Iranian Journal of Infectious Diseases and Tropical Medicine
Year:2006 | Volume:11 | Issue:33|Papers Count:13

Background and Objectives: Nowadays, using ready to use and fast foods like sausage and hamburger is very delicious. These foods are provided in many ways, but one of them that is used in IRAN and some other developing countries, is by using a material that is named MDM (Mechanically Deboned Meat). As skeleton and residues are prepared from many unhygienic places, it may be contaminated with many agents like Salmonella spp., E.coli, Staph.aureus, Molds &Yeasts. In this research, we want to detect the microbial agent that had been forbidden to be in these products, because most consumption of these products is with childes and teenagers. Material and methods: This research was performed on 100 samples, have been sent from veterinary organization. These samples were sent us, in 10Kg frozen packing. And were studied in microbial lab for determination above agents. Results: The results showed that, the contamination of the samples were as follow: 53% Salmonella spp., 59% E.coli, 68% Staph. aureus, 21% Molds and 62%Yeasts. Serotyping of the contaminated samples with Salmonella spp. was as below: 13% S.gallinarum, 10% S.typhimorium, 9% S.enteritidis, 8% S.paratyphi A, 8% S.paratyphi C and 5% S.paratyphi B. Conclusion: Therefore, it most notify that, the microbial contamination of this product is very high, that is show the violation in the process of production of this material. Because the presence of bacterial strains like, Salmonella spp. and E.coli had forbidden. So the consumption of this material for producing sausage and hamburger, which is used with most of people, must be forbidden.

Background and objectives: hepatitis B infection is a major problem in HIV Patients. Because of similar port of transmission, all of HIV patients are at risk to acquisition of HBV infection. The major way for prevention of HBV infection is vaccination against HBV. In this study the seroconversion rate to HBV vaccination in HIV Patients referred to consulting center of Kermanshah, was evaluated. Material and methods: In this cross sectional study, 169 HIV Patients who were HBs-Ag and HBc-Ab negative ,vaccinated against hepatitis B viruses (20 μg of recombinant HBsAg at 0-1-6 mo schedule in deltoid region) in 2004 .We measured anti-HBs titer 30 days after delivery of the third dose. Patients with titer above 10μIu/ml considered immune. Some factors included: Age, Sex, IVD using, hepatitis C coinfection, CD4 count, evaluated and data,s analyzed using X2 test. Results: Among 169 HIV Patients (157 males, 12 females) immune response rate was 52/7%, this rate was 66/7 % and 51/9% for female and male group respectively ( NS). Immune response was 54.3%, 44.3% and 45.3% in CD4 count >500,200-499 and <200 respectively (P<0.039). In antiretroviral treated group response rate was 81.8% (P<0.045). Immune response rate was 51% in IVDU's and 51.3% in HCV co infected individuals (PV=0.294%). Conclusion: In this study immune response rate to HBV vaccine was similar to most other studies. We demonstrated that two factors included Antecedent anti retroviral therapy and CD4 count were associated with seroconversion rate ,Thus we recommend that vaccination against HBV in early phase of HIV infection that CD4 count was not significantly reduced and during of anti retroviral therapy, could improve response rate to HBV vaccine.

Background and objectives: Chronic rhino sinusitis (CRS), with or without polyposis is a common disease among population. Up to date so many studies have performed to find a clear ethio pathogenesis for chronic rhino sinusitis. Recently, some of researchers claim that fungal agents within sinus cavity trigger CRS cascade. However, it is accepted that in 100% of healthy people and 96% of CRS cases have fungal agents extra mucosal within their sinuses but they have different immune responses to these agents. Material and methods: This study is a quasi-clinical trial evaluating therapeutic effects of intranasal Amphotricine-B in CRS with or without polyposis. Patients with CRS with or without polyposis who were referred to Loghman Hakim Hospital, were diagnosed and classified regard to clinical (SNOT) , radiological(L&M) and endoscope (MALM) findings. These patients treated with intranasal normal saline twice a day and then intranasal Amphotricine-B 100 mic/cc twice a day (20 cc in each nasal nare) and beclomethason nasal spray 2 puff each side twice a day for two months. After receiving the above-mentioned treatment, the patients were evaluated again clinically (SONT), radiological (L&M) and endoscope (MALM) indexes. Results: The clinical findings, according to SNOT-score changed from 2/3 to 0/9, showed an improvement that was statistically significant (P<0/0001). The score of CT scan findings (Lund & Mackay) reached from 9/25 to 5/3.Those changes were statistically significant (P<0.0001). Malm staging according to endoscopic finding 84% down graded. Conclusions: According to above mentioned results perhaps intranasal Amphotricine-Badministration would be one of multiple adjuvant factors, which treats CRS & prevents CRS recurrences.

