study of lichen planus and its association with hepatitis C infection

The association of lichen planus with chronic hepatitis C virus [HCV] has been widely reported in the literature. However, there are wide geographical variations in the reported prevalence of HCV infection in patients with lichen planus. This study was conducted to determine the association of lichen planus with HCV in Iraqi patients in Basra governorate [southern Iraq]. From January 2008 to October 2009, 97 cases of lichen planus, 47 women [48.5%] and 50 men [51.5%] were diagnosed on the basis of characteristic clinical features, and if necessary, typical histological findings on biopsy. The patients were screened for the presence of anti-HCV antibodies by third generation ELISA. The control group [2070 person] consisted of healthy blood donors who were screened for HCV in the Central Blood Bank of Basra. Anti-HCV antibodies were detected in 3 [3.1%] cases. This was significantly higher in blood donors [pvalue = 0.002]. A statistically significant association was demonstrated between lichen planus and hepatitis C virus infection. Liver function tests, plasma glucose and gender were not significantly different between HCV infected and non-infected patients. The prevalence of HCV among Iraqi patients with lichen planus [3.1%] was significantly higher than in the control group [0.14%]. It seems that there is an association between HCV and lichen planus among Iraqi patients in Basra city; however, liver function tests are not pivotal means in screening for HCV in lichen planus patients

Evaluation of endoscopic versus serologic and histopathologic changes in the diagnosis of celiac disease

To evaluate the endoscopic versus serologic and histopathologic changes in the diagnosis of celiac disease and to correlate the endoscopic changes with the degree of mucosal damage. Seventy two patients with symptoms of chronic diarrhea, 38 females whose ages ranged from 11 to 60 years and 34 males whose ages ranged from 10-59 years were tested for anti-tissue transglutaminase after they underwent upper gastroduodenoscopy. Duodenal mucosa was visualized carefully for any changes of celiac disease. Four endoscopic biopsies were taken from each patient and sent for histopathologic examination.Duodenal biopsies were classified according to modified. Marsh's classification. Among the 72 patients who were enrolled in the study, 28 patients tested positive for anti tissue transglutaminase, 47 patients had histopathologic changes, 26 patients who had both anti tissue transglutaminase and histopathologic changes were classified as celiac patients, among them 19 patients had endoscopic changes. The sensititvity, specificity, positive predictive value and negative predictive value of endoscopic changes were [73.07%], [86.95%], [76%], and [85.1%], respectively. The endoscopic appearance of the duodenum may be predictive of the severity of mucosal damage; but overall, the endoscopic changes have a wide range of sensitivity because the endoscopic findings had been normal in the presence of minor mucosal changes. Anti tissue transglutaminase was well correlated with histopatholgic changes in celiac disease

Diagnostic duodenal bulb biopsies in celiac disease

To evaluate duodenal bulb biopsies with respect to histological changes in the diagnosis of celiac disease as compared with biopsies from second part of duodenum. Endoscopic biopsies were obtained from 44 patients [23 females and 21 males] suspected clinically as having celiac disease. Four biopsy samples were obtained from each duodenal bulb and second part of duodenum. The histological changes were reported according to Marsh's classification. The histological changes were equally similar from biopsies of duodenal bulb as compared to second part in all except four patients. Mucosal specimens taken from duodenal bulb and second part of duodenum were strongly correlated histologically

Silent myocardial ischemia and microalbuminuria in asymptomatic type - 2 diabetic patients

To detect silent myocardial ischemia [SMI] in asymptomatic type 2 diabetic patients with or without microalbuminuria, and the importance of microalbuminuria as a predictor for diabetic cardiovascular complications. Sixty asymptomatic patients with type 2 diabetes were included in this study. Thirty [17 males, 13 females] with mean age of 54 +/- 8.3 years had microalbuminuria [Group-I] were compared with another thirty [21 males and 9 females] with a mean age of [52 +/- 7.8 years] who had normoalbuminuria [Group-II]. A maximum symptom-limited treadmill exercise test was used to detect silent ischemia. In Group-I, 9 patients [30%] had SMI, with 6 patients showing SMI at higher work load and 3 at low work load. In Group-II, 2 patients [6.6%] showed SMI, one at high load and another at low load. The prevalence of SMI in asymptomatic microalbuminuric and normalbuminuric type 2 diabetic patients were 30% and 6.6% respectively. Even with a maximum exercise, myocardial ischemia might be completely asymptomatic in type 2 diabetic patients

prolymphocytic leukemia: a clinico-pathological study

The clinical histopathological and histochemical features of ten patients with prolymphocytic leukemia were reviewed. Seven of the patients had clinical evidence of massive splenomegaly at the time of the diagnosis. None of the patients had significant lymph nodes enlargement. The initial leucocyte count was elevated in all patients and was greater than 100 * 10[9]/1 in eight of them. The absolute prolymphocyte count range from 18.4 to 395.3 * 10[9]/1 and was greater than 100 * 10[9]/1 in eight patients

significance of intestinal metaplasia in endoscopic biopsy specimens of gastric mucosa

A total of 402 cases of endoscopic gastric biopsies were carried out at the Basrah Teaching Hospital. The specimens were remined microscopically for histological diagnosis and to determine the variants of intestinal metaplasia and their significance to various gastric lesions biopsied. Three types of intestinal metaplasia were identified: Type I [Complete Intestinal Metaplasia], Type II [Incomplete Intestinal Metaplasia] and Type III [Incomplete Intestinal Metaplasia with Hyperplastic Epithelium]. Type III intestinal metaplasia was a more significant associated with cases of gastric dysplasia and carcinoma than with those of benign gastric lesions. But no such association was found with either type I or type II intestinal metaplasia. The significance of the different type of entestinal metaplasia in relation to various gastric lesios is discussed

pattern of pleural effusion in Southern Iraq

The causes of pleural effusions in 394 patients were determined [between December 1984 and November 1987] by physical examination and investigations. Tuberculous [38%], cancerous [20%] and bacterial [20%] effusions were found to be the most common causes. The cause of effusion was not found in 44 patients. Tuberculous effusion was diagnosed by character and culture of the pleural fluid and pleural biopsy, cancerous effusion was diagnosed by cytological examination of pleural fluid and biopsy of the pleura, lung and lymph nodes. Empyema was found to be caused by gram positive and gram negative cocci and a few anaerobes