فناوری

Abstract:
Introduction: Incidence of brucellosis was growing up in Iran during the past years. Kermanshah province-west of Iran is one of the endemic regions of the disease. The aim of this study was to evaluate the incidence and risk factors of brucellosis in Kermanshah province during a recent five-year period.
Material and Methods: This study was an observational cross-sectional study performed on registries of the patients with brucellosis at the center for the zoonotic disease of Kermanshah University of medical sciences during 2010-2014. The data was collected using a questionnaire containing demographic data and the risk factor of brucellosis. Collected data were analyzed by SPSS-22
Software using descriptive statistic, Chi-square, and student t-test.
Results: The five-years mean incidence of brucellosis in our study was 46.5 in one hundred thousand, and male to female ratio was 1.37/1. The most common risk factors of brucellosis in our patients were unpasteurized dairy products’ consumption (47%) and occupational contact with livestock (14.4%). 84% of the patients were rural. The most common diagnostic method was the standard agglutination test within 1/160 and 1/320 titers.
Conclusion: Risk factors of brucellosis in our study were like other studies, but in more than one third of the patients, no risk factor was identified. Lack of livestock vaccination history and incomplete registered data about other possible transmission routes of transmission were the limitations of the study

Tuberculous ventriculitis is an inflammatory infection of the ventricular system of the
brain, and is caused by Mycobacterium tuberculosis. We herein present the case of an
immunocompromised patient with brain tuberculomas who developed ventriculitis during
treatment. The patient was successfully treated with a high dose of steroid, long-term antituberculosis
drugs, and aggressive supportive care.

Background: Hepatitis G virus (HGV) is a hepatotrope virus with unknown importance. The genome of the virus
has been detected in patients with acute or chronic non-A-E hepatitis, cirrhosis, and hepatocellular carcinoma.
The aim of this study was to determine the association between hepatitis G and unknown chronic hepatitis.
Methods: This case-control study was performed in Ebne-Sina military hospital in Hamadan, Iran. The cases
were 35 military staff with unknown chronic hepatitis. The control group consisted of 59 healthy subjects who
had normal levels of serum alanine aminoteransferase (ALT). The data were analyzed by SPSS, version18, using
Fisher’s exact test, the Student’s t-test, and multivariate logistic regression analysis.
Results: Only one patient in the case group (2.9%) tested positive for HGV antibodies, and no one was infected
in the control group. There was no association between HGV infection and unknown chronic hepatitis in our
study (P=0.37). A significant association was found between the male gender and unknown chronic hepatitis
(OR=14.9, P=0.01).
Conclusion: No association between HGV infection and unknown chronic hepatitis was found in our study, so it
was not necessary to evaluate these patients for HGV infection.

Brain hydatid cyst constitutes one of the leading causes of cranial mass in
the endemic region, especially among the children. Symptoms of the disease
are associated with rising of intracranial pressure and focal neurological deficit.
Surgical excision of the cyst is essential to treatment. Here we present a
19 yr-old male livings in Ardabil, northwest of Iran, referred to Neurosurgery
Clinic in Khanevadeh University Hospital, Tehran, Iran with a large
brain hydatid cyst and atypical symptoms. He was treated by surgical excision
of the cyst without any complication. There were not any clinical or
radiological signs of recurrence after one-year follow-up.

Introduction: As the novel coronavirus pandemic continues to affect people worldwide, immune-mediated inflammatory syndromes related to this virus have been reported. SARS Coronavirus-2 infection disease (COVID-19)mayaccompany various cutaneous symptoms, such as viral exanthems or wheels. These symptoms may occur at the early course of the disease or after that. Cutaneous symptoms of COVID-19 usually have a favorable outcome.
Case Presentation: We presented a rare case of inpatient COVID-19 pneumonia, who developed a purpuric rash, abdominal pain, and hematuria. His dermal histopathological study revealed small-vessel vasculitis. We diagnosed Henoch–Schoenlein purpura based on clinical and histopathological findings and treated him with intravenous dexamethasone followed by oral prednisolone. The purpuric rashes disappeared in two weeks.
Conclusions: Cutaneous manifestation of COVID-19 is usually diffuse maculopapular rashes. Other presentations include vesicular rashes and acral cyanosis. Dermal histopathological study in most patients with COVID-19 who developed cutaneous symptoms revealed perivascular inflammation and microthrombus in some cases. Thus, COVID-19 should be considered in any patient with a new onset of cutaneous symptoms.

