Molecular Pathology
Sarah Siahbani; Akbar Safaie; Masoumeh Faghih; Marzieh Hosseini; Afsaneh Fendereski; Behnaz Valibeigi; Ahmad Monabati
Abstract
Background & Objective: Acute Promyelocytic Leukemia (APL) is a medical emergency with potentially fatal complications. APL primarily results from a chromosomal translocation (t(15;17)(q22;q21)), leading to the formation of the PML-RARA fusion gene with three possible isoforms. This study aims to ...
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Background & Objective: Acute Promyelocytic Leukemia (APL) is a medical emergency with potentially fatal complications. APL primarily results from a chromosomal translocation (t(15;17)(q22;q21)), leading to the formation of the PML-RARA fusion gene with three possible isoforms. This study aims to investigate the characteristics of Iranian APL patients, the distribution of PML-RARA isoforms, and survival analysis.Methods: We included 145 consecutive eligible patients in this study. Data were collected through archived documents and phone inquiries, following consent. Subsequently, we analyzed the data using SPSS software version 26.0.Results: We examined 75 men and 70 women, with a mean age of 34 years (range: 2-78 years). Besides t(15;17) (q22;q21), 45.6% had other chromosomal abnormalities. The prevalence of bcr1 and bcr3 isoforms was 73% and 27%, respectively. bcr3 correlated with higher white blood cell (WBC) counts, additional chromosomal abnormalities, and faster Complete Hematologic Response (CHR). Early death occurred in approximately 36% of all patients. The mean overall survival time was 73.5 months, with 120-month survival rates of 53.8% for all patients and 83.9% for those who achieved CHR. Univariate analysis identified old age, relapse, lower platelet (PLT) counts, higher WBC counts, and leukocytosis as survival risk factors. However, in multivariate analysis, only old age and higher WBC counts were identified as adverse prognostic factors.Conclusion: In Iranian APL patients, bcr1 predominates, while bcr3 correlates with higher WBC counts, high-risk categorization, additional chromosomal abnormalities, and faster CHR. Survival is negatively impacted by old age, relapse, lower PLT counts, higher WBC counts, and leukocytosis.
Infectious Diseases
Parisa Khorasani Esmaili; Shahriar Dabiri; Tooraj Reza Mirshekari; Fatemeh Nabipour; Ayeh Shamsadini; Hadi Eslami; Mohammad Ali Damghani; Ali Asghar Arabi; Maryam Amizadeh; Fatemeh Fani; Navid Gharaei; Shiva Pouradeli
Abstract
Background & Objective: Mucormycosis (also called black fungus) is an opportunistic serious fungal infection caused by mucormycetes. It can occur in diabetes mellitus patients and other immunosuppressive conditions with recent predisposing factors such as maxillofacial surgery and corticosteroid ...
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Background & Objective: Mucormycosis (also called black fungus) is an opportunistic serious fungal infection caused by mucormycetes. It can occur in diabetes mellitus patients and other immunosuppressive conditions with recent predisposing factors such as maxillofacial surgery and corticosteroid usage.Methods: In this study, 14 patients were referred to the otorhinolaryngology or ophthalmology ward of Shafa Hospital (Kerman, Iran) with primary symptoms of nasal fullness and Facial nerve dysfunction; they were admitted to the hospital to rule out the fungal infection. An endoscopic biopsy was taken from facial sinuses or orbit, and a microscopic evaluation was performed using hematoxylin and eosin (H&E) and periodic acid–Schiff (PAS) staining methods to rule out mucormycosis.Results: In the histopathological examination, broad-based nonseptate branching fungal hyphae were found in nasal sinuses through the endoscopic biopsy. Most of the patients had diabetes mellitus with a primary symptom of facial nerve palsy; also, most of them received corticosteroids (intravenous [IV] or intramuscular [IM] injection). All patients have recently been infected with COVID-19 (less than 1 month ago).Conclusion: COVID-19 infection could play a predisposing factor for many opportunistic infections, such as fungal elements); thus, the physician should be aware of the dose and day of corticosteroid therapy to prevent these infections.
Infectious Diseases
Mohamad Javad Zahedi; Sara Shafieipour; Mohammad Mahdi Hayatbakhsh Abbasi; Nader Pourjamali; Mohsen Nakhaie; Javad Charostad; Mohammad Rezaei Zadeh Rukerd; Mohammad Mehdi Lashkarizadeh; Fatemeh Karami Robati; Azam Dehghani; Yunes Jahani; Seyed Mohamad Ali Arabzadeh; Hamid Reza Mollaei; Ebrahim Ranjbar
Abstract
Background & Objective: Hepatitis E Virus (HEV) infection may be common in Human Immunodeficiency Virus (HIV-1) patients and may lead to chronic infection as well as cirrhosis. We intended to determine the incidence of HEV infection among HIV-1 patients in comparison to individuals without HIV-1 ...
