alireza monsef

This study aimed to determine diagnostic value of immunoperoxidase in comparison with immunofluorescence in the diagnostic assessment of kidney biopsy specimens. Forty-eight kidney biopsy specimens were used to compare a direct immunofluorescence technique with immunoperoxidase techniques on paraffin sections. The sensitivity and specificity were calculated. The kappa statistic for agreement between the two tests was categorized as poor (zero to 0.2), moderate (0.21 to 0.45), good (0.46 to 0.75), and almost perfect concordance (0.76 to 1.0). Compared with immunofluorescence, the immunoperoxidase technique presented a sensitivity of 88.55% and a specificity of 69.22%. Its sensitivity in the staining for IgG, IgM, and IgA was 93.75%, 95.45%, and 76.47%, respectively. The specificity of this test in the staining for IgG, IgM, and IgA was 54.54%, 57.14%, and 96.00%, respectively. The overall kappa value was 0.60 and it was 0.60 for assessing staining intensity. There was a moderate agreement between immunoperoxidase and immunofluorescence in the positive or negative staining for IgG and IgM, as well as a good agreement in the positive or negative staining for IgA. For the staining intensity, the two tests had a good concordance for IgG and IgA and a moderate concordance for IgM. Although immunoperoxidase method has a lower overall diagnostic performance as compared to immunofluorescence, given the good concordance between the two techniques, it can be an alternative method for immunofluorescence study of kidney biopsy specimens, particularly where immunofluorescence fails or is not available.

Basal cell carcinoma is the most common form of skin cancer in men. Increased marker expressions of apoptosis and cell proliferation have been found in the majority of basal cell carcinomas. Our purpose was to determine whether any correlation between immunohistochemical expressions of P53 and Ki-67 in different histopathological variants of basal cell carcinoma and patient’s age, gender and tumor localization existed. We evaluated basal cell skin specimens obtained from 100 previously diagnosed cases of basal cell carcinoma at the Dermatology Clinic of Farshchian Hospital, Hamadan, Western Iran. At first the specimens were fixed by formalin and stained by hematoxylin-eosin. Histopathological types of the tumor were determined. Immunohistochemical expressions of Ki- 67and P53 were examined. Clinical features of the patients such as age, gender, and lesion site were collected from their files. The specimens were obtained from 62 (62%) men and 38 (38%) women with an age range of 22-107 years. Of basal cell carcinoma specimens, 76% expressed P53 and 60% expressed Ki-67. There was strong staining intensity of P53 protein in 70% and Ki-67 antigen in 30% of specimens. Strong staining intensity of Ki-67 in patients of lower ages was significantly correlated. There was no statistically significant correlation between these markers and other variables (P>0.05). This study highlighted the value of P53 and Ki-67 markers in basal cell carcinoma. We did not observe any significant difference between the histopathological types based on the P53 and Ki-67 expressions and their staining intensities.

Autoimmune bullous diseases are associated with autoimmunity against structural components in the skin and mucous membranes. Autoantibodies are against the intercellular junctions in pemphigus disease and hemidesmosomal unchoring complex in pemphigiod diseases and epidermolysis bullosa aquisita. The tissue-bound and circulating serum autoantibodies can be detected with direct immunofluorescence (DIF) and indirect Immunofluorescence (IIF) tests. The aim of this study was to pinpoint the immunofluorescence pattern of Iranian patients with autoimmune bullous diseases. In a prospective case series study, sixteen patients with autoimmune disease enrolled in the study for two years. Perilesional skins and sera from the patients were used in DIF and IIF for detection of immunofluorescence pattern. Out of 16 cases, 9 cases had pemphigus and 7 cases had bullous pemphigoid. All cases of pemphigus had positive DIF in intercellular region with lacelike pattern; IgG was detected in all cases, IgA in 1(11.1%) case and C3 in 3 (33.3%) cases. One (11.1%) case of pemphigus had positive IIF in intercellular region with lacelike pattern; circulating autoantibodies were IgG and IgA. All cases of bullous pemphigiod had positive DIF in dermal-epidermal Junction with linear pattern. IgG was detected in all cases, IgM in one (14.3%) case, and C3 in six (85.7%) cases. One (14.3%) case of bullous pemphoid had positive IIF in dermal-epidermal Junction with linear pattern; circulating autoantibody was IgG. Immunofluorescence tests are sensitive diagnostic methods for autoimmune bullous diseases. IIF positive cases in our study were lower compared to the previous reports.

