[External Ophthalmomyiasis in Yazd/Iran: report of four cases]

Myiasis of different organs has been reported from various regions in the world. Infection of the eye might appear as eyelids problems or conjunctiva [ophthalmomyiasis externa], or the larvae may invade into the eye [ophthalmomyiasis interna]. We report 4 human cases of external ophthalmic myasis from Yazd province, in central region of Iran. All of them referred with symptoms of acute conjunctivitis. Mean age of patients was 34 years. All of them were male and from rural areas. Multiple larvae were observed over the bulbar conjunctiva and cornea. After removing larva, symptoms relieved within a few hours. The organisms were identified as Oestrus ovis

survey of tuberculosis patients in Yazd and Shiraz

Although many activities have been done to control tuberculosis in Iran but unfortunately, tuberculosis is an important public health problem in Iran like many other developing countries. In this study, tuberculosis patients who had, for their diseases, file to be recorded were evaluated in Yazd and Shiraz at the same time. This cross-sectional study was case series conducted in Yazd and Shiraz at the same time, and all the pulmonary tuberculosis patients who had file to be recorded entered into the study. We used questionnaire which recorded the patient's age,sex, occupation, nationality, smear and culture results, ESR and TB location. Totally, 136 pulmonary tuberculosis case records [32 in Yazd, 104 in Shiraz] were evaluated. Most of the patients were 51-75 years old in Yazd and 26-50 years old in Shiraz [P-value = 0.00]. Of the patients, 52.9% in Yazd were female and 63.7% in Shiraz were male [P-value =0.02]. Positive smear rate in Yazd was 68.7% and in Shiraz 69.2%. Twenty three and half percent of tuberculosis patients in Yazd and 40.8% in Shiraz were Afghan and others were Iranian [P-value =0.01]. About ESR, there was no significant difference in both sexes. Finally in both cities, 59.5% of patients had pulmonary tuberculosis and 40.8% extra pulmonary tuberculosis. The most common location of extra pulmonary tuberculosis was respectively lymph node, bone, and pleura. The rate of positive and negative smear of pulmonary tuberculosis is near the expectancy of WHO [70%], but extra pulmonary tuberculosis was more than expectancy so we suggest that diagnosis indices of extra pulmonary tuberculosis should be more considered

Relation between glaucoma and sensor1neural hearing loss

Glaucoma is one of the leading causes of blindness throughout the world. Some studies have suggested a relationship between glaucoma and sensorineural hearing loss, while others have found no evidence of an association. We performed a study to determine whether there is a significant difference in hearing of patients with glaucoma and a match control population. In this cross-sectional study, from February, 2005 till April, 2006, 44 patients with glaucoma were studied. The age range was between 15 to 60 years. After taking a complete medical history, those suffering from presbycusis, history of exposure to ototoxic drugs and substances and history of ear surgery were excluded from the study. All of the patients were cases of open-angle glaucoma, and were surveyed separately for normal-pressure glaucoma. Then complete audiometric tests [PTA, SDS, SRT, Impedance] were conducted for all of them, and the results compared with a control group. There was no statistically significant difference between the case group and control group in PTA, SDS, and SRT, except for Normal Tension Glaucoma [NTG]. There wasn't any statistically significant difference between two groups with respect to age, gender, and history of diseases. In the NTG group, significant difference was seen only in high frequencies. As mentioned, there was a statistically significant difference between NTG group and control group. It is therefore recommended to conduct complete audiometric tests and histopathologic examinations in this group for early detection of hearing loss and application of rehabilitative measures

[ chest X-ray findings of tuberculosis patients]

Pulmonary tuberculosis is common and lower lung field tuberculosis is an atypical presentation of pulmonary tuberculosis, which often causes confusion in diagnosis. Its incidence has been increased worldwide with more cases of AIDS. This study was designed to identify the prevalence of pulmonary tuberculosis, in different clinical conditions, its common clinical and radiological presentations, Asid Fast Bacilli [AFB] status, and the outcome of treatment. This is a cross- sectional study. All pulmonary tuberculosis patients referred to Nikoopoor clinic [YAZD] were included in the study [217 patients] for routine evaluation, especially, sputum for AFB, blood sugar, HIV testing, and CXR investigations. From 217 patients, 19.81% had lower lung field tuberculosis. Female patients 21.8% were affected more than male 17.75%, 41.86% aged >60 years. Unilateral involvement was more common [52%] and the right side was more frequently affected [60%]. Consolidation [47%] and cavitations [26%] were the main radiological findings. Lower lung field tuberculosis is fairly common in Yazd [central region of Iran]. Its clinical presentation is similar to classical upper lung field tuberculosis and short course chemotherapy has equall effect as similar as standard therapy

Clinical study of lower-lung field tuberculosis

Lower lung field tuberculosis is atypical presentation of pulmonary tuberculosis which often causes confusion in diagnosis. HIV/AIDS epidemic has considerably increased its incidence. This study was designed to identify the prevalence and different clinical conditions of lung tuberculosis in conjunction with its common clinical and radiological presentations and its treatment. The patients diagnosed as having pulmonary tuberculosis with lesions below an arbitrary line across the hila of their chest X-rays, considered lower lung field tuberculosis, are included in this study. Laboratory testing was done on sputum for acid-fast bacillus. HIV testing, blood sugar and other relevant examinations were performed in each patient. Out of a total of 217 patients with pulmonary tuberculosis, 19.8% had lower lung field tuberculosis. The majority of the patients [41.8%] were over 60-yrs of age. It was more common in female [21.8%] than in male patients [17.7%]. Unilateral disease was more common [52%] and the right side involvement was more frequently affected [60%]. Consolidation [47%] and cavitations [26%] were the main radiological findings. Lower lung field tuberculosis is fairly common in central part of Iran. Its clinical presentation is similar to that of classical upper lung field tuberculosis

Dental health care personnel [DHCP] exposures to human immunodeficiency virus, hepatitis B virus and hepatitis C virus: risk, prevention and management

Current data indicates that the risk of transmilssion of blood-borne pathogens in dental health care settings is low. Pre-exposure hepatitis B vaccination and the use of standard precautions to prevent exposure to blood are the most effective strategies for preventing DHCP from occupational infection with HIV, HBV or HCV. Dental health care facility should develop a comprehensive written program for preventing and managing occupational exposures to blood that, describes types of blood exposures that may place DHCP at risk for infection, outlines procedures for promptly reporting and evaluating such exposures, and identifies a health care professional who is qualified to provide counseling and perform all medical evaluations and procedures in accordance with the most current USPHS recommendations. Finally, resources should be available that permit rapid access to clinical care, testing, counseling, and PEP for exposed DHCP and testing and counseling of patients

[Night sweats]

Night Sweats are a common outpatient compliant, yet literature on the subject is scarce. Tuberculosis, brucellosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases

Antihypertensive, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider wright, a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid - stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy

Brucellosis associated with acute acalculous cholecystitis

Brucellosis is a rare cause of acute acalculous cholecystitis. We report a 45-year-old, previously healthy, man with brucellosis who presented with abdominal pain due to cholecystitis