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Background and purpose: Recently, due to the reduction of hepatitis A in Iran there are people with low or no Hepatitis A Virus- Antibody (HAV-Ab), therefore, people at Arbaeen Pilgrimage are at risk for hepatitis A. This study aimed at examining HAV-Ab in pilgrims traveling from Mazandaran province, Iran to Karbala in 2018. Materials and methods: This cross-sectional study was performed in 200 people selected from 40,000 pilgrims in Mazandaran province. Serum samples were evaluated for presence of HAV-Ab and data for demographic characteristics and history of hepatitis A immunity were recorded. Data analysis was performed in SPSS V16. Results: The participants were 137 (68.5%) males and 63 (31.5%) females. Positive and negative HAV-Ab were seen in 156 (78%) and 44 (22%), respectively. Mean ages of people with positive and negative HAV-Ab were almost similar (50 years and 47 years, respectively). HAV-Ab status was found to be significantly associated with job (P0.05). Conclusion: Twenty-two percent of people who were travelling to Karbala had no HAV-Ab, which is significant because the risk of developing fulminant hepatitis increases in adults, therefore, vaccination of Karbala pilgrims for hepatitis A virus is suggested.

Mature cystic teratoma of the ovary (MCTO) is the most common ovarian germ cell tumor. Its malignant transformation is a rare complication that occurs in almost 2% of the MCTs. MCTO is benign and usually appears between 30 and 40 years of age, but patients with malignant ovarian MCT are 10–15 years older than those with benign MCT. The most common malignant transformation in MCTO is Squamous Cell Carcinoma (SCC) which is rarely diagnosed with pre-operative imaging.We report the case of a postmenopausal woman, presenting with severe abdominal pain and a large palpable mass in her abdomen. She was diagnosed postoperatively with SCC arising from MCTO which was confirmed histopathologically. The patient received postoperative chemotherapy and was well at 6-month follow-up after chemotherapy.MCTO is benign, but can rarely become malignant in older ages. So MCTO-arising SCC should be considered in elderly women with abdominal pain and mass, and also some other evident features such as large tumor diameter, elevated serum markers, and solid components in Magnetic resonance imaging (MRI).