Kikuchi-Fujimoto disease in a young female with discoid lupus and alopecia

Kikuchi-Fujimoto disease is an uncommon, benign, autoimmune condition characterized by lymphadenopathy, fever, and neutropenia. It is a self-contained condition of unidentified etiology. A 38-year-old female of Iranian Kurdish origin referred to us with multiple neck swellings, fever, and generalized arthropathy. There was no weight loss and no history of tuberculosis, medication intake, or allergy. Clinical examination revealed bilateral large, mobile, and tendercervical lymphadenopathy. Cardiovascular, respiratory, and neurological examination was normal. The patient had leucopenia and thrombocytopenia. Kikuchi-Fujimoto disease must be considered in the differential diagnosis of a female patient with fever and cervical lymphadenopathy

Evaluation of the status of antibiotic prescription in patients admitted to a teaching hospital in west of Iran

BACKGROUND: The aim of this study was to evaluate the status of the appropriate use of antibiotics by type, dosage, and length of treatment and the route of administration in Tohid teaching hospital, Sanandaj, Iran.METHODS: In a retrospective descriptive study, 400 patients were systematically selected from patients receiving antibiotics hospitalized in Tohid hospital from March 2016 to March 2017. Demographic characteristics, hospitalization ward, diagnosis, antibiotic prescribed, dosage, length of treatment, the route of administration, and prescribing physician were recorded. The treatments were compared with standard treatment based on Harrison reference. The data were analyzed using STATA software.RESULTS: Out of total patients, 54% were men and 46% were women with a mean age of 57.87 ± 9.87 years. The mean duration of hospitalization was 6.37 ± 2.69 days. More and less numbers of patients were admitted in the internal medicine ward (23.75%) and intensive care unit (ICU) (1.00%), respectively, The highest antibiotics were administered by internal medicine specialists (40.25%), the most commonly prescribed antibiotic was ceftriaxone (34.59%), and the most common cause of antibiotic therapy was pneumonia (20.50%). Out of 595 antibiotics prescribed, 28.50% of the administrations were inappropriate. In addition, the objective for the prescription of the first and second antibiotic was inappropriate in 27.50% and 33.70% of cases, respectively. Dosage, route of administration, and the length of treatment of the prescribed antibiotic was inappropriate in 9.00%, 0.50%, and 41.00% of cases, respectively. The highest and lowest rate of inappropriate antibiotic prescription was observed in surgical (51.31%) and infectious diseases (12.90%) wards.CONCLUSION: Due to the increase inappropriate administration of antibiotics, it is necessary to train the specialists about the planning, appropriate medical consultations for antibiotic therapy, and limitation of the new antibiotics prescription.

The Effectiveness of Sovodak in the Treatment of Patients with Chronic Hepatitis C

Background: Recently, interferon-free treatment has been considered for the treatment of chronic hepatitis C due to their high therapeutic success and lack of serious side effects. The combination of Sofosbuvir and Daclatasvir is effective in the treatment of the disease because of its pan-genotype. In the present study, the effectiveness of Sovodak, which is a combination of the aforementioned two drugs in one tablet, in the treatment of patients with chronic hepatitis C and cirrhosis was investigated. Methods: Patients with chronic hepatitis C whose diagnosis was confirmed by HCV RNA–PCR test were included in the study. These patients received one Sovodak tablet daily (for 12 weeks for non-cirrhotic patients and 24 weeks for cirrhotic patients). Sustained virologic response (SVR) was assessed by PCR test 12 weeks after the end of the treatment and one year later. Also, serum levels of liver enzymes, platelet count, and liver stiffness (using elastography method) were measured and their levels were compared before and after treatment in patients. Results: Findings related to the PCR test in patients showed that the level of SVR was 100% in patients 12 weeks after treatment (SVR-12). In three cirrhotic patients who received only 12 weeks of drug treatment, the disease recurred a year later. According to the results, ALT and AST serum levels were significantly decreased (P < 0.001), and platelet count level was increased (P < 0.001) one year after the end of the treatment period. Also, the liver stiffness index measured using FibroScan was significantly decreased in patients 12 weeks after the end of the treatment (P < 0.001). Conclusion: The results of this study, in line with other studies, showed the effective role of Sovodak in completely eliminating the HCV virus in patients with chronic hepatitis C. Cirrhotic patients need to receive treatment for at least six months. Key words: Sovodak, hepatitis C, sustained virologic response, effectiveness, liver cirrhosi

Seroprevalence of West Nile Virus in Regular Blood Donors Referred to the Blood Bank of Kurdistan Province, Iran

Background: West Nile virus is an infection that is most commonly caused by infected mosquito bites, however, blood transfusions, organ transplants, breast feeding, pregnant mother-to-the-fetus transmission, and occupational transmission among laboratory and medical staff are also the less common routes of infection. Given the endemic nature of this virus in the Middle East, the aim of this study was to investigate the presence of this virus in regular blood donors, as the reliable source of blood supply needed for patients in hospitals. Methods: In this descriptive-analytical study, venous blood samples were collected from 259 regular blood donors referred to the Blood Transfusion Organization of Kurdistan. After separating blood serum, the amount of IgM and IgG antibodies against West Nile virus was measured via ELISA test. Results: Concerning antibodies, IgG and IgM against West Nile virus were positive in 14 patients (5.4%) and 3 patients (1.2%), respectively. Seropositive IgG levels were observed in 11 patients over the age of 40 (12.5%) but only in 3 patients under 40 years of age (1.8%). The difference was statistically significant (OR = 7.95; 95% CI: 2.16–29.32; p < 0.01). Conclusion: Given the value of blood and blood products obtained from regular blood donors for therapeutic purposes and the significant prevalence of the virus and considering the presence of cases with positive IgM, it seems necessary to screen blood donors in blood transfusion centers in the western parts of Iran

Methicillin-Resistant Staphylococcus aureus Using Broth Micro Dilution Method in Iran: A Meta-Analysis (2007-2016)

Background:      Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most signifuicant pathogens in Iran; it is one of the WHO-declared microbial resistance emergencies; and also one of the most important challenges facing the prevalence of resistance. The aim of this study was to detect MRSA using Broth Micro Dilution method and meta-analysis in Iran from 2007 to 2016. Methods:       Persian databases (including Magiran, Irandoc, and SID) and International databases (including pubmed, science direct, and scopus) were searched during this period (2007-2016), such that the high heterogeneity (50% < I2) in this study was analyzed using the DerSimonian Laird method. Data were categorized into subgroups based on year of study and province. Due to the high validity of the diagnosis of organisms and quantitative results, antimicrobial susceptibility test (AST) was used to detect MRSA. Data analysis was performed using statsdirect software. Results:      Based on the available data in medical databases, 678 articles were selected. In total, 29 remaining studies entered the meta-analysis phase. In this study, the overall prevalence of MRSA using MIC is 53% (95% CI: 0.42.31, 63.90); in 2016 it was 77.56% (95% CI: 76.07, 78.99) and in 2007 was 57.49% (95% CI: 53.17, 61.72). The heterogeneity was estimated to be 98.5% (95% CI: 98.4, 98.6). Conclusion:    Based on the results, there is an increasing prevalence of MRSA in Iran. These may be due to the failure or lack of infection control activities and antimicrobial selection pressure

Comparison of sexual dysfunction between diabetic and non-diabetic women

Context: Sexual dysfunction (SD) among diabetic women is an important disorder. It has many negative effects on general health. Aims: This study aimed to compare SD status between diabetic and non-diabetic women. Settings and Design: This study was conducted on 200 women, half of them diabetic and the others as non-diabetic in Tohid Hospital (Sanandaj, Iran). Materials and Methods: The non-diabetic group was matched for age (±5 years) and education. Data were collected using an interview-based questionnaire containing demographic characteristics and female sexual function index (FSFI). Statistical Analysis Used : Univariate and multivariate analyses were performed to assess and interpret the results. Results: Analyses of the data showed that low educational levels, longer duration of diabetes and poor controlled diabetes were associated with the lower FSFI scores. In both groups the prevalence of SDs for all FSFI domains was high. Furthermore, multivariate analysis showed that these three variables were associated with lower FSFI scores. Conclusions: Study confirms that Kurdish Iranian diabetic women are at an increased risk of SD. Low educational level, longer duration of diabetes, and poor controlled diabetes were associated with a lower FSFI score

Effectiveness of different treatment regimens on patients with COVID-19, hospitalized in Sanandaj hospitals: a retrospective cohort study

Abstract Objectives Different drugs have different effects on the prognosis of patients with COVID-19. This study aimed to evaluate the effect of different drug regimens on patients with COVID-19, hospitalized in Sanandaj city. Methods In this retrospective cohort study, 660 patients with COVID-19, hospitalized in the Tohid, Kowsar and Besat hospitals located Sanandaj (Kurdistan Province, Iran) were studied from February 2020 to February 2021 with clinical symptoms and positive test results. Results The results of multivariate regression analysis showed the days of hospitalization for patients who had received the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) was 1.92 times higher than those who had received the drug regimen 1 (hydroxychloroquine group or a combination of chloroquine and azithromycin) while a significant association was observed (OR = 1.92, 95% CI: 1.16–3.16, P = 0.011). Also, the hospitalization in ICU was longer in patients treated by the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) (OR = 4.63, 95% CI: 1.80–11.82, P = 0.001), however, drug regimens did not show a significant effect on mortality and use of ventilator in patients (P > 0.05). Conclusion The study results showed the drug regimens 2 and 5 increased the days of hospitalization and hospitalization in ICU, respectively, while the other drug regimens had no significant effect on mortality and use a ventilator in the studied patients and none of the drug regimens had an effect on reducing mortality compared to other ones

DIAGNOSTIC UTILITY OF ADENOSINE DEAMINASE IN SERUM AND BRONCHOALVEOLAR LAVAGE FLUID FOR SCREENING LUNG CANCER IN WESTERN IRAN DIJAGNOSTI^KA KORIST ADENOZIN-DEAMINAZE U SERUMU I BRONHOALVEOLARNOM LAVA@U ZA SKRINING RAKA PLU]A U ZAPADNOM IRANU

Summary Background: This study aimed to determine adenosine deaminase (ADA) activity as a possible screening tool in lung cancer patients. Methods: Blood samples were collected from 30 subjects with positive pathological tests and 62 patients with negative pathological tests as a control group. The enzymatic activity of total ADA and its isoenzymes was determined. Results: tADA and ADA2 isoenzyme activity was significantly higher in cancerous patients compared to benign controls in serum and BAL fluid. Using a cut-off level of respectively 35.22 U/L and 31.80 U/L for BAL total ADA and ADA2, sensitivity and specificity were 100% and 81% for total ADA and 95% and 98% for ADA2. Conclusions: Adenosine deaminase may play important roles in the pathophysiology of lung cancer and because of it

The Effectiveness of Sovodak in the Treatment of Patients with Chronic Hepatitis C

Background:&nbsp;Recently, interferon-free treatment has been considered for the treatment of chronic hepatitis C due to their high therapeutic success and lack of serious side effects. The combination of&nbsp;Sofosbuvir&nbsp;and&nbsp;Daclatasvir&nbsp;is effective in the treatment of the disease because of its pan-genotype. In the present study, the effectiveness of&nbsp;Sovodak, which is a combination of the aforementioned two drugs in one tablet, in the treatment of patients with chronic hepatitis C and cirrhosis was investigated. Methods:&nbsp;Patients with chronic hepatitis C whose diagnosis was confirmed by HCV RNA–PCR test were included in the study. These patients received one&nbsp;Sovodak&nbsp;tablet daily (for 12 weeks for non-cirrhotic patients and 24 weeks for cirrhotic patients). Sustained virologic response (SVR) was assessed by PCR test 12 weeks after the end of the treatment and one year later. Also, serum levels of liver enzymes, platelet count, and liver stiffness (using elastography method) were measured and their levels were compared before and after treatment in patients. Results:&nbsp;Findings related to the PCR test in patients showed that the level of SVR was 100% in patients 12 weeks after treatment (SVR-12). In three cirrhotic patients who received only 12 weeks of drug treatment, the disease recurred a year later. According to the results, ALT and AST serum levels were significantly decreased (P &lt; 0.001), and platelet count level was increased (P &lt; 0.001) one year after the end of the treatment period. Also, the liver stiffness index measured using FibroScan was significantly decreased in patients 12 weeks after the end of the treatment (P &lt; 0.001). Conclusion:&nbsp;The results of this study, in line with other studies, showed the effective role of&nbsp;Sovodak&nbsp;in completely eliminating the HCV virus in patients with chronic hepatitis C. Cirrhotic patients need to receive treatment for at least six months. Key words: Sovodak, hepatitis C, sustained virologic response, effectiveness, liver cirrhosi