Prevalence of human papillomavirus genotypes in women with normal and abnormal cervical cytology in Iran

Introduction: HPV infection has a prime etiologic role in development and progression of cervical cancer, one of the most frequent forms of cancer among women in developing countries. This study was designed to determine the most prevalent HPV genotypes in women with normal and abnormal cervical cytology in Iran. Materials and Methods: Samples from134 patients, including 127 who attended gynecology clinics and 7 with solid cervical tumors were used. All 127 patients underwent routine Pap tests for cytological evaluation and at the same visit a sample of cervical epithelial cells was obtained by scraping the cervix osteum. In each case HPV infection was primarily evaluated by PCR using GP 5/6 primers and then subtyping was performed in proved infected samples with specific primers for HPV 16, 18, 31, 33, 11 and 6. After cytological evaluation, 50 patients with abnormal Pap tests were categorized as the abnormal group and the remaining 77 patients as the normal group. Results: In the normal group, HPV infection was established in 10 cases (13% infection rate), while 30 HPV positive cases were discovered in the abnormal group (60% infected). The most prevalent genotypes among the infected samples were HPV 16 (76%), HPV18 (12.7%) and HPV11/6 (8.5%). Moreover, all 7 tumor samples were positive for HPV general primers of which, 5 samples were infected with HPV 16, two were co-infected with HPV16,18 and HPV16,31 genotypes and one was infected with HPV 18. Conclusions: Infection with HPV 16 was found to be significantly higher in abnormal group in comparison with normal group (42% vs. 11.6%, P value <0.005), likewise HPV18 genotypes were proved to be more prevalent in abnormal group (8% vs. 0%, P value <0.05). No significant relation between other HPV genotypes and pathologic cervical changes was obtained. According to our study high rates of infection with HPV genotypes in sexually active Iranian women makes molecular investigation for HPV16 and 18 very essential in clinical approaches to patients with proven dysplasia in their screening tests and also for those patients with borderline (i.e. ASCUS) or incongruous pathology reports. Larger studies are required to determine the most appropriate vaccine with highest protection in Iranian women

Accuracy of Visual inspection with acetic acid (VIA) for early detection of cervical dysplasia in Tehran, Iran

Objective: To evaluate the accuracy of visual inspection with 5 acetic acid (VIA) when used to detect cervical cancer and its precursors. Methods: The study population included women attended Family Planning and Gynecological Clinic in Bagher Abad Health Center and Mirza Koochak Khan Hospital for regular cervical screening tests. After obtaining informed consent from each woman, VIA was performed. One hundred with a positive VIA test and 100 women with a negative VIA test were randomly selected for this study. Cytology and colposcopy examination were performed for all 200 cases and cervical biopsies were conducted for those individuals showing abnormal colposcopic findings. Results: Nine cases in VIA-positive group and two cases in VIA-negative group had an abnormal cytology. Ninety five women in the VIA-positive group and 25 in the VIA-negative group had abnormal colposcopic findings. From biopsy examination, 67 (71) of cases in the VIA-positive group and 3 (12) cases in the VIA-negative group had a final diagnosis of dysplasia. Among biopsied samples, only 7 cases of VIA-positive group showed abnormal result and the remaining were normal. Based on these results, VIA test sensitivity and specificity were 95.7 and 44.0 respectively, while they were 10 and 92 for cytology tests. Conclusions: The results of this study indicate that although VIA is a sensitive screening test for detection of cervical dysplasia, it can not be used by itself. Applying VIA along with Pap smears helps to detect a higher number of cases with cancer precursor lesions

Empirical developments in retraction

This study provides current data on key questions about retraction of scientific articles. Findings confirm that the rate of retractions remains low but is increasing. The most commonly cited reason for retraction was research error or inability to reproduce results; the rate from research misconduct is an underestimate, since some retractions necessitated by research misconduct were reported as being due to inability to reproduce. Retraction by parties other than authors is increasing, especially for research misconduct. Although retractions are on average occurring sooner after publication than in the past, citation analysis shows that they are not being recognised by subsequent users of the work. Findings suggest that editors and institutional officials are taking more responsibility for correcting the scientific record but that reasons published in the retraction notice are not always reliable. More aggressive means of notification to the scientific community appear to be necessary

Malignant mixed mullerian tumor of the uterus associated with tamoxifen therapy in a patient with a history of breast cancer

Tamoxifen is the drug of choice in the treatment of breast cancer. Recent reports show an increased incidence of endometrial carcinoma in patients taking tamoxifen. In this article, we report a case of malignant mixed mullerian tumor after tamoxifen use. Copyright © 2006 by Razi Institute for Drug Research (RIDR)

Can we substitute brush cytology for biopsy in the evaluation of cervical lesions under the guidance of colposcopy?

