Extreme ßHCG levels in first trimester screening are risk factors for adverse maternal and fetal outcomes.

Multiples of the normal median (MoM) of free ßHCG is a valuable parameter in evaluation of risk of adverse pregnancy outcomes. In the current retrospective study, we assessed the maternal and fetal outcomes in pregnant women having free ßHCG MoM levels < 0.2 or > 5 in their first trimester screening (FTS). Relative risk of trisomy 21 was significantly higher in patients having free ßHCG MoM > 5. On the other hand, relative risk of trisomies 13 and 18 and Turner syndrome were higher in those having free ßHCG MoM < 0.2. Other chromosomal abnormalities were nearly equally detected between those having free ßHCG MoM < 0.2 or > 5. Relative risk of hydrocephaly and hydrops fetalis was higher when free ßHCG MoM was below 0.2. On the other hand, relative risk of low birth weight was higher when free ßHCG MoM was above 5. Moreover, frequency of gestational diabetes mellitus, preeclampsia, preterm delivery and vaginal bleeding increased with levels of free ßHCG MoM. However, polyhydramnios had the opposite trend. Frequencies of premature rupture of membranes and pregnancy induced hypertension were highest among pregnant women having levels of free ßHCG MoM < 0.2. The current study indicates importance of free ßHCG MoM in identification of at-risk pregnancies in terms of both fetal and maternal outcomes. In fact, ßHCG MoM < 0.2 or > 5 can be regarded as risk factors for adverse maternal or fetal outcomes irrespective of the presence of other abnormalities in the FTS results.

The frequency of latent prostate carcinoma in autopsies of over 50 years old males, the Iranian experience.

BACKGROUND: Latent adenocarcinoma of prostate refers to cases who present no obvious sign or symptom during their life spans and the tumor is incidentally found at postmortem examination. Its frequency can be very important in epidemiologic investigations, prevention and treatment. No previous study has been done in this regard in Iran and the studies performed in other countries show various results. The aim of present study is to determine the frequency of latent prostate carcinoma by studying the corpora of men above 50 years old referred to forensic medicine organization in Tehran in 2008 and 2009. METHODS: In this study, 149 men aged above 50 who had died of different reasons and undergone autopsy were examined. Their prostates were excised and the slides were studied for the presence of adenocarcioma and prostatic intraepithelial neoplasia (PIN). In each case, age, weight of prostate, location of lesion, and grading according to Gleason's system were determined and the results were analyzed by SPSS software (version 16). RESULTS: Out of 149 cases, 34(22.8%) had low grade PIN, 26(17.4%) high grade PIN, and 14(9.4%) invasive adenocarcinoma. Most of the tumors were located in posterior lobe of prostate and they were more frequent in older cases (>65 years of age) and heavier prostates (p value <0.05). All invasive adenocarciomas were accompanied by PIN. CONCLUSION: Worldwide studies show lower prevalence of latent carcinoma of prostate in Asian men than white European ones. Considering the absence of such studies in Iran, a larger study to compare and find out the precise rate of this kind of carcinoma, is recommended.

Prevalence of human papillomavirus infection among Iranian women using COBAS HPV DNA testing.

BACKGROUND: Persistent infection with High Risk Human Papillomavirus (HR HPV) typesplaysamajor role in the development of cervical cancer. Therefore, the detection of HR HPV types is an essential part of cervical cancer screening. The aim of this study was to estimate the prevalence of HR HPV infection among healthy women undergoing routine cervical cancer screening in Iran. METHODS: In this cross-sectional study,the results of HPV DNA typing in 2453 normal Iranian womenwhowere referred for routine cervical cancer screening from September 2015 to March 2017 were analyzed. Participants were screened using COBAS assay for HPV DNA typing and liquid based cytology. RESULTS: A total of 2453 healthy sexually active women were included in this study. The mean age was 35.1 ± 8.08 years. The overall prevalence of HR HPV infection was 10.3%. HPV16 was found in 73 (3%) women. The prevalence of HPV18 and other HR HPV typeswere 16(0.7%) and166 (8.2%),respectively. Approximately, 5% of the study population had an abnormal cervical cytology (ASCUS or worse), of whom 34% were infected by HR HPV. CONCLUSION: The prevalence of HR HPV infection among Iranian women has increased in the recent years which indicates the need for public education and health planning toprevent this cancer through vaccination and early diagnosis using screening tests.HPV DNA typing, diagnosisand the distribution of prevalent genotypes should be considered in the development of comprehensive cervical cancer prevention programs in Iran.

Sudden Death Due to Association between NAFLD and Cardiovascular Changes in a 37-Year-Old Man: a Case Report.

Fatty liver disease (FLD) is the most prevalent form of liver disease worldwide. Overnutrition can induce nonalcoholic fatty liver disease (NAFLD), a spectrum of conditions ranging from simple steatosis [or nonalcoholic fatty liver (NAFL)] to nonalcoholic steatohepatitis and cirrhosis. Some of the epidemiological and pathological studies have also suggested an association between the presence of fatty liver and sudden death. A 37-year-old man was found dead when he was asleep in the bed at home. According to his family, he was single and a costermonger. He was not an athlete, and there was no history of any physical and mental disorder. He was not addicted and did not use any drugs or alcohol. The positive points, in this case, were: a large heart with mild coronary stenosis and steatohepatitis in autopsy and sudden death. Since steatohepatitis did not have any complication such as fat embolism, it can be concluded that the combination of steatohepatitis and cardiovascular disorder led to sudden unexpected death. Heart more than 450 gr is susceptible to arrhythmia, and fatty liver disease can cause cardiovascular changes.