Analysis of the related factors in hepatitis C virus infection among hemophilic patients in Isfahan, Iran

Patients with hemophilia are at high risk of post-transfusion hepatitis because of widespread use of plasma-derived products. As a consequence, hepatitis C virus [HCV] is the most common cause of chronic liver disease among hemophilic patients. The objectives of this study are to determine HCV prevalence, and analyze the effective agents in HCV infection in hemophilic patients. All patients with inherited coagulation disorders registered in hemophilia center of Isfahan [553 persons] were checked for HBsAg and anti-HCV, using enzyme-linked immunosorbent assay [ELISA] test. Positive tests for anti-HCV were confirmed by RT-PCR. Clinical history, laboratory and treatment data of all cases were studied in January 2006. From 465 men and 88 women with inherited coagulation disorders with the mean age of 23.4 +/- 12.9 years, 125 patients [22.6%] were HCV positive, 2 [0.4%] were HBV positive and one [0.2%] was both HCV and HBV positive. Odds ratio between HCV infection and cryoprecipitate usage was 3 [CI 95%: 2-4.5] and between HCV and factor usage was 0.21 [CI 95%: 0.07-0.7]. Considering the high chance of HCV infection after transfusion of cryoprecipitate and, a more careful pre-transfusion screening of blood for anti-HCV must be introduced in all blood banks. The usage of FFP less chance of HCV infection, instead of cryoprecipitate in patients who do not have volume restrictions may be preferable

Frequency of resistance to systemically administered meglumine antimoniate [Glucantime] in patients with acute cutaneous leishmaniasis: a cross-sectional study

Pentavalent antimony compounds are the first line of treatment for cutaneous leishmaniasis. Clinical resistance to pentavalent antimony in the form of meglumine antimoniate [Glucantime] has been recognized as a problem in leishmaniasis. Herein, clinical response to Glucantime was studied in patients suffering from cutaneous leishmaniasis. In a cross-sectional study 370 patients with cutaneous leishmaniasis were treated with systemic Glucantime, 50 mg/kg/day, for 2 to 3 weeks. They were visited weekly for 3 weeks and also followed up for 3 months after treatment was completed. The clinical and parasitological response to this treatment was evaluated, and classified into partial and complete response and failure to treatment. Two hundred forty-seven men and 123 women were followed up. The mean age was 36.7 +/- 16 years. There were 64.1% partial response after 2 weeks and 73% partial response at the third week of treatment. 11.6% of lesions were not cured after 3 weeks of treatment and 8.1% were not still cured 12 weeks thereafter. Clinical resistance to Glucantime is an important problem. The mechanisms of resistance and using drug combinations are needed to be considered

Patch test results in patients with clinical diagnoses of contact and/or atopic dermatitis in Isfahan

Patch testing is an important diagnostic tool to confirm allergic contact dermatitis. Determination of the validity and usefulness of a standard patch test allergen series with consideration of age, sex and race difference can reduce diagnostic errors in patients with allergic contact dermatitis. This study was done to determine the frequency of contact sensitization to 28 common allergens in patients with clinical diagnoses of contact and/or atopic dermatitis. Materials and In a cross sectional study during 6 months, 250 patients with contact and/or atopic dermatitis were patch tested with DKG standard patch test series and evaluated after 24, 48 and 72 hours after application of patch test. Data were analyzed using SPSS. 11 software by X[2], Fisher's exact and t tests. Positive patch test results were seen in 32% of all evaluated patients. 45.8% of patients with age above 40 years and 28.0% of patient with age below 40 years had a positive patch test. Potassium dichromate and nikel sulfate were the most common allergens in our study. In this study only 13 of 18 [46.4%] tested allergens showed positive reaction. Low positive rate of standard DKG series in this study shows that allergen series of standard patch test should be revised based on reginal conditions, allergens and social habits

[Efficacy of combination of topical honey with intralesional injection of glucantime in the treatment of acute cutaneous leishmaniasis]

Cutaneous leishmaniasis [CL] is an edemic disease widely spread in Iran. Although several treatments have been tried, none has been found as simple and effective. Honey has been used in the treatment of chronic ulcers and its anti-leishmanial effects have also been reported. So we assessed the efficacy of honey in acute CL. In a randomized clinical trial, 100 patients with CL referred to Skin and Leishmaniasis Research Center were treated with either weekly intra-lesional injection of Glucantime alone or combined with twice daily topical application of honey. The patients were evaluated clinically 2,3 and 4 months after treatment. Ninety patients completed the study, forty-five patients were treated in each group. At the end of trial, 32 patients [71/1%] of these treated with Glucantime alone and 23 patients [51/1%] treated with honey were cured [P=0.04]. Drug interference and inhibition of bioavailability of Glucantime by honey may decrease the efficacy of Glucantime in treatment of CL