Background: Invasive fungal infection (IFI) is a life-threatening condition, particularly in individuals with compromised
immune systems.
Objectives: Our study aims to evaluate IFI in hospitalized patients with hematological malignancies.
Methods: In this retrospective cross-sectional study, we evaluated patients with hematological malignancies admitted to two
university hospitals in Tehran, Iran, from 2020 to 2021 for IFI. We selected only those patients who had been hospitalized for at
least four days for antimicrobial treatment. Data analysis was conducted using SPSS-26 software, employing Mann-Whitney U,
chi-square, and Fisher exact tests.
Results: During the study period, 60 out of 213 patients with hematological malignancies were admitted for antimicrobial
treatment. The average age of the patients was 57.1 years, with fever being the most common symptom, reported in 63.3% of
cases. We identified 24 cases of IFI, including three proven cases (Candida spp.) and 21 probable cases. Statistical analysis showed
a lower mean neutrophil count in the IFI group compared to the non-IFI group (3862 versus 12881, P = 0.001) and a higher
mortality rate (58.3% versus 27.8%, P = 0.031).
Conclusions: Our study revealed that severe neutropenia is a significant risk factor for IFI, and the mortality rate associated
with IFI remains high despite advances in the treatment of hematological malignancies

The global crisis caused by the SARS Corona virus-2 infection is continuing through 2021, with more than 3.5 million deaths. Several risk factors for this virus’s severity and death were documented, including diabetes, hypertension, and ischemic heart disease. To evaluate the relation between serum vitamin D3 level, the disease severity, and prognosis of the patients with SARS Corona virus-2 infection. Patients with COVID-19 were evaluated for serum vitamin D levels and laboratory data. Correlation between vitamin D levels and laboratory data with disease severity and prognosis was assessed. Cox and logistic regression tests, as well as ROC curves, were used for data analysis. Ninety-eight patients with Corona virus-2 disease (COVID-19), which consisted of sixty patients with moderate COVID-19 in the general wards, and thirty-eight patients with severe COVID-19 in the intensive care unit (ICU), were evaluated. The mean age in the general wards was lower than in ICU (60.96±14.86 compared to 67.94±16.46, P=0.001), and the mean serum vitamin D level in the patients admitted in the general wards was higher than in the ICU (31 ng/mL compared to 20.57 ng/mL, P=0.003). Furthermore, vitamin D deficiency (25 (OH) D <25 ng/ml) significantly increased the risk of severe disease. (odds ratio=2.91, P=0.019) and mortality (odds ratio=3.64, P=0.026). Vitamin D deficiency is a risk factor for disease severity and poor prognosis in COVID-19. Vitamin D levels of 25 ng/mL can be used as a cut-off value for predicting severity and prognosis.

This study retrospectively analyzed the clinical characteristics of patients with new coronavirus infection (COVID-19) and summarizes the treatment experience. A total of 239 COVID-19 patients admitted to the Hajar Hospital, Aja University of Medical Science, Tehran, Iran from March 22, 2020 to May 18, 2020 were selected, including 176 cases in the ordinary group and 63 cases in the severe/critical group. We collected and compared the clinical data of the two groups of patients, including general conditions, clinical symptoms, signs, laboratory tests, lung CT imaging and prognosis, and analyzed the treatment plans of the two groups. The mean age of 239 COVID-19 patients was 48.1±17.6 years, including 132 males. Patients in the severe and critically ill groups were older than the normal group, with more males and more underlying diseases. The difference was statistically significant (p < 0.05). The lymphocyte (LYM) counts and albumin (ALB) counts of the severe and critically ill groups were more significantly lower than those of the normal group; while the percentage of neutrophils (NEU), C-reactive protein (CRP), D-dimer, and lactate The increase of lactate dehydrogenase (LDH) and urea nitrogen (BUN) was more significant, and the difference was statistically significant (p < 0.05). Patients in the severe and critically ill groups received more antiviral drugs, glucocorticoids, and nasal catheters than those in the normal group, and the difference was statistically significant (p < 0.05). Also, we observed that the most radiological finding was bilateral ground-glass opacity in both groups, however, the rate of typical abnormalities in both chest CT scan and chest x-ray was significantly higher in sever/critical group except air-bronchogram. Taken together, we showed that combination of oseltamivir and glucocorticosteroid such as dexamethasone was very effective in severe patients.

