rare presentation of primary heptic lymphoma: a case report

Primary hepatic lymphoma [PHL] was a rare malignancy usually presenting with abdominal pain, malaise, Hepatomegaly, B-symptoms, fatigue, nausea, vomiting and jaundice. It mostly involves liver without any palpable lymphadenopathy and leukemia in peripheral blood smear. On July 22, 2014, a 64 year old man presented with abdominal pain localizing in Right upper quadrant and fullness from 2 years ago without any weight loss or constitutional symptoms. His physical examination revealed no mass or lymphadenopathy and lab data showed rise in Alkaline phosphatase [ALP] and Gamma-glutamyl transferase [gamma-GT]. Abdominal computed tomography [CT] scan with contrast showed a calcified lesion in the left lobe of liver and ill-defined hypodense area in medial segment of the left lobe of liver adjacent to gallbladder associated with mild central intra hepatic bile ducts dilation showing more enhancement in delay phase suggested peripheral cholangiocarcinoma. Finally surgical core needle biopsy of the liver confirmed malignant lymphoma of B cell type and patient was referred to oncologist for chemotherapy. His chemotherapy regimen consisted of rituximab 600 milligram [mg], endoxan 1250 mg, adriamycin 80 mg, vincristine 2 mg, prednisolone 100 mg [durgin five days] for 6 courses. After 5 months chemotherapy, on December 22, 2014 a follow up CT scan with IV and oral contrast was done. There was no evidence of previous mass lesion in the liver. In the follow up on May 9, 2015, he had no specific symptoms and all of his lab data were in normal range

Effect of Roux-en-Y gastric bypass surgery on ventricular function and cardiac risk factors in obese patients: a systematic review

Introduction: Weight gain and obesity are two important public health problems, which are associated with many diseases such as cardiovascular disorders. Various policies such as bariatric surgery have been proposed for the treatment of morbid obesity

Methods: PubMed and Scopus were searched thoroughly with the following search terms [roux-en-y gastric bypass surgery] AND [ventricular function, OR cardiac risk factors OR heart]] AND [BMI OR body mass index] to find the articles in which the effect of roux-en-Y gastric bypass [RYGB] surgery had been evaluated in severely obese patients

Result: Out of 120 articles which were found in PubMed, and 28 records which were found in Scopus, only 18 articles fully met the inclusion criteria. Out of 2740 participants in the included studied, 1706 were patients with body mass index [BMI] over 40 kg/m2 who had undergone RYGB surgery, and 1034 were control participants. Results of the studies showed that RYGB surgery could reduce BMI, and cardiac risk factors, and improve diastolic function, systolic and diastolic blood pressures, and aortic function, postoperatively

Discussion: Obesity is associated with increased risk of cardiovascular diseases, impaired cardiac function, and hypertension. It is shown that RYGB surgery reduces the serum level of biochemical markers of cardiac diseases. Cardiac structure, parasympathetic indices of autonomic function, coronary circulatory function, hypertension, epicardial fat thickness, and ventricular performance improve after bariatric surgery

Conclusions: It is concluded that RYGB surgery is an effective strategy to improve ventricular function and cardiac risk factors in morbid obese patients

Asymptomatic isolated retroperitoneal castleman's disease: a case report

Castleman's disease, giant lymph node hyperplasia, is a kind of benign lymphoproliferative disease with gentle behavior. Its etiology and prevalence are unclear. This rare disease is usually found in mediastinal area asymptomatically and incidentally. It is also rare to see this tumor in the retroperitoneum. In this study, we have introduced a 34-year-old woman who referred just with occasional abdominal pain caused by compressive symptoms. Laboratory findings only reported microcytic anemia [MCH: 18.5, MCV: 63, Hemoglobin 10.2 g/dl]. Chest and abdominal X-ray imaging showed no remarkable point. In abdominal ultrasonography, a solid and firm tumor with 12.2x5.3x6.6 cm was reported in patient's retroperitoneum. Patient's surgery was done and the tumor [covered by a fibrous thick capsule, with no bizarre appearance and bleeding] was completely removed. Pathologic examination indicated a Castleman's tumor, type of unicentric and hyaline-vascular. This item had been one of the rare reported items of Castleman's disease in the retroperitoneal space

Evaluation of antimicrobial resistance pattern of nosocomial and community bacterial pathogens at a teaching hospital in Tehran, Iran

