Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Are Osteopontin and Ki67 Expressions Different in Various Histologic Grades of Meningioma? An Iranian Experience2532571260310.7508/ijp.2015.04.001ENForough HashemiDept. of Pathology, Iran University of Medical Sciences, Tehran, IranPegah BabaheidarianDept. of Pathology, Iran University of Medical Sciences, Tehran, Iran0000000194887228Soheila DabiranDept. of Social Community Medicine, Tehran University of Medical Sciences, Tehran, IranJournal Article20140525Background: Meningioma is among the most common slow growing central nervous neoplasms, which recurs locally despite the benign histologic features. The aim of this study was to evaluate osteopontin and ki67 expressions in different histologic grades of meningioma in a group of Iranian people. Methods: In this cross-sectional study, first, the paraffin blocks with the definite pathological diagnosis of meningioma in 70 patients were cut by microtome, in 4-5 micron sizes and stained for immunohistochemical markers of osteopontin and ki67. Then, all samples were evaluated for positive immunoreactivity and contributing factors. Results: Among 70 pateints studied, the mean for the Ki67 level was 8.6±12.3 and the mean for the osteopontinm IHC score was 45.2±77.9. There was a high correlation between markers, tumor recurrence and grade (<em>P</em><0.001). In addition, there was a significant direct correlation between ki67 and osteopontin levels (<em>P</em><0.001, r=0.760). In other words, as OPN and ki67 expressions increased, the chance of tumor recurrence increased. Conclusion: ki67 and osteopontin expressions in patients with meningioma can be used as good prognostic markers for tumor recurrence and for distinguishing the grade of meningiomas.
<span style="color: #0000ff;">How to cite this article:</span> Hashemi F, Babaheidarian P, Dabiran S. Are Osteopontin and Ki67 Expressions Different in Various Histologic Grades of Meningioma? An Iranian Experience. Iran J Pathol. 2015; 10(4): 253 - 257.https://ijp.iranpath.org/article_12603_a0e8131b9fd19cd754b4c621c9ad1aaa.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001The Microbial Surface Components Recognizing Adhesive Matrix Molecules (MSCRAMMs) Genes among Clinical Isolates of Staphylococcus aureus from Hospitalized Children2582641321210.7508/ijp.2015.04.002ENAbdolmajid GhasemianDept. of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranShahin Najar PeerayehDept. of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran0000-0001-5404-9190Bita BakhshiDept. of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranMohsen MirzaeeDepartment of Laboratory Sciences, Borujerd Branch, Islamic Azad University, BorujerdJournal Article20140818<em>Background:</em>Isolates of <em>Staphylococcus aureus</em> express a myriad of adhesive surface proteins that play important role in colonization of the bacteria on nasal and skin surfaces, beginning the process of pathogenesis. The aim of this study was to screen several of the Microbial Surface Components Recognizing Adhesive Matrix Molecules (MSCRAMMs) genes among the isolate of <em>S. aureus</em> from hospitalized children.
<em>Methods:</em>A totalof 22 <em>S. aureus</em> isolates were collected from hospitalized children in Tehran from 2012 to 2013. Detection of the <em>mecA</em> and several adhesive surface proteins genes including <em>clfA, B</em> (encoding clumping factors A, B); <em>fnbA</em>, <em>B</em> (encoding finronectin binding proteins A, B); <em>fib</em> (encoding fibrinogen binding protein); <em>eno</em> (encoding laminin binding protein); <em>cna</em> (encoding collagen binding protein); <em>ebps</em> (encoding elastin binding protein) and <em>bbp</em> (encoding bone sialo-protein binding protein), was performed by PCR.
<em>Results:</em> The <em>clfAB</em> genes were detected among all the isolates. The prevalence of <em>fnbA</em>, <em>fnbB</em>, <em>fib</em>, <em>eno</em>, <em>cna</em>, <em>ebps</em> and <em>bbp</em> was 63%, 6%, 50%, 59%, 82%, 63%, 9% and 0%, respectively.
