فهرست مطالب

  • Volume:2 Issue:4, 2008
  • تاریخ انتشار: 1386/12/11
  • تعداد عناوین: 10
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  • Masoud Mardani Page 167
  • Mojtaba Varshochi, Behrooz Naghili Page 169
    Background
    Mycetismus or mushroom poisoning is an important health concern and a potentially fatal state that usually occurs after incidental ingestion of mushroom’s sexual organs or fruiting bodies of fungus among the mycologists and the one who desire a natural or organic diet. The vast majority of mortality due to mushroom poisonings is attributed to fungus belonging to genus Amanita.
    Materials And Methods
    This report describes 34 cases with A. phalloides mushroom poisoning regarding the epidemiological presentation, clinical manifestation and laboratory findings. These patients were admitted in three hospitals of Tabriz University of Medical Sciences during 1989-1994.
    Results
    The age of victims ranged from 4-75 years. Diagnosis of A. phalloides mushroom poisoning was confirmed by mycologist in 12 cases, toxicological studies in 5 cases and combined mycological and toxicological approaches in 3 cases. It was only suspected in 14 cases as the patients had died before being admitted or immediately after hospitalization. Ingestion of doubtful mushrooms was found either in their histories or mushrooms poisoning was documented in their relatives. Most of the victims (68%) were affected in spring, while no case was reported in summer.
    Conclusion
    Mushroom poisoning should be considered in differential diagnosis of any case of acute gastroenteritis, especially during spring and fall when moderate temperature and moist conditions facilitate mushroom’s growth.
  • Maryam Amini, Mozhgan Bahador, Mansore Malekhoseyni Page 177
    Background
    Hydatid cyst is one of the most important and dangerous human and herbivore animal helminthic disease. Infection is quite prevalent in Iran, however, patients’ features and manifestations have not been clarified thoroughly, thus, in the present study we evaluated Iranian patients with hydatid cyst referred to a tertiary hospital in Tehran during a 20-year period.
    Materials And Methods
    For this descriptive study, initial data including age, sex, clinical symptoms, cyst type, the place of cyst replacement, diagnostic technique, laboratory findings, treatment modalities and relapse were obtained from patients medical files.
    Results
    Totally, 60 patients aged 4-70 years were entered, of whom 32(53.3%) were females and 28(46.7%) were males. House-wives (75%) and farmer men (42.8%) were more commonly affected. In 80% of the cases cyst was found in liver (lonely or with other organ involvement). Echinococcous Granulosus was detected in all patients. RUQ pain and cough and sputum were the most common symptoms of liver and lung cysts, respectively. Totally, 20% of patients referred with relapses, most of whom were multivesicular.
    Conclusion
    Our results revealed that hydatid cyst in Iran is more or less the same as other western societies, however, a high rate of relapse in multivesicular cysts was noted
  • Abdolreza Soudbakhsh, Mahboobe Hagiabdolbaghi, Hamideh Bagherian, Omid Yussefnejad Page 181
    Background
    Infective endocarditis (IE) is a serious complication of intravenous (IV) drug use. During the recent decades, its incidence has been increased. The present study was designed to compare the clinical and laboratory findings of IE among IV drug users and non-drug users.
    Materials And Methods
    Totally, 40 IV drug users and 40 non-drug users were included and their medical files reviewed. Initial data including age, sex, fever, heart murmur, systemic emboli, cough, hemoptysis, pleuretic chest pain, abscess, and the possible organism were gathered by a questionnaire.
    Results
    IV drug users were younger and showed a male predominance. When compared with non-drug users, right-sided IE, abscess, and history of previous antibiotic therapy before admission were more commonly found among IV drug users. Staphylococci were the most prevalent causative organism among IV drug users, while among non-drug users, streptococci were the most common agents. Heart murmur was detected more frequently among non-drug users.
    Conclusion
    Infective endocarditis among IV drug users is a serious entity produced mainly by S. aureus, and affects preferentially the right-side cavity. Our results emphasized on the importance of clinical characteristics of IE among IV drug users.
  • Fatemeh Fallah, Abdollah Karimi, Gita Eslami, Hossein Goudarzi, Mostafa Sharifian, Farzaneh Jadali, Shahnaz Armin, Yadollah Mehrabi, Ali Jahansepas Page 185
    Background
    The Bam earthquake in southeastern Iran turned an ancient city to dust, killing thousands and destroying 80% of all infrastructures. More than 30,000 people died and It left some 100,000 people homeless. Direct contact with polluted water increases the risk of infection, particularly wound infections, cellulitis, dermatitis, conjunctivitis, and ear, nose and throat infections. The prevalence of NTM (non-tuberculosis mycobacteria) is difficult to obtain. The aim of this study was isolation of bacteria and mycobacterial agents‚ especially atypical species from dermal lesions of children in Bam earthquake.
