ABSTRACT
Nocardiosis has been reported increasingly in recent two decades, probably due to improvement in isolation of the organism and increased burden of immune compromised patients. Nocardia occasionally has been reported in healthy people. A case series of definitive Nocardiosis (2002 to 2010), clinical characteristics, underlying diseases, immune status and in-patient outcome were studied in a tertiary referral center. Twenty one patients with definite diagnosis of Nocardiosis were studied. 17 cases (81%) had an underlying disease (diabetes mellitus, corticosteroid therapy, and chronic granulomatous disease and collagen vascular diseases). Four patients (19%) were immune-competent without any predisposing disease. In 17 patients (81%), Nocardiosis was limited to respiratory tract and in 4 cases (19%) it was disseminated with multi organ involvement. Two cases (9.5%) died in hospital.
ABSTRACT
BACKGROUND: Good knowledge, attitude and practice (KAP) of the physicians allow them to handle their patients in such a way that they prevent themselves from contracting, and their patients from spreading, the infection. However, the Iranian standardized KAP questionnaire of physicians about viral hepatitis is not available. So, we developed a standard questionnaire. OBJECTIVES: The purpose of this study was to provide a standard questionnaire as a basic tool for assessment of the present situation of the KAP of clinicians. It can also be used for evaluating educational programs and interventions on physicians in addition to any trends in their KAP about viral hepatitis. PATIENTS AND METHODS: In order to design and standardize a 29-item self-administered questionnaire, we developed a cross sectional pilot study on 60 Iranian physicians. Ten experts in the field of liver diseases and/or designing the questionnaire answered questions about its validity. Cronbach's Alpha (on 60 physicians that participated in a congress) and factor analysis (on 370 persons; participants of two viral hepatitis congresses in Tehran and Zanjan and physicians of two university hospitals in Ahvaz) were used in the analysis. RESULTS: Reliability was 0.7 according to Cronbach's Alpha score. Face validity was higher than 80%. Content validity of the whole parts of the questionnaire was 96.25% for clarity, 91.56% for relevancy, 96.25% for simplicity and 98.44% for consistency of each question with the questions' set. Factor analysis showed that 13 components account for 67.4% of the total variance. CONCLUSIONS: This study provided evidence that our questionnaire is a feasible, valid and reliable measure of physicians' KAP status in Iran. The factor analysis did not reveal a strong cluster structure. This questionnaire should be interpreted as a one-dimensional element by the sum of all items, rather than a multi-dimensional instrument.
ABSTRACT
In the modern world, with developed traveling facilities, tourism is an important factor in emerging new infectious diseases in non-endemic areas. Therefore, the epidemiology of infections is a considerable issue for physicians and should be taken into account. We report a case of melioidosis in a 69-year-old Iranian man during his trip to Southeast Asia. On admission, he was febrile with tachycardia and tachypnea and had diabetes mellitus and hypertension since eleven years ago. Bronchoscopy and bronchoalveolar lavage (BAL) were performed. Blood and BAL cultures revealed heavy growth of Burkholderia pseudomallei. According to the aforementioned culture results, the patient was treated with meropenem and TMP-SMX, while other antibiotics were discontinued. After 3 weeks, the patient was discharged with stable status and normal pulmonary function; and eradication therapy with TMP-SMX continued for about 3 months. The control lung CT scan after one month demonstrated significant improvement.
