A case of antiphospholipid syndrome following gastric signet ring cell adenocarcinoma

Objective: Rare disease Background: Antiphospholipid syndrome (APS) is a rare autoimmune disease characterized by arterial, venous, and small-vessel thrombosis, pregnancy-related morbidity and the presence of antiphospholipid antibodies such as an-ticardiolipin antibody, and/or anti-beta2-glycoprotein I. In the recent years, APS was observed in patients with solid tumors and the renal cancer, lung carcinoma and breast tumors were the most common tumors linked with APS. Case Report: A 53-year-old female presented with pain and pitting edema of left lower extremity that had begun 6 months prior to hospitalization. Deep vein thrombosis (DVT) in the popliteal vein diagnosed by Doppler ultrasonogra-phy and the patient was treated with heparin followed by warfarin. Following subdural hematoma, anticoagu-lant therapy was stopped, and the patient underwent craniotomy. One month later, the patient returned with pain and DVT diagnosed in its right leg. Laboratory tests showed high levels of lupus anticoagulant, IgM and IgG anticardiolipin antibodies. Following a high alkaline phosphatase, diffuse bone marrow involvement was found by whole body bone scan. Looking to find primary tumor, a large infilterable lesion in gastric was seen by endoscopic images, and biopsy histopathology showed a signet ring cell adenocarcinoma. The patient re-fused chemotherapy and died 6 months after diagnosis. Conclusions: APS is associated with gastric signet ring cell adenocarcinoma. © Am J Case Rep, 2020

A Case of Knee Monoarthritis Caused by Mycobacterium Tuberculosis

BACKGROUND Skeletal involvement is an uncommon form of extrapulmonary Mycobacterium tuberculosis (MTB) that occurs in 1-3 of the patients. Knee joints may be affected in 8 of cases. CASE REPORT We reported a case of TB knee arthritis in a 35-year-old Afghan male who was referred to Kashan Rheumatology Clinic for pain and swelling in the left knee. The patient had no history of fever, chills, weight loss, or anorexia. His chest radiography was normal. The synovial fluid culture was positive for M. tuberculosis. Magnetic resonance imaging (MRI) of the left knee demonstrated a marked joint effusion, chondromalacia in the lateral patellar facet, and edema in the origin of the gastrocnemius muscle. The histopathologic examination revealed multiple granulomas with foci of necrosis. CONCLUSIONS This case demonstrated that clinicians should pay particular attention to the possibility of TB as the cause of chronic monoarthritis even when pulmonary involvement is not documented

The study of factors associated with pregnancy outcomes in patients with systemic lupus erythematosus

Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease that can lead to unfavorable pregnancy complications in women. This study aimed to evaluate the factors associated with pregnancy outcomes in patients with SLE. Results: Fifty-nine pregnant women with SLE (121 pregnancies) participated in this retrospective cohort study. The mean age of the patients was 33.74 ± 3.80 years (range 21 to 48 years). Fetal loss occurred in 43.8 of pregnancies. The most common laboratory findings in SLE patients were antinuclear antibody (81.4) and anti-ds DNA positivity (54.2). High levels of C-reactive protein (CRP) during pregnancy, renal involvement, anti-double-stranded DNA positivity, anti-phospholipid antibody (APA) positivity and younger age at disease onset were significantly correlated with unfavourable pregnancy outcomes. A significant difference was observed between duration of SLE and low birth weight (P = 0.003), pre-eclampsia (P = 0.012) and still birth (P = 0.036). High CRP, APA positivity, anti-dsDNA positivity and kidney involvement were predictors of adverse pregnancy outcomes in SLE patients. Renal involvement increased risk of pregnancy with complication 8.5 times (OR = 8.5, 95 CI 1.396-63.373, P = 0.017). Antiphospholipid syndrome (APS) also was associated with an odds ratio of 5.18 (95 CI 1.681-13.647, P = 0.001). © 2020 The Author(s)

