Brief historical perspectives of malaria in Iran

The history of malaria as a serious human disease dates back to ancient times. For centuries, malaria has been a deadly disease with high morbidity and mortality that profoundly impacted the socioeconomic status of endemic countries. However, its causative agent remained unidentified until the last decades of the nineteenth century. There were no effective synthetic anti-malarial agents until the mid-twentieth century. Currently malaria has been eliminated or pre-eliminated in numerous countries; however, this preventable and curable disease remains a significant global health problem. A major concern is drug resistance. Presented here, is a brief look at the history of malaria in Iran and the rest of the world, particularly during the nineteenth and twentieth centuries

historical profile of diphtheria in Iran during the 19th and 20th centuries

Diphtheria is a contagious and life-threatening disease historically regarded as a major cause of mortality, particularly in children. Over the past centuries, frequent diphtheria outbreaks have occurred. Herein, after a quick look at the history of diphtheria throughout the world, a historical account of this lethal disease in Iran during the 19th and 20th centuries is presented

Cerebral tuberculoma in pregnancy: overview of the literature and report of a case

Tubercle bacilli infect about one third of the world's population and over the past decade resurgence of tuberculosis has been a major health threat mainly due to increasing frequencies of immunosuppressive states and drug-resistant organisms. Although tuberculosis is essentially a lung disease, intracranial elements become involved in 5-10% of cases either as meningitis or tumour-like masses [tuberculoma]. Tuberculoma is common in endemic areas but its occurrence during pregnancy is occasional and of particular interest is its intriguing clinical picture mimicking toxemia of pregnancy and brain tumor. In addition, the effects of pregnancy on tuberculosis or vice versa have been controversial. We present here a review of the recent literature and discuss a case coming to medical attention with manifestations of intracranial hypertension during 2 consecutive pregnancies; 4 years apart. On operation a dura-attached mass was detected that proved to be a tuberculoma. After 18 months of close observation and under drug therapy she obviously improved with no ensuing complication. Immunodeficiency state associated with pregnancy is likely to play a role in activation of infection. Tuberculoma should be considered in differential diagnosis of eclampsia and brain mass particularly in women coming from endemic areas for this infection even in the absence of pulmonary involvement

brief history of tuberculosis in Iran during the 19[th] and 20[th] century

The history of tuberculosis as a worldwide fatal illness traces back to antiquity, a well-known disease in ancient civilizations. However, its causative agent remained unidentified until the last decades of the 19[th] century, when discovered by Robert Koch. In due course, preparation of the BCG vaccine, application of the Mantoux intradermal diagnostic tuberculosis test and administration of proper antituberculosis medications eventually controlled tuberculosis. However, despite these significant advancements tuberculosis remained uneradicated, particularly in developing countries after the emergence of both multidrug-resistant tuberculosis and HIV co-infection. Presented here, is a brief review of the history of tuberculosis in the world as well as its historical background in Iran, mainly during the 19[th] and 20[th] centuries

history of leprosy in Iran during the 19[th] and 20[th] centuries

From ancient time leprosy has been regarded as a terrifying, stigmatized disease; nevertheless, its cause remained unidentified up to the late 19[th] century. For centuries numerous leprosy victims worldwide suffered from its morbidity and were socially isolated. The afflicted individuals were segregated because they were considered [unclean] and had to live in leper colonies, generally under very poor conditions. Physicians believed that leprosy was an incurable, highly contagious, and hereditary disease. In 1873, the Norwegian physician, Gerhard Armauer Hansen [1841 - 1912], ended the myth of leprosy and discovered its causative agent, known as Mycobacterium leprae. Hansen's discovery was a great triumph in the fight against leprosy. In the 1930's, the first effective antileprosy drug, dapsone, was introduced and in the early 1980's multi-drug therapy was popularized because of high efficacy in resistant cases. Here, we have presented a brief look at the history of leprosy in the world with special focus on the historical account of leprosy in Iran, particularly during the 19[th] and 20[th] centuries

