Optimization of registry records [registration of patients] of hemodialysis patients it in the country

Background and Aim: Establishment of registry system is an important criterion for health care management system. In this study we extended registry system which included only a few items of personal information

Data concerning epidemiologic issues and important criteria influencing the status of these patients were collected

Materials and methods: In a cross-sectional study, in cooperation with the specific diseases and organ transplantation management of Ministry of Health and Medical Education, we collected and studied data of the hemodialysis patients in our country

This study included 18,160 patients from 428 dialysis departments

We collected demographic, clinical and laboratory data including demographic characteristics, disease duration, cause of renal disease and recorded serum levels of hemoglobin, calcium, PTH, ferritin and, during a period of 2 months

Using SPSSv.18 software data were analyzed by t-test

Results: The mean age of the patients was 67.86 +/- 16.7 years. The most common causes of ESRD were diabetes [37.35%] and hypertension [23.9%] respectively. 2.2 percent and 3.06 percent of the patients were positive for HBSAg and HCVAb respectively

Most patients [75.7%] had been on dialysis 3 times a week. Hemoglobin levels were less than 10 mg / dl in 42.3 % of the patients . 20.3 % of the patients had calcium levels of less than 8 mg/dL PTH level was more than 300mg/dl in 22.6% of the patients

Conclusion: Poor control of hemoglobin, albumin, ferritin, etc., as predictors of survival in hemodialysis patients can lead to higher mortality and development of cardiovascular disease in these patients

Control of diabetes and high blood pressure can be effective in reducing the incidence of ESRD

Cynara scolymus l. in treatment of hypercholesterolemic type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial

Type 2 diabetes mellitus with hyperlipidemia is a common disease. Conventional anti-hyperglycemic and anti-hyperlipidemic drugs have limited efficacies and important side effects, so that alternative agents are needed. Previous studies suggest that fiber-free artichoke [Cynara scolymus L.] leaf extract may have anti-hyperglycemic and anti-hypercholesterolemic effects in hypercholesterolemic type 2 diabetic patients. Moreover, artichoke leaves are used traditionally as an anti-hyperglycemic and anti-hyperlipidemic remedy to treat diabetes mellitus and hyperlipidemia. The effects of artichoke leaf extract in treatment of hypercholesterolemic type 2 diabetic patients were studied. In this randomized double-blind placebo-controlled clinical trial with hypercholesterolemic type 2 diabetic patients aged 40 to 60 years not using other antihyperlipidemic agents and resistant to daily intake of two 5 mg glyburide tablets and two 500 mg metformin tablets, the efficacy and safety of taking fiber-free artichoke leaf extract [one 400 mg capsule t.i.d. for 2 months] combined with the aforementioned drugs in treatment of 36 patients were evaluated and compared with the placebo group [n = 36]. The extract lowered the blood levels of total cholesterol and LDL cholesterol significantly [P=0.002 and p=0.040 respectively] without any significant effects on the blood levels of fasting glucose, postprandial glucose, glycosylated hemoglobin, other lipids, SGOT, SGPT and creatinine [P>0.05] compared with placebo at the endpoint. No adverse effects were reported. Fiber-free artichoke extract may be a safe anti-hypercholesterolemic agent but does not improve glycemic control in hypercholesterolemic type 2 diabetic patients, suggesting the involvement of fibers in the anti-hyperglycemic effect of artichoke

[Relationship between self-reported exposure to passive smoking and maternal urinary cotinine level in pregnant women]

Passive smoking during pregnancy increases the risk of pregnancy complications. The purpose of this study was to determine the relationship between self-reported exposure to passive smoking and urinary cotinine level of the pregnant women. This cross-sectional study was done on 108 non-smoker pregnant women referred to Arash hospital in Tehran, Iran for delivery during 2010. A questionnaire including smoke exposure during pregnancy was completed for all the participants. Urine samples were collected from the mothers in the delivery room. The urinary cotinine levels was measured by ELISA method. Data were analyzed using SPSS-16, Student t-test, Chi-Square and one-way ANOVA tests. The Kappa test was used to evaluate the variability of mothers which report exposure to passive smoking with maternal urinary cotinine level. The geometric mean cotinine of the maternal urine in the exposed group [27.4 +/- 29.96 ng/ml] was significantly higher than the non-exposed group [0.75 +/- 2.29 ng/ml] [P<0.05]. There was a significant association between maternal reports of cigarette smoke exposure and urinary cotinine [Kappa=96%] [P<0.05]. This study indicated that there is a relationship between maternal self-reporting and urinary cotinine level during pregnancy

