Human Papillomavirus-Associated Oral Epithelial Dysplasia: A Practical Approach to Make the Diagnosis

Background: High-risk Human Papillomavirus (HPV) genotypes are found in malignant oral epithelial lesions, and HPV infection is proposed as a risk factor for initiating Squamous cell carcinoma (SCC) in the head and neck region. This study suggests a practical approach to detect HPV in HPV-associated oral epithelial dysplasia (HAOED).Methods: Fifty-four oral epithelial dysplasia specimens were examined, comprising twenty-seven cases diagnosed with high-grade dysplasia and twenty-seven cases diagnosed with low-grade dysplasia using a binary grading system. To assess the cases for HPV, the specimens were examined for p16 protein using an immunohistochemical (IHC) study, and then, the Chromatin In Situ Hybridization (CISH) test was performed for all positive cases. Chromatin Immunoprecipitation-Polymerase Chain Reaction (ChIP-PCR) was performed on CISH-positive specimens to assess the outcome. This cross-sectional study was conducted in 2020 at Tehran University of Medical Science. SPSS software version 22.0 was used to perform the Chi square or Fisher’s exact test to examine the relationship between variables (statistically significant level P0.99), and in the nine cases, undergone the ChIP-PCR study, two cases (22.2%) showed positivity for HPV-16, while one case (11.1%) demonstrated positivity for HPV-51.Conclusion: Regarding HAOED, here, we proposed a step-by-step combination approach using different diagnostic methods, including IHC for p16 protein, CISH, and ChIP-PCR based on a complementary algorithm

The Role of Open Diagnostic Peritoneal Lavage in the Evaluation of Peritoneal Cytology for Advanced Gastric Cancer: An Old Diagnostic Modality with New Usage

Background: Positive peritoneal cytology is a critical factor in prognosis. Peritoneal lavage is associated with long-term survival in patients with gastric cancer. Diagnostic peritoneal lavage (DPL) is a method for diagnosing visceral injury in trauma patients. This study aimed to investigate the usage of DPL in staging the work-up of patients with gastric cancer. Method: In this prospective study, we enrolled gastric cancer patients referring to Cancer Institute; they underwent DPL and washing specimen was sent for cytology review. After DPL, all patients underwent staging laparoscopy (SL) via the same abdominal incision. Results: DPL and SL were successful in all patients. There were six (11%) cases of peritoneal seeding discovered in SL; all of these patients had positive peritoneal cytology on DPL. Also, four patients showed positive cytology in the absence of positive SL. Thus, sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of DPL were 100 % (95% CI: 54.1-100), 91.6 % (95%: 79.2-97.5), 100 % (95%CI: 85.3-100), and 60 % (95%CI: 37-79.3). The accuracy of DPL in determining the peritoneal dissemination of gastric cancer was 92.31% (95% CI: 81.5-97.9). Conclusion: DPL had an excellent ability to find peritoneal dissemination in a gastric cancer patient, which is of great value in the setting of low-resource countries

Metformin Protects against Radiation-Induced Pneumonitis and Fibrosis and Attenuates Upregulation of Dual Oxidase Genes Expression

Purpose: Lung tissue is one of the most sensitive organs to ionizing radiation (IR). Early and late side effects of exposure to IR can limit the radiation doses delivered to tumors that are within or adjacent to this organ. Pneumonitis and fibrosis are the main side effects of radiotherapy for this organ. IL-4 and IL-13 have a key role in the development of pneumonitis and fibrosis. Metformin is a potent anti-fibrosis and redox modulatory agent that has shown radioprotective effects. In this study, we aimed to evaluate possible upregulation of these cytokines and subsequent cascades such as IL4-R1, IL-13R1, Dual oxidase 1 (DUOX1) and DUOX2. In addition, we examined the potential protective effect of metformin in these cytokines and genes, as well as histopathological changes in rat’s lung tissues. Methods: 20 rats were divided into 4 groups: control; metformin treated; radiation + metformin; and radiation. Irradiation was performed with a 60Co source delivering 15 Gray (Gy) to the chest area. After 10 weeks, rats were sacrificed and their lung tissues were removed for histopathological, real-time PCR and ELISA assays. Results: Irradiation of lung was associated with an increase in IL-4 cytokine level, as well as the expression of IL-4 receptor-a1 (IL4ra1) and DUOX2 genes. However, there was no change in the level of IL-13 and its downstream gene including IL-13 receptor-a2 (IL13ra2). Moreover, histopathological evaluations showed significant infiltration of lymphocytes and macrophages, fibrosis, as well as vascular and alveolar damages. Treatment with metformin caused suppression of upregulated genes and IL-4 cytokine level, associated with amelioration of pathological changes. Conclusion: Results of this study showed remarkable pathological damages, an increase in the levels of IL-4, IL4Ra1 and Duox2, while that of IL-13 decreased. Treatment with metformin showed ability to attenuate upregulation of IL-4–DUOX2 pathway and other pathological damages to the lung after exposure to a high dose of IR

Correction to: Viral hepatitis and prevention- current status and future prospects

Correction to: Viral hepatitis and prevention- current status and future prospects   Mohammad Jafar Saffar1,  Hiva Saffar2,  Hana Saffar2   1 Department of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 2 Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran                                                                                                                      In the article published in volume 18, issue 67, 2008, the affiliation of Hiva Saffar and Hana Saffar was published incorrectly, which is now corrected.       J Mazandaran Univ Med Sci 2021; 30(194): 210-211 (Persian)

