[Complications leading to hospitalization due to consumption of anti-TB drugs in patients with tuberculosis in Gorgan, Iran [2007-12]]

Anti tuberculosis drugs therapy is the most effective method for controling the tuberculosis [TB]. Early detection and appropriate treatment can prevent the TB-drug resistance. This study was carried out to determine the complications leading to hospitalization due to consumption of anti-TB drugs in patients with tuberculosis. In this descriptive-analytic study, 1550 records of patients with TB in urban and rural health centers of Gorgan, north of Iran were assessed during 2007-12. Checklist consists of demographic and clinical data for each patient was recorded in a questionare. 44 cases experienced the complications of anti-TB drugs. 27 [61.4%] of cases with complications were women. 77.3% and 22.7% of patients affected with pulmonary and extra pulmonary tuberculosis,respectively. 38.6% of patients were diabetic. The hepatic complication was seen in 37 cases [84.1%]. Skin and other complications were seen in 5 and 2 cases, respectively. There was not any relationship between drug complications and other disases. Hepatic damage is the most common complication leading to hospitalization in tuberculosis patients using anti-TB drugs

[Recurrent fever in a patient with hereditary spherocytosis: a case report]

Borreliosis or recurrent fever is a spirochete disease which is caused by various species of borrelia and characterized by recurrent episodes of fever, chills and spirochetemia that could lead to multiple organ involvement and even death. In this case report, a 23 years old man was presented with shaking chills, fever and abdominal pain from a week before hospital admission. Borrliosis was confirmed following observation of Spirochete in peripheral blood smear. The patient was treated with doxycycline orally and one week after treatment discharged with a good general condition. Coincidence of borreliosis with underlying haemolysis in this patient was misled clinical presentation

Diagnostic value of high resolution computed tomographic scan in active pulmonary tuberculosis

Since accurate and quick clinical and paraclinical diagnostic methods are not available, in some cases diagnosis of active pulmonary tuberculosis occurs after considerable time from the onset of disease. This study was designed to determine the diagnostic value of High Resolution Computed Tomographic [HRCT] scan in active pulmonary tuberculosis, in Gorgan, Golestan province, North of Iran. This diagnostic screening study was carried out on 135 [79 male and 56 female] hospitalized patients suspected with active pulmonary tuberculosis, and HRCT was used in their course of treatment as recommendation of their clinician. The patients were chosen from 5[th] Azar hosptial during 2009-10. Also it should be mentioned that patients were selected on avaliabity bases, and they were examined by smear, and sputum culture. The patients with negative smear and culture were set up as true healthy group [64 subjects]. The lung or small nuddles in HRCT was considered as proper position of lung involvument in active lung pulmonary. The HRCT findings between the case group [71 subjects] and healthy group were compared. According to HRCT findings, the sensitivity and specifity were determined for each patient. Data were analyzed using SPSS-16 and Chi-Square test. In this study, sensitivity, specificity, positive predictive value and negative predictive value of HRCT in active pulmonary tuberculosis were equal to 97.2%, 71.9%, 79.3% and 95.8% respectively. Involvement of upper and middle lobe of the right lung and upper lobe of the left lung were significantly higher than the control group [P<0.05]. This study showed that HRCT has high sensitivity and specificity in diagnosis of active pulmonary tuberculosis and can be used as a quick diagnostic way in active pulmonary tuberculosis, especially in patients with strong clinical suspicion and negative smear

[Distribution of hepatitis C virus genotype among HCV infected patients in Golestan province, Iran]

Background: Hepatitis C virus [HCV] is one of the main causative factors of liver disease which can lead to chronic hepatitis C infection in 80% of cases. HCV genotypes have a special worldwide geographic distribution. The goal of the present study was to detect HCV genotypes in patients with anti-HCV positive titers in Golestan Province, Iran

Materials and Methods: In this cross-sectional study, 95 positive HCV samples as detected by RIBA were evaluated. Viral RNA was extracted with a Roche extraction kit and the Fermentase cDNA kit Random hexamer primers was used for viral genomic cDNA synthesis. PCR was performed on all samples by a general pair of primers. Second-step PCR was done with specific primers, and the results were obtained following electrophoresis in 1.5% agarose gel and ethidium bromide staining in documentation gel

Results: General primer PCR revealed 91 positive samples. Assessment of 77 samples determined that the following genotypes were present: 1 and 3 [1a [19.5%], 1b [19.5%], 3a [15.6%], 3b [24.7%]], 2a [2.6%], 4 [7.8%]. The remaining samples were a mixture of genotypes 1 and 3 [6.5%]

Conclusion: The ingmost prevalent genotypes found were types 1 and 3 in Golestan Province. This distribution pattern differed from other areas in Iran, however genotype 4 was in accordance with other studies. Genotype 2 was only reported in this study and a study in Tehran. Thus, additional, larger studies of HCV genotypes should be performed for further analysis of genotypic distribution patterns

Possible role of TORCH agents in congenital malformations in Gorgan, northern Islamic Republic of Iran

