Imprint cytology: a simple, cost effectiveness analysis for diagnosing Helicobacter pylori, in west of Iran

This study was to determine the sensitivity, specificity, positive predictive value [PPV], negative predictive values [NPV] and agreement between two methods of the stained gastric imprint cytology smears and stained gastric specimen biopsy mucosal methods for detection of H. pylori. Air-dried imprint smears of gastric biopsies from 330 patients were stained by the Grunwald- Giemsa method in the endoscopy suite and examined for H. pylori, providing results within minutes. The grade of H pylori infection was documented. The same biopsy was processed and stained with HandE and Grunwald- Giemsa stains, and reviewed by two different pathologists blind to the imprint cytology results. Ninety-four of the 238 patients were male with a mean age of 46 [ +/- 16.4] years. Based on histology, the H. pylori prevalence was very high at 77.87% and according to cytology H.Pylori prevalence was high at 75.45% in this region our country. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 96.88% and 90.12%, respectively. The PPV and NPV were 96.88% and 90.12%, respectively. The agreement between two diagnostic methods was 95.26% which confirms reliability of imprint cytology method for ion of H.pylori detection. Gastric imprint smears stained with Grunwald-Giemsa method is a rapid and cost effective method in addition to histology for detecting H. pylori in patients undergoing upper gastrointestinal endoscopy and biopsy. It does not require any additional biopsy

functional outcome of surgically treated unstable pelvic ring fractures by open reduction, internal fixation

Unstable Pelvic fracture, a result of high energy antero-posterior compression injury, has been managed based on internal fixation and open reduction. The mode of fixation in Unstable Pelvic fracture has, however, been a subject of controversy and some authors have proposed a need to address the issue of partial breach of the pelvic ring elements in these injuries. This study was performed to evaluate the functional and radiological results of treatment of pelvic ring fractures by open reduction, internal fixation. Thirty eight patients with unstable pelvic fractures, treated from 2002 to2008 were retrospectively reviewed. The mean age of patients' was 37 years old [range 20 to 67]. Twenty six patients were men and 12 women. The most common cause was a road traffic accident [N=37, 97%]. There were 11 type-C and 27 type-B fractures according to Tile's classification. Thirty six patients sustained additional injuries. The most prevalent additional injuries were lower extremity fractures. Open reduction, internal fixation as a definite management was applied for all patients. Quality of reduction was graded according to the grades proposed by Matta and Majeed's score was used to assess the clinical outcome. The mean period of follow-up was 25 months [ranged from 6 to 109 months]. About 81.6% of patients had either good or excellent radiological reduction. The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients. There were 4 postoperative infections. No sexual function problem was reported. Nerve deficits recovered completely in 2 and partially in 3 of 11 patients with preoperative neurologic deficiency. There was no significant relation between functional outcome and the site of fracture Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization that must be carried out as soon as the general condition of the patient permits, and even up to two weeks