فهرست مطالب mood

Acute viral respiratory diseases are among the most prevalent diseases in humans. Viral respiratory infections are the main reasons for hospitalization and death in developing countries. The aim of this study is to determine the prevalence and clinical symptoms of the respiratory viruses including influenza viruses A and B, respiratory syncytial virus type A and B (RSV-A and RSV-B), human parainfluenza virus type 1 to 4 (HPIV-1-4) among patients with Influenza-like illness (ILI) in Zahedan City, Southeastern Iran from October 2015 to March 2016. Clinical and epidemiological data from patients who presented to outpatient clinics with ILI from October 2015 to March 2016 in Zahedan were collected. A total of 240 throat swabs were tested for Influenza virus by RT-PCR, and then those with negative results were tested for RSV-A, RSV-B, and HPIV type 1 - 4 using Multiplex-PCR. Among 240 patients, 115 (47.9%) were male and 125 (52.1%) were female. Influenza A virus was detected in 196 (81.7%) patients, out of them 157 (65.4%) had H1N1 subtype and the remaining patients had H3N2 subtype. Influenza B virus was observed in 9 (3.8%) patients. Respiratory syncytial virus type A and B, and human parainfluenza virus type 1 to 4 were not detected in this study. The highest rate of influenza A infection was in the age range of 16 - 45 years old and for influenza B was in the age group of more than 46 years. The most common clinical manifestations in both influenzas A and B were fever, cough, and myalgia. Over half of the patients with influenza B had dyspnea compared to 30% of ILI patients with influenza A virus infection. The results of the study revealed the highest rate of Influenza A infection with H1N1 subtype among patients presented to the outpatient clinics with the clinical manifestations of influenza-like illness. This study suggests continuing surveillance, infection control, and annual vaccination for Influenza.

Acid-base disturbances are common in critically ill patients, and contribute to morbidity and mortality. We evaluated the prevalence of acid-base disturbances in cases with acute poisoning admitted to intensive care unit (ICU). In this cross-sectional study, patients with acute poisoning hospitalized in ICU of a university hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran, from March 2016 to December 2017 were included. The acid-base status of the patients on admission time in emergency room, and its association with demographic factors, as well as clinical manifestations and outcome was recorded. Outcome was defined as survived without complication and complication/death. The majority of patients had acid-base disorder (89.7%). Most patients had metabolic acidosis (31.3%) on admission time, and most of them were men (71.6%) (P = 0.01). 48 patients (22.4%) were alert, of whom, 93.8% had an acid-base disorder. 60 patients (28.03%) were admitted with stupor and coma, of whom, 89.1% had acid-base disorder. There was a significant relationship between acid-base state with gender and level of consciousness at the time of admission (P < 0.05). There was also a significant correlation between treatment outcome with age, toxic agents, and abnormal electrocardiography (ECG). Among different evaluated variables, age was the determinant factor in outcome prediction (P = 0.01; odds ratio (OR) = 1.02; 95% confidence interval (CI) = 1.004-1.04). Acid-base disorders are common in patients with acute poisoning. The level of consciousness on admission and gender are important associated factors. The status of acid-base on the admission is not the only factor affecting outcomes and prognosis, and should be assessed along with other factors.

In view of the high prevalence of poisoning with antipsychotics, antidepressants, and benzodiazepines, the aim of this study was to compare the cardiovascular complications of poisoning with antipsychotic and antidepressant drugs with or without benzodiazepines. In this case-control study, 120 patients poisoned with psychiatric drugs were divided into two groups of case (with benzodiazepine) and control (without benzodiazepine). Demographic and clinical features as well as cardiac complications of patients were extracted from their files at the time of admission to the emergency department, and then the data were analyzed. There was no significant difference between the groups in terms of demographic information, poisoning way, drug type, duration of hospitalization, pupil size, hemodynamic data, electrocardiography findings, and outcomes (P > 0.05). Poisoning with antidepressants and antipsychotics, when combined with benzodiazepines, led to a decreased level of consciousness than those who did not take benzodiazepine. Meanwhile, hemodynamic symptoms, changes in electrocardiography, vital signs, nervous system status, and even the outcome of patients in the benzodiazepine group were not significantly different from those who did not take this drug.