This study tried to assess sensitivity, specificity, positive and negative predictive value of procalcitonin for diagnosis of neonatal bacterial infections. This prospective cross sectional study was carried out during an 18-month period in NICU and neonatal wards of Besat Hospital in Hamedan province, Iran. 39 symptomatic infants with clinical and laboratory findings in favor of bacterial infection with a positive blood, CSF, and/or supra pubic urine culture entered the study; 32 newborns without any bacterial infection served as control group. Quantitative procalcitonin level ≥0.5 ng/ml was accepted as pathological. Finally sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were calculated for procalcitonin test. 20 blood cultures, 17 urine cultures and 8 CSF cultures were positive. Sensitivity, specificity, PPV and NPV for procalcitonin test was 76.9%, 100%, 100% and 78% respectively. Diagnostic value of procalcitonin test in accordance with blood culture for mentioned items was 85%, 100%, 100% and 91.4% respectively. Its diagnostic value according to urine culture was: sensitivity 70.6%, specificity 100%, PPV 100% and NPV 86.4%, and according to CSF culture was: sensitivity 75%, specificity 100%, PPV 100% and NPV 94.1% respectively. The results show that the procalcitonin test has high sensitivity, specificity, PPV and NPV for diagnosis of neonatal infections.

Esophageal atresia is often associated with other anomalies. Hereditary and environmental factors may influence the incidence of associated anomalies, particularly of the urogenital system. We had 63 neonates with esophageal atresia admitted to 2 centers in Hamadan, Iran, from 2002 to 2008. They were 38 girls (60.3%) and 25 boy (39.7%). Tracheoesophageal fistula was present in 54 neonates (85.7%), and other associated anomalies in 10 (15.9%). Cardiac anomalies were found in 7 neonates; anorectal anomalies, in 4; urinary tract anomalies, in 2; and limb anomaly, in 1. Urinary tract anomalies (3.2%) were bilateral polycystic kidney in 1 neonate and unilateral hydronephrosis due to ureteropelvic junction obstruction in another. Both neonates with urinary tract anomalies were female and both had tracheoesophageal fistula, as well. Many of the associated congenital abnormalities influence the management protocol of esophageal atresia, and therefore, should be detected as soon as possible after birth

Enteroparasitic infections constitute a serious public health problem in different populations including developed countries. Patients who receive chemotherapy of cancer have an increased probability of acquiring parsitic infections, generally with a high degree of severity. The aim of present study was to ascertain the frequency of intestinal parasites in patients admitted in oncology ward for chemotherapy. In a descriptive study, all the patients whith malignancy who admitted in Sina Hospital in Hamadan, Iran, during 2005 were included. Data including demographic characteristics, type of malignancy, and the time past from the diagnosis entered the questionnaires. A stool specimen were examined for each patients. Data were analyzed using SPSS software. Out of 190 patients, 94 (49.5%) were male and 96 (50.5%) were female. The mean age was 48.518.7 years (12-88 years). Thirty-one (16.3%) patients were involved intestinal parasites. The most common parasites were: Ascaris (41.9%), Giardia (35.5%), Indolimax nana (3.2%), Blastocytis hominis (3.2%), and Cryptosporidium (3.2%). The highest prevalence of intestinal parasites belonged to 40-60 years age group. This study indicated that, the prevalence of intestinal parasites in patients undergoing chemotherapy for malignancy is lower than general population, which can be related to the effect of antineoplastic agents.

Rosacea is a common and ill-defined disease and Demodex folliculorum has been reported in rosacea in a number of clinical studies. Since demodex mite is present in many healthy individuals, the mite may have a pathogenic role only when it is present in high densities. Therefore, in this study, the possible role of demodex folliculorum and the importance of mite density were investigated using an elliptical incisional skin biopsy technique. Thirty-nine patients with rocacea, twenty-five females, 14 males, and 41 age- and sex-matched healthy individuals as control were included in the study. With the incisional skin biopsy of face, we studied six sections of each sample. We also studied the number of follicles, mite density, epidermal changes, solar elastosis, inflammatory cells in the dermis and their pattern, granuloma formation, and vascular changes. Varying degree of vasodilatation, solar elastosis, and inflammatory infiltrate were found in all patients. The infiltrate was lympho-histiocytic in 29 cases, lympho-plasmacytic in 6 cases, neutrophilic, especially around hair follicles in 2 cases, and eosinophilic infiltration mixed with mononuclear cells in 2 cases. The number of D. folliculorum was statistically significant. There was also a significant difference between males and females regarding the number of mite in rosacea in relation to age (p = 0.047). There was also granuloma around appendages in 3 cases and granuloma around hair follicle in 2 cases. One case in the latter group had degenerated demodex cuticle. Rosacea is a multifactorial disease and high densities of demodex are important in the form of hypersensitivity reaction to antigens or granuloma formation in response to its cuticle or destructed hair follicles. The individual properties may modify the severity of inflammatory response to demodex.