clinicopathologic study of lung cancer cases in Iran

Lung cancer remains the leading cause of cancer-related deaths in the world. In Iran, lung cancer is the fifth leading cancer and its prevalence rate has been increasing steadily. In this study, the clinicopathological aspects of lung cancer are discussed. Between October 2002 and November 2005, 242 [178 men, 64 women] patients with histologically confirmed lung cancer were interviewed according to a questionnaire. Women developed the disease at an earlier age than men [55.9 +/- 14.2 versus 61.3 +/- 12.3 years; p=0.004]; 66.5% of lung cancer patients [85.4% of men and 14.1% of women] were smokers [p<0.0001]; 76.3% of participants, who had exposure to secondhand smoke, were females. Among the environmental carcinogens, the most exposures were to inorganic dusts [49.8%] and chemical compounds [34.9%].Most male and female patients suffered from adenocarcinoma [28.9%] and non small cell carcinoma [28.5%]. The prevalence of adenocarcinoma was higher in the non-smoker group, whereas incidence of squamous cell carcinoma and small cell carcinoma was higher among smokers [p<0.0001]. In this study, most patients [74.0%] presented with an advanced-stage tumor [IIIB or IV]. Our results suggest that in addition to cigarette smoking, other environmental, occupational and socioeconomic factors may play a role in the development of lung cancer

Comparison of Nramp1 gene polymorphism among TB health care workers and recently infected cases; Assessment of host susceptibility

A link between polymorphisms in the natural resistance -associated macrophage protein gene 1 [Nramp] and susceptibility to tuberculosis [TB] has been demonstrated worldwide. This study aimed to investigate the Nramp1 gene variants among workers exposed to TB bacilli [1-2 hours per day for 1 to 20 years] who did not develop the diseases with those who developed the disease through recent transmission. The polymorphism of Nramp1 at INT4, D543 and 3'UTR was examined in 71 newly smear-positive TB cases and 39 healthcare workers exposed to TB. Polymerase chain reaction [PCR] and restriction fragment length polymorphism [RFLP] were used to genotype Nramp1 polymorphism. Patients' clinical and demographical data were collected. The heterozygote patterns of INT4 [G/C], D543 [G/A] and 3'UTR [+/del] occurred more frequently in control subjects than in patients [P =0.012], respectively [odds: 1.9 CI95%] [1.13-3.12]. Although, the homozygous patterns of INT4 [C/C; 8.5%], D543 [A/A; 1.4%] and 3'UTR [del/del; 1.4%] were only seen in patients [sensitivity 11% and specificity 100%]. The other risk factors like gender, age, resistance and PPD were not associated with Nramp1 gene polymorphism. Individuals with homozygous type mutation have an increased risk of developing tuberculosis. Therefore, we suggest detection of Nramp1 variants in high-risk groups i.e., health workers and close contact cases

Assessment of angiotensin-converting enzyme gene in idiopathic pulmonary fibrosis

Interstitial pulmonary fibrosis [IPF] is a progressive fibrotic interstitial lung disease with a distinct histopathological form referred to as usual interstitial pneumonia [UIP]. Evidence has indicated that a local renin-angiotensin system is present in distal lung parenchyma. Expression of the component of this system is present in a number of fibrotic lung diseases. In this study, we assessed the association of Insertion/Deletion [I/D] polymorphism of angiotensin-converting enzyme [ACE] gene in IPF. By using semi-nested PCR, we determined the I/D polymorphism of ACE gene in 23 paraffinembedded open lung biopsy specimens from patients having clinical and imaging findings of IPF and pathologic diagnosis of UIP at National Research Institute of Tuberculosis and Lung Disease [NRITLD]. Afterwards, we compared the results with I/D polymorphism of ACE gene in a healthy control group [n= 88]. The frequency of I allele was 71.7%[33 out of 46] and the frequency of D allele was 28.3% [13 out of 46]. The frequent genotype was I/D [56.5%] which was statistically significant comparing with healthy group [27.3%]. We had no D/D genotype .There was a difference in the distribution pattern of ACE genotype between patients and controls [P < 0.05]. Our study revealed an association between carriage of I allele and I/D genotype in IPF

