[Evaluation of diagnostic value of procalcitonin in severity indexes of acute pyelonephritis]

Background: Due to the characteristics of the low CRP and WBC count in acute pyelonephritis, Procalcitonin [PCT] measurement can be a useful and practical option in acute pyelonephritis. According to different results in the investigation of the diagnostic value of PCT; the aim of this study was to evaluate the diagnostic value of PCT in differentiation of the lower urinary tract infection from acute pyelonephritis

Methods: All patients with a diagnosis of urinary tract infection in Imam Reza and Sina hospitals were enrolled in this study. Positive urine culture was considered as a urinary tract infection. If urinary tract infection with a pathogen colony more than 105 or more than 104 colonies is marked in person, it was considered as a urinary tract infection. In all patients, leukocyte count, ESR, CRP, and serum PCT was measured. In all patients with febrile urinary tract infection, radioisotope scan was performed. If a parenchymal defect was found in scan, they were considered as acute pyelonephritis. And also, patients without fever and normal radioisotope scan were considered as urinary tract infection. The end prolactin levels were compared according to final diagnosis

Results: In this study, 100 patients were studied: 47 patients with acute pyelonephritis, 53 cases with cystitis. Mean age of patients in acute pyelonephritis and cystitis did not differed significantly; but its P value was 0.106, which was significantly higher than the cut-off point. Gender also had no significant differences between two groups [P-value=0.948]. The mean of Procalcitonin was 6.34%; with the range of 2% - 38%

Conclusion: No statistically significant differences were found between both groups. But the mean of WBC was higher in acute pyelonephritis than cystitis. ESR levels between bath groups were significantly different and it was significantly higher in patients with acute pyelonephritis. The mean of Procalcitonin in the two groups had no significant difference

Thrombolytic therapy for cerebral vein thrombosis in antiphospholipid syndrome secondary to systemic lupus erythematosus

A 20-year-old woman was admitted to a Gynecology Hospital in her 6[th] month of pregnancy for high blood pressure and tonic-clonic seizure. Primary diagnosis was eclampsia, and for that reason she underwent cesarean section. She also had headache on frontal and parietal areas without nausea or vomiting. There was not a focal neurological sign. Rheumatology consultation was requested. Systemic lupus erythematosus and secondary antiphospholipid [APS] was confirmed. The patient had headache that continued several days after cesarean section, therefore, brain magnetic resonance imaging [MRI] and magnetic resonance venography [MRV] were performed, and cerebral vein thrombosis was documented. Distal segment of right lateral sinus and sigmoid sinus were not appeared in brain MRV. Abnormal hypersignal intensity of right lateral sinus/coronal T2 was detected. Thrombolytic therapy with 20 mg tissue plasminogen activator on right sigmoid and transverse sinus was performed by an interventional neurologist. After this procedure, the patient's headache healed and she was discharged in a good condition

Clinical manifestations of patients with novel H1N1 infecction hospitalized in infectious disease ward, Sina hospital, Tabriz, Iran

Novel H1N1 influenza virus is a unique type of an influenza virus which is built due to abrupt structural alterations. This virus created a pandemic disease. The manifestations and severity may be affected by environmental, cultural and economical condition. From October 2009 until December 2009, we had recruited 40 patients with H1N1 infection documented with RT-PCR. Their demographic features and presenting signs and symptoms as well as their associated laboratory data were recorded. During the study period, 40 patients were studied with a mean age of 36.8 +/- 13.0 years of whom 21 were admitted to ICU. Totally, 37.5% of patients had risk factors. Pneumonia was the most frequent lung involvement. The most prominent radiographic findings were bilateral ground glass opacity and ARDS [25%]. Cough and fever was the most prevalent presenting clinical symptoms. Unfortunately, 8 patients died. Independent risk factor of death was ICU admission and mechanical ventilation. Our findings were more or less the same as other centers, however, most of the studied subjects did not have an underlying risk factor. Except for pneumonia and ARDS, bilateral pulmonary thromboembolism were detected in patients all of whom discharged after complete recovery