Association between anthropometric measures and bone mineral density: population-based study

Osteoporosis is a major public health concern around the world. It has been shown that bone mineral density is correlated to anthropometric measures like height and weight, but this association may vary depending on ethnic and environmental factors. The aim of this study was to identify probable relations between anthropometric measures and bone mineral density. In this population-based study, we compiled the data collected from Iranian Multicenter Osteoporosis Study to assess the possible associations between different anthropometric indices and bone mineral density at femur and lumbar spine. The gathered data was analyzed using t-test and one way ANOVA. Data was available for 4445 subjects, consisting 1900 males [42.7%] and 2545 females [57.3%]. We observed statistically significant correlations between bone mineral density and height, weight, waist circumference, hip circumference, waist to hip ratio and body mass index [BMI]. Based on the result of linear regression modeling studies, BMI could be considered an independent predictor of bone mineral density. Iranian population shows similar measures compared to analogous studies in other populations. Lower weight should be carefully considered as a predisposing factor for bone loss and osteoporosis

[ effect of calcium hydroxide as an intracanal medicament on the apical microleakage]

Nowadays, calcium hydroxide is used as a dressing for canal sterilization and repair progression of apical lesions. The aim of this study was to investigate the effect of calcium hydroxide as an intracanal medicament on the apical microleakage of root filling. In this experimental study, 46 extracted single-rooted human teeth were instrumented with step-back technique to master apical file [MAF] size 35. Specimens were randomly divided into 2 groups [n=20]. In group 1, the specimens were treated with calcium hydroxide intracanal medication; and in group 2, did not receive any medication. The teeth were incubated in 100% humidity at 37 [degree sign] C for one week. After that, calcium hydroxide was removed using irrigation with normal saline and reaming with MAF. The root canals were obturated with gutta- percha and AH26 sealer using lateral compaction technique. Specimens were incubated in 100% humility at 37 [degree sign] C for 72 hours and then immersed in India ink for 1 week. Finally, the teeth were cleared and the maximum linear dye penetration was measured under a stereomicroscope at 4X magnification. The data were analyzed by T-test and Chi-square. There was no significant difference between the two experimental groups [P=0.068]. The findings of this study indicated that using calcium hydroxide as an intracanal medicament did not influence the apical microleakage after final obturation of the root canal system

effect of reflexology on pain intensity and duration of labor on primiparas

Reflexology is an ancient, mild and non-invasive technique, used widely as one of the nonpharmacological methods for pain relief. The aim of this research was to determine the effect of reflexology on pain intensity as well as to determine the duration of labor in primiparas. In 2008, a randomized clinical trial study was conducted randomly enrolling 120 parturient women with low risk pregnancy into three groups in Shahid Akbarabadi Hospital, Tehran, Iran. The first group received 40 minutes of reflexology at the beginning of active phase [4-5 cm cervical dilatation]. Emotional support was offered for the second group in the same stage of pregnancy and with the same duration. The third group received only routine care during labor. Pain severity was evaluated with visual analogue scale [0 to 10 cm]. In all groups, pregnant women were asked to evaluate the severity of pain experienced before and after intervention and also at cervical dilatations of 6-7 cm and 8-10 cm respectively. Data were collected through the numerical pain scale. Pain intensity at all the three stages of cervical dilatation was significantly lower in the reflexology group. During the 4-5 cm dilatation stage, women in the supported group reported less severe pain compared to those receiving routine care, but no significant differences at the later stages of labor. This indicates that reflexology could decrease the duration of first, second and third stages of labor. Our findings showed that reflexology can be useful to decrease the pain intensity as well as duration of labor

Effects of semelil [ANGIPARS[TM]] on diabetic peripheral neuropathy: a randomized, double-blind Placebo-controlled clinical trial