<em>Conclusion</em><em>:</em> The high prevalence of these genes is important for future plans in vaccine designation. MRSA and MSSA isolates similarly can produce adhesive surface proteins for colonization.https://ijp.iranpath.org/article_13212_9c4b1686635e4ea3b098644a5eaa696c.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Detection of Multidrug Resistant (MDR) and Extremely Drug Resistant (XDR) P. Aeruginosa Isolated from Patients in Tehran, Iran2652711321310.7508/ijp.2015.04.003ENHorieh SaderiMolecular Microbiology Research Center, Shahed University, Tehran, IranParviz OwliaMolecular Microbiology Research Center, Shahed University, Tehran, IranJournal Article20150617<em>Background:</em> This study was done to detect multidrug resistant (MDR) and extremely drug resistant (XDR) of<em> Pseudomonas aeruginosa</em> among strains isolated from patients in Tehran, Iran, due to importance of these phenotypes in treatment of human infections. <em>Methods:</em> Eighty eight<em>P. aeruginosa</em> were isolated from patients in Tehran, Iran, and identified by routine methods and PCR for <em>oprL</em> gene. Their antimicrobial susceptibility to 16 antimicrobial agents from 7 antimicrobial categories (aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, penicillins/ß-lactamase inhibitors, monobactams, polymyxins) were determined by disk diffusion method, according to recommendation of Clinical and Laboratory Standards Institute. Characterization of <em>P. aeruginosa</em> isolates as MDR and XDR was done according to standardized international terminology presented by European Centre for Disease Prevention and Control as well as the Centers for Disease Control and Prevention in 2011. MDR was defined as acquired non-susceptibility to at least one agent in ≥3 antimicrobial categories and XDR was defined as non-susceptibility to at least one agent in ≥6 antimicrobial categories. <em>Results:</em> The rates of susceptibility to antimicrobials were as follows: gentamicin 27.3%, tobramycin 54.5%, amikacin 56.8%, netilmicin 36.4%, imipenem 55.7%, meropenem 55.7%, doripenem 60.2%, ceftazidime 63.6%, cefepime 56.8%, ciprofloxacin 59.1%, levofloxacin 60.2%, ticarcillin-clavulanic acid 37.5%, piperacillin-tazobactam 63.6%, aztreonam 43.2%, colistin 90.9%, polymyxin 95.5%. Altogether, 48 (54.5%) and 29 (33%) isolates were characterized as MDR and XDR, respectively. <em>Discussion:</em>The high frequency of antibiotic resistance in clinical isolates of <em>P. aeruginosa</em> in Iran makes epidemiological surveillance of susceptibility of this bacterium more essential for the best selection of empirical antibiotics.https://ijp.iranpath.org/article_13213_49e2b4e5e4f4a782e587e65d88865257.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Protective Effects of Hydrocortisone, Vitamin C and E Alone or in Combination against Renal Ischemia-Reperfusion Injury in Rat2722801321410.7508/ijp.2015.04.004ENOmid AzariDept. of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar Univercity of Kerman, Kerman, IranReza KheirandishDept. of Pathobiology, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, IranMohammad Farajli AbbasiVeterinary Medicine, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, IranShahin Ghahramani Gareh ChamanVeterinary Medicine, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, IranMasoud BidiVeterinary Medicine, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, IranJournal Article20140827<em>Background:</em> Renal ischemia reperfusion injury may occur in a variety of clinical situations, following a transient drop in total or regional blood flow to the kidney. This study was performed to investigate the protective effects of different antioxidants such as vitamin C, vitamin E, hydrocortisone and combination of these agents against experimental renal ischemia-reperfusion injury.
