Epidemiology of rotavirus-norovirus co-infection and determination of norovirus genogrouping among children with acute gastroenteritis in Tehran, Iran

Background: Enteric viruses, particularly human rotavirus and norovirus, have been shown to replace bacteria and parasites, as the most common pathogens responsible for acute diarrhea. However, there are still few epidemiological data on the simultaneous occurrence of these viruses in Iran. In this regard, the aim of this study was to assess the useful epidemiological data on the gastroenteritis associated with rotavirus-norovirus mixed infection and to examine the prevalence of norovirus genogrouping among children aged less than five years old in Iran

Methods: A total of 170 stool samples were collected from children under five years of age with the clinical signs and symptoms of acute gastroenteritis, from May 2013 to May 2014. For the detection of both rotavirus and norovirus, total RNA was extracted from all samples, followed by reverse transcription polymerase chain reaction [RT-PCR]. For both detected rotaviruses and noroviruses, genogrouping was performed

Results: Of 170 samples, 49 [28.8%] and 15 [8.8%] samples were found to be positive for rotavirus and norovirus infections by RT-PCR. Interestingly, 6 [3.5%] patients were positive for both infections. Among the 15 norovirus-positive patients, 13 [86.6%] and 2 [13.3%] belonged to genogroups GII and GI

Conclusions: The norovirus genogroup GII and rotavirus lead to the serious infections in children with acute gastroenteritis. However, more well-designed studies are needed to further elucidate the role of other enteric viruses in acute gastroenteritis

Expression of two basic mRNA biomarkers in peripheral blood of patients with non-small cell lung cancer detected by real-time RT-PCR,individually and simultaneously

Although extensive research has been conducted on lung cancer markers, a singular clinically applicable marker has not been found yet. The objective of this study was to evaluate the sensitivity and the specificity of carcinoembryonic antigen [CEA] mRNA and lung-specific X protein [LUNX] mRNA biomarkers in peripheral blood to detect lung cancer individually and simultaneously.Thirty patients affected by lung cancer and 30 healthy individuals were studied in this research. Three vials of cDNA were made from each sample after taking peripheral blood samples and extracting total RNA. Each sample was examined by the real-time RTPCR technique. The result from each vial was then compared with the sensitivity of overall marker. The CEA mRNA was positive in 24 out of 30 lung cancer patients. Hence, its sensitivity was determined at 80%,differing significantly from that observed in healthy individuals, where 11 positive cases were seen. The overall sensitivity of this marker was significantly associated with positivity in vials 2 and 3 but not in vial 1 The LUNX mRNA was positive in 21 out of 30 patients, indicating 70% sensitivity. This finding significantly differed from that in healthy individuals. The overall sensitivity of this marker was significantly associated with positivity in vials 1 and 3, but not in vial 2. In 93.3% of the patients, at least one positive marker was observed.The mentioned mRNA could be suggested as sensitive and specific markers in peripheral blood for primary diagnosis of lung cancer.

Clinical and demographic characteristics of confirmed cases in H1N1 [2009] influenza

Presentation of pandemic H1N1 influenza [H1N1] is widely evolving as it continues to involve different geographic locations and populations. This study was conducted to improve the precision of clinical diagnosis of H1N1 [2009] influenza infection in an outpatient setting. A prospective cross-sectional study was conducted among adult patients [age >15 years] with influenza-like illnesses [ILI] from November 2009 to February 2010. Clinical, laboratory and epidemiological findings in the first week of illness were collected using a standardized datasheet. Influenza testing was performed by real-time reverse-transcriptase polymerase chain reaction [rRT-PCR]. Thirty nine [24%] patients were positive for H1N1 and 123 [76%] were negative for any subtype of influenza A virus. Whilst otalgia [14% vs. 0 p= 0.01] was more prevalent in non-influenza A cases, cough [90% vs. 72% p = 0.03] and shortness of breath [67% vs. 47% p = 0.02] were more often associated with H1N1-infection. Comparative analysis of coexisting conditions and demographic factors of patients revealed no other significant differences between the two groups. The clinical presentation of H1N1 [2009] infection is largely indistinguishable from other acute respiratory diseases. Although previous studies suggested significant differences in demographic and co-existing conditions of H1N1 infected patients, our study shows that as the pandemic spreads worldwide and affects the majority of the population, H1N1 diagnosis based on clinical presentation and demographic characteristics has become less practical and much more difficult in tertiary care centers