Diabetic neuropathy is the most common diabetic complication that often is accompanied by significant morbidity, mortality and economic burden. The purpose of this study was evaluation of effect of Semelil [ANGIPARS[TM]], a new herbal drug for treatment of diabetic foot ulcers or diabetic peripheral neuropathy. In this double blind clinical trial, 49 type 2 diabetes patients with different degrees of neuropathy were evaluated in two groups [ANGIPARS[TM] and placebo groups]. All patients were assessed at the start and 12 weeks after treatment, with laboratory tests, United Kingdom screening test, Michigan neuropathy screening score, Michigan diabetic neuropathy score, vibration perception thresholds, nerve conduction study, monofilament test and visual analog scale. Michigan diabetic neuropathy score was decreased notably in ANGIPARS[TM] group. In the nerve conduction study, appropriate meaningful changes were observed in the distal latency and amplitude in the motor ulnar nerve in ANGIPARS[TM] group. The results showed limited evidence of efficacy of ANGIPARS[TM] in diabetic neuropathy treatment and more studies with a larger sample size and longer duration are required

prevalence of diabetic peripheral neuropathy and related factors

Diabetic peripheral neuropathy [DPN] accounts for 80% of diabetic foot ulceration; therefore neurologic examination plays a critical role in screening at risk patients. Our objective was assessment the prevalence of DPN and related factors based on clinical findings. This cross-sectional study was conducted on 124 diabetics who were randomly recruited from Diabetes Clinic of Dr. Shariati University Hospital [Tehran/Iran] in 2004. After gathering demographic data and blood sampling for fasting blood sugar [FBS], the questionnaires United Kingdom [UK], Michigan, Diabetic Neuropathy Score [DNS], and 10-g monofilament testing were administered. Analysis tests were chi-square, pearson correlation and logistic regression. The patient's age ranged 17-75 years; with 44% male. Ninety one percent suffered from type two diabetes and the mean duration of diabetes was 10 years. The mean FBS level was 181.5 mg/dl. While the prevalence of DPN based on Michigan, DNS, and monofilament testing was about 32-28%, some 54% were diagnosed by UK test. Tingling in the lower extremity was the most frequent complaint [42%]. The strongest linear correlation was reported between Michigan and DNS [r=0.7], and then between monofilament test and DNS [r=0.6]. The age >50 years, length of diabetes > 10 years, and FBS >200 mg/dl were the main risk factors for DPN based on DNS. It seems that the combination of Michigan and monofilament test can provide an accurate screening tool for detecting DPN. In addition, tight glucose control, regular assessment of the lower extremity, and to educate diabetics is urged in elderly diabetics, longer duration of diabetes, and those with high FBS

[Efficacy of oral angipars in chronic diabetes foot ulcer: a double blind placebo controlled study]

Diabetes mellitus is the most common human metabolic disease and chronic non healing diabetic foot ulcers are a critical complication for these patients. ANGIPARS is a new herbal extract which has been introduced to accelerate healing of these ulcers. The purpose of this study was to investigate the efficacy and safety of oral ANGIPARS in patients with chronic diabetic foot ulcers and also its effect on inflammatory blood markers. In a double-blind placebo-controlled trial, 40 patients with diabetic foot ulcers of at least 4 weeks duration, were randomized to receive either oral ANGIPARS, or placebo twice a day, until the ulcer was completely healed or for a maximum of 6 weeks and followed up to 12 weeks. Standard foot ulcer care was given to all patients. The healing process was assessed with measuring ulcer surface area and time needed to achieve complete wound healing. Drug safety was assessed by monitoring adverse events, using clinical and laboratory evaluations. In both groups, wound surface area decreased significantly [p<0.0005]. Mean improvement ratio was 95.8% in the ANGIPARS group and 79.2% in the placebo group, although mean percent of wound area reduction in the former group was higher than in the placebo group at weekly assessments, this difference was not statistically significant [p=0.25] except for at the 4[th] week. [84/2% vs. 56%, p=0.013] Ultimately, complete wound healing was achieved in 90% and 70% of ANGIPARS group and placebo group, respectively, after 12 weeks. Time to achieve complete wound healing, also, was not different significantly in either groups. [6.2 vs 7.4 weeks, p=0.3] Significant reduction in ESR was sent in the ANGIPARS group. [p=0.04] There was no significant changes in laboratory parameters. Two complications most likely attributable to ANGIPARS reported were worsening of proliferative diabetic retinopathy in one patient and acute renal failure and acute hepatitis in another patient with diabetic nephropathy. Although ANGIPARS enhanced wound healing at least within weeks 2 to 4 of treatment, we did not observe a significant effect in the outcome. Therefore, standard foot ulcer care seems to be the cornerstone of diabetic foot ulcer management and ANGIPARS should probably be reserved for treatment of the non-healing or difficult-to-heal ulcers that do not respond to standard treatments. Further studies are required to assess the efficacy of this new herbal extract

