Iranian Journal of Infectious Diseases and Tropical Medicine
Year:2002 | Volume:7 | Issue:17|Papers Count:17

Needle necropsy is a method in which different tissue samples are taken from body after death without skin incision, opening the chest and abdomen or making any disfiguration in body. In current study 92 tissue samples were taken iTom35 bodies including 25 male (71%) and 10 female(29%) with age ranging iTom13to 92 Years old at the time of death. Necropsied organs included liver Lung Bone marrow, heart, brain and Of which the most samples were taken from liver (35 cases, 38%) and the least from bone (One case, 1%). The yielded results of these35 bodies are as follows: IS cases (43%) with definite diagnosis Postmortem - 18 cases (51%) with nonspecific histopathology findings and without andy diagnisis-2 cases (6%) with nonspecific histopathology findings but with positive microbial cultures(blood, pleural fluid) in patients when they were alive. Considering 43% results of needle necropsy with definite determination of causes of death and due to religious and Cultural limitations of autopsy(Which is an ideal method) in Iran, we suggest needle necropsy as an alternative for autopsy in determination of cause of indefinite deaths.

Background: H, pylori is strongly associated with chronic active gastritis and 95-99% of duodenal ulcers and most gastric ulcers as well. Metronidazole based therapies show an optimal efficacy ranging from 80' to 95% in western countries but in areaswitha high Metronidazole resistance such as IRAN the eradication rate is usually suboptimal. Fufazolidone shows a promising efficacy while replacing Metronidazole in different eradication regimens. This study 15 trying to determine the efficacy of a quadruple therapy based on Furazolidone as a second line treatment in Metronidazole resistant patients. Materials and methods: 89 H. pylori infectedpatients who were treated for at least 14 days with Metronidazole based quadruple therapy and still had a positive UBT had been included. They were treated with Furazolidone, Bismuth, Amoxicilline and Omeprazole for 2 weeks. Eradication was described as negative 14 C-Urease Breath test, 4 to 6 weeks after of the treatment. Results: Total eradication rate in 89 patients who completed the treatment course was 68/89 (75.6%) Eradication rate has not significant relationship with gender of patients (35/48 in males versus 35/41 in females, P > 0.05). 19 patients out of 90 (21.1%) were smoker. Eradication rate among smokers was 11/19 and in non-smokers was 57/70 (P < 0.05) and there was a significant relationship between smoking and decrease of eradication rate (Ci > 95% & OR = 3.12). Distribution of H. pylori associated problem in our patients (determined) by endoscopy) was duodenal ulcer (DU) (11.1%) and nonulcer dyspepsia (NUD) (10%). Eradication rate was different in these groups: in DU patients 55/70, in GU patients 6/10 and in NOD patients 7/9(P>0.05). Therefore we couldn't show any significant relation between these items.Discussion: This study determines the efficacy of a quadruple therapy regimen based on Furazolidone as a second line treatment. So in Iran, where Claritromycin is very expensive and difficult to archive, Furasolidone could be used sufficiently.

This prospective study was performed on CSF changes in 50 patients with bacterial and viral and T.B meningitis in infectious department of Booali hospital between years 95 and 98. From 50 patients 30 cases had bacterial meningitis. 14 cases had viral and 6 cases had T.B meningitis. 24% of them were female and 76%of them were male. Range of age in patients with viral meningitis was 14-24 years, in bacterial meningitis was 17-54years, and in T.B meningitis was 19-65years. In CFS study in bacterial meningitis we had protein 100mg%in 66.6%. CSF GLC/Serum GLC20% in 46.6%leukocyte count in range of 1000- 10000 in 53.3% and PMN dominancy in 93.3% of patients In Patients with viral meningitis in CSF study we had normal protein in 71.4% normal GLC in 85.7% leukocyte count in range of 100-500 in 57.1%With mononuclear dominancy. Patients with T.B meningitis: CSF protein 45-100 mg% in 66.6%, CSF GLCl Serum GLC<20%in 100%, leukocyte count in range of 100-500 in 100% with. mononuclear dominancy. In study patients CSF, 7-14 days after start of treatment, most of patients with bacterial and viral meningitis had some amount of GLC protein & cells which had came back to normal. In patients with T.B meningitis leukocyte count were <100 with mononuclear dominancy. CSF proteins were 45-100 mg'1o and CSF GLC/Serum GLC<20% were persistant7-14 days after treatment beginning. In the other words though CSF index amount had been decreased. none of them were in normal range. We had mortality in 7 case (that 4 cases in bacterial and 2 cases in T.B and I case in viral meningitis).