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Background & Objective: Hepatitis E Virus (HEV) infection may be common in Human Immunodeficiency Virus (HIV-1) patients and may lead to chronic infection as well as cirrhosis. We intended to determine the incidence of HEV infection among HIV-1 patients in comparison to individuals without HIV-1 infection.Methods: In our cross-sectional study, 87 HIV-1-positive patients were compared to 93 healthy individuals in Kerman, Iran. Plasma and peripheral blood mononuclear cells (PBMCs) were obtained from all participants. Plasmas were evaluated for HEV IgM and IgG using the ELISA kit. Then, reverse transcriptase-nested polymerase chain reaction (RT-nested PCR) was used in RNA extractions from PBMCs to check for the presence of HEV RNA.Results: Among the subjects examined in our study, 61 (70.1%) and 71 (77.4%) out of patients with HIV-1 infection and healthy individuals were male, respectively. The average ages of patients with HIV-1 and the control group were 40.2 years and 39.9 years, respectively. No discernible differences existed between the two groups based on IgM and IgG seropositivity against the HEV. However, HEV-RNA was found in 8% of patients with HIV-1 and 1.1% of HIV-1-negative individuals (P=0.03). There was also an association between the HEV genome and anti-HEV and anti-HCV antibodies in HIV-1-positive patients (P=0.02 and P=0.014, respectively).Conclusion: HEV infection was more common in HIV-1 patients and may develop a chronic infection in immunocompromised individuals. Here, we suggest molecular-based HEV diagnostic tests, including RT-PCR assays, should be performed in HIV-1 patients with unknown impaired liver function tests.
Endocrine Pathology
Mansoureh Shokripour; Mohammad Hadi Imanieh; Saghar Garayemi; Navid Omidifar; Babak Shirazi Yeganeh; Fadhil Althabhawee
Abstract
Background & Objective: The TSH reference range's validity affects the thyroid dysfunction diagnosis. The primary objective of this study is to determine the reference range, which is established according to age and region.Methods: The data were collected retrospectively from people over the age ...
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Background & Objective: The TSH reference range's validity affects the thyroid dysfunction diagnosis. The primary objective of this study is to determine the reference range, which is established according to age and region.Methods: The data were collected retrospectively from people over the age of one who visited Motahari Clinic for routine health checkups between August 2017 and October 2019. TSH, T4, T3, personal drug usage, and thyroid history were collected. After excluding subjects with thyroid diseases and outliers, a list of 1392 participants was analyzed. Hormone intervals of men and women ≥1 year old have been determined using the non-parametric method.Results: The non-disease subjects' TSH, T3, and T4 reference ranges were 0.64 to 5.94 lU/mL, 0.91 to 2.47 ng/dL, and 5.53 to 12.48 g/dL, respectively. According to this range, total thyroid dysfunction prevalence in our study in children was 8.94%. There was no significant difference between TSH, T4 level, and sex in the non-disease population (P=0.46 and 0.13, respectively), but there was a statistical difference between sex and T3 (P =0.03). Our study also illustrates that for subjects under 18 years old and above it, hormones (TSH, T3, T4) concentration is statistically different (P≤0.001).Conclusion: We found a statistical difference between hormone values after and before age 18 (P=≤0.01); therefore, it is not appropriate to use the same reference range for children under age 18 and adults. There was male dominance in the population 1-18 years old.
Head and Neck Pathology
Mitra Rezaei; Mahboobeh Karimi-Galougahi; Azin Kheradmand; Mihan Pourabdollah Toutkaboni; Hassan Mir Mohammad Sadeghi; Alireza Abdollahi; Amirnader Emami Razavi; Ali Safavi Naini; Farahnaz Bidari- Zerehpoosh
Abstract
Background & Objective: Human papillomavirus (HPV) has been associated with prognosis in patients with head and neck squamous cell carcinoma (HNSCC). Similar to the global studies, different prevalence rates of this viral infection have been reported in Iran. Therefore, we aimed to report the prevalence ...
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Background & Objective: Human papillomavirus (HPV) has been associated with prognosis in patients with head and neck squamous cell carcinoma (HNSCC). Similar to the global studies, different prevalence rates of this viral infection have been reported in Iran. Therefore, we aimed to report the prevalence of this virus and its significance in HNSCC patients.Methods: Patients who were referred to the five hospitals of Tehran city from May 2018 to May 2019 were enrolled in this study. All patients were diagnosed with HNSCC based on pathologic study. The pathologic disease staging was defined, and DNAs were extracted from the fresh tissue samples via kits. After polymerase chain reaction (PCR), HPV positive samples were evaluated for determining genotypes and data analysis.Results: Of the 46 patients, three patients (6.5%) had positive HPV with the following subtypes: 18 (in two patients), 52 (in three patients), 61 (in two patients), 67, and 73.Comparison of variables between the groups with and without HPV showed a significant difference based on the tumor’s lymphatic invasion (p =0.041), peripheral lymph node involvement (p =0.008), and histologic grade (p =0.011), but there was no statistically significant difference in terms of other variables such as age, primary tumor site, size, pathologic stage, vascular or perineural invasion, metastasis, smoking, and alcohol consumption.Conclusion: HPV positivity is an important factor in the lymphatic invasion, peripheral lymph node involvement, and histologic grade of cases with HNSCC and should be further investigated for its effect on prognosis.
