[Correlation between staging of hepatic fibrosis and biochemical markers in patient with liver fibrosis]

Liver fibrosis is an inevitable result of chronic liver diseases which may ultimately lead into liver cirrhosis. Diagnosis and grading of liver fibrosis is of considerable importance in both treatment strategy, treatment response, prognosis and potential risk factors for the disease complications. Although liver biopsy is the best known technique for evaluation of liver fibrosis, researchers have been searching for a more appropriate alternative to be used instead due to its harsh nature along with several side effects. One of the suggested ones is the use of biochemical markers. Our aim in this study, therefore, was the assessment of some of these biochemical markers. In a retrospective trial, 130 patients [94 men [72.3%] and 36 women [27.7%]] of whom had undergone liver biopsy, were studied. Former biopsy samples were reviewed. Gathered data from their medical file and pathology reports were analyzed by SPSS 11.5. It was revealed that there was a positive correlation between age and severity fibrosis. There was no significant relationship between liver fibrosis and gender. Comparing the patients with liver fibrosis and non-fibrotic ones, we found that the AST/platelet index is an appropriate marker for distinction of these patients. To distinguish the patients without liver fibrosis from ones with moderate liver fibrosis, a cut off point=0.39, PPV=0.7 and NPV=0.54 was obtained, whereas for differentiating them from sever liver fibrosis patients, the cut off point of 0.25, PPV=0.76 and NPV=0.7 was achieved. Distincting the mild and moderate fibrosis, platelet was found to be an appropriate variable, having a cut off point of 158500. Moreover, to set mild and sever fibrosis apart, platelet and albumin were more valuable. In this study cut off point of 151000 for platelet and 3.6 for albumin was obtained, respectively. Similar to other relevant studies we also could not find any appropriate marker for making the distinction between moderate and severe fibrosis. Our study outlines that AST/platelet index has an appropriate cut off point for distinction between non-fibrotic and moderate and sever liver fibrosis. Distinguishing the mild cases from both moderate and sever fibrosis, platelet is a good marker. Furthermore, albumin is another marker for distinction between mild and sever fibrosis. The studied markers are not able to distinct all stages of fibrosis. Due to their limitations, they can not be applied in various clinical situations. In this regard, no definite substitute for liver biopsy has been found yet. Acquiring a test or technique that contains all necessary standards for evaluation of liver fibrosis requires further studies and researches

[Detection of human papilloma virus among women with cervical cancer using PCR method]

Cervical cancer is the second leading cancer among women, worldwide. It is also the second malignant cause of death, particularly in women aged 25-65. In order to progress a cancer from dysplasia to invasive carcinoma, a cascade of cellular changes should occur. Since genital HPV carries oncogenes responsible for these essential changes, today HPV is considered as the major risk factor of cervical cancer. It is believed that HPV can increase the rate of cancer progression when associating with other risk factors such as smoking, taking contraceptive drugs, immunosuppression, etc. Paraffin-embedded cervical tissues of 70 patients with cervical cancer were analyzed by PCR method for presence of HPV. In addition, high risk typing of HPV positive samples was performed using HPV high risk typing PCR kit. Among all patients 49% were positive for HPV. HPV16 was the most common type detected in HPV-positive cases. Investigation of age classification showed that a majority of HPV positive cases aged between 35 and 44 years. Considering the prevalence of HPV among young women with cervical cancer and its long premalignant period, we suggest to examine all the women above 20 years of age and also check the suspected cases for HPV

Value of urease test in the detection of helicobacter pylori infections

H.pylori is a microaerophilic, garm-negative, spiral organism with 4-6 flagella. The bacterium is an etiologic agent for chronic gastritis and plays a major role in effecting peptic ulcer, gastric cancer, lymphoma, H. pylori infection has a high seroprevalence in iran [> 90%], thus, diagnosis and treatment of H. pylori infection is very important. The presence of H. pylori infection was determined in 100 patients undergoing upper gastrointestinal endoscopy over 9 month period. The presence of H. pylori was detected in gastric mucosal biopsy specimens through Biopsy Urease Test, PCR and histopathology. A medium was used for urease test, Normal Broth Urea. The biopsy is placed in a both containing urea and a PH indicator. The gold standard is histopathology examination. We designed a PCR for amplifying the H. pylori gene encoding ure C [294bp]. The results of urease test were 66.6% sensitivity and 69.7% specefity. The results of PCR assay were 98.6% sensitivity and 93% specifity. There was a significant difference between the specifity and sensitivity of urease test and PCR. The result of this study showed that urease test was not a sensitive and specific method for accurate detection of the infection, level of the sensitivity is too low to be used as the sole method of detection in ordinary practices. In this situation, other tests should be used

evaluation of cytomegalovirus in infants following exchange transfusion in Children Medical Hospital

During the infancy period, exchange transfusion is the main and effective method of cure for hyperbilirubineamia in hemolytic neonates. One of the risks involved in these patients is CMV infection. Since CMV can inflict and kill children with immunodeficiency, we decided to evaluate blood transmitted CMV infection in infants for the first time in Iran. In this prospective study, the levels of IgG and IgM antibody against CMV in infants blood sera before and after exchange transfusion, sera of their mothers, and the plasma of donors were evaluated by ELISA method and conventional kits. The data were then analyzed by nonparameteric and mac nemar test. The level of specific IgM antibody of CMV was 14% in the serum of infants before exchange transfusion and 48% two months after exchange which came out to be significant [p<0.0001]. This indicates transmittability of CMV infection through blood transfusion since the amount of primary infection of CMV in mothers [IgM] was only 1%. According to the high level of CMV infection in infants [14%] compared to mothers [1%], it can be concluded that some mothers have latent CMV infection. On the other hand, the high level of CMV infection in infants [48%] 2 months after transfusion is caused by post-transfusion CMV infection. Analysis of the data obtained from dependent varibles such as volume of transfused blood, number of exchange transfusion attempts, weight, age, sex and blood group analyzed by the nonpara-meteric method indicated that the volume of transfused blood to infants has a direct correlation with the rate of transmission of infection to them but other variables do not have any correlation