Background: HSV2 has an important role in acquiring and transmitting HIV through genital ulcers. ... more Background: HSV2 has an important role in acquiring and transmitting HIV through genital ulcers. This study was conducted to determine the prevalence of this virus in HIV infected subject in Kermanshah, Iran. Methods: This descriptive study was performed among 170 HIV positive patients (case group) and 165 non-HIV cases (control group)) referred to Behavioral Counseling Center of Kermanshah, western of Iran. For the evaluation of HSV2 infection, blood sample was obtained and assessed for IgG antibody of HSV2 using ELISA method. The data were collected and analyzed. Results: Out of 170 cases, 11 were seropositive for HSV2 (6.5%) in case group and 2 of 165 (1.21%) in control group (p=0.015). Seropositivity was 17.6% in female and 5.2% in male, 59% under and 8% age over 40. In HIV infected subjects, seroprevalence in female was 17.6% and in male was 5.2% (p=0.083). Conclusion: It can be derived that the seroprevalence of HSV2 in HIV positive patients in our region is relatively low. Hence, we do not recommend that HSV2 needs to be considered in HIV pretreatment evaluation program.
Background: Influenza can causes morbidity and mortality that are greatly enhanced in patients wi... more Background: Influenza can causes morbidity and mortality that are greatly enhanced in patients with underlying chronic diseases such as Cirrhotic patients. This study was performed to assess the immunogenicity of Influenza vaccination in patients with cirrhosis and inactive carriers of Hepatitis B virus infection. Methods: In this clinical study 93 enrolled subjects divided into 3 groups: Cirrhotic (N=28), Inactive carriers of Hepatitis B (N=31) and subjects (N=34). All the participants were vaccinated by Influenza vaccine (Influvac®). Serum samples were taken before and 4 weeks after vaccination and the Humoral Immunogenicity was assessed by the Hemagglutination Inhibition (HI) test. Results: Four weeks after vaccination, seroconversion rates of vaccine strains ranged between 71.4% and 100% in Group 1, 70.6% and 94.1% in Group 2, and 58.1% and 80.7% in Group 3. No significant differences were seen in the rates of Seroconversion and antibody Geometric Mean Titers (GMTs) against Influenza A (H1N1 and H3N2) vaccine components in the three groups (P>0.05).The rates of Seroconversion and antibody GMTs against Influenza B vaccine component were significantly higher in Cirrhotic and inactive carriers of Hepatitis B than healthy subjects (P<0.005). No significant (P>0.05) differences in the rates of Seroprotection were observed within the three groups. Antibody GMTs against all three strains of Influenza vaccine increased significantly (P<0.001) after vaccination in three groups. Conclusion: Influenza vaccination is effective in Cirrhotic patients and inactive carriers of Hepatitis B as well as healthy individuals. It means that vaccination should be considered in such patients in order to reduce the morbidity and mortality of Influenza.
Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive proced... more Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive procedures are major causes of HBV infection in Kermanshah and should be more closely supervised. We recommend to read this article by health policy makers, gastroenterologists, hepatologists, infectious especialists and Internists. Background: hepatitis B virus (HBV) infection is a major public health problem that affects billions of people worldwide. The lack of information on HBV prevalence among the general population is an obstacle to formulate effective policies to reduce the burden of viral hepatitis. Objectives: This population based serological survey was conducted in Kermanshah province to determine the local prevalence and risk factors of HBV infection. Patients and Methods: 1979 healthy subjects were selected from all districts of Kermanshah province (in the west of Iran) using random cluster sampling. Subjects between 6 and 65 years of age were included with mean age of 35 ± 13. Serum samples were tested for HBcAb, HBsAg and anti-HDV antibody. To carry out lab tests the third generation of ELISA was used. Various risk factors were recorded and multivariate analysis was performed. Results: The prevalence of HBsAg and HBcAb in Kermanshah was 0.75% (95% CI 0.44; 1.21) and 8.28% (95% CI 7.13; 9.56), respectively. One case of HDV-Ab was found. Predictors of HBsAg or HBcAb in multivariate analysis were: old age, being male, history of tattooing and history of dental procedure. Conclusions: approximately 8% and less than 1% of general population in Kermanshah are HBcAb seropositive and active carriers of HBV infection, respectively. Age, sex and history of tattoo and dental procedures are major risk factors of HBV seropositivity in this province.
Coronavirus disease 2019 (COVID-19) is still an emergency in many countries. Herein, we report tr... more Coronavirus disease 2019 (COVID-19) is still an emergency in many countries. Herein, we report treatment with human placental-derived mesenchymal stromal cells transfusion (hPD-MSCT) in a critically ill infant diagnosed with COVID-19. A 28-day-old male infant with a history of pneumonia was referred to our center with decreased SpO2 (92%) and fever (38.5 °C). Real-time reverse transcription polymerase chain reaction (RT-PCR) and chest computed tomography (CT) confirmed COVID-19 infection. Considering the deteriorating clinical status of the patient despite the routine treatments (SpO2 82%), human placental derived mesenchymal stromal cells (hPD-MSCs) was transfused to him on day 9 and 11 (7 × 106 cells/session). The patient’s general condition started to change 3 days after hPD-MSCT and poor feeding and low SpO2 improved day by day. On day 20, the patient was discharged (SpO2 97%) and our one-year follow-up showed a successful response to the treatment with no reported complications. hPD-MSCT may be considered as a possible treatment option in infants/children diagnosed with COVID-19 who fail to respond to conventional therapies. However, required dose, safety, and mechanistic studies are still warranted to further investigate this treatment.
The authors report about one new case of hepatic tuberculosis in a pseudotumoral form, and emphas... more The authors report about one new case of hepatic tuberculosis in a pseudotumoral form, and emphasize the diagnostic difficulties even in a country where tuberculosis is endemic. Hepatic puncture, either with sonographic monitoring or during laparotomy, is the paraclinical examination of choice. The histological study supports the diagnosis. The medical treatment is that of any form of tuberculosis. The surgical treatment is most often indicated when a diagnosis of liver tumor is assumed.
