نجمه آل طه

Biliary papillomatosis is a disorder characterized by numerous adenomatous polyps of variable distribution and extent in intrahepatic bile ducts. It should be considered as a premalignant condition because a high proportion of the lesions undergo malignant transformation. In this report, we present a patient with abdominal pain and jaundice.
According to his presenting signs and symptoms, ERCP was done for him and multiple biopsies were taken from the common bile duct. Due to high grade dysplasia in the pathological report, Whipple surgery was performed and specimens were sent for microscopic evaluation. Histological examination showed intraductal biliary papillomatosis.

Polycystic ovarian syndrome (PCOS) is a condition associated with chronic anovulation, insulin resistance and androgen excess. Women with this syndrome are at increased risk of metabolic syndrome. The aim of the present study was to determine the prevalence of metabolic syndrome (MBS) in women with PCOS referred to Arash Hospital in different ages and body mass index (BMI). A cross-sectional study was conducted in Gynecologic Clinic at Arash Hospital affiliated with Tehran University. A total of 282 women with PCOS ages between 15-40 years were included. The prevalence of Metabolic Syndrome and its components in this population were the main outcomes. Height, weight, waist circumference, blood pressure and laboratory tests (FBS, TSH, HDL-C, serum prolactin, triglycerides and total cholesterol) were measured in this population. The prevalence of MBS in PCOS women was 22.7% (64 cases). The rate of central obesity, FBS more than 110 mg/dl, triglycerides more than 150 mg/dl, high-density lipoprotein cholesterol levels (HDL-C) less than 50 mg/dl, and blood pressure? 130/85 mmHg in PCOS women was 31% (87), 3.2% (9), 33% (93), 68.8% (194), and 10.6% (30), respectively. The risk of MBS was increased in older and the obese women (BMI? 30 kg/m2). The present sample showed women with PCOS have a high prevalence of MBS and its individual components, particularly decreased HDL-C.

Endosonography is a distinct method in evaluating gastrointestinal (GI) structural lesions, particularly in the pancreatobiliary system. This procedure has made a fundamental change in the diagnosis of pancreatic mass lesions through fine needle aspiration (FNA). This study aims to evaluate the results and efficacy of endosonographic fine needle aspiration (EUS-FNA) in patients presenting with solid pancreatic masses. This was a descriptive, prospective, case series study of patients who presented with solid pancreatic masses to Imam Khomeini Hospital, Tehran, Iran over a one year period (from November 20092010-) In order to determine false negative cases, patients were followed for 6 to 12 months. A total of 53 patients underwent EUS-FNA with no complications. The results were diagnostic in 46 (87%) cases. The majority of patients were male (68%) and 81% had a mass in the pancreatic head. Cytopathology results revealed 36 (68%) adenocarcinomas, 7 (13%) other malignancies, 3 (6%) benign lesions and 7 (13%) nondiagnostic cases. The frequency of nondiagnostic results was significantly more in masses smaller than 3 cm (6 vs. 1, p < 0.002). Patients with nondiagnostic results were younger than those with malignant cytopathologies (52 ± 7.5 vs. 66 ± 7.5 years, p < 0.001). Sensitivity, specificity, PPV, NPV and accuracy of EUS-FNA in adenocarcinoma cases were 88%, 100%, 100%, 70% and 90%, respectively. EUS–FNA is an effective and safe procedure in the histopathologic diagnosis of pancreatic tumors.