Back ground and objectives: M. tuberculosis affected one third of population in the world If the disease is not correctly treated it will cause failing the treatment, remaining infectious source probability of MDR - TB and wasting Cost. DOTS strategy is the best way to control of TB. Materials and Methods: A cross sectional-descriptive study was performed for all patients infected to TB listed in Mashhad Health centers during 1379 - 1381. We studied variables such as age, gender, education, job, marriage, nationality, prison, diagnostic method, kind of TB (pulmonary, extra pulmonary) and result of treatment. Results: From 2840 Patients, there were 75% Iranian, 24% Afghans, 39.9 % males 60.1% females, the highest incidence is in elders more than 65 years old.  53.5% (1518) smear positive pulmonary TB, 15.4% (437) smear negative pulmonary TB, 31.1% (885) extra pulmonary. 91.9% (2610) new case and 1383 (48%) new case and smear positive pulmonary TB. Follow up results were: Cure rate 66.2%, complete treatment 11.9%, Death due to TB 0.7%, Death due to others 1.3%, Unknown origin of death 4.6 %, Failure 2.5%, Defaulted 6.7%, and transfer 6.3 %. Conclusion: Success Rate in this study was 78.1% (in comparing with WHO 85%). Probably due to transfer to other sites and treatment failure was 2.5% (in com paring with WHO <4%) and default was 6.7% (in comparing with WHO<10%)

Background and objectives: Brucellosis is one of the most important zoonotic diseases. It transmits with contact with Blood, Placenta, other animal genital production, milk and other Productions. The most important control way is Prevention. Material and methods: This survey is a cross - sectional study. From 1376 until 1382 exactly 3880 brucellosis Patients was studied. The Index for patient was Right agglutination test 1/80 and more. All patients with this Index were investigated and was gathered all data from them. The date was analyzed with SPSS. Results: In these Survey 3880 Patients was investigated. 2020 (% 52/1) were male and 1860 (47/9%) were Female. 707 (%18/2) were urban and 3173 (%81/8) were Lived in rural area. The incidence rat due these years has had an increasing value only with a defect in 1379. The high incidence rat in Kurdistan Province was in 1382 and it was 89 per 100000. The incidence rat in rural area was more Than 5 than urban area. The most Patients were in eastern cities (2 cities) with %52 of all patients. The commons most job was home keeper wives. The average age of incidence was 30/03. There was significant relation between age and sex (PV<0/0001). There was a relation between sex and Place of live (PV<0/002). Conclusion: The increasing trends of brucellosis in these years are not like other infectious diseases. It can be due to brucellosis in animal. The findings of this survey are different with other survey with sex. The control of brucellosis, must considered with Prevention disease in animal. People training especial home keeper wives can be benefit. Rural area must be target group for intervention.