Evidence-based approach to HIV/AIDS policy and research prioritization in the Islamic Republic of Iran

In formulating the second national strategic plan for prevention of HIV/AIDS in the Islamic Republic of Iran a more evidence-based approach was needed. This paper reports on a systematic review of the local evidence about the determinants of HIV/AIDS transmission in 3 categories: poor knowledge and negative attitudes about HIV transmission; injection drug use; and sexual promiscuity. Of 93 reports reviewed, 53 met the inclusion criteria. Information about the prevalence and magnitude of effect for the 3 risk determinants at the national and regional level was scarce. Heterogeneity between studies, even in the same sub-population, was significant. An improved research base and better sharing of information are needed within countries of the Eastern Mediterranean Region

[Effect of acupressure at SP6 point on labor pain intensity]

Despite conventional views that pain is unavoidable during delivery and should be suffered; today pain relief is introduced as new idea. Our aim was to evaluate acupressure effect at SP6 point on labor pain intensity and women delivery type. A single blind, clinical trial was undertaken to evaluation acupressure effect at point of SP6 on pain intensity, labor duration and women delivery type. The subjects were 131 pregnant women in their term pregnancy and labor condition that were randomly divided to experimental group of pressure on SP6 point [41 women], and control groups of SP6 touch [41women] and common care [49 women]. Data then were analysed by means of SPSS and using descriptive statistics, ANOVA and non-parametric Test. Average modified difference of labor pain intensity had statistically significant decrease within 2 minutes after intervention among the three studied groups [P<0.001] but there was no statistically significant difference in stages 30 minutes after intervention and 30 minutes after the end of intervention. There was also no difference between the three groups in delivery type. Findings show that applying pressure on SP6 is effective 2 minutes after intervention. It could be an effective supplementary method to decrease pain intensity

[ effect of acupressure at the 3[rd] point of liver channel on quality of life of female students with primary dysmenorrhea in Tehran teacher training center in 2008: a randomize clinical trial]

Dysmenorrhea affects women's quality of life; moreover it results in physical, mental, social and economical problems. The aim of this study was to evaluate the effect of acupressure at the third point of liver channel [liv3] on quality of life in female students of Tehran Teaching Training [Tarbiat Moallem] Center with primary dysmenorrhea. This single-blind randomized clinical trial was conducted on 194 female students of Nasibeh Tarbiat Moallem center in Tehran who had had inclusion criteria. In the first cycle, the severity and duration of pain and quality of life were determined. Therefore, the participants were randomly assigned to either experimental or control group. In the second, third and fourth cycles, acupressure at liv3 and placebo point during 3-7 days before menstruation for 20 minute were carried out. In the fourth cycle, participants completed SF-36 questionnaire after menstruation again. Data-gathering Instruments used in this study included wrong-Baker faces pain scale, Beck-21 questionarre, SF-36 questionnaire, clock, Acuhealth tens pro 900 set, force guage. Data were analyzed with SPSS 16 and x[2] test, Man Whitney U, independent and paired test. P values were set as 0.05 [p<0.05]. There was no significant difference in mean quality of life dimension between two groups in the first cycle [p>0.05] but there was a significant difference in mean quality of life dimension between two groups in the fourth cycle [p<0.05]. The comparison between the first and the fourth cycle in two group showed a significant difference in all dimension [p<0.05] but there was not any significant difference between two cycles in Role Emotional functioning dimension in experimental group [p>0.05]. Moreover, there was no significant difference between two cycles in Role Emotional functioning and social functioning dimensions in experimental group [p>0.05]. with regard to the results of this study, acupressure at liv3 point is suggested as useful, effective, cheap and available treatment for primary dysmenorrheal