Fiberoptic bronchoscopy: correlation of cytology and biopsy results

Fiberoptic bronchoscopy is a diagnostic method for respiratory diseases. At present, its diagnostic yield has been increased by different cytologic and histologic procedures by convention. This study was conducted to evaluate the concordance and agreement between cytologic and histologic findings in conventional diagnostic bronchoscopic methods [washing and biopsy] for lung malignancies. This was a cross-sectional study performed on 2076 cases of bronchial biopsy and bronchial washing between 1996 and 2003. Of 2163 patients who underwent fiberoptic bronchoscopy after omitting 87[4%] cases due to unsatisfactory specimens, 2076 cases were studied including 832 [36.9%] females and 1244 [63.1%] males in the age range of 2 to 100 years, [mean age 57.7 +/- 16.3 yrs]. Male to female ratio was 1.5. Malignancy was diagnosed in 657[31.6%] biopsy and 283[13.6%] cytology specimens. Two hundred and sixty-five cases had malignant lesions according to both bronchial biopsy and bronchial washing; therefore, Kappa coefficient in both methods was 46.7% [P value = 0.000]. Concordance rate was 77.4%. Ninety-seven point three percent of malignant cases were diagnosed by biopsy and 41.9% by cytology. Cytology contributed to an additional diagnostic rate of 2.6%. Kappa agreement is classified as fair and although there is a very good concordance between the two sampling techniques, the diagnostic yield of cytology for malignancy must be improved by combination of multiple assays

TNF alpha gene polymorphism in idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis [IPF] is characterized by a chronic inflammatory process and abnormal wound healing. Tumor Necrosis Factor alpha [TNF alpha] is considered to play a key role in fibroblast proliferation and increased collagen synthesis. It appears that there is a genetic predisposition to IPF. The genetic associations of TNF-alpha with IPF have been reported in different cohorts and revealing conflicting results. This study was conducted to evaluate the association of TNF- alpha-308 G/A polymorphism with IPF in Iranian patient by PCR-RFLP method. Materials and Methods: TNF alpha gene polymorphism at position 308 G/A was examined on DNA extract of 41 cases with IPF defined clinically, radiologically and histologically and compared with 82 unrelated healthy controls who were kidney donors. Results: The understudy population included 20 males and 21 females with the mean age of 50.4 yrs. Data showed that the frequencies of G allele [NO:72] and A allele [NO:10] were 87% and 12% respectively. The frequency of G/G genotype [NO:31] was 76%, followed by G/A [No:10] being 24%.we had no A/A genotype. Conclusion: There was no association between TNF alpha-308 G/A polymorphism and IPF in Iranian patients

Proliferative Marker in distinction between benign and malignant mesothelial proliferations

Differentiation of benign from malignant mesothelial proliferations is a major problem in the pathology of the serosal membranes, particularly in small biopsy specimen. This study was conducted for the evaluation of proliferative marker for distinction between malignant mesothelioma [MM] and mesothelial hyperplasia [MH]. Thirty six cases of malignant mesothelioma [MM] with the mean age of 62.94 years [range: 36-80 years, M/F: 3.58] and 22 cases of mesothelial hyperplasia [MH] were evaluated for proliferative status by immunohistochemical [IHC] method with monoclonal antibody, Ki-S5 [Ki-67]; the labeling indices [LI] were evaluated. Average count revealed a significant increase in MM as compared with reactive MH [p value < 0.0001]. Considering a threshold of 9% for ki-67, a sensitivity of 88% and specificity of 94% were resulted. Proliferative marker of Ki-67 can be useful in distinction between malignant mesothelioma and mesothelial hyperplasia [p-value < 0.0001]

Detection of epstein barr virus DNA in thymic epithelial tumor using nested PCR

Thymus is a lymphoepithelial organ composed of epithelial cells and lymphocytes. Primary tumors of the thymus are uncommon and a definite risk factor has not been found. There are some reports regarding the association of the [EBV] Epstein Barr Virus with thymic epithelial tumors. This study was conducted to evaluate the presence of EBV genome in thymic epithelial tumor. EBV genome, EBNA2 was examined from DNA extracts of 41 paraffin embedded specimens including 16 thymic epithelial tumors as subject cases and 25 mediastinal lymph nodes as controls. Nested PCR assay revealed that 31.25% of cases were positive for EBV genome. The presence of EBV genome EBNA2 in thymic epithelial tumor suggesting that this association may be due to the endemic nature of EBV infection