Background: While the progressed phase of urinary tuberculosis is a known entity and it has been characterized by the findings of intravenous pyelogram and sterile pyuria, but symptoms regarding to the earlier stage of disease have not been fully described. The clinical presentation, methods of diagnosis and outcome of 15 cases of isolated and early detected urinary tract tuberculosis and a review of literature are presented here. Materials and methods: A Prospective and descriptive analysis of 89 cases with persistent urinary tract symptoms that were referrals to clinics of nephrology and infectious diseases in Isfahan University of medical sciences revealed 15 cases of isolated urinary tract tuberculosis. 3 morning urine were collected. Then all volume of urine centrifuged on 3000 g of 15 minutes. Several smears from sediments prepared and Ziehl Nelson staining were performed by standard techniques. Results: 15 specimens were positive for Mycobacterium tuberculosis and all the ceases were immune competent and seronegative for HIV and had no other evidence of disease elsewhere according to their vigorous work up. Those who had persistent urinary symptoms in spite of antibiotic therapy and were smear or culture positive for Mycobacterium tuberculosis were known as tuberculosis. 2cases were only smear positive, 5 cases had positive smear and culture simultaneously and 7 cases only positive culture. Conclusion: We discuss isolated urinary tract tuberculosis and symptoms related to early stage of disease that has not been discussed formerly. We concluded that anyone with prolonged urinary symptoms and microscopic haematuria even with normal radiology deserves to be evaluated for tuberculosis.

Background and objectives: Brucellosis is one of the infectious bacterial zoonosis diseases. It has been considered as one of the most important of health and hygienic situation among Khuzestan nomads. Due to the lack of accurate investigation regarding brucellosis, this research was conducted. The aims of this study were to determine the seroepidemiological prevalence of brucellosis among Khuzestan nomads and apply the appropriate results for prevention, control programs and treatment of the disease. Materials and methods: This is a descriptive, cross – sectional study, which was done in Khuzestan, during spring 2004. 3594 persons, (49.9% male and 50.1% female) took part in this study by randomized cluster sampling. The diagnosis of infection was made with serologic tests such as rose Bengal, Wright and 2ME.  In addition questionnaire was used for demographic information. Those with positive Wright tests were retested with 2ME. Wright and 2ME with titers equal 1/80 or more were considered positive. Epidemiological data, such as occupation, exposure to animals, and ingestion of high-risk foods (un-pasteurized dairy products) were derived from questionnaires, which were filled for every person. The results were analyzed by descriptive – analytic statistical methods with SPSS software. Results: 287 of 3594 were positive with rose Bengal test (prevalence = 7.98%). 283 of specimens were positive for Wright test (prevalence = 7.87%). 228 of 3594 were positive with 2ME test (Prevalence = 6.3%). 98.2% of positive rose Bengal cases were also positive with Wright test. In addition 80.5% of Wright positive samples were positive with 2ME test. Conclusion: Seroprevalence of brucellosis in Iran is about 3% (according to previous studies). This study showed that the prevalence of brucellosis infection among nomads in Khuzestan is 7.9%, so this population is highly infected. This high prevalence may be due to their life style (close contact with goats, consumption of un-pasteurized dairy products poor hygienic situation). We recommend that everybody in nomads with low back pain, sweating with or without fever must be considered for brucellosis and preventive measures in domestic animals such as vaccination and other roles of disease control should be noted.

Background and objective: Respiratory infections are among the most common presentation of HIV infection. Respiratory infections in these patients differ in various region of the world. Material and methods: In a period of JAN 2002 to JAN 2005 all patients with documented HIV infection who were admitted to a referral center for pulmonary disease in IRAN were included. Sputum was examined for B.K, bacteria and fungi. In some cases BAL was taken for PCP, BK, fungi and cytology. Pleural fluid (if present) was tapped and sent for mycobacteriology and bacteriology. Data were collected prospectively and analyzed by SPSS. Results: 55 patients were included. Mean age was 37.3.92.7 were male. Route of transmission was IVDU, heterosexual and homosexual in 67.3%, 9.1% and 1.8% respectively. In 20% of cases both IVDU and heterosexual was possible route of transmission. The most common respiratory infection was TB (85.5%) followed by pneumonia (9.1%) and PCP (5.5%). TB was pulmonary in 70.2% of cases and extra pulmonary in 12.8%.In 17% of patients PTB and EPTB were present simultaneously.5% of TB cases were MDR. Other opportunistic infections were oral candidiasis (70%) toxoplasma encephalitis (9.1) cmv retinitis (5.5%), cmv pneumonitis (1.8%) and cryptococal meningitis(1.8%). In 81.8% of patients HIV was diagnosed for first time in hospital. In hospital mortality rate was 18.2.In 27.3%of patients HAART was started. Conclusion: TB is the most common lower respiratory tract infection among HIV patients in IRAN and for the most of them it is the first manifestation of their illness. PCP is uncommon in IRAN.