Paraquat (PQ) poisoning is a serious public health problem in many countries. In spite of different treatments, the
mortality is still high. We performed a meta‑analysis to see whether hemoperfusion (HP) in combination with other treatments reduces the mortality more than HP alone in patients with PQ poisoning. We searched EMBASE, PubMed, Google Scholar, ISI Web of Knowledge, Cochrane Central Register of Controlled Trials, Scopus, Springer, TRIP, ProQuest, and references of the included studies from January 2000 to August 2017. Two reviewers independently searched and extracted data. We measured I2 to determine variance contributed by heterogeneity. To investigate the publication bias, Begg’s and Egger’s tests were used along with funnel plot analysis. Ultimately 12 articles were included in the meta‑analysis. Five articles compared HP with conventional therapy with a total of 1311 patients, and seven articles compared mortality of patients received HP versus those received HP in combination with an additional treatment. HP alone reduced the odds of death (odds ratio [OR] = 0.20; 95% confidence interval [CI]: 0.11–0.40, P < 0.0001) compared to conventional therapy. Furthermore, the odds of death was higher in HP group compared to those received HP in combination of additional treatments (OR = 1.24; 95% CI: 1.05–1.46, P = 0.01). The mortality was less in HP‑treated group compared to those received only conventional therapy. Addition of other treatments with HP reduced the mortality more than HP alone.

Paraquat (PQ) poisoning is a serious public health problem in many countries. In spite of different treatments, the mortality is still high. We performed a meta‑analysis to see whether hemoperfusion (HP) in combination with other treatments reduces the mortality more than HP alone in patients with PQ poisoning. We searched EMBASE, PubMed, Google Scholar, ISI Web of Knowledge, Cochrane Central Register of Controlled Trials, Scopus, Springer, TRIP, ProQuest, and references of the included studies from January 2000 to August 2017. Two reviewers independently searched and extracted data. We measured I2 to determine variance contributed by heterogeneity. To investigate the publication bias, Begg’s and Egger’s tests were used along with funnel plot analysis. Ultimately 12 articles were included in the meta‑analysis. Five articles compared HP with conventional therapy with a total of 1311 patients, and seven articles compared mortality of patients received HP versus those received HP in combination with an additional treatment. HP alone reduced the odds of death (odds ratio [OR] = 0.20; 95% confidence interval [CI]: 0.11–0.40, P < 0.0001) compared to conventional therapy. Furthermore, the odds of death was higher in HP group compared to those received HP in combination of additional treatments (OR = 1.24; 95% CI: 1.05–1.46, P = 0.01). The mortality was less in HP‑treated group compared to those received only conventional therapy. Addition of other treatments with HP reduced the mortality more than HP alone.

For many years, medicinal plants and herbal therapy have been widely used in di?erent societies for the treatment of various diseases. Besides their therapeutic potency, some of the medicinal plants have strong toxicity in human, especially in children and elderly. Despite common beliefs that natural products are safe, there have been few reports on their toxicities. In the present study, we aimed to systematically review the literature wherein acute plant poisoning and herbal intoxication have been reported in pediatric patients. After literature search and selection of the appropriate documents, the desired data were extracted and described qualitatively. A total of 127 articles with overall 1453 intoxicated cases were collected. Te results of this study showed that some medicinal plants can cause acute poisoning and complications such as hepatic and renal failure in children. Te fndings of this survey showed that acute plant poisoning can be life?threatening in children, and since a single?ingested dose of toxic plants can cause acute poisoning, parents should be aware of these toxic e?ects and compare the side e?ects of self?medication with its potential benefts.