Metabolomics in medicine

Genomic studies provide scientists with new techniques to quickly analyse genes and their products in mass. The post genomics era has brought ever increasing demands to observe and characterize variations within biological systems. These variations have been studied under Systems Biology. Systems biology is a multi disciplinary and multi-instrumental analysis of all molecules within the cell, tissue and organism. This technology includes studies regarding genomics [gene function], transcryptomics [mRNA function], proteomics [protein regulation] and the metabolomics [low molecular weight metabolites].The suffix " - omic " is added at the end of each part of the systems. Metabolomics/metabonomics has been labeled one of the new "- omics " joining genomics. It is rapidly becoming one of the platform sciences of the " omics ", with the majority of papers in this field having been published only in the past two years [Rochfort S, 2005]and the manufacture sale rose up to $230 million in 2005 [Lok C, 2005]. Metabolomics is concerned with the measurement of global sets of low-molecular weight metabolites. It is the study of metabolites and their roles in various disease states and is a novel methodology which arose in the last 3-5 years. The concept, characteristics, technologies and history of metabolomics are introduced. The techniques used in data acquisition and data analysis including NMR, GC/MS, LC/MS, and others, as well as the possibilities and the limitation of techniques are introduced. Metabolomics made on lab-on-a-chips techniques to provide earlier, faster, and more accurate diagnoses for many diseases. The major application of metabolomics is in toxicology, clinical trial testing, pharmacology and drug phenotyping,nutrient industry and food /beverage tests, cancer research, clinical pathology tests, and many others which have been tabulated in the text. Metabolomics developed mostly in plants, which are easier to study compared to mammals. Although use of metabolomics in medicine is in its infancy, this approach is considered to have the potential to revolutionize medical practice in prevention, predicting and personalizing health care

Detection of human papillomavirus in squamous cell carcinoma of the lung by semi-nested PCR

Background: Lung cancer is the second common malignancy in human. Human papillomavirus [HPV] has a well established association with squamous cell carcinoma of anogenital region. This study was performed in Massih Daneshvari hospital, between 1999 and 2003 to evaluate association of human papillomavirus type 16 and 18 in squamous cell carcinoma of the lung among Iranian patients

Materials and Methods: Paraffin embedded block of pathology archive of Massih Daneshvari hospital with diagnosis of SCC were selected for determination of HPV DNA by semi-nested PCR. For each specimen, all hematoxyline-eosin stained slides were reviewed by two pathologists; if the initial slide was inappropriate, a new slide was prepared. All inadequate specimens were excluded from the study

Results: 18 out of 45 paraffin- embedded specimens with diagnosis of squamous cell carcinoma were selected. Six specimens were positive for HPV type 16, and 2 were positive for HPV type 18. None of the specimens was shown to have concurrent positivity of HPV types 16 and 18

Conclusion: The present study showed that high risk HPV was associated with squamous cell carcinoma of the lung and more prevalent type was HPV 16. We suggest further investigations to evaluate this relationship

case of angiomyolipoma of the posterior upper mediastinum

Angiomyolipoma [AML] is uncommon outside the kidney, and it rarely occurs in mediastinum. This article presents a case of posterior upper mediastinal AML with a review of the literature on angiomyolipoma. A 56-year-old woman was referred to our hospital with 8-month history of cough and chest pain. Radiology showed a mass in the posterior upper mediastinum. Left thoracotomy was done for surgical removal of the tumor. Pathologic findings revealed an AML tumor in the left paravertebral and posterior upper mediastinal regions with massive infiltration of the intercostal nerves and subtle invasion of the adjacent thoracic spinal canal. This case is the third reported AML of posterior upper mediastinum. To prevent misdiagnosis, it is suggested that AML could be considered for the differential diagnosis of mediastinal tumors

Applications of molecular diagnostics; solid tumorgenetics can determine clinical treatment protocols

Solid tumor diagnosis is now entering an era in which molecular genetics plays an important role. Clinical trials have shown different responses to various therapies that correlate with molecular alterations. Biological determinants, related to treatment-response markers which have aimed at individualized therapies, are being defined and implemented. Patients are now being treated based on the profile of molecular genetic alterations in individual tumors. Protocols based on molecular markers will increase the chances for cure by opting for the right management approach. In most situations, they also will improve the quality of life of patients with cancer, for example by facilitating organ preservation strategies. The molecular characterization therefore, has an important prognostic and practical role in diagnosis