Chlamydia Pneumoniae Infection and Cardiac Risk Factors in Patients with Myocardial Infection

<p class="abstract"><strong>BACKGROUND:</strong> Evidences support the possible involvement of microorganisms such as Chlamydia pneumonia in the pathogenesis of ischemic heart diseases through a chronic inflammatory process. The aim of this study was to determine the relation between Chlamydia pneumoniae seropositivity with acute myocardial infarction and its related risk factors.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>In this case-control study, 88 patients admitted in CCU with a diagnosis of acute coronary syndrome, without a history of chronic diseases including cancers were selected as cases and 49 surgical patients without an evidence of cardiovascular disease according to clinical examinations and ECG were selected as controls. Demographic characteristics and background risk factors were obtained using a questionnaire by expert nurses. Venous blood sample was obtained from participants for measuring the anti Chlamydia IgG and IgM antibodies using ELISA method. The prevalence of antibodies was compared in both groups and its relation with coronary syndrome was evaluated.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> 88 and 49 patients were enrolled in case and control groups, respectively. Mean age of patients and the controls was 14 &plusmn; 59.7 and 13 &plusmn; 56.9 years, respectively (P = 0.26). Anti Chlamydia IgG seropositivity rate was 63(71.9%) and 23(46.9%) in case and controlcontrol groups, respectively (P &lt; 0.01; OR: 2.85; CI 95%: 1.38 - 5.9). Anti Chlamydia IgM was positive in 1 patient and 1 control. Anti Chlamydia IgG seropositivity rate was higher in patients older than 50 years old than those younger than 50 years old (OR: 2.83; CI 95%: 1.31 -1.14). There was a significant relation between BMI, smoking and Anti Chlamydia IgG seropositivity.<strong></strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Considering the relation between anti Chlamydia antibody IgG seropositivity with BMI and myocardial infarction, it seems that appropriate diagnosis and treatment of these prone patients can be benefical.</p

Persistence of immunity to hepatitis B vaccine as infants, 17 years earlier

Background: In Iran since 1992, hepatitis B vaccination was a part of the national vaccination program. Hepatitis B vaccination is effective in the epidemiology of hepatitis B. The aim of this study was to evaluate the long – term persistence of immunity. Methods: This cross-sectional analytical study was conducted on children and adolescents aged between 6-18 years in Birjand, who received a three – dose hepatitis B vaccination in accordance with the national immunization program. No students were infected with hepatitis B. Antibody titer higher than10 IU/L was considered positive. Results: A total of 530 patients (307 boys and 223 girls) were recruited for the study of which 44% had positive antibody titer (≥10 IU / L). The geometric concentration mean (GMCs) of antibody in subjects was 64.9±34.2, HBS antibody titer was positive in 40.4% of the boys and 59.6% of the girls. A significant difference in antibody titers was observed in terms of gender and according to the time elapsed since the last vaccination. Antibody titer in children older than 13 years had passed since their last vaccination and was significantly less than those children younger than thirteen years old had passed since their vaccination logistic regression analysis showed that the only predictive factor of anti-HBS low titer (<10 IU/L) is elapsed time of vaccination. Conclusions: Based on results of this study, hepatitis B vaccine has created a good level of protection in 44% of the adolescents after 17 years

Comparison of PPD test in household contacts of smear-positive and -negative tuberculosis (TB)

Introduction: Pulmonary tuberculosis (TB) is an old disease that has been consistently considered as an important cause of inability and mortality. TB is a major human killer that is progressing as before. Pediatric TB causes 5% to 15% of clinical TB. This study investigated the relative prevalence of infection in the 15- to 25-year-old family members or relatives who were in constant, domestic contact with smear-positive and -negative pulmonary TB patients. Methods: This is a descriptive, cross-sectional study conducted on individuals having household contact with negative and positive pulmonary tubercular patients during 2011. After identifying positive and negative smear TB in the Tuberculosis Center of Birjand, all 15- to 25-year-old household contacts were identified. After a physical exam, and in order to rule out, a PPD test was conducted with 0.1cc of the 5 unit PPD solution. The test result was measured and recorded between 48 and 72 h later by a scaled ruler. Induration >5 mm was considered a positive tuberculin test. None of the case contacts has had a BCG vaccination in the last 7 years. In all, CXR was normal. The results were analyzed with the Fisher test. Results: Of 126 case contact with 75 smear-positive and -negative TB, 102 cases had contact with smear-positive TB and 24 cases had contact with smear-negative TB. Of 102 cases that had contact with smear-positive TB, 17 cases have positive PPD (PPD>5 mm), and 85 cases have negative PPD. All of the household contacts with negative smear TB have negative PPD; 60% of PPD positive subjects were male and 40%were female. Individuals with positive PPD included 15 children and 2 relatives of a TB patient. The average size of PPD was 7.2±1.4 mm. All contacts with positive PPD had normal CXR. Thus, 13.5% of all case contacts and 16.7% of contacts with smear-positive TB were infected with MTB. There was statistically significant differences between the two groups (p = 0.04), but there was no significant difference between the sexes. Conclusions: The most important way to prevent TB is omission of the disease transmission sources (TB patients) by anti-TB treatment. Extensive studies are needed to ensure that contacts of patients with pulmonary TB are identified and appropriately screened