Midazolam is commonly and safely used in poisoning management and intensive care for the control of the agitated poisoned patients. Despite the introduction of newer and safer antidepressants, tricyclic antidepressants (TCA) are still prescribed and used in many countries due to their cost-effectiveness. Severe morbidity and mortality associated with these drugs arises largely from their well-documented cardiovascular toxicity. In this study we aimed to investigate the probable effect of midazolam on some hemodynamic indices in TCA poisoned patients.
In this clinical study we have evaluated some cardiovascular and hemodynamic indices of 100 TCA poisoned patients whom were randomly allocated for receiving midazolam with a first loading dose of 0.1 mg / kg (2 mg /min.) followed by a 6-hours maintenance infusion of 0.1 mg /kg /h of the drug in dextrose-saline (3.33% of dextrose and 0.33% of NaCl) or placebo (dextrose-saline infusion without midazolam). Pulse rate, systolic/diastolic blood pressure, respiratory rate, neurologic status and the outcome of therapy were recorded at the time of admission and hourly for the next 6 hours.
There was a statistically significant reduction in the heart rate of the midazolam treated group after the first hour of hospital admission. There were no significant differences in the respiratory rate, central nervous system manifestations and other indices between the two groups.
Midazolam may reduce tachycardia (and its fatal consequences) in the first hour of admission in TCA poisoned patients.

Poisoning is a common cause of seizure in an emergency department. Type of the seizure can be isolated, recurrent or as status epilepticus. Since accessing to different poisons and drugs is various among people of different societies and because of seizure complications, we investigated the prevalence of different type of seizures in poisoned cases.
In a cross-sectional descriptive and analytic study, all cases with poisoning due to drugs or poisons admitted in Noor Hospital, Isfahan, Iran, during May 2014 till October 2016 were enrolled and those with seizure were evaluated regarding different variables including type of seizure and outcomes. Data were recorded in a check list and analysis using SPSS software.
Findings: From 2319 evaluated patients, 137 cases were recorded to have seizures (101 cases of isolated type and 35 cases of recurrent or status epilepticus types). 123 patients committed suicide. Most of the cases were in age of 20-29 years. The seizure was common more in men. The most common drug in isolated seizure type was tramadol (61.4%), combination of different drugs (8.0%) and anti-convulsants (7.9%); and in recurrent and status epilepticus type, tramadol (37.1%), combination of different drugs (28.6) and anti-depressant and stimulants (8.6% each one) were the most used drugs, respectively.
Isolated seizure was the most prevalent type of seizure in cases with poisoning. Most of the observed seizures were in men, age of 20-29 years, and by tramadol tablets.

Studies show that nearly 40 million people are living with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) around the world and since the beginning of the epidemic, about 35 million have died from AIDS. Heterosexual intercourse is the most common route for transmission of HIV infection (85%). People with a sexually transmitted infection (STI), such as syphilis, genital herpes, chancroid, or bacterial vaginosis, are more likely to obtain HIV infection during sex. On the other hand, a patient with HIV can acquire other infections such as hepatitis C virus (HCV) and hepatitis B virus (HBV) and also STIs. Co-infections and co-morbidities can affect the treatment route of patients with HIV/AIDs. Sometimes, physicians should treat these infections before treating the HIV infection. Therefore, it is important to identify co-infection or comorbidity in patients with HIV/AIDS..
This study was conducted in order to understand the prevalence of HIV/AIDS/STI co-infection..
Patients and In this cross-sectional study, we evaluated all HIV/AIDS patients who were admitted to the infectious wards of Boo-Ali hospital (Southeastern Iran) between March 2000 and January 2015. All HIV/AIDS patients were studied for sexually transmitted infections (STI) such as syphilis, gonorrhea, hepatitis B virus (HBV) and genital herpes. A questionnaire including data on age, sex, job, history of vaccination against HBV, hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), hepatitis B surface antigen (anti-HBs), HCV-Ab, venereal disease research laboratory (VDRL) test, fluorescent treponemal antibody absorption (FTA-Abs) test, and urine culture was designed. Data was analyzed by the Chi square test and P values of Among the 41 patients with HIV/AIDS (11 females and 30 males; with age range of 18 to 69 years) five cases (12.1%) had a positive test (1:8 or more) for VDRL. The FTA-Abs was positive for all patients who were positive for VDRL. Gonorrhea was found in seven patients (17%) and three cases had genital herpes in clinical examinations. All patients who had positive test results for these STIs were male. Eleven patients (26.8%) had HBV infection (three females and eight males). hepatitis C virus (HCV) was found in 13 cases (31%). Eighty percent of patients were unemployed. Seventy-eight percent of patients with HIV/STI were aged between 18 and 38 years. There was a significant difference between sex and becoming infected with HIV and also STI (P Patients with HIV/AIDS are more likely to acquire other STIs, because the same behaviors that increase the risk of becoming HIV infected can also increase the risk of acquiring STIs. Having a sore on the skin due to an STI can make the transmission of HIV to the sex partner more likely than people who don’t have such sore in their genital area..

