[Compraision of urease test with Giemsa staining for detection of Helicobacter pylori infection in patients with gastric ulcer and gastritis]

Background and Objective: Helicobacter pylori are one of the most common gastrointestinal bacterium infections. This study was done to compare the urease test with Giemsa staining to detection of Helicobacter pylori infection in patients with gastric ulcer and gastritis

Methods: This descriptive- analytic study was conducted on 601 patients' diagnosed with gastric ulcer and gastritis, whom under went endoscopy in 5th Azar hospital, Gorgan, Iran during 2008-12. Rapid urease test was immediately taken during endoscopy. Pathological examination, Giemsa staining on paraffin blocks and haematoxylin and eosin stain were done to assess either presence or absence of Helicobacter pylori

Results: Based on biopsy results, Gastritis and gastric ulcer were diagnosed in 80.69% and 19.3%, respectively. In gastritis and gastric ulcer patients, there was a significant differences between urease test [91.5% and 90%, respectively] in comparison with Giemsa staining [91.5% and 90%, respectively] [P<0.05]

Conclusion: The study revealed that in primary diagnosis and screening of role of Helicobacter pylori in patients with gastric ulcer and gastritis, urease test is suitable than giemsa staining

[Assessment of babA2 and hsp genotype frequency in helicobacter pylori specimens isolated from digestive disorders patients]

Helicobacter pylori is the main gastric pathogen in human. BabA2 and Hsp genotypes are essential for enormous clinical outcomes in gastreodeoneal and dyspepsia. This study was done to determine the assessment of babA2 and hsp genotype frequency in Helicobacter pylori specimens isolated from digestive disorders patients. This descriptive-analytic study was carried out on 80 digestive disorders patients in 5th hospital, Gorgan, northern Iran. Stomach specimen biopsy was taken by a gastroenterologist. Urease test, histopathologic assessment and DNA extraction were performed. The frequency of babA2 and hsp geno-types was determined using poly merase chain reaction. In 80 affected patients with H.pylori, 36, 18 and 26 patients were found to suffer from gastritis, stomach cancer and stomach ulcer, respectively. 51 specimens [63%] were positive babA2 genotype. 49 specimens [61%] were positive hsp genotype. No significant relationship was found between babA2 and hsp geno types with stomach diseases. In spite of positive babA2 and hsp genotype in isolated Helicobacter pylori speicments from digestive disorders patients, this finding was not correlated with type of digestive disorders

[Anatomical and histopathological distribution of gastrointestinal polyps in Gorgan, Iran [1999-2008]]

Gastrointestinal polyps have pre-carcinomatous potential. In regard to increasing rate of gastrointestinal cancers and the relation between polyps with cancers, this study was done to determine the anatomical and histopathological distribution of gastrointestinal polyps in Gorgan, Iran. This cross-sectional study was conducted on 290 patients with gastrointestinal polyps were undergoing colonoscopy or endoscopy in 5th Azar teaching hospital in Gorgan, northern Iran during 1999-2008. The diagnosis was confirmed by histopathologic method. Gender and age was recorded for each patient. 56.6% of patients were males 19.3% of polyps was diagnosed in the sixth decade of patient's age. The most frequent pathological type of gastrointestinal polyps was adenoma [54.1%] followed by hyperplastic [19.7%], acute inflammatory [13.8%] and young polyps type [11.4%]. Tubular type with 63% was the most common type of adenoma polyp followed by various villouses [19.1%] and tubulovillous [17.9%]. 87.2% and 12.8% of polyps were in colon and stomach, respectively. The most frequent anatomical position of polyps was rectum [30%] followed by sigmoid with 26/1%. Adenoma polyp in colon was the most common type in gastrointestinal tract

[Colonoscopic and histopathological findings in patients with hematochezia]

Colonoscopy is the best method for management of patients with Hematochezia or lower gastrointestinal bleeding [LGIB]. This study was conducted to assess the endoscopic and histopathologic findings in patients with hematochezia. This descriptive -analytical study was done on 117 [50 males, 67 females] patients whom referred to 5th Azar hospital in Gorgan, northern Iran during 2010. Demographic characteristics, medical history and colonoscopic and histopathologic findings were recorded for each patient. Hemorrhoid was the most common finding in colonoscopic examination. Inflammatory bowel disease [IBD] and cancer were the most common feature in the under and higher than 43 age old patients, respectively [P<0.05]. Ulcerative colitis [22.2%] was the most common finding in histopathological examination. Rectosigmoid was the most common anatomical location of involvement in IBD cases. Cancer and IBD were occurred in the left colon. Flexible sigmoidoscopy can be a selected procedure for evaluation of hematochezia in the <43 age old patients but in >43 age old subjects sigmoidoscopy or colonoscopy should be made based on patients' status