Vaccination in Developing Countries: A Review of Probable Factors for Lower Responses to Vaccine

ABSTRACT Prevention of infectious diseases by immunization in children has markedly diminished the morbidity and mortality of once common contagious diseases in many countries worldwide. Immunization programs have led to the global eradication of smallpox, elimination of measles and poliomyelitis in regions of the world, and substantial reduction in the morbidity and mortality attributed to diphtheria, tetanus, pertussis, and measles. Childhood vaccination was estimated to prevent more than 2.5 million deaths for vaccine preventable- diseases each year. However, at current levels of coverage, it still causes 1.7 million deaths annually, most of them in developing countries. The main objectives of this review are as following: To overview the expanded programme of immunization and WHO global vision and strategies for vaccination. To review underlying mechanisms that influence host immune response to vaccine, and differentiate primary from secondary vaccine failure. To determine the environmental factors that may reduce the potency of the vaccines or vaccinees. To explain the probable factors that lead to lower responses in vaccine recipients in developing countries

Vaccination in Developing Countries: A Review of Probable Factors for Lower Responses to Vaccine

Prevention of infectious diseases by immunization in children has markedly diminished the morbidity and mortality of once common ontagious diseases in many countries worldwide. Immunization programs have led to the global eradication of smallpox, elimination of measles and poliomyelitis in regions of the world, and substantial reduction in the morbidity and mortality attributed to diphtheria, tetanus, pertussis, and measles. Childhood vaccination was estimated to prevent more than 2.5 million deaths for vaccine preventable- diseases each year. However, at current levels of coverage, it still causes 1.7 million deaths annually, most of them in developing countries. The main objectives of this review are as following: To overview the expanded programme of immunization and WHO global vision and strategies for vaccination. To review underlying mechanisms that influence host immune response to vaccine, and differentiate primary from secondary vaccine failure. To determine the environmental factors that may reduce the potency of the vaccines or vaccinees. To explain the probable factors that lead to lower responses in vaccine recipients in developing countries

Is the Evaluation of Entamoeba Histolytica Infection in HIV-Positive Patients of any Clinical Significance?

Amoebiasis caused by Entamoeba histolytica (E. histolytica) is one of the most problematic parasitic infections worldwide. Data regarding the effect of HIV-induced immunodeficiency on the status of E. histolytica infection are sparse in Iran. This study aimed to assess the seroprevalence of anti-E. histolytica IgG among Iranian HIV patients. Further, it determined whether the advancement of immunodeficiency accompanies an increased risk of amoebiasis. A total of 91 HIV-infected patients and 91 controls were enrolled in this case-control study. Controls were matched to cases with respect to age, gender, and where possible socioeconomic status. Patients with a history of treatment for intestinal parasitism within last two weeks were not included in the study. Blood samples were obtained from all participants. Serum IgG against E. histolytica measured using a commercial enzyme-linked immunosorbent assay (ELISA). The mean serum anti-E. histolytica IgG was significantly higher in HIV patients than controls (9.34 ± 4.18 vs. 2.07 ± 0.60, P<0.001). HIV-infected patients showed a significantly higher positive serology for E. histolytica IgG comparing healthy controls (30.8% vs. 0% P<0.001). There was no statistical difference in the serology of E. histolytica among AIDS stage and non-AIDS HIV patients. This study demonstrated that HIV is significantly associated with higher prevalence of E. histolytica infection. Early evaluation and treatment of E. histolytica in this population is recommended to prevent and control this infection

Increasing antibiotic resistance among uropathogens isolated during years 2006-2009: impact on the empirical management

Urinary tract infections (UTI) are one of the most common infections with an increasing resistance to antimicrobial agents. PURPOSE: Empirical initial antibiotic treatment of UTI must rely on susceptible data from local studies. MATERIALS AND METHODS: Retrospective analysis of isolated bacteria from children with UTIs was performed at the university hospital during years 2006-2009. The findings were compared with data collected in a similar study carried out in 2002- 2003. RESULTS: A total of 1439 uropathogens were isolated. Escherichia coli (E.coli) was the leading cause, followed by Enterobacter, and other gram negative bacilli. It was observed resistance of E.coli to ceftriaxone, cefexime, amikacin, gentamycin, and nalidixic acid; Enterobacter to cefexime; and the resistance of gram negative bacilli to gentamicin and cefexime increased significantly. The highest effective antibiotic was Imipenem, ciprofloxacin, and amikacin with 96.7%, 95% and 91% sensitivity rates , respectively, followed by ceftriaxone 77.2%, gentamicin 77%, nitrofurantoin 76.4%, nalidixic acid 74.3% and cefexime with 70%. CONCLUSION: The use of nitrofurantoin or nalidixic acid as initial empirical antibacterial therapy for cystitis seems appropriate. For cases of simple febrile UTI, the use of initial parenteral therapies with amikacin or ceftriaxone followed by an oral third generation cephalosporin also seemed appropriated, and in cases of severely ill patients or complicated UTI, imipenem as monotherapy or, a combination of Ceftriaxone with an aminoglycoside, are recommended