Antimicrobial resistance in pathogens not only in hospitals but also in the community has become an important public health problem. The aim of this study was to determine the antimicrobial resistance patterns of predominant pathogens from hospitalized and outpatients in a university hospital in Tehran, Iran. A total of 820 samples of common Gram-negative and Gram-positive bacteria were collected from a major referral and teaching hospital affiliated to Tehran University of Medical Sciences in Iran during April 2010 to February 2011. The pattern of antibiotic resistance was determined by disk diffusion test as recommended by the Clinical Laboratory and Standards Institute [CLSI]. Gram-negative bacilli were the most isolated pathogens. Acinetobacter spp. and Pseudomonas aeruginosa [P. aeruginosa] was the most antibiotic-resistant pathogens. Imipenem and piperacillin/tazobactam were the most active antimicrobials against gram-negative bacilli whereas vancomycin was the antimicrobial agent most consistently active against the Gram-positive cocci. Community-acquired organisms were more susceptible to antimicrobial drugs tested than nosocomial isolates. The rates of antibiotic resistance among isolated pathogens in this study were approximately similar to other studies. However, high rates of antibiotic resistance amongAcinetobacter spp and P. aeruginosa, the most isolated pathogens, indicating that antibiotic policy is urgently needed to prevent the resistance development ago

Inter-observer reproducibility before and after web-based education in the gleason grading of the prostate adenocarcinoma among the Iranian pathologists

This study was aimed at determining intra and inter-observer concordance rates in the Gleason scoring of prostatic adenocarcinoma, before and after a web-based educational course. In this self-controlled study, 150 tissue samples of prostatic adenocarcinoma are re-examined to be scored according to the Gleason scoring system. Then all pathologists attend a free web-based course. Afterwards, the same 150 samples [with different codes compared to the previous ones] are distributed differently among the pathologists to be assigned Gleason scores. After gathering the data, the concordance rate in the first and second reports of pathologists is determined. In the pre web-education, the mean kappa value of Inter observer agreement was 0.25 [fair agreement]. Post web-education significantly improved with the mean kappa value of 0.52 [moderate agreement]. Using weighted kappa values, significant improvement was observed in inter-observer agreement in higher scores of Gleason grade; Score 10 was achieved for the mean kappa value in post web-education was 0.68 [substantial agreement] compared to 0.25 [fair agreement] in pre web-education. Web-based training courses are attractive to pathologists as they do not need to spend much time and money. Therefore, such training courses are strongly recommended for significant pathological issues including the grading of the prostate adenocarcinoma. Through web-based education, pathologists can exchange views and contribute to the rise in the level of reproducibility. Such programs need to be included in post-graduation programs

Elevated vancomycin trough concentration: increased efficacy and/or toxicity?

Vancomycin susceptibility of methicillin-resistant Staphylococcus aureus has been changed over time and its average minimum inhibitory concentration increased from 1.5 to 1.75 mg/L.A recently published guideline by the American Society of Health Pharmacist recommended a daily dose of 15-20 mg/Kg every 8 to 12 hours of vancomycin to achieve a trough concentration between 15-20 mg/L for treatment of severe infections. Medical records of 69 patients from infectious ward of Imam Khomeini hospital, with suspected or confirmed gram-positive infection who had at least one trough level of vancomycin, were evaluated regarding vancomycin therapeutic goal; efficacy and renal safety. Most of patients [60.6%] with severe infections did not achieve the recommended vancomycin trough level during treatment course. Time to normalization of the signs and symptoms of infection did not correlate with the patients' serum vancomycin trough levels. At the end of treatment course, there was no significant correlation between patients' creatinine clearance and vancomycin trough levels [P=0.32]. However, patients'cratinine clearance showed a negatively significant correlation with trough level of vancomycin [P=0.01]. Vancomycin induced nephrotoxicity was detected in 4.3% of the patients. These data showed that vancomycin trough level may not necessarily assure treatment success, and also it would not essentially predict the risk of vancomycin induced nephrotoxicity. However, more well designed studies with larger sample size needed for better clinical and practical judgment

relationship between renal artery stenosis and ischemic nephropathy

Ischemic nephropathy is defined as a clinically significant progressive reduction in glomerular filtration rate that is usually associated with significant renal artery stenosis [unilateral or bilateral involvement]. Atherosclerotic renal artery disease is known as the most common cause of the ischemic nephropathy. These patients may develop secondary hypertension. In addition, epidemiologic data has showed a clear association between atherosclerotic renal artery stenosis and coronary artery disease and other cardiovascular disease. Despite the preserving function of kidney on various autoregulation processes, unusual microvascular function will be resulted due to sustained decline in renal perfusion. The ischemic nephropathy of asymptomatic cases may result in renovascular hypertension and renal failure. The reduction of renal function in these patients might be decreased or stopped by early appropriate diagnosis and also might be treated with renal artery angioplasty or surgery, after medical management. There is a debate about the occurrence of ischemic nephropathy as a result of atherosclerotic renal artery stenosis. In this study we aimed to review the prevalence of ischemic nephropathy due to atherosclerotic renal artery stenosis

