Microbiology
Kosar Jalalvand; Nasrin Shayanfar; Freshteh Shahcheraghi; Elahe Amini; Masha Mohammadpour; Pegah Babaheidarian
Abstract
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 ...
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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.
Ali Zare Mirzaei; Fatemeh Abdorrazaghi; Maryam Lotfi; Behrang Kazemi Nejad; Nasrin Shayanfar
Abstract
Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim ...
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Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim of the present study is to investigate the effect of this factor on the prognosis of the patients presenting with stage III colon cancer and to compare the result with the effect of lymph node stage on their prognosis. Methods: This cross-sectional study was carried out on 66 patients of stage III colon cancer, who met the study inclusion criteria. Patients were categorized into four groups based on Kaplan-Meier plots: LNR1 0-12%, LNR2 13-40%, LNR3 41-84% and LNR4 85-100%. Survival was estimated by Kaplan-Meier method, and differences analyzed by Log-rank test. A Cox proportional hazards model was used for multivariate analysis. Results: Lymph nodes ratio was a significantly variable both in overall survival (P<0.0001) and in disease-free survival (P=0.009). Lymph node stage was significant in overall survival (P=0.008) but not in disease-free survival (P=0.05). Multivariable analysis of overall survival showed lymph nodes ratio as the only independent prognostic factor. Conclusion: Lymph node ratio is a more accurate prognostic factor than lymph node stage in overall survival and, in particular, in disease-free survival in patients with stage III colon cancer.
Nasrin Shayanfar; Mitra Rezaei; Mehdi Ahmadi
Volume 5, Issue 1 , January 2010, , Pages 34-39
Abstract
Background and Objective: To evaluate extended spectrum betalactamase (ESBL) positive strains of Klebsiella pneumonia and Escherichia coli in positive bacterial cultures. Materials and Methods: In this analytical cross-sectional study, between March 2006 and March 2007, 170 bacterial isolates ...
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Background and Objective: To evaluate extended spectrum betalactamase (ESBL) positive strains of Klebsiella pneumonia and Escherichia coli in positive bacterial cultures. Materials and Methods: In this analytical cross-sectional study, between March 2006 and March 2007, 170 bacterial isolates including 133 cases of E. coli and 37cases of K. pneumonia were examined. All cases underwent double disk diffusion for ESBL. Demographic data were assessed and all data analyzed accordingly. Results: Patients’ mean age was 55±26.63 yr. Ninety six cases (56.5%) were female and 74 cases (43.5%) were male. Clinical presentation of infection were 118 cases UTI (96.4%), 15 cases septicemia (8.8%), 16cases wound infection (9.4%), 7 cases pneumonia (4.1%), 1 case meningitis (0.6%) and 13 cases other presentations (7.6%). Frequency of ESBL positive in E. coli isolates was 38 cases (28.6%) and in K. pneumonia isolates was 10 cases (27%). There was no significant correlation between ESBL positivity and age, gender, ward or clinical presentation of infection. Conclusion: Incidence of ESBL positive isolates of E. coli and K. pneumonia was high. These results should be considered in administration of broad-spectrum antibiotics by clinicians.
Nasrin Shayanfar; Shahriar Zohourian Shahzadi
Volume 4, Issue 4 , September 2009, , Pages 167-171
Abstract
Background and Objective: Neuroendocrine differentiation has not been proved to have effects in behavior of colorectal carcinomas. The aim of this study was Immunohistochemical evaluation of neuroendocrine differentiation in colorectal cancer. Patients and Methods: In this cross-sectional study, 83 ...
