ABSTRACT
Depression is a possible side effect associated with antiviral therapy for chronic hepatitis B [CHB] and chronic hepatitis C [CHC]. The objective of this study was to evaluate the prevalence of depression in patients receiving different anti-viral medications before, during and after treatment. This descriptive cross-sectional study was undertaken on 248 CHB or CHC patients referred to two clinics of Mazandaran University of Medical Sciences between March 2011 and April 2012. Those who received alpha interferon, another antivirus medication or combination of them were evaluated by Hospital Anxiety and Depression Scale [HADS] and clinical psychiatric interview before initiation of the medications, 12 and 24 weeks after the initiation of the treatment and 6 weeks after termination of antiviral therapy. The prevalence of depression in patients with either hepatitis B or C was higher than general population, but similar to each other. During the 12 and 24 week of the antiviral therapy, the prevalence of depression was increased especially in whom were receiving alpha-interferon. Six weeks after the termination of medical therapy, the prevalence of depression in whom received alpha interferon was decreased statistically. However, this event did not happen in the group that did not use interferon. It is suggested that patients receiving alpha-interferon should be psychologically assessed in the course of treatment. Displaying the symptoms of depression, doctors should apply the prophylactic and therapeutic measures as soon as possible
ABSTRACT
The annual risk of tuberculosis [TB] in Iran is about 0.5% with annual incidence rate of 23/100000 [16322 cases]. Different factors have been postulated as TB predisposing factors. Several studies have linked smoking with pulmonary tuberculosis as the TB incidence in their adult men was 2.4 times higher than women. In Iran, however, this ratio is equal and somewhere the ratio in women is greater. We decided to carry out a case control study in order to evaluate the effect of cigarette smoking on pulmonary TB. A case-control was achieved in health care centers of Mazandaran province [affiliated to Mazandaran University of Medical Sciences]. Participants were men Aged 15 years and older who were enrolled in health care centers with the diagnosis of active pulmonary tuberculosis. One hundred men [aged 15-85 years] with bacteriological TB [smear or culture positive] were selected as cases and 300 age-matched men without TB were selected randomly as controls. Information on smoking status, quality of tobacco smoked and duration of cigarette smoking and also the age at which smoking was first commenced were collected by a questionnaire. Smokers were 2.1 times more likely to develop pulmonary TB [OR=2.10, 95% confidence interval [CI]:1.33-2.33, p<0.04]. The age adjusted odds ratio was 1.804 [95% CI;1.66-2.5, p<0.05]. Quantity of cigarette smoking and duration of smoking had positive association with pulmonary TB. The Ors for mild [1-10 cigarette/ day], moderate [11-20/day] and heavy [>20/day] smoking were 1.68, 2.46, and 2.56, respectively [p<0.05]. The Ors for duration of smoking with <10 years, 11-20 years and >20 years of smoking were 0.91, 2.48, and 2.9, respectively [p<0.001]. We conclude that smoking may increase the risk of pulmonary TB in men. Further studies should be conducted to investigate this association and to establish whether smoking strategies contribute to tuberculosis control
Subject(s)
Humans , Male , Smoking/adverse effects , Causality , Case-Control Studies , Tuberculosis, Pulmonary/epidemiologyABSTRACT
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. 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. 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]. 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