Does serum N-terminal pro-brain natriuretic peptide level predict the severity of angiographic lesions in patients with acute coronary syndrome?

Serum N-terminal pro-brain natriuretic peptide [NT-proBNP], a polypeptide secreted by ventricular myocytes in response to stretch, was suggested as a predictor of adverse prognosis of the acute coronary syndrome [ACS]. We examined the association between NT-proBNP level and angiographic findings in ACS patients to determine whether it could be used as a predictor of the severity of angiographic lesions. This cross-sectional study was performed on 126 patients with chest pain or other ischemic heart symptoms suggestive of ACS. Venous blood samples were drawn to measure serum levels of NT-proBNP. Afterward, coronary angiography was performed and the patients were categorized into four groups according to the number of coronary vessels with significant stenosis. The severity of angiographic lesions was assessed with the Gensini scoring system. According to angiographic diagnosis, 11 [8.7%] patients had normal coronary arteries [no coronary artery disease [CAD]] and 115 [91.3%] had CAD, of whom 108 [85.7%] had obstructive CAD and 7 [5.6%] had minimal CAD. The serum NT-proBNP concentration was higher in the CAD group than in the non-CAD group [p value <0.01]. A progressive significant increase in the NT-proBNP concentration according to the Gensini score and the number of involved vessels was reported after adjustment for sex and age. Furthermore, the Receiver Operating Characteristic Curve [ROC] analysis indicated that an NT-proBNP cut-point of 400 pg/ml could predict obstructive CAD with a sensitivity of 65% and a specificity of 78%. Higher levels of NT-proBNP among our ACS patients were associated with the severity of angiographic lesions in terms of both the Gensini score and the number of involved vessels. This finding underscores the potential role of NT-proBNP in predicting the severity of CAD before performing angiography

[Evaluation of high dose atorvastatin therapy 24 hours before elective percutaneous coronary intervention on peri-PCI myocardial infarction]

Background: Percutaneous coronary intervention [PCI] may been associated with high-er risk of cardiac events during this procedure. The goal of this study was to compare high dose atorvastatin therapy with low dose atorvastatin therapy 24 hours before PCI to a reduction in Peri- percutaneous coronary intervention myocardial infarction

Methods: One hundred ninety patients with stable angina were enrolled in a randomiz-ed controlled clinical trial study. All patients received low dose atorvastatin. The patients scheduled for elective PCI were randomized to atorvastatin [80 mg/d, n=95] or placebo [n=95] within 24 hours before the procedure. Creatine kinase-MB, troponin I, and high sensitive C- reactive protein levels were measured at baseline and at 6 and 12 hours after the procedure. PCI related myocardial infarction was defined as increasing of Creatine kinase-MB or troponin I three times compared with values before procedure

Results: Myocardial infarction was detected after coronary intervention in 4.2% of patients in the atorvastatin group and in 13.7% of those in the placebo group [P=0.022]. Mean of changed levels of Creatine kinase-MB [0.7+/-0.5 versus 3.3+/-1.9 ng/mL, P<0.001], troponin I [0.1+/-0.2 versus 0.4+/-0.7 ng/mL, P=0.052] and hs-CRP [0.1+/-0.5 versus 1+/-0.9 ng/mL, P<0.001] were significantly lower in the statin than in the placebo group

Conclusion: Pretreatment with high dose atorvastatin within 24 hours before elective percutaneous coronary intervention significantly reduces procedural myocardial infarct-tion in elective coronary intervention

Applying maternal serum and amniotic fluid CRP concentrations, and cervical length to predict preterm delivery