Mycobacterium tuberculosis, Mycobacterium leprae, and non-tuberculous mycobacteria (NTM) are among the most significant human pathogens within the Mycobacterium genus. These pathogens can infect people who come into contact with biomaterials or have chronic illnesses. A characteristic pathogenic trait of mycobacteria is the development of biofilms, which involves several molecules, such as the GroEL1 chaperone, glycopeptidolipids, and shorter-chain mycolic acids. Bacterial behavior is influenced by nutrients, ions, and carbon sources, which also play a regulatory role in biofilm development. Compared to their planktonic phase, mycobacterial biofilms are more resilient to environmental stresses and disinfectants. Mycobacteria that produce biofilms have been found in several environmental studies, particularly in water systems. NTM can cause respiratory problems in individuals with underlying illnesses such as cystic fibrosis, bronchiectasis, and old tuberculosis scars. Mycobacteria that grow slowly, like those in the Mycobacterium avium complex (MAC), or rapidly, like Mycobacterium abscessus, can be pathogens. Infections related to biomaterials represent a significant category of biofilm-associated infections, with rapidly growing mycobacteria being the most frequently identified organisms. A biofilm produced by M. tuberculosis can contribute to caseous necrosis and cavity formation in lung tissue. Additionally, M. tuberculosis forms biofilms on clinical biomaterials. Biofilm formation is a major contributor to antimicrobial resistance, providing defense against drugs that would typically be effective against these bacteria in their planktonic state. The antibiotic resistance of biofilm-forming microbes may render therapy ineffective, necessitating the physical removal of biofilms to cure the infection. Recently, new approaches have been developed with potential anti-biofilm compounds to increase treatment effectiveness. Understanding biofilms is crucial for the appropriate treatment of various NTM diseases, and the recent discovery of M. tuberculosis biofilms has opened up a new field of study. This review focuses on the biofilm formation of the Mycobacterial genus, the mechanisms of biofilm formation, and anti-mycobacterial biofilm agents.

Background: SARS-CoV-2 may affect vital organs. The present study investigated the histopathology of pulmonary and cardiac tissues with clinical correlation in deceased patients with COVID-19.

Methods: We obtained pulmonary and cardiac tissues from 30 deceased patients with COVID-19 in Tehran, Iran, from January to May 2021. Sampling was performed through a percutaneous needle biopsy. After slide preparation, two expert pathologists studied them. We assessed the correlation between clinical and pathological data by Fisher’s exact test.

Results: The mean age of the patients was 73.8±13.4 years, and the male-to-female ratio was 23/7. The most common underlying disease was hypertension (HTN) in 25 patients (83%). Fifty-five tissue samples were achieved, including 28 pulmonary and 27 cardiac samples. Our results showed that all patients (100%) developed diffuse alveolar damage (DAD), and 26 (93%) developed hyaline membrane formation. The most common phase of DAD was the exudative-proliferative phase in 16 (57.1%). Three cardiac samples (11%) revealed myocarditis, and seven (26%) showed cardiomyocyte hypertrophy. In univariate analysis using Fischer’s exact test, myocarditis had significant relationships with C-reactive protein (CRP) levels higher than 80 mg/dL (P=0.008) and elevated cardiac troponin levels higher than two-fold (P=0.01).

Conclusion: COVID-19 can affect the major vital organs. However, only myocarditis had a significant relationship with the circulating levels of inflammatory factors.

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