Hepatitis B is still a major health problem in many parts of the world. In some developing countries the most common cause of chronic hepatitis and liver cirrhosis is hepatitis B virus (HBV). The progression of chronic hepatitis B to cirrhosis and hepatocellular carcinoma (HCC) include such viral factors as genotype C and high levels of serum HBV DNA in addition to host factors such as older age, male gender, obesity and diabetes. Other factors that influence progression to cirrhosis and HCC are simultaneous alcohol use, and co-infections with HIV, HDV and HCV. The present study aims to determine the correlations between serum HBV DNA viral load and related factors. In this study, new HBV DNA and ALT levels that enable better separation between different stages of this disease are presented.Chronic hepatitis B patients who presented to the Liver Clinic at Imam Khomeini Hospital in 1388 who were HBsAg positive for more than six months were enrolled in this study. Patients who had previously been treated or those with concurrent HIV, HCV and HDV infections as well as those with autoimmune hepatitis and fatty liver were excluded. Patients’ data, HbeAg state, demographics, liver enzymes, HBV DNA level, smoking history, cirrhosis and disease stage were recorded.In order to better differentiation between non-replicative and reactive chronic hepatitis B patients, statistical analysis was done to distinguish between their HBV DNA levels. Evaluation of the relationships between HBV DNA level and the above mentioned variables was performed.High Levels of HBV DNA correlated with HBeAg positive state, smoking (p=0.005) and elevated liver enzymes (p=0.002). The cut-off value for ALT level that separated HbeAg-positive group (immunoclearance and immunotolerancephases) was set at 42 U/l on the roc curve(r=0.889 area under curve) with 100% sensitivity and 67.7% specificity. The cut-off value for serum HBV DNA levels that differentiated between the Hbe Ag-negative group (non-replicative and reactive phases) was set at 3000 IU/ml on the roc curve (r=0.987 area under curve) with 97% sensitivity and 92% specificity.Coclusion:The present study determined that serum HBV DNA at a level of 3000 IU/ml was a better level for classification of HBeAg-negative patients into the non-replicative and reactive groups.

E-cadherin is a calcium-dependent molecule that contributes to intercellular adhesion. Its proper functioning is important in the maintenance of epithelial structure and integrity. E-cadherin serves as a very important tumor suppressor. In this study, we aim to determine the frequency of E-cadherin expression aberrancy and itsrelationship to the biological behavior of gastric adenocarcinoma.A total of 52 patients with gastric cancer who underwent gastrectomies in Imam Khomeini Hospital were investigated in a cross-sectional study. Their tissues were stained by immunohistochemistry methods toinvestigate the expression of E-cadherin. Patients’ information including age, ge nder, Helicobacter pyloriinfection, lesion location, adenocarcinoma subtype, metastasis, differentiation and regional lymph node involvement, depth of invasion and staging were collected and compared.Age, gender, Helicobacter pylori infection, lesion location, regional lymph node involvement, metastasis, depth of invasion, differentiation and staging did not have a statistically significant relationship with abnormal E-cadherin expression. Abnormal E-cadherin expression was significantly higher in the diffuse sub-type ascompared with the intestinal type (90.9% vs. 48.8%, p = 0.016).The present study assessed the frequency and relationship between abnormal E-cadherin expression and certain biological variables of tumor behavior in Iranian patients with gastric adenocarcinoma. A significant correlation existed only between diffuse sub-typing and reduced E-cadherin expression.Keywords:.

Although gastroesophageal reflux disease (GERD) is a common disorder, its etiologies are still largely unknown. There are limited data on the association between psychological status and GERD in the world, in general, and in Iran, in particular. This study was conducted to determine the role of psychological factors in causing GERD. 1,016 randomly-selected subjects were invited for a face-to-face interview. 1,000 persons participated in this study (age range: 18-40 years). Those who reported heartburn and/or regurgitation, at least once a week, during the last 12 months were defined as GERD patients. Controls were persons who did not complian of those symptoms. The psychosocial status was assessed by a reliable general health questionnaire for Iranian, GHQ-28. The prevalence of "at least weekly GERD" was 12.3%. Somatic disorders (OR: 3.50; 95% CI: 2.17-5.66), anxiety (OR: 4.02; 95% CI: 2.51-6.43), social disorders (OR: 1.95; 95% CI: 1.21-3.17), and depression (OR: 3.29; 95% CI: 1.95-5.50), increasing age and obesity were associated with developing GERD. The prevalence of GERD in northern Iran is more than that in most Asian countries and is comparable to Western countries. The result of this study indicates significant association between psychiatric disorders with reflux symptoms. The psychosocial factors may play important roles in the production of GERD symptoms.