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About usA Bimonthly Peer-Reviewed Medical Journal Published by the Academy of Medical Sciences of the I.R. Iran; Indexed in PubMed/MEDLINE, ISI Web of Science, EMBASE, SCOPUS, CINHAL, PASCAL, CSA, SID, ISSN: Print 1029-2977, Online 1735-3947 Online-first Article (Authors' copy)Influenza A(H1N1) pandemic in Iran: Report of first confirmed cases from June to November 2009 Mohammad Mehdi Gooya MD, Mahmoud Soroush MD, Talat Mokhtari-Azad PhD, Ali Akbar Haghdoost MD PhD, Peyman Hemati MD, Mohsen Moghadami MD, Behnam Sabayan MD, Seyyed Taghi Heydari MSc, Seyyed Hasan Emami Razavi MD, Kamran B. Lankarani MD• Selected ArticleShahin Merat MD*, Farzaneh Khadem-Sameni MD**, Mehdi Nouraie MD*,***, Mohammad H Derakhshan MD*,†, Seyed Mohammad Tavangar MD**, Sara Mossaffa MD*, Reza Malekzadeh MD*, Masoud Sotoudeh MD•*,**
Authors’ affiliation: *Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, **Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. ***Department of Internal Medicine and Center for Sickle Cell Disease, Howard University, Washington, DC. †Section of Gastroenterology, Medical Faculty, University of Glasgow, Glasgow, UK •Corresponding author and reprints: Masoud Sotoudeh MD, Department of Pathology, Shariati Hospital, N. Kargar St.Tehran, 14117, Iran. Tel: +98-218-801-2992, E-mail: sotoudeh@ams.ac.ir Accepted for publication: 16 December 2009 Background: Nonalcoholic steatohepatitis is a common cause of chronic liver disease. It is important to have a uniform and validated method for scoring liver histology in these patients. Therefore, we propose a modification of the Brunt system by scoring the four histologic features separately and reporting their sums as the nonalcoholic steatohepatitis activity index. Methods: A nonalcoholic steatohepatitis activity index was defined which scored the grade of disease activity between 0 and 12 according to four histologic features: steatosis, hepatocyte ballooning, portal inflammation, and lobular inflammation. Fibrosis was separately scored between 0 and 4. A total of 60 liver specimens collected from nonalcoholic steatohepatitis patients were scored by two pathologists at the time of biopsy and after three months. Liver enzyme levels were also correlated with the histologic score. Results: The intra-rater agreement (weighted kappa) for various variables of the scoring system was between 0.59 and 0.80 for one pathologist and 0.78 to 0.95 for the other. The repeatability of the nonalcoholic steatohepatitis activity index was excellent with only 4% of the repeated measures out of the acceptable range of agreement. In addition, liver enzyme levels strongly correlated with the nonalcoholic steatohepatitis activity index. Conclusion: This system provides a fine graduation of liver histologic damage in nonalcoholic steatohepatitis and is well suited for use in clinical trials or natural history studies. more
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Photoclinic
A 41-year-old female complaining of an eight month history of dysphagia from 8 months ago presented to the Otolaryngology Department at Loghman Hakim Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. There was no history of any current infections of the upper respiratory tract, dental problems, and inflammations of the oral cavity, oropharynx, salivary glands, nose, or paranasal sinuses. There was no pain, malaise, fever, or weight loss. more... Upcoming Events
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