alireza mesbah

Bowen's disease (BD) is an epidermal in-situ squamous cell carcinoma (SCC). Most Human Papilloma Viruses (HPV)-positive lesions in Bowen's disease are localized to the genital region or distal extremities (periungual sites) in which HPV type-16 is frequently detected. Patient was a 64-year-old construction worker for whom we detected 2 erythematous psoriasiform reticular scaly plaques on peri-umbilical and medial knee. Biopsy established the diagnosis of Bowen's disease and polymerase chain reaction assay showed HPV-6, -18 co-infection. Patient was referred for surgical excision.

Discoid Lupus Erythematosus (DLE) is an autoimmune disorder that usually occurs on sun exposed areas of head and neck. Infrequently it could be presented by palpebral involvement and rarely unilateral upper eye lid edema and erythema have been reported as the sole manifestation of DLE. We describe a 38-year-old woman with chronic left upper eye lid edema and erythema from one year ago which was induced by steroid injection for left eyebrow alopecia. Histopathologic and direct immunofluorescent studies were made on palpebral skin tissue and confirmed DLE diagnosis. Antinuclear antibody (ANA) titer was 1/160 with speckled pattern. She was treated by oral hydroxychloroquine (400 mg daily) with moderate improvement after three months. We should think about DLE in cases with chronic upper eye lid edema and erythema. The aim of this case report is to emphasize that ophthalmologist and dermatologists should be aware of different presentations of DLE in the periorbital area to prevent misdiagnosis.

Primary intracranial leiomyosarcomas are rare tumors that arise from the mesenchymal cells of the dura mater or cerebral blood vessels Here we report the case of an extra axial leiomyosarcoma in the right parieto-occipital region of a 19-year-old male who had normal clinical and laboratory findings. Diagnostic imaging showed bony destruction, dural involvement and no parenchymal invasion. No primary site was found after metastasis work up. Specific serology tests were negative. The patient underwent a craniotomy, total tumor resection, duraplasty and skull reconstruction. He received radiotherapy and after 18 months of follow-up, no clinical and radiological signs of recurrence have been found.

There are conflicting reports about the effect of wiping cervix with cotton on Pap-smear results. Therefore, we aimed to do a research about this subject. 234 eligible women attended to have Pap-smear at an educational hospital in Rasht, Iran, from July to September 2011, were allocated by block randomization into two groups. In the intervention group, we cleaned cervix with a sterile cotton rotating 360 degrees and obtained samples using spatula for exocervix and cytobrush for endocervix. This method was performed without cleaning the cervix on the control group. Data collection, vulvovaginal examination, laboratory assay were done by investigators masked to the group allocation. Participants were also blind. The data were analyzed using logistic regression in SPSS-13. Rate of sufficient endocervical cell of the slides in the intervention group was significantly higher than in the control group (70.3% vs. 57.8%, p=0.03). In the intervention group 42.4% of the slides were satisfactory and 57.6% had limited quality for interpretation. These figures in the control group were 37.1% and 62.9%, respectively. This difference was not statistically significant. Also, there was no significant difference between the groups on rate of slides with inadequacy of squamous cells and obscuring 75% or more of the slides with inflammatory exudate or blood (p>0.05). There were no significant differences between the groups on some quality indicators of the smears. However, frequency of smears with sufficient endocervical cells was higher in the group with cervical wipping. Therefore, it is recommended to clean cervix before obtaining the smears.

Measurement of serum enzymes levels, such as lactate dehydrogenaze (LDH) and its isoenzymes is a routine way for diagnosis of myocardial infarction. One of these isoenzymes is LDH-1 which is raised after myocardial infarction. The purpose of this study was to evaluate total-LDH / heat resistant- LDH ratio in patients with acute myocardial infarction and unstable pectoral angina. In an descriptive analitical study 220 patients with suspected myocardial infarction (MI) or unstable pectoral angina (UA), hospitalized in CCU ward of Ekbatan Hospital in Hamedan city were studied. Using WHOs criteria, 110 were classified as having myocardial infarction and 110 as having unstable pectoral angina. The serum level of total-LDH and heat resistant- LDH was measured by NADH exchange method, 24 to 48 hours after their admission to the hospital. Data were analyzed by student-t test and Mann-Witheny test. Our study showed that total-LDH / heat resistant- LDH ratio in MI patients was 1.27±0.18 and it was 2.51±1.39 in UA patients (P<0.001). In our study, we found that when total LDH/ heat resistant- LDH ratio is decreased the severity of myocardial infarction (number of involved leads) and creatine phosphokinase (CPK) is increased (P<0.01). We did not find any relationship between total LDH/ heat resistant- LDH ratio with sex, age, type of MI (Q-wave & Non Q-wave), block after MI and arrhythmia following MI. Our results revealed that measuring heat resistant- LDH can be used as a method for accurate diagnosis of MI. This simple method can be used in centers where other accurate tests are not available.

Cervical thymic cyst is not a common pathology encountered in either an adult or a child. Our case presentation is of an infant girl with a right cervical soft mass. It was totally resected and histological analysis revealed a thymic cyst. The diagnosis of thymic cyst is not possible prior to histological examination. Therefore, in children the disorder should be considered as a differential diagnosis of each cervical soft tissue mass and evaluation of mediastinum should be done for the presence of thymic tissue.