Prevalence of renal lesions in slaughtered cattle in Shiraz, Iran, and detection of Leptospira in them by nested PCR-RFLP.

Renal diseases in cattle are frequently not recognized due to the subclinical conditions. Some species of Leptospira are the main cause of infectious agents that damage the kidneys and lead to abortion and economic losses in cattle and are also of major concern in the public health. This study was aimed to assess the prevalence of renal lesions of slaughtered cattle in the Shiraz abattoir and to determine the correlation between rejected kidneys and infection with Leptospira using nested PCR-restriction fragment length polymorphism (RFLP) techniques. Out of 1000 inspected animals, 205 (20.5 %) revealed the renal lesions. Chronic nephritis (7.5 %), white-spotted kidney (7.3 %), and petechial hemorrhage (3.5 %) were the most prevalent forms of the lesions. A direct correlation between increasing the age and significant increase in the rate of lesions was also observed (P = 0.03). Using nested PCR-RFLP assay, 40.8 % of the tested kidneys were turned to be infected to the pathogenic species of Leptospira. The risk of infection of the kidneys with white spot to pathogenic species of Leptospira (53.8 %) was more than that of the kidneys with other lesions (25.0 %) (P = 0.014). The odd ratio indicates that the kidneys with white spot lesions are likely to be infected with pathogenic species of Leptospira, five times greater than other lesions. This study showed that renal lesions especially white-spotted kidney, which were considerably associated with Leptospira in slaughtered cattle in Shiraz, were very high. This is important in terms of public health and in particular, increases the risk of transmission of disease to human specially in the high-risk careers including farmers, veterinarians, and abattoir workers.

Circumscribed Palmar Hypokeratosis With Superimposed Actinic Keratosis.

A man in his late 70s with a history of psoriasis and non-melanoma skin cancer presented with a progressive rash on his right thenar eminence. He first noticed it about one year ago. He denied any pruritus in the affected region but did note some overlying skin breakdown. He had used topical betamethasone and calcipotriene cream in the past with minimal improvement. Physical examination revealed a pink atrophic plaque with linear hyperkeratotic borders and central fissuring on the right thenar eminence extending into the first webspace. A shave biopsy revealed hypokeratosis with a rim of surrounding hyperkeratosis and associated parakeratosis, basal keratinocyte atypia, and lichenoid inflammation. These histopathological features were consistent with circumscribed palmar hypokeratosis and central actinic keratosis. Circumscribed palmar hypokeratosis is often considered a benign entity, but there have been reports suggesting an association with premalignancy. The decision was made to treat with 5-fluorouracil and calcipotriene cream twice daily for six weeks. At his two-month follow-up, he endorsed a robust reaction, which was further suggestive of premalignant change. He had a near-complete resolution of the rash. This case features circumscribed palmar hypokeratosis and suggests a novel treatment option for patients who develop concomitant actinic keratosis.

Assessment of Otolaryngology Residency Training Program in Iran: Perspectives of Faculty Members and Recently Graduated Medical Students.

INTRODUCTION: There is limited evidence regarding the quality of otolaryngology residency programs in Iran. Regarding this, the present study aimed to assess some aspects of otolaryngology residency program in the field of otology in Iran based on the perspectives of faculty members and graduates. MATERIALS AND METHODS: This study was conducted on 105 recent graduates and 30 faculty members and/or program directors in otolaryngology using two self-administered questionnaires. RESULTS: While the faculty members believed that a resident should work on at least 5.4 temporal bone surgeries on average, the actual number was 2.49. Tympanoplasty was assigned the highest rate of satisfaction by the recent graduates, whereas the lowest score belonged to middle ear exploration, ossiculoplasty, and stapes surgery. Only 53.6% of the graduates stated that there was an organized training curriculum in temporal laboratory. The recent graduates reported to have more frequent experiences of performing usual otology operations. However, they had fewer experiences of performing more advanced surgeries. The recently graduated subjects had a significantly low level of satisfaction with their competencies in carrying out more complex types of otology surgeries. CONCLUSION: High prevalence of otology surgeries in Iran provides valuable opportunities for training otolaryngology residents to achieve an acceptable level of competency. However, the results of this study strongly suggest the necessity of quality improvement both in teaching-learning and assessment processes in otolaryngology training programs.