[Comparison of serum androgens and progesterone in preeclampsia and normal pregnancy]

Androgens are among the causative factors in preeclampsia. This study was done to compare the serum androgens and progesterone in preeclampsia and normal pregnancy. This case-control study was done on 30 preeclamptic and 30 healthy pregnant women in Gorgan, Iran. Higher or equal to 140/90 mmHg and proteinuria equal or more than +1 in dip stick test in the third trimester of pregnancy were considered as the diagnostic criteria of preeclampsia. Progesterone, free and total testosterone, and dehydroepiandrosterone sulphate [DHEA] were measured by ELISA method. Total testosterone level was 1.8 +/- 0.3 ng/ml and 1.3 +/- 0.9 ng/ml in cases and controls, respectively. This difference was not significant. Progesterone was lower in cases [95 +/- 46.9 ng/ml] than in controls [165.4 +/- 75 ng/ml] [P<0.01]. Free testosterone and DHEA were 5.6 +/- 2.3 ng/ml and 1 +/- 0.5 ng/ml in cases, respectively which was significantly higher than the controls [3.2 +/- 1.5 ng/ml and 0.7 +/- 0.4 ng/ml, respectively] [P<0.045]. Serum level of free testosterone, DHEA and progesterone increased and reduced respectively in preeclampsia

[Diagnostic value of simultaneous use of anti-cyclic citrulinated peptide and rheumatoid factor in rheumatoid arthritis]

Rheumatoid arthritis [RA] is a systemic and chronic disease. Anticitrulinated anticyclic antibody [Anti-CCP] and rheumatoid factor [RF] are applied for the diagnosis of rheumatoid arthritis. This study was designed to evaluate the diagnostic value of anticitrulinated cyclic antibody and rheumatoid factor in rheumatoid arthritis patients. This laboratory study was done on 238 affected RF patients and 152 RF symptom free subjects in Gorgan, Iran. Anti-CCP and RF were measured by ELISA and Latex agglutination. Out of 238 patients with rheumatoid arthritis Anti-CCP test was positive in 196 patients, and the sensivity was 82%. In control group, Anti-CCP was positive in 5 cases, and the specificity for RA was 96%. RF test was positive in 206 patients and sensitivity for RF in rheumatoid factor was 86%. In control group, RF was positive in 28 cases and specificity was 81%. Positive RF and Anti-CCP [simultaneously] showed sensitivity as 89%. The specificity of CCP is higher than RF and therefore can be substituted as diagnosis of rheumatoid factor

[Frequency of HBsAg in pregnant women in Gorgan, Iran]

The prevalence of hepatitis B infection is increasing worldwide. The main way to prevent hepatitis B transmission to newborns can be through accurate detection of HBsAg positive pregnant women and implementation of standard protocol for their infants. Therefore, this study carried out to determine the frequency of HBsAg in pregnant women in Gorgan, Iran. This cross sectional study was done on 1553 pregnant women whom attended to Dezyani hospital in Gorgan, North of Iran during 2008-09. Blood samples were taken and tested for HBsAg and HBeAg using ELISA method. HBsAg was found positive in 15 [1%] pregnant women. However, HBeAg were negative in all cases. Seven of these cases [46.7%] were not diagnosed before admission to the hospital for delivery and therefore had not received any immunoprophylaxis or HBIG treatment for their newborns. In contrary, six mothers and their newborns received immunoprophylaxis due to falsely diagnosed HBsAg seropositive. This study showed that the current protocols for dealing with HBsAg seropositivity and case finding among pregnant women in this region should be thoroughly revised. Furthermore, it is suggested that pregnant women during third trimester should be screened for HBsAg

[Mucocutaneons manifestation in end stage renal disease patients under hemodialysis in 5th Azar hospital in Gorgan, Iran [2009]]

Mucocutaneons manifestations are common in hemodialysis patients.The aim of this study was evaluate the prcvalence of cutaneous and mucosal manifestations in end stage renal disease [ESRD] patients who are on the maintenance hemodialysis. This cross sectional study was performed on 100 [51 males, 49 females] hemodialysis patients in 5 Azar hospital in Gorgan, North of Iran during 2009. Patients selected on randomly based an all of them completely examined by a deramatologist for any changes in skin, hair, nail and mucous membrane. If necessary biopsy perform and refer to a pathologist. Data analysed with SPSS-13, mann-whitney, t-test, Chi-Square and Fisher tests. The average age was 49 +/- 12.3 years. The most common causes of ESRD was dibetes mellitus. The most common skin lesion was xerosis [78.3%], after that pruritis [39.1%] lentigo [34.8%] skin discoloration [32.6%] leukonychia [32%] thining of nail bed [24%] were common lesions. Lentigo was more common in female than male 42.85% vs 21.50% [p=0.042]. Xerosis [p<0.01], scaling [p=0.042], lentigo [p<0.01], folliculitis [p<0.01], idio pathic guttate hypopigmentation [p<0.01] leukonychia [p<0.01] and half and half nail [p<0.01] have meaningful correlation with age. There was also meaningful correlation between dialyis duration and skin discoloration [p<0.031] and leukonychia [p<0.041]. Clubhing and ca-p product also have meaningful correlation [p<0.027]. Pruritis [p<0.048] and skin fungal infection [p<0.047] [tinea versi color] also have meaningful correlation with serum ferritin level. Mucocutaneous manifestation were common in end stage renal disease patients

