Al-rawi, Rafal has completed his M. B. Ch. B. in 1999 and F.I.C.PATH in 2006 (University of Almustanseria, Baghdad, Iraq). His thesis title was: Expression of β -HCG and its pathological aspects in breast tumors. Currently, he is Assistant Professor at the Department of Pathology (Clinical Analysis), College of Pharmacy, Hawler Medical University, Erbil, Iraq since 2012. He published 12 scientific papers. He received more than 25 acknowledgments and outstanding awards.

Tuberculosis (TB) and lung cancer remain important causes of death worldwide. The incidence of TB in Iraq is 56 per 100 000 population per year with 25 out of the 56 being infectious cases. Sputum cytological examination followed by sputum smears for acid-fast bacilli (AFB) are useful ways for identifying and diagnosis tuberculosis and other pulmonary associated lesions. The purpose of this study was to investigate the importance of sputum cytology and smears for AFB in diagnosis of TB in patients living in Erbil, Kurdistan, Iraq. A total of 95 patients with signs and symptoms suspected of pulmonary tuberculosis were included in this study. Results showed that age of the patients included in this study ranged from 11 to 92 years and they were 64% males. Fifty percent (50%) of sputum smears were positive for acid-fast bacilli (AFB) and 61% were suggestive positive for tuberculosis by sputum cytological examination. The results of cytological investigation showed that 78% had predominantly chronic inflammatory cells, 22% had mixed inflammatory cells, 24% of the patients had metaplastic squamous cells, 43% showed necrotic background and 7% had red blood cells. On the other hand, only 1% of the cases had dysplastic cells (premalignant cells) and none of the smears showed granulomatous, giant or malignant cells. It was concluded that sputum cytological examinations followed by sputum smears for AFB are useful ways for diagnosis TB. It is recommended that using the combination of sputum smears for acid-fast bacilli (AFB) and sputum cytological examination resulted in a significantly increased positivity rate in diagnosis of lung lesions.

Maha K Eldosouky is working at Department of Pathology, Faculty of Medicine in Taibah University, KSA as well as Department of Anatomy, Faculty of Medicine, Alminia University, Egypt.

Background: Uterine smooth muscle tumors constitute a spectrum of neoplasms. Usually diagnosis of leiomyomas (LMs) is straight forwards; however atypical leiomyomas (ALMs), and smooth muscle tumors of uncertain malignant potential (STUMPs) have overlapping features and need to be distinguished from leiomyosarcoma. Aim: To evaluate progesterone receptor (PR), epithelial growth factor receptor (EGF-R) and galectin-3 expression in LMs, ALMs, STUMPs, and leiomyosarcomas and to assess their possible role in differentiating those tumors. Materials: Immunoexpression of EGF-R, PR and galectin-3 were studied in 44 cases of uterine smooth muscle tumors. Tissue samples from 20 LMs, 9 ALMs, 5 STUMP and 10 leiomyosarcoma cases were studied. Semiquantitative score was used to evaluate immunohistochemical staining. Results: EGF-R overexpression was detected in leimyosarcomas compared to lack of or reduced EGF-R expression in the non-sarcomatous group (LMs, ALMs and STUMPs) with a highly significant difference (p < 0.001). On the contrary, there was weak or negative PR staining in leiomyosarcom as compared to intense PR expression in the non-sarcomatous group with a highly significant difference (p < 0.001). Regarding galectin-3, it was downregulated in leiomyosarcomas compared to the non-sarcomatous group with a significant difference (p < 0.01). Correlation analysis revealed negative correlation between EGF-R and PR expression with significant statistical results. While correlation of galectin-3 with EGF-R and PR showed insignificant statistical results. Conclusion: Immunoexpression of EGF-R, PR and galectin-3 could be of help in differentiating challenging cases of uterine smooth muscle tumors. Further studies are recommended to investigate interactions between EGF-R, PR and galectin-3 and to plan new therapeutic strategies.

Tuberculosis (TB) and lung cancer remain important causes of death worldwide. The incidence of TB in Iraq is 56 per 100 000 population per year with 25 out of the 56 being infectious cases. Sputum cytological examination followed by sputum smears for acid-fast bacilli (AFB) are useful ways for identifying and diagnosis tuberculosis and other pulmonary associated lesions. The purpose of this study was to investigate the importance of sputum cytology and smears for AFB in diagnosis of TB in patients living in Erbil, Kurdistan, Iraq. A total of 95 patients with signs and symptoms suspected of pulmonary tuberculosis were included in this study. Results showed that age of the patients included in this study ranged from 11 to 92 years and they were 64% males. Fifty percent (50%) of sputum smears were positive for acid-fast bacilli (AFB) and 61% were suggestive positive for tuberculosis by sputum cytological examination. The results of cytological investigation showed that 78% had predominantly chronic inflammatory cells, 22% had mixed inflammatory cells, 24% of the patients had metaplastic squamous cells, 43% showed necrotic background and 7% had red blood cells. On the other hand, only 1% of the cases had dysplastic cells (premalignant cells) and none of the smears showed granulomatous, giant or malignant cells. It was concluded that sputum cytological examinations followed by sputum smears for AFB are useful ways for diagnosis TB. It is recommended that using the combination of sputum smears for acid-fast bacilli (AFB) and sputum cytological examination resulted in a significantly increased positivity rate in diagnosis of lung lesions.

