Assessment of Allergic Biomarkers; Total Immunoglobulin E Antibodies Levels and Peripheral Blood Eosinophil among Public Transporter Drivers with Traffic–Related Respiratory Diseases in Tehran

Background: Traffic air pollution can be induced or developed the different respiratory diseases. Megacity has potential magnitude in the production of high density and large- volume traffic triggering factors in the outdoor environment. High concentrations of Formaldehyde and polycyclic aromatic hydrocarbons (PAHs) are found in traffic density of ambient air in urban area. It can be stimulated both allergic state and diseases. The PAHs originates from the motor engine are as pro-inflammatory compounds which can enhance Immunoglobulin E (IgE) responses. The purpose of the study was evaluation of allergic markers among public drivers in Tehran, to assess the respiratory diseases.Materials and Methods: A total of 151 subjects were sequentially enrolled among public drivers with traffic related respiratory diseases. The total IgE antibodies in serum were measured according to manufacture recommendation.Results: The mean age recorded 47.66±8.82 standard deviation (SD). The peripheral eosinophil proportion was 3.19±2.16 SD. The mean IgE antibody levels were 205.89±238.67SD. Allergic state was found in 47% of target population. Frequencies of traffic-related air pollution diseases (TRAPD) in chronic obstructive pulmonary disease (COPD) 34%, asthma 25%, rhinitis 21% and bronchitis 21%, respectively. Allergic state distributed high frequency in asthma, rhinitis, COPD and bronchitis diseases, respectively.Conclusion: Allergic biomarkers of IgE antibody and peripheral eosinophilia were widely distributed among TRAPD. They observed more frequency on the allergic base diseases than non-allergic small airway diseases. It may be reflected the actual role of traffic -related air pollution on the sensitization of all categories of TRAPD

Antipsychotic Drug Poisoning in Children Under 12 Years Old in Loghman-Hakim Hospital During 2016-2022

Background: Unintentional pediatric poisoning with antipsychotic medications represents an important clinical entity. This study aimed to evaluate the epidemiology, clinical manifestations, and outcomes of antipsychotic poisoning among children presenting to a referral hospital.Methods: This descriptive, cross-sectional study reviewed medical records of children <12 years old hospitalized for antipsychotic drug poisoning at Loghman Hakim Hospital in Tehran from 2015-2016. Data extracted included demographic details, agent and dose ingested, clinical findings, treatments administered, and patient dispositions.Results: 141 cases were identified, comprising 2.3% of all pediatric poisonings. Patient ages ranged from 6 months to 12 years (mean 5.5 years), with a male predominance (52.5%). The most common offending agents were risperidone (53.2%) and olanzapine (13.4%). Unintentional exposures accounted for 72.3% of cases. Central nervous system (CNS) effects like somnolence (61.7%) and dysarthria (19.1%) were most prevalent. Significant toxicity was infrequent; no fatalities occurred. Mean length of stay was 2 days for uncomplicated admissions. Conclusion: Antipsychotic poisoning in children chiefly involves atypical agents with a largely benign course. Risperidone predominated due to prescribing patterns. Somnolence represented the principal clinical manifestation. With reasonable supportive care, favorable outcomes are achievable in the pediatric population

Pyogenic Brain Abscess: A Comprehensive Review of Epidemiology, Pathogenesis, Diagnosis, and Management

Background: Pyogenic brain abscess is a severe neurological infection associated with significant morbidity and mortality. Despite advances in diagnostic techniques, neurosurgical procedures, and antimicrobial therapy, managing pyogenic brain abscesses remains challenging. This article reviews the current understanding of the epidemiology, pathogenesis, diagnosis, and treatment of pyogenic brain abscesses, highlighting the importance of a multidisciplinary approach to improve patient outcomes. Materials and Methods: A comprehensive literature review was conducted using PubMed, Scopus, and Google Scholar databases. The search terms included "pyogenic brain abscess," "epidemiology," "pathogenesis," "diagnosis," "treatment," "antibiotic therapy," and "prognosis." Relevant articles published in English between 2010 and 2023 were selected, focusing on the most recent advances and evidence-based recommendations for managing pyogenic brain abscesses. Results: Pyogenic brain abscess is a life-threatening condition that requires prompt diagnosis and treatment. A multidisciplinary approach involving neurosurgeons, infectious disease specialists, and radiologists is necessary to manage pyogenic brain abscesses successfully. Conclusion: Early recognition, appropriate antibiotic therapy, and timely neurosurgical intervention are essential for improving patient outcomes and minimizing neurological sequelae. Antibiotic therapy and surgical approach should be tailored to the individual patient, considering factors such as the suspected pathogens, immune status, and the primary source of infection. Long-term follow-up is crucial, as recurrence and neurological sequelae are common among survivors. Continued research is needed to improve our understanding of this complex condition and develop more effective treatment strategies

Nasopharyngeal Colonization and levofloxacin Susceptibility of Streptococcus pneumoniae among Healthcare Workers in a Teaching Hospital in Tehran, Iran

