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Brucellosis

Epidemiologic, Clinical and Laboratory Findings of Patients with Brucellosis in Hamadan, West of Iran

Dr. Peyman Eini, Dr. Fariba Keramat, Dr. Mehdi Hasanzadehhoseinabadi

Journal of Research in Health Sciences (JRHS), 2012:12;2;105-108

Abstract:

Background: Brucellosis is one of the most common infectious diseases in some areas of Iran. Brucellosis has various clinical manifestations and should be considered in the differential diagnosis of many infectious and non-infectious diseases. The aims of this study were to determine the epidemiological, clinical and laboratory findings of the disease in patients with brucellosis in Hamadan, west of Iran.

Methods: In this cross- sectional study, 230 brucellosis patients admitted in Farshchian Hospital in Hamadan from March 2005 to March 2010 were studied for epidemiological, clinical and laboratory characteristics of brucellosis. The patients who had manifestations compatible with brucellosis and standard tube agglutination test or Coombs test ≥1/80 plus 2ME ≥1/40 were enrolled. Data were analyzed using SPSS statistical package, version 15.

Results: About 43.5% of patients were female with mean age of 40.84 yr old. 27.8% of cases were living in urban and 72.2% in rural areas. The most contagious seasons were spring and summer. The most common transmission way was consuming of contaminated dairy products (60.3%); however, 39.7% of patients had a history of animal contacts. The most common symptoms were fever (77.4%), arthralgia (70%), sweating (47%), malaise and fatigue (46.5%). The most common clinical signs were fever and peripheral arthritis. Leukocytosis and elevated ESR (>20 mm/h) were reported in 20.8% and 59.5% of cases, respectively. Elevated CRP was detected in 52.9% of patients.

Conclusion: Brucellosis should be considered in the differential diagnosis of patients with prolonged fever, spondylitis or peripheral arthritis in endemic areas.

Keywords: Brucellosis, Clinical manifestations, Epidemiology, Iran

 

A retrospective evaluation of epidemiological, clinical and laboratory features of brucellosis in 230 patients in Hamadan, Iran: a brief report

Dr. Peyman Eini, Dr. Farzaneh Esna-Ashari, Dr, Ahmad Reza Mobaien, Dr. Mehdi Hasanzadeh

Tehran University Medical Journal. 2012;70(2):130-135

Background: Brucellosis is one of the most common infectious diseases in Iran with very different clinical manifestations.

Methods: In this retrospective descriptive study, all patients with brucellosis, who were admitted in Farshchian Hospital in Hamadan, Iran in 2005 to 2010, were enrolled in the study. The data were collected from the patients medical records and were entered in forms for analysis.

Results: A total of 230 patients with brucellosis, including 130 (56.5%) male and 100 (43.5%) female patients with a mean age of 40.84±20.29 years, who mostly (72.2%) lived in rural areas were enrolled in the study. Outbreaks were most common in spring and summer and the main route of transmission was consumption of contaminated dairy products (60.3%). The most common symptoms were fever (77.4%), arthralgia (70%), sweating (47%), malaise and fatigue (46.5%). Arthritis and epididymo- orchitis were seen in 121 (52.9%) and 48 (8.20%) patients, respectively. CBC analysis showed leukocytosis in 20.8% of the participants. ESR rise was noted in 59.5% of the patients and 52.9% had positive CRP.

Conclusion: Given to various clinical presentations, brucellosis should be considered in the differential diagnosis of individuals with chronic fever with or without other organ abnormalities.

Key words: Brucellosis. Clinical, Epidemiology. Manifestation

 

Pharingitis 

Importance of diagnostic laboratory methods of beta hemolytic streptococcus group A in comparison with clinical findings in the diagnosis of streptococcal sore throat and unnecessary antibacterial therapy

Dr. Peyman Eini, Dr. Ahmadreza Mobaien, Dr. Mehdi Agha Sharif

Iranian South Medical of Journal (ISMJ) 2012;15(1):59-68

Background: Streptococcus Pyogenes (group A streptococcus, GAS) is the most important cause of bacterial pharyngitis in children and adolescents. Acute pharyngitis is one of the most common conditions in all ages but it is most common in children. Over diagnosis of acute pharyngitis represents one of the major causes of antibiotic abuse. The goal of this study is to make an estimate of the frequency of group A streptococcus in sore throat patients in Farshchian hospital emergency department and clinic in Hamadan.

Methods: For estimation of the clinical features role in diagnosis of streptococcal sore throat, we took samples of 100 patients with average age of 32.96±29.86 years with sore throat. We took samples from pharynx and used standard methods of bacteriology in order to detect streptococcus.

Results: Group A Streptococcus (GAS) accounts for 3 percent of all cases of pharyngitis. Clinically, all of the patients had sore throat. The percent breakdowns are as follows: 30% had exudate, 78% had fever, 8% had lymphadenopathy and 7.7 percent of exudative pharyngitis was streptococcal. The cost for unnecessary antibiotic therapy for every single patient who had negative pharynx culture was approximately 32160 Rails.

Conclusion: The low frequency of streptococcus pharyngitis in treated patients reveal that diagnosis based on clinical features is not reliable. We recommend use of other diagnostic methods such as Rapid Antigen Detection Tests (RATs). Only reliable and scientific protocols for antibiotic to therapy.

Keywordssore Throat, group A beta-hemolytic streptococci, antibacterial therapy 

Hepatitis B 

Evaluation of the Relation between Salivary Beta-2 Microglobulin and Viral Proliferation in HBS Ag+, HBV DNA PCR+ and HBV DNA PCR- Subjects

HamidReza Abdolsamadi, Peyman Eini, Negin Ronasi, Mehrdad Hajiluei, Fatemeh Ahmadi-Motamayel

GOVARESH. 2013;17:4:228-235

http://govaresh.org/

Background:

Hepatitis includes a wide range of clinical and pathological conditions. The beta-2 microglobulin (ß2M), as part of theHLA complex, is responsible for transmission of viral antigens on the surface of liver cells. The purpose of this study is to determine the concentration of salivary ß2M as a marker of viral proliferation in subjects who are HbsAg+, HBV DNA PCR+ compared with those who are HbsAg+, HBV DNA PCR-.

Materials and Methods:

In this case-control study, we enrolled 25 patients who were Hbs Ag+, HBV DNA PCR+ in addition to 21 patients who were Hbs Ag+, HBV DNA PCR-. We obtained sputum samples from all patients and measured salivary ß2M levels by nephelometry. Data analyses were performed by the descriptive, students t- and chi-square tests.

Results:

There were 25 men (54.3%) and 21 women (45.7%) with a mean age of 35.72±11.86 years who participated. Of PCR+ patients, 72% were on medication, however 85.7% of the PCR- patients did not take medication (p‹0.001). Salivary Β2M concentration in the PCR+ patients (5.28±5.45) was greater than observed in the PCR- patients (1.51±0.77), of which this difference was statistically significant (p‹0.003).

Conclusion:

Salivary ß2M levels, as a marker of viral replication, could be used in patients with hepatitis B.

Keywords: Beta-2 microglobulin; Saliva; Hepatitis B; Virus proliferation marker