[ effect of Nigella sativa extract on biochemical bone markers in osteopenic postmenopausal women]

The extract of the seeds of Nigella sativa [Ns] has been used therapeutically for centuries as a safe herbal medicine, and has been reported to have beneficial effects in the treatment of diabetic osteopenia and bone healing in animal models. In the present study, we examined the effect of Ns seed oil extract on biochemical bone markers in osteopenic postmenopausal women. In a placebo controlled clinical trial, 30 osteopenic postmenopausal women, aged 49-72 years, were randomized to either 3-month Ns [oil] treatment [3cc, 0.05 cc/kg/day p.o.] or placebo groups. In all subjects, calcium-D supplements [1 tab per day] were administered during the 3 month study period. At baseline and after 3 months CBC diff, liver and kidney function tests, and serum levels of calcium and phosphate and plasma levels of bone markers [including CTX, Osteocalcin and Bone-ALP] were measured. Twenty-two participants completed the 3 month study period [9 in the Ns group and 13 in the placebo group]. Women in the placebo group had relatively higher BMI in comparison with those in the Ns group. Other characteristics and bone markers levels were similar between two groups at the baseline. Plasma levels of bone markers including CTX, Osteocalcin and Bone ALP did not differ significantly between the Ns and placebo groups at the end of the 3 months neither did changes in bone markers over the course of study show statistically significant differences between the two groups. Although Ns oil was safe, no reports of adverse reactions were observed in this study, we found no beneficial effect of Ns treatment on bone turnover markers. Based on our results, we do not recommend it for the prevention or treatment of bone loss. However this needs to be further investigated in the long-term clinical trials and with larger sample sizes

effect of silybum marianum [L] Gaertn. seed extract [Silymarin] on galactose induced cataract formation in rats

Increased oxygen free radical and reduced glutathione level in the eye lens are important risk factor for cataract formation. The antioxidative property and increasing cellular and extra cellular glutathione level have been reported by several herbal medicines including silymarin. In present interventional study Silybum marianum L. seed extract [silymarin] was tested against galactose-induced cataract development in rats. Thirty male 45 days old wistar rats [150-200 g], were divided in three groups of 10 rats each. Cataract was induced in two groups of rats following feeding them with 30% galactose diet for 40 days. One group kept as control and silymarin in the dose of 200 mg/kg/d was administered orally [mixed with galactose diet] to other group for 40 days. Cataract development in the rats lens was observed daily by ophthalmoscope and naked eye during the study. The glutathione [GSH] and lipid peroxides [LPO] levels were determined after 20 days in all rats left eye lens. The results indicated that, in silymarin treated group all stage of cataract development were significantly delayed as compared to control group. In rats treated with silymarin the lens GSH level was increased significantly [P < 0.01] and LPO levels was decreased significantly as compared to control group [P < 0.05]. Administration of silymarin to galactose fed rats showed beneficial effect on prevention of cataract development as well as antioxidative defence system such as increase in lens GSH and decrease LPO levels

Comparison of knowledge, attitude and practice of urban and rural households toward iron deficiency anemia in three Provinces of Iran

Lack of nutritional knowledge is one of the most important reasons of nutritional problems and consequently improper practice, which can lead to several complications. This study has been designed in order to compare knowledge, attitude and practices of the urban and rural households regarding iron deficiency anemia [IDA] in Boushehr, Golestan and Sistan and Balouchestan provinces in 2004. The sampling method at household's level in each province was the single-stage cluster sampling with equal size clusters. The necessary data were gathered with a structured questionnaire and via the interviews between the questioners and the eligible people in each household. Comparison of frequency of variables between urban and rural areas were tested by chi square test. A total of 2306 households were selected as overall sample size. In urban areas, people recognized iron food sources better than rural areas. Knowledge level of respondents about vulnerable group for IDA and the favorite attitude of households toward IDA were better in urban areas of Sistan and Blouchestan and Golestan provinces. In Sistan and Balouchestan and Golestan, rural households who drank tea immediately before or after meal was more than urban ones. The majority of pregnant and lactating mothers [except for rural areas of Bushehr] did not take iron supplement regularly. Less than 60 percent of children used iron drop regularly. Knowledge, attitude, and practice levels of households toward IDA were not acceptable. One of the best ways of improving nutritional practice is nutritional education with focus on applying available food resources