Osteochondritis is a joint condition in which bone underneath the cartilage of a joint destroys due to lack of blood flow. Then bone and cartilage can break, causing pain and sometimes affecting joint motion and skin around the involved joint might be swollen and tender. Osteochondritis occurs most commonly in the knee, but also occurs in elbows, ankles and other joints. Decreased blood flow to the end of the affected bone due to trauma is the main cause, but there might be a genetic component, making some persons more susceptible to get this disorder. Some infections such as brucellosis can lead to osteochondritis. Bone and joint complications are common in brucellosis, but osteochondritis of sternoclavicular joint is a rare presentation..
Here, we presented a 34-year-old woman referred to our hospital for fever, chills and arthralgia in the sternoclavicular joint, which has been started two months before admission. Finally, with more evaluations, we found that she had sternoclavicular osteochondritis due to brucellosis..
Although, brucellosis can cause arthritis more in knee, elbow and hip and causes spondylodiscitis, osteochondritis of sternoclavicular joint is very rare in brucella infection..

Air pollution is a major concern of new civilized world, which has a serious toxicological impact on human health and the environment. It has a number of different emission sources, but motor vehicles and industrial processes contribute the major part of air pollution. According to the World Health Organization, six major air pollutants include particle pollution, ground‑level ozone, carbon monoxide, sulfur oxides, nitrogen oxides, and lead. Long and short term exposure to air suspended toxicants has a different toxicological impact on human including respiratory and cardiovascular diseases, neuropsychiatric complications, the eyes irritation, skin diseases, and long‑term chronic diseases such as cancer. Several reports have revealed the direct association between exposure to the poor air quality and increasing rate of morbidity and mortality mostly due to cardiovascular and respiratory diseases. Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer, ventricular hypertrophy, Alzheimer’s and Parkinson’s diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight. In this review article, we aimed to discuss toxicology of major air pollutants, sources of emission, and their impact on human health. We have also proposed practical measures to reduce air pollution in Iran.

Methadone toxicity is rising not only in those who are under maintenance methadone therapy (MMT) treatment but also in those who face accidentally to drugs, which result in increased morbidity and mortality. Naloxone is used for the treatment of methadone poisoning. The aim of this study was to evaluate the effect of oral naltrexone on treatment of unintentional methadone poisoning.
The study was a prospective clinical trial, included 64 patients with clinical signs of methadone intoxication who were referred to Noor and Ali-Asghar Hospital Poison Center between October 2013 and October 2014 in Isfahan, Iran. Patients were randomly divided into two groups: intervention and control. Both groups received naloxone 0.4 mg IV due to loss of consciousness with or without respiratory depression however the intervention group also received naltrexone 25 mg capsule after awaking. The vital signs in both groups were studied during hospitalization. The variables were compared using t test, ANOVA, chi-square and Mann-Whitney tests.
Findings: The mean ± SD age of patients in the group receiving naltrexone was 29.58 ± 9.21 years and in control group was 30.33 ± 9.25 years. Heart rate four hours after taking naloxone in the group receiving naltrexone and control group was 81.37 ± 5.93 and 86.71 ± 4.92, respectively (P = 0.032). By eliminating time as confounding factor, respiratory rate was significantly different between the two groups, that in the control group was lower than intervention (P = 0.005). All patients survived without complications.
This study showed that patients receiving naltrexone due to methadone poisoning had less respiratory depression and tachycardia.