Biology & Genetic
Narjes Soltani; Farzaneh Mirzaei; Hossein Ayatollahi
Abstract
Background & Objective: Primary amenorrhea refers to the absence of menstruation in females of reproductive by age 16 when the development of secondary sexual characteristics is evident (breast development, pubic hair) or by age 14 when there are no secondary sexual characteristics are present. Primary ...
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Background & Objective: Primary amenorrhea refers to the absence of menstruation in females of reproductive by age 16 when the development of secondary sexual characteristics is evident (breast development, pubic hair) or by age 14 when there are no secondary sexual characteristics are present. Primary amenorrhea can occur in several quite different reasons. Common hormonal causes of primary amenorrhea include constitutional delay, hypothalamic or pituitary disorders, chronic systemic disease, and primary ovarian insufficiency, some endocrine gland disorders, and other causes. Previous studies suggested that chromosomal abnormality is the second most common cause of amenorrhea. This report aims to measure the prevalence of the chromosomal abnormality in primary amenorrhea (PA) patients in the northeast of Iran.Methods: Chromosomal study was carried out on 200 patients with clinical features. The standard method for culturing peripheral venous blood lymphocyte was to prepare metaphase chromosomes and perform routine GTG band analysis.Results: The results revealed that 71% of PA had normal female karyotype (46,XX) and 29% showed different chromosomal abnormalities. The chromosomal abnormalities can be categorized into seven primary groups with or without mosaicism. 1- The most common karyotype was X chromosome aneuploidy (10.5%, n=21), 2- Male karyotype with or without structural abnormality of Y chromosome (5.5 %, n=11), 3- Mosaicism of turner karyotype and structural anomalies of X chromosome (4%, n=8), 4- Structural anomalies of the X chromosome (3.5%, n=7), 5- Mosaicism of turner karyotype and normal karyotype (3%, n=6), 6- Mosaicism of turner karyotype and male karyotype (1.5%, n=3) and 7- Super female karyotype (1%, n=2).Conclusion: The present study has emphasized that early cytogenetic and timely investigation can be necessary for the evaluation of primary amenorrhea.
Uropathology
Maryam Khayamzadeh; Fereshte Aliakbari; Zahra Zolghadr; Majid Emadeddin; Mahsa Ahadi; MohammadEsmaeil Akbari; Amir Reza Abedi; Shahrzad Nematollahi; Seyed Jalil Hosseini
Abstract
Background & Objective: Bladder cancer is the fourth most common cancer in men and the most common cancer in women, comprising 8% of all males and 3% of female tumors. The present study aimed to estimate the five-year survival rates of bladder cancer in Iran.Methods: Information on3,337 registered ...
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Background & Objective: Bladder cancer is the fourth most common cancer in men and the most common cancer in women, comprising 8% of all males and 3% of female tumors. The present study aimed to estimate the five-year survival rates of bladder cancer in Iran.Methods: Information on3,337 registered cases of bladder cancer was obtained from the Office of National Cancer Registry in the Ministry of Health and Medical Education (MOH & ME). A telephone survey was conducted to gather additional information, such as survival status, demographic, and clinical profile. Kaplan–Meier estimates of five-year survival rates were calculated according to the age of diagnosis, gender, pathological type, and provincial pole.Results and Conclusion: Overall five-year survival rate was 77%. According to the pathologic type, five-year survival rates were 81%, 66%, 81%, 42%, 77%, and 82% in low-grade urothelial carcinoma, high-grade urothelial carcinoma, adenocarcinoma, undifferentiated carcinomas, Squamous Cell Carcinomas (SCCs), and other tumors, respectively. Additionally, those tumors were 93%, 88%, 81%, 64%, and 44% among patients whose average ages at diagnosis were < 50, 50–59, 60–59, 70–79, and > 80 years old, respectively. Our study revealed that age and histological type were the major prognostic factors for survival in patients with bladder cancer. Therefore, given the histologic features of the tumor and patients with advanced age, a continuous screening would be highly warranted.
Microbiology
Mina Mobini Kesheh; Hossein Keyvani
Abstract
Background & Objective: Human papillomavirus (HPV) is the main cause of genital warts and some anogenital cancers in male and female subjects which is commonly transmitted by sexual contacts. The objective of this cross-sectional study was to examine the prevalence of HPV genotypes in 10,266 Iranian ...
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Background & Objective: Human papillomavirus (HPV) is the main cause of genital warts and some anogenital cancers in male and female subjects which is commonly transmitted by sexual contacts. The objective of this cross-sectional study was to examine the prevalence of HPV genotypes in 10,266 Iranian male and female population, according to their age. Methods: Samples were collected from the penile and anal sites of male subjects and the vagina and cervix of female subjects in a time period between 2011 and 2016. HPV DNA was detected in PCR using the MY09 and MY11 primers, and the INNO-LiPA assay was applied for HPV genotyping. To investigate the relevance of HPV infection and age, the samples were classified into 4 age groups (13-29, 30-44, 45-59, and 60-74). Results: Totally, the most common low risk HPV genotypes detected in the studied male and female subjects were HPV-6 (77.7% and 43.3%) and HPV-11 (13.7% and 11.4%), and more frequent high risk HPV genotypes were HPV-16 (5.5% and 16.6%) and HPV-52 (3.2% and 9.6%), respectively. High burden of the HPV infection was observed at ranges of 30 and 44 years (51.8%) with a peak at ranges between 30 and 32 years. No considerable statistically significant correlation was found between HPV infection and age (P=1). Conclusion: This study gave an epidemiological overview of circulating HPV genotypes in Iranian population to develop future vaccination policies, though the findings of prevalent HPV genotypes in female subjects were inconsistent with the previous studies reported in Iran.