Background: Streptococcus pneumoniae commonly asymptomatically colonizes the human upper respiratory tract and the carriage rate varies between geographical regions. The colonized individuals are not only at risk of infections but also can be a source of transmission of the pathogen. The risk of the droplet or airborne transmission of pneumococcal strains healthcare workers is considerable.  The current study aimed to determine the extent of nasopharyngeal colonization with S. pneumoniae and their levofloxacin susceptibility at a tertiary hospital in Tehran, Iran. Materials and Methods: During a six-month period, the nasopharyngeal swab samples collected from 300 volunteer healthcare workers of Imam Hossein Hospital. Samples screened for S. pneumoniae using standard conventional biochemical methods. The minimum inhibitory concentration (MIC) of levofloxacin was determined using a commercially available strip antibiotic test according to the clinical laboratory standards institute (CLSI) guidelines. Results: A total of 19 (6.3%) enrolled healthcare workers were colonized with S. pneumoniae. Amongst the enrolled volunteers, nurses had a higher rate of pneumococcal colonization (47.3%) followed by interns (21%) and laboratory workers (15.8%). Our analysis revealed that there was a significant correlation between smoking and pneumococcal colonization. The antimicrobial susceptibility testing showed that all of the isolates were susceptible to levofloxacin (MIC≤2 μg/ml). Conclusion: This low rate of pneumococcal colonization amongst healthcare professionals may be attributed to the low risk of horizontal transmission of severe pneumococcal infections in the hospital. Additionally, our findings indicated that levofloxacin was an effective antimicrobial agent for the treatment of pneumococcal infections

Role of Prophylactic Antibiotic Administration in Growth of Methicillin Resistant Staphylococcus Aureus in Rhinoplasty

Background: Septoplasty and septorhinoplasty are common surgical procedures in modern surgical practice. Pre or postoperative antibiotic administration has raised concerns about the possible increase in the antibiotic-resistant species. The aim of this study was to evaluate the role of postoperative antibiotic prophylaxis in increasing Methicillin-Resistant Staphylococcus Aaureus species (MRSA) in patients, who underwent septoplasty or septorhinoplasty in Loghman Hakim Hospital in Tehran, Iran.Methods: A total of 102 patients, who were planned to undergo septoplasty or septorhinoplasty, participated in this double-blind randomized clinical trial. The patients were divided into the case (n=60, mean age of 28.2 years) and control (n=38, mean age of 28.9 years) groups. Overall, 98 patients participated in the study. The case group received a preoperative injection of cephalothin (1g) and postoperative oral cephalexin regimen (500mg 4 times a day for 7 days). The control group only received a preoperative injection of cephalothin (1g). Vestibular nasal swab cultures were obtained preoperatively and on postoperative day 7. The samples were, then, quickly transferred to the laboratory and cultured on proper media. The results indicated that five MRSA species in the case group and tow MRSA species in the control group were present, postoperatively.Results: The findings of this study suggest that oral antibiotic prophylaxis may lead to a statically non-significant increase in MRSA infection in patients, who require this treatment. Conclusion: Further knowledge of the endogenous nasal flora and the microbiology of common pathogens in patients undergoing septorhinoplasty will help reduce the incidence of infectious complications to a greater level

Echocardiographic Findings of ICU-Admitted COVID-19 Patients: a Multicenter Retrospective Study

Background: The coronavirus disease 2019 (COVID-19) pandemic has left many victims and caused many problems for the healthcare systems of different countries. Many COVID-19 patients have cardiovascular complications, which are detectable using echocardiography. This study aimed to determine the echocardiographic findings and their association with mortality in an intensive care unit (ICU)-admitted COVID-19 patients. Materials and Methods: In this retrospective study, COVID-19 patients admitted to the ICU of four hospitals in Tehran, Iran, from April 2020 to March 2021 were recruited. Data were collected by the census method. We reviewed the medical records regarding demographic features, clinical history, laboratory results, and echocardiographic findings. Finally, variables were compared regarding disease outcomes at the end of hospitalization. We used the Chi-square test, Fisher’s exact test, independent-samples t-test, and logistic regression model to analyze the data. Results: This study showed that the mean age of 629 COVID-19 patients was 66.42±14.53 years. Overall, 56.8% of the patients were male. Multivariate regression analysis showed that age (OR=1.03; 95% CI: 1.01-1.05), left ventricular ejection fraction (OR=0.95; 95% CI: 0.92-0.98), and systolic pulmonary arterial pressure (OR=1.12; 95% CI: 1.06-1.18) were predictors of mortality. Conclusion: Cardiovascular involvement is prevalent among critically ill COVID-19 patients. Among echocardiographic findings, EF and s-PAP were significantly associated with the disease outcomes

