation and antibiotics tolerance. Conclusion: The results of this study showed that considering the importance of persistence and the tolerance to antibiotics, further studies on persister cells formation and related genes such as the TA system genes in Brucella strains might help us to identify the precise mechanisms leading to persister cells formation.
Brucella melitensis
Brucella abortus
Persister cell
TA systems
Real-time PCR
2020
04
01
127
133
https://ijp.iranpath.org/article_38307_fd9ee80fa0cbde27d65534196d62e9df.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Desmoplastic Fibroma of the Jaws: A Case Series and Review of Literature
Abbas
Karimi
Samira
Derakhshan
Monir
Moradzadeh Khiavi
Farzaneh
Mosavat
Faeze
Mirjalili
Desmoplastic fibroma (DF) is a benign, locally aggressive neoplasm that rarely occurs in the facial skeleton. It usually presents during the first three decades of life. Due to its aggressiveness and high recurrence rate, early diagnosis is imperative, and complete surgical removal of the lesion is the treatment of choice. Herein, we present three cases of DF namely a 2 year-old girl with a mandibular DF, a 9 year-old boy with a maxillary lesion and a 1.5-year old boy with a mandibular DF. Complete clinicopathological information, treatment plan and long-term follow-up of patients are discussed. Histopathologic features of 3 cases revealed non-capsulated spindle cell tumor with fascicular or swirling patterns in incisional biopsy. Immunohistochemical staining was performed to make a definitive diagnosis. Strongly positive nuclear immunoreactivity for β-catenin confirmed the diagnosis of desmoplastic fibroma in 3 cases. Segmental mandibulectomy, partial maxillectomy and hemimandibulectomy were done for the cases. There was no recurrence in our reported cases after 8 and 11 months and 3 years follow up, respectively. It is noteworthy that despite the aggressive nature of DF, young patients often respond well to wide resection treatment.
Benign
Desmoplastic
Fibroma
Jaw
2020
04
01
134
143
https://ijp.iranpath.org/article_38308_2bfefb63eb6fc71fc1110334ae437757.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Epithelial-Myoepithelial Carcinoma of the Palate: Report of a Case and Review of the Literatures
Nazanin
Mahdavi
Maedeh
Ghorbanpour
Epithelial-myoepithelial carcinoma (EMC) is considered as a rare malignant salivary gland neoplasm with good prognosis, low recurrence rate and rare metastasis. Here we present a case of epithelial-myoepithelial carcinoma in a 42-year-old female with a swelling of 3-year duration in her palate. Histopathologic evaluation of the lesion demonstrated a well-circumscribed, biphasic salivary gland tumor composed of double-layered ductal/glandular structures, composed of small luminal eosinophilic cells and abluminal larger clear myoepithelial cells, and luminal cells were positive for pan-cytokeratin, while the abluminal cells exhibited strong immunoreactivity for p63. Ki-67 proliferative index was 1% in abluminal cells. In this article, histopathologic and immunohistochemical features of EMC and its mimics are discussed and the previously reported cases of EMC in the literature are summarized.
Epithelial-myoepithelial carcinoma
salivary gland tumor
Clear cell tumors
Head and Neck
oral mucosa
2020
04
01
144
150
https://ijp.iranpath.org/article_38309_4316467a411839ac2c92fe893e58bf92.pdf
Iranian Journal of Pathology
Iran J Pathol
1735-5303
1735-5303
2020
15
2
Sarcomatoid Carcinoma of the Penis: An Uncommon Penile Neoplasm
Sucheta
Gandhe
Rahul
Patil
Raj
Nagarkar
Sarcomatoid squamous cell carcinomas are extremely rare, high grade, aggressive variant of penile cancers. Sarcomatoid carcinoma are biphasic neoplasms with a combination of both sarcomatoid components and carcinomatous elements. These neoplasms are very rare in the urogenital system. We report a 53-year-old male presented with an ulcerated lesion on the glans penis. The rarity of this case reiterates the importance of thorough morphological and histological examination along with immunohistochemistry in diagnosing, staging, treatment and follow up of patients.
Sarcomatoid Carcinoma
Penis
Immunohistochemistry
Case Report
2020
04
01
151
153
https://ijp.iranpath.org/article_38310_689936cb4b296322f521a985d92b82aa.pdf