Behnam Mohammadi-Ghalehbin; Shahram Habibzadeh; Mohsen Arzanlou; Roghayeh Teimourpour; Saeideh Amani Ghayum
Abstract
Background & objective: Pneumocystis pneumonia (PCP) is responsible for pulmonary infection in immunocompromised patients. This study aimed to investigating the frequency of Pneumocystis colonization in patients hospitalized in the intensive care unit (ICU) and evaluating the relationship between ...
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Background & objective: Pneumocystis pneumonia (PCP) is responsible for pulmonary infection in immunocompromised patients. This study aimed to investigating the frequency of Pneumocystis colonization in patients hospitalized in the intensive care unit (ICU) and evaluating the relationship between PCP and Pneumocystis colonization. Methods: In the current cross sectional study bronchoalveolar lavage (BAL)fluids of 100 patients were collected from surgery and neurosurgery ICUs with different underlying corticosteroid therapy conditions. Patients were divided into 2 groups (patients who received corticosteroids and not received corticosteroids). Direct examination on BAL fluids was performed by the Gomori methenamine silver andGiemsa staining techniques. Additionally, 2 filtered air samples of the 2 above mentioned units were collected. A nested-PCR targeted mtLSUrRNA gene and sequencing were used to identify Pneumocystis spp. Results: In direct microscopy, 31 out of 100 hospitalized patients (31%) showed positive results. Twenty-three (46%) of smear positive patients were from the group of patients who received corticosteroid, the other 8(16%) were from the group of patients who didn’t receive corticosteroids (P= 0.001). Pneumocystis jirovecii DNA was detected in 77 out of 100 BAL samples by nested-PCR (77%) in which 40(52%) and 37(48%) samples were obtained from the patients who received and not received corticosteroids, respectively. Pneumocystis genome was found in 1 of the 2 filtered air samples. Conclusion: A significant number of patients who received corticosteroids were also colonized by P. jirovecii that may predispose to PCP or be transmitted to susceptible patients. A significant relationship was observed between the mean hospital stay and detection rate.
Abdolmajid Ghasemian; Kobra Salimian Rizi; Hassan Rajabi Vardanjani; Farshad Nojoomi
Abstract
Background & Objective: The spread of carbapenem-resistant Pseudomonas aeruginosa is a global concern. Metallo-beta-lactamase (MBL) enzymes cause extensive drug resistance among Gram-negative bacteria. The current study aimed at determining the prevalence of MBL-producing P. aeruginosa in Iran. Methods: ...
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Background & Objective: The spread of carbapenem-resistant Pseudomonas aeruginosa is a global concern. Metallo-beta-lactamase (MBL) enzymes cause extensive drug resistance among Gram-negative bacteria. The current study aimed at determining the prevalence of MBL-producing P. aeruginosa in Iran. Methods: A total of 43 studies were found out of which 36 were adopted. Data were collected from Google, Google Scholar, Science Direct, PubMed, Scopus, Embase, and Sciverse. The terms “Pseudomonas aeruginosa”, “metallo-beta-lactamase”, “prevalence”, “carbapenems”, and “Iran” were searched. Data from the isolates not producing MBLs were excluded from the study. Data were analyzed with Graph Pad Prism 6, meta-analysis section. Results: According to the results of the current study, 36 surveys indicated that 55% of the clinically isolated P. aeruginosa in Iran were resistant to imipenem and meropenem, among which 37.72% were the MBL producers. Among genes encoding MBLs, blaVIM and blaIMP were predominant with the prevalence of 12.91%±11.01% and 12.50%±23.56%, respectively. No report of harboring blaNDM1 and blaSPM1 by P. aeruginosa was found, similar to most of the other countries in Asia. The prevalence of blaVIM and blaIMP from burn settings were 11.50%±3.5% and 24.65%±23%, respectively. Furthermore, the prevalence of these genes was not significantly different among burn and non-burn isolates (P=0.942 and P=0.597, respectively). Moreover, no relationship was observed between the MBL production and patients’ age range. Conclusion: Approximately half of P. aeruginosa isolates were carbapenem-resistant in Iran, and approximately half were the MBL producers. The blaVIM and blaIMP were the predominantMBLs among P. aeruginosa strains, while other genes were not found in P. aeruginosa. Moreover, there was no significant difference between blaVIM and blaIMPamong burn and non-burn isolates. Due to the multiple drug resistance conferred by MBLs, detection and control of their spread alongside proper therapeutic regimens in hospitals and community settings are essential to prevent infection acquisition.
Amir Sohrabi; Massoud Hajia
Abstract
Background: The accuracy of diagnostic assays in Human Papillomavirus (HPV) genital infection and cervical cancer has remained a clinical challenge in diagnosis. Evidence indicates that a large proportion of cervical cancer can be prevented through organized care for HPV and testing. Countries ...
