Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Knowledge of Laboratory Medicine in Medical Students: Is It Sufficient?61653828710.30699/ijp.2020.94221.1916ENHiva SaffarDepartment of Pathology and Laboratory Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran0000-0003-1489-9611Maryam SaatchiDepartment of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, IranAnahita SadeghiDigestive Research Institute, Tehran University of Medical Sciences, Tehran, IranFahimeh Asadi AmoliDepartment of Pathology and Laboratory Medicine, Farabi Hospital, Tehran University of Medical Sciences, Tehran, IranSeyed Mohammad TavangarDepartment of Pathology and Laboratory Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran0000-0002-4253-2385Farzaneh ShiraniDepartment of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranAli AliasgariDepartment of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranJournal Article20181006<span style="font-size: 14px;"><span style="text-align: justify;"><span style="font-family: 'times new roman';"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span></span><br /> <span style="font-size: 14px; font-family: 'times new roman';">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.</span><br /> <strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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.</span><br /> <strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong><br /> <span style="font-size: 14px; font-family: 'times new roman';">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 (</span><em style="font-size: 14px; font-family: 'times new roman';">P</em><span style="font-size: 14px; font-family: 'times new roman';">=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 (</span><em style="font-size: 14px; font-family: 'times new roman';">P</em><span style="font-size: 14px; font-family: 'times new roman';">=0.638).</span><br /> <strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong><br /> <span style="font-family: 'times new roman'; font-size: 14px;">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.</span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Modified Ultrafast Papanicolaou Stain in Ultrasound Guided FNAC of Intra-abdominal Lesions66743828810.30699/ijp.2020.98405.1971ENSweta Kamalkant ShastriDepartment of Pathology, N.K.P Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, IndiaArchana JoshiDepartment of Pathology, N.K.P Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, IndiaJournal Article20181126<span style="font-size: 14px;"><span style="text-align: justify;"><span style="font-family: 'times new roman';"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span></span><br /> <span style="font-size: 14px;"><span style="font-family: 'times new roman';">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.</span></span><br /> <strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong><br /> <span style="font-size: 14px;"><strong style="font-family: 'times new roman'; font-size: 16px;"></strong><span style="font-family: 'times new roman';">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.</span></span><br /> <strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong><br /> <span style="font-size: 14px;"><span style="font-family: 'times new roman';">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 (</span><em style="font-family: 'times new roman'; font-size: 16px;">P</em><span style="font-family: 'times new roman';"><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 (</span><em style="font-family: 'times new roman'; font-size: 16px;">P</em><span style="font-family: 'times new roman';"><0.001) between the two stains.</span></span><br /> <strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong><br /> <span style="font-size: 14px;"><span style="font-family: 'times new roman';">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.</span></span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Micronucleus Assay of Buccal Mucosa Cells in Waterpipe (Hookah) Smokers: A Cytologic Study75803829210.30699/ijp.2020.101701.2010ENMehdi DehghanNezhadFaculty of Dentistry, Shahed University, Tehran, IranNoushin Jalayer NaderiDepartment of Oral and Maxillofacial Pathology, Faculty of Dentistry, Shahed University0000-0002-7356-3205Hasan SemyariDepartment of Periodontics, Faculty of Dentistry, Shahed UniversityJournal Article20190114<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="text-align: justify;"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span><br /> <span style="text-align: justify;">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.</span><br /> <strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong><br /> <span style="text-align: justify;">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.</span><br /> <strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong><br /> <span style="text-align: justify;">The mean number of micronuclei in waterpipe smokers and non-smokers was 1.94</span><span style="text-align: justify;" dir="RTL">±</span><span style="text-align: justify;">0.39 and 1.68</span><strong style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"><span dir="RTL">±</span></strong><span style="text-align: justify;">0.35, respectively. The micronuclei count in waterpipe smokers was significantly higher than non-smokers (</span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">P</em><span style="text-align: justify;">=0). The difference between the number of waterpipe smoking and micronuclei count was significantly different (</span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">P</em><span style="text-align: justify;">=0).</span><br /> <strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px;">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.