[Comparison of Harris Benedict and Mifflin-St Jeor equations and indirect calorimetry for assessing resting energy expenditure]

An understanding of resting energy expenditure [REE] in hospitalized patients is essential for determining their daily energy needs, which can be measured or estimated by equations. Estimation is by far the more common method. This cross-sectional study investigated the degree of agreement between the resting energy expenditure as measured by indirect calorimetry and that predicted by the Harris Benedict and Mifflin-St Jeor equations. In 60 randomly selected patients, aged 18 and 83 years; REE was measured by fitmate indirect calorimetry [Cosmed Company, Rome, Italy] and compared with values predicted using Harris Benedict and Mifflin-St Jeor equations. Statistical analysis was done using the method of Bland-Altman, one-sample t-test and Pearson's correlation. There were no significant differences between mean REEs measured by indirect calorimetry [1311.66 +/- 373.98 kcal/day] and mean REE values predicted by Mifflin-St Jeor [1303.11 +/- 230.94 kcal/day] or Harris Benedict [1339.36 +/- 223.48 kcal/day] equations. However, at an individual level the limits of agreements between the measured values and those predicted by both equations were quite wide [Mifflin-St Jeor: 792.83 to 775.73 kilocalorie/day, Harris Benedict: 714.58 to 769.98 kilocalorie/day]. At a group level, Harris-Benedict and Mifflin-St Jeor equations are suitable for predicting REE of hospitalized patients. However, the results suggest that for an individual the limits of agreement are very wide in both equations and clinically important differences in REE would be obtained

Hypothyroidism following thyroid surgery

Postsurgical hypothyroidism and its incidence has not been fully investigated. In this study, the incidence of hypothyroidism and its possible risk factors at Shariati Hospital was assessed. One hundred and two patients with benign thyroid diseases, who had undergone thyroidectomy, were investigated with regards to thyroid function profile during period of one year after the operation every three months with post-operative sample as the baseline. Hypothyroidism was developed in 36 patients [35.2%] on average 5 +/- 3.2 months after surgery. Factors such as increased age, operation type, histopathologic type, underlying disease, lymphocytic infiltration and use of levothyroxine before surgery were associated with the increased incidence of hypothyroidism. It seems that use of indicators such as Graves' disease and lymphocytic infiltration in pathologic specimens should be helpful in projecting the potential occurrence of hypothyroidism in patients undergoing thyroidectomy

[Comparison of musculoskeletal complaints between helicopter and aero plane pilots]

Background: some previous surveys have indicated on high prevalence of low back pain in helicopter pilots, but there are a few studies about comparing of musculoskeletal complaints between helicopter and aero plane pilots

Materials and Methods: an interview based Nordic questionnaire was carried out in 150 aero plane pilots and 209 helicopter pilots. For this analytical study, we used x2 and fisher exact test for comparing qualitative variables, and for quantitative variables with normal distribution we used parametric tests. Odds ratio [OR] and %95 CI were used for comparing the proportion of risks estimate

Results: the means of monthly flight hours were 12.6±10 and 54.5±12 in helicopter and aero plane pilots, respectively. After flight's low back pain was prevalent among both groups %42 and %40 in helicopter and aero plane pilots, respectively. Classification of other musculoskeletal complaints ware %35 and %37 for upper back, %33 and %30 for neck, %32 and %30 for shoulder and arm, %25.4 and %32.8 for knee and leg, %25 and %23.3 for thigh and buttock and %18 and %30 for ankle and foot in helicopter and aero plane pilots, respectively. [all results were with p-value >0.005]. Odds ratios [OR] for comparing of risk estimate between helicopter and aero plane pilots were not significant after flight in any site. But, ORs for effect of musculoskeletal pain on normal daily activity during the last year were 6.2 [95%CI: 1.4-26.8] for low back pain, 8.4 [95%CI: 1.12-63.43] for upper back pain and 9.6 [95% CI: 1.2-72] for neck pain