    Materials And Methods
    In this descriptive study, 88 children settled in camps in 2004 were enrolled. Samples from dermal lesions of children were obtained and transported with middle brook 7H9 and Brain Heart (BH) media to laboratory for isolation of mycobacterial agents and other bacteria. For isolation of mycobacterium, after decontamination and acid-fast staining, they had been cultured in Lewenstein-Jensen medium. Having isolated mycobacteria by differential tests their antibiotic resistance and susceptibility were studied. Meanwhile, other bacteria were identified by staining and culturing in standard media.
    Results
    The study population included 32 girls and 56 boys. Of 88 samples, 3 mycobacteria were isolated (3.4%) of which 2 were M. chelonae (rapidly growing) and 1 was M. scrofulaceum (slowly growing). The most common isolated bacteria were E.coli (41%) and Coagulase negative staphylococcous (38%).
    Conclusion
    Infectious disease epidemics may play a role in the post disaster period. Since atypical mycobacteria exist in soil, and some cases were reported from Iran, isolation of these microorganisms is of utmost importance especially in children after a disaster such as earthquake.
  • Gita Eslami, Fariborz Taremian, Bahram Kazemi, Hossein Goudarzi, Fatemeh Fallah Page 189
    Background
    Cardiovascular disease (CAD) is the leading cause of death in developed countries. The cause is multifactorial. A substantial proportion of patients with CAD do not have traditional risk factors. Infectious diseases may play a role in these cases, or they may intensify the effect of the risk factors. The association of CAD and Chlamydia pneumoniae infection is firmly established, but causality is yet to be proven. We investigated their presence in carotid atherosclerotic plaques.
    Materials And Methods
    One-hundred two atherosclerotic plaques in dead patients were studied. The highly sensitive polymerase chain reaction method was employed with primers specific for this agent. PCR targeting the 16S rRNA gene and a nested PCR targeting the ompA gene were performed to detect C pneumoniae DNA.
    Results
    The presence of Chlamydia DNA was detected in 22 (23.3%) samples. The following risk factors were found among these 23 C. pneumoniae-infected cases: low HDL in 8 (34.8%), hypertension in 5 (21.7%), diabetes mellitus in 4 (17.4%), smoking in 11 (47.8%) and family history of cardiovascular disease in 6 (26.1%).
    Conclusion
    The presence of Chlamydia DNA supports the hypothesis that this agent is associated with atherosclerosis.
  • Batool Sharifi Mood, Masoud Mardani, Malihe Metanat Page 193
    Background
    Crimean-Congo hemorrhagic fever (CCHF) is caused by Nairovirus, genus Bunyavirus in family of bunyaviridae, and is spread by the tick Hyalomma spp or via blood transfusion and contaminated blood of human and animal. During the recent years, disease has been reported from Iran, especially from Sistan and Baluchestan, Isfahan, Kermanshah and Kohkilouyeh-bouyerahmad provinces. Now, CCHF is endemic in Sistan and Baluchestan province. The resent study describes the clinical features of CCHF among pregnant women.
    Materials And Methods
    We report our experience with six pregnant women with CCHF, who were admitted to Boo-Ali hospital during 2000 to 2005. All patients were treated by Ribavirin. We studied the clinical manifestations, laboratory findings and clinical outcome of disease in all cases.
    Results
    Our results showed that, fever, headache, myalgia and gingival bleeding were the most common clinical manifestations. Thrombocytopenia, anemia and decreased protrombin time were the commonest laboratory findings. Abortion was observed in 3 patients and stillbirth in one patient. In fact, 66.6% of pregnant women had fetal loss.
    Conclusion
    It is found that fetal loss is high in CCHF parturients, however, it should be further studied in endemic areas.
  • Shervin Shokouhi, Shahryar Nikpour, Morteza Sanei Taheri, Seyed Amin Zamiri Page 199
    Background
    Mycobacterium tuberculosis is the cause of 43% of the peripheral lymphadenopathy cases in developing countries. However, psoas abscesses are usually secondary to the extension of infection from an adjacent site. In the present study, we describe a case of abdominal and cervical lymphadenopathy and multiple abscesses due to mycobacterium tuberculosis.Patient: A 55 years old man with abdominal and cervical lymphadenopathy, psoas muscle sheath abscess and a large abscess of abdominal wall was admitted. Vertebral column was intact and the patient didn’t have immunodeficiency or history of illicit drug use. Analysis of aspirated pus with PCR for mycobacterium tuberculosis was positive, however, Ziehl-Neelsen and gram staining was negative. Culture of pus was positive for mycobacterium. Treatment was commenced with 4 drug antituberculosis regimen. During the treatment period, paradoxical reaction occurred and prednisolone was administered. Following 9 months of treatment, the abscesses resolved and the patient recovered completely.
    Conclusion
    our patient presented with a group of uncommon extrapulmonary presentations including GI involvement, paraaortic lymphadenopathy and abscess formation secondary to tuberculosis that was aroused without any immunodeficiency context with hematogenous origin. He responded well to our therapeutic protocol.
  • Simindokht Shoaei, Bahram Nasri Razin, Alireza Family, Mahmoud Nabavi Page 203
  • Naser Sharafaddinzadeh, Ali Moghtaderi, Roya Alavi Naini Page 207