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Background: The accuracy of diagnostic assays in Human Papillomavirus (HPV) genital infection and cervical cancer has remained a clinical challenge in diagnosis. Evidence indicates that a large proportion of cervical cancer can be prevented through organized care for HPV and testing. Countries with low per capita income, such as Iran and its neighbours, have no national organized program for cervical cancer screening and vaccination. The aim of this study was to review recent published papers in this region for evaluating the efficacy of released data regarding HPV genotyping system in genital infections and cervical cancer Methods: Investigating various medical search engines retrieved 46 reports, mostly after 2010, consisting of either home brew protocols or commercial technologies in this field. Results: Summarized results demonstrated that except a few cases, all reports were limited studies performed in confined populations focusing on attending patients at clinics for regular checkups. In the present study, 52.8% of papers were from Iran and the rest belonged to other countries. The rate of HPV infection was reported in the range of 0.62% to 25% in the normal population, while it varied from 18.75% to 100% in females with cervical cancer. In HPV genotyping surveys, only 26.1 % (12/46) of reports had validated and World Health Organization (WHO) proficient procedures. Also, multiple infections were not mentioned in 56.52% (25/46) of researches. Conclusions: Employing reliable genotyping methods is the best way for regular screening of cervical cancer related to HPV and precancerous diseases in females of these areas. The focus of most surveys was to come up with the best national policies for establishing a preventive program in Iran and Persian Gulf area.
Biology & Genetic
Shahriar Dabiri; Mohammadmehdi Moeini aghtaei; Jahanbano Shahryari; Manzume Shamis meymandi; Sahar Amirpour-Rostami; Reza Foutohi-Ardekani
Volume 11, Issue 2 , April 2016, , Pages 104-111
Abstract
Background: The breast cancer is the most prevalent cancer among women, on the other hand absence of myoepithelial cells play a pivotal role in pathogenesis of this cancer. Thus we aimed to investigate the possible abilities of the molecular assay technique to find a relationship between mammary serine ...
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Background: The breast cancer is the most prevalent cancer among women, on the other hand absence of myoepithelial cells play a pivotal role in pathogenesis of this cancer. Thus we aimed to investigate the possible abilities of the molecular assay technique to find a relationship between mammary serine protease inhibitor (Maspin) gene expression possibly secreted by myoepithelial cells, grade of breast cancer and other prognostics factors (ER, PR, and c-erb-B2). Methods: Paraffin embedded blocks of 31 breast cancer patients together with two normal breast tissues were used for IHC staining and Maspin gene RNA detection uses the real-time PCR method. Applying QIAGEN kit, we were able to measure Maspin RNA and Extract the cDNA of different samples for evaluating the Maspin RNA level. Results: We found that the RNA level was considerably lowerin these cancer samples compared with normal samples. In addition, different grades of breast cancer in the obtained results adopt some distinguishable values. The Maspin expression in samples with grades II and III is much lower than the ones in normal group (P<0.05) which could be considered as a promising way in diagnosing of this disease. The results showed no considerable differences in Maspin gene expression of the c-erb-B2 scores in the tumor group except the samples having score 0. The other observation of this research study confirmed that Maspin gene expression couldn't show any differences between the values of both ER and PR in different scores of the tumor group. On the other hand, the cDNA of these patients showed lower values compared with normal samples. Conclusion: Maspin expression was reduced in samples with grade II& III of invasive ductal carcinoma. Based on expression of Maspin Inc-erb-B2, it seems that more expression happened in normal group comparing with different scores of it. We could suggest that there was a reverse relationship between tumor formation and Maspin gene expression. These results showed possible role of Maspin as prognostic factor.
Maryam Rabiee; Jalal-Aldin Shams; Nafiseh Zafargandie
Abstract
Hemoglobin (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 ...
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Hemoglobin (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.
Oral Pathology
Fariba Binesh; Mohammad Hossein Dadgarnia; Yasaman Khaksar; Abbas Mirvakili
Abstract
Paragangliomas 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 ...
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Paragangliomas 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.
Amir Hosein Jafarian; Amin Rahpeyma; Saeedeh khajehahmadi
Abstract
The glandular odontogenic cyst (GOC) is a rare lesion with odontogenic origin. It shows a propensity for recurrence revealed in 30% of all case. This investigation reports a case of recurrent GOC in a 35-year-old female in the anterior region of the maxilla, which is uncommon and discusses about IHC ...
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The glandular odontogenic cyst (GOC) is a rare lesion with odontogenic origin. It shows a propensity for recurrence revealed in 30% of all case. This investigation reports a case of recurrent GOC in a 35-year-old female in the anterior region of the maxilla, which is uncommon and discusses about IHC finding, surgical methods, and differential diagnosis. Under general anesthesia, peripheral bone ostectomy via large round bur for removal of remaining epithelium of the cyst wall was done. Finally liquid nitrogen was used to remaining bone. This article recommends that soft tissue adjacent to the cortical bone perforation should be excised, as well as peripheral bone ostectomy by large round bur for removal of remaining epithelium of the cyst and liquid nitrogen application to the bony cavity. Because of high recurrence rate of the lesion close follow up of the patients is needed.