<em>Method:</em>Thirty male rats were divided into six groups. Group Sham, Group I/R: (45 min of ischemia followed by 1h of reperfusion), Group I/R+Vit C: (50 mg/kg Vit C, IV, immediately after reperfusion), Group I/R+Vit E: (20 mg/kg Vit E, IM, 15 min before reperfusion), Group I/R+Hydrocortisone: (50 mg/kg, IV, immediately after reperfusion), and Group Combination: Ischemia-reperfusion plus combination of Vit C, E and hydrocortisone. After the experiments, the left kidney was removed and the tissues were processed for histopathological examination.
<em>Result:</em> Severe injuries such as necrosis of tubules, atrophy of glomerulus, and hemorrhage were observed in group I/R. Histological scores indicating tissue injury significantly decreased in all treatment groups compared to the group I/R. The renal tissue in group treatment was preserved in comparison with the group I/R. Comparison between the treatment groups showed that group combination was more effective and group vit E was less effective in protecting of renal tissue against I/R injuries.
<em>Conclusion:</em> The results demonstrated simultaneous administration of combination of Vit C, E and hydrocortisone before reperfusion of blood flow to the ischemic tissue could show a synergy against deleterious effects of I/R injuries in kidney.https://ijp.iranpath.org/article_13214_9bbc94fb1c41ea3787040a98ecca3735.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Renal Tumours in Adults with Correlation between Fuhrman Grading and Proliferative Marker2812891321510.7508/ijp.2015.04.005ENSabuj Ghana MukhopadhyayDepartment of Pathology, Burdwan Medical College, Burdwan, West Bengal,IndiaKrishnendu MukherjeeDepartment of Immunohematology and Blood Transfusion, Medical College. KolkataAsim Kr. MannaDepartment of Pathology, IPGMER, KolkataJournal Article20150617<em>Background</em><em>:</em> Definite data regarding the incidence and distribution of renal tumours in eastern India is not known. For better management, as it is essential to identify patients with poor prognosis, prognostic factors like stage, nuclear grade and their relationship to molecular markers are also unclear in this region. The purpose of our study was to assess the spectrum of adult renal tumours with respect to age and sex and to correlate Fuhrman nuclear grading with Ki-67 labeling index in a tertiary care hospital in eastern India.
<em>Methods</em><em>:</em> All adult patients with kidney tumour referred to our hospital who were preoperatively diagnosed and undergone surgical resection were included. Distribution of histological subtypes of kidney tumours according to age and sex were done by Hematoxylin and Eosin stain. Fuhrman grading, performed by ocular morphometry and derivation of Ki-67 labeling index (LI), were done in malignant cases only. Correlation of Fuhrman grading and KI-67 LI were done individually.
<em>Results</em><em>:</em> Among total 36 cases, 3 were benign and 33 were malignant. Among the malignant cases: Fifteen, twelve, four and two cases were of Fuhrman grade I, II, III, IV with mean Ki67 labeling index of 6.5, 18.2,44 and 76 respectively. Statistical correlation between mean Ki-67 LI and Fuhrman grading revealed significant correlation between Grade I and II, II and III and combined Grade I,II and III,IV tumours.
<em> Conclusion</em><em>:</em> Malignant Kidney tumours, especially, grade I RCC were commonest tumour. Fuhrman grading correlated well with Ki-67 labeling index. A 2-tier system for grading is proposed for better correlation with proliferation.https://ijp.iranpath.org/article_13215_55c6d51a6741e7b585f0acd80e963ae9.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001A Five Years Study of Tuberculous Meningitis in Iran2902941323210.7508/ijp.2015.04.006ENMassoud HajiaDept. of Medical Microbiology, Research Center of Reference Laboratories, Ministry of Health and Medical Education, Tehran, Iran0000-0001-5524-7252Ali Akbar AmirzargarDepartment of Immunology, School of Medicine, Tehran University of Medical SciencesMina NazariNoor Pathobiology LaboratoryNeda Razavi DavodiNoor Pathobiology LaboratoryMorteza Karami ZarandiNoor Pathobiology LaboratoryJournal Article20150617<em>Background:</em> Tuberculous meningitis (TBM) is a severe form of extra pulmonary tuberculosis with high mortality and morbidity rate in all age group patients specific in adults and children. The incidence and prevalence are not exactly known in Iran. In this study, we tried to evaluate the role of rapid diagnosis and to find out the highest risk group patients.