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Background and Objective: Neuroendocrine differentiation has not been proved to have effects in behavior of colorectal carcinomas. The aim of this study was Immunohistochemical evaluation of neuroendocrine differentiation in colorectal cancer. Patients and Methods: In this cross-sectional study, 83 paraffin blocks from patients admitted in Rasoul-e-akram Hospital, Tehran, Iran, during 2003 to 2008, were evaluated in Pathology Department. All sections were stained with immunohistochemistry method for neuron specific enolase (NSE) and Chromogranin A(CgA). Data were analyzed using SPSS 12.0. Results: Median age of patients was 56 yr. Forty four cases (53%) were female. According to TNM staging system, 11% of cases were in stage I, 29% in IIa, 7% in IIb, 2% in IIIa, 23% in IIIb, 24% IIIc and 2% were in stage IV. Thirteen cases (16%) were NSE positive, 15 cases (18.1%) were CgA positive. Two, 8 and 5 percent of the patients in grade I, II and III were CgA positive, respectively. Two, 6 and 5 percent of the patients in grade I, II and III were NSE positive. In grades II and III, NSE and CgA were significantly higher than grade I (P<0.001). CgA incidence was higher significantly in mucinous carcinomas (P<0.05). Conclusion: Less than 20% of colorectal cancers showed neuroendocrine differentiation. There was no significant relationship between NSE and CgA incidence with stage or tumor site. There was a relationship between histologic grade and above-mentioned markers; this finding may help us in our knowledge about tumor behavior.
Nasrin Shayanfar; Behrang Kazeminejad
Volume 3, Issue 1 , January 2008, , Pages 30-34
Abstract
Background and Objective: Determination of hormone receptor status in the management of breast cancer is well-established. The aim of this study was to evaluate the frequency of androgen receptor (AR) expression in invasive ductal carcinoma of breast. Materials and Methods: For this purpose, ...
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Background and Objective: Determination of hormone receptor status in the management of breast cancer is well-established. The aim of this study was to evaluate the frequency of androgen receptor (AR) expression in invasive ductal carcinoma of breast. Materials and Methods: For this purpose, 55 cases of invasive ductal breast carcinoma were examined using a monoclonal antibody against AR on formalin-fixed paraffin-embedded archival material. The results were correlated with the results of estrogen and progesterone receptors (ER and PR) previously done immunohistochemically on the specimens. Results: It was found out that AR was positive in 24 cases (43.6%). In addition, AR was positive in 33% (3) of grade 1, 45% (16) of grade 2, and 38% (15) of grade 3 tumors. Previously, ER and PR were done on 34 cases including 5 grade 1, 18 grade 2, and 11 grade 3 carcinomas. Among the grade 1 cases, 2 out of them were AR positive which were also ER and PR positive but 2 (11%) out of grade 2 and 3 (27%) out of grade 3 tumors were AR positive and ER negative. Also, 5 (28%) out of grade 2 and 3 (27%) out of grade 3 tumors were AR positive and PR negative. In grade 2 tumors, correlation between ER and PR negativity with AR positivity was significant. Conclusion: AR expression is common in invasive breast carcinomas. Some high grade carcinomas are ER and PR negative and AR positive. We suggest that immunohistochemical evaluation of AR may help in providing more information about steroid receptors in breast carcinomas
Nasrin Shayanfar; Shahriar Shahriar Zohourian Shahzadi
Volume 3, Issue 1 , January 2008, , Pages 43-46
Abstract
Schwannomas are benign nerve sheath tumors that originate from any anatomical site. Most of the schwannomas are found in the head, neck or limbs. Schwannoma arising in a lymph node is extremely rare. We have found only four cases in the review of the literature. We experienced a case of intranodal ...
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Schwannomas are benign nerve sheath tumors that originate from any anatomical site. Most of the schwannomas are found in the head, neck or limbs. Schwannoma arising in a lymph node is extremely rare. We have found only four cases in the review of the literature. We experienced a case of intranodal schwannoma in a perigastric lymph node. A 72 year-old female underwent cholecystectomy due to clinical signs of cholecystitis. A mass was found in perigastric area on lesser curvature of the stomach. The mass was excised in an encapsulated state. On histological examination, the node was composed of a proliferation of bland spindle cells, which immunohistochemically was positive for S100 protein and negative for smooth muscle actin, desmin, and cytokeratin. The morphologic and immunatistochemical studies revealed an extremely rare case of schwannoma of the lymph node.