Background and Objective: There are some concerns on the safety of blood donation. The most important blood transmitted viral infectious are HIV, Hepatitis B and hepatitis C. First time donors have different incentives for blood donation and existence of theses incentives for the donor leads to conceal deferrable risk factors; before donation. Thus, this study was planned in order to determine the rate of blood transmitted viral infections in first time donors, and regular donors in Hamadan blood transfusion center, 2004-2005. Material and Methods: This was a cross-sectional study, which was done on 18306 blood donors referred to Hamadan blood transfusion center. All blood units donated were evaluated for blood group, Rh, hepatitis C, HIV and syphilis in blood transfusion center. Hepatitis B, hepatitis C and HIV were diagnosed by ELISA test and for further evaluation, N.T, RIBA and western blot tests were done. Data concerning to age, sex, marriage, presence of HIV, hepatitis B, hepatitis C were entered the questionnaires. Results: From 18306 blood donors, 16330 persons (89.2%) were male and 1976 persons (10.8%) were female. From these, 11290 persons (61.7%) were married and 7016 persons (38.3%) were single. From 18306 blood donors, a one first time donor was a 20 years old married man, who was positive for HIV. Frequency distribution of positive cases for hepatitis B and hepatitis C were 141 cases (0.8%) and 78 cases (0.4%) respectively. Positive cases for hepatitis B (in the first time donors and repeat donors) were 7 times and 4 times more than regular donors, respectively and hepatitis C prevalence in first time donors and repeat donors was 1.7 times more than regular donors. Conclusion: This study showed that the prevalence of blood transmitted viral infectious rate, in first time and repeat donors are more than regular donors.

Background and objectives: Nosocomial infections are the most serious problems in Hospitals. Bacterial contamination of Medical instrument is one of the most important factors for nosocomial infection. Previous study indicated that percent of nosocomial infection had different in hospital wards. The aim of this study was determine and comparable investigation of bacterial frequency in three ICU (Surgical, Medical and Neonate) wards in Semnan educational hospitals. Material and methods: In this surveillance samples (n=161) were taken from different parts of ICU wards in hospitals during 18 month and were classified in 2 groups (Semi critical and non critical) and then all samples were cultured. Then samples categorized by location, time and bacterial infection and recorded in tables and statically analysis and comparison. Results: Results indicated that in medical ICU 77/3% was contaminated (Staphylococcus coagulase negative 50%, Bacillus15/9%, E- coli 9% and Bacill gram negative 2.3%). In surgical ICU 44% was contaminated (Staphylococcus coagulase negative 12%, Klebcilla %16; E- coli 9% and Yercinia 4%). In Neonatal ICU 20/6% was contaminated (Staphylococcus coagulase negative 9/8%, Klebcilla 6.5% and Bacillus 4/3%) Conclusion: Finding above shown that the Medical and surgical ICU wards were the most contaminated than the Neonate ICU. Reduce of nosocomial infection in neonate ICU probably is due to more and exactly cares in that ward. These factors and species of prominent bacteria were important for choosing efficient infectious control policies by nosocomial infection control comity in that part.

Esophageal perforation is a serious condition with a high mortality rate. It most commonly occurs following diagnostic or therapeutic procedures, foreign body ingestion and trauma. Prognosis depends on the diagnosis and treatment within the first 24 hours. A case of esophageal perforation due to fish bone ingestion in a 59-year-old diabetic female is described here. She had a history of fish bone ingestion and was treated with the diagnosis of pharyngitis. Several days later she was referred to our hospital with deterioration of general condition. CT scan showed mediastinal abscess and empyema.  Surgical drainage was performed and broad-spectrum antibiotics were given to her but she died of sepsis and septic shock.