Background: Increasing blood supply safety is one of the most important goals of blood services i... more Background: Increasing blood supply safety is one of the most important goals of blood services in the world. In this study, we reviewed the prevalence rate and the trends of three main infections in whole blood donations and strategies for improving blood safety in Yazd blood transfusion center, Iran. Materials and methods: In this cross sectional study, data on hepatitis B, C and HIV infection were extracted from Iranian Donor Database of blood donation from 2004 to 2010 in Yazd province. All donors with positive confirmatory test were included. The data was analyzed by SPSS software due to demographic factors. Results: The prevalence rate of hepatitis B, C and HIV infection decreased during these years (From 0.37%, 0.14% and 0 percent in 2004 to 0.14%, 0.05% and 0 in 2010, respectively). Both hepatitis B and C infections were significantly more in first-time blood donors with BSc or BA educational level. The prevalence rate of hepatitis B was significantly higher in donors with less than 20 year-old and female donors. The prevalence rate of hepatitis C was higherin30-39 age group (P-value= 0.014). Conclusion: The results showed that the strategies used for improving blood safety were efficient. Increasing public knowledge on blood-borne infections and their routes of transmission, importance of donating blood only by healthy donors are necessary to have a safe blood supply in future.
Archives des maladies du coeur et des vaisseaux, 1986
Two cases of primary cardiac tumour are reported. The first was that of a 16 year old girl invest... more Two cases of primary cardiac tumour are reported. The first was that of a 16 year old girl investigated after the detection of a systolic murmur on routine examination. The clinical signs suggested a diagnosis of pulmonary stenosis. The second case was that of a 36 year old man admitted to hospital for right ventricular failure. Echocardiography revealed right ventricular tumours in both cases and also indicated their size, form, mobility and site of implantation. The outcome of the first case, a fibromyxoma, was favourable with no detectable recurrence after one year. In the second case, the patient unfortunately died of cardiogenic shock in the immediate preoperative period. These two cases emphasise the value of echocardiography in the diagnosis of isolated right ventricular tumours, especially considering the difficulty of clinical diagnosis and the risks of angiocardiography.
Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive proced... more Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive procedures are major causes of HBV infection in Kermanshah and should be more closely supervised. We recommend to read this article by health policy makers, gastroenterologists, hepatologists, infectious especialists and Internists. Background: hepatitis B virus (HBV) infection is a major public health problem that affects billions of people worldwide. The lack of information on HBV prevalence among the general population is an obstacle to formulate effective policies to reduce the burden of viral hepatitis. Objectives: This population based serological survey was conducted in Kermanshah province to determine the local prevalence and risk factors of HBV infection. Patients and Methods: 1979 healthy subjects were selected from all districts of Kermanshah province (in the west of Iran) using random cluster sampling. Subjects between 6 and 65 years of age were included with mean age of 35 ± 13. Serum samples were tested for HBcAb, HBsAg and anti-HDV antibody. To carry out lab tests the third generation of ELISA was used. Various risk factors were recorded and multivariate analysis was performed. Results: The prevalence of HBsAg and HBcAb in Kermanshah was 0.75% (95% CI 0.44; 1.21) and 8.28% (95% CI 7.13; 9.56), respectively. One case of HDV-Ab was found. Predictors of HBsAg or HBcAb in multivariate analysis were: old age, being male, history of tattooing and history of dental procedure. Conclusions: approximately 8% and less than 1% of general population in Kermanshah are HBcAb seropositive and active carriers of HBV infection, respectively. Age, sex and history of tattoo and dental procedures are major risk factors of HBV seropositivity in this province.
The Cutaneous Leishmaniasis (CL) contains a range of factors, which provide different patterns of... more The Cutaneous Leishmaniasis (CL) contains a range of factors, which provide different patterns of transmission that make it difficult to control. The aim of this study was to identify the different species of Leishmania in the Jahrom district of Fars province, southern Iran. This descriptive study was done on CL suspected cases who were referential to the Reference of Jahrom Health Center laboratory in 2017 from all different zones mentioned. Demographic variables (age, sex, location, number and place of wounds) was recorded by a questionnaire. The blood smears were checked for the existence of amastigotes by light microscopy. After microscopic examination smears were extract DNA and used in the Polymerase Chain Reaction (PCR) method. Totally 165 slide samples checked were found to be positive for amastigotes via microscopy and positive for leishmanial DNA in the PCR. two (1.2%) of the slide samples gave the 750-bp indicative of Leishmania tropica and 163 samples (98.8%) gave the 560-bp indicative of Leishmania major. Although the actually that both species of CL are common in Iran, but our results showed that in Jahrom district the main specie was L. major. Thus, this fact displays the importance of reservoir rodents in programs of CL control in this County.
Journal of Kermanshah University of Medical Sciences, Dec 29, 2021
Context: Infections are a major cause of disease and mortality in transplant recipients. Despite ... more Context: Infections are a major cause of disease and mortality in transplant recipients. Despite the studies conducted in Iran, no comprehensive and general research is available in this area. The present study aimed to determine the frequency of infectious agents in patients after bone marrow transplantation in Iran. Method: In this systematic review, relevant studies were selected based on type and objective, and data were collected from the articles published in Iran regarding the frequency of infectious agents after bone marrow transplantation in different regions of Iran. The studies were collected using systematic search methods. Results: In total, 11 studies were identified regarding infectious agents after bone marrow transplantation. Six studies were conducted in Tehran, three studies were performed in Shiraz, and Mashhad and Semnan provinces were the locations of two separate studies. Most of the case studies identified viral agents (54.5%; n = 6), followed by fungal infectious agents (27.3%; n = 3) and bacterial agents (18.2%; n = 2). Gram-positive bacteria (bacterial agents), cytomegalovirus (viral agents), and Candida and Aspergillus (fungi) had the highest frequency after bone marrow transplantation. Conclusions: According to the results, viral, fungal, and bacterial infectious agents were respectively most frequent in patients receiving bone marrow transplants. Gram-positive bacteria (bacterial agents), cytomegalovirus (viral agents), and Candida and Aspergillus (fungi) had the highest frequency after bone marrow transplantation.