[Antibiotic sensitivity of isolated E.coli from pregnant women urine]

Urinary tract infection is the most common bacterial infection during pregnancy. The pregnant women seems to be at risk for pyelonephritis and untreated infection. Timely recognition and on-time appropriate treatment of urinary tract infection particularly in pregnant women reduce the related complications. This study was done to assesse Sensitivity of isolated E.coli from pregnant women urine to antibiotics. In this descriptive study E.coli isolated from 360 urine samples from pregnant women, were examined, using Eosin Methylene Blue, blood sugar method. Antibiogram diffusion disk Kirby-Bauer was performed to assess the antibiotic response. The persent of sensitivity of Escherichia coli to antibiotics were Co-amoxiclav [5.72%], Ampicillin [8.86%], Amoxicillin [11.87%], Cefazolin [32.12], Cephalexin [36.1%], Gentamicin [40.28%], Co-trimoxazole [48.15%], Nalidixic acid [55.3%], Nitrofurantoin [72.48%] and Ceftriaxone [80.78%]. This study showed that there is a high level of E.coli antibiotics resistance toward Amoxicillin and Ampicillin high sensevity is related to Ceftriaxone and Nitrofurantoin in this region

[Serologic immunity of Gorgan medical personnels against hepatitis B [2003]]

Hepatitis B, is a common kind of viral hepatitis. Vaccination is the most secure way of prevention for the health care worker. The present study was designed to survey the seropositivity of Gorgan teaching hospitals. This descriptive and cross-sectional study was done on 300 medical and official personals at 3 hospitals in Gorgan in 2003, with using 3ml of peripheral blood, sampling assay was performed to determine HBs-Ab and HBs Ag. Questionnaire form concerning demographic information, vaccination status and risk factors were compeleted for participants. Statistical analysis was done by means of SPSS soft ware with confidence interval equal to 95%. 13% of individuals were not be vaccinated and 74.6% of them were vaccinated completely. There were statistically significant differences between HBs Ag and vaccination status, individual's age, the last vaccination time, occupation and use of glove [p<0.05]. Furthermore, 1% of samples [one female, two males] were HBs Ag -positive. These three Persons has 10 years at service and were vaccinated compeletely were HBs -Ab neagtive. As a result of vaccination project, vaccination coverage of employees and immunologic status of them were satisfactory. Because of repetitive encountering of under considertion individuals with hepaptitis virus, 2% of unvaccinated subject had been infected but fortunately were be cured. Concomitant reduction in probability of immunity was being occurred after vaccination with the passing time and considering the importance of booster dose injection

[Frequency of hepatitis B virus, hepatitis C virus and Human Immunodeficiency Virus in blood donors and patients in Gorgan blood transfusion organization in 2003]

Consultation prior to blood donation and screening tests of common blood born diseases such as Hepatitis B,C and AIDS are very important issue in blood quality assurance, therefore we decided to compare frequency of such diseases in blood donors and outpatients admitted in the blood transfusion centers. For this purpose the initial tests including HBsAg, HCVAb, and HIVAb were performed on all blood donors and outpatients' blood samples in Gorgan transfusion center by ELIZA methods during 2003 and confirmatory tests including neutralization for HBsAg, RIBA for HCVAb and Western blot for HIVAb performed in condition where ELIZA report was positive. The blood donor in this study had the following positive results: HbsAg 2.5%, HCVAb 3%, HIV 0.35%. The same indeces for the out patients were positive as follow: 13%, 8.3% and 2.04% respectively. The other finding from this investigation indicate that the blood donors positive cases with the ELISA technique were confirmed by Western blot 92%, 20.1% nad 0% for HBSAg, HCVAb, as HIV respectively. The confimatory results of the positive out patient's cases were as follow, 97%, 47% and 60% for HBSAg, HCVAb and HIV respectivley. This study reveals frequency of Hepatitis B and C and AIDS among outpatients which considered being high risk group are more than the blood donors. We conclude that the measurement of HBSAg by ELIZA methodes in comparision to the HCV and HIV are more accurate