<em>Methods:</em>Totally, 1783-suspected patients with tuberculous meningitis whose CSF specimens were admitted at Noor Pathobiology Laboratory, Tehran, Iran were enrolled in this study from January 2009 until December 2013.All specimens were checked for MTB by direct examination, culture and PCR tests, andfor the adenosine deaminase (ADA).
<em>Results:</em>Confirmed positive cases were aged from 13 to 82 yr old with mean age 46.63 yr (SD±18.84). The number of diagnosed positive MTB was different by the 3 applied protocol, 64 by PCR, 28 by culture and 33 by direct examination. Considering the result of PCR protocol theTBM was approved in 64 patients with rate of 3.59%. Two patients had other infection as well, one 56 years old with VZV and the other patient who was HIV positive was 27 years old. Increased ADA titer higher than cutoff was relevant with other results of positive samples except in two cases.
<em>Conclusion:</em>Analysis of the results proved adults are more at risk for tuberculous meningitis than children in Iran are. It is also confirmed PCR method provide the most efficient, rapid and reliable results for these patients who are at the critical situations.https://ijp.iranpath.org/article_13232_e4b7947163a499e110563b928d8a4a1a.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001The Diagnostic Accuracy of Frozen Section Compared to Permanent Section: A Single Center Study in Iran2952991323410.7508/ijp.2015.04.007ENHossein HatamiDepartment of Public Health, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IranZhaleh MohsenifarPathology Department, Taleghani General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000000277667570Seyed Navid AlaviDepartment of MPH, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20150617<em>Background:</em>The diagnostic accuracy of frozen section as an important source of information in surgical pathology is important not only in the management of surgical patients but also as a measure of quality control in surgical pathology. In this study, we evaluated the diagnostic accuracy of frozen sections over a 6-year period in a teaching hospital in Iran.
<em>Methods:</em> We retrospectively reviewed frozen sections performed in the Pathology Department of Taleghani Hospital (Shahid Beheshti University of Medical Sciences), Tehran, Iran from 2007 to 2013. The results were compared to the permanent sections to evaluate diagnostic accuracy, sensitivity and specificity, of frozen section test. Discordant cases were reassessed to find the reasons for discrepancy.
<em>Results:</em> A total of 306 frozen section specimens from 176 surgical cases were evaluated. In eleven specimens (3.59%) the diagnoses were deferred. Of the remaining 295 specimens, 6 (2.03%) were discordant and 289 (97.96%) were concordant to permanent diagnoses. Specimens were primarily from the head & neck, thyroid, ovary, parathyroid and lymph nodes. The overall sensitivity, specificity, positive predictive value and negative predictive value of the frozen section compared to permanent section (as gold standard) were 92.95%, 99.55%, 98.50% and 97.80% respectively. Of the 6 discordant diagnoses, two (33.3%) were due to sampling error and four (66.6%) were due to interpretative errors.
