[Epidemiological survey of confirmed influenza A [H1N1] in Kashan, Aran and Bidgol cities during 2009-10]

The first outbreak of Influenza A [H1N1], the first pandemic influenza in the present century, in Iran was in Kashan in July 2009. This study was carried out to describe the stages of spread and also the outcome of influenza A [H1N1] in terms of incidence and death in Kashan, Aran and Bidgol cities during 2009-10. In this case series-study of confirmed influenza A [H1N1], clinical and demographic data of all confirmed cases were recorded using SPSS software and were analyzed by Mann-Whitney test. The total number of confirmed cases [mean and median of age were 29.8 +/- 18.7 and 26 years, respectively] was 86 with a male/female ratio of 1:1. Among the 7 cases who died [mortality rate: 8.1%] the mean age for death was 46.9 +/- 27.9 years, though greater than that of the recovered cases [30.01 +/- 18.1 years], but non-significant statistically. Beginning of new educational year for schools was identified as the most important factor in spread of the disease. Considering the mortality rate and other related variables, no significant difference was seen between Kashan, Aran and Bidgol cities compared to other countries. However, comparing the present findings with the findings of other domestic medical universities can disclose the reasons for disparities. Moreover, a 10 week time interval between the first outbreak and the peak for pandemy highlights the presence of an efficient surveillance system for disease control

Evaluating outbreak of cutaneous leishmaniasis in military personnel referring to the 554 military Zanjan hospital in 2008

Leishmaniasis is one of the important parasitic diseases in tropical and subtropical regions of the world.Iran is one of the endemic areas of cutaneous leishmaniasis in worldwide. Staff of the Armed Forces, sometimes, are forced to accommodate in or around cities and villages thus they are at the risk of this disease and they can transfer the disease to other parts of the country. In this study cutaneous Leishmaniasis status has been studied in patients referring to a 554 military Zanjan hospital in 2009. This study is descriptive and cross-sectional. The military personnel with Leishmaniasis returning from the south west of the country [Fakeh] were examined according to questions of a questionnaire. This Study was done on 37 cases of positive cutaneous Leishmaniasis referred to the 554 military Zanjan hospital. Most of the patients had one scar [54.1%]. The wounds were mostly on hand [35.1%] and then foot [24.3%]. 90% of patients did not notice their bites, because the bite may had no symptoms and pain at first. The results of this study shows that prevention and control among the troops is necessary and recommended before the establishment of camps in the endemic areas of leishmaniasis

[ case of idiopathic CD4+ lymphocytepenia]

Opportunistic infections are common in patient with cell mediated immunodeficiency. We report here a case of multiple opportunistic infections and lymphoproliferative disease in patient eith idiopathic cd4+ lymphocy topenia. A 45 years old man was admitted in our hospital due to respiratory distress and diffuse skin lesions

BX of skin lesions and cdture of synovied fluid contained TB infection and prepared smear of synovid fluid contained aspergilus. The white blood cde count was 1000/ml with pmn [63%] and lymphocyte[28%] and cd4 [10.4%]. persistent cd4+ lymphocy to penia below 300/ml and lack of evidence for HIV1, 2 infection and also HTLV1, 2 infection svggests that immunosupression was due to idiopathic cd4+ lymphocytopenia [ICL] the paticnt was treated with antifungal and antibiotics and clinically improved. One years lates he almittes due to left side paresis. In brain MRI a lesion was seen in frontal. Also there was multiple lymph in inguinal region. Biopsy of lymph node showed lympo proliferative disordes. Unfortunately despite treatmen he died

[Hemophagocytic lymphohistiocytosis and cases Report of secondry form]

Background: this Syndrom is rare, but aggressive and potentially life-threatening disease most often affects infants from birth to 18 months of age, but cases in older children and adults have been reported

Materials and Methods: cases Report Study in Masih daneshvary Hospital.All related records in this regard were collected from late year

Result: superiority of sexual[Men] and low mortality rate

Conclusions: because HLH is often fatal, one must have a high index of suspicion that patients who present with several of the following: high fevers, maculopapular rash, failure to thrive, central nervous system symptoms, hepatosplenomegaly, lymphadenopathy, cytopenias, coagulopathy, abnormal liver function tests, and high serum ferritin, Sudden decrease of ESR, may have HLH