[Intraperitoneal hemarrhage due to gastric leiomyoma [A case report]]

A 70- years old female referred with left upper quadrant pain since about 72 hours prior to hospital admission. In physical examination the patient was pale, hypotensive, tachycardiac and a vague left upper quadrant [LUQ] mass palpated. LUQ mass and free intraperitoneal fluid declared by ultrasound investigation there was no history of abdominal trauma and with impression of intraabdominal bleeding; of unknown origin the patient underwent laparotomy. A huge fundal gastric mass identified with surrounding rupturea retroperitoneal hematoma and intraperitoneal hemorrhage. No intragastric penetration or hemorrhage was seen, so complete excision of the mass with safe margin was done with subsequent splenectomy. She had an uneventful post operative course and was discharged at the 7th post- op day. A microscopic analysis of the excised tumor demonstrated gastric leiomyoma

value of thyroid fine needle aspiration in evaluation of follicular neoplasms

The presence of single or multiple nodules with in the thyroid glandis a common clinical problem. It is immposible to differentiate benign and malignant follicular neoplasms in cytologic examinations. Estimation of risk of malignancy in thyroid nodules who are cytologically assumped to be follicular neoplasm has a critical importance. The aim of this research is evaluation of diagnostic value of thyroid FNA in follicular neoplasm. This survey was done on 476 patients with thyroid nodule whome were biopsied in a 7 years period [in 5th Azar hospital, Gorgan]. Standard aspirations and biopsies techniques performed and necessary smears prepared. Wet-fixed smear glass slides are placed immediately in alcohol [70%] 7-10 slides from the aspiration. The patients with cytologic report whome considered follicular neoplasm followed total thyroidectomy or lobotomy. From 476 patients for thyroid nodules 412 cases [86.5%] are suitable for cytologic evaluation which 312 cases [77.9%] of them were benign and 14 cases [3.3%] were malignant. The rest [77 cases] reported to have follicular neoplsm, this patients also undergone thyroid surgery. The result of histological findings appeared in 32 cases [57.1%] follicular adenoma, 15 cases[26.7%] non-euplastic nodules, 5 cases[8.9%] follicular carcinoma and 4 cases [7.1%]follicular type of papillary carcinoma. 9 cases [16%] found malignant among cases which cytologic reports considered as "follicular neoplasms" and subsequently undergone thyroid surgery [consist of follicular carcinoma and follicular type of papillary carcinoma], confirme the importance of histopathologic study of follicular lesions for differentiation between malignant and benign lesions

Hydatidiform mole and surviving coexistent twin [a case report]

Hydatidiform mole with a coexistent fetus is a rare occurrence with an incidence of 1 per 22000-100000 pregnancies. It is associated with persistant gestational trophoblastic tumor. Hence an early and correct diagnosis is imperative to plan subsequent management of such patients. We report a case of primigravida who presented with vaginal bleeding and severe nausae and vomiting. Expectant management was carried out for her pregnancy with finally ended in abortion

[Rare cutaneous metastasis of laryngeal cancer presenting as an abscess: Case report]

Cutaneous metastasis from carcinoma of the larynx are very rare. We observed a 75-year-old male patient with squamous cell carcinoma of the larynx who developed a subcutaneous nodule as an abscess presentation in the buttock. It was found to be a metastatic squamous cell carcinoma of the laryngeal cancer, histopathologically. The skin manifestations proceeded laryngeal metastases by 18 months after laryngectomy and radical neck dissection. After 3 months, the patient died. Cutaneous metastasis of laryngeal carcinoma should be considered in all patients with previous laryngeal carcinoma representing with cutaneous lesion

[ comparison of total protein / creatinine ratio versus 24-hour urine protein in women with suspected preeclampsia]

Preeclampsia is a common complication of pregnancy it's about 5-7 percent in pregnants and it may complicate mother or fetus which ends with death. The purpose of this study was to determine the value of the protein / creatinine ratio in prediction of 24-hour urine total among women with suspected preeclampsia. 60 women who were evaluated for suspected preeclampsia at >/- 24 weeks of gestation were studied prospectively in Deziani hospital Gorgan. There was no concurrent or preexisting systemic disease. They were undergoing a 24-hour urine collection for the determination of proteinuria. A single voided urine specimen was obtained after completion of the 24-hour urine collection and analyzed for the P/C ratio. The random urinary protein to creatinine ratios is strongly associated with the 24-hour total protein excretion [P<0.05, r=0.75]. The best cut off of 0.5 yields a sensitivity of 47% and a specificity of 100%. The random urinary protein to creatinine ratio could replace the 24-hour urine collection as a simple, faster more useful method for the diagnosis of significant protenuria