Zohreh Nozarian; Alireza Abdollahi
Abstract
Background and Objectives: Urinary tract infections (UTI) are one of the most common infectious diseases with different microbial agent and antimicrobial resistant pattern in hospitalized patients and outpatients. In order to assess the adequacy of therapy, knowledge of prevalence and resistance pattern ...
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Background and Objectives: Urinary tract infections (UTI) are one of the most common infectious diseases with different microbial agent and antimicrobial resistant pattern in hospitalized patients and outpatients. In order to assess the adequacy of therapy, knowledge of prevalence and resistance pattern of the bacteria is necessary. The main aim of this study was to evaluate the prevalence and the antimicrobial resistance pattern of main bacterial responsible for UTI in order to establish an appropriate empirical therapy. Methods: All urine samples were referred to Imam Hospital Laboratory, Tehran, Iran during 2011-2012, urine culture isolated and bacteria were identified and the profile of antibiotic susceptibility was characterized. Result: From 1851 urine cultures, UTI was more frequent in woman (68%) E. coli was as usual the most common pathogen implicated in UTI. Most susceptibility was to imipenem (98.9%). nitroforantoin (96%) and amikacin (94.1%) and increased resistance to penicillin (66.6%), nalidixic acid (62.1%) ampicilin (60.1%) and cotrimoxazole 54.3%. Discussion: The most common isolated pathogen was E. coli. According to antibiogram susceptibility, the recommended antimicrobial drugs are nitroforantoin and imipenem. nalidixic acid and cotrimoxazole are not recommended because drug resistance is high.
Fariba Abbasi; Rahim Mahmudlu; Yasaman Nikniaz; Makan Rezaie
Abstract
Cutaneous leiomyosarcoma is a relatively rare tumor accounts for about 2-3% of superficial soft tissue sarcomas. It occurs more frequently in males in fifth and sixth decades with a predilection for extremities. We report a 27 years old male with cutaneous leiomyosarcoma of thigh, previously diagnosed ...
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Cutaneous leiomyosarcoma is a relatively rare tumor accounts for about 2-3% of superficial soft tissue sarcomas. It occurs more frequently in males in fifth and sixth decades with a predilection for extremities. We report a 27 years old male with cutaneous leiomyosarcoma of thigh, previously diagnosed as pleomorphicfibroma. The tumor composed of pleomorphic spindle shaped cells with blunt ended nuclei and high mitotic activity. Smooth muscle actin was positive. In this case, the young age of the patient and previous misdiagnosis of the tumor are interesting. Subtle histologic features of low grade leiomyosarcoma can be a pitfall in diagnosis and so affects the optimal management of the patient as it occurred in previous sample of this case.
Ehsan Malekianzadeh; Sedigheh Khazaei; Babak Izadi; Mahtab Rahbar
Volume 9, Issue 4 , October 2014, , Pages 268-272
Abstract
Although breast tuberculosis still remains rare, but in endemic countries should be in differential diagnosis of breast cancer and abscess. Imaging modalities cannot distinguish between cancer and tuberculosis. Acid fast bacilli stain; culture and PCR are helpful diagnostic methods but unfortunately ...
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Although breast tuberculosis still remains rare, but in endemic countries should be in differential diagnosis of breast cancer and abscess. Imaging modalities cannot distinguish between cancer and tuberculosis. Acid fast bacilli stain; culture and PCR are helpful diagnostic methods but unfortunately are not very sensitive. Negative results do not rule out this diagnosis, so it seems definite diagnosis can be made by open biopsy and histologic evidence (granuloma tissues). In this case, a 33 years old woman was referred to the Infectious Ward in Imam Reza Hospital, Medical University of Kermanshah, western Iran in 2011; complaining of one lump in her left breast which did not response to usual therapy (painkillers and antibiotics). Fine needle aspiration for histologic and cytologic evaluations were negative but open biopsy showed granulomatous tissues, anti-tuberculosis chemotherapy was begun and response was significant then PCR was reported positive. We think in endemic area, empirical treatment can be started based on histological evidence and proper clinical manifestation.
Fahimeh Mousavi; Mehrdad Noruzinia; Elahe Keyhani; Feridoon Seirati; Samira Rezaei; Forough Mojtahedi; Farkhondeh Behjati
Volume 9, Issue 2 , April 2014, , Pages 117-123
Abstract
Background and Objective: The DBC2 (deleted in breast cancer 2) or RhoBTB2 (Located on 8p21) is a tumor suppressor gene associated with tumorigenesis. Mutational studies of DBC2 at its promoter region in breast cancer revealed an important role for epigenetic changes contributing to its low expression. ...
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Background and Objective: The DBC2 (deleted in breast cancer 2) or RhoBTB2 (Located on 8p21) is a tumor suppressor gene associated with tumorigenesis. Mutational studies of DBC2 at its promoter region in breast cancer revealed an important role for epigenetic changes contributing to its low expression. Epigenetic changes through hypermethylation of the promoter can cause the inactivation of DBC2 gene. The purpose of this study was to investigate methylation pattern of DBC2 gene in the peripheral blood of 40 Iranian women with breast cancer and its comparison with healthy women.