Journal of Kermanshah University of Medical Sciences, Apr 3, 2010
Background and purpose: Aluminum phosphide (AlP) is commonly used in Iran (especially in north) t... more Background and purpose: Aluminum phosphide (AlP) is commonly used in Iran (especially in north) to keep stored rice and cereal grains safe from pests. There are several reports on intentional or accidental poisoning with AlP tablets also referred to as rice tablets. The goal of this research was to study the epidemiological, clinical and laboratory features in patients poisoned with AIP tablets. Materials and methods: In this cross-sectional study, information was extracted from patients' records in Qaemshahr Razi Haspital and Sari Imam Khomeini Hospital, 2013-2014. Data including demographic characteristics, number of tablets, methods of intake, time and season of abuse, the time interval between tablet ingestion and hospital admission, vital signs, and laboratory data were recorded in a check list. Results: Fifty two cases (mean age: 23.4±9.2 years) were investigated including 38 females (73.08%) and 14 males (26.92%). The overall number of poisoned patients was higher in autumn (28.8%) and in evenings (51.9%). Death occurred in 16 cases (5 males and 11 females) and 36 patients survived of whom four (2 males and 2 females) developed complications. Conclusion: In this study, the number of women poisoned with ALP tablet was dramatically higher compared to that of males. Autumn and evenings were found with highest rates of poisoning.
Indian Journal of Hematology and Blood Transfusion, Mar 1, 2008
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that may also be transmitted throu... more Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that may also be transmitted through person-to-person transmission by exposure to infected body fl uids. Despite its wide geographic distribution in animals, CCHF virus is rarely associated with recognized human diseases. We report the fi rst case of CCHF in Kermanshah province, Iran. Clinical presentation was characterized by fever, myalgia, and hemorrhage. The levels of liver enzymes, creatinine phosphokinase, and lactate dehydrogenase were elevated, and bleeding markers were prolonged.
Gastroenterology and hepatology from bed to bench, Apr 18, 2018
Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta vi... more Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta virus (HDV) in Kermanshah. Background: Hepatitis delta is one of the most complex viral infections of liver that along with hepatitis B virus could lead to fulminant hepatitis, progressive chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Methods: Referrals with positive HBs Ag were included and tested for HDV Ab using ELISA. Seropositives were subsequently evaluated for viremia by assaying HDV RNA and HBV DNA using real-time PCR. Viremia-related variables were also assessed. Results: From 1749 patients included, 30 had positive HDV Ab, which makes HDV seroprevalence 1.7%. Twenty-nine out of 30 seropositives were assayed for viremia. Fourteen cases (48.3%) had positive HDV PCR, 18 (62.1%) had positive HBV DNA. Eight patients (27.6%) had simultaneous replication of HBV and HDV, six (20.7%) only had HDV replication, ten (34.5%) only had HBV replication and five (17.2%) had no replication of either viruses. Conclusion: Kermanshah seems to be a low prevalent area in Middle East. Viremic HDV infection was lower compared to Europe and Africa, probably due to genetic variations of the hosts or the differences in genotypes or sub-types of hepatitis B and D viruses. Keywords: Hepatitis D, Prevalence, Viremia, Iran. (Please cite as: Sayad B, Naderi Y, Alavian SM, Najafi F, Janbakhsh A, Mansouri F, et al. Hepatitis D virus infection in Kermanshah, west of Iran: seroprevalence and viremic infections. Gastroenterol Hepatol Bed Bench 2018;11(2):145-152).
Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta vi... more Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta virus (HDV) in Kermanshah. Background: Hepatitis delta is one of the most complex viral infections of liver that along with hepatitis B virus could lead to fulminant hepatitis, progressive chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Methods: Referrals with positive HBs Ag were included and tested for HDV Ab using ELISA. Seropositives were subsequently evaluated for viremia by assaying HDV RNA and HBV DNA using real-time PCR. Viremia-related variables were also assessed. Results: From 1749 patients included, 30 had positive HDV Ab, which makes HDV seroprevalence 1.7%. Twenty-nine out of 30 seropositives were assayed for viremia. Fourteen cases (48.3%) had positive HDV PCR, 18 (62.1%) had positive HBV DNA. Eight patients (27.6%) had simultaneous replication of HBV and HDV, six (20.7%) only had HDV replication, ten (34.5%) only had HBV replication and five (17.2%) had no replication of either viruses. Conclusion: Kermanshah seems to be a low prevalent area in Middle East. Viremic HDV infection was lower compared to Europe and Africa, probably due to genetic variations of the hosts or the differences in genotypes or sub-types of hepatitis B and D viruses.
The pandemic of coronavirus (COVID‐19) has significantly increased the admission of patients with... more The pandemic of coronavirus (COVID‐19) has significantly increased the admission of patients with extensive complications, especially for respiratory support, to intensive care units (ICUs) worldwide. These patients also suffer from pressure ulcers (PUs) as another complication that occurs due to increased length of hospitalisation and acute conditions of patients. Therefore, this study aimed to evaluate the incidence and prevalence of PU and the factors affecting it in COVID‐19 patients admitted to ICUs. This cohort retrospective study used registry data in Imam Reza Hospital located in west of Iran. Four hundred and forty‐five COVID‐19 patients older than 20 years hospitalised in corona ICUs from 20 March 2020 to 30 December 2020, with a Braden score of less than 14 were included in the study. To investigate the relationship between variables in rate prevalence, univariate logistic regression analysis was used to calculate odds ratio, and for incidence rate in estimating PU risk generated in ICUs, hazard ratio was calculated using cox regression. One hundred and eighty‐three (41.12%) patients were male. The mean age of patients was 63 (SD = ±9.78) years. A total of 1152 cases of PU were generated, with the highest prevalence of PU with 234 cases in the sacrum. One hundred and seventy‐six (55.87%) patients underwent non‐invasive ventilation ulcers. The prevalence of PU was 79.7%. The highest prevalence was found in people over 80 years with 90.67%. The incidence ratio was 46.74%. The highest number of new cases was seen in diabetic patients with 60.96%. First‐degree ulcers were the most common degree of ulceration in 252 (55.38%) patients. Incidence and prevalence excluding first‐degree wounds were 24.04% and 49.66%, respectively. Age, Braden score, BMI, comorbidity, diabetes mellitus, stool incontinence, Glasgow coma scale, vasopressor, and length of hospital stay were significantly associated with PU (P < .05). The incidence and prevalence of PU in patients were high in this study. The length of hospitalisation and Braden score were the most important factors in the development of PU. The widespread prevalence of COVID‐19 and the relatively long stay of patients in the ICU created unfavourable conditions for patients and the treatment system, therefore, it emphasised the use of appropriate measures to prevent PU to avoid double costs and longer stays.
