فهرست مطالب

  • Volume:9 Issue:3, 2014
  • تاریخ انتشار: 1393/07/29
  • تعداد عناوین: 8
|
  • Muhammad Waqar *, Asad Ullah Khan, Amjad Ali, Muhammad Wasim, Muhammad Idrees, Zobia Ismail, Agha Asad Noor, Noorul Akbar, Shaista Bano, Muhammad Arif Khan, Rahim Ullah Khan Page 2
    Background
    Hepatitis C virus (HCV) infection is the most significant source of chronic liver diseases in the globe. About 170 million individuals are infected by HCV worldwide. The reported prevalence of HCV in different areas of Khyber Pakhtunkhwa (KP) ranges from 4.1 to 36%..
    Objectives
    The current study aimed to analyze the true prevalence of HCV infection in Khyber Pakhtunkhwa, Pakistan..
    Materials And Methods
    Three hundred and ninety HCV enzyme-linked immunosorbent assay (ELISA) positive samples that belonged to the different regions of Khyber Pakhtunkhwa were sent to the Genome Centre for Molecular Based Diagnostics & Research (GCMBDR), Lahore, from January 2011 to March 2011, and were selected for the current study. Serological and biochemical data of these samples were provided by clinicians. Out of 390 samples, 40 were provided from Mardan, 65 from Dir (Lower), 185 from Swat and 100 from Malakand districts of Pakistan..
    Results
    Out of 390 patients, 140 were found HCV RNA positive (by Polymerase Chain Reaction method) and 250 subjects were excluded from further analysis. Out of PCR positive subjects, 81 were male and 59 were female. All individuals were categorized in four age groups that is, 0 to 20, 21 to 40, 41 to 60 and above 60 years. HCV RNA was found in 16.67%, 37.5%, 35.51% and 36% of these groups, respectively. District wise HCV positivity rates were 36.2 % in Swat, 38.4% in Dir (L), 36% in Malakand and 30% in Mardan, respectively..
    Conclusions
    It was found that among the studied areas, Dir district had the highest prevalence of HCV, the majorly of affected patients were among the age group of 21 to 40, male patients were found more susceptible to this infection (P = 0.0103 < 0.05), and the possible reason can be the high exposure of males to the HCV infection risk factors. Furthermore the current study was unable to find the important risk factors responsible for the frequent prevalence of HCV infection in Khyber Pakhtunkhwa.
    Keywords: Hepatitis C Virus, Prevalence, Gender, Disparity, Khyber Pakhtunkhwa
  • Gita Eslami, Hossein Goudarzi, Elnaz Ohadi *, Arezou Taherpour, Bita Pourkaveh, Soudabeh Taheri Page 3
    Background
    Listeria monocytogenes as one of the foodborne pathogens is a causative agent of listeriosis. The transfer of L. monocytogenes bacteremia in pregnant women occurs as self-limited flu-like symptoms, but it may result in abortion, stillbirth or premature birth of the infected baby. One of the best methods for detection of this bacterium is polymerase chain reaction (PCR)..
    Objectives
    The purpose of this study was detection of virulence factors (hlyA and plcA) of L.monocytogenes in women with abortion, using PCR..Patients and
    Methods
    In this pilot and cross-sectional study, 96 patients with abortion admitted in educational university, Tehran, Iran were surveyed for L. monocytogenes by PCR and culture methods. Some variants like age, occupation, history of abortion and education were considered for all patients. Vaginal swabs and secretions were transferred to trypticase soy broth as the transport media and then all the samples were transferred to a microbiology laboratory. The tubes were incubated in 4 ºC and the specimens were cultured on PALCAM media. The isolates were verified by Gram staining, catalase and oxidase test, methyl red-Voges-Proskauer(MR-VP), sugar fermentations and motility in 20-25ºC. Then, PCR was performed for the extracted DNAs. Data were analyzed by SPSS software version 17 and χ2 (Chi-square test)..
    Results
    Out of 96 samples, 16 isolates of L. monocytogenes by PCR (plcA and hlyA) and four isolates by culture were identified. There was a significant difference between PCR and culture methods (P = 0.003). The results of this study showed that PCR was more sensitive and specific than culture method. There was also a significant association between the bacteria and hlyA and plcA genes and human abortion and between patients with abortion precedence and education..
    Conclusions
    Based on our study, plcA and hlyA played key role in the virulence determination of L. monocytogenes. Data analysis also showed that L. monocytogenes could be a causative agent of abortion in pregnant women..
    Keywords: Listeria monocytogenes, Abortion, Polymerase Chain Reaction, Culture
  • Rahim Raoufi Jahromi, Jamal Mirzaei, Jalil Rajabi *, Seyed Javad Hoseini Shokouh, Taraneh Liaghat Page 4
    Background
    Helicobacter pylori is the main pathogenic factor for chronic gastritis and peptic ulcer disease. Therefore, its successful eradication is important in the disease management. Multiple first-line treatments have been employed; the eradication rates in the most successful regimens have been 75%-92%. Primary bacterial resistance to antibiotics and patient compliance are two main cause of therapy failure. Furazolidone with a broad spectrum of antimicrobial activities is widely used in the treatment of bacterial and protozoal infections in both humans and animals, which could also be used in treatment of H. pylori infection..
    Objectives
    This study was designed to evaluate the efficacy of the therapeutic regimen containing furazolidone in comparison with a standard regimen against H. pylori..
    Materials And Methods
    In this randomized clinical trial, 110 patients with a positive urease breath test (UBT) were selected and randomly divided into two equal groups. The first group received the standard regimen consisting of clarithromycin (500 mg Q12h), amoxicillin (1 g Q12) and a proton pump inhibitor (PPI) (omeprazole 20 mg BID). The second group received bismuth subcitrate (120 mg Q6h), furazolidone (100 mg Q6h) and tetracycline (250 mg Q6h) and a PPI (omeprazole 20 mg BID) for two weeks. UBT was performed again for all the patients two months after completing..
    Results
    UBT was negative in 83.6% of patients in the standard group two months after the end of the treatment. Eradication of H. pylori was reported in 94.5% of patients in the experimental group. No significant relationship between age and eradication of H. pylori was observed in both groups. Nausea and vomiting was reported in 5.45% of patients treated with our experimental regimen. These symptoms were tolerable and the treatment was completely continued. No adverse effect was recorded in the standard group. Moreover, no relationship was observed between gender and eradication of H. pylori in both groups. Finally, despite a better therapeutic response to our experimental group in comparison with the standard one, no statistically significant difference was observed (P = 0.067)..
    Conclusions
    Based on our finding in this study and similar studies in different parts of the world, furazolidone could be prescribed as an effective antibiotic against H. pylori in patients with gastritis..
    Keywords: Gastritis, Furazolidone, Helicobacter pylori
  • Elsadig Mohamed *, Mohamed Ounsa, Mohamed Al Mansour, Mansour Alzahrani, Sawsan Abdalla, Khalid Medani, Hatim Sidahmed, Waqas Sami Page 5
    Background
    Tuberculosis (TB) continues to be a major public health problem worldwide. In developing countries, the burden of the disease is explosive, as 95% of global TB patients reside and 98% of global TB deaths occur in these regions. Patients’ satisfaction may play a major role in adherence to medications and hence improve tuberculosis cure rate..
    Objectives
    The current study aimed firstly to determine the level of patients’ satisfaction with TB services in Gezira state, and secondly to identify it’s major contributing factors..Patients and
    Methods
    This was a cross-sectional study by design, which included newly diagnosed TB patients in the Gezira state, located in central Sudan. The data was collected by simple random sampling from 292 patients using a pre tested questionnaire after obtaining an informed consent..
    Results
    The level of satisfaction with the provided TB services was 56.2%. Patients with no income were more satisfied (82.7%) with TB services than those with debts (67.1%) and savings (42.7%). Patients who attended private facilities were more satisfied with TB services (85.3%) than those who attended public health facilities. Patients were more satisfied with TB services provided by the medical assistants (70%) than that provided by general practitioners (54.4%), interns (44.7%) and chest physicians (38.3%). Tuberculosis patients who spent shorter time to receive their required service were more satisfied (63.3%) than those who spent a longer duration of time (45.4%)..
    Conclusions
    The level of satisfaction of TB patients with the provided services was moderate. Patients having high income were more satisfied with the provided TB services than those with low income. Patients who attended private hospitals and general/chest hospitals showed high satisfaction with the provided TB services than those who attended health centers and the Tuberculosis Basic Management Units (TBMUs). Tuberculosis patients treated by a junior staff showed more satisfaction than patients treated by a senior physician..
    Keywords: Patient Satisfaction, Tuberculosis, Services, Gezira, Sudan, Mycobacterium tuberculosis
  • Mohammad Yasin *, Amir Hossein Moghtader Mojdehi Page 6
    Introduction
    Brucellosis is a zoonotic infection with high distribution all over the world and has many clinical manifestations, one of which is neurobrucellosis (NB)..
    Case Presentation
    Our case was a 78-year-old man who presented acute decreased level of consciousness, acute parkinsonism signs and hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH), which was caused by brucellosis..
    Discussion
    Neurobrucellosis is a rare presentation of brucellosis and should be considered when neurological problems cannot be explained by other etiology especially in endemic areas..
    Keywords: Brucellosis, Neurobrucellosis, Inappropriate ADH Syndrome, Parkinsonism
  • Bahaadin Siroos, Zahra Sharify Bahram, Omid Ghaemi, Seyyed Mahdi Zia Ziabari, Mojtaba Hedayat Yaghoobi * Page 7
    Introduction
    Rhino-orbito-cerebral mucormycosis is a progressive angioinvasive fungal disorder which almost always complicates immunocompromised patients..
    Case Presentation
    We described a case of fulminant rhino-orbito-cerebral mucormycosis in a 65-year-old woman, who presented with progressive neurological deficits due to involvement of orbital apex and the central nervous system by local invasion of the left inferior frontal lobe, retrograde perineural spreading to the brain stem and middle cerebral arteries thrombosis..
    Discussion
    Early diagnosis is mandatory in managing of this life-threatening disorder. Urgent surgical debridement associated with antifungal agents (amphotericin with posaconazole) is the mainstay of treatment..
    Keywords: Mucormycosis, Orbital Diseases, Middle Cerebral Arteries
  • Reza Hashemi, Alireza Majidi *, Ali Tabatabaey, Hassan Motamed Page 8
    Introduction
    Cryptococcosis is an opportunistic fungal infection mostly in immunocompromised patients. Here we present the immunocompetent case with crypotoccosis..
    Case Presentation
    A 60-year-old man without any history of immunodeficiency or major risk factor of fungal infection, referred to the emergency department with systemic symptoms and low back pain. The patient’s condition gradually deteriorated within days by forming the clinical picture of a multi−system disease and eventually leading to a fatal outcome. The results of skin biopsy, BAL, gastrointestinal biopsy samples and post mortem lung and liver necropsies confirmed the disseminated Cryptococcus neoformans infection in smears and cultures..
    Discussion
    This case emphasizes the need for a high index of suspicion for fungal infections in patients with multi−organ involvements who are unresponsive to treatment. Even without any obvious history or sign of immunodeficiency..
    Keywords: Cryptococcosis, Immunocompetence, Mycoses