I (Dr Punam Paudyal) have completed MD in Pathology at the age of 30 years from B P Koirala institute of Health Sciences, Dharan, Nepal. I am working now at the same institute as an Associate professor and have published six papers as an author and eleven papers as a co author in an indexed journal of Nepal.

Background: Pigmented skin lesions include both melanocytic as well as non-melanocytic lesions. Pigmentation is not just a cosmetic deformity but can also reflect underlying pathology, as nevi and other benign pigmented lesions which are important precursor of malignant melanoma. Objectives: The objective of this study was to evaluate the spectrum of clinicohistopathological and clinicoepidemiological profile of pigmented skin lesions at BPKIHS. Material and Methods: A total of 46 biopsies diagnosed clinically and/ or confirmed by histopathology were studied spanning over a period of 1 year. Results: Among the total cases studied histopathologically 36 cases (78.3%) were benign whereas 10 cases (21.7%) were malignant.The 36 benign cases comprised of benign melanocytic nevi (27), seborrheic keratosis (5), angiokeratoma (1), sebaceous hyperplasia (1), trichoepitheloma (1), venous hemangioma (1). Malignant cases included malignant melanoma (5) and pigmented BCC (5). In this study an analysis of the clinical diagnosis with the histopathological diagnosis revealed a positive correlation in 26 cases (56.5%) and negative correlation in 20 cases (43.5%). Conclusion: Most of the pigmented skin lesions are of melanocytic lesion (69.6%). Majority of the pigmented skin lesions are benign, with benign melanocytic nevi being the commonest (41.30%). Nonmelanocytic pigmented skin lesions comprised of 30.4% of cases.

Jaber Aslanzadeh has completed his PhD from ABMM and. He is the director of Clinical Microbiology, at Hartford Hospital Hartford, CT. Currently he is Associate Professor of Laboratory Medicine at University of Connecticut School of Medicine, Farmington, CT, USA

Background: Infections with Carbapenem resistant microorganisms are associated with a high morbidity and mortality. Carbapenem resistance makes empirical and targeted treatment of infections challenging. Carbapenem resistance can arise by several mechanisms; with the greatest emphasis on those bacteria that have acquired transferable carbapenemase genes such as KPC, OXA 48, IMP-1, VIM and NDM. The goal of this study was to compare the performance of the Cepheid Xpert-Carba-R assay to modified Hodge test (MHT) and carbapenem inactivation method (CIM). Method: MHT, CIM and Carba-R were performed on a panel of 24 isolates that included Acinetobacter baumannii (7), Klebsiella pneumoniae (9), Klebsiella oxytoca (1) Citorbacter freundii (1), E. Coli (3), Morganella morganii (1) and Pseudomonas aeruginosa (2) as well as 18 carbapenem resistant organisms isolated from patients at Hartford Hospital [ E. coli (11), K. oxytoca (3), K. pneumoniae (7), P. aeruginosa (1) and Serratia marcescens (1)]. Antimicrobial susceptibility of the panel isolates revealed that all except for 1 A. baumannii, 1 E. coli and 1 K. pneumoniae were resistant or intermediate to one or more carbapenems. Similarly, antimicrobial susceptibility of the clinical isolates revealed that all isolates were resistant or intermediate to one or more carbapenems except for S. marcescens. Results: Of the 42 isolates, 21 isolates tested negative and 15 isolates tested positive for carbapenemase by all three tests. 2 isolates (Acinetobacter baumannii) positive by MHT tested negative by CIM and CarbaR PCR and 1 isolate (Pseudomonas aeruginosa) tested positive by CIM tested negative by MHT and CarbaR PCR. 1 isolate (Acinetobacter baumannii) tested positive by MHT and CIM, tested negative by CarbaR PCR and 1 isolate (Acinetobacter baumannii) tested positive by CarbaR PCR (NDM) and MHT tested negative by CIM. 1 isolate (Klebsiella oxytoca) tested positive by CarbaR (NDM) tested negative by MHT and CIM. This was considered a true positive missed by MHT and CIM. Conclusions: CarbaR detected all isolates with KPC, OXA 48, IMP-1, VIM and NDM carbapenemases. Both MHT and CIM were associated with false positive and false negative results. The turnaround time for CarbaR was less than 90 minutes compared to 24 hours for MHT and CIM.