SummaryVaccination against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a cruc... more SummaryVaccination against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a crucial step in ending the current worldwide pandemic. However, several particularly vulnerable groups in the population were not included in sufficient numbers in coronavirus disease 2019 (Covid‐19) vaccine trials. Therefore, as science advances, the advice for vaccinating these special populations against Covid‐19 will continue to evolve. This focused review provides the latest recommendations and considerations for these special populations (i.e., patients with rheumatologic and autoimmune disorders, cancer, transplant recipients, chronic liver diseases, end‐stage renal disease, neurologic disorders, psychiatric disorders, diabetes mellitus, obesity, cardiovascular diseases, chronic obstructive pulmonary disease, human immunodeficiency virus, current smokers, pregnant and breastfeeding women, the elderly, children, and patients with allergic reactions) using the currently available research evidence.
The immunization of HIV/AIDS patients against Hepatitis B Virus infection is one of the most impo... more The immunization of HIV/AIDS patients against Hepatitis B Virus infection is one of the most important issues confronted by physicians. The results of this study suggest that Levamisole as an adjuvant to hepatitis B vaccine might be considered for increase the immune response to vaccination in these patients. Background: Human immunodeficiency virus (HIV) infected patients are also frequently exposed to the hepatitis B virus (HBV), due to the common routes of transmission, therefore, prevention of hepatitis B results in decreased complications of the disease. Objectives: Since the immune response of HIV patients to hepatitis B vaccination is less robust than that found in healthy individuals, this study aimed to evaluate the effect of a levamisole adjuvant on increasing the immune response. Patients and Methods: In this study, 89 HIV infected patients, without a history of HBV infection or vaccination, were randomly allocated into experimental (44 patients) and control (45 patients) groups. HBV vaccination was performed using the Hepavax-Gene TF vaccine, 40 μg three times at intervals of; zero, one, and three months. Levamisole 50 mg twice a day or a placebo, was administered to the experimental and control groups, respectively, for a period of six days before to six days after the vaccination. Immune response was evaluated by measuring hepatitis B surface antibodies (HBsAb) concurrently with the second and third vaccine administration, and at one and three months at the conclusion of the vaccination program. Results: The immune response following the threevaccinations was higher in those who were receiving levamisole compared with the controls (90% vs. 65.38%) (P = 0.05). Furthermore, the immune response and the mean antibody titer following the repeated vaccination in the experimental group showed a higher increase than in the control group. The immune response and the mean titer of antibody were not associated with; age, sex, body mass index, history of smoking and/or intravenous drug use in either of the groups. However, regarding CD4+ cells more than 200 cell/mm3, mean antibody production significantly increased in both groups. Conclusions: Using levamisole with the hepatitis B vaccination can increase the immune response and antibody titer mean in HIV infected patients. Since these patients have a more complete response with CD4+ cells more than 200 cell/mm3, vaccination and effective adjuvants seem to be most beneficial when CD4+ cells are greater than 200 cell/mm3, in HIV infected patients.
Iranian Journal of Clinical Infectious Diseases, Nov 16, 2020
Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in F... more Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in February 2020. Here, we report the epidemiological and clinical characteristics of patients with COVID-19 and factors associated with mortality in these patients. Methods: A retrospective cohort study was conducted from February 22, 2020, to March 24, 2020, in Golestan Hospital in Kermanshah, Iran. Demographic data including underlying diseases and clinical data including the presenting symptoms, chest computed tomography (CT) scan, reverse transcription polymerase chain reaction (RT-PCR) test results, and outcomes were extracted from electronic medical records. Simple and multiple logistic regression methods were used to explore the factors associated with mortality. Results: Of 245 patients admitted with COVID-19, 155 (63.30%) were male. The mean age of the subjects was 54.68 ± 19.21. Forty-five (18.48%) patients had underlying diseases. Common symptoms were dyspnea (n = 137; 55.9%), cough (n = 93; 38.0%), and fever (n = 78; 31.8%). All patients had pneumonia with abnormal findings on chest CT scan (100%), and RT-PCR test results were positive in 87 (35.50%) patients. Of the total admitted cases, 38 (15.5%) patients died during hospitalization. An old age (OR = 1.09; 95% CI: 1.02 to 1.06), history of heart disease (OR = 5.07; 95% CI: 1.46 to 17.58), hypertension (OR = 5.82; 95% CI: 1.13 to 30.04), smoking (OR = 11.44; 95% CI: 1.01 to 29.53), history of at least one underlying disease (OR = 3.31; 95%CI: 1.54 to 7.09), and symptoms of decreased consciousness at the time of admission (OR = 24.23; 95% CI: 2.62 to 223.39) were associated with mortality. Also, the symptoms of cough (OR = 0.383; 95% CI: 0.17 to 0.88) and fever (OR = 0.278; 95% CI: 0.10 to 0.74) had a negative association with mortality. Conclusions: In the current study, factors including old age, smoking, symptoms of decreased consciousness, and underlying diseases such as heart disease, hypertension, and history of at least one underlying disease were associated with mortality. Factors associated with mortality should be considered so that we can better manage patients with COVID-19.