Material & Methods: We used peripheral blood samples from 40 patients with sporadic breast cancer and 40 normal individuals. Analysis of the methylation statues of DBC2 promoter region was done by MSP (Methylation Specific PCR ) technique on the DNA extracted from the blood samples. The results were validated by sequencing. The methylation status was then correlated with the clinicopathological parameters of breast cancer patients.
Results:Methylation pattern was detected in 60% of the patients, whereas 25% of the normal individuals demonstrated a positive methylation pattern (P ≤ 0.01, odd ratio : 2.143). No significant correlation was obtained between methylated DBC2 and cliniclpathological parameters.
Discussion: Aberrant hypermethylation was observed preferentially in the patients. These findings along with the previous studies, propose that abnormal methylation pattern in DBC2 promoter region may be one of the main reasons for low expression of DBC2 in breast cancer and this hypermethylation pattern could play a fundamental role in the breast tumorigenesis.
Mohsen Meidani; Zohreh Aminzadeh; Mahya Faghih; Nooshin Ahmadi
Volume 9, Issue 2 , April 2014, , Pages 133-137
Abstract
Background and Objective: It is presumed that human herpes virus 8 (HHV-8) is the necessary cause of all different forms of Kaposi’s sarcoma which is the most common neoplasm in HIV-infected persons. In this study, we wanted to determine the prevalence of HHV8 infection in all the available ...
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Background and Objective: It is presumed that human herpes virus 8 (HHV-8) is the necessary cause of all different forms of Kaposi’s sarcoma which is the most common neoplasm in HIV-infected persons. In this study, we wanted to determine the prevalence of HHV8 infection in all the available Isfahan (Central Iran) HIV positive individuals in comparison with healthy blood donor, and also investigating the risk factors of HIV infections in both groups.
Material and Methods: Inthis cross sectional study, the samples were consisted of 50 healthy HIV –negative blood donors and all the available Isfahan HIV positive individuals (55 persons). The selected people fulfilled a questionnaire about personal demographic information. The blood samples were examined using Biotrin kit to detect anti HHV8 antibody (IgG).
Results:In HIV positive group, 10 persons (18.2%) tested positive for HHv8, but none of the control group had positive test. We analyzed risk factors for AIDS and found, as expected, strong associations between HIV infection with addiction, being in prison, travelling out of Iran, low educational status and being single or having multiple sexual partner but there is no differences between HHV8 positive and negative group.
Conclusion:The prevalence of HHV8 in HIV positive persons is high in Isfahan and preventive care may be beneficial. A future study including a large population from different high risk groups and general population in Iran is needed in order to define seroepidemiology and risk factors associated with HHV8 infection.
Abolfazl Khoshdel; Ebrahim Saedi Dezaki; Froozan Ganji; Roya Habibian; Reza Imani; Elham Taheri; Azar Nikkhah
Volume 9, Issue 1 , January 2014, , Pages 23-27
Abstract
Background and Objectives: An increasing number of tularemia was reported in all over the world. This infection is characterized by different clinical syndromes that can be considered in differential diagnosis of infectious disease. Despite effective antibiotics against Francisella tularensis, ...
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Background and Objectives: An increasing number of tularemia was reported in all over the world. This infection is characterized by different clinical syndromes that can be considered in differential diagnosis of infectious disease. Despite effective antibiotics against Francisella tularensis, this infection is still as one of the agent of mortality and disability among infectious disease.The aim of this study was investigation of seroepidemiological of F. tuleransis among children between 2-18 years old in a risky zone in Iran.
Methods: This cross-sectional, laboratory-based study in two distinct villages Saragha seyed and Khoye in Chaharmahal va bakhtiari Province involved 183 children, adolescents who had no sign and symptom of disease and were screened for tularemia immunoglobulins G (IgG), using the ELISA-based quantitative assay.
Results: In general, from 183 children 11 persons (6%) were seropositive, compared with 172 persons (94%) were seronegative.
Conclusion: According to the high prevalence of antibodies against F. tularensis in this study, this infection must be considered as differential diagnosis of infectious disease in suspect patients.
Hamidreza Azimi; Saeedeh Khajehahmadi; Amin Rahpeyma
Volume 9, Issue 1 , January 2014, , Pages 28-32
Abstract
Background and Objectives: Squamous cell carcinoma of the tongue (SCCOT) is the most common malignant neoplasm in oral cavity. At the time of the diagnosis of SCCOT regional metastases with a high mortality rate are common, which is due to the extensive lymphatic system drainage of the tongue. ...
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Background and Objectives: Squamous cell carcinoma of the tongue (SCCOT) is the most common malignant neoplasm in oral cavity. At the time of the diagnosis of SCCOT regional metastases with a high mortality rate are common, which is due to the extensive lymphatic system drainage of the tongue. Although the level of healthcare has significantly improved, the survival rate is still low with an unsatisfactory cure rate. The present study was designed to establish a clinical review on adults with SCCOT and to determine whether the rate of SCCOT has been changed over the 20-year.
Methods: A cohort of 102 patients was recruited for this retrospective study. The study was carried out by reviewing the medical reports and case notes of patients with histologically confirmed SCCOT.