Intentional poisoning in pregnant women is not common in our society. In this paper, we report a case of pesticide poisoning in a pregnant woman.
Case Report: A 36-year-old housewife with 24 weeks pregnancy following ingestion of pesticide presented with low level of consciousness, tachycardia, and vomiting and was diagnosed as insecticide poisoning. 20 minutes after the arrival generalized tonic-colnic seizure and cyanosis was occurred. She recovered with supportive cares. Because of abdominal pain and vaginal bleeding she was referred to the gynecology department. The mother was discharged with good general condition, and due to suicide attempt underwent psychiatric consultation. However premature infant died after 25 days living in the incubator.
Pesticides poisoning, especially in a suicide attempt can be dangerous for mother and fetus.

Dear editor,
We read the recent article of Rahmani et al entitled "Medical Management and Outcome of Paraquat Poisoning in Ahvaz, Iran: A Hospital-Based Study" in your journal (1). In their study they performed upper gastrointestinal (GI) endoscopy as a routine for all paraquat poisoned patients, because they considered paraquat a caustic agent and that it may cause severe mucosal injuries in esophagus. This approach seems rather excessive, as Yen et al established that paraquat is a mild caustic agent and produces only grades 1, 2a, and 2b esophageal injury that can be managed with supportive measures (2). In addition, Chen et al ascertained the same implication showing in their study that paraquat is only a weak caustic agent (3). In our experience (4), low rate of GI injury occurs in paraquat poisoning, and moreover, GI tract complications alone do not have any impact on patients’ survival (4).
Taking these facts together, because paraquat poisoning is common in some regions and upper GI endoscopy is an anecdotal routine in some hospitals for this type of poisoning, in our opinion the following comments are better to be considered in day to day practice and for future studies: 1- The relationship between clinical signs and symptoms of mucosal injury (vomiting, odynophagia, dysphagia, retrosternal pain, etc.) with the degree of injury in GI endoscopy in paraquat poisoning has not been determined yet.
2- The association of paraquat serum level with the level of mucosal injury (determined by endoscopy) has not been established in paraquat poisoned patients.
3- As paraquat poisoning may cause severe liver dysfunction and coagulopathy, for performing endoscopy, the optimal time should be considered. In this case, invasive measures may just worsen the patient's condition by exposing them at the risk of uncontrollable bleeding.
4- Comparing the specificity and sensitivity of chest esophageal CT scan (as a possible substitute for GI endoscopy) and GI endoscopy (as a gold standard method) for evaluation of esophageal injury seems to be beneficial.
5- Finally, in order to determine the severity of paraquat poisoning and better define prognosis, severity index of paraquat poisoning (SIPP) is a widely used tool (5). Performing GI endoscopy for patients with SIPP scores less than 10, which are indicative of better prognosis, can be taken into account for follow up purpose (5).