Background: HSV2 has an important role in acquiring and transmitting HIV through genital ulcers. ... more Background: HSV2 has an important role in acquiring and transmitting HIV through genital ulcers. This study was conducted to determine the prevalence of this virus in HIV infected subject in Kermanshah, Iran. Methods: This descriptive study was performed among 170 HIV positive patients (case group) and 165 non-HIV cases (control group)) referred to Behavioral Counseling Center of Kermanshah, western of Iran. For the evaluation of HSV2 infection, blood sample was obtained and assessed for IgG antibody of HSV2 using ELISA method. The data were collected and analyzed. Results: Out of 170 cases, 11 were seropositive for HSV2 (6.5%) in case group and 2 of 165 (1.21%) in control group (p=0.015). Seropositivity was 17.6% in female and 5.2% in male, 59% under and 8% age over 40. In HIV infected subjects, seroprevalence in female was 17.6% and in male was 5.2% (p=0.083). Conclusion: It can be derived that the seroprevalence of HSV2 in HIV positive patients in our region is relatively low. Hence, we do not recommend that HSV2 needs to be considered in HIV pretreatment evaluation program.
Background: Influenza can causes morbidity and mortality that are greatly enhanced in patients wi... more Background: Influenza can causes morbidity and mortality that are greatly enhanced in patients with underlying chronic diseases such as Cirrhotic patients. This study was performed to assess the immunogenicity of Influenza vaccination in patients with cirrhosis and inactive carriers of Hepatitis B virus infection. Methods: In this clinical study 93 enrolled subjects divided into 3 groups: Cirrhotic (N=28), Inactive carriers of Hepatitis B (N=31) and subjects (N=34). All the participants were vaccinated by Influenza vaccine (Influvac®). Serum samples were taken before and 4 weeks after vaccination and the Humoral Immunogenicity was assessed by the Hemagglutination Inhibition (HI) test. Results: Four weeks after vaccination, seroconversion rates of vaccine strains ranged between 71.4% and 100% in Group 1, 70.6% and 94.1% in Group 2, and 58.1% and 80.7% in Group 3. No significant differences were seen in the rates of Seroconversion and antibody Geometric Mean Titers (GMTs) against Influenza A (H1N1 and H3N2) vaccine components in the three groups (P>0.05).The rates of Seroconversion and antibody GMTs against Influenza B vaccine component were significantly higher in Cirrhotic and inactive carriers of Hepatitis B than healthy subjects (P<0.005). No significant (P>0.05) differences in the rates of Seroprotection were observed within the three groups. Antibody GMTs against all three strains of Influenza vaccine increased significantly (P<0.001) after vaccination in three groups. Conclusion: Influenza vaccination is effective in Cirrhotic patients and inactive carriers of Hepatitis B as well as healthy individuals. It means that vaccination should be considered in such patients in order to reduce the morbidity and mortality of Influenza.
Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive proced... more Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive procedures are major causes of HBV infection in Kermanshah and should be more closely supervised. We recommend to read this article by health policy makers, gastroenterologists, hepatologists, infectious especialists and Internists. Background: hepatitis B virus (HBV) infection is a major public health problem that affects billions of people worldwide. The lack of information on HBV prevalence among the general population is an obstacle to formulate effective policies to reduce the burden of viral hepatitis. Objectives: This population based serological survey was conducted in Kermanshah province to determine the local prevalence and risk factors of HBV infection. Patients and Methods: 1979 healthy subjects were selected from all districts of Kermanshah province (in the west of Iran) using random cluster sampling. Subjects between 6 and 65 years of age were included with mean age of 35 ± 13. Serum samples were tested for HBcAb, HBsAg and anti-HDV antibody. To carry out lab tests the third generation of ELISA was used. Various risk factors were recorded and multivariate analysis was performed. Results: The prevalence of HBsAg and HBcAb in Kermanshah was 0.75% (95% CI 0.44; 1.21) and 8.28% (95% CI 7.13; 9.56), respectively. One case of HDV-Ab was found. Predictors of HBsAg or HBcAb in multivariate analysis were: old age, being male, history of tattooing and history of dental procedure. Conclusions: approximately 8% and less than 1% of general population in Kermanshah are HBcAb seropositive and active carriers of HBV infection, respectively. Age, sex and history of tattoo and dental procedures are major risk factors of HBV seropositivity in this province.
Coronavirus disease 2019 (COVID-19) is still an emergency in many countries. Herein, we report tr... more Coronavirus disease 2019 (COVID-19) is still an emergency in many countries. Herein, we report treatment with human placental-derived mesenchymal stromal cells transfusion (hPD-MSCT) in a critically ill infant diagnosed with COVID-19. A 28-day-old male infant with a history of pneumonia was referred to our center with decreased SpO2 (92%) and fever (38.5 °C). Real-time reverse transcription polymerase chain reaction (RT-PCR) and chest computed tomography (CT) confirmed COVID-19 infection. Considering the deteriorating clinical status of the patient despite the routine treatments (SpO2 82%), human placental derived mesenchymal stromal cells (hPD-MSCs) was transfused to him on day 9 and 11 (7 × 106 cells/session). The patient’s general condition started to change 3 days after hPD-MSCT and poor feeding and low SpO2 improved day by day. On day 20, the patient was discharged (SpO2 97%) and our one-year follow-up showed a successful response to the treatment with no reported complications. hPD-MSCT may be considered as a possible treatment option in infants/children diagnosed with COVID-19 who fail to respond to conventional therapies. However, required dose, safety, and mechanistic studies are still warranted to further investigate this treatment.
The authors report about one new case of hepatic tuberculosis in a pseudotumoral form, and emphas... more The authors report about one new case of hepatic tuberculosis in a pseudotumoral form, and emphasize the diagnostic difficulties even in a country where tuberculosis is endemic. Hepatic puncture, either with sonographic monitoring or during laparotomy, is the paraclinical examination of choice. The histological study supports the diagnosis. The medical treatment is that of any form of tuberculosis. The surgical treatment is most often indicated when a diagnosis of liver tumor is assumed.