<em>Conclusion:</em> Frozen section is an accurate and valuable test and can be relied on in surgical managements. The results of this study also confirm that the accuracy of frozen section diagnosis in our institution compares well with internationally published rates.https://ijp.iranpath.org/article_13234_513c7e8a79a3fd0b1c4824756cb66b0a.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Extensive Focal Epithelial Hyperplasia: A Case Report3003051323710.7508/ijp.2015.04.008ENZahra MansouriDept. of Oral Medicine, Dental School, Shahid Beheshti University, Tehran, IranSedigheh BakhtiariDept. of Oral Medicine, Dental School, Shahid Beheshti University, Tehran, IranRobab NoormohamadiDept. of Oral Medicine, Dental School, Shahid Beheshti University, Tehran, IranJournal Article20150617Focal epithelial hyperplasia (FEH) or Heck’s disease is a rare viral infection of the oral mucosa caused by human papilloma virus especially subtypes 13 or 32. The frequency of this disease varies widely from one geographic region and ethnic groups to another. This paper reports an Iranian case of extensive focal epithelial hyperplasia. A 35-year-old man with FEH is described, in whom the lesions had persisted for more than 25 years. The lesion was diagnosed according to both clinical and histopathological features. Dental practitioner should be aware of these types of lesions and histopathological examination together and a careful clinical observation should be carried out for a definitive diagnosis.https://ijp.iranpath.org/article_13237_55d7e2de38cefcb04c621a31ab29752b.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Gastric Calcifying Fibrous Tumor Resembling Gastrointestinal Stromal Tumor: A Case Report3063091323810.7508/ijp.2015.04.009ENSmiley Annie GeorgeDept. of Histopathology, Mubarak Al Kabeer Hospital, Jabriya, KuwaitSuad AbdeenDept. of Histopathology, Mubarak Al Kabeer Hospital, Jabriya, KuwaitJournal Article20150617Calcifying fibrous tumor (CFT) is a rare mesenchymal tumor, affecting children and young adults with a predilection for the soft tissue and the abdominal cavity. CFT of the tubular gastrointestinal tract is very rare with less than 20 cases of gastric CFTs reported in English literature. This benign hypocellular fibrosclerotic calcifying lesion can resemble other spindle cell tumors particularly sclerosing gastrointestinal stromal tumor of the stomach. Differentiating between these lesions is particularly important for prognostic and therapeutic purposes. Herein a case of gastric calcifying fibrous tumor incidentally detected during bariatric surgery in a 27-year-old woman is described, with a discussion on its clinicopathological features and differential diagnoses.https://ijp.iranpath.org/article_13238_c069c0c143f9b89a2fcffa30f992e1f8.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Cystic Hygroma in an Adult Male: A Diagnostic Challenge3103131324010.7508/ijp.2015.04.010ENVarsha BhatiaDept. of Pathology, Grant Government Medical College and Sir JJ Group of Hospitals,Byculla, Mumbai, Maharashtra, IndiaRahul TaksandeDept. of Pathology, Grant Government Medical College and Sir JJ Group of Hospitals,Byculla, Mumbai, Maharashtra, IndiaDivyaja SondankarDept. of Pathology, Grant Government Medical College and Sir JJ Group of Hospitals,Byculla, Mumbai, Maharashtra, IndiaJournal Article20150617Cystic Hygroma is a well-recognized lesion in paediatric patients but it is very rare in adults. We report here a case of Cervical Cystic Hygroma in a 45 yr old male. The reasons to present this case are 1) Its rarity in adults 2) Unusual age of presentation 3) Simulates various benign and malignant lesions at this site 4) Is a diagnostic challenge and 5) Role of histology for definitive postoperative diagnosis. https://ijp.iranpath.org/article_13240_c5c521e6da1945ea529aeb6efb927401.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Giant Cell Fibroma of the Buccal Mucosa with Laser Excision: Report of Unusual Case3143171324210.7508/ijp.2015.04.011ENFatemeh BagheriDept. of Oral Medicine, shahid Beheshti University of Medical Sciences, Tehran, IranSomayyeh RahmaniDept. of Oral Medicine, shahid Beheshti University of Medical Sciences, Tehran, IranSomayyeh AzimiDept. of Oral Medicine, shahid Beheshti University of Medical Sciences, Tehran, IranJamileh Bigom TaheriDept. of Oral Medicine, shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20150617Giant Cell Fibroma (GCF) was described as a new entity of fibrous hyperplastic soft tissue. It seems that stimulus from an unexplained origin can have a role in its etiology. Histopathologically