The current study was conducted to compare ELISA with thin layer chromatography (TLC) methods for diagnosis of morphine in the urine.
Positive urine samples for morphine confirmed by immunochromatographic strips were collected from the Imam Reza Toxicology Laboratory, Mashhad University of Medical Sciences, Mashhad, Iran in 2012 for the current study. Then, the collated urine samples (70) were analyzed by both ELISA and TLC methods.
On analyzing samples by TLC, 57 out of 70 (81.4%) revealed morphine spot, whereas by ELISA method all samples were positive. The difference was statisticaly significant (P=0.0001). Both immunoassays had the same 100% positive results. The possible 18.6% false positive results might be due to drug interactions. TLC is more specific but time-consuming and less sensitive than ELISA is. However, TLC is an old method but more reliable than ELISA.
Contrary to the claim that commercially available ELISA kits have a high specificity for detection of morphine derivatives; it seems that false positive results may occur. It is thus recommended that all positive results obtained from ELISA be checked by a cheap widely available confirmation test of TLC or ideally by a quantitative technique such as GC-Mass spectroscopy, particularly for legal purposes.

Tattoos are associated with blood-borne infections that result from viruses such as the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the human immunodeficiency virus (HIV). This association is equally evident among people without major risk factors and among those with major risk factors like injected drug users (IDUs)..
In this study we evaluated all tattooed patients admitted to our hospital (the Boo-Ali hospital in southeastern Iran) between February 2006 to January 2015..
Patients and The patients enrolled in our study were admitted to infectious disease wards for different illnesses (e. g., Pneumonia, Sepsis, Tuberculosis, etc.).We only studied the patients who agreed to be included in our study. When we found at least one tattooed area, regardless of its size, we took a blood sample and tested it for the presence of HIV, HBV, and HCV..
Among the 63 patients with tattoos (21% female, 79% male, age range:16 to 79-years-old), four patients (6.3%) tested positive for HBsAg and PCR-HBV, seven patients (11%) tested positive for HCV, and five (7.9%) tested positive for HIV. The last group consisted in IDUs and all five had several tattooed areas on their bodies..
Upon our results, tattooed people even with a small size of tattoo on the body are more at risk for HCV, HBV, and HIV infection..

Determining the depth of anesthesia or loss of consciousness in poisoned patients admitted to hospitals is one of the most important issues in determining the necessity to tracheal intubation. This study aimed to investigate the relationship between the scores of Bispectral index (BIS) and Glasgow coma scale (GCS) in poisoned patients with loss of consciousness requiring tracheal intubation. 24 poisoned patients referred to Noor Hospital in Isfahan, Iran were enrolled. The level of consciousness was recorded using the GCS and BIS in two times, one at the beginning and the other at the time of tracheal intubation. Finally, the data were analyzed using independent-t and Pearson's correlation and regression analysis tests via SPSS software. There was a significant correlation between the BIS and GCS scores at admission that as BIS increased in patients, the GCS score increased, too (P = 0.050). In addition, a significant relationship was found between the BIS scores at the admission and during tracheal intubation (P = 0.001). As in our study, the hemodynamic changes was very low and the BIS changes was lower than the GCS, we can understand that BIS is more indicative in showing hemodynamic changes and complications associated with tracheal intubation.

A 41-year-old man was referred with a complaint of visual loss in his left eye and his best corrected visual acuity was 20/80. Slit lamp examination showed arborizing conjunctival vessels and dry eye. Fundus examination and fluorescein angiography revealed a non-ischemic central retinal vein occlusion. Cardiovascular, rheumatologic, and hematologic work up showed no abnormal findings. An ascertained history of exposure to sulfur mustard during the Iran-Iraq war was documented in his medical history. Four sessions of intravitreal bevacizumab injections were done as needed. After two-year follow-up, visual acuity in his left eye improved to 20/25 and macular edema was resolved without any need for further interventions. We conclude that sulfur mustard gas exposure may be considered as a predisposing factor for central retinal vein occlusion, as was found in our patient (an Iranian war veteran) by excluding all yet known etiologies and predisposing factors.