In cervical cancer screening, colposcopically directed biopsy is the gold standard method for identifying intraepithelial and occult invasive lesions of the uterine cervix. As biopsy needs special expertise and the procedure is not convenient for the patients, we sought to evaluate colposcopically directed brush cytology as a substitute for biopsy of cervical lesions. We studied a series of 150 women who were referred for colposcopic evaluation. Colposcopically directed brush cytology and biopsy were performed for all patients with abnormal colposcopic findings. A total of 40 samples were excluded due to unsatisfactory report of brush cytology. Of the remaining 110 samples, 34 abnormal pathologies were reported in biopsy evaluations, while only 9 abnormal cytologies were reported in brush cytology specimens. Brush cytology sensitivity and specificity were 26 and 97, respectively. We conclude that colposcopically directed brush cytology is not a safe substitute for biopsy in the evaluation of cervical lesions. © 2005 IGCS

THE RELATIONSHIP BETWEEN PRIMARY HYPERTENSIVE PATIENTS’ KNOWLEDGE ON HYPERTENSION AND COMPLIANCE WITH SODIUM RESTRICTED DIET THERAPY, AT A REFERRAL HOSPITAL IN SWAZILAND

One of the major health concerns in the healthcare field is the increasing number of primary hypertensive patients. Primary hypertension is a condition that occurs without underlying health problems, it is an asymptomatic, chronic, debilitating, and silent killer disease if it is uncontrolled. However, primary hypertension can be prevented and successfully controlled. This descriptive correlational study assessed: the primary hypertensive patients’ knowledge about hypertension, level of compliance with sodium restricted diet therapy, and the relationship between the primary hypertensive patients’ knowledge and compliance with sodium restricted diet therapy. The study was conducted at the Mbabane Government Hospital. The systematic probability sampling method was utilized to obtain a sample of N = 90 primary hypertensive patients. The researchers selected every fifth participant. There were 74 (82%) females and 16 males (18%), between 35 and 65 years of age. Subjects’ knowledge scores on hypertension was 58%, and compliance with sodium restricted diet therapy was 64% among both males and females. The correlation coefficient indicated a relationship that was not statistically significant (r = .09, p > .05).between knowledge and compliance. The findings suggest that there may be other factors that influence self-care on compliance, besides knowledge on hypertension

National guidelines for cognitive assessment and rehabilitation of Iranian traumatic brain injury patients

Background: Individuals with moderate to severe traumatic brain injury (TBI) often have prolonged cognitive impairments, resulting in long-term problems with their real-life activities. Given the urgent need for evidence-based recommendations for neuropsychological management of Iranian TBI patients, the current work aimed to adapt eligible international guidelines for cognitive assessment and rehabilitation of the TBI patients in Iran. Methods: The project was led by an executive committee, under the supervision of the Iranian Ministry of Health and Medical Education (MOHME). Following a systematic literature search and selection process, four guidelines were included for adaptation. Clinical recommendations of the source guidelines were tabulated as possible clinical scenarios for 90 PICO clinical questions covering all relevant phases of care. After summing up the scenarios, our initial list of recommendations was drafted according to the Iranian patients� conditions. The final decision-making, with the contribution of a national interdisciplinary panel of 37 experts from across the country, was conducted in two rounds using online and offline survey forms (Round 1), and face-to-face and telephone meetings (Round 2). Results: A total of 63 recommendations in six sections were included in the final list of recommendations, among which 24 were considered as key recommendations. In addition, some of the recommendations were identified as fundamental, meaning that proper implementation of the other recommendations is largely dependent on their implementation. Conclusion: Iranian health policy makers and rehabilitation program managers are recommended to address some fundamental issues to provide the necessary infrastructure to set up an efficient cognitive rehabilitation service system. © 2020 Academy of Medical Sciences of I.R. Iran. All rights reserved