This descriptive, cross-sectional study was carried out to explore the frequency of contamination with TORCH agents in neonates with congenital malformations in a referral centre in Gorgan city, Islamic Republic of Iran. Blood samples were taken from 64 neonates and their mothers over a 20-month period in 2003-04. Serologic tests showed that 4/64 infants born with congenital malformations [6%] had positive IgM antibody titres for Toxoplasma gondii [2 cases], rubella virus [1 case] and cytomegalovirus [1 case]. IgM was positive in 9/63 mothers [14%], also for T. gondii [3 cases], rubella virus [3 cases] and cytomegalovirus [3 cases]. No cases of herpes simplex virus type II or Treponema pallidum were found

effect of active education on knowledge of health care workers of Golestan university of medical sciences about avian influenza

The main goal of medical education is preparing experts in health care fields. Medical education should answer the population needs and develop in accordance with technology changes. The aim of this study was to evaluate the effect of active education on knowledge of health care workers of Golestan University of Medical Sciences about avian influenza. In 2005-2006, this semi experimental study was conducted through before-after design. At the beginning, knowledge of the samples regarding to avian influenza was evaluated with self-administered questionnaire. After intervention [active participation in lectures and group workshops] the questionnaires were distributed once again. Data were analysed by non-parametric tests [Wilcoxon, Mann- Whitney, Kruskal-Wallis] to evaluate the effect of active education on knowledge about Avian Influenza. The mean score of knowledge increased significantly after educational intervention [P-value < 0.001]. Previous information was significantly related to pretest scores. The mean score of knowledge was not significantly related to gender and age. Educational workshops are effective in increasing knowledge of healthcare workers about avian influanza. While educational programs of the mass media are effective knowledge, it doesn't meet the special educational needs in the field of health

Isolated gastric tuberculosis; A case report

Tuberculosis is an important problem in the world and Iran. Tuberculosis is an ancient disease but because of different presentations is a mysterious disease too. A 20-year-old girl who complained of abdominal pain with peptic ulcer and weight loss was admitted in our hospital. Since 4 months ago before referring, she had been treated many times for peptic ulcer including treatment for helicobacter pylori. Then endoscopy and biopsy were done. In endoscopy one ulcer in antrum with malignant appearance was observed. At biopsy granulomatous inflammation compatible with tuberculosis reported. She was treated by anti-tuberculosis drug for six months. Endoscopy repeated after 2 months of therapy showed completely normal pattern and she had 5 kg weight gain and totally symptom free after completion of therapy. Gastric TB should be considered for differential diagnosis of patient with gastric symptoms in endemic regions

[Tuberculin reaction in 4.5 months babies and 7 years old children, vaccinated with BCG at bith]

Approximately one-third of the world's population is infected with Mycobacterium Tuberculosis [T.B], which is an indicator of high distribution of these bacteria in our environment. The only vaccine currently available against TB is the attenuated Mycobacterium bovis strain bacillus Calmette-Gu‚rin [BCG], which used regularly for many years to prevent the tuberculosis in Iran and many part of the world. The efficacy of this vaccine varies in different populations, and is a matter for discussion. On this basis, the present study has been set up to determine the level of tuberculin reaction in 4.5 month and in 7 years old children that receive BCG vaccine at birth time, in Golestan province. 2700, 4.5 month infant and 2400, 7 years old children in Golestan province were chosen by cluster sampling after the proper permission from the parents, public health centers and educational authorities were taken. The presences of the BCG scar were assessed, and 0.1ml of 5tu tuberculin were injected subcutaneously. The induration was measured 48-72 h after tuberculin injection. The results were determined as percent and compare with t test. In these study 2559 infants and 2193 child were taken part in the final evaluation. The BCG Scar were present in 97.9% of infants and 87.8% of 7 years children, this difference was meaningful. The average induration in 4.5 months babies were 2.29 mm, and in 7 years child was 0.66 mm, this difference was significant [P<0.05]. More than 44.7% of babies and 82% of 7 years children did not show any reaction after PPD test, this difference was also significant [P<0.05]. The level of positive tuberculin reaction in infants of this province in spite of vaccination was very low, and this level was reduced after 7 years time, this indicate that BCG vaccination at birth did not have any major role in positive tuberculin reaction. Our results also indicate that the presence of scar can be a good indicator for previous vaccination. In regard to the negative tuberculin reaction in majority of babies, it is suggested to evaluate the efficacy of BCG vaccine in preventing the TB disease itself, by other method such as studying the TB incidence among children in long term or by determination of cytokines level after tuberculin injection

[Bilatral optic neuritis following measles/rubella [MR] vaccination [a case report]]

A thirteen years old female caucasition admitted in 5 Azar General hospital with a 3-day history of deteriorating vision. Two weeks prior to admission she had received a measles-rubella vaccination at school [as a mass campain of MR vaccination in IRAN]. General and neurological examination except lung wheezing and occular findings were normal. In visual exam she had questionable light perception in right eye and hand motion sensation in left eye. Funduscopy revealed moderate bilateral opitc disc hypermia. Investigations revealed normal full cell blood count, biochemistry profile, clotting studies and sputum. Brain CT scan and MRI were normal except pansinusitis. CSF examination revealed normal constituents. The patient treated with methyl prednisolon [1 gr/daily] for 7 days and patient had dramatic response to therapy. After 6 weeks of starting medical treatment ophthalmologic exam revealed 2 meters finger count vision in Rt eye and 6/10 visual aquity in Lt side. This patient is a rare case of bilateral optic neuritis after MR vaccination