Background: Increasing blood supply safety is one of the most important goals of blood services i... more Background: Increasing blood supply safety is one of the most important goals of blood services in the world. In this study, we reviewed the prevalence rate and the trends of three main infections in whole blood donations and strategies for improving blood safety in Yazd blood transfusion center, Iran. Materials and methods: In this cross sectional study, data on hepatitis B, C and HIV infection were extracted from Iranian Donor Database of blood donation from 2004 to 2010 in Yazd province. All donors with positive confirmatory test were included. The data was analyzed by SPSS software due to demographic factors. Results: The prevalence rate of hepatitis B, C and HIV infection decreased during these years (From 0.37%, 0.14% and 0 percent in 2004 to 0.14%, 0.05% and 0 in 2010, respectively). Both hepatitis B and C infections were significantly more in first-time blood donors with BSc or BA educational level. The prevalence rate of hepatitis B was significantly higher in donors with less than 20 year-old and female donors. The prevalence rate of hepatitis C was higherin30-39 age group (P-value= 0.014). Conclusion: The results showed that the strategies used for improving blood safety were efficient. Increasing public knowledge on blood-borne infections and their routes of transmission, importance of donating blood only by healthy donors are necessary to have a safe blood supply in future.
Archives des maladies du coeur et des vaisseaux, 1986
Two cases of primary cardiac tumour are reported. The first was that of a 16 year old girl invest... more Two cases of primary cardiac tumour are reported. The first was that of a 16 year old girl investigated after the detection of a systolic murmur on routine examination. The clinical signs suggested a diagnosis of pulmonary stenosis. The second case was that of a 36 year old man admitted to hospital for right ventricular failure. Echocardiography revealed right ventricular tumours in both cases and also indicated their size, form, mobility and site of implantation. The outcome of the first case, a fibromyxoma, was favourable with no detectable recurrence after one year. In the second case, the patient unfortunately died of cardiogenic shock in the immediate preoperative period. These two cases emphasise the value of echocardiography in the diagnosis of isolated right ventricular tumours, especially considering the difficulty of clinical diagnosis and the risks of angiocardiography.
Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive proced... more Lack of adherence to Hygiene protocols by dentists and those who conduct cosmetic invasive procedures are major causes of HBV infection in Kermanshah and should be more closely supervised. We recommend to read this article by health policy makers, gastroenterologists, hepatologists, infectious especialists and Internists. Background: hepatitis B virus (HBV) infection is a major public health problem that affects billions of people worldwide. The lack of information on HBV prevalence among the general population is an obstacle to formulate effective policies to reduce the burden of viral hepatitis. Objectives: This population based serological survey was conducted in Kermanshah province to determine the local prevalence and risk factors of HBV infection. Patients and Methods: 1979 healthy subjects were selected from all districts of Kermanshah province (in the west of Iran) using random cluster sampling. Subjects between 6 and 65 years of age were included with mean age of 35 ± 13. Serum samples were tested for HBcAb, HBsAg and anti-HDV antibody. To carry out lab tests the third generation of ELISA was used. Various risk factors were recorded and multivariate analysis was performed. Results: The prevalence of HBsAg and HBcAb in Kermanshah was 0.75% (95% CI 0.44; 1.21) and 8.28% (95% CI 7.13; 9.56), respectively. One case of HDV-Ab was found. Predictors of HBsAg or HBcAb in multivariate analysis were: old age, being male, history of tattooing and history of dental procedure. Conclusions: approximately 8% and less than 1% of general population in Kermanshah are HBcAb seropositive and active carriers of HBV infection, respectively. Age, sex and history of tattoo and dental procedures are major risk factors of HBV seropositivity in this province.
The Cutaneous Leishmaniasis (CL) contains a range of factors, which provide different patterns of... more The Cutaneous Leishmaniasis (CL) contains a range of factors, which provide different patterns of transmission that make it difficult to control. The aim of this study was to identify the different species of Leishmania in the Jahrom district of Fars province, southern Iran. This descriptive study was done on CL suspected cases who were referential to the Reference of Jahrom Health Center laboratory in 2017 from all different zones mentioned. Demographic variables (age, sex, location, number and place of wounds) was recorded by a questionnaire. The blood smears were checked for the existence of amastigotes by light microscopy. After microscopic examination smears were extract DNA and used in the Polymerase Chain Reaction (PCR) method. Totally 165 slide samples checked were found to be positive for amastigotes via microscopy and positive for leishmanial DNA in the PCR. two (1.2%) of the slide samples gave the 750-bp indicative of Leishmania tropica and 163 samples (98.8%) gave the 560-bp indicative of Leishmania major. Although the actually that both species of CL are common in Iran, but our results showed that in Jahrom district the main specie was L. major. Thus, this fact displays the importance of reservoir rodents in programs of CL control in this County.
Journal of Kermanshah University of Medical Sciences, Dec 29, 2021
Context: Infections are a major cause of disease and mortality in transplant recipients. Despite ... more Context: Infections are a major cause of disease and mortality in transplant recipients. Despite the studies conducted in Iran, no comprehensive and general research is available in this area. The present study aimed to determine the frequency of infectious agents in patients after bone marrow transplantation in Iran. Method: In this systematic review, relevant studies were selected based on type and objective, and data were collected from the articles published in Iran regarding the frequency of infectious agents after bone marrow transplantation in different regions of Iran. The studies were collected using systematic search methods. Results: In total, 11 studies were identified regarding infectious agents after bone marrow transplantation. Six studies were conducted in Tehran, three studies were performed in Shiraz, and Mashhad and Semnan provinces were the locations of two separate studies. Most of the case studies identified viral agents (54.5%; n = 6), followed by fungal infectious agents (27.3%; n = 3) and bacterial agents (18.2%; n = 2). Gram-positive bacteria (bacterial agents), cytomegalovirus (viral agents), and Candida and Aspergillus (fungi) had the highest frequency after bone marrow transplantation. Conclusions: According to the results, viral, fungal, and bacterial infectious agents were respectively most frequent in patients receiving bone marrow transplants. Gram-positive bacteria (bacterial agents), cytomegalovirus (viral agents), and Candida and Aspergillus (fungi) had the highest frequency after bone marrow transplantation.