Tuberculosis of the Breast: A Case Report

Primary tuberculosis of the breast is a rare disease. It usually occurs in female of reproductive age. Any form of tuberculosis mastitis may present with feature of malignancy. Diagnosis is mainly based on identification of tubercle bacilli. We report a 42-year-old woman with primary tuberculosis abscess of the breast, who underwent surgical resection. Fine needle biopsy failed to achieve specific diagnosis before surgical operation. She responded to anti-TB therapy postoperatively. In endemic area, tuberculosis should be considered in the differential diagnosis of breast tumor

Seroepidemiology of hepatitis E in mental retardation in Birjand city in 2017

Background and Aim: Hepatitis E is a viral disease transmitted through contaminated water, which is most commonly reported as an epidemic. Mental retardation among high-risk groups are at high risk of infection, Therefore, the present study was designed and conducted to evaluate the seroepidemiology of hepatitis E in mentally retarded individuals. Materials and Methods: This cross-sectional descriptive-analytic study was performed on 300 clients in Birjand and they were selected by the census. The Diapro Anti-Hev-IgG kit was used in this study. Data were collected by SPSS software (revision 19) and descriptive statistics were analyzed by Chi-square and Mann-Whitney tests at the level of α: 0.05. Results: Of the 300 individuals selected, a total of 267 subjects were included: 180 (67.5%) male and 87 (32.5%) female were included in the study, 62 of which (23.1%) had E-positive hepatitis and 205 (76.5%) had E-negative hepatitis. The results of the study showed that there was no significant relationship between sex and positive serology of hepatitis E, but there was a direct correlation between age and age of entering the center with positive hepatitis E serology(P=0/001). Also, the relationship between hepatitis E serology and duration of stay in the center was not significant (P = 0/27). Conclusion: The high prevalence of hepatitis E in mentally retarded individuals is alarming and emphasizes the need for appropriate screening and hygiene strategies

Time to Sputum Smear Conversion in Smear-Positive Pulmonary Tuberculosis Patients and Factors for Delayed Conversion

Pulmonary tuberculosis is a common infection worldwide. In the eastern part of Iran, fluctuations in tuberculosis prevalence are seen due to the migration of people from Afghanistan. The aim of this study was to evaluate the time of bacteriologic sputum conversion after treatment and affecting factors in those whose smear does not become negative. This study was carried out on 85 smear-positive pulmonary tuberculosis patients with the mean age of 65.6±16.7 years. There were 38 male patients (44.7%), 47 urban residents (55.3%), and only 6 patients (7.1%) from Afghanistan. The mean time of sputum conversion after starting treatment was 1.99±1.06 months. The mean time of sputum conversion was significantly higher in males (P=0.046), increased bacilli density in the primary sputum sample (P<0.0001, R=0.507), and pre-existing medical illness (P=0.001). In this study, it was revealed that pre-existing illness, bacilli density in initial smear, and severe involvement of the lung on radiography, could be associated with delay in sputum smear conversion

Comparison of Azithromycin and Ciprofloxacin in treating adults\\\' acute non amebiasis dysenter

Background and Aim: Invasive diarrhea is a self-limited disease but its antibiotic treatment not only reduces the disease marking time, but also excretion of the microbes and, consequently, a decrease in the pathogenicity of the disease. The present study was conducted to compare patients' resistance to ciprofloxacin and to azithromycin in non-amoebic acute dysenteric. Materials and Methods: In this clinical- trial study 84 patients suffering from non-amoebic dysentery were selected through successive sampling, and were randomly divided into two groups. One group was administered Ciprofloxacin 500mg every 12 hours, the other group Azitromycin 250mg daily (every 24 hours). Then patients examined after 48 hours to see the probable improvement of their previous clinical symptoms. Besides, their first day feces culture was assessed. The obtained data was fed into SPSS software (V: 1/3), and then it was analysed using X2 statistical test at the significant level α=0.05.for afebrility and decreased diarrhea .data analyzed in using test. Results: Out of 84 patients, shigella was diagnosed in 41 (48.8%), 18 patients of whom (43.9%) had been treated with azitromycin and 23 cases (56.1%) had received ciprofloxacin .In 14 samples (16.7%) other microbes had grown (e.g. Salmonella, Campylobacter jejuni, Escherichia Coli). Antibiogram of 55 patients showed that 32 (58.2%) of them were sensitive to ciprofloxacin and 41 subjects (74.5%) to azitromycin .On the third day of treatment the clinical response of the patients was assessed through their probable fever and diarrhea .It was found that 29 cases (93.5%) in azitromycin group and 31 patients (88.5%) in ciprofloxacin group were a febrile. Thus, no significant difference between the two groups was observed (P=0.6). Conclusion: The present study proved that Azitromycin and Ciprofloxacin have the same efficacy in treating non-amoebic dysenter