To investigate the clinical advantage of several prognostic factors for predicting preterm delivery. Eighty and six patients with a singleton pregnancy admitted to Vali-Asr hospital underwent genetic amniocentesis between the 15[th] and 23[th] weeks were included in this study. Maternal serum C-reactive protein [CRP], transvaginal sonographic measurement of cervical length [CL], were examined on genetic amniocentesis time. Receiver-operating characteristic [ROC] analysis was performed to determine the efficacy of maternal serum and amniotic fluid CRP levels in predicting women with preterm delivery. Correlation between each factor and the duration of pregnancy was investigated. The prevalence of spontaneous preterm delivery before 37 weeks of gestation was 11%. ROC analysis revealed that maternal serum CRP level was the parameter, which had a significant power in the prediction of preterm delivery. The optimum cut-off level was 1.2 mg/L. The sensitivity and specificity were 95.1% and 91.8%, respectively. The positive predictive value for CL length with the cut off value of 25 mm was 72.1%. No statistically significant difference correlation observed between CL and the duration of pregnancy or amniotic fluid and maternal serum CRP levels. The maternal serum CRP level has a good sensitivity and specificity in the prediction of preterm delivery and this may be helpful in predicting preterm delivery during genetic amniocentesis. Maternal serum CRP measurement is a safe, simple clinically useful, cost effective, non invasive method, that may assist clinicians in evaluation for high-risk patients and determine strategies for the prevention of preterm delivery

Acute and long term outcomes of coronary intervention in unprotected left main lesions

Significant left main coronary artery stenosis jeopardizes the entire myocardium of the left ventricle and has the worst prognosis of any form of coronary artery disease. Coronary-artery bypass grafting [CABG] has been considered as the standard therapeutic approach for such patients. There are limited data on the safety and effectiveness of percutaneous coronary intervention [PCI] in patients with unprotected left main coronary artery disease. In this study we have reported our experience on early, intermediate and long term results of LMC intervention. From Dec. 2007 to Mar. 2012, PCI with drug eluted stent [DES] or in some cases by a bare stent was performed on denovo lesions of unprotected left main coronary artery in 50 patients. The inclusion criteria were: patients having refused CABG but with favorable anatomy for stenting; patients with poor general condition or comorbidity whom were refused by the cardiac surgeon and emergent patients for whom CABG was not accessible. The angiographic and procedural success rate was 100%. Four patients died, two because of severe heart failure, the third due to noncardiac etiology, and the fourth due to probable stent thrombosis. We have one target lesion revascularization [TLR=2%] and no reinfarction was occurred. Routine DES implantation in unprotected left main disease seems a feasible and safe method with favorable outcomes

Extrinsic and intrinsic coagulation pathway, fibrinogen serum level and platelet count in HIV positive patients

Infection with human immunodeficiency virus [HIV] is a progressive condition which may cause endothelial dysfunction and liver damage leading to coagulopathy. With adventure of highly active antiretroviral therapy [HAART], life expectancy has prolonged in HIV positive patients but several acquired immunodeficiency syndrome [AIDS]-related conditions such as coagulopathies are responsible for associated morbidity and mortality. This study aimed to evaluate the extrinsic and intrinsic pathways of coagulation, serum level of fibrinogen and platelet count in HIV positive patients and compare it with negative healthy individuals. Through a case-control study, 114 HIV seropositive patients were compared with 114 seronegative samples in terms of hematological and other coagulation parameters. Mean age of study patients was 37.48 years. Intra venous drug abuse was the most common route of infection transmission with a prevalence of more than 50%. HIV route of transmission had a direct relationship with PTT abnormal levels [P<0.0001]. However, this relationship was not significant for PT values. Stages of HIV disease and administration of HAART did not reveal any significant relationship with PT and PTT. There was also a statistically significant correlation between CD4[+]< 200 and PT in case group [P=0.008]. On the other hands, in control group, CD4[+] had a weak relationship with PTT [P=0.02] and an inverse correlation with serum fibrinogen [P=0.013]. Hematological parameters and serum fibrinogen are decreased in HIV positive patients especially in direct relation with CD4[+] cell count<200 cell/ micro l. PT and PTT abnormal values are also more prevalent in this population

Locus coeruleus lesions and PCOS: role of the central and peripheral sympathetic nervous system in the ovarian function of rat