Journal of Kermanshah University of Medical Sciences, Apr 3, 2010
Background and purpose: Aluminum phosphide (AlP) is commonly used in Iran (especially in north) t... more Background and purpose: Aluminum phosphide (AlP) is commonly used in Iran (especially in north) to keep stored rice and cereal grains safe from pests. There are several reports on intentional or accidental poisoning with AlP tablets also referred to as rice tablets. The goal of this research was to study the epidemiological, clinical and laboratory features in patients poisoned with AIP tablets. Materials and methods: In this cross-sectional study, information was extracted from patients' records in Qaemshahr Razi Haspital and Sari Imam Khomeini Hospital, 2013-2014. Data including demographic characteristics, number of tablets, methods of intake, time and season of abuse, the time interval between tablet ingestion and hospital admission, vital signs, and laboratory data were recorded in a check list. Results: Fifty two cases (mean age: 23.4±9.2 years) were investigated including 38 females (73.08%) and 14 males (26.92%). The overall number of poisoned patients was higher in autumn (28.8%) and in evenings (51.9%). Death occurred in 16 cases (5 males and 11 females) and 36 patients survived of whom four (2 males and 2 females) developed complications. Conclusion: In this study, the number of women poisoned with ALP tablet was dramatically higher compared to that of males. Autumn and evenings were found with highest rates of poisoning.
Indian Journal of Hematology and Blood Transfusion, Mar 1, 2008
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that may also be transmitted throu... more Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that may also be transmitted through person-to-person transmission by exposure to infected body fl uids. Despite its wide geographic distribution in animals, CCHF virus is rarely associated with recognized human diseases. We report the fi rst case of CCHF in Kermanshah province, Iran. Clinical presentation was characterized by fever, myalgia, and hemorrhage. The levels of liver enzymes, creatinine phosphokinase, and lactate dehydrogenase were elevated, and bleeding markers were prolonged.
Gastroenterology and hepatology from bed to bench, Apr 18, 2018
Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta vi... more Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta virus (HDV) in Kermanshah. Background: Hepatitis delta is one of the most complex viral infections of liver that along with hepatitis B virus could lead to fulminant hepatitis, progressive chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Methods: Referrals with positive HBs Ag were included and tested for HDV Ab using ELISA. Seropositives were subsequently evaluated for viremia by assaying HDV RNA and HBV DNA using real-time PCR. Viremia-related variables were also assessed. Results: From 1749 patients included, 30 had positive HDV Ab, which makes HDV seroprevalence 1.7%. Twenty-nine out of 30 seropositives were assayed for viremia. Fourteen cases (48.3%) had positive HDV PCR, 18 (62.1%) had positive HBV DNA. Eight patients (27.6%) had simultaneous replication of HBV and HDV, six (20.7%) only had HDV replication, ten (34.5%) only had HBV replication and five (17.2%) had no replication of either viruses. Conclusion: Kermanshah seems to be a low prevalent area in Middle East. Viremic HDV infection was lower compared to Europe and Africa, probably due to genetic variations of the hosts or the differences in genotypes or sub-types of hepatitis B and D viruses. Keywords: Hepatitis D, Prevalence, Viremia, Iran. (Please cite as: Sayad B, Naderi Y, Alavian SM, Najafi F, Janbakhsh A, Mansouri F, et al. Hepatitis D virus infection in Kermanshah, west of Iran: seroprevalence and viremic infections. Gastroenterol Hepatol Bed Bench 2018;11(2):145-152).
Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta vi... more Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta virus (HDV) in Kermanshah. Background: Hepatitis delta is one of the most complex viral infections of liver that along with hepatitis B virus could lead to fulminant hepatitis, progressive chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Methods: Referrals with positive HBs Ag were included and tested for HDV Ab using ELISA. Seropositives were subsequently evaluated for viremia by assaying HDV RNA and HBV DNA using real-time PCR. Viremia-related variables were also assessed. Results: From 1749 patients included, 30 had positive HDV Ab, which makes HDV seroprevalence 1.7%. Twenty-nine out of 30 seropositives were assayed for viremia. Fourteen cases (48.3%) had positive HDV PCR, 18 (62.1%) had positive HBV DNA. Eight patients (27.6%) had simultaneous replication of HBV and HDV, six (20.7%) only had HDV replication, ten (34.5%) only had HBV replication and five (17.2%) had no replication of either viruses. Conclusion: Kermanshah seems to be a low prevalent area in Middle East. Viremic HDV infection was lower compared to Europe and Africa, probably due to genetic variations of the hosts or the differences in genotypes or sub-types of hepatitis B and D viruses.
The pandemic of coronavirus (COVID‐19) has significantly increased the admission of patients with... more The pandemic of coronavirus (COVID‐19) has significantly increased the admission of patients with extensive complications, especially for respiratory support, to intensive care units (ICUs) worldwide. These patients also suffer from pressure ulcers (PUs) as another complication that occurs due to increased length of hospitalisation and acute conditions of patients. Therefore, this study aimed to evaluate the incidence and prevalence of PU and the factors affecting it in COVID‐19 patients admitted to ICUs. This cohort retrospective study used registry data in Imam Reza Hospital located in west of Iran. Four hundred and forty‐five COVID‐19 patients older than 20 years hospitalised in corona ICUs from 20 March 2020 to 30 December 2020, with a Braden score of less than 14 were included in the study. To investigate the relationship between variables in rate prevalence, univariate logistic regression analysis was used to calculate odds ratio, and for incidence rate in estimating PU risk generated in ICUs, hazard ratio was calculated using cox regression. One hundred and eighty‐three (41.12%) patients were male. The mean age of patients was 63 (SD = ±9.78) years. A total of 1152 cases of PU were generated, with the highest prevalence of PU with 234 cases in the sacrum. One hundred and seventy‐six (55.87%) patients underwent non‐invasive ventilation ulcers. The prevalence of PU was 79.7%. The highest prevalence was found in people over 80 years with 90.67%. The incidence ratio was 46.74%. The highest number of new cases was seen in diabetic patients with 60.96%. First‐degree ulcers were the most common degree of ulceration in 252 (55.38%) patients. Incidence and prevalence excluding first‐degree wounds were 24.04% and 49.66%, respectively. Age, Braden score, BMI, comorbidity, diabetes mellitus, stool incontinence, Glasgow coma scale, vasopressor, and length of hospital stay were significantly associated with PU (P < .05). The incidence and prevalence of PU in patients were high in this study. The length of hospitalisation and Braden score were the most important factors in the development of PU. The widespread prevalence of COVID‐19 and the relatively long stay of patients in the ICU created unfavourable conditions for patients and the treatment system, therefore, it emphasised the use of appropriate measures to prevent PU to avoid double costs and longer stays.
