Pulmonary tuberculosis in patients with HIV/AIDS in Iran

Pulmonary tuberculosis is still the most common form of tuberculosis in HIV infected patients having different presentations according to the degree of immunosuppression. This study appraised the impact of HIV infection on clinical, laboratory and radiological presentations of tuberculosis. The clinical, laboratory and radiological presentations of pulmonary TB in 56 HIV-infected patients were compared with 56 individually sex and age matched HIV-seronegative ones, admitted to Imam Hospital in Tehran [1999-2006] using paired t-test in a case control study. All cases and the controls were male. Fever was found in 83.9% of the HIV positive patients compared to 80% of the HIV negative ones. Cough was the most common clinical finding in the HIV negative group [89.3% vs. 82.1% in HIV positive group]. Among radiological features, cavitary lesions, upper lobe and bilateral pulmonary involvement were observed significantly less often in the HIV-infected group. On the contrary, lymphadenopathy was just present in the HIV positive group in this series of patients [12%] and primary pattern tuberculosis was more common, as well [71% vs. 39%, P= 0.02]. The Tuberculin test was reactive in 29% of the HIV/TB patients. The coexistence of both infections alters the picture of tuberculosis in many aspects and should be taken into account when considering a diagnosis of HIV infection and its potential for TB co-infection, and vice-versa

rare case of caniform osteomyelitis of actinomycet due to foreign - body is reported

Actinomycosis is a slow growing infection due to gram positive, anaerobic, or microaerophilic bacteria. A 19 years old man with foot pain witch has a history of trauma last year Trauma caused a mild erythema swelling and tendernss and heald spontenously after one year he had foot pain during playing football. He didn't have fever, cell counts were normal and the MRI had abnormal signal in medial portion of left foot and bone and soft tissue inflammation, in culture from operation room actinomyces species growed. The patient didn't have mycetoma triad and actinomyces probably due to foreign body [wood] peneterated. This disease is rare and reported to increase knowledge of the system

Adverse drug reactions in an Iranian department of adult infectious diseases

This study aimed to assess the frequency and severity of adverse drug reactions [ADRs] [WHO definition] in hospitalized adult patients in an infectious diseases referral ward in Tehran. Of 281 patients evaluated over 6 months, a total of 170 suspected ADRs were reported among 101 patients [35.9%]. The most commonly affected organ system was gastrointestinal [47.5%], and the most common class of drugs responsible was anti-infectives [93.1%]. ADRs were high among HIV-positive patients [82.9%], mainly due to anti-tuberculosis drugs. Attention to appropriate prescription of drugs is required with more careful clinical and laboratory monitoring of patients

[Evaluation of two surveillance methods for surgical site infection]

Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods. In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient's discharge. Review of patient's history and daily records and interview with patient's surgeon and the head-nurse of the ward considered as a gold standard for surveillance. The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended. The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended

Frequency of hypothyroidism and factors affecting it in HIV-infected patients in Tehran, Iran [2004]

A wide spectrum of endocrine abnormalities including thyroid dysfunction has been observed in HIV-infected patients with different results. This study was conducted to determine the frequency of thyroid dysfunction and to identify factors affecting the development of hypothyroidism in HIV-infected patients. Free T4, FT3, TSH, and thyroglobulin levels of 88 HIV-infected patients receiving care at UT counseling center for Behavioral Disorders in Tehran, an out patient referral center, were measured and data on their age, sex, body weight, BMI, history of opium and injection addictions, duration of HIV infection, disease stage, history of opportunistic infection or malignancy, CD4 cell count, antiretroviral treatment with antiretroviral drugs [HAART], receipt of other drugs [TMP-SMX, antituberculosis drugs, and steroids], and hepatitis C virus Co-infection were collected. Inclusion of the subjects was simply random. 17% of subjects had hypothyroidism; 1.1% had overt hypothyroidism; 2.3% subclinical hypothyroidism and 13.6% had low FT4 levels. The multivariate analysis showed that none of the studied factors were associated with the development of hypothyroidism. As none of the above-mentioned factors are not associated with the development of hypothyroidism, hypothyroidism should be considered in HIV-infected patients