"Polycystic ovary syndrome [PCOS] is a complex endocrine and metabolic disorder associated with ovulatory dysfunction". "Autonomic and central nervous systems play important roles in the regulation of ovarian physiology". The noradrenergic nucleus locus coeruleus [LC] plays a central role in the regulation of the sympathetic nervous system and synaptically connected to the preganglionic cell bodies of the ovarian sympathetic pathway and its activation is essential to trigger spontaneous or induced LH surges. This study evaluates sympathetic outflow in central and peripheral pathways in PCO rats. Our objectives in this study were [1] to estimate LC activity in rats with estradiol valerate [EV]-induced PCO; [2] to antagonized alpha2a adrenoceptor in systemic conditions with yohimbine. Forty two rats were divided into two groups: 1] LC and yohimbine and 2] control. Every group subdivided in two groups: eighteen rats were treated with estradiol valerate for induction of follicular cysts and the remainders were sesame oil groups. Estradiol concentration was significantly augmented by the LC lesion in PCO rats [p<0.001], while LC lesion could not alter serum concentrations of LH and FSH, like yohimbine. The morphological observations of ovaries of LC lesion rats showed follicles with hyperthecosis, but yohimbine reduced the number of cysts, increased corpus lutea and developed follicles. Rats with EV-induced PCO increased sympathetic activity. LC lesion and yohimbine decreased the number of cysts and yohimbine increased corpus lutea and developed follicles in PCO rats

Reliability of disk diffusion test results for the antimicrobial susceptibility testing of nosocomial gram-positive microorganisms: is e-test method better?

Disk diffusion test is the usual applicable method for assessing the antimicrobial susceptibility pattern in most institutions and hospitals. The aim of this study was to determine the reliability of resistant-reported results of disk diffusion test for 6 routinely used antibiotics against Gram-positive microorganisms of nosocomial origin, using E-test method. Over a 1-year period, clinical specimens [e.g. blood, tracheal secretions, wound secretions, urine, etc.] were obtained from hospitalized patients with defined nosocomial infection and were cultured. Isolated Gram-positive bacteria underwent disk diffusion test for cephalothin, oxacillin, clindamycin, ciprofloxacin, vancomycin, teicoplanin [only for Enterococci], and meropenem antibiotics. E-test method was performed for all isolates resistant or intermediately sensitive to the disks of any mentioned antibiotics. Data showed compatible results of disk diffusion test with the results of E-test method for cephalothin, oxacillin, ciprofloxacin, vancomycin, and teicoplanin. None of ciprofloxacin- and vancomycin-resistant isolates in disk diffusion test showed sensitivity in E-test method. Significant differences between the results of disk diffusion and E-test methods were observed for clindamycin and meropenem against S.aureus [p = 0.01 and 0.04, respectively] and Enterococcus spp [p = 0.03 and 0.02, respectively]. In order to increase the reliability of antimicrobial susceptibility results, it is recommended to perform E-test for nosocomial Gram-positive microorganisms that show antibiotic resistance by disk diffusion test and it is more important for clindamycin and meropenem

Hyperhomocysteinemia in HIV-infected individuals: correlation of a frequent prothrombotic factor with CD4+ Cell count

This study was aimed at providing an analysis of the correlation between CD4/CD8 counts and some coagulation factors in HIV-Positive Iranian patients. A case-control study on 58 HIV-infected patients and control group [58 healthy individuals]. Patients and controls were matched for sex and age. In this study, several blood parameters were measured in 58 HIV-infected patients and the controls. Laboratory data were then measured including hemoglobin, platelets, homocysteine, serum levels of IgM and IgG antiphospholipid antibodies [aPL], IgM and IgG anticardiolipin antibotdies [aCL], and CD4[+] and CD8[+] cell count. The HIV-infected patients, compared to healthy controls, showed a significant decline in platelets, CD4 count and CD8 count [p<0.0001], and an increase of homocysteine [p<0.0001] and IgG aPL levels [p<0.0001]. No statistical difference was found between patients with CD4 count 200 in the evaluated variables. The results showed that thrombophilic abnormality in the form of hyperhomocysteinemia is more frequent in HIV-infected patients and should be considered by clinicians in view of an early diagnosis of the hypercoagulability state to prevent thrombotic complications

Changes in 4-year antimicrobial resistance pattern of gram-positive bacteria at the main referral teaching hospital, Tehran, Iran