Complications of national program vaccination have great importance, because widespread use of vaccines and expanded age range of vaccinees increases the percentage of side effects. Present study was performed for evaluating the complications of national measles and rubella vaccination in Hamedan province. This cross-sectional descriptive study was done from December sixth to January fifth 2003 and two months after termination of vaccination program. The study was performed by filling complication forms that were distributed in the vaccination centers. The data was analyzed by SPSS software. A total of 827468 persons had been vaccinated in Hamedan, 260 out of them showed different complications. They had occurred mostly in 10 to 14 year old age group and had reported mainly by vaccination teams. 61.41 % of complications had been occurred in the first 24 hour after vaccination. 86 % of them had reactions to vaccination. 91 % of cases were outpatient. The complications with incidence rate more than were urticaria, fever, head ache, vomiting, lymphadenopathy, cough, skin rash, myalgia, pharyngitis, arthritis, rhinitis, restlessness and occular complications in decreasing order. The complications with incidence rate less than were sever dyspnea, seizure, diarrhea, paresthesia, anaphylaxis, encephalitis, thrombocytopenia, and Gillan – Barre syndrome. Mild complications were more frequent than severe ones. Most of the complications were related to reaction to vaccine, we didn’t have any program fault. Therefore we suggest a potent and flexible care system for reacting to side effects.

Breast cancer comprise approximately one third of malignant cases in women and is considered as the most common invasive condition in women at an age range of 15-54 years and as the second most prevalent cause of mortality at an age range of 55-74 years. Tumor inhibiting factor p53 is a vital homeostatic regulator and its inactivation at the related gene or molecule could lead to tumor growth and development in various tissues. Therefore, in this research study it was tried to evaluate the diagnostic methods Ag-NOR andp53 immunohistochemistry in malignancy of mammary gland using cytochemical staining methods and its relationship with tumor grade. In this research study, 50 referred breast specimens to Deaprtment of Pathology (Sina Hospital, Hamedan) were studied. They were processed as usual and 3micrometer sections were prepared from related blocks. Then, staining methods for nucleolus organizing regions (Ag-NOR) and p53 immunohistochemistry were applied. Out of these specimens, 41 had malignancy (40 cases of invasive ductal carcinoma and 1 case of invasive lobular carcinoma) and 9 cases were normal. The latter cases were compared with malignant ones. Tumor grade in studied individuals was I (3 cases; 7.3%), II (23 cases; 56.1%), and III (15 cases; 36.6%) respectively. Statistical analysis of data showed that there is only a significant difference regarding frequency distribution of cluster shape and there is no such difference for satellite shape, satellite size, and cluster size. In addition, staining intensity for p53+, p53++, and p53+++did not show any significant difference in various grades of the disease. Using Spearman regression analysis, it was found out that there was a relationship between p53negative and p53+ (r = 0.723) (p<0.01) and between p53+ and p53++ (r = 0.78). Furthermore, it was found out that a higher expression of p53 protein is negatively correlated with darklystained granules using silver nitrate method. These findings showed that higher expression of p53 protein is negatively correlated with darkly-stained granules using Ag-NOR method and this may indicate its antitumor activity. It appears that this method is an essential tool for evaluation of normal and malignant cases of breast tissue regarding its replication pattern and intensity and expression of those chromosomal segments which are involved in encoding of ribosomal RNA.

The aim of this study was to evaluate an enzyme – linked immunosorbent assay (ELISA) for the detection of anti – helicobacter pylori (H. pylori) specific IgG antibodies in specimens of oral fluid.All subjects over the age 18 years undergoing endoscopy for any reason were asked to participate in the study. Two groups of 44 patients in each were selected as HP+ and HP-. At the same time, 5 milliliters of unstimulated saliva was collected from these patients, and the antibody titration against H.P. was evaluated by “ELISA” method.In overall, the level of salivary antibody in H.P+ group was significantly more than those in H.P- group (P<0/001). In the best cut – off, sensitivity and specificity obtained in this test were respectively 88.6% and 81.8% and positive predictive and negative predictive values were determined as 83% and 87.8%, respectively. Positive Likelihood Ratio and negative likelihood ratio were 6.8 and –0/083, respectively.Oral fluid ELISA is relatively a comfortable, fast and noninvasive test for diagnosis of H. pylori infection.

Preperative autologous blood donation (PABD) is one of the three methods of autologous blood transfusion. With stimulating bone marrow erythropoiesis and satisfactory iron supplies maintained, blood can be collected as frequency as once a week from an autologous donor and had transfused to patient during the surgery.There are many advantages in this method (PABD) elimination of transfusion - transmitted disease such as hepatitis and ADIS . Immunologic complications related to the transfusion of foreign cells and HLA antigens , including hemolysis and febrile reactions to white cells, are also prevented. The PABD has used in elective orthopedic surgery, cardiovscular, pediatrics, elderly,gynecological, elective plastic surgery procedure. In this study we report two cases of plastic surgery undergoing reductive mammoplasty and abdominoplasty . The PABD procedure has done for them and the results were very good.