Generally, a moment that sediment particles start moving in stream is called incipient motion. A lot of research has been recently done to determine the conditions of incipient motion velocity of uniform and non-cohesive sediment in open channels and many Relationships or graphs are presented. But studies on non-cohesive and non uniform sediments are very little. With regard to the channel sediments are mostly non-uniform, Determination of the flow rate for prevent of sediment deposition can be an effective role in increasing of transmission efficiency and which reduced costs.
In this study, incipient motion of non-cohesive and non-uniform sediment was investigated by Laboratory modeling and dimensional analysis. In this study 9 non-cohesive and non-uniform sediment has been tested with different dimensions and uniformity coefficient in 0.0005, 0.001 and 0.002 slopes.
Results showed that increasing channel slopes from 0.0005 to 0.002 for sediments with different size, stability parameter on average decreases 45 percent. Also increasing particle size parameter from 0.12 to 0.35 for different slope, stability parameter on average decreases 15 percent. Results showed that with increasing uniformity coefficient from 4.5 to 7.5 for different size of sediment and channel slope, stability parameter on average increases 6 percent.
With increasing the slope and particle size parameters, decrease stability parameter and stability parameter, will increase with increasing uniformity coefficient.

Distinction of hydatidiform moles (HMs) from non-molar abortions and sub-classification of HMs are important for clinical practice; yet, diagnosis based solely on morphology is affected by interobserver variability. The objective of this study was to determine the role of DNA flow cytometry in distinguishing molar from non-molar pregnancies. This retrospective study was conducted at the Department of Pathology, Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran, between 2006 and 2010. DNA ploidy analysis and histopathologic re-evaluation were performed on paraffin-embedded tissue from 36 (17 complete and 19 partial) molar and 24 hydropic abortus (HA) cases which were previously diagnosed based on histomorphologic study. Of the 17 cases initially diagnosed as complete HM (CHM), 9 were diploid, 2 were triploid, 5 were tetraploid and 1 was aneuploid. Of the 19 initial partial HMs (PHMs), 2, 8, 1 and 8 cases were diploid, triploid, tetraploid and aneuploid, respectively. In the initial HA category (n=24), 14 diploid, 1 triploid, 5 tetraploid, and 4 aneuploid cases existed. Following flow cytometry and histopathologic reevaluation, 1 case with previous diagnosis of HA was reclassified as PHM, 2 initial PHMs were reclassified as CHM and 2 initial CHMs were categorized as PHM. The results show that correct diagnosis of PMH is the main challenge in histological diagnosis of gestational trophoblastic disease (GTD). DNA flow cytometric analysis could be an informative supplement to the histological interpretation of molar and hydropic placentas.

Th e coexistence primary cancers of the endometrium and ovary are relatively uncommon. Th e purpose of this study was to characterize patients diagnosed primary synchronous endometrial and ovarian cancer (SEOC), endometrial cancer (EC) with ovarian metastasis, and ovarian cancer (OC) with endometrial metastasis and compare clinicopathologic variables and prognosis. All the patients with diagnosis of both endometrium and OC, who hospitalized between 2002 and 2012 in an academic center affi liated to Tehran University of Medical Sciences, were evaluated with respect to diff erent clinicopathologic variables, follow-up times, and outcomes. Fifty-fi ve patients had been diagnosed with both endometrium and OC. 17, 26, and 12 patients were diagnosed as SEOC, EC, and OC, respectively. Th e frequency of abnormal uterine bleeding was signifi cantly lower in OC (16.7%) compared to others (58.8% in SEOC and 53.8% in EC). However, the abdominal/pelvic pain was signifi cantly higher in OC (50%) compared to others (35.3% in SEOC and 34.6% in EC) (P < 0.05). Complex atypical hyperplasia (87.5%), endometriosis (88.8%), and endometrioid carcinoma (54.5%) was observed most in SEOC group. Th e duration of follow-up time was between 3 and 171 months with a mean of 16 months. Th ere was no death in SEOC who followed. Survivals of patients between three group were statistically signifi cant (P = 0.032). Our results showed that overall survival (OS) and progression-free survival (PFS) of SEOC patients is better than those with EC and OC (P = 0.032).