Bacterial Infection of Pacemaker in Patients with Endocarditis

Background: The advancement of technology in recent decades has been lead to use the electrophysiology cardiac devices. Although these devices are used increasingly, but the frequency of subclinical infection is unknown. We investigate bacterial infections due to implantable cardioverter defibrillator (ICDs) in patients with endocarditis.Materials and Methods: Population of the study was considered among all adult patients in whom the cardiac electrophysiology device was removed. Associated infection endocarditis defined by the Duke criteria. 35 pacemakers (PM) were aseptically removed from these patients during January 2012 to November 2014. Intraoperative swabs from the different part of devices were collected, cultured in BHI (Brain Heart Infusion Broth) and then bacterial classical cultures were done under aerobic and anaerobic conditions. Biochemical and differential media were used to detect the bacteria species. Data analysis was performed by using SPSS version 16 software.Results: 13 cases of 35 patients with endocarditis diagnosed by modified Duke Criteria and removed pacemaker had positive culture. Of the 13 cases with infection 43% were identified as gram positive and 57% had gram negative bacteria.Conclusion: Based on our study and similar studies, bacteria can colonize in electrophysiology devices which can lead to bacterial infections.

The Characteristics of Persian Historical Gardens (Case Study: Emarat Birooni Garden of Urmia, Iran)

Persian gardens are valuable historical and cultural human-built landscapes however, Persian gardens are deteriorating gradually. Thus, comprehensive studies would be helpful in obtaining deeper insights into different aspects and meaning of Persian gardens. The descriptive-analytical approach was used to review the EmaratBirooni garden of Urmia (Campus of Urmia University) as it is the only remnant of Qajar period demonstrating a clear image of the past of the Persian garden model in Urmia. Data were employed through literature review and on-site field study. It was found that the Campus of Urmia University had three historical eras- era 1: Before the garden was purchased by American missionaries, era 2: The settlement of American missionaries, era 3: After American missionaries left and delivered the garden to the government. By examining the periods, it was seen that the survival of the campus stemmed from proper uses in each era. This suggests that new uses suiting the contemporary conditions could be beneficial in protecting historical gardens. In this respect, it is essential to protect historical gardens since these gardens can become a cultural capital to the future generations

Hepatitis E virus infection in hemodialysis patients: A seroepidemiological survey in Iran

BACKGROUND: The hepatitis E virus (HEV) has a global distribution and is known to have caused large waterborne epidemics of icteric hepatitis. Transmission is generally via the fecal-oral route. Some reports have suggested parenteral transmission of HEV. Anti-HEV prevalence data among chronic hemodialysis (HD) patients are few and give conflicting results. METHODS: This cross-sectional study was conducted in August of 2004. We tested 324 chronic HD patients attending three different units in the city of Tabriz, northwestern part of Iran, for anti-HEV antibody. A specific solid- phase enzyme-linked immunoassay (Diapro, Italy) was used. RESULTS: The overall seroprevalence of hepatitis E was 7.4 %(95% CI: 4.6%–10.6%). The prevalence rate of HBV and HCV infection were 4.6% (95% CI: 2.3%–6.9%) and 20.4% (95% CI: 16%–24.8%), respectively. No significant association was found between anti-HEV positivity and age, sex, duration of hemodialysis, positivity for hepatitis B or C virus infection markers and history of transfusion. CONCLUSION: We observed high anti-HEV antibody prevalence; there was no association between HEV and blood borne infections (HBV, HCV, and HIV) in our HD patients. This is the first report concerning seroepidemiology of HEV infection in a large group of chronic HD individuals in Iran

The evaluation level of carboxyhemoglobin in children blood with chief complain of headache, nausea, and dizziness referring to pediatric clinics of Loghman hakim hospital in year 2018-2019

Carbon monoxide poisoning is common, challenging and serious poisoning with wide range of non-specific flu-like clinical manifestations that leads to misdiagnosis. This cross-sectional descriptive controlled study conducted in Loghman Hakim Hospital on 3-14 year-old patients presenting with non-specific Flu-like (headache, dizziness, nausea, vomiting, malaise) symptoms from November 2018 to May2019. In all subjects carboxyhemoglobin level measured via noninvasive pulse CO-oximetry (Massimo Company, USA). Demographic data, cigarette, shisha, opium smoke exposure, type of home heater, carboxyhemoglobin level were collected and statistically analyzed via SPSS v16.0. A total of 93 children 3-14 year-old were enrolled the study. Their mean age was 4.6+4.3 years, 46% were male and54% female. Mean carboxyhemoglobin level was 27.8+9.7 %( range 2.7% to 44%). The most frequently encountered symptoms were nausea &vomiting (44%), dizziness (36%), headache (32%) and myalgia (23%). We obtained the COHb levels using noninvasive pulse oximeter for all study patients and their mother, and the levels > 5% for non-smokers were considered as CO poisoning. Of the 93 study patients, 49%had normal carboxyhemoglobin levels (CoHb level< 5%). Of the remaining 51% study patients, 47 patients had CoHb levels between 5% and 10%, and seven patients > 10%. Closer attention to early and nonspecific signs and symptoms of Carbon Monoxide poisoning and higher clinical suspicion could reduce the rate of misdiagnosis and therefore minimize complications in this serious poisoning