GCF is consisted of multinucleated fibroblasts that have oval shape nuclei within the eosinophilic cytoplasm. Surgical excision is the treatment of choice and recurrence is very rare. Here we report a case of relatively large GCF in a 54-year-old man. Gingiva is the common location of GCF. As in our case, it may be mistaken as irritation fibroma especially if it is on the buccal mucosa, the most common location for fibroma. Correct diagnosis is based on biopsy and clinical examination to see surface texture roughness. To minimize bleeding because of its large size an excisional biopsy with Diod laser was performed under local anesthesia for this patient.https://ijp.iranpath.org/article_13242_4cda6a60b22bb509f07f3176a1f3a9c2.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001The Adverse Effects of Pregnancies Complicated by Hemoglobin H (HBH) Disease3183211324410.7508/ijp.2015.04.012ENMaryam RabieeDept. of Obstetrics and Gynecology, Faculty of Medicine, Shahed University, Tehran, IranJalal-Aldin ShamsDept. of Oncology and Hematology, Faculty of Medicine Shahed University, Tehran, IranNafiseh ZafargandieDept. of Obstetrics and Gynecology, Faculty of Medicine, Shahed University, Tehran, IranJournal Article20150617Hemoglobin (Hb) H disease is a moderate form of α- thalassemia resulting from various genetic defects. HbH disease is not necessarily a benign disorder as has been generally thought. We present hereby a 25- year-old Iranian pregnant woman whom referred to our hospital for blood transfusion. She exhibited the clinical and hematological manifestation of HbH disease. Her father carries a common α-thalassemia deletion while her mother was normal in the hematological profile. The object of this report was to provide information about pregnancies affected by HbH disease.https://ijp.iranpath.org/article_13244_5351ac87d221068544e8fa75693dba86.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Laryngeal Paraganglioma: A Diagnostic Challenge3223251324510.7508/ijp.2015.04.013ENFariba BineshDept. of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran0000-0002-6917-3028Mohammad Hossein DadgarniaDept. of Otolaryngology, Shahid Sadoughi University of Medical Sciences, Yazd, IranYasaman KhaksarFaculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, IranAbbas MirvakiliDept. of Otolaryngology, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20150617Paragangliomas are neoplasms of neural crest origin. In the head and neck, they uncommonly involve the larynx. The distinction between paragangliomas and other neuroendocrine tumors can be difficult. Precise diagnosis is important in order to optimize patient treatment. Diagnosis relies mostly on histopathologic examination followed by immunohistochemistry. Here we report a 77-year-old woman with laryngeal paraganglioma that initially misdiagnosed as laryngeal carcinoid tumor.https://ijp.iranpath.org/article_13245_9d31f0e61ace0d83444d675e55d683ff.pdfFarname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530310420151001Diarrhea Can Be an Important Clinical Presentation of 2014 Western Africa Ebola Virus Infection3263261324710.7508/ijp.2015.04.014ENBeuy JoobSanitation 1 Medical Academic Center, Bangkok ThailandViroj WiwanitkitJoseph Ayobabalola University, NigeriaJournal Article20150617Dear Editor-in-Chief
The present global consideration is on the recent outbreak of 2014 Western Ebola virus in West Africa (1 – 3). This viral hemorrhagic fever wide spreads to several countries in West Africa and remote countries (1 - 3). With high death rate, the disease is presently on the list of public health threatens. The main problem for management of the infection is the limited knowledge on its clinical presentation.
An interesting concern is on the gastroenterology presentation of this new disease. In fact, some new viral diseases such as atypical influenza virus infection can have an important clinical presentation as diarrhea (4). Here, the authors try to summarize on the magnitude of diarrhea in clinical presentation of this new disease. From information reported from 15 confirmed cases from Guinea (1 – 3, 5), 73.3% of the cases primarily present with diarrhea. This rate is considerable high comparing to those observed in other viral hemorrhagic disease such as dengue (rate of diarrhea at presentation < 5% (6).
This calls for the attention that it is necessary to think about new Ebola disease in any febrile illness patient with diarrhea who has history of visiting to outbreak area.https://ijp.iranpath.org/article_13247_5c66981b5157c408f664ae47633c7a0e.pdf