Conclusion: this study showed that after flight's low back pain was more prevalent in nearly two groups. And normal daily activity affected by musculoskeletal complains was significantly more prevalent in helicopter pilots. But for accurate conclusion we need more data

[Evaluation of retinoblastoma expression in benign and malignant thyroid neoplasms]

Several factors are involved in the thyroid tumourigenic process. The role of Retinoblastoma [Rb] tumor suppressor gene mutation in thyroid carcinogenesis has been discussed. In this study we investigated the expression of Retinoblastoma gene in thyroid neoplasms and its association with clinical and histological findings, to evaluate its ability in distinguishing benign and malignant thyroid neoplasms and as a prognostic factor. The present cross sectional study investigated Avidin - Biotin immunohistochemistry using the Dako Rb - 1 clone in a series of 200 formalin - fixed, paraffin - embedded thyroid lesions, including 39 benign and 161 malignant neoplasms. Nuclear immunoreactivity in more than 10% of tumor cells was assessed as positive. Rb was positive in 74.2% of follicular adenoma, 87.5% of hurthle cell adenoma, 46.2% of papillary carcinoma, 66.7% of follicular carcinoma, 29.4% of medullary carcinoma and 50% of anaplastic carcinoma. Overall Rb nuclear immunoreactivity was observed in 76.9% of benign tumors and 45.9% of malignant lesions. No significant difference in Rb expression between follicular adenoma and follicular carcinoma was seen; also no association was found between Rb expression and invasiveness in malignant tumors. The results of this study indicate that Rb gene expression in benign thyroid tumors is significantly higher than in malignant ones [P=0.001], an association observed particularly in women. Rb gene inactivation is likely to play a role in malignant evolution of thyroid neoplasms and considering female predominance in thyroid tumors, Rb immunohistochemistry can potentially aid in the distinction between benign and malignant thyroid tumors in conjunction with morphology, but it is not helpful in differentiation between follicular adenoma and follicular carcinoma

[Expression of Nm23 marker in benign and malignant thyroid neoplasms immunohistochemical]

Several prognostic factors affect the outcome of thyroid carcinomas including tumor stage and distant metastases. Nm23 is a metastasis suppressor gene and has a crucial role in the control of metastatic potential of several carcinomas. The aim of our study is to evaluate expression of nm23 marker in benign and malignant thyroid neoplasms using the immunohistochemistry method and to elucidate its relationship with tumor size, vascular or capsular invasion and lymph node involvement. In a descriptive study, 200 paraffin blocks comprising of 38 benign and 162 malignant thyroid neoplasms stained with nm23 marker were studied. Cytoplasmic staining in more than 10% of cells was considered as positive. The relationship between nm23 and tumor size, vascular or capsular invasion, lymph node involvement was analysed using SPSS 11.5 software [p=0.05]. There was 40% positive incidence of nm23 in follicular adenoma, 87.5% in hurthle cell adenoma, 67.2% in papillary carcinoma, 66.7% in follicular carcinoma, and 64.7% in medullary carcinoma. In follicular adenoma, frequency of nm23 positive tumors was directly correlated to tumor size [p=0.04]. There are no statistically significant correlation between nm23 and tumor size, vascular or capsular invasion or lymph node involvement in malignant thyroid neoplasms. In papillary and medullary carcinoma, negative predictive value of nm23 for lymphnode involvement was over 80%. Also in follicular carcinoma, sensitivity and negative predictive value of nm23 for vascular invasion were approximately 90%. Lack of significant correlation between nm23 and tumor invasiveness [and probably metastasis] factors, demonstrate that although nm23 is a potentially metastasis suppressor gene, whereas in many other tumors it may play a different role in thyroid neoplasms, a role which necessitates further studies to be conducted