Infectious diseases are one of the most common causes of morbidity and mortality and the spread of resistant microorganisms is playing a significant role in this regard. The purpose of this study was to assess the trend in antimicrobial resistance of gram-positive bacteria at the main referral teaching hospital in Tehran during a 4-year period. All patients' biological isolates such as blood, urine, wound drainage, synovial fluid, sputum, and cerebrospinal fluid sent to the central laboratory of the hospital from 2007 to 2010 for identification and subsequently, antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method were considered. All isolates [100%] of S. aureus were sensitive to vancomycin and linezolid and resistant to amoxicillin. The rate of S. aureus resistance to oxacillin increased from 60.78% in 2007 to 72% in 2010. All isolates of Streptococci in 2007 and 2008 were sensitive to vancomycin; while, 3.33% and 4.76% of Streptococci isolates were reported to be vancomycin-resistant in 2009 and 2010, respectively. Enterococci isolated from the entire specimens were identified to be sensitive to teicoplanin and linezolid and resistant to cloxacillin and oxacillin. The rates of Enterococci sensitivity to vancomycin were 90.91%, 81.25%, 86.67%, and 93.3% in 2007, 2008, 2009, and 2010, respectively. Changes of antibiotics sensitivity against g positive pathogens were significant during four years in this study. To minimize the spread of resistant gram positive pathogens, periodic and regular surveillance of antimicrobial resistance pattern is highly recommended.

Brucella infection in HIV infected patients

The purpose of this study was to assess the possible correlation between Brucella and HIV infections. Iran is a country where HIV infection is expanding and Brucellosis is prevalent. In the present study. 184 HIV infected patients were assigned and for all of them HIV infection was confirmed by western blot test. In order to identify the prevalence rate of Brucella infection and systemic brucellosis in these subjects, sera samples were obtained and Brucella specific serological tests were performed to reveal antibody titers. Detailed history was taken and physical examination was carried out for all of patients. 11 [6%] subjects had high titers but only 3 of them were symptomatic. Most of these subjects were injection drug user [IDU] men and one was a rural woman. Considering both prevalence rates of Brucella infection [3%] and symptomatic brucellosis [0.1%] in Iran, our HIV positive patients show higher rates of Brucella infection and systemic brucellosis. Preserved cellular immunity of participants and retention of granulocytes activity may explain this poor association; whereas other explanations such as immunological state difference and non-overlapping geographical distribution of the 2 pathogens have been mentioned by various authors

Simultaneous Measurement of two Serum Markers [CA-125 and HE-4] while diagnosing malignant ovarian epithelial tumors

To evaluate the benefits of simultaneous measurement of CA-125 and HE-4 markers while diagnosing malignant epithelial tumors in the ovary. By this, the combined measurement of serum markers will possibly add to the accuracy of diagnosing such ovarian tumor. Performing a cross- sectional study on 87 women with ovarian mass, serum levels of CA125 and HE4 markers were measured before surgery or biopsy. In the wake of the surgery or biopsy, the results obtained from these tests were compared and analyzed with pathological report. The average serum level of CA-125 and HE-4 serum was notably higher in women with ovarian malignancy than in those with benignancy [CA-125: 502 vs. 19.3 v/ml, P < 0.001- HE4: 195 vs. 15.8 P mol/L, P < 0.001]. As the disease stage rises, the level of these markers increases significantly. The two markers were also directly proportionate. [r = 0.85 and P < 0.001]. There is also a meaningful difference between the levels of markers, specifically HE-4, in epithelial and non-epithelial tumors of ovary [HE-4: 195 vs. 93 P mol/L P < 0.001]. The simultaneous measurement of CA-125 and HE-4 increases the sensitivity and specificity of diagnosing malignant epithelial tumors in ovary, compared with one- by- one measurement guideline. The sensitivity and specificity of simultaneous measurement of CA125 and HE4 for diagnosing epithelial ovarian cancer were calculated to be 99.5% and 100%, respectively. Simultaneous measurement of CA-125 and HE-4 increases the sensitivity and keep the specificity still high in diagnosing malignant epithelial tumors in ovary, compared with one-by-one measurement system

Bacterial contamination of hospital telephones

To assess the contamination of phones in different wards of one academic hospital in order to find out the association and pattern of the contamination with seasons, wards, and cleaning methods used. Samples were collected in a six months period. The samples were collected on a specified day on each month and at two different times of day. Samples were taken from mouthpiece and earpiece of the phones and were used for culture. S. epidermidis was the most common bacterium cultured in each month and in each ward. Contamination of mouthpiece was more common than earpiece. Considering the possibility of transmission of the contamination via phones by people who use them and in order to reduce the burden of nosocomial infections, special attention should be directed toward disinfection of the phones as well as other hospital devices