Survival rate of patients with bladder cancer in Yazd, central province of Iran

Abstract Background: Bladder cancer is the ninth most commonly diagnosed malignancy worldwide. The trend of bladder cancer incidence and mortality is rising in Iran. This study was aimed to evaluate the survival rate of patients with bladder cancer in Yazd province, Iran. Methods: In this retrospective cohort study, data were collected from 340 patients suffering from bladder cancer referred to Shahid Rahnemon and Shohada-Kargar Hospitals in Yazd province, Iran between April, 2001 and March, 2012. Variables included age, gender, stage of cancer, place of residence and type of treatment. The Kaplan-Meier and Cox regression analyses were used to evaluate the relationship between each variable and survival time. A P value less than 0.05 was considered significant. Results: The mean age of total patients was 65.8 ± 13.6 years, and their mean survival time was 68.55 ± 6.05 months. Cumulative survival rates at the end of 1, 3, and 5 years in bladder cancer patients were 91%, 58%, and 51.4%, respectively. A statistically significant association was found between age (P = 0.005), stage of disease (P = 0.0003), type of treatment (P = 0.0003) and survival time of patients. Data showed no significant correlation between age, gender, place of residence and patients’ survival. Conclusions: The survival of patients suffering from bladder cancer in this study was less than other reports. Patients’age and cancer stage were the effective factors in survival time. Continuous screening of older people for cancer diagnosis in early stages is seemed to improve survival in patients. Keywords: Bladder; Cancer; Survival Rate; Ira

Prevalence of torque teno virus in healthy individuals and those infected with hepatitis C virus living in Yazd, Iran

Background: Torque teno virus (TTV) is a non-enveloped DNA virus that its role as a helper or causative agent in hepatitis is still unclear. TTV prevalence varies in different regions of the world. This study aimed to determine the prevalence of TTV in healthy individuals and those infected with hepatitis C virus (HCV) living in Yazd city, Iran. Methods: In this case-control study, 50 healthy subjects and 68 HCV-positive individuals who referred to Yazd hospitals participated in this study. TTV DNA in serum samples were detected by nested polymerase chain reaction (PCR) using specific primers of 5?-UTR and N22 regions. The genotypes of HCV and TTV were determined by sequencing method. Results: TTV-DNA was detected in 2 out of 50 (4?) healthy individuals and in 4 out of 68 (5.8?) HCV-positive persons. There was not a significant correlation between the prevalence of TTV and HCV infection. The most common TTV genotypes among HCV-positive individuals were 3, 17 and 13, respectively. There was not a significant association obtained between HCV genotypes and TTV genotypes. Conclusion: The prevalence of TTV in Yazd province was low compared with the other areas of Iran. The prevalence of TTV in HCV infected people was not significantly higher than its rate in uninfected individuals. © 2020 Caspian Journal of Internal Medicine. All rights reserved

The risk of nosocomial infection with multidrug-resistant corynebacterium urealyticum after prostate cancer surgery

Corynebacterium urealyticum is a Gram-positive, lipophilic, multidrug resistant, and urease positive microorganism with diph-theroid morphology. C. urealyticum causes several diseases such as urinary tract infection, chronic urological disease, urinary tract infections, and bacteremia in immunocompromised individuals. This study reports a rare case with nosocomial infection and hematuria caused by multidrug-resistant C. urealyticum after prostate cancer surgery. © 2019, Archives of Clinical Infectious Diseases

Prevalence of high-risk human papillomavirus types among women screened for cervical cancer in yazd, iran, and comparison of cytology, histology, and colposcopy results