</span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Napsin-A Expression, a Reliable Immunohistochemical Marker for Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas81853830310.30699/ijp.2020.106598.2222ENFatemeh NiliDepartment of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran0000-0002-9835-897XMansoureh TavakoliDepartment of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranNarges Izadi-MoodDepartment of Pathology, Mohebb-e-Yas Women Hospital, Tehran University of Medical Sciences, Tehran, IranHana SaffarDepartment of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranSoheila SarmadiDepartment of Pathology, Mohebb-e-Yas Women Hospital, Tehran University of Medical Sciences, Tehran, IranJournal Article20190820<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="text-align: justify;"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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.</span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City86953830410.30699/ijp.2020.111181.2188ENKosar JalalvandDepartment of Pathology, Hazret-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran0000-0002-9457-7876Nasrin ShayanfarDepartment of Pathology, Hazret-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran, IranFreshteh ShahcheraghiDepartment of Bacteriology, Pasteur Institute of Iran, Tehran, IranElahe AminiSkull Base Research Center, Hazret-e-Rasoul Hospital, The Five Senses Institute, Iran University of Medical Sciences, Tehran, IranMasha MohammadpourMedical student, Tehran University of Medical Sciences, Tehran, IranPegah BabaheidarianDepartment of Pathology, Hazret-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran0000000194887228Journal Article20190806<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="text-align: justify;"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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</span><strong style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">-</strong><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">resistant Enterobacteriaceae in a referral hospital in Tehran, Iran.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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 (</span><em style="text-align: justify; font-family: 'times new roman'; font-size: 14px;">KPC)</em><span style="text-align: justify; font-family: 'times new roman'; font-size: 14px;">, New Delhi metallo-β-lactamase</span><em style="text-align: justify; font-family: 'times new roman'; font-size: 14px;"> (NDM)</em><span style="text-align: justify; font-family: 'times new roman'; font-size: 14px;">, and OXA-48 genes by conventional PCR method.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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 </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">OXA-48</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> gene, 11 isolates for </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">OXA-48</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> and </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">NDM</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> genes, 11 isolates for </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">OXA-48</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">, </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">NDM</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> and </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">KPC</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> genes, 4 isolates for </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">OXA-48</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> genes and </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">KPC</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">, 3 isolates for </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">NDM</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">, one isolate for </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">KPC</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">. On the other hand, two isolates were negative for all three genes examined.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong></span></span><br /> <em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">OXA-48</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> 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.</span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Assessment of Susceptibility to Five Common Antibiotics and Their Resistance Pattern in Clinical Enterococcus Isolates961053825710.30699/ijp.2020.114009.2236ENSara Masoumi ZavaryaniDepartment of Microbiology, Islamic Azad University of Varamin-Pishva Branch, Tehran, IranReza MirnejadMolecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran0000-0002-7297-3085Vahhab PiranfarResearch and Development Department, Farname Inc., Thornhill, Canada0000-0003-3653-5739Mehrdad Moosazadeh MoghaddamApplied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran0000-0002-4645-8661Nikta SajjadiCNC, Center of Neuroscience and Cell Biology, University of Coimbra, Coimbra, PortugalSomayyeh SaeediDepartment of Microbiology, Faculty of Advanced Sciences and Technology, Pharmaceutical Sciences Branch Islamic Azad University, Tehran, Iran (IAUPS)Journal Article20190908<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="text-align: justify;"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">400 clinical </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">Enterococcus </em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">isolates were collected from different hospitals in Tehran, Iran. Standard