The predictive value of C-reactive protein (CRP) and procalcitonin chemical biomarkers in the premature diagnosis of infection in brain ischemic stroke

BACKGROUND: The infections are common complications after the ischemic stroke. The aim of this study was to evaluate the anticipatory value of C-reactive protein (CRP) and procalcitonin (PCT) biomarkers in diagnosis of stroke-induced infection.METHODS: In the current prospective study, 184 patients with cerebral ischemia were enrolled. Serum samples were obtained from patients. The CRP and PCT, white blood cells (WBCs) and monocytes, and final infections were evaluated.RESULTS: In the first 72 hours, the analysis for CRP revealed that the sensitivity was 41.60%, the specificity was 100%, positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 82.90%. PCT showed that the sensitivity was 85.41%, the specificity was 98.54%, PPV was 95.34%, and NPV was 95%.CONCLUSION: According to our findings, the evaluation of CRP and PCT with simultaneous clinical observation could be considered as a good step in start of antibiotic therapy

Clinical Manifestations and usual and unusual CXR manifestation of smear positive Pulumonary tuberculosis; in Sari, Qaemshahr and Neka

, , , (Received 7 June, 2009; Accepted 22 July, 2009)AbstractBackground and purpose: Clinical and radiological manifestations of Pulumonary tuberculosis are well known. However, it appears there is an increasing rate of unusual radiological patterns in immuno-competent adults, with smear positive pulmonary tuberculosis (based on our experience). The aim of this study was to analyze chest X-ray (CXR) findings and clinical patterns among immuno-competent men and women with smear positive pulmonary tuberculosis (TB) in Sari, Qaemshahr and Neka, during March 2006 to March of 2007.Materials and methods: All new cases of pulmonary TB diagnosed during 12 months in 3 districts in Northern Iran, (Mazandaran Province) were included in a cross-sectional study. Inclusion criteria's were: positive smear of sputum and absence of any immuno-suppressive state. 65 cases fulfilled the inclusion criteria. Descriptive methods were used for data analysis.Results: The common presenting symptoms were: coughing at 83%, hemoptysis at 24.6%, night sweating at 55%, anorexia at 60%, weight loss at 73.8 %, and fever at 60%. Usual radiological patterns was found in 70.8% of patients (upper lobe lesion with or without the remaining part) and incidence of an unusual radiographic pattern was 29.2%(middle and lower lob infiltration without upper lob lesion, milliary pattern, hilar lymphadenopathy and normal CXR).Conclusion: This study showed that TB with atypical radiographic manifestations is more common than reported previously.These varieties of radiologic manifestations can mimic other disease entities. Therefore, recognition and understanding of radiologic manifestations and complication of tuberculosis are important to facilitate a diagnosis.Key words: J Mazand Univ Med Sci 2009; 19(70): 61-66 (Persian

Bilateral breast swelling in a 23-year-old woman with Burkitt lymphoma

Primary breast lymphoma (PBL) of the breast is a rare type of localized non-Hodgkin lymphoma, which is usually of the B-cell. The majority of breast lymphoma present as a unilateral painless breast masses in an older woman, average age at diagnosis 55-60. A less common but distinctive presentation is a young woman of childbearing age who presents during or immediately after pregnancy. We present a 23-year-old postpartum woman with bilateral breast swelling. After surgical drainage and debridement and pathologic examination, the diagnosis of breast Burkitt lymphoma (BL) was confirmed. Chemotherapy was immediately started for her and the patient showed a good response with complete remission

Effect of Intranasal Mupirocin in Preventing Post-operative Infection after Open Heart Surgery

Background and purpose: Surgical site infection is one of the most important complications of cardiac surgery, and in 50% of cases, is caused by Staphylococcus species. This study evaluated the effectiveness of intranasal administration of mupirocin in reducing nasal bacterial colonization, mediastinal, sternal, pulmonary, and skin infections after open-heart surgery. Materials and methods: This descriptive study investigated the records of patients who developed post-operative infection following open-heart surgery in Sari Fatemeh Zahra Hospital during 2011-2015. Treatments were done in two different periods: first period from 2011 to September 2013 and the second period from October 2013 to March 2015. In second course, intra-nasal administration of mupirocin was done to all patients, as a routine hospital care. Then, the incidence of post-operative infection, type, and site of infection were compared. Results: Frequency of infection was 78.26% in the group that had recieved mupirocin and 46.29% in the group that had not received mupirocin. The rate of surgical site infection in the group that had received mupirocin was 21.74% and in the group without mupirocin it was 53.71% (P= 0.000). We observed significant reductions in the incidence of superficial infection of the incision (1.85% in the group that was given mupirocin vs. 10.9% in the group without mupirocin, P= 0.009), foot superficial infections (23.1% in the group that had received mupirocin vs. 27.7% in the group without mupirocin, P= 037), and deep soft tissue infection of foot (10.3% in the group that had received mupirocin and 18.18% in the group that had nor received mupirocin). Conclusion: Intra-nasal administration of mupirocin could prevent cutaneous infections after cardiac surgery and also reduce hospital length of stay

Chest CT Scan Findings and Severity of Disease in Patients with COVID-19 Admitted to Qaemshahr Razi Hospital, 2020-2021

Background and purpose: Timely diagnosis of patients with suspected COVID-19 using chest Computed tomography (CT) scan is of great benefit in reducing the severity of the disease. Previous studies did not address this issue, so, this study aimed to investigate the findings of chest CT scan images and the severity of lung involvement in patients hospitalized with COVID-19. Materials and methods: We performed a retrospective descriptive-analytical study in all patients admitted to Qaemshahr Razi Hospital with symptoms of COVID-19 and positive RT-PCR test results in 2019-2020. All chest scans were reviewed and reported by a radiologist. Data were analyzed using Chi-square and t-test. Results: The patients (n= 666) included 51.36% women and 48.64% men. The mean age of patients was 54.06±16.55 years. Moderate lung involvement was more common and ground-glass opacity (GGO) was the highest encountered pattern (39.33%). Also, in severe lung involvement, GGO pattern was found to be more prevalent (22.37%). Minimal lung involvement (0-25%), moderate lung involvement (25-50%), and sever lung involvement (> 75%) were seen in 6.75%, 22.29%, and 20.27%, respectively. Most of the patients were highly suggestive of COVID-19 and moderate lung involvement (45.97%) was found to be higher in this condition. No significant difference was seen between the extent of lung involvement in patients studied (P= 0.535). Conclusion: The CT scan results in our patients in Mazandaran province with COVID-19 showed primarily GGO followed by consolidation and crazy paving patterns

Rabies Virus Infection: A Case Series and Literature Review

Background: Rabies is a fatal and often neglected disease leading to encephalomyelitis following a bite by an infected mammal. According to the necessity of rabies disease in Iran, we present four cases of rabies virus infection.  Case Presentation: We presented 4 cases of rabies virus infection hospitalized in different hospitals in Iran in 2021-2022. Three patients were male. The youngest patient was 6 years old and the oldest was 81 years old. In all 4 cases, RT-PCR detected the positive virus infection. Three cases received rabies immunoglobulin. All of them received at least one dose of rabies vaccination; but, unfortunately, all patients died. Conclusions: The present case series showed the necessity of early rabies vaccination and also the early organization of stray dogs in the community. Unfortunately, two cases were lost to follow-up. So, the population education and follow-up of suspected rabies patients must be taken seriously by healthcare facilities