SummaryVaccination against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a cruc... more SummaryVaccination against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a crucial step in ending the current worldwide pandemic. However, several particularly vulnerable groups in the population were not included in sufficient numbers in coronavirus disease 2019 (Covid‐19) vaccine trials. Therefore, as science advances, the advice for vaccinating these special populations against Covid‐19 will continue to evolve. This focused review provides the latest recommendations and considerations for these special populations (i.e., patients with rheumatologic and autoimmune disorders, cancer, transplant recipients, chronic liver diseases, end‐stage renal disease, neurologic disorders, psychiatric disorders, diabetes mellitus, obesity, cardiovascular diseases, chronic obstructive pulmonary disease, human immunodeficiency virus, current smokers, pregnant and breastfeeding women, the elderly, children, and patients with allergic reactions) using the currently available research evidence.
The immunization of HIV/AIDS patients against Hepatitis B Virus infection is one of the most impo... more The immunization of HIV/AIDS patients against Hepatitis B Virus infection is one of the most important issues confronted by physicians. The results of this study suggest that Levamisole as an adjuvant to hepatitis B vaccine might be considered for increase the immune response to vaccination in these patients. Background: Human immunodeficiency virus (HIV) infected patients are also frequently exposed to the hepatitis B virus (HBV), due to the common routes of transmission, therefore, prevention of hepatitis B results in decreased complications of the disease. Objectives: Since the immune response of HIV patients to hepatitis B vaccination is less robust than that found in healthy individuals, this study aimed to evaluate the effect of a levamisole adjuvant on increasing the immune response. Patients and Methods: In this study, 89 HIV infected patients, without a history of HBV infection or vaccination, were randomly allocated into experimental (44 patients) and control (45 patients) groups. HBV vaccination was performed using the Hepavax-Gene TF vaccine, 40 μg three times at intervals of; zero, one, and three months. Levamisole 50 mg twice a day or a placebo, was administered to the experimental and control groups, respectively, for a period of six days before to six days after the vaccination. Immune response was evaluated by measuring hepatitis B surface antibodies (HBsAb) concurrently with the second and third vaccine administration, and at one and three months at the conclusion of the vaccination program. Results: The immune response following the threevaccinations was higher in those who were receiving levamisole compared with the controls (90% vs. 65.38%) (P = 0.05). Furthermore, the immune response and the mean antibody titer following the repeated vaccination in the experimental group showed a higher increase than in the control group. The immune response and the mean titer of antibody were not associated with; age, sex, body mass index, history of smoking and/or intravenous drug use in either of the groups. However, regarding CD4+ cells more than 200 cell/mm3, mean antibody production significantly increased in both groups. Conclusions: Using levamisole with the hepatitis B vaccination can increase the immune response and antibody titer mean in HIV infected patients. Since these patients have a more complete response with CD4+ cells more than 200 cell/mm3, vaccination and effective adjuvants seem to be most beneficial when CD4+ cells are greater than 200 cell/mm3, in HIV infected patients.
Iranian Journal of Clinical Infectious Diseases, Nov 16, 2020
Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in F... more Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in February 2020. Here, we report the epidemiological and clinical characteristics of patients with COVID-19 and factors associated with mortality in these patients. Methods: A retrospective cohort study was conducted from February 22, 2020, to March 24, 2020, in Golestan Hospital in Kermanshah, Iran. Demographic data including underlying diseases and clinical data including the presenting symptoms, chest computed tomography (CT) scan, reverse transcription polymerase chain reaction (RT-PCR) test results, and outcomes were extracted from electronic medical records. Simple and multiple logistic regression methods were used to explore the factors associated with mortality. Results: Of 245 patients admitted with COVID-19, 155 (63.30%) were male. The mean age of the subjects was 54.68 ± 19.21. Forty-five (18.48%) patients had underlying diseases. Common symptoms were dyspnea (n = 137; 55.9%), cough (n = 93; 38.0%), and fever (n = 78; 31.8%). All patients had pneumonia with abnormal findings on chest CT scan (100%), and RT-PCR test results were positive in 87 (35.50%) patients. Of the total admitted cases, 38 (15.5%) patients died during hospitalization. An old age (OR = 1.09; 95% CI: 1.02 to 1.06), history of heart disease (OR = 5.07; 95% CI: 1.46 to 17.58), hypertension (OR = 5.82; 95% CI: 1.13 to 30.04), smoking (OR = 11.44; 95% CI: 1.01 to 29.53), history of at least one underlying disease (OR = 3.31; 95%CI: 1.54 to 7.09), and symptoms of decreased consciousness at the time of admission (OR = 24.23; 95% CI: 2.62 to 223.39) were associated with mortality. Also, the symptoms of cough (OR = 0.383; 95% CI: 0.17 to 0.88) and fever (OR = 0.278; 95% CI: 0.10 to 0.74) had a negative association with mortality. Conclusions: In the current study, factors including old age, smoking, symptoms of decreased consciousness, and underlying diseases such as heart disease, hypertension, and history of at least one underlying disease were associated with mortality. Factors associated with mortality should be considered so that we can better manage patients with COVID-19.
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