Results: The peak incidence was observed between 60 and 70 years. Stage I disease was found in 24, stage II in 64, stage III in 10 and stage IV in four patients. Seventy-three patients were treated with combined therapy; surgery and radiation, whereas, 29 patients received only surgery. The overall 5-year survival was 60%. Thirty patients developed tumor recurrence including 12 local, 12 nodal, four locoregional, and two distant. Thirty-four patients died during the follow-up period, six with persistent disease, and 62 remained cancer free, giving a mortality and morbidity rate of 39%.
Conclusion: This study recommends aggressive early treatment of patients with SCCOT including resection of the primary tumor with a safe margin (1.5cm) in addition to an appropriate neck dissection.
Amitis Ramezani; Mandana Shams; Nader Zarinfar; Mohammad Banifazl; Arezoo Aghakhani; Ali Eslamifar; Fatemeh- Alsadat Mahdaviani; Ghorban Deiri; Masoomeh Sofian
Volume 9, Issue 1 , January 2014, , Pages 50-55
Abstract
Background and Objectives: Laboratory reference values are an important tool for clinical management of patients. Reference values being used in most laboratories in Iran have been provided from the established reference values from developed countries. However, several variables can affect on ...
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Background and Objectives: Laboratory reference values are an important tool for clinical management of patients. Reference values being used in most laboratories in Iran have been provided from the established reference values from developed countries. However, several variables can affect on these laboratory parameters. Therefore, this study was carried out to establish the reference values of hematological parameters in the blood donors of central province of Iran as a general population.
Methods: Blood samples of 1100 male blood donors were collected consecutively from Blood Transfusion Organization. Complete blood cell (CBC) count in 2012 and differential was performed using an automated hematology analyzer.
Results: The median and 95% reference values (2.5th-97.5th) for Hb and platelet counts were 15.5 g/dl (14.1-17.7) and 209 ×109 cells/L (151-322) respectively. The median for total WBC count, neutrophil, lymphocyte, monocyte and eosinophil were 6.7 ×109 cells/L (4.3-11.2), %58 (%50-%70), 40% (30-49%), 0% (0-2) and %1 (0-3%), respectively.
Conclusion: The hematological profile of the population in central province of Iran was different from the reports of other countries and also the standards reference ranges described in textbook. So, further nationwide study should be carried out to establish the hematological reference values of the Iranian population as a whole.
Seyed Hassan Hosseini Hooshyar; Hamid Zeinalinejad; Mehran Mosallami; Shahriar Dabiri; Jahanbanoo Shahryari; Moeinadin Safavi
Volume 8, Issue 4 , October 2013, , Pages 267-272
Abstract
We present unusual retained remnants of hidden conjoined twin of possible abdominal pagus after 21 years who presented with abdomenpain and incidentally have found his forbidden conjoined twin. He presented for many years with a palpable epigastric mass, and recent abdominal pain, early satiety, nausea ...
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We present unusual retained remnants of hidden conjoined twin of possible abdominal pagus after 21 years who presented with abdomenpain and incidentally have found his forbidden conjoined twin. He presented for many years with a palpable epigastric mass, and recent abdominal pain, early satiety, nausea and vomiting. The mass was a like deformed fetus weighing 815 gr who was anencephalic and deprived of viscera but there was a distinct vascular connection through the rig limb. Microscopic examination revealed a normal epidermis with melanocytes overlying dermis with mature adnexa. The fetus plain film after surgery showed a rather complete skeletal system. All above findings were in favor of fetus in fetus, a rare congenital entity in which a nonviable parasitic fetus grows within the body of its twin.
Masomeh Bayani; Sepideh Siadati; Seddigheh Esmaeilzadeh; Samaneh Asgari; Saeed Salmani
Volume 8, Issue 3 , July 2013, , Pages 171-177
Abstract
Background and Objectives: Chicken pox has potential complications during pregnancy for both the mother and her baby. The aim of this study was to determine the Varicella-zoster virus (VZV) immune status in pregnant women in Babol and its surrounding neighborhoods.
Materials and Methods: This seroepidemiological ...
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Background and Objectives: Chicken pox has potential complications during pregnancy for both the mother and her baby. The aim of this study was to determine the Varicella-zoster virus (VZV) immune status in pregnant women in Babol and its surrounding neighborhoods.
Materials and Methods: This seroepidemiological study was carried out on 427 pregnant women referred to Rohani Hospital, Babol, northern Iran from 2010 to 2011. The immune status (IgG level) was determined using ELISA method and correlation with age, place of residence, history of VZV infection and the number of siblings were evaluated.
Results: The mean age of the subjects was 27.16 + 5.7 years and their mean antibody level was 103.552 + 63.37 U/ml. Out of 427 pregnant women studied, 8.7% were seronegative, 1.2% were equivocal and 90.2% were seropositive. There was no correlation between age, the place of residence (urban or rural) and titer of antibody. However, higher antibody titer was found in women with more siblings.
Conclusion: Considering 90.2% of pregnant women were VZV seropositive, evaluation of VZV antibody in order to prevent complications in non-immune pregnant women and vaccination for women with age less than 25 years old and no VZV infection history, prior to pregnancy is recommended.