Clonality of the immunoglobulin heavy chain genes in B cell non-Hodgkin lymphoma using semi-nested PCR

Identification of gene rearrangements and clonality analysis are important techniques for the diagnosis of malignant lymphoproliferative diseases. These methods have various sensitivities based on the type of primer used and method of determination of polymerase chain reaction [PCR] products. This study aimed at determining the clonality of B cell non-Hodgkin lymphoma in Iranian patients using PCR method and 2 primers of FR2 and FR3. Paraffin embedded blocks of 67 patients with B cell lymphoma and 19 cases with lymphoid hyperplasia of the lymph nodes who presented to NRITLD, Masih Daneshvari Hospital were retrospectively reviewed. After extracting the genomic DNA using phenol and chloroform, clonal analysis was performed using semi-nested PCR by using two primers: FR2 and FR3. PCR products were determined using 2 techniques of heteroduplex analysis, polyacrylamide gel and silver staining and the conventional method of agarose gel and ethidium bromide staining. Appearance of 1 or 2 bands in the desired location were considered as a sign of clonality. Monoclonal gene rearrangement was observed in 62 out of 67 patients [92.5%] as one or two discrete bands appeared within 60-120 base pairs [bp] and 200-300 bp range. Of the mentioned patients, 53 cases [79.1%] had FR2 and 51 [76.1%] had FR3 rearrangement. Heteroduplex analysis along with silver nitrate staining detected 3 out of the remaining 5 cases of lymphoma to be monoclonal. These cases had been reported negative by the conventional technique. In total, 65 out of 67 patients [97%] showed monoclonal gene rearrangement using both the abovementioned techniques. All hyperplasia cases were polyclonal by this method. Our study showed that evaluation and detection of clonality using PCR, FR2 and FR3 primers along with heteroduplex analysis is a rapid sensitive technique for the diagnosis of malignant lymphomas

Prevalence of oseltamivir-resistant 2009 H1N1 influenza virus among patients with pandemic 2009 H1N1 influenza infection in NRITLD, Tehran, Iran

Oseltamivir-resistant cases were reported during the 2009 pandemic influenza outbreak and therefore, widespread emergence of oseltamivir-resistant 2009 H1N1 virus is imaginable. Underlying medical conditions like immunosuppression increase the chance of oseltamivir resistance. In a retrospective cross-sectional study, respiratory tract specimens of confirmed cases of 2009 H1N1 influenza referred to the Masih Daneshvari Hospital were analyzed for presence of H275Y mutation. From November 2009 through March 2010, oseltamivir-resistant 2009 H1N1 infection was observed and confirmed in 4 patients [including 2 immunocompromised patients] by performing H275Y mutation molecular testing. Close monitoring of resistance to neuraminidase inhibitors is essential in tertiary care centers. The H275Y mutation [oseltamivir-resistant genotype] could appear in the absence or presence of selective drug pressure

Transient localized hemophagocytosis in pleural effusion

Epstein-Barr virus [EBV] is one of the most important causes of hemophagocytic syndrome. We report a 76-year-old man who presented with pneumonia like symptoms and pleural effusion following upper respiratory tract infection. He underwent thoracentesis and pleural fluid cytology revealed large number of histiocytic macrophages that had phagocytosed RBCs and other inflammatory cells like lymphocytes and neutrophils. Pleural fluid analysis showed Epstein-Barr virus Antigen [EBNA] as the causing agent and corticosteroid therapy was initiated. A few days later, pleural effusion subsided and further cytologic examinations revealed no trace of hemophagocytosis