phenotypic-biochemical tests and PCR were used to identify the </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">Enterococcus </em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">According to the biochemical and PCR analyses, among 400 </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">Enterococcus </em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">species, 72% of samples were </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">Enterococcus faecalis</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">, 10.75% </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">Enterococcus faecium</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">, and 17.25% other </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">Enterococcus </em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">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 </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">E. faecium</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> or </span><em style="font-family: 'times new roman'; font-size: 14px; text-align: justify;">E. faecalis</em><span style="font-family: 'times new roman'; font-size: 14px; text-align: justify;"> 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.</span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong></span></span><br /> <span style="font-size: 14px; font-family: 'times new roman';">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.</span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Comparison of Diagnostic Methods in Detection of Squamous Cell Abnormalities in Iranian Women with Abnormal Pap’s Smear Test and Associated Demographic and Issues1061163830510.30699/ijp.2020.114626.2248ENFatemeh Samiee RadDepartment of Pathology, Metabolic Disease Research Center, Qazvin University of Medical Sciences, Qazvin, Iran0000-0001-6091-4347Mehdi GhaebiGeneral Physician, Qazvin University of Medical Sciences, Qazvin, Iran0000-0001-7136-3886Simin ZarabadipourQazvin University of Medical Sciences, Qazvin, Iran0000-0003-3486-3149Arezoo BajelanQazvin University of Medical Sciences, Qazvin, Iran0000-0002-6680-7830Fatemeh PashazadeQazvin University of Medical Sciences, Qazvin, IranMehri KalhorDepartment of Reproductive Health, Tarbiat Modarres University, Tehran, IranAmane BarikaniDepartment of Epidemiology, Qazvin University of Medical Sciences, Qazvin, IranJournal Article20190925<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="text-align: justify;"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span><br /> <span style="font-family: 'times new roman'; text-align: justify;">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.</span><br /> <span style="font-family: times new roman;"><strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong></span><br /> <span style="font-family: 'times new roman'; text-align: justify;">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 (</span><em style="font-family: 'times new roman'; font-size: 16px; text-align: justify;">P</em><span style="font-family: 'times new roman'; text-align: justify;"><0.05).</span><br /> <span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong></span><br /> <span style="font-family: 'times new roman'; text-align: justify;">A significant relationship between histopathology and Pap smear findings was found (</span><em style="font-family: 'times new roman'; font-size: 16px; text-align: justify;">P</em><span style="font-family: 'times new roman'; text-align: justify;">=0.009), also there was a significant correlation between histopathology and colposcopy findings (</span><em style="font-family: 'times new roman'; font-size: 16px; text-align: justify;">P</em><span style="font-family: 'times new roman'; text-align: justify;">=0.001). However, there was no significant relationship between clinical symptoms and histopathology findings (</span><em style="font-family: 'times new roman'; font-size: 16px; text-align: justify;">p</em><span style="font-family: 'times new roman'; text-align: justify;">=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.</span><br /> <span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong></span></span><br /> <span style="font-family: 'times new roman'; font-size: 16px; text-align: justify;"><span style="font-size: 14px;">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.</span></span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Changes in Cytokeratin 18 during Neoadjuvant Chemotherapy of Breast Cancer: A Prospective Study1171263830610.30699/ijp.2020.116238.2261ENDanial Fazilat-PanahCancer Research Center, Babol University of Medical Sciences, Babol, IranSomaye Vakili Ahrari RoudiDepartment of Pathology, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, IranAlireza KeramatiDepartment of Radio-Oncology, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, IranAzar FanipakdelCancer Research Center, Mashhad University of Medical Sciences, Mashhad, IranMohammad Hadi SadeghianDepartment of Pathology, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, IranFatemeh Homaei ShandizCancer Research Center, Mashhad University of Medical Sciences, Mashhad, IranSoudabeh ShahidSalesCancer Research Center, Mashhad University of Medical Sciences, Mashhad, IranSeyed Alireza JavadiniaCellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran0000-0003-2467-837XJournal Article20191024<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="text-align: justify;"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span><br /> <span style="font-family: times new roman;">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.</span><br /> <span style="font-family: times new roman;"><strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong></span><br /> <span style="font-family: times new roman;">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.</span><br /> <span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong></span><br /> <span style="font-family: times new roman;">Pre- and post-chemotherapy levels of M30 were respectively 223.9±18.94 and 250.7±23.92 U/L (<em>P</em>=0.24). For M65, these levels were respectively 301.5±313.9 and 330.2±352.2 U/L (<em>P</em>=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 (<em>P</em>=0.1). For M65, these changes were respectively -247±55 and 76±240 (<em>P</em>=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.</span><br /> <span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong></span></span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;">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.</span></span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Persister cells formation and expression of type II Toxin-Antitoxin system genes in Brucella melitensis (16M) and Brucella abortus (B19)1271333830710.30699/ijp.2020.118902.2294ENFatemeh AmraeiMicrobial Biotechnology Research Center, Iran University of Medical Science, Tehran, IranDepartment of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, IranNegar NarimisaMicrobial Biotechnology Research Center, Iran University of Medical Science, Tehran, IranDepartment of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, IranBehroz SadeghiClinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, IranVahid LohrasbiMicrobial Biotechnology Research Center, Iran University of Medical Science, Tehran, IranDepartment of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, IranFaramarz Masjedian JaziMicrobial Biotechnology Research Center, Iran University of Medical Science, Tehran, IranDepartment of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, IranJournal Article20191221<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="text-align: justify;"><strong><span style="color: #0000ff;">Background & Objective:</span></strong></span></span><br /> <span style="font-family: times new roman;">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 <em>Brucella</em> strains by evaluating toxins of type II TA systems (<em>RelE</em>, <em>Fic</em>, <em>Brn</em> <em>T</em>, cogT) expression.</span><br /> <span style="font-family: times new roman;"><strong style="color: #0000ff; font-family: 'times new roman'; font-size: 14px;">Methods:</strong></span><br /> <span style="font-family: times new roman;"><em>Brucella</em> 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.</span><br /> <span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Result:</span></strong></span><br /> <span style="font-family: times new roman;">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.</span><br /> <span style="font-family: times new roman;"><strong style="font-family: 'times new roman'; font-size: 14px;"><span style="color: #0000ff;">Conclusion:</span></strong></span></span><br /> <span style="font-size: 14px;"><span style="font-family: times new roman;">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 <em>Brucella</em> strains might help us to identify the precise mechanisms leading to persister cells formation.</span></span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Desmoplastic Fibroma of the Jaws: A Case Series and Review of Literature1341433830810.30699/ijp.2020.103833.2049ENAbbas KarimiDepartment of Oral and Maxillofacial Surgery, Dentistry School, Tehran University of Medical Sciences, Tehran, IranSamira DerakhshanDepartment of Oral and Maxillofacial Pathology, Dentistry School, Tehran University of Medical Sciences, International Campus, Tehran, Iran0000-0003-4373-9043Monir Moradzadeh KhiaviDepartment of Oral and Maxillofacial Pathology, Dentistry School, Tehran University of Medical Sciences, Tehran, IranFarzaneh MosavatDepartment of Oral and Maxillofacial Radiology, Dentistry School, Tehran University of Medical Sciences, Tehran, IranFaeze MirjaliliDepartment of Oral and Maxillofacial Radiology, Dentistry School, Kashan University of Medical Sciences, Kashan, IranJournal Article20190604<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="font-size: 24px;"><strong>D</strong></span>esmoplastic 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.</span></span>
Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Epithelial-Myoepithelial Carcinoma of the Palate: Report of a Case and Review of the Literatures1441503830910.30699/ijp.2020.105039.2076ENNazanin MahdaviDepartment of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran0000-0002-0691-1580Maedeh GhorbanpourDepartment of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, IranJournal Article20190311<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="font-size: 24px;"><strong>E</strong></span></span></span><span style="font-size: 14px;"><span style="font-family: times new roman;">pithelial-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.</span></span>Farname Inc in collaboration with Iranian Society of PathologyIranian Journal of Pathology1735-530315220200401Sarcomatoid Carcinoma of the Penis: An Uncommon Penile Neoplasm1511533831010.30699/ijp.2020.117401.2275ENSucheta GandheDepartment of Pathology, HCG Manavata Cancer Centre, Nashik, Maharashtra, IndiaRahul PatilDepartment of Pathology, HCG Manavata Cancer Centre, Nashik, Maharashtra, IndiaRaj NagarkarDepartment of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, Maharashtra, IndiaJournal Article20191122<span style="font-size: 14px;"><span style="font-family: times new roman;"><span style="font-size: 24px;"><strong>S</strong></span>arcomatoid 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.</span></span>