Background: Human Papillomavirus (HPV) is a DNA virus with more than 100 genotypes, at least 12 of which are high-risk and associated with high-grade cervical lesions. Data on the prevalence of high-risk HPV genotypes among women are not yet available for the total regions of Iran. Objectives: The present study aimed to determine the prevalence of high-risk HPV types among women screened for cervical carci-noma in Yazd and compare the cytology, histology, and colposcopy results. Methods: In this cross-sectional study, 402 women referring to gynecology clinics of Shahid Sadoughi University of Medical Sci-ences, Yazd, Iran, were selected. The Pap smear and HPV typing were performed on cervical samples. The high-risk HPV types were detected by the polymerase chain reaction (PCR)-based reverse blot hybridization assay. Colposcopy was carried out on patients with high-risk HPV types, and biopsies were taken for histological examination. Results: Among 402 women screened by HPV-PCR, 32 (7.97) women were positive for high-risk HPV types. Human papillomavirus 16 and HPV18 were the most frequent genotypes (46.9). The cytology, histology, and colposcopy results were abnormal in 56.2, 29.1, and 71.9 of patients, respectively. Pap smear had 100 sensitivity and 58.3 specificity for the detection of high-grade cervical lesions, while these values for colposcopy were 75 and 87.5, respectively. Conclusions: The frequency of high-risk HPV types was relatively low among women living in Yazd than in those from other provinces of Iran. A significant percentage of patients with HPV had normal cervical cytology and histology. Therefore, HPV typing is recommended to decrease the development of cervical cancer. Colposcopy had acceptable sensitivity and specificity for the detection of high-grade cervical lesions. © 2020, Author(s)

Bacterial spectrum and antimicrobial resistance pattern in cancer patients with febrile neutropenia

Background: Bacterial bloodstream infections are one of the most common complications in cancer patients under treatment. Bacteremia in these patients is a medical crisis that needs antibiotic treatment. The aim of this study was to determine bacterial spectrum and antimicrobial resistance pattern in febrile neutropenic cancer patients. Methods: In this prospective study, 212 cancer patients with febrile neutropenia who were referred to Shahid Sadoughi hospital in Yazd from 2012 to 2015 were participated. Bacterial pathogens isolated by the BACTEC media and antimicrobial susceptibility tests performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The mean age of patients was 43.5 ± 24.98 years old. Out of 212 participants, 62.3 (132/212) were suffering from hematologic malignancies, and 37.7 (80/212) had solid tumors. Gram-negative bacteria were the predominant microorganisms (84.9). E.coli was the most frequently isolated pathogen (38.68 ), followed by Klebsiella (14.15) and Acinetobacter species (11.32). In addition, Staphylococcus epidermidis was the most common isolated Gram-positive bacteria (8.5). Gram-negative bacteria were susceptible to ciprofloxacin with a response range of 53.7 to 100. The majority of E.coli isolates were sensitive to ceftazidime (87.8) and were resistance to Co-trimoxazole (15.8). Klebsiella isolates were 100 susceptible to cephalosporins, meropenem and imipenem. Conclusion: The majority of bacterial pathogens were resistance to various antibiotics. Judicious use of antibiotic therapy can prevent the emergence and spread of antibiotic-resistant Gram-negative bacteria. © 2019, Asian Pacific Journal of Cancer Prevention

Crimean-Congo hemorrhagic fever virus vaccine: past, present, and future

Crimean-Congo hemorrhagic fever (CCHF) has been recognized as a tick-borne infection caused by a member of the Nairoviridae family within the Bunyavirales order, named CCHF virus. CCHF virus is a zoonotic virus, so transferred between vertebrates and humans. Therefore, vaccination in humans and animals might reduce the risk of infection. Currently, there are no globally licensed vaccines or therapeutics for CCHF. Although several studies have been performed on the production of the CCHF vaccine, any of these vaccines were not fully protective. Hence, the development of a new generation of vaccines could contribute to better management of CCHF. In this review, we will discuss on features of these vaccine candidates. © 2022 Lippincott Williams and Wilkins. All rights reserved

The prevalence and genotype distribution of adenovirus respiratory infection among Iranian Hajj pilgrims in 2015

Aim: Respiratory viruses are the most common cause of hospitalization of pilgrims during Hajj. This study aimed to detect adenovirus genotypes among Iranian pilgrims with acute respiratory tract infection in Hajj season of 2015. Materials & methods: In this cross-sectional study, throat swab samples of 338 Iranian pilgrims with flu-like symptoms were screened for adenovirus by polymerase chain reaction, and virus genotypes were determined using sequencing method. Results: Seventy-seven cases were positive for adenovirus (22.78). The adenovirus type 6 was the most frequently detected virus followed by type 5, 1, 2 and 57. Conclusion: The prevalence of adenovirus respiratory infection among Iranian pilgrims is considerable. Preparation and administration of an effective adenovirus vaccine is recommended. © 2020 Future Medicine Ltd