The frequency of peptic ulcer disease is increased in cirrhotic patients. whether Helicobacter pylori infection is a risk factor for peptic ulcer in these patients remains to be determined. The aim of this study was to evaluate the correlation between H. pylori infection and peptic ulcer in cirrhotic patients. In a case control study 106 well- established cirrhotic patients underwent upper gastrointestinal endoscopy. H. pylori status was assessed by rapid ureas test of gastric antral biobsy specimen. Mean age of patients was 46.19 ± 18, 70 males and 36 females. There was no difference between mean age of H. pylori positive and negative cirrhotic patients (P=0.69). 36 out of 106 (34%) patients had peptic ulcer. There was no significant difference in the frequency of H. pylori in the antrum of cirrhotic patients with and without peptic ulcer (55.6% verusus, 42.9%). The prevalence of H. pylori infection in cirrhotic with and without varices or hypertensive gastropathy did not show any statistical difference. We found a weak association between H. pylori infections and peptic ulcer in cirrhotic patients. High prevalence of peptic ulcer in cirrhotic patients should be related to causes other than H. pylori infection.

Liver is a common organ involved in HIV infected patients. The most important reason is liver infection caused by hepatotropic viruses via sexual contact or sharing contaminated needles for drug abuse. About 50 Percent of HIV - infected patients are confected with either HCV or HBV. Coninfected HCV patients with HIV have a significant rate of hepatic disease activity and progression to cirrhosis and hepatic failure in comparison with isolated HCV infected cases without concomitant HIV infection. In this study, HIV positive patients were evaluated for HCV infection by ELIZA serologic test with confirmation tests performed for some of them. 85% had serologic evidence of HCV infection and all of the patients undergone liver biopsy suffered from chronic active hepatic disorder. We conclude that prevention of both infections by education of general population. particularly drug addicts is a major priority.

Human brucellosis, continues to be a major public health problem worldwide and Iran is considered as one the endemic polluted regions of brucellosis. A number of treatment modalities have been recommended for the treatment of brucellosis. Each children under 12 years and affected with brucellosis who had reported at the children outpatient department or were admitted in the ward between 1368 and 1379 and treated with a combination of cotrimoxazole and Gentamycin. Out of 101 cases, 100 revealed an improvement or altogether disappearance of, clinical signs likewise, the wrights and 2ME titers showed a decline following one weeks of treatment. 100 patients showed a decrease in the titers of Wright and 2ME 6 weeks after treatment. Only one of the cases had persistence of symptoms and rising titers 6 weeks after the treatment. An assessment revealed later that the mother had provided her child with medicines less than that recommended by the physician and for a period shorter than the recommended duration. On completion of the treatment, the patient regained full recovery without any relapses. In conclusion, our treatment protocol proved to be. hundred percent effective.

Introduction: one of the most comJ1oncauses of mortality in the world is coronary artery disease (CAD). Major known cases of CAD include diabet mellitus , Hypertension, smoking, obesity and Positive family history. Recently, many studies reported other relationships particularly microorganisms such as helicobacter pylori and clamidia pneumonia. Method and material: this is the first Iranian study about CAD and helicobacter pylori performed in cardiology clinic of shaheed Beheshti hospital in Babol university of medical sciences within 1376 &1377. We used 90 persons in this descriptive analytical case- control study. Case group had documented coronary artery desease, and control group was free of any coronary problem. We used ELISA method for assay of igA level in serum. Results: mean serum levels for both IgG and IgA in cases were higher than control group, but mean IgG level in both males and females was higher than IgA level. Mean serum levels of both IgG and IgA in females were higher than mles.  Conclusion: in this case - control study we detected marked high levels of both anti HP IgG and  IgA in CAD patient. This correlation was me prominent in IgA levels in males.

Toxoplasma gondii is the obligate intracellular protozoa which causes toxoplasmosis. This disease is one of the most common parasitic infectious disease throughout the world particularly in Iran (51.8%), which is important in veterinary and medical sciences due to being common between men and animals. As regards to the high prevalence of this parasite in north of Iran (55.7%), and concerning to this fact that one of the most common ways for the infection of main host(cat) is eating the rodents having toxoplasma cyst in the brain and other tissues, we decided to select Lahijan due to the ouburst of warehouse rodents among the northern cities and to survey their infection with T. gondii. In this research, 100 warehouse rodents types Ratuus ratuus and Ratuus norvegus were examined by using the diagnostic direct slide method$, injection into the lab white n1ceand serologic test in dye test method. For this, purpose, it was bled from the heart of rodents to perform the dye test, and the sera were isolated by centrifuging for 5-10 minutes in 1500 rounds. After preparing dilution of 11.and performing the dye test stages, 24 cases (23 of 93 Rattus morvwergicuses and 1 of 7 Rattus ruttuses) were positive and 78 cases were negative. Then, in order to prepare the direct slide and intraperitoneal injection into the lab white mice, we sampled and used the brains of rodents. All direct slide were negative from the view point of toxoplasma cyst existence, and also the tackyzoite from and intracellular from were not observed and separated in the peritoneal.

Hospitalized medical record evaluation of 507 cases of children with pneumonia at Hazrat Ali-Asghar Children's hospital within 2 years (1995 and 1996) revealed association of underlying causes in 139 cases (i.e. one third of the patients), ages from one day to 13 years with slight predilection in males. The highest frequency of Pneumonia was in age group of 1to 5 years, particularly in one to 12 months of age. The most common associated predisposing factors were as follows: Congenital Heart Disease 23.7% and Asthma 22.3%, Down syndrome 8%, cystic fibrosis 7%, Acute Lymphocytic leukemia 5%. Early children diagnosis and appropriate management of predisposing factors of pneumonia in certainly provides improvement of final outcome. Proper consoling in cases of disorders immunologic, metabolic and genetic will minimize further family problems in future.

The causes of fever of unknown Origin are varied with new diagnostic methods and geographical locations. With this aim this study was d7signed on all patients with FUO diagnosis who admitted in educational hospital of hamadan city in 1996-2001 .In this study 120 patients who had fever 'higher than 38.3 C on several occasions persisting without diagnosis for at least 3 weeks in spite of at least 3 days investigation in hospital. or more than 3 visits were known FUO. In this study infections (60%) have been the commonest cause of FUO. Miscellaneous causes (15.8%), Neoplasm (10.5%) connective tissue diseases (8.3%) have been the second, third and fourth cause of FUG. Extra pulmonary tuberculosis (20.9%) and Abdominal abscess (19.5%) brucellosis (9.2%) were the most common cause of infectious diseases. Adult still disease, (1.6%) is the most common cause of connective tissue diseases. Lymphoma (3.3%) is the most common causes of neoplasm's. FUO is more common in male sex (59.2%) and FUO is more common in Patients older than 50 years. Tuberculosis and brucellosis which are two common disease in Hammadan city, are the most common cause of FUO too.

Background & Objectives: This study was carried out for efficacy of rapid diagnostic tests (CRP, ESR, Leukocyte count) in early diagnosis of neonatal septicemia. Materials & Methods: This study was done in year 2000 as a prospective quantitative descriptive study. the cases were 75 septic neonates admitted in neonatal wards of Sina & Ghaem hospital, with positive blood culture, in these neonatal the ESR , CRP 8: CBC obtained from their file. Results: According to the results of this study, the sensitivity of ESR was (48%), CRP (57.3%), leukocytosis (28%), Leukopenia (2.7%), neutrophilia (40%)and neutropenia (6.7%). Conclusion: Because sensitivity of these test are low, there is no significant relation between results of rapid diagnostic tests and early diagnosis of neonatal septicemia and gold standard for diagnosis of neonatal septicemia is positive blood culture.

Clostridium botulinum Type A Neurotoxin is one of the 7 recognized types that is available in clinical use. The reference standard criteria for medical uses of toxin is necessary. It should be based on its chemical and physical properties, such as: extinction coefficient as an equal 1.65 and a 260/278 nm absorbance ratio of <0.55 to quantitatively measure the toxin. This study was conducted to examine the effect of different ingredient culture media on growth, protein production, extinction coefficient and 260/278 nm absorbance ratio of Neurotoxin Clostridium type A. The different concentration of culture media was made, each if them were spectrophotometry scanned in 200 nm. Then inoculated with preculture and 300-anearobicly incubation was carried out. After incubation period, growth and protein production was assayed- Nerutoxin production was tested in albino mice by inducing paralysis through i.p. injection. In addition to toxicity assay, the production and extraction of toxin sheme were monitored by 260/278 nm absorbance ratio and extinction of coefficient was calculated respectively. The results showed that, a change of ingredient culture